New Producer Contracting

IMG New Producer Contracting

Please complete the Producer Agreement application process below to contract with IMG to sell our international medical insurance plans, including travel medical, international health, international private medical insurance, and iTravelInsured plans.

If you are a Travel Retailer wanting to get contracted with IMG, please register here.

If you are already contracted with IMG and need access to our online Producer Area, please go to the "New User Registration Form".

Please note, the following form is only for licensed insurance producers. If you are a current policy holder and wish to manage your insurance plan, please go to MyIMG.

Primary Email * 
Confirm Primary Email * 


You are requesting a contract with International Medical Group®, Inc. and its affiliates, iTravelInsured, Inc. and International Medical Adminstrators, Inc.
Please select one of the options listed below to signify the appropriate producer type to which you are requesting a contract:

*License Required: Life & Health or Accident & Health (U.S. State + FL resident/non-resident) (Non-U.S. – Caribbean)

**License(s) Required: Property & Casualty, and/or Travel or Limited Lines Travel (license is determined by state)

First Name * 
Last Name * 
Middle Initial 
Suffix ( Jr. I, II, III ) 
Date of Birth * 

Agency / Entity Name * 
Business Country * 
Business Address * 
Business City * 
Business Postal Code * 
Business Phone * 
Business Email * 
Fax Number 

Country * 
Address * 
City * 
Postal Code * 
Phone * 

Country Licensed *   
State Licensed *   
License Number * 

If Non-US where license is not applicable please enter N/A

NPN Number * 

If Non-US where NPN is not applicable please enter N/A

For Tax Reporting Purposes, please enter one of the following options: 


Commissions and renewal commissions equal to the percentages shown shall apply to premiums received on Certificates placed in force under this Producer Agreement (Agent) during the effectiveness of this Schedule, excluding applicable taxes, if any. Commissions and renewal commissions, bonuses or other compensation which IMG pays directly to Sub-Producers or their executors, administrators, surviving spouses, or estates.

Product Commission (%)
Certificate Year 1
Renewal commissions (%)
Certificate Years 2 plus
Referral Fee Per referral
Patriot Series 10 N/A
(Patriot Series extensions and renewals are considered at 1st year commision rate)
$15 Standard
$25 Platinum
Global Series 15 5 $100
GEO / GEM & Patriot Group Exchange Annual Plan 6 (Dental 4%) 6 (Dental 4%) N/A
Travel Insurance Series 10 N/A $10 Lite
$12 SE
$25 LX

Monthly Commissions are calculated using the following formula:

Monthly Gross Premium - Applicable Surplus Lines Taxes X Commission Percentage = Gross Commission
Example: $1,000 - 70 X 1% = $9.30

Signature * 

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