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J-1 Check-In, Insurance, and Address Update

The following form is for J-1 Scholars to complete for one of the three following reasons:

  1. Initial check-In to University (upload immigration documents and provide insurance information)
  2. To update Health Insurance Information
  3. To update Address with ISSS

This form should only be completed by the J-1 Scholar and should not be filled out by any university department.

ISSS recommends that you complete this form using Firefox, Google Chrome, or Safari as your web browser. 

Initial check-In for J-1 Scholar


This form should only be completed by the J-1 Scholar. This form cannot be completed until the J-1 has arrived in the U.S. There are certain documents and information that will not be available to the J-1 Scholar unless they are in the U.S. Please see the list of documents that are required to complete this form.


Documents from J-1 Scholar:

  • Copy of J-1 VISA/Stamp
  • Copy of J-2 VISA/Stamp(s) [if applicable]
  • Copy of all DS-2019(s) with information from Consulate
  • Copy of I-94(s) [https://i94.cbp.dhs.gov/]
  • Current Address in the U.S.
  • Current Phone Number in the U.S.
  • Current E-mail Address
  • Address of Department/Location on campus
  • Phone Number of Department on Campus
  • Emergency Contact Information (Phone, E-mail)
  • Health Insurance Information for you [and your dependents if applicable]


Insurance Verification Form Update


This should only be completed if you are:

  • Updating your insurance because the current insurance has expired
  • Updating your insurance because you have changed insurance providers
  • Updating insurance because of J-2s Arriving in the U.S.
  • Updating Insurance due to Extension of J Status


You will need your complete insurance information to complete this form.


Please see the Insurance Requirement Document for specific requirements.

Address Update with ISSS


Thank you for updating your address with our office. We will use the information you provide in this form to change your address in SEVIS.


Please make sure you have the following information:

  • Current Address in U.S.
  • Current Phone Number in U.S.
  • Current E-mail Address
Do you Have the Required Documentation Mentioned Above?*

Check-In Information

Name on Passport*
Upload Copy of J-1 VISA with stamp from Port of Entry*
No File Chosen
File uploads may not work on some mobile devices.
Upload Copy of DS-2019 with information from Consulate*
No File Chosen
File uploads may not work on some mobile devices.
Upload Copy of I-94*
No File Chosen
File uploads may not work on some mobile devices.
Go to https://i94.cbp.dhs.gov/ to retrieve your I-94
Did you travel to the U.S. with J-2 Dependents?*
If your J-2 Dependents have not arrived yet, please select 'No'

Dependent 1

Dependent 1: Name on Passport*
Dependent 1: Copy of J-2 VISA with stamp from Port of Entry*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 1: Upload Copy of DS-2019 with information from Consulate*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 1: Upload Copy of I-94*
No File Chosen
File uploads may not work on some mobile devices.
Go to https://i94.cbp.dhs.gov/ to retrieve the I-94

Dependent 2

Dependent 2: Name on Passport*
Dependent 2: Copy of J-2 VISA with stamp from Port of Entry*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 2: Upload Copy of DS-2019 with information from Consulate*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 2: Upload Copy of I-94*
No File Chosen
File uploads may not work on some mobile devices.
Go to https://i94.cbp.dhs.gov/ to retrieve your I-94

Dependent 3

Dependent 3: Name on Passport*
Dependent 3: Copy of J-2 VISA with stamp from Port of Entry*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 3: Upload Copy of DS-2019 with information from Consulate*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 3: Upload Copy of I-94*
No File Chosen
File uploads may not work on some mobile devices.
Go to https://i94.cbp.dhs.gov/ to retrieve your I-94

Dependent 4

Dependent 4: Name on Passport*
Dependent 4: Copy of J-2 VISA with stamp from Port of Entry*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 4: Upload Copy of DS-2019 with information from Consulate*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 4: Upload Copy of I-94*
No File Chosen
File uploads may not work on some mobile devices.
Go to https://i94.cbp.dhs.gov/ to retrieve your I-94

Dependent 5

Dependent 5: Name on Passport*
Dependent 5: Copy of J-2 VISA with stamp from Port of Entry*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 5: Upload Copy of DS-2019 with information from Consulate*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 5: Upload Copy of I-94*
No File Chosen
File uploads may not work on some mobile devices.
Go to https://i94.cbp.dhs.gov/ to retrieve your I-94

Dependent 6

Dependent 6: Name on Passport*
Dependent 6: Copy of J-2 VISA with stamp from Port of Entry*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 6: Upload Copy of DS-2019 with information from Consulate*
No File Chosen
File uploads may not work on some mobile devices.
Dependent 6: Upload Copy of I-94*
No File Chosen
File uploads may not work on some mobile devices.
Go to https://i94.cbp.dhs.gov/ to retrieve your I-94

Address & Contact Information

Current U.S. Living Address*

Name of J-1 Scholar*

Address of Department

Department Address*

Emergency Contact

Name of Emergency Contact*

Insurance Verification Form

According to immigration regulations (22 CFR S62.14), J-1 exchange visitors and accompanying J-2 dependents are required to maintain comprehensive medical insurance with evacuation and repatriation coverage that meets U.S. government minimum requirements beginning on the start date of the J-1 program (indicated in item 3 of the DS-2019) continuing to the end of the J-1 program. There cannot be any breaks or lapses in insurance coverage even if one travels outside the U.S for an extended period of time during the J program.


For a Printable Version of this information please click HERE. The form must be completed electronically.


ISSS may terminate the SEVIS record of an exchange visitor who:

  1. Does not provide ISSS with a valid Insurance Compliance Form by the start of the J program; or
  2. Does not submit an updated Insurance Verification Form when the previously reported insurance expires; or
  3. Does not submit an updated Insurance Verification Form when s/he seeks to extend the J-1 program.


The willful failure to carry the required insurance for yourself and, if applicable, your dependents, or material misrepresentation of insurance coverage will result in the termination of your J program and legal status in the U.S.

Insurance Requirements

(For a Printable Version, please see the Insurance Requirements Document)


The J insurance coverage must provide the following minimum coverage:

  • Minimum medical benefit of $100,000 per person per accident or illness;
  • Deductible that does not exceed $500 per accident or illness;
  • Minimum repatriation of remains in the amount of $25,000;
  • Minimum medical evacuation expenses in the amount of $50,000; and
  • Co-insurance paid by J-1 not to exceed 25% of covered benefits per accident or illness. Insurance policies:
  • May require a waiting period for pre-existing conditions that is reasonable as determined by current industry standards; and
  • Must not unreasonably exclude coverage for the perils inherent to the activities of the exchange program in which you participate

Any policy, plan, or contract secured to fill the J insurance requirements must at minimum be:

  • Underwritten by an insurance corporation having:
    • An A.M. Best rating of “A-“ or above; or
    • A McGraw Hill Financial/Standard & Poor Claims-paying Ability rating of “A-“ or above; or
    • A Weiss Research, Inc. rating of “B+” or above; or o
    • A Fitch Ratings, Inc. rating of “A-“ or above; or
    • A Moody’s Investor Services rating of “A3” or above;
  • Be backed by the full faith and credit of the exchange visitor’s home country; or Part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor; or
  • Offered through or underwritten by a federally qualified Health Maintenance Organization or eligible Competitive Medial Plan as determined by the Centers of Medicare and Medicaid Services of the U.S. Department of Health and Human Services

Coverage Information

Please enter your qualifying insurance policy information in the sections below. ISSS does not have the expertise to evaluate individual insurance policies. J-1 Exchange Visitors are responsible for verifying with the insurance provider that the policy meets the minimum insurance requirements established by the U.S. Department of State in 22 CFR S62.14. If necessary, you may show this form to your insurance provider in order to verify sufficient insurance coverage.


If you are a J-1 Scholar, on CU Payroll, and will enroll in a University health insurance plan:

  • You must enroll in University insurance within 30 days of starting your employment with CU.
  • If you begin your position at CU on the first of the month, your CU health insurance will start the same day.
  • If you begin your position at CU after the first day of the month, your CU health insurance will not begin until the first day of the next month. You must purchase a temporary health insurance policy that meets the insurance requirements that begins on your J program start date and runs until the start of your CU health insurance. You must submit an updated Insurance Compliance Form to ISSS to indicate your new insurance information once your CU health insurance begins.
  • CU health insurance does not include evacuation and repatriation coverage; you must purchase evacuation and repatriation coverage for the duration of your J program for yourself and your J-2 dependents (if applicable).
  • The high deductible CU health insurance plan does not meet the Department of State J insurance requirements.


The CU health insurance coverage ends on June 30 every year. In early May employees receive information about “Open Enrollment” for medical insurance and other benefits for the period of time beginning July 1.


If necessary, be sure to reenroll by the Open Enrollment deadline in order to continue to have University health insurance coverage.

Name of J-1 Scholar*

University of Colorado Health Insurance Enrollment

Will you or Have you Enrolled in a CU Health Plan*

If you are unsure of the plans, please see the information on the Medical Plans Website.

Which Eligible CU Health Plan?*
What Date will your Insurance Begin?*

Medical/Health Insurance Coverage

My policy below will cover:*
Insurance Company Address*

Insurance Start Date*
Insurance End Date*
Does this insurance include evacuation & repatriation?*
If you are unsure, please read the insurance requirements closely and your insurance policy

Evacuation & Repatriation Coverage


REMINDER. The CU HEALTH Plan does not cover Evacuation & Repatriation. You will need to have purchased additional insurance to cover Evacuation and Repatriation Coverage.

My policy below will cover:*
Insurance Company Address*
Insurance Start Date*
Insurance End Date*

ATTESTATION— I certify under that the above information is true and correct. I confirm my, and if applicable, my J-2 dependent(s)’, insurance coverage meets the U.S. Department of States’ requirements as outlined in 22 CFR S62.14.


  • I understand it is my responsibility to provide proof of continuous insurance coverage to ISSS throughout my J program.
  • I understand that if I fail to obtain and maintain adequate health, repatriation, and evacuation insurance for myself and my J-2 dependents (if applicable) for the duration of the J program, the University of Colorado will terminate my J program which will result in my loss of my legal J-1 immigration status and the J-2 status of any dependents accompanying me.
  • I understand that I may also be subject to the requirements of the Affordable Care Act (ACA) and, if so, will purchase insurance that meets the requirements set forth in the ACA legislature in addition to the requirements established in 22 CFR S62.14.
  • I understand that if any J-2 dependents enter the U.S. after the beginning of my start date on my DS-2019, I am required to provide updates of their entry into the U.S. and insurance information for my J-2 dependents
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Acknowlegement of Responsibility

Acknowledgment of Responsibility

For Maintenance of Lawful Immigration Status


Immigration Status. Federal regulations require all international students to maintain lawful immigration status while in the United States. Failing to maintain immigration status is an extremely serious matter and can result in severe penalties.

  1. Role of the International Student Scholar Services (ISSS) department. The role and purpose of the staff of ISSS in relation to U.S. government immigration regulations is to provide you with information, advising, and assistance so that that you can maintain your lawful immigration status while in the United States. Under U.S. immigration law the University is obligated to report certain information about you and your program to the U.S. government, including potential violations of immigration regulations.
  2. Limitations of the International Student Scholar Services (ISSS) department. While the staff provides a high level of professional assistance, they are not employees of the Department of Homeland Security (DHS) nor are they attorneys who specialize in immigration law. You have the right to consult an immigration officer or an attorney specialized in immigration law at any time, and the ISSS staff will be pleased to provide you with information to help you find appropriate counsel.
  3. J-1 Visa Holders' Responsibilities for Compliance with all Laws and Regulations. You are responsible for:
    1. Fully and properly complying with all laws and regulations of U.S. federal, state and local governments; for
    2. Maintaining your lawful status including not working without authorization and, if you are a student, carrying a minimum course load; and
    3. Ensuring that any necessary documents are forwarded to the U.S. Government in a timely manner.
  4. Medical Insurance Coverage. The Department of State requires that all J-1 visa holders have appropriate medical insurance coverage while they are in the United States in J-1 status. The University makes group medical insurance plans available to employees who are J-1 scholars. Medical evacuation and repatriation of remains insurance must be purchased separately. It is your responsibility to purchase the required insurance plans for yourself and any dependents and you are responsible for continuously maintaining comprehensive coverage that meets University of Colorado Denver and U.S. Department of State requirements.

Verification of Understanding. By my signature below, I verify that I have read this document and understand its contents. I acknowledge that it is my responsibility to maintain continuous lawful immigration status and that I will bear the consequences of violating my immigration status. I also affirm that I have been informed of my responsibility to maintain appropriate medical insurance throughout the duration of my program. Therefore, I hereby release and hold harmless the University of Colorado Denver; the Board of Regents of the University; and the University's faculty, staff, agents, and employees from any claim which could result from any failure on my part to maintain lawful immigration status and mandatory, appropriate, comprehensive medical insurance.

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Name of Scholar*
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