Products: Travel
  • Contracting
  • Transfer Release
  • Demographic Changes
  • Add Non Resident State
  • EFT Changes
  • Assignment Commissions
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Contracting
You can make the contracting request above or by emailing [email protected]. 
Transfer/Release Policy

​Demographic Changes

Add Non-Resident State

EFT Changes

Assignment of Commissions
Complete the Humana Assignment of Commission form and send to [email protected] and [email protected]. Please include “Commission Assignment Form” and your SAN # in the subject line of your email.

    International Medical Group (IMG)

    If a field does not pertain to your situation, please enter "n/a".
    Agency Contracting