Two easy ways to apply or renew. Find instructions and forms below by using the dropdown menus to select your state and your facility or profession type.

OPTION 1: Apply or renew by email

Complete and save the PDF fillable application online, then email the completed form (as an attachment) to your insurance agent. If you are not working with an agent, you can send the completed form directly to MMIC at NewBusiness@MMICGroup.com

To complete your application online:

  1. Save the PDF application to your computer.
  2. Ensure you have the current version of Adobe Reader.
  3. Open Adobe Reader.
  4. Choose File > Open, and find the PDF application you saved to your computer. Open it.
  5. Complete all required fields. When you are finished, click the Signature of Applicant field.
  6. Follow the steps onscreen to create and insert your electronic signature.
  7. Save the document.

OPTION 2: Apply or renew by mail or fax

Print the application, complete it by hand, and fax or mail it to your insurance agent. If you are not working with an agent, you can fax or mail it directly to MMIC:

MMIC
ATTN: Sales and Marketing
7701 France Avenue South, Suite 500
Minneapolis, MN 55435
Fax: 952.838.6808

Questions? Use the provided contact form to send an email to MMIC Support.

Select State Application Forms:

Select Type of Application: