Become an agent

Offer your clients the assurance and security of our travel insurance by becoming an ASSIST-CARD agent. Our Associate Program will allow any agent to resell our product directly to their travelers, offering them the peace of mind they are looking for. To begin, complete the form below.

Business Name*

Federal Tax ID*

Do You Currently Have An Insurance License* Yes No

If Yes, Enter Your License Number*

If No, Do You Need To Be Licensed* Yes No

Sole Proprietorship	Partnership
Other	It Does Not Apply

It Does Not Apply, Enter Your SSN*

First Name*

Last Name*

Address*

City*

State*

Zip*

Email*

Additional Contact Agent

Your Title*

Telephone Number*

Fax Number*

Please wait while we process your request

Travel Agents

Become an agent