Renewal Form

APPLICATION FOR DUES RENEWAL
RENEWAL FORM
AND ANNUAL FEES

Please review the membership categories, which have been changed.   

You may now qualify under a different category with a different fee.

There is no longer a category for “Part time” work of less than 4 hours a week.

CATEGORIES OF MEMBERSHIP:  

Active ($200/year)
Associate ($100/year)
Emeritus ($35/year)

Active: meaning physicians who are Medical Directors,
Associate or Assistant Medical Directors, or Medical Consultants of insurance companies, or other physicians with equivalent duties; may vote and hold office.

Fee $200 Associate: meaning physicians who are not Medical Directors, Associate or Assistant Medical Directors or Medical Consultants of insurance companies but who have a professional interest in insurance medicine;

may not vote or hold office. Fee $100 Emeritus: being those who have retired from active medicine but who wish to stay in touch and to access the Proceedings of the annual meeting. Fee $35 **Dues are payable in full by December 31 of each year**