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 must also complete the TPA Application Checklist with application and renewal submissions. Those third-party administrators that are licensed or registered in another state which does not report licensure or registration to the Producer Database, must complete the Uniform Application for Business Entity License/Registration, complete the TPA Application Checklist, and create a filing in OPTins for a new application or renewal, submit the filing fee of 100.00, and upload all required documents. If you don't already have an OPTins account, you will need to contact OPTins to set up an account.
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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 of expiration date, a new third-party administrator application must be submitted. Renewals must be submitted online through the National Insurance Producer Registry (NIPR) and the TPA Application Checklist with required documents must be submitted electronically. If the renewal is not available on NIPR the renewal application and supporting documents must be submitted electronically through OPTins.
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.
Under Iowa Code section 510.21, a person is required to hold a certificate of registration to act as a third-party administrator in the State of Iowa. Iowa Administrative Code rule 191-58.3 allows exceptions to this requirement. To claim an exception please complete the Third-Party Exception from Registration Form.
The National Association of Insurance Commissioners (NAIC) site allows visitors to lookup a license.
Visit the NAIC's State Based Systems to print your license.
If you need assistance, please contact the Iowa Insurance Division.