Covid-19 Update: RPS Bollinger Specialty Group remains fully operational during this crisis. Our Customer Support Staff, Claims Department and New Business Team are here to answer questions. Connect with RPS Bollinger Specialty Group through your usual channels or through the "Contact Us" link options on this site. We wish you and your families good health during this difficult time, and a safe transition back to your workplaces and schools in the near future.

Request Proof of Coverage

Important! Please read.

If you require Proof of Coverage for any of the reasons below please complete the form below.
  • You are leaving the country and require proof of worldwide coverage
  • Your new insurance company is requesting proof of coverage
  • Your college or university is requesting this for the program that you attend
  • Your plan with Bollinger will be terminating

Students Information

Student's First Name:

Student's Last Name:

Your Email:

Email Confirmation:

Student's Birth Date:

College Student Attended:


Mailing Address:




FAX Proof of Coverage to this number: (optional)

Comments: (optional)