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Global Benefits USA
 Travel Insurance Quote Request 
Please complete the travel insurance quote request form and we will contact you as soon as possible with our recommendations.
Primary Contact and Trip Information:
 
 

* Total Trip Cost: Include pre-paid and non-refundable costs that you would lose if you had to cancel or interrupt your trip. Include trip expenses that have a partial refund from the travel supplier.  DO NOT include travel expenses that you incure after trip departure.

** Initial Trip Deposit Date: This is the earliest date that you made a trip deposit or payment that would be applicable to the above "Trip Cost Basis" definition