Skip to main content

State Requirements for Third Party Administrators

Please fill out this questionnaire and click Submit to send it.

Or print out the attached questionnaire, fill out and fax it to:  301-718-9440.  

Or print out the attched questionnaire, fill out, scan and email to:

Questions? Call Elizabeth at (301) 718-7722


To contact for further information
Type, Amount, Due Date and Frequency

Use this form to send us a copy of the statute containing requirements for TPA licensing.

Please upload the statute requiring a minimum level of stop-loss coverage for self-funded plans.

Form completed by
2014 SPBA Survey Form-1.pdf94.85 KB