(And Why It Matters to You as an Agent)
If you’ve been in the Medicare space for a while, you’ve probably heard terms like regional FMO, SGA, and regional NMA thrown around like alphabet soup.
But what do they actually mean? And more importantly—does it matter when you’re trying to grow your book of business?
Short answer: yes, it really does.
Let’s break it down in plain, agent-to-agent language.
First, a Little Medicare History: What Happened to SGAs?
Let’s rewind a bit.
For years, UnitedHealthcare (UHC) used a tiered system for agency distribution. One of those key tiers was the SGA, which stands for Super General Agency.
SGAs were highly respected, high-volume partners who worked directly with UHC and were authorized to appoint downlines—like MGAs (Managing General Agents), GAs (General Agents), and independent agents.
But a few years back, UHC restructured. They eliminated the “SGA” title and started calling all distribution partners in that tier simply FMOs—Field Marketing Organizations.
While the labels changed, the power structure didn’t disappear. There are still big FMOs with national influence, and smaller ones with deep local roots.
That’s where the regional FMO vs. NMA conversation comes into play.
What Is a Regional FMO?
A regional FMO is often a smaller, more focused group that works directly with agents in a specific area or state. These are the teams who:
- Help you with contracting and onboarding
- Answer your calls (like, really answer them)
- Host trainings and events you can actually attend
- Offer hands-on support during AEP and beyond
They know your zip code. They’ve been to your Walgreens. They understand the local market, not just the national playbook.
They’re close enough to care—and that matters when you’re running an independent business.
What Is an NMA?
An NMA, or National Marketing Alliance, is a larger national-level partner that typically works behind the scenes to support multiple FMOs across the country.
They often:
- Have direct relationships with major carriers
- Provide infrastructure, technology platforms, and compliance resources
- Negotiate national-level contracts and marketing support
Think of them as the “wholesale distributor” to your FMO’s local storefront.
You, as the agent, might never interact directly with the NMA—but you do benefit from their reach, tools, and scale (if your FMO is partnered with one).
The Best of Both Worlds: Why This Structure Matters
Here’s where it gets powerful.
When you work with a regional FMO that’s partnered with a national NMA, you get the perfect blend:
- Personal support and local market knowledge
- National-level tools, tech, and top-tier contracts
At TMS Insurance Brokerage, we’re proud to be a regional FMO with deep Texas roots and growing reach—but we also partner with a top-tier NMA to give our agents access to everything they need to grow and compete nationwide.
That means:
- You get real support from a real team.
- You keep your independence and flexibility.
- And you tap into national contracts and tools without getting lost in the shuffle.
In Conclusion: Know Who You’re Really Working With
The Medicare hierarchy can be confusing—especially with all the title changes over the years.
But understanding the difference between an FMO and an NMA—and how the old SGA model evolved—can help you make smarter decisions about who’s truly supporting your business.
If you’re looking for that sweet spot between local loyalty and national strength, we’d love to talk.
👉 Reach out to learn how TMS blends personal service with powerful partnerships—and why it might just be the support you’ve been missing.