DIAN

1

Quote

2

Quote Result

3

Information

4

Confirmation

5

Payment

Step 1. Quote

Please fill in English

Choose Data Entry Method

Has Sponsor

No Sponsor

Do you have a sponsoring organization?

Yes, I have sponsoring organization.

No, I don't have sponsoring organization.

Form

Excel

How would you like to enter the personal data of the insured person?

I will input all the information by myself.

I will upload the information.

CSV Upload

Please download the member file template and open it using Microsoft Excel (do not use Apple Numbers). Complete the member information in English, and then upload the completed file.

Enter referral code, if applicable

Status of Residence

View Policy

Home Country

Destination Country

United States

Insurance Plan: 2026-2027 Blue 80

Coverage Start

Coverage End

Your Age

Fall - Spring/Summer : 2026-08-01 ~ 2027-07-31

Fall : 2026-08-01 ~ 2026-12-31

Selecting by myself

Will you add spouse?

Yes No

How many child will you add?

How many school friends will you add? (except you)

Friend 1 Age

Will you add spouse?

Yes No

How many child will you add?

Friend 2 Age

Will you add spouse?

Yes No

How many child will you add?

Are any of the applicants currently pregnant or hospitalized?

Yes No

My Account

E-mail (This address is used for receiving insurance files, and also used for login)

Password

Step 2. Quote Result

Step 3. Information

Step 4. Confirmation

Step 5. Payment