Contact Us

We look forward to helping you build your insurance program for students, alumni and/or staff. Please complete the form below and we'll follow up within two business days.

If you are an alumnus/a of a college or university, and are seeking coverage for yourself, or if you are a current customer seeking help with a policy, please visit www.alumniinsuranceprogram.com or email us at info.cir@usiaffinity.com.

Fields indicated with an asterisk (*) are required.

* Full Name
* Company/School/Assn
Title
* Email Address
* Phone Number
Preferred contact method:	Phone Email
Address
City
ST, Zip	-- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
How did you hear about us?	Mailings Referral Advertisement Search Engine Conference/Trade Show Other
Select your area(s) of interest:	Students Alumni Faculty/Staff
Check the product(s) of interest for Students: Mandatory Student Health Insurance Waiver Student Health Insurance Voluntary Student Health Insurance Nationwide PPO International Student Health Insurance Study Abroad Health Insurance Intercollegiate Athletic Health Insurance Other Number of students: 0 - 4,999 5,000 - 14,999 15,000 - 24,999 25,000 - 34,999 35,000 or more Type of student health insurance: Mandatory Voluntary Waiver Other Check the product(s) of interest for Alumni: Dental Insurance Disability Income Home, Auto & Renter's Annuity ID Theft Recovery Long Term Care Pet Health Insurance Major Medical Insurance Short Term Medical Coverage Travel Health Insurance Life Insurance/AD&D Number of graduating students/year: 0 - 499 500 - 999 1,000 - 1,999 2,000 - 2,999 3,000 or more Number of addressable alumni: 0 - 4,999 5,000 - 14,999 15,000 - 24,999 25,000 - 49,999 50,000 - 99,999 100,000 - 149,999 150,000 - 199,999 200,000 - 249,999 250,000 - 299,999 300,000 or more Check the product(s) of interest for Faculty/Staff: Long Term Disability ID Theft Recovery Home, Auto & Renter's   Number of staff: 0 - 99 100 - 299 300 - 499 500 - 999 1,000 - 1,999 2,000 or more Number of employees: 0 - 99 100 - 299 300 - 499 500 - 999 1,000 - 1,999 2,000 or more
Comments or questions:

Your privacy is our priority. We will only use the information you provide to send you relevant information about our offerings, to follow up and discuss your requirements, or to invite you to upcoming events. We will not share your name or e-mail address with third parties, except as noted in our Privacy Policy.