Who May Enroll

Non-registered graduate students of the University of California Berkeley campus on Withdrawal status (see definition below), and undergraduate students on Concurrent Enrollment status (see definition below), may purchase plan coverage for a maximum of one semester while on either status. The student must have been covered by the plan in the term immediately preceding the term for which the student wants to purchase coverage or, if the student waived plan enrollment in the prior term, must show proof of loss of the coverage used to obtain the waiver. These students may enroll by contacting Wells Fargo Insurance Services at 800-853-5899.

For purposes of UC SHIP eligibility, the following definitions apply:

Withdrawal Status (Graduate students only):
Graduate students must apply to their academic departments for official Withdrawal status. This status applies to graduate students who are on department-approved leave to perform field research, work on their dissertations, or for other reasons permitted by the department. To complete the UC SHIP enrollment process, a student must submit a letter from his or her academic department confirming the student’s approved Withdrawal status to the Student Health Insurance Office.

Concurrent Enrollment Status (Undergraduate students only):
Undergraduate students in their final semester of study who are completing degree requirements through UC Berkeley Extension's Concurrent Enrollment Program are considered to be on Concurrent Enrollment Status. To complete the UC SHIP enrollment process while on Concurrent Enrollment Status, a student must submit a letter of approval from his or her academic department and proof of payment for the class(es) at UC Berkeley Extension to the Student Health Insurance Office.

ENROLLMENT PROCESS: Enrollment is handled by Wells Fargo Insurance Services, a third party administrator. Enroll by phone (800) 853-5899 or send enrollment form (see form below) and payment by mail or fax: Wells Fargo Insurance Services, 11017 Cobblerock Drive, Ste. 100, Rancho Cordova, CA 95670, Fax (916) 231-0527.

• GRADUATE students - please use the Graduate Student Enrollment Form (PDF)
• UNDERGRADUATE students - please use the Undergraduate Student Enrollment Form (PDF)