The Forms & Applications listed below are available for you to download and print / fax if you do not wish to utilize our secure on-line SelectaPlan Program for quick and reliable quotes and/or purchases. To do so, click on the file you desire. These files are in Adobe Acrobat (Portable Document File - PDF) format. If you don't already have Acrobat Reader on your computer, you may download it for free from Adobe's secure site by selecting the box below:
Once you have opened our forms in your browser, you may print it or save it for future use. All IMG applications should be faxed to IMG directly at 1.317.655.4505. All others please FAX to 1.417.459.4623
Download times will vary depending on the speed of your modem. Please be patient, as downloads can take up to 120 seconds for larger files with dial up modems.If you have any difficulty retrieving these files or if you have any questions please contact us .
Global Medical Insurance SM (GMI) 
