Health Insurance Forms
Health insurance is mandatory for all students who have F-1, J-1, or J-2 visas.
To attend classes at the English Language Institute, your health insurance must comply with the requirements mandated by the University of Florida.
Please complete the following form and return it to the E.L.I before classes begin.
In order to attend classes at the English Language Institute at the University of Florida I must select one:
* OPTION A
I am submitting a completed Insurance Verification Form (on the reverse side), which:
? has been filled out by my health insurance representative.
* has responses to all six (6) questions as “Yes,” thus showing that my insurance policy meets the requirements mandated by the University of Florida.
* OPTION B
I choose to enroll in the “International Student & Scholar Injury and Sickness Insurance Plan,” which meets the requirements mandated by the University of Florida for student health insurance. I will purchase this policy during the health insurance workshop presented during the first week of check-in and registration.
Please send this completed form with your application documents, or bring it with you when you arrive at the English Language Institute.
“I understand that I cannot attend class unless my health insurance is in compliance with the University of Florida’s requirements. I have read the above and agree that if OPTION A is not completed fully and correctly, I accept OPTION B by default, and I will purchase UF/ELI recommended health insurance.
Name (please print) ________________ Signature Date _________________
Category: Financial Forms
