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For TPA licenses, as per C.G.S. 38a-720j(b), please upload the following to the NAIC “Attachment Warehouse” once you’ve submitted an application:

• All basic organizational documents of the applicant, including: any articles of incorporation, articles of association, partnership agreement, trade name certificate, trust agreement, shareholder agreement and other applicable documents and all amendments to such documents.
• The bylaws, rules, regulations, or similar documents regulating the internal affairs of the applicant.
• NAIC biographical affidavits for the individuals responsible for the conduct of affairs of the applicant, including (A) all members of the board of directors, board of trustees, executive committee or other governing board or committee, (B) the principal officers in the case of a corporation or the partners or members in the case of a partnership, association or limited liability company, (C) any shareholders or member holding directly or indirectly ten per cent or more of the voting stock, voting securities or voting interest of the applicant, and (D) any other person who exercises control or influence over the affairs of the applicant.
  1. Any Affidavits that have already been provided to the Department in previous years do not need to be re-provided. If all have already been provided to us, please provide a list of personnel who fall into categories A-D above instead.
  2. If submitting a new affidavit, it must be signed & notarized within the last 12 months.
• A statement describing the business plan of the applicant, including information on staffing levels and activities proposed in this state and nationwide. The plan should provide details setting forth the applicant’s capability for providing a sufficient number of experienced and qualified personnel in the areas of claims processing, record keeping and underwriting.
• A current Certificate of Good Standing from your domiciliary state that has been issued within the last 12 months.
• Evidence of the required surety bond or audited financial statements; The TPA applicant must execute a surety bond in the amount to be determined by the Commissioner, but (1) sufficient to protect insurers or others using TPA services and (2) not less than $500,000. A TPA must maintain the bond as a condition for license renewal. The Commissioner may waive the bond requirement if the TPA applicant submits audited financial statements for the two most recent fiscal years that prove the TPA has a positive net worth.
• Submit all required licensing supportive documentation through the NIPR warehouse or send via fax to 860-297-3872 or send via email to CID.TPA@CT.GOV. Please do not send any documents or correspondence via regular mail—it will be returned.

After completing the NIPR online application, you must complete the additional TPA registration form.

Submit all required licensing supportive documentation through the NIPR warehouse or send via fax to 860-297-3872 or send via email to CID.TPA@CT.GOV. Please do not send any documents or correspondence via regular mail—it will be returned.

The documentation requirements for new and renewal TPA License applicants are identical.

If you elect to place the following documents in the Attachment Warehouse, we will not request them every year unless there has been a significant change to those documents: Organizational Documents, Bylaws/Operating Agreement, Business Plan.

Documents may also be submitted to us via Secure Fax (860.297.3872) or e-mail (cid.tpa@ct.gov). Please do not mail paper documents to us, as we do not accept documents sent in this manner for TPA licensing or registration.

As C.G.S. 38a-720j states, the purpose of the bond is to “to protect insurers and other persons utilizing the services of the third-party administrator”. With that in mind, we are looking for a Surety Bond for the protection of the consumers of the State of Connecticut. Crime bonds, insurance coverage, etc. are not acceptable replacements, as they protect the TPA.

No license may be issued or renewed until such time as all required documentation is submitted and reviewed. There is no way to issue or renew a license pending receipt of required documents. All licenses and registrations expire on September 30 of each year, and we review applications in the order in which they are received. For this reason, you may wish to consider submitting your application and supporting documents through the NIPR warehouse in advance of your license’s expiration date. The NIPR system opens 90 days before the actual expiration date.

TPA’s are not permitted to have a DBA. The license must be issued in the actual business name being used. If the TPA is using more than one business name, then there should be a license or registration application submitted for each name.

No. C.G.S. 38a-720j(a)(2) states that in the event that two years of audited financial are submitted, “The Commissioner may waive the requirement to execute such surety bond…” The decision to waive the Bond requirement is at the Department’s discretion. Also, we are unable to consider this option unless the previous two years’ audited financials show a positive net worth.

Please contact NIPR at customerservice@nipr.com or (855) 674-6477.

We are unable to offer this type of assistance. Please speak with your legal counsel or company Compliance Officer to make this determination.

Once a TPA license or registration has lapsed or cancelled, it cannot be “late renewed”. Please apply as “new” via National Insurance Producer Registry (NIPR).

Please complete the Voluntary Surrendered Request and email to: cid.tpa@ct.gov, Attn: TPA voluntary surrender.