Graduate Appointee Insurance Program (GAIP)
Forms and Resources

All forms are in .pdf format.

Claim Forms	LifeWise forms website: http://student.lifewiseac.com/uw/gaip/Forms.aspx Medical / Dental / Vision Claims Prescription Drug Claims
Identification Card	Note: LifeWise ID cards are issued within a few days of enrollment. LifeWise ID Card (temporary)
Mail Order Forms	Mailing Agreement (read first) Mail Order Patient Registration
Petition Forms	Reduced Enrollment Petition Petition for Self-Pay Graduate Appointee Insurance While on Academic Leave
Marriage / Same-Sex Domestic Partnership Forms	Declaration of Marriage/Same-Sex Domestic Partnership Declaration of Tax Status (for SSDPs only)
Other Resources	Declaration of Tax Status Worksheet (for Determining Dependent Status) Medical Plan Summary Dental Plan Summary Vision Plan Summary Complete Health Plan Book (large download)
Address Updates	Employee Self Service (ESS) LifeWise Assurance Company (LifeWise)

GAIP
Topics