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      Location ID:
      This number can be found on the back of your brochure.
      (Example: 33-7777)
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Location Number: (if applicable)
this number can be found on the
back of your brochure (e.g.:33-7777)
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Departure Date:*
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Number of Travelers:
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Base Plan Benefits
Trip Cancellation 100% of Trip Cost 100% of Trip Cost 100% of Trip Cost 100% of Trip Cost 100% of Trip Cost
Trip Interruption 100% of Trip Cost 150% of Trip Cost 150% of Trip Cost 150% of Trip Cost 150% of Trip Cost
Trip Delay / Missed Connection $500 $750 $1,000 $750 $1,000
Itinerary Change $250 $250
Baggage / Baggage Delay $500 / $100 $1,000 / $250 $2,500 / $600 $1,000 / $250 $2,500 / $600
Medical Expense Benefits $15,000 Sickness
$15,000 Accident
$50,000 $100,000 $50,000 $75,000
Medical Evacuation / Repatriation of Remains $100,000 $500,000 $1 Million $250,000 $2 Million
Common Carrier AD&D $50,000 $100,000
24 Hour AD&D $25,000 $25,000 $25,000 $25,000
Travel Assistance Included Included Included Included Included
Plan Upgrades
Cancel for Any Reason Available Available Available
All Events Available Available
Flight Accident AD&D Available with the
Transportation Pak
Available with the
Transportation Pak
Available with the
Transportation Pak
Available Available
Medical Expense Benefits Available Available
Rental Vehicle Coverage /
Collision Damage Waiver
Available with the
Transportation Pak
Available with the
Transportation Pak
Available with the
Transportation Pak
Available
$50,000
$50,000
Included in base plan
Transportation Pak Available Available Available
Adventure Pak Available
Athlete / Student Pak Available
Family Pak Available
Professional Pak Available
Protector Pak Available
Plan Highlights
Pre-existing Condition Waiver Purchase plan within 21 days of initial trip deposit Purchase plan within 30 days of initial trip deposit Purchase plan within 21 days of initial trip deposit Purchase plan within 21 days of initial trip deposit
Pre-existing Look Back Period 60 Days 60 Days 60 Days 60 Days 60 Days
Primary / Secondary Coverage Primary Primary Primary Primary Primary
Children Free Under 18 Under 18 Under 18
Plan Details
Maximum Trip Cost $10,000 $25,000 $50,000 $30,000 $75,000
Maximum Trip Length 30 Days 180 Days 180 Days 365 Days 365 Days
Underwriter Nationwide Mutual Insurance Company Nationwide Mutual Insurance Company Nationwide Mutual Insurance Company Old Republic Insurance Company Old Republic Insurance Company
A.M. Best Rating A+ A+ A+ A+ A+
Refund Policy 10 day review period 10 day review period 10 day review period 10 day review period 10 day review period
 
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For assistance please call (800) 228-9792  
© 2009 Travelex Insurance Services Inc., and its liscensors. All Rights Reserved.
The above information contains a brief description of benefits. Refer to the applicable Certificate of Insurance or Evidence of Coverage (the "Policy") for full policy details. Certain conditions, exclusions, and limitations apply as set out in the Policy. Products may not be available to residents of all states. If there is any conflict between the contents of this website and the Policy, the Policy will govern in all cases.
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