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Texas Department of Insurance
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Third Party Administrator Companies

Third Party Administrator (TPA) Agents

Registered by Company Licensing. Email:

Company Licensing TPA Forms

Please note, the email address is no longer being used.


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

Submit evidence along with:

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 - In addition, submit a detailed letter explaining the transaction, as well as, before and after organizational charts.

License Duration

TPA licenses do not expire. There is no annual renewal, but there are 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 on or before June 30. Upon submission, you will receive an automated receipt email. There will be no other communication regarding your annual report.

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: 12/2/2022