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  • Health Insurance Agreement Form - California State Polytechnic ... - Csupomona

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AGREEMENT TO PURCHASE CAL POLY POMONA GROUP HEALTH INSURANCE This form is a part of the application process and is necessary before your I-20 can be issued. I understand that as a condition of enrollment.

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California State Polytechnic University, Pomona (Cal Poly Pomona, CPP, or Cal Poly) is a public polytechnic university in Pomona, California. It has the largest student body of the three polytechnic universities in the California State University system.

The CSU-sponsored Student Health Insurance Plan (SHIP) is designed specifically for CSU students.

Cal Poly will enroll students in the campus health insurance plan upon enrollment in classes each term including summer. You are also strongly advised to continue your coverage during school breaks. Detailed instructions about how to use your plan can be found on Relation Insurance.

Cal Poly Pomona is among the best public universities in the West and is nationally ranked for helping students achieve economic success. As an inclusive polytechnic university, we cultivate success through experiential learning, discovery and innovation.

What about Health Insurance? Per Executive Order 943, Health Services will provide general medical care to all matriculated students who have paid the appropriate mandatory Health Services Fee.

Medi-Cal. Medi-Cal is California's Medicaid program, a public insurance program that provides free and low-cost medical services to children and adults with limited income. Visit the Medi-Cal site to see if you're eligible.

Health insurance is provided by AETNA Student Insurance through JCB Insurance Solutions. Please visit the JCB website to purchase the insurance plan, and view the benefits.

Most students, unless they qualify for an exemption, will have to purchase health insurance or they will be subject to a tax penalty.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232