PURPOSE: This rule prescribes the process and forms to be used by a third-party administrator in applying for a certificate of authority to transact business in Missouri.

1. (1) A third-party administrator must complete an application for a certificate of authority, accompanied by a fee in the amount of one thousand dollars ($1000), along with all the documents requested by the application form, including a notarized Biographical Affidavit to be completed and 20 CSR 200-9

signed by the appropriate persons, a completed Notification of Insurer/Trust Agreements form (see 20 CSR 200-9.800), a completed TPA Questionnaire, and a completed TPA 376.1092 Form. The above-referenced forms are available on the department’s website or by contacting the department.

1. (2) Each application also must be accompanied by an audited financial statement or report for the two (2) most recent fiscal years in accordance with sections 375.1025– 375.1062, RSMo, showing the current financial condition of the applicant. If the applicant has been in existence for fewer than two

2. (2) fiscal years, this requirement may be satisfied by the provision of financial statements or reports, certified by an officer of the applicant and prepared in accordance with generally accepted accounting principles (GAAP) or the statutory statement of accounting principles (SSAP), for each completed fiscal year and for each month during the current fiscal year for which such financial statements or reports have been completed. An audited financial/annual report prepared on a consolidated basis shall include a columnar consolidating or combining worksheet filed with the report including:

   1. (A) Amounts shown on the consolidated audited financial report shown on the worksheet;
   2. (B) Amounts for each entity stated separately; and
   3. (C) Explanations of consolidating and eliminating entries.
3. (3) The amount of the surety bond prescribed by section 376.1092.7, RSMo, is fifty thousand dollars ($50,000). A third-party administrator that is an affiliate or subsidiary of an insurance company licensed in this state need not file such a bond so long as the director is satisfied with the financial condition of that insurance company. If exempt from the surety bond filing requirement, a third-party administrator must submit in writing the name of the insurance company with whom the third-party administrator is affiliated.

AUTHORITY: sections 374.045 and 376.1095, RSMo 2016.* Original rule filed Dec. 13, 1993, effective Aug. 28, 1994. Amended: Filed April 23, 1999, effective Nov. 30, 1999. Amended: Filed Jan. 8, 2019, effective July 30, 2019.

*Original authority: 374.045, RSMo 1967, amended 1993, 1995, 2008 and 376.1095, RSMo 1993, amended 1995. FINANCIAL INSTITUTIONS AND Division 200—Insurance Solvency and PROFESSIONAL REGISTRATION Company Regulation