Exemptions

Those who collect charges or premiums from or adjust / settle claims on residents of this state in connection with life / health insurance or annuities, and are acting directly through their officer(s) and employees, are exempt from holding a third-party administrator (TPA) license. However, a Notice of Exemption (Form 1200) must be completed and submitted to the Special Licensing Office at our department.

TPAs administering only single-employer, self-funded (ERISA) plans, or Section 125 Cafeteria Plans, are not required for licensure. The United States Internal Revenue Department regulates Section 125 Cafeteria Plans. Section 38-51-10 provides a detailed list of those who are exempt from the licensing requirements.