Third Party Administrator (Life/Health)
- For existing life and health administrators, the renewal application has been updated. Form 111 has been replaced with Form E-111, available from this web page.
- Before applying for or renewing a Life and Health Administrator (TPA) license, you must first make sure that information about the TPA on the Arizona Corporation Commission web site is up to date. If the application contains information that is different from information maintained by the Arizona Corporation Commission, the application will be rejected.
- All applications must be completed on the computer. The computer will check the application to help make sure it is complete. Do not print your application until you have entered all required information on it.
ARS § 41-1030(G) requires most Arizona government agencies to prominently print the provisions of ARS § 41-1030(B), (D), (E) and (F) on all license applications. The following is the language in ARS § 41-1030(B), (D), (E) and (F):
B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition.
D. This section may be enforced in a private civil action and relief may be awarded against the state. The court may award reasonable attorney fees, damages and all fees associated with the license application to a party that prevails in an action against the state for a violation of this section.
E. A state employee may not intentionally or knowingly violate this section. A violation of this section is cause for disciplinary action or dismissal pursuant to the agency’s adopted personnel policy.
F. This section does not abrogate the immunity provided by section 12-820.01 or 12-820.02.