INTERNATIONAL STUDENT HEALTH INSURANCE AGREEMENT

INTERNATIONAL STUDENT HEALTH INSURANCE AGREEMENT

+1-971-722-7150 pcc.edu/international-students

PCC International Student Health Insurance Requirement

? All F-1 international students with active I-20s from PCC must be covered by the international student health insurance provided by PacificSource, our official student health insurance provider.

? For your first term at PCC, health insurance should be purchased during the mandatory orientation week.

? You are required to pay for health insurance to PacificSource directly every: Fall, Winter, Spring, and Summer terms vacation terms OPT reduced course load terms

? Health insurance coverage for F-2 dependents is not required, but is recommended due to high healthcare costs in the U.S.

? Additional information about the F-1 international student health insurance requirement on our Health Insurance webpage.

Exception for Government-Sponsored Students

? Health insurance exceptions will only be granted to government-sponsored students and their dependents with health insurance that is itemized in their Financial Guarantees.

? Examples of government sponsors include SACM, Embassy of Kuwait, Qatar, etc.

? To receive an exception, accepted government-sponsored students must submit a copy of their Financial Guarantee to oiss.insurance@pcc.edu before the first day of every term.

I have read the information provided and understand that I must purchase the PacificSource health insurance every term, or submit my government-sponsored exception, while studying at PCC.

Signature

Date

Revised 02/2022

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