Overview

The Third-Party Administrator State Guide is a 51-state compilation of statutes and regulations addressing the relationship of third-party administrators (TPAs) with insurers, policyholders, and state regulators, such as the state insurance departments. Each state section of the guide includes an accessible list of more than 240 forms that TPAs use. To the extent available, the guide also references form numbers and revision dates as well as TPA contacts for each state. For insurers, the guide addresses: Contract Approval Filing Requirements with Insurance Departments Contract Requirements Authority to Terminate Contracts with a TPA Payment Restrictions to a TPA Notice Requirements for Terminating a TPA's Settlement Authority For TPAs, the guide addresses: Application Requirements Surety Bond Requirements Renewal Requirements TPA's Rights to Performance-Based Compensation Notification Requirements to Policyholders Claims Reporting Time Fames to Insurer Frequency of Electronic Transmission of Claims Files Time Frames for Delivery of Insurer's Communications to Policyholders Record Maintenance Requirements Reimbursement and Liability Insurance Requirements Prohibitions Penalties Grounds for Suspension or Revocation of a TPA's Certificate of Authority TPA's Rights Upon an Insurer's Liquidation, Rehabilitation, etc.

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