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How To Complete
Enrollment Form Process

College Students

Online Enrollment Made Easy for Students

  • Please click on ONLINE ENROLLMENT to fill out your enrollment application.

  • ​Please choose one of the two plans chosen for students.

  • Please complete all sections of your enrollment application.

  • Please submit payment with your application.

Once your application is completed and received, we will then mail out to you your welcome packet which will include the following:

Once enrolled and your payment is processed, you will receive your Enrollment Packet in the US mail within 5 Business days: 

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1) Welcome Packet which includes your welcome letter with your Summary of Benefits (SOB). You will also receive a temporary Member ID Card and OptumRx Card which can be used right away.

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2) Your ID member card from the First Health Network is a Aetna | Coventry Company   

 

  • First Health Network is a Aetna | Coventry Company, You will need to take your ID Network Card to your doctor appointments as proof of coverage.

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3) Optum Rx ID Card

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  • You will need your Optum Rx ID Card when you pick up your prescriptions from any of the major pharmacies.

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Customer Service Center hours: M-F, 7am - 5pm

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Office Telephone Number: 915.803.4198

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Example

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Example

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