The letters describe where an organisation sits in the carrier hierarchy. They are not regulated categories, and three of them are used interchangeably. Here is what each one means, plus the rest of the vocabulary in a Medicare agent contract.
An FMO (Field Marketing Organization), IMO (Independent Marketing Organization) and NMO (National Marketing Organization) all describe an organisation that contracts directly with insurance carriers and distributes their products through independent agents. Where the industry draws distinctions between them, it is about size and scope rather than function — and different carriers apply the labels differently.
An MGA (Managing General Agent) and a GA (General Agent) sit below those organisations in the hierarchy, managing downline agents at progressively lower contract levels.
None of these is a regulated classification. Any organisation can call itself an FMO. So the label on the door tells you very little — what tells you something is the contract: your commission level, whether the carrier pays you directly, whether renewals vest immediately, and what happens if you want to leave.
A typical Medicare distribution chain, top to bottom. The structure varies by carrier, and the labels are applied loosely.
The further down the chain you sit, the lower your contract level tends to be — and the more parties may need to sign off if you want to move. That is why "what level am I contracted at?" is a better question than "are you an FMO or an IMO?"
Because the labels are not standardised, they are a poor filter. These five questions are not:
What contract level am I being offered? This is the number that determines your commission. Ask for it explicitly, in writing.
Am I paid street level, directly by the carrier? If commissions flow through the upline first, ask why — and ask what is retained.
Are renewals vested from day one? And do I keep them if I leave? See what renewals are actually worth.
What does the release clause say? Not the marketing page — the clause. Our guide to reading an FMO contract covers the language to look for.
Who do I call when something breaks? A named human or a ticket queue is a real difference, and it shows up during AEP.
In practice, very little — the terms are used interchangeably across the insurance industry. Both describe an organisation that contracts directly with carriers and distributes their products through independent agents. Where people draw a distinction it is usually about size or scope, with IMO sometimes implying a smaller organisation. Neither is a regulated classification, so the label alone tells you almost nothing about what an agent will actually receive.
NMO stands for National Marketing Organization. It generally describes an organisation contracting directly with carriers on a national basis, and it is frequently used interchangeably with FMO and IMO. Like those, it is a descriptive label rather than a regulated category.
A Managing General Agent sits below an FMO, IMO or NMO in the carrier hierarchy and manages a group of downline agents. An MGA typically receives a lower contract level than the organisation above it and provides less infrastructure — less contracting support, training, technology and marketing.
Commonly: carrier at the top, then FMO, IMO or NMO, then MGA, then GA, then the writing agent. The exact structure varies by carrier and the labels are applied loosely, but the practical point holds — the further down the chain you sit, the lower your contract level and the more people must approve a release if you want to move.
Less than the label suggests. What matters is your contract level, whether you are paid street-level commissions directly by the carrier, whether renewals are vested from day one, how carrier appointments and back-office support are handled, and what the release language actually says. Two organisations using the same three letters can offer completely different terms.
It is the standard commission rate a carrier publishes for a product — the baseline an independent agent should expect. Being paid "at street" means you receive the carrier's full published rate. Being paid below street means part of your commission is being retained somewhere in the hierarchy above you.
Vesting determines whether renewal commissions belong to you. Vested from day one means you own your renewals immediately and keep them if you leave. Some contracts use a schedule that phases ownership in over several years; others describe renewals as vested but tie them to remaining contracted, which functionally is not ownership at all.
The terms that appear in Medicare agent contracts and carrier paperwork, in plain English.
A distribution organisation that contracts directly with insurance carriers and, in turn, contracts independent agents and agencies to sell those carriers' products. An FMO sits at or near the top of the carrier hierarchy and typically provides contracting, training, marketing support and back-office services. Most FMOs are licensed across most or all states.
Functionally the same as an FMO, and the two terms are used interchangeably across the industry. Where a distinction is drawn, it is usually about size or scope rather than function — IMOs are sometimes smaller, and may sit below an FMO in a given carrier's hierarchy.
Another label for an organisation contracting directly with carriers, usually implying national scope. Like IMO, it is frequently used interchangeably with FMO. The label is a marketing choice more than a regulatory classification.
An organisation that sits below an FMO/IMO/NMO in the hierarchy and manages a group of downline agents. An MGA earns commission on its own production plus overrides on its downline's, but generally receives a lower contract level — and typically provides less infrastructure — than the organisation above it.
A contract level below MGA, usually managing a smaller group of writing agents. The same pattern applies: less override, and progressively less support the further down the chain you sit.
The contractual chain running from the carrier down to the writing agent — commonly carrier → FMO/IMO/NMO → MGA → GA → agent. Your position in it determines your commission level and who must approve a release if you want to move.
Whoever sits directly above you in the hierarchy. Your upline is who you request a release from, and often who your commissions flow through if you are not paid directly by the carrier.
The agents contracted beneath you. Building a downline generates override income but is a different business from writing policies yourself.
The standard commission rate a carrier publishes for a given product. It is the baseline an independent agent should expect. An agent paid below street is having part of their commission retained somewhere in the hierarchy; an agent paid at street receives the carrier's full published rate.
Compensation paid by the carrier to an upline organisation based on the production of agents beneath it. A properly structured override is paid by the carrier in addition to the agent's commission — it does not come out of what the agent is paid.
Whether, and when, renewal commissions become the agent's property. "Vested from day one" means you own renewals immediately. Watch for vesting schedules that phase in over years, and for language that ties renewals to remaining contracted — that is a different thing wearing the same word.
Recovery of commission already paid, triggered when a policy terminates inside a defined window. Chargebacks are set by CMS rules and carrier contracts, not by the FMO.
A member leaving a plan shortly after enrolling, typically within the first three months of the effective date. It usually triggers a full chargeback of the initial commission.
The in-force policies and client relationships an agent has built. Whether you keep it when you change uplines depends entirely on your contract — which is why release and vesting language matters more than most agents realise when they sign.
Permission from your current upline to move your contracting to a different organisation. Because hierarchy changes run through each carrier separately, a release is rarely a single document — it is a process, and how hard your upline makes it varies enormously.
A release policy with no waiting period, no "for cause" requirement and no release fee. See our Open Release policy and the guide to reading yours.
The state of having completed everything required to legally write business for a given carrier — certification, appointment, background and licence verification. "RTS" is the status you need before AEP opens, and it is per-carrier, not universal.
A carrier's authorisation for a specific agent to sell its products. Appointments are per-carrier and per-state, and they are what a hierarchy change actually moves.
The unique identifier assigned to a licensed producer through the NAIC's national registry. It follows you across states, carriers and uplines, and it is what most contracting paperwork keys off.
A CMS-required record documenting which product types a Medicare beneficiary agreed to discuss, completed before a sales meeting takes place. It is a compliance requirement, not a formality, and the rules around timing and retention change periodically.
A CMS-defined category covering organisations that market Medicare Advantage or Part D plans, or generate leads for them, without being the plan itself. TPMO status carries specific disclosure and call-recording obligations.
The document a plan must send existing members each autumn describing the following year's premium, benefits and cost-sharing. It generally arrives by September 30 and is what prompts most AEP client conversations.
We publish our release policy, our commission structure and our carrier list because we would rather you check than take our word for it. Book a 20-minute call and bring the list above.