Waive or Reactivate RA-TA Health Insurance Plan

If you wish to decline (waive) coverage on the NC State RA-TA health insurance plan, please complete the form linked below. If the form is not working properly, please email your request to ncstate-gssp@ncsu.edu. Please remember include your name, student ID number, effective date of requested action, and briefly document the reason for declining coverage. If you are an international student, you are required to maintain health insurance throughout the duration of the I-20/DS-2019 — please do not complete this form unless you have alternative adequate health insurance coverage. Please see the Office of International Services for more information.

Request Form to Decline Health Insurance Coverage on NC State RA-TA Plan

Please remember that you also need to also waive the University Mandatory Plan (also known as the Student Health Insurance Plan (SHIP)) if you have health insurance coverage outside of one of the university student health insurance plans.

**Please be aware that there is another Student Blue (BCBS of NC) administered plan on campus, the University Mandatory Plan (Student Health Insurance Plan (SHIP)). This health insurance plan option is for students ineligible for the Graduate Student Support Plan, but meet the eligibility requirements outlined on the Student Health Center website. Nonetheless, it is a plan similar in health insurance coverage to the NC State RA-TA plan (Graduate Student Support Plan), but the student is responsible for payment and enrollment into this plan.

Withdrawing a Previous Waive/Decline Request for NC State RA-TA Coverage

If you wish to withdraw a previously submitted/requested decline for NC State RA-TA coverage (in other words, to be eligible for coverage again), please complete the form linked below. If the form is not working properly, please email your request to ncstate-gssp@ncsu.edu. Please remember include your name, student ID number, effective date of requested action.

Withdraw Previous Waive/Decline Form