THIRD PARTY ADMINISTRATORS

DEFINITION

In Wyoming, a Third Party Administrator (TPA) is defined as a company that directly or indirectly underwrites, collects charges, or adjusts or settles claims on residents of this state, in connection with life, annuity, health, or stop-loss coverage offered or provided by an insurer or Multiple Employer Welfare Arrangement (MEWA). Exceptions are outlined below.

Any questions on if a company qualifies as a TPA should be directed to Bryan Stevens at wydoitpa@wyo.gov.

EXCEPTIONS

  • An employer on behalf of its employees or the employees of one (1) or more subsidiary or affiliated corporations of such employer;

  • A union on behalf of its members;

  • A fully self-funded insurance plan meeting the definition of employee benefit plan as set forth in the Employee Retirement Income Security Act of 1974;

  • An insurance company licensed in this state;

  • A prepaid hospital or medical care plan;

  • An insurance agent or broker licensed in this state when acting as an insurance agent or broker;

  • A creditor on behalf of its debtors with respect to insurance covering a debt between the creditor and its debtors;

  • A bank, credit union or other financial institution which is subject to supervision or examination by federal or state banking authorities when acting as a bank, credit union or other financial institution and not as an administrator;

  • A credit card company which advances for and collects premiums or charges from its credit card holders who have authorized it to do so, provided such company does not adjust or settle claims;

  • A person who adjusts or settles claims in the normal course of the person’s practice or employment as an attorney at law or an adjuster licensed in this state and who does not collect charges or premiums in connection with insurance coverage or annuities.

LICENSING REQUIREMENTS

No TPA shall transact business in the State of Wyoming unless they are first licensed by the Wyoming Department of Insurance. Written acknowledgement is required for any TPA that does not meet the definition of a TPA in Wyoming.

No license will be granted to any TPA applicant unless they first have a contractual agreement with an admitted insurer or MEWA.

Any TPA that intends to offer sales of coverage will be required to obtain a producer license.

INITIAL APPLICATION

All applications should be submitted electronically via Sircon ↗. The required documentation below will need to be attached to the application. Any incomplete applications will not be approved.

  • $200 non-refundable registration fee.

  • A bond for not less than 10% of the actual or expected premium written within the State of Wyoming. The bond shall be no less that $1,000, and shall not exceed $500,000 unless a larger amount is deemed necessary by the commissioner for the protection of the citizens of Wyoming. Wyoming TPA Bond Form*

  • Audited financial statements for the TPA for the most recent 2 fiscal years, submitted in US GAAP format. The statements shall show that the TPA has a positive net worth and is financially responsible.

  • A Wyoming TPA Appointment Form* for each insurer or MEWA with which the TPA has a contractual agreement for coverage in the State of Wyoming.

  • A Wyoming TPA Contract Checklist* for each insurer or MEWA with which the TPA has a contractual agreement for coverage in the State of Wyoming.

  • A Wyoming TPA Funds Handled Disclosure* for the estimated amount of funds that will be handled by the TPA in the first year of operations within the State of Wyoming.

Any registration questions should be emailed to wydoitpa@wyo.gov.

LICENSE RENEWALS

Licenses renew every two years on March 31. For example, a license issued on June 4, 2020 would renew on March 31, 2022 and every even numbered year thereafter.

License renewals shall be submitted through Sircon ↗.

Renewal applications and supporting documentation must be submitted no later than March 31 in the renewal year. The required documentation below will need to be attached to the renewal application. Any incomplete renewal applications will not be approved.

  • $200 non-refundable renewal fee.

  • Audited financial statements for the TPA for the most recent 2 fiscal years prior to the renewal year, submitted in US GAAP format. The statements shall show that the TPA has a positive net worth and is financially responsible.

  • A Wyoming TPA Funds Handled Disclosure* for the actual amount of funds handled in the year immediately preceding the renewal year by the TPA within the State of Wyoming.

  • An updated Wyoming TPA Appointment Form* for each insurer or MEWA with which the TPA has a contractual agreement for coverage in the State of Wyoming.

  • Verification of continuation of bond, for which the amount shall be for no less that 10% of the funds handled in Wyoming or $1,000, whichever is more. The bond shall not exceed $500,000 unless a larger amount is deemed necessary by the commissioner for the protection of the citizens of Wyoming.

Any renewal questions should be emailed to wydoitpa@wyo.gov.