International medical plan - travel insurance plan: FAQ's

Customized Online Account

Please complete questionnaire to see if your organization qualifies.

ADMINISTRATIVE INFORMATION

Group Name:

Contact Name:

Address:

City:

State/Province:

Zip Code:

Phone:

Fax:

E-mail:

COVERAGE INFORMATION

Destination Country(ies):

Desired Effective Date:

If yes, please list:

Deductable:

Maximum Benefit:

Daily Rate:

How many teams do you anticipate sending during the next year?

How many members does a typical team include?

What is the average age of your team members?

What is the average length of stay per participant?

An Extreme Sports Rider is available for purchase and it adds coverage for abseiling, aviation (except when traveling as a passenger in a commercial aircraft), BMX, bobsleigh, bungee jumping, canyoning, caving, high diving, hang gliding, heli-skiing, hot-air ballooning, inline skating, jet skiing, kayaking, mountain biking, paragliding, parascending, rappelling, rock climbing, sky diving, snow skiing, snowboarding, snowmobiling, spelunking, surfing, trekking, wind-surfing and whitewater rafting. Will your group require the Extreme Sports Rider?

Enter Code:

Does your group currently use travel medical insurance?

Company:

Please select Yes/No:

International medical plan - travel insurance plan

International medical plan Travel insurance plan

International medical plan
Travel insurance plan