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UT Dallas Wellness and Retirement Fair

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UT Dallas is excited to partner with Passport Health to provide vaccinations at our Wellness and Retirement Fair - Fit for Life: Mind. Body. Wealth. Please complete this online registration form and follow the below instructions so you are prepared for your appointment. If you have any questions regarding this program, please contact Nora M. Pena at or 972-883-4559.

For employees with the following insurance, your immunizations are covered at 100% under your plan.

• UT SELECT Blue Cross Blue Shield of Texas PPO
• UT Student Insurance administrated by Blue Cross Blue Shield of Texas

Other health insurance plan options:
• Blue Cross Blue Shield Non HMO Plan*
• Aetna Non HMO Plan**
• United Health Care Non HMO Plan
• Cigna Non HMO Plan
• Humana Non HMO Plan

The University WILL NOT cover immunization costs for employees that do not have acceptable insurance.

UT Dallas Retirees and dependents covered under the UT Select Plan are eligible to participate.

If you do not have one of the accepted insurance plans you may still participate. We accept cash or checks. The following fees will apply:

Trivalent Flu Shot - $10
Quadrivalent Flu Shot - $20
TDaP - $70
Pneumonia (Pneumovax 23) - $80
B12 injection - $15 (Not covered by insurance)

We require that all participants bring their medical insurance card so that the ID number is correctly submitted for insurance coverage. In addition, after you register, you will see a confirmation message containing a link to a consent form. Please click the link to download the consent form and bring a signed copy with you to your appointment, along with a photo copy of your insurance card and a photo copy of your driver’s license. This will ensure the shortest possible wait. If you are receiving more than one vaccination you only need to bring one consent form. B12 has a separate form.

Thank you!

*Blue Cross Blue Shield plans with an id prefix of FJC, NCF, RSK, TEA, UGD, UDT, UZF, WFQ, XZA, YUN, ZGP groups 000955, 090047, 00700, 000301, 023535, 045636, ZGR do not cover immunizations.

**Aetna Assurant group SRC, and Care N Care do not cover immunization.
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