Self Enrollment

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1. Agreement
2. Select Sponsor
3. Review Plan
4. Personal Data
5. Payment
6. Confirmation
AgreementI understand that in order to be eligible for this Group insurance, all of the following statements about myself must be true:
  • I am a participant of an international education program that has a group insurance plan in place with CISI.
  • I certify that the personal information, which I will provide on the application that follows, will be truthful and accurate.

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Have a Question?

Email CISI
enrollments@ culturalinsurance.com

or call toll-free

(800) 303-8120

Sponsor Code

Please contact your international education program if you do not know your Sponsor's code.

Coverage Start Date

The earliest your coverage can begin is two days from now. You may purchase coverage for additional days before and /or after the actual dates of your international program, but the total number of additional days may not exceed 30.

Coverage End Date

The last day on which you will need coverage. You may purchase coverage for additional days before and/or after the actual dates of your international program, but the total number of additional days may not exceed 30.

Program Name

If your sponsor has given your trip a program name, please enter it here(optional)

Participant ID

If your sponsor has assigned their own ID to you, please enter it here (this is optional, and is different from the CISI participant ID that will be assigned to you at the conclusion of this enrollment process).

Email Address

Please provide a valid email address to which we can send your confirmation policy materials.

Credit Card Number

Please provide your credit card number. We accept Visa, MasterCard and American Express.

Credit Card Expiration Date

Please indicate the expiration month and year of the credit card in the fields below.

Study Abroad Location

Country to which you will be traveling.

If you are travelling to more than one country, please select "WW - Worldwide" as your location.

Same as contact address

Check this box if your billing address is the same as your previously-entered US mailing address.