Every third-party administrator is required to renew its license by March 1 of each year. The following information must be submitted to the department before March 1. Renewals received after March 1 are subject to administrative disciplinary action. If you wish to surrender your license, please contact the department for instructions.
Please note: All signatures and documents must be original. Documents with reproduced or stamped signatures will not be accepted. Faxed documents will also not be accepted.
The application must be signed by the president if the administrator is a corporation; a partner if the administrator is a partnership; and the individual proprietor in the case of a sole proprietorship. The information furnished on the application must be given under oath. The application must disclose a contact person. Incomplete or improperly competed applications will not be accepted.