I , citizen of , and permanent resident of , certify that I will subscribe and maintain for me and every member of my family, during my program as an Exchange Visitor (J-1) in the University of Puerto Rico, an accident insurance policy with the following minimum benefits:

Medical Benefits of at least $100,000 per accident or illness

Repatriation of Remains in the amount of $25,000

Expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $50,000

A deductible not to exceed $500 per accident or illness

A policy underwritten by an insurance carrier with:

An A.M. Best rating of “A-“ or above;

A McGraw Hill Financial/ Standard & Poor’s Claims paying Ability rating of “A-“ or above;

A Weiss Research, Inc. rating of “B+” or above;

A Fitch Ratings, Inc. rating of “A-“ or above;

A Moody’s Investor Services rating of “A3” or above;

If I do not comply with this requirements, I accept that my J-1 Program will be terminated and I will return to my country.

Name:	Date:

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