Print and complete Enrollment Form. Attach the Roster of Insureds for your traveling participants.
Full payment must be received prior to the effective date of insurance. You may pay by check, check-by-fax, money order, MasterCard, Visa or Discover. Make check or money order for total
group premium payable to Travel Insurance Services. All payments must be in U.S. dollars drawn on a U.S. bank. Do not send cash.
Mail with completed Enrollment Form and Roster to: Group Department, Travel Insurance Services, 2950 Camino Diablo, Suite 300, Walnut Creek, CA 94597-3991. You may fax your enrollment to 925-932-0442 when paying by credit card or check-by-fax. To avoid duplication, DO NOT mail the original enrollment form when faxing.
Refund of premium, less a $20 processing fee, will be returned only if a written request is received by Travel Insurance Services prior to the effective date of coverage. After the effective date of coverage, the premium is considered fully earned by the insurance company and non-refundable.
NOTE: Incomplete and/or incorrect applications and payments will not be processed and
will be returned.
Outline
