Get Rice University J Exchange Visitor Insurance Verification Form For Insurance Companies

The Rice University J Exchange Visitor Insurance Verification Form is essential for verifying that J-1 Exchange Visitors hold adequate health insurance as required by the U.S. Department of State. This guide provides comprehensive, step-by-step instructions to help users navigate the form online successfully.

Follow the steps to complete the form accurately and efficiently.

1. Click the ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering the name of the insurance company in the provided field.
3. Next, indicate the country where the insurance company is based.
4. Fill in the first and last name of the insurance company representative or human resources benefit representative.
5. Provide the contact phone number of the representative, including the country code if outside of the U.S.
6. Enter the email address of the representative for future correspondence.
7. Document the name of the policyholder by entering their first and last name.
8. Specify the insurance plan that the policyholder is enrolled in.
9. Fill in the group number and policy number associated with the insurance.
10. Indicate the coverage effective date and the coverage termination date accordingly.
11. Respond to the statements regarding the insurance plan by checking the 'YES' or 'NO' box, ensuring each criterion is addressed.
12. Lastly, print the name and signature of the insurance company or human resources representative, along with the date.
13. Once completed, users can save changes, download, print, or share the form as necessary.

Complete the Rice University J Exchange Visitor Insurance Verification Form online today.