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Fill Out The Form Below For Your COPA Travel Insurance.

COPA Members Travel Insurance Application

Under Age 70 Annual Premium: $327
70 – 74 Annual Premium: $570
75 & Up Annual Premium: $1140

COPA Information



Business Information



Primary Residence



COPA Member



Spouse Of Member



Dependants & Children



Under age 70 Annual Premiums: $327
70 - 74 Annual Premiums: $570
75 - 79: $1140


Disclaimer - COPA Travel Insurance is exclusive to COPA Members. Membership with COPA is mandatory for the coverage to be in force. If you are not a COPA member at the time of claim, coverage is not in force.

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