Third-Party Administrators, A State Legal Guide, 2024 Edition

IMPORTANT NOTE: Please do not repurchase this guide if you are a current TPA subscriber.

The 2024 edition of the "Third-Party Administrators State Guide" is available electronically on Payhip.com and is available in print on Amazon.com. If you purchased a print copy, you may return to Payhip.com to purchase the form links.

The "Third-Party Administrators 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.

The TPA guide exceeds 600 pages and intended for informational purposes only. It should not be construed as the rendering of legal advice. Due to complexity of TPA laws and regulations, it is recommended that you consult with your legal counsel to ensure compliance with state laws and any associated rules or regulations.

This guide is non-returnable and non-refundable once purchased.