Please complete the fields below to create a user name and password for the Medico Information Center (MIC).

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INDIVIDUAL AGENT REGISTRATION FOR MYENROLLER
Social security number:	--  Hide * Value must be numeric
Confirm ssn:	-- * SSN must match *
* SSN not found
AGENCY REGISTRATION ONLY FOR COMMISSIONS
Tax ID:	-  Hide * Value must numeric
Confirm Tax ID:	- * Tax ID must match *
User Name
Enter your desired user name. If the user name you have chosen already exists, you will be asked to create a different user name.
User name:	* User name already exists, username may not contain an @ symbol, Please choose another. User name can only contain alphanumeric characters
Confirm user name:	* User names must match *
Password
Password must be at least 8 characters with at least one upper case letter, one lower case letter, and one number.
Password:	* Password format incorrect   Strength:   Weak Not rated Medium Strong Best
Confirm password:	* Passwords must match *
Email
Email:	* Email must contain one '@' and one '.' symbol (e.g. username@gmail.com).
Confirm Email:	* eMail address must match *

By clicking Submit, the user name and password you have specified above will become the user name and password you will use to access the Medico Information Center. Please keep this information in a safe place and do not share it with others.