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You can now register for all 3 services by completing the registration form at the bottom of this page. If you are only needing to register for one service, you can simply click on the service below and register individually.


Becoming a representative is quick and easy! Please complete the following form to activate your website accounts.

BestHealth (NO CHARGE) - Your very own sales website! (NO CHARGE) - The compliment higher deductible plans with benefits that help you pay out-of-pocket, accident-related medical expenses. The are available through your membership in the AAAC. (NO CHARGE) - the main NIA website where you will find knowledgebase training, online commission statements, lead order forms, carrier forms and much much more!

ONE form 3 - website signup accounts you are now in the express lane towards success!

FIRST STEP enter your manager's email address

Choose a Unique Password:
Confirm Password:
Company Name:
First Name:
Last Name:
The text you enter into this field will become your website location. You cannot enter a space in the name, it must be all ONE word such as "mycompany" and MUST be all lowercase. Your website location will become :
Address 1:
Address 2:
Zip Code:
Alternative Phone:
Tax ID or SSN:
Pay Commision To: