Uf Teamassist Insurance Form

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Uf teamassist insurance form. Tips for waiver completion if you have medicaid medicare or tricare or your insurance does not have numbers for the fields requested enter 99999 or n a in the field s. Initials or n a if i am traveling to an embargoed country i have. And have received my teamassist card. Uf international travel check list return date.

The online insurance verification form does not replace the insurance waiver. Complete provisions pertaining to this insurance are contained in the master policy on file with university of florida under form number ah 15090. Please complete this form and send it to the person in your department responsible for travel. University of florida international travel check list.

Physical address 1908 stadium rd yon hall rm249 gainesville fl 32611 phone 352 294 2925. This plan is underwritten by ace american insurance company policy terms and conditions are briefly outlined in this description of coverage. Private insurance verification uf insurance plan. United healthcare student resources uf insurance requirement visit uf s health compliance website for.