Waiver Appeal

Note: The form below is a late waiver appeal not a health insurance waiver application.

Late Waiver Policy (Fall semester)

Students who fail to submit a health insurance waiver by the appropriate deadline may file a late waiver appeal request to Health Promotion Services. Decision notices will be sent by mail within 4-5 business days of receiving a complete waiver appeal. If your late waiver appeal is approved a $250.00 late waiver fine will be placed on your student account and you will receive a full refund of the semester health insurance premium. If your late waiver appeal is denied you will have an opportunity to waive the USF-sponsored insurance plan the following semester.

In order to qualify for a late waiver appeal the effective date of your coverage must be prior to September 1st, and remain in effect for the remainder of the academic year. Late Waiver Appeals for the Fall 2015 semester will not be accepted after October 5, 2015.

Health Promotion Services

2130 Fulton Street
University Center, Fifth Floor
San Francisco, CA 94117

Hours: 8:30am to 5:00pm

Tel: (415) 422-5797
Fax: (888) 471-2290
Email: hps@usfca.edu

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