Discount Medical Program Organization

IC 27-17

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. 

  1.  Application - Each question must be completed in full.  If additional space is needed, attach a separate sheet of paper properly signed.  Application Instructions.
  2. Fees- $500 application fee and $35 marketing forms fee
  3. 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.
  4. DMPO Marketing Forms Checklist- Attach sample forms.
  5. Surety Bond- $35,000 Bond

If registering by paper submission, the DMPO application package shoule 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 rvaughan@idoi.in.gov.