Third Party Administrator

Resident/Nonresident

• Initial Application
  • Compliance Officer (DRP)
  • Firm
• Renewal:
  • Individuals - Please file the NAIC Uniform Renewal Application and note at the top of form "TPA Renewal". The renewal fee is $300.
  • Firms - Please contact the division to obtain a duplicate copy of your renewal form.
• Other Forms:
  • Third Party Administrator Exemption Form
  • Third Party Administrator Quarterly Filing Form
  • ERISA Annual Exemption Filing Form