Are You A COPA Member?

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Fill Out The Form Below For Your COPA Travel Insurance.

COPA Members Travel Insurance Application

Under Age 70 Annual Premium: $222
70 – 74 Annual Premium: $386
75 & Up Annual Premium: $722

COPA Member Information



Information



Primary Residence



COPA Member



Spouse Of Member



Dependants & Children



Under age 70 Annual Premiums (Class A & B): $222

70 - 74 Annual Premiums (Class A & B): $386

75 - 79 (Class A & B): $772



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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