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Full-time Student Certification Form - mpiphp - Welcome

Full-time Student Certification Form - mpiphp - Welcome 2026

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The document outlines the requirements for maintaining health insurance coverage under the MPI Health Plan for unmarried dependent children who are full-time students. It specifies eligibility criteria, including age limits and enrollment status, and details the responsibilities of participants to submit a Student Certification Form and notify MPI of any changes in student status. Additionally, it provides contact information for further inquiries.

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How to use or fill out Full-time Student Certification Form - mpiphp - Welcome

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Participant Name, Address, City, State, and Zip Code in the designated fields. Ensure all information is accurate for processing.
Provide the SSN or ID Number of both the participant and dependent. This information is crucial for verification purposes.
Fill in the Dependent Name, Dependent SSN, and Dependent Birth Date. Double-check these details to avoid any discrepancies.
Certify that your child is a full-time student by selecting the appropriate school name and address. Indicate the number of credits/units/hours they are enrolled in.
Specify the enrollment period by filling in the start and end dates (mm/dd/yy). This helps establish eligibility for benefits.
Review all entered information carefully before signing and dating the form at the bottom to confirm accuracy and compliance.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I add dependents to my insurance?

You can add a dependent to your health insurance plan during open enrollment. Open enrollment for government-sponsored insurance plans is typically held between November and January. Employers usually offer a similar open enrollment period, with many occurring during October and November.

How do I add dependents to my VA health benefits?

You can apply for benefits by calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or by visiting your local Social Security office.

Does MPI cover dental?

As an eligible Active Participant, you have an extensive package of benefits that includes comprehensive medical, hospital, prescription drug, behavioral health and substance abuse, vision, dental, and life insurance coverage.

How many hours do you need for mpiphp qualifying?

To qualify for healthcare insurance coverage through the MPIPHP, you must first be credited with 600 hours of work within a 6-month qualifying period. Contributions are made on the basis of 60 hours of work per week.

How do I add dependents to Mpiphp?

I have a new dependent and need to add him/her to my coverage. You need to complete a new beneficiary/enrollment form. Mail this form to the Studio City Plan Office with a copy of the marriage/birth certificate (or hospital record), and we will add your dependent.

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