Use this form ONLY if you have ALREADY been on the GTFF insurance plan

If you are a NEW GE–OR NEVER BEEN ON THE GTFF INSURANCE–you need to FIRST fill out an enrollment application. This form will be part of an application you will do in-person with Glenn, the benefits administrator. Do NOT fill this out yet!

If you are a RETURNING GE WHO HAS PREVIOUSLY BEEN ON THE GTFF INSURANCE PLAN you NEED to fill this out to have your insurance continue/be reinstated starting fall term and to be waived out of the the UO’s International Student insurance plan (if you are an Int. GE).

This form allows you to:

1) pay your premiums via payroll deductions,

2) waive out of the UO’s int. student plan if you are international,

Additionally, now is the time to add or drop someone to your plan, and change dental plan if you want to. Forms for this below as well.


AY 26/27 GTFF PAYROLL DEDUCTION & INT. GE WAIVER FORM

WANT TO ADD OR DROP SOMEONE TO/FROM YOUR PLAN? USE THIS FORM

WANT TO CHANGE YOUR DENTAL PLAN? USE THIS FORM