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The ISU Department of Athletics requires verification of primary personal health insurance 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your personal details, including your name, cell phone number, Bengal ID#, date of birth, and sport. Ensure all information is accurate.
- Complete the PRIMARY HEALTH INSURANCE INFORMATION section. Fill in the policy holder’s name, their date of birth, relationship to you, and contact details. Attach a copy of both sides of your health insurance card.
- Indicate whether your insurance requires a second opinion or pre-authorization for surgery by checking the appropriate boxes.
- If applicable, provide details about any secondary insurance coverage and attach its card as well.
- Review the TERMS section carefully. Confirm that all information is accurate and complete before signing.
- Finally, submit the completed form along with copies of your insurance cards via mail or email as specified at the bottom of the document.
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Related links
This is the official Website of NY State of Health: The Official Health Plan Marketplace, a part of the NYS Department of Health. Contact Us.Read more
Verify Your Primary Health Insurance. All requests and supporting documentation are subject to review and verification before coverage is approved.