Apply For Coverage
Become An MIEC Policyholder Today!
Alternatively fill out one of the application forms below and email it to firstname.lastname@example.org.
PDF Application Quick Links
- Solo Physician
- Physician Joining an MIEC Covered Group
- Group Application (Medical Corporations and Partnerships)
Don’t see the application you’re looking for? Click here to see all our applications!
You may also call us at 800-227-4527 or email email@example.com to request an application by mail, fax or E-mail.