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Online Enrollment Agreement
This plan is designed for and open to faculty and staff employed by Northwestern University.
I hereby certify that as a proposed participant, I am employed by Northwestern University and will be a Northwestern University employee for the entire duration of my international travel. I further certify that I am not a citizen of my destination country or countries and that my travel to destination country or countries is for Northwestern University business purposes. Further, I understand that a participant whose coverage under this policy lapses shall be subject to all policy exclusions as of any subsequent effective date and I understand that the Company will pay benefits for Pre-Existing Conditions.
Verification of visa and employment may be required at the time of claim submission.
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