Third Party Administrators (TPA)
Effective 4/17/2023 – New process to apply for a TPA license and to file the annual report
- Texas is excited to announce an online application process for Third Party Administrator licenses. No more forms to email or paper checks to mail. You can submit the application and fee electronically via Sircon.com.
- Submit Annual Reports online through the electronic renewal process for Third Party Administrators. Again, no more forms to email or paper checks to mail. Submit the Annual Report with attachments, and pay the fee electronically via Sircon.com.
- Tutorials – detailed instructions and tutorials are now available. If you currently hold a Texas agent or firm license, you should find many similarities in the process.
- New License Number - All TPAs were issued a new license number. A copy of the license with a new license number will be sent by email. Check your spam or junk folder if you didn't receive it.
Licensing handled by Company Licensing. Email: CompanyLicense@tdi.texas.gov
Company Licensing TPA Forms
Please note, the registrationteam@tdi.texas.gov email address is no longer being used.
Application
Resident and nonresident entities seeking to do business in Texas may be required to register with the Texas Secretary of State. Contact the Texas Secretary of State’s office at www.sos.state.tx.us or call 512-463-5701 to confirm.
Apply online at www.Sircon.com. Review the Resident TPA or Non-Resident TPA tutorial and make sure you have all attachments ready prior to starting the process.
- Completed Application for a Certificate of Authority - FIN489 along with all applicable supporting documents outlined on page 2 of the form.
- Officers and Directors Page - FIN306
- Use UCAA form 11 or TPA Biographical Affidavit - FIN484
- Fingerprinting requirements
- TPA Service of Process - FIN485 if applicable
To submit deficiencies to your application review Tutorial for attaching a deficiency to TPA application.
Insurers or HMOs that are currently licensed in Texas that wish to register as a TPA should complete Notification that an Insurer or HMO will be acting as an Administrator and send to CLRFilings@tdi.texas.gov
License Duration
TPA licenses do not expire. The June 30 expiration date is the annual report due date. If the license is no longer needed, surrender your license for cancellation by completing form Surrender of Third Party Administrator Certificate of Authority - FIN497 and email to CLRFilings@tdi.texas.gov.
Annual Reporting
March 1 - Report to Texas Comptroller
Administrators must file a Texas Annual Insurance Maintenance, Assessment and Retaliatory Report with the Texas Comptroller on or before March 1. Summary of Maintenance Tax and Assessment Rates
June 30 - Annual Report to TDI (NEW PROCESS)
Administrators must file an annual report on or before June 30. Use the renewal function at www.Sircon.com to submit the TPA annual report and pay the $200.00 filing fee. Be sure to use the new license number and have all attachments ready prior to starting the process. Review the Tutorial for submitting TPA annual report.
- TPA Annual Report Workbook (Microsoft Excel file)
- Insurers and HMOs that are authorized to act as a TPA, complete tab FIN487. All other TPA license holders, complete tab FIN486. All other exhibits must be completed regardless of license type.
- Audited financial statement;or
- For TPA license holders who receive less than $10 million annually as compensation for performing administrative services submit:
- (1) unaudited financial statement and
- (2) a completed Certification of Financial Statement for Administrators - FIN490
- Certification on company letterhead, signed by an Officer, Partner, or Sole Proprietor, stating that the information provided in the annual report filing is true and correct.
New process does not apply to Insurers and HMOs acting as TPAs. If you are an Insurer or HMO, upload the report via the Financial Filing Submission Portal and mail the filing fee. No financials are needed.
Email for official communication
All licensed administrators are required to maintain a business email for official communication (see TAC 1.1302(c)) If you need to update your email address, complete TPA Change of Address and/or Contact - FIN498 and email to the address at the bottom of the form.
Pharmacy Benefit Managers licensed as TPAs
Pharmacy Benefit Managers must file an annual report in accordance with Insurance Code Section 1369.502 concerning rebates, fees, and other payments by a PBM in the preceding calendar year.
Pharmaceutical Benefits Reporting
Other Forms
TPA Change of Address and/or Contact - FIN498
TPA Change of Control - FIN502 - In addition, submit a detailed letter explaining the proposed transaction, as well as proposed pre-acquisition and post-acquisition organizational charts.