Travel Protection Enrollment
- You can enroll online using our easy, secure enrollment form, OR download a copy of the enrollment form, complete it, and return it to our office.
Already a customer?
Need to pay your invoice?
If you are renewing your coverage (that has not yet lapsed), you can simply pay your invoice online.If you are changing dependents on an existing family plan, at renewal time, please complete our dependent change form.
Looking for coverage for the first time?
Choose this option if you have not had coverage in the past.Online enrollment form*
PDF enrollment form** (PDF 23k)
Has your coverage lapsed?
Choose this option if your coverage is currently lapsed but you have had coverage in the past.Online enrollment form*
PDF enrollment form** (PDF 23k)
* Online enrollment - you'll need a valid credit card to complete this enrollment form. All information will be transmitted over a secure connection, to protect your privacy.
**PDF enrollment – download a PDF enrollment form, print it, and mail or fax your completed form to our office. You can pay by credit card or check using this method.
Form download requires free Adobe Reader. Download free Adobe Reader now.
**PDF enrollment – download a PDF enrollment form, print it, and mail or fax your completed form to our office. You can pay by credit card or check using this method.
Form download requires free Adobe Reader. Download free Adobe Reader now.