Congratulations on taking the first step to become a certified Medicare Agent!

Please fill out the following Agent Information Form so we can help you get started. If you have any questions or technical difficulties, please call our friendly GMIA, Inc Representatives at (480) 821-9188 or toll free at (833) 797-8683. We look forward to working with you.

AGENT INFORMATION FORM

If you wish to contract as an agency (TIN), please provide a copy of your agency's health insurance license
LLC's and Corporations MUST have an insurance license to receive commission
Ask us about our co-op funding

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