If looking for a new quote and/or to obtain new coverage and save significantly on your health insurance premiums, go to http://insurance-quotes.com 




WELCOME IMA Regional Service Agents (RSAs)
Let's Help Each Other Prosper!

Please Print and Fax to 1.800.683.9483
 


First Name __________________________


Last Name __________________________


Phone Number _______________________


Resident State of Licensing _____________


EMAIL ADDRESS _____________________  (Will Not Be Abused)
 
To opt out simply email optsouts@aol.com Type STOP in Subject Line


Medicare Supplement/Long Term Care Licensed: YES_____   NO_____ (PLEASE CHECK ONE)



THANK YOU
LOOKING FORWARD!