Discount Medical Program Organization
The IDOI provides requirements for certificate of registration for a Discount Medical Program Organization (DMPO) under IC 27-17.
Initial registration for a new DMPO can be completed electronically at www.sircon.com/indiana or submitted by paper. The following items must be submitted in order to register as a DMPO.
- Application - Each question must be completed in full. If additional space is needed, attach a separate sheet of paper properly signed. Application Instructions.
- Fees- $500 application fee and $35 marketing forms fee
- DMPO Checklist- Identify in the "Located" column on the checklist the section or page number of the submission indicating where the item can be found. Attach supporting documentation.
- DMPO Marketing Forms Checklist- Attach sample forms.
- Surety Bond- $35,000 Bond
If registering by paper submission, the DMPO application package should be sent to the following address:
Indiana Department of Insurance
Attn: DMPO Coordinator
311 W. Washington Street, #300
Indianapolis, Indiana 46204-2787
For questions, contact Rebecca Vaughan at (317) 232-2187 or firstname.lastname@example.org.