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This form outlines the mandatory sickness and accident insurance requirements for J-1 Exchange Visitors and their accompanying dependents as stipulated by U.S. Department of State regulations.
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How to fill out j-1 insurance notification form

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How to fill out J-1 INSURANCE NOTIFICATION FORM

01
Obtain the J-1 Insurance Notification Form from the designated authority or institution website.
02
Fill out your personal information in the designated sections, including your name, address, and J-1 visa details.
03
Provide details about your insurance coverage, including the provider's name, policy number, and coverage dates.
04
Sign and date the form to confirm that all information is accurate and complete.
05
Submit the completed form as instructed, either online or in person, to the appropriate office.

Who needs J-1 INSURANCE NOTIFICATION FORM?

01
Individuals participating in the J-1 Exchange Visitor Program who are required to maintain health insurance.
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A letter from an insurance company, on official letterhead or stationery, including:A letter or premium bill from your former insurance company that shows you or your dependent's cancellation/termination from health coverage.
Sickness and Accident Insurance Requirement Note all exchange visitors and their dependents are responsible for ensuring they are covered by medical insurance from the day you arrive through the day you leave the United States, including the 30 day grace period before and after the training/internship program.
The 3-month premium payment grace period starts the first month you didn't pay, even if you make payments for the following months. Example of grace period: You don't make your premium payment for May. You submit premium payments on time for June and July, but still haven't paid for May.
This document explains the health benefits you and your dependents have under the plan. It details the services that will and will not be covered. Services that are not covered are called exclusions.
Per USDOS, minimum levels of health insurance coverage must provide: medical benefits of at least $100,000 per illness or accident. deductible not to exceed $500 per accident or illness. expenses associated with medical evacuation in the amount of $50,000.
Sickness and Accident Insurance Requirement Note all exchange visitors and their dependents are responsible for ensuring they are covered by medical insurance from the day you arrive through the day you leave the United States, including the 30 day grace period before and after the training/internship program.
Please note that you are not allowed to work in the U.S. during the 30-day grace period. If you exit the U.S. during the 30-day grace period and wish to reenter, you must do so as a tourist with a B-1/B-2 visa or on a visa waiver.
There are two nonimmigrant visa categories for persons to participate in exchange visitor programs in the United States. The J-1 visa is for educational and cultural exchange programs designated by the Department of State.
This document explains the health benefits you and your dependents have under the plan. It details the services that will and will not be covered. Services that are not covered are called exclusions.
How to Get the Proof of Insurance Letter? You must contact the employer or insurance company (whichever is applicable) if any authority demands a proof of insurance letter or document.

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The J-1 Insurance Notification Form is a document that certifies that J-1 visa holders have obtained the mandatory health insurance required under U.S. Department of State regulations.
All J-1 visa holders, including students, scholars, and interns, are required to file the J-1 Insurance Notification Form as a demonstration of compliance with insurance regulations.
To fill out the J-1 Insurance Notification Form, provide your personal information, details of your insurance coverage, and ensure all sections are completed accurately before submission.
The purpose of the form is to ensure that J-1 visa holders are in compliance with health insurance regulations, thus protecting their health and safety while in the United States.
The J-1 Insurance Notification Form must report information such as the name of the insurance provider, policy number, coverage dates, and confirmation that the plan meets the U.S. Department of State's insurance requirements.
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