Skip to Top Main Navigation Skip to Left Navigation Skip to Content Area Skip to Footer
Texas Department of Insurance
Topics:   A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All

Third Party Administrator Companies

Third Party Administrator (TPA) Agent's

Registered by Agent and Adjuster Licensing.  Email:

Company Licensing TPA Forms


The third party administrator company must first be formed at the Texas Secretary of State's Office.

Submit evidence along with:

Insurers and HMOs, use Notification that an Insurer or HMO will be acting as an Administrator - FIN482

All others,use Application for a Certificate of Authority - FIN489

Company Licensing Fee Transmittal Form - FIN321

Fingerprinting requirements

Other Forms

TPA Biographical Affidavit - FIN484

TPA Service of Process - FIN485

TPA Change of Address and/or Contact - FIN498

TPA Name Change - FIN499

TPA Change of Control - FIN502

License Duration

TPA licenses do not expire.  There is no annual renewal; however, you must comply with annual reporting requirements.

To surrender your license, submit Surrender of Third Party Administrator Certificate of Authority - FIN497 to

Annual Reporting

March 1 - Report to Texas Comptroller

TPA license holders must file a Texas Annual Insurance Maintenance, Assessment and Retaliatory Report with the Texas Comptroller on or before March 1. 

June 30 - Annual Report to TDI

TPA license holders must file an annual report with TDI each year on or before June 30.

Instructions for Filing the Third Party Administrators Annual Report - FIN500 

Company Licensing Fee Transmittal Form - FIN321

TPA Annual Report Workbook (Microsoft Excel file)

  • Insurers and HMOs that are authorized to act as a TPA, complete tab FIN487. All other TPA license holders, complete tab FIN486. All other exhibits must be completed regardless of what other types of TDI certificates of authority held.
Submit to

Pharmacy Benefit Managers licensed as TPAs

Pharmacy Benefit Managers must file an annual report in accordance with Insurance Code Section 1369.502 concerning rebates, fees, and other payments by a PBM in the preceding calendar year.

Pharmaceutical Benefits Reporting 

Third Party Administrator Statutes and Regulations

Texas Insurance Code Chapter 4151

Texas Administrative Code, 28 TAC §§ 7.1601-7.1618

For more information, contact:

Last updated: 8/4/2022