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Waiver Appeals

How To File An Appeal

If you submitted a waiver and your waiver application was denied, you may file an appeal if you feel you made an errorPlease read all of the instructions below before filing an Appeal: If your Waiver Application was denied because you missed the waiver application deadline, DO NOT FILE AN APPEAL. 

Appeals will not be considered for students missing the waiver deadline. 

Your appeal must be submitted online through the secure login portal below to the Insurance office within seven (7) days of the date of notice of denial. Appeals received after the (7) day grace period will Not be considered.

Appeals will be considered for the current semester only. Waivers granted on appeal will NOT be applied to any previous semester. 

Failure to complete the entire Waiver Appeal form, or to provide appropriate documentation, will result in your appeal being denied. You will remain enrolled in UCSHIP for the appropriate semester and be responsible for all UCSHIP fees. 

Evaluation of your Appeal will be based on comparability insurance guidelines in effect at the time of the original Waiver Application.

Important Notice

Health Insurance Waiver On Checklist


If you entered the health insurance waiver from your student portal but did not receive and email stating it was approved or denied, you did not complete the waiver despite your checklist showing it is "completed." The health insurance waiver deadline has been extended until 08/09/17 and there will not be a "late waiver fee" for the Fall 2017 semester. You will need to complete the waiver by 08/09/17. If you do not complete the waiver by 08/09/17, you will be enrolled in UC SHIP. If your waiver is denied, you will have 7 days to complete and submit your electronic appeal. You will need to go back into your student portal and complete the waiver now. Please see below for instructions.

Please go back into your student portal.  Go to completed items and click on the Health Insurance Waiver. This will take you to another page that states the message below:

If you have left the waiver application at Wells Fargo and have not received and approval or a denial notice because you did not complete the application and you still wish to waive out of the schools insurance, click on Student Insurance Waiver and this link will take you to Wells Fargo to complete your waiver application.

Once you complete and submit your waiver, you will receive an immediate approval or denial. This ensures you have completed the Health Insurance Waiver and you will be sent an email confirmation to your UC Merced email account.

If you need further information on how to complete your health insurance waiver, please click on the following link:

Required Documents you MUST submit to File a Waiver Appeal

  1. Attach the completed Waiver Appeal Form PDF

  2. Attach copy of Waiver Denial Notice.

  3. Attach copy of front and back of current insurance card.

  4. Attach copy of the Complete Insurance Benefit Summary (this can be found online at your insurance company’s website by making a user name and password login or by calling your insurance company).

  5. Submit the Waiver Appeal Form and all supporting documents by clicking the Submit Appeals button below. 

Waiver Appeal documents must ALL be sent in (PDF) format.

No action will be taken on your appeal without ALL of the above attachments.


You must initial ALL spaces on the second page where it states to initial. DO NOT PUT AN X.

You Must sign and date your Waiver Appeal or it will be denied as incomplete.

Example of Insurance Benefit Summary Page 1


Example of an Insurance Card for Merced County Central California Alliance.


Communication regarding the status of your Waiver Appeal will be sent to your UC Merced email address. It can take the Insurance Office up to 30 days to process your waiver appeal. Waiver appeals are processed in the order they were received.

Please only submit your Waiver Appeal one time. Once we receive your appeal we will send an email confirmation.


If you still want to file a Waiver Appeal, download the Waiver Appeal Form PDF and submit the completed form and the required documents below within seven (7) days of the date you received the notice of your waiver denial.


Disclaimer: Submission of an appeal is not a guarantee of an approval.