- How many units/primary insureds would you like to enroll? Enter the number of people you want to enroll for insurance coverage. If this is only for you, enter 1.
When would you like the coverage to take effect? Enter the date you would like the coverage to begin; this should be the date you will be leaving the USA.
When would you like the coverage to expire? Enter the date you would like the coverage to end; this should be the date you will be returning to the USA.
Click on Submit
- When you get to the next page (second page), go to box listed “Default Coverage.“
You must click on “Change All.”
When the window opens, click on the Deductible per Coverage Period drop down and Select $250.00, then click on the Medical Maximum drop down and Select $125,000.00. Complete other fields as applicable. Click on Submit.
- In the Applicant Information box, fill in Name(s) and Date(s) of Birth.
- In the Organization/Team Information box, enter the Team Name you are traveling with Contact Name and Phone Number.
In the Primary /Organization Email blank: please put email@example.com
You do not need to fill out any other blanks. Click on the Continue button on the bottom right. Verify information. Click Continue.
- On the next page, complete payment information. Click on Purchase Quote.
Email confirmation of coverage will be sent to Brian Bucy, director of Youth Outreach Ministry.
If you have any questions about this insurance, please contact Good Neighbor Insurance at firstname.lastname@example.org or call toll-free 1-866-636-9100.