Student Health Benefit Plan Short-term Extension Payment

Students who have lost eligibility on Student Health Benefit Plan (SHBP) and are enrolled onto the SHBP short-term extension will be able to use this option to submit a one time payment to extend their coverage to the end of the month in which their coverage on SHBP was set to terminate. By using this option, you will be able to pay your premium using your debit/credit card. Please enter the amount provided by the Student Health Benefit Office.
Fields with asterisk are required.
The price must be from $0.00 to $1,000.00
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