Create Username and Password

Step 1 of 3

In the fields below, enter all of the information requested. Once all fields are complete, click the Submit button. Your reference number is the series of letters and numbers immediately following your name in the "Who Is Insured" section of your MLMIC policy Declaration Page, as seen in the sample image below.
 
 
Last 4 digits of Social Security Number:
Date of Birth(MM/DD/YYYY):
Reference Number:
 


If you need assistance or have a question, please click here to contact MLMIC electronically,
or call us at 1(888)234-0752.