Third-Party Administrator (TPA) Application Instructions

The Nevada Division of Insurance (Division) has provided the TPA Application Checklist and Instructions that must be incorporated into the application packet or electronic folder. The TPA application must be bound, numbered and tabbed according to the Checklist or it will be returned without being reviewed. Electronic versions must be identified, organized and numbered according to the Checklist as subfolders.

Application Fee:

The Certificate of Registration for a TPA license is $185. Fees are payable by check, money order or electronic funds transfer to the Nevada Division of Insurance; please contact ifn@doi.nv.gov for the Incoming Funds Deposit Notification form which must be submitted for electronic funds transfers. Fees are also payable through Sircon at www.sircon.com if the application is submitted online. (Additional online fees may apply.) Fees are nonrefundable.

Application may be submitted by:

• Sending your completed application with Checklist and fee payment to:
• Nevada Division of Insurance
  1818 East College Pkwy., Ste. 103
  Carson City, NV 89706
• Submitting the complete organized and numbered application documents via email to the analyst listed under Contact Information.