Saturday, April 26, 2014

Why The TPA License Renewal Compliance Is Important

By Eloise Hewitt


Third party licensing regulations are currently used in about 44 states. They are regarded by many organizations as very tiresome and inconvenient. This explains why many businesses will contract the service of a consultant in securing the registration or the renewal thereof. Consultants are quite experienced and fast in this aspect. TPA license renewal compliance varies from state to state, although there are some close similarities.

Some information is often required by many states as a whole. It is therefore important to obtain a specific checklist concerning the state in which you intend to be licensed or renewed. The checklist and license guidelines save time that could otherwise be wasted in compiling unnecessary information and documents. Some of which may not be needed, according to your states of interest.

The commissioner of commerce is the ultimate assessor as to who is eligible for the registration. The commissioner, upon application, satisfies whether the administrator is able to offer deliver third party administration or not. This is particularly based on the financial position of the administrator, that is, should be solved. The ability to process claims in timely and equitably is also a vital factor.

The conduct of the administrator in the previous periods also matters. For registration, the administrator is required by law to maintain a file of the dealings with clients. If such record is not satisfactory, then the application stands a chance of being scraped. The report illustrates the kind of services the administrator served to his clients within the period.

The required reports are embodied in an annual activity report that is filed within the last sixty days of the year. The report states the name and physical address of the clients that the licensee administered in the state during the previous year. Also, the area and the type of service performed to each plan and the commencing and termination dates each client was served. It is presented in the form of a letter bearing the company name and date on it.

The administrative incense shall be deemed to operate for a period of not more than 12 months. This starts immediately upon renewal. In many states, the reinstatement entails filing and submitting the following documents; an application form, bond continuation form, certificate of TPA licensing in home state, a list showing names and the address of individuals permitted to act at as agents. In case of any administrative action against you by any state, it is required that you append a copy of the same application.

Sometimes the home state may not exercise third party licensing. In this case, it is prudent to just indicate the state concerned and provide evidence that it is indeed licensed. It is also important to evidence the renewal of a bond. This is often the case with when presenting the continuation certificate for bonds. Changes in bonds should also be reflected through attaching a copy of the new state.

Every applicant is required to pay a renewal fee. The fee, currently stands at 100 dollars per license. In filing the application form, provide the information accurately and honestly. Other than this, there is need for clarifying the third administrator party status. Also, ensure to fill all the relevant fields and provide the name and contact of a resource person that can clarify any inquiries when necessary. It is always important to retain a copy of the same for future reference and follow up.




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