The Maine Bureau of Insurance provides on this page all of the information necessary to license a Third Party Administrator (TPA). Contact Us if you have questions or are unable to find what you are looking for.
- TPA Application Checklist (PDF) or TPA Application Checklist (DOCX)
- TPA License Application - with Exhibits (PDF) or TPA License Application - with Exhibits (DOCX)
- TPA Contract Certification (PDF) or TPA Contract Certification (DOCX)
- TPA Bond (PDF) or TPA Bond (DOCX)
- Bond Calculation (PDF) or Bond Calculation (DOCX)
NOTE: Foreign Corporations, Foreign Limited Partnerships, Limited Liability Companies, or Limited Liability Partnerships (Title 31 §852) may also be required to apply to the Maine Secretary of State for authority to do business in Maine. See Secretary of State website for additional information. http://www.maine.gov/sos/cec/corp.
TPA license renewals are due May 1st of each year and the renewal notices are generally mailed by the end of March. Renewals cannot be completed online at this time and must be returned to the address indicated on the renewal notice. Included within the renewal notice is a bond calculation that must be completed, signed and returned to the Bureau of Insurance. Complete instructions for renewal payment and bond calculation are included within the renewal notice.
- Company Renewal Dates and Fees (PDF)
- Fee Schedule - (Scroll to Item 18)
- Authorization of Credit Card Payment (PDF) or Authorization of Credit Card Payment (DOCX)
- Third Party Administrator (TPA) Report -- Health Claims Paid by Plan Sponsor (Note: This TPA report form is different than the annual TPA license renewal that requires a fee). The report is due annually by April 30th. This report must be filed by all TPAs with authority to administer Health claims in Maine.
The documents on this page are also available in hard copy by contacting the Bureau.