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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 14 calendar days of the date of notice of denial. Appeals received after the (14) 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.

 


Required Documents you MUST submit to File a Waiver Appeal

 

  1. Complete and attach the Waiver Appeal Form.

  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.

Please only submit your Waiver Appeal one time.

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

 

 

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

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.

 

Example of Insurance Benefit Summary Page 1

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