Download Enrollment Brochures |
Only full time students in grades Pre Kindergarten through 12th grade and vocational technical school students that are actively attending a registered Polk County approved school are eligible for the student insurance plan benefits. Persons that are not enrolled as full time students are not eligible to collect benefits from the basic plan or enroll in the 24 Hour Extended Coverage Option. We cannot accept 24 Hour enrollments or bind coverage On-Line or by telephone. 24 Hour Extended Coverage enrollments can only be accepted by mailing the completed enrollment form along with payment to School Insurance of Florida. Any enrollments or payments received from ineligible persons will be returned and no claims can be processed for ineligible persons. |
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POLK INSURANCE ENROLLMENT FORM
Polk County Schools |

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File size: 989 KB
Acrobat Reader required - download here. |
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