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You are here: www.tdi.texas.gov . licensing . company . agtpa1

THIRD-PARTY ADMINISTRATORS (TPAs)

***** NOTICE *****

Tax Forms, Filings, Inquiries

TPA Maintenance Taxes

Maintenance Tax Form

You may download a weekly-updated list of all currently licensed third party administrators in a Zip file format.

Mailings & Requests

Filings With Money Send To:
TPA/Premium Finance, MC 9999
Texas Department of Insurance
P.O. Box 149104
Austin, Texas 78714-9104

Filings Without Money Send To:
TPA/Premium Finance, MC 305-TPA/PF
Texas Department of Insurance
P.O. Box 149104
Austin, Texas 78714-9104

Filings Sent Overnight
With Money Send To:
TPA/Premium Finance, MC 9999
Texas Department of Insurance
333 Guadalupe Street
Austin, Texas 78714-9104

Filings Sent Overnight
Without Money Send To:
TPA/Premium Finance, MC 305-TPA/PF
Texas Department of Insurance
333 Guadalupe Street
Austin, Texas 78714-9104

Direct inquiries To:
Phone 512-305-7521
FAX 512-322-5026
Email TPA@tdi.texas.gov

JUNE 30TH IS THE DEADLINE
FOR FILING THE TPA ANNUAL REPORT.
(There are no provisions for an extension.)
HARD-COPY ANNUAL REPORT FORMS WILL NOT BE MAILED TO YOU.

Please download blank forms from our Forms Page.

The due date for the TPA Annual report is June 30th (see Texas Insurance Code §4151.205, and 28 Texas Administrative Code §7.1609). This filing requires a $200 filing fee and the following forms:

For TPAs (not insurers)

  • FIN 486, Annual Report Form for Administrators Holding a Certificate of Authority under TIC 4151;
  • FIN 488, Annual Report Exhibits A-E;
  • FIN 306, Officer and Directors Page;
  • FIN 490, Certification of Financial Statement (if submitting unaudited financials);

or

For TPAs (that are insurers)

  • FIN 487, Annual Report Form for Insurers and HMOs Subject to 28 TAC §7.1605; and
  • FIN 488, Annual Report Exhibits A-E

These forms can be found at the link located at the bottom of this page, "General Forms used by TPAs". Be reminded that the maintenance tax filing is due March 1st to the Texas Comptroller's Office. Maintenance tax fees and reporting should include all workers' compensation fees. Line 12 is the only line applicable to to TPAs.

DEFINITION

Generally, an "administrator" is a person who, in connection with annuities or life benefits, health benefits, accident benefits, pharmacy benefits, or workers' compensation benefits, collects premiums or contributions from or adjusts or settles claims for residents of this state.

STATUTE AND RULES

The TPA statute, Texas Insurance Code (TIC) Chapter 4151, is available for viewing and printing at Texas Insurance Code. The TPA rules are available for viewing and printing at Texas Administrative Code, 28 TAC §§ 7.1601-7.1618.

These rules establish the licensing, contracting, auditing, reporting, and other requirements of the TIC 4151 for all administrators, including administrators with delegated duties in the workers' compensation system.

Please note that although we make every attempt to insure the currency of the code references on this page, they should be used only as guides. The TAC is subject to change as needed, and the TIC changes a few months after a legislative session.

TPA FORMS

Note: All TPA-related forms are available on the TDI Forms Page. Need software to view files?

  • For your convenience most of the forms on the Forms Page are in an interactive .pdf format which are designed to be viewed, completed, printed and mailed.
  • The Annual Report Exhibit form may be downloaded, completed and emailed back to TPA@tdi.texas.gov. The other forms must be downloaded, completed, printed, and mailed back to the applicable return address with any required fees.

These forms are legal documents and should not be edited. Printed copies of these forms may be requested from the Department. Please allow 10 days for processing.



For more information contact:

Last updated: 09/06/2014

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Translation by WorldLingo


Translation by WorldLingo