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Reinstatement Form

If your payment is more than 45 days late, you need to complete a Reinstatement Form. If for any reason your reinstatement is declined, your payment will be refunded to you.

Download the Reinstatement Form below

Complete the Insurance Reinstatement Form with your electronic signature.
Email your completed form to custserv@usi.com or FAX it to 1-614-481-2400.
Make your payment online on the Pay My Bill page

Select/Verify Your School

Download a Reinstatement Form (Word .doc)

The University of Oregon Alumni Association receives financial benefits from the administrator that provides this program. These benefits fund alumni programs and activities.