State Requirements for Third Party Administrators

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

Questions? Call Elizabeth at (301) 718-7722

State: *

To contact for further information

Name: *

Department: *

Address: *

City: *

State: *

Zip code: *

Telephone: *

Fax: *

E-mail: *

State code or statute citation: *

1. Fees: *

Type, Amount, Due Date and Frequency

2. Bonding Requirement?: *

Yes

Fidelity or surety bond?: *

3. Other specific requirements:

Please list other specific requirements for TPAs must be aware of to receive a licence in your state or, alternatively, upload a copy of the state statute below.

Upload the statute:

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

4. Minimum net worth: *

Does your state require TPAs to establish a minimum net worth to become licensed? What amount is the TPA required to show to maintain or to renew their license?

5. Minimum stop-loss: *

Yes

Does your state have a statute that requires a minimum level of stop-loss coverage for self-funded plans?

If so, what is that minimum?:

Upload the statute:

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

6. Does your State require licensure of all resident and non-resident TPA.: *

7. Please provide any additional information related to Health Care Reform that you will require of TPAs applying for a license in your state:: *

8. Is your State TPA statute expected to undergo changes in the next 12 months? 24 months? Please explain?:

Form completed by

Name: *

Title: *

Date :

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State Requirements for Third Party Administrators

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