Assurant Student Select Applications and Brochures
Student Health Insurance from Assurant Health Insurance Company is available in the states listed below.  The applications and brochures can be downloaded or printed directly from the Internet using Adobe Acrobat Reader®. If you don't have Adobe Acrobat, you can download it by clicking HERE. 
Click on the State you currently have residence in.  The Application will open in a new window. Applications are State specific.  If you plan on moving or traveling while you are covered, your student health insurance coverage will follow you throughout the United States.
Complete the application and either mail or fax the application with payment made payable to: Assurant Health.  Your policy will be processed on the day we receive it by mail or fax.
The Assurant Student Select plan is NOT available to those who reside in AND attend school in the following states: HI, ME, MA, MT, NH, NJ, NY, RI, VT.  As an alternative plan, we offer plans up to 6 or 12 months in MT, ME, NH and RI.  These plans are available by clicking HERE.

Note: The following information is included with the application and brochure.

If paying by Credit Card, you can fax the completed application to Long Term Consumer Care, Inc. at: (262) 523-1910.  If paying by check or money order, you can mail the completed application along with payment to:

Long Term Consumer Care, Inc.
N27 W23960 Paul Road - Suite 201
Pewaukee, WI  53072
Note: Make all checks or money order payable to Assurant Health.
If you have any questions, need a quote or would like to receive the temporary health insurance application and brochure by fax or mail, please call toll free: (800) 544-9505

Your effective date of coverage will begin on the later of: 1) 12:01a.m. the day after your requested policy date; or 2) 12:01a.m. the day after the post mark date affixed by the U.S. Post office*, provided the following conditions are met.
  • Your application for Student Health Insurance and the full premium payment is received by Long Term Consumer Care, Inc. or Assurant Health;
  • Your answers on the student health insurance application are correct and meet the requirements for acceptance.
  • All policy's that meet these conditions are issued immediately upon receipt and are mailed to the applicant via first class mail. 
 
 
Long Term Consumer Care, Inc.
N27 W23960 Paul Road Suite 201 ~ Pewaukee, WI  53072
Toll Free: 1.800.544.9505  Fax: 1-262.523-1910