Third-party administrators (TPAs) collect charges of premiums in connection with life insurance coverage, health insurance coverage, and/or annuities. Third-party administrators may also adjust or settle claims for Iowa residents. Iowa Insurance Division administrative rules regarding third party administrators can be found in Iowa Administrative Code chapter 58.
Third-party administrators that are licensed or registered in another state may go online to the National Insurance Producer Registry (NIPR) to apply for a certificate of registration with the Iowa Insurance Division. Third-party administrators should review the TPA Application Checklist for Registration for application/renewal instructions. Those third-party administrators that are not licensed or registered in another state must complete the Uniform Application for Business Entity License/Registration, complete the TPA Application Checklist, and mail all documents with the application fee of $100 to the Iowa Insurance Division. Upon receipt by the Iowa Insurance Division, notification of approval is generally sent via email within 5-10 business days.
At the time of new application and upon renewal, all resident and non-resident third-party administrators are required to have an active, current surety bond. The bond must be in an amount equivalent to 10 percent of the third-party administrator's average daily client account balance during the preceding calendar year. In no case shall the bond be less than $50,000 or more than $1,000,000. The bond shall be payable to the Iowa Insurance Division to ensure the financial protection of the third-party administrator's customers, subject to the dollar limitation of the surety bond. A Certificate of Liability or a Fidelity (Crime) Bond will not be accepted in lieu of the required TPA surety bond.
Third-party administrators wishing to renew the registration must do so every three years. If a renewal is not completed within one calendar year, a new third-party administrator application must be submitted. Renewals must be submitted online through the National Insurance Producer Registry (NIPR). Once the renewal is submitted the TPA Application Checklist and documents must be emailed to the Iowa Insurance Division. If the renewal is not available on NIPR the renewal application and supporting documents must be mailed to the Iowa Insurance Division with the renewal fee of $100.
All third-party administrators must submit an annual report via Opt-Ins, and, include the verification form signed by two company officers by July 1 of every year. If the third-party administrator is acting as a pharmacy benefits manager the third party-administrator must also file a pharmacy benefits manager annual report, include the verification form, and upload the documents in Opt-Ins by February 15th of every year.
Should a third-party administrator wish to request an extension, the request must be submitted in writing to the Iowa Insurance Division at least ten days prior to the due date. Extensions may be granted in increments of 30 days if the insurer and its independent certified public accountants show good cause for an extension.
Iowa Administrative Code rule 191-58.12 requires a third-party administrator to provide written notification to the Iowa Insurance Division within 30 days of change in company name, address or company officers. When making a company name change, the third-party administrator must submit amended articles of incorporation/organization, a surety bond rider reflecting the new company name, and change in FEIN (if applicable). For any changes in company officers, please complete the TPA Company Officers/Directors Notice of Change Form. For changes in company address, please complete the TPA Change of Address Form.
A third-party administrator shall maintain at its principal administrative office adequate books and records in accordance with prudent standards of insurance recordkeeping.
All companies functioning under the ERISA Taft Hartley Act are exempt from registration requirements, however, they must complete the Third-Party Affidavit Form and file it with the Iowa Insurance Division. Iowa Administrative Code rule 191-58.3 lists other exemptions to the registration requirements.
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If you need assistance, please contact the Iowa Insurance Division.