ELCA - Post Grad & Part-Time Students

Post Graduates and Part-Time students must enroll themselves and their dependents directly with UnitedHealthcare.

Please print the enrollment form and submit to UnitedHealthcare with your premium. The coverage date will become effective when the correct premium is received by UnitedHealthcare. Please keep a copy of your completed forms for your records.

ELCA Post Grad Enrollment Form
ELCA Part-Time Enrollment Form
ELCA Dependent Enrollment Form
ELCA Dependent Enrollment Form - Spring/Summer