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Private Insurance Option
International students on F and J visa statuses may substitute the
LSU Medical Health Insurance Plan with a private medical health
insurance plan which meets all mandatory requirements set forth by
the University (and the United States Department of State for J
visas status holders.)
PLEASE FOLLOW THE INSTRUCTIONS BELOW:
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Have your private insurance agent completely fill out and sign
the "F-1 or J-1 Insurance Coverage Evaluation form" and then
send the form back to you for your signature on the "Student
Signature Line" at the bottom of the form. This form is located
at the front desk of 101 Hatcher Hall or you may scroll down to
the bottom of this page to download the appropriate form
according to your visa status.
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Bring this form to International Services, 101 Hatcher Hall,
by
Tuesday, June 12, 2012 (absolute
deadline date. No exceptions will be considered.)
This
form may also be faxed to International Services at 225-578-1413
or e-mailed to Janice Goodloe at
jgoodlo@lsu.edu.
You may also choose to request the health insurance waiver on
line at:
www.lsustudentinsurance.com.
PLEASE NOTE:
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INSURANCE COVERAGE EVALUATION FORMS MUST BE COMPLETELY FILLED
OUT, DATED, SIGNED BY PRIVATE HEALTH INSURANCE COMPANIES AND
SUBMITTED TO INTERNATIONAL SERVICES BY THE DEADLINE DATE AT THE
BEGINNING OF EACH AND EVERY SEMESTER, REGARDLESS OF THE
INSURANCE COVERAGE END DATE STATED ON ANY PREVIOUSLY SUBMITTED
AND/OR APPROVED FORMS.
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Your private insurance policy must be effective from June 4,
2012 - July 26, 2012 for the Summer 2012 semester.
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Please realize a credit of the insurance charge is not immediate
upon receipt of the waiver form. This form must be processed.
I.S. is responsible for contacting the private insurance carrier
to verify benefit coverage.
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It is your responsibility to check your fee bill and/or to
inquire with International Services at the beginning of the
Summer 2012 semester to determine if your submitted form was
received.
INSURANCE COVERAGE EVALUATION FORMS BELOW:
PLEASE NOTE:
Forms must be completed, dated and signed by your private insurance
agent
no
earlier than Monday, May 14, 2012.
Forms will be accepted by International Services
beginning Monday, May 14, 2012.
F-1 Insurance Coverage Evaluation Form
J-1 Student Insurance Coverage Evaluation Form
This page was last updated , May 7, 2012
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