Third Party Administrators

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.

Application Information

• 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)

Corporate Authorization to do Business in Maine

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.

Renewal Information

TPA license renewals are due May 1st of each year and the renewal notices are generally sent by the end of March.  Renewal notices will be emailed to those that have provided an email address; those that have not provided an email address will receive their notice by mail.  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.

Fees

• 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)

General Information for Third Party Administrators

• Possible Additional Licenses Required for Third Party Administrators (PDF)

Data Reporting Requirements

• 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.
  • Instructions (PDF)
  • Reporting Form (XLSX)

Change your contact information / Request copy of license

• Change your contact information
• You will need your Maine registration number and Access Code.  License copies can be downloaded or emailed; you will get to choose the preferred method of delivery. 

Requesting Confidential Treatment of Documents

• Instructions for requesting confidential treatment of documents

Statutory Requirements

• Title 24-A M.R.S.A. Chapter 18 "Insurance Administrators"

The documents on this page are also available in hard copy by contacting the Bureau.