§ 27-1-25-11.1 — Resident third party administrator license; application; refusal to issue license; notice of material change; bond

Indiana § 27-1-25-11.1

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 1: DEPARTMENT OF INSURANCE
• Ch. 25: Insurance Administrators

Text

1. (a) If the home state of a person is
Indiana, the person shall:
(1) apply to act as an administrator in Indiana upon the uniform
application for third party administrator license;
(2) pay an application fee in an amount determined by the
commissioner; and
(3) receive a license from the commissioner;
before performing the function of an administrator in Indiana. The
commissioner shall deposit a fee paid under subdivision (2) into the
department of insurance fund established by IC 27-1-3-28.
(b) For the purposes of this section:
(1) if:
(A) an administrator is incorporated in Indiana; or
(B) Indiana is the administrator's principal place of business
within the United States;
the administrator shall apply to Indiana for a resident
administrator license; and
(2) if:
(A) neither the state in which an administrator is incorporated
nor the state that is the administrator's principal place of
business have adopted this chapter or a substantially similar law
governing administrators; and
(B) the administrator has not designated any other state that has
adopted this chapter or a substantially similar law governing
administrators as its home state;
the administrator shall apply to Indiana for licensure as its
designated home state.
(c) The uniform application for third party administrator license
must include or be accompanied by the following:
(1) Basic organizational documents of the applicant, including:
(A) articles of incorporation;
(B) articles of association;
(C) partnership agreement;
(D) trade name certificate;
(E) trust agreement;
(F) shareholder agreement;
(G) other applicable documents; and
(H) amendments to the documents specified in clauses (A)
through (G).
(2) Bylaws, rules, regulations, or other documents that regulate
the internal affairs of the applicant.
(3) The NAIC biographical affidavits for individuals who are
responsible for the conduct of affairs of the applicant, including:
(A) members of the applicant's:
(i) board of directors;
(ii) board of trustees;
(iii) executive committee; or
(iv) other governing board or committee;
(B) principal officers, if the applicant is a corporation;
(C) partners or members, if the applicant is:
(i) a partnership;
(ii) an association; or
(iii) a limited liability company;
(D) shareholders or members that hold, directly or indirectly, at
least ten percent (10%) of the:
(i) voting stock;
(ii) voting securities; or
(iii) voting interest;
of the applicant; and
(E) any other person who exercises control or influence over the
affairs of the applicant.
(4) Financial information reflecting a positive net worth,
including:
(A) audited annual financial statements prepared by an
independent certified public accountant for the two (2) most
recent fiscal years; or
(B) if the applicant has been in business for less than two (2)
fiscal years, financial statements or reports that are:
(i) prepared in accordance with GAAP; and
(ii) certified by an officer of the applicant;
for any completed fiscal years and for any month during the
current fiscal year for which financial statements or reports
have been completed.
If an audited financial statement or report required under clause
(A) or (B) is prepared on a consolidated basis, the statement or
report must include a columnar consolidating or combining
worksheet that includes the amounts shown on the consolidated
audited financial statement or report, separately reported on the
worksheet for each entity included on the statement or report, and
an explanation of consolidating and eliminating entries.
(5) Information determined by the commissioner to be necessary
for a review of the current financial condition of the applicant.
(6) A description of the business plan of the applicant, including:
(A) information on staffing levels and activities proposed in
Indiana and nationwide; and
(B) details concerning the applicant's ability to provide a
sufficient number of experienced and qualified personnel for:
(i) claims processing;
(ii) record keeping; and
(iii) underwriting.
(7) Any other information required by the commissioner.
(d) An administrator that applies for licensure under this section
shall make copies of written agreements with insurers available for
inspection by the commissioner.
(e) An administrator that applies for licensure under this section
shall:
(1) produce the administrator's accounts, records, and files for
examination; and
(2) make the administrator's officers available to provide
information concerning the affairs of the administrator;
whenever reasonably required by the commissioner.
(f) The commissioner may refuse to issue a license under this
section if the commissioner determines that:
(1) the administrator or an individual who is responsible for the
conduct of the affairs of the administrator:
(A) is not:
(i) competent;
(ii) trustworthy;
(iii) financially responsible; or
(iv) of good personal and business reputation; or
(B) has had an:
(i) insurance certificate of authority or insurance license; or
(ii) administrator certificate of authority or administrator
license;
denied or revoked for cause by any jurisdiction;
(2) the financial information provided under subsection (c)(4)
does not reflect that the applicant has a positive net worth; or
(3) any of the grounds set forth in section 12.4 of this chapter
exists with respect to the administrator.
(g) An administrator that applies for a license under this section
shall immediately notify the commissioner of a material change in:
(1) the ownership or control of the administrator; or
(2) another fact or circumstance that affects the administrator's
qualification for a license.
The commissioner, upon receiving notice under this subsection, shall
report the change to the centralized insurance producer license registry
described in IC 27-1-15.6-7.
(h) An administrator that applies for a license under this section and
will administer a governmental plan or a church plan shall obtain a
bond as required under section 4(g) of this chapter.
(i) A license that is issued under this section is valid:
(1) for one (1) year after the date of issuance, unless subdivision
(2) applies; or
(2) until:
(A) the license is:
(i) surrendered; or
(ii) suspended or revoked by the commissioner; or
(B) the administrator:
(i) ceases to do business in Indiana; or
(ii) is not in compliance with this chapter.

Legislative History

As added by P.L.160-2003, SEC.15. Amended by P.L.11-2011, SEC.19; P.L.124-2018, SEC.48; P.L.158-2024, SEC.9.