I am replying to an old post, but it comes up on search engines so I thought maybe some people might benefit from the response:
Visit the link below for informaton about my company, which provides TPA licensing services. I've also provided some general information about TPA licensing requirements below the link. Currently, there are 41 states that have a TPA licensing requirement. Here's the link:
CRS Licensing (www.CRSlicensing.com) Generally, most states define a TPA as a company that collects premium and/or administers claims on behalf of residents of the particular state with respect to life or health insurance benefit plans. This definition varies from state to state, but that is a general definition that most states use to determine whether a TPA has to be licensed.
From there, some states allow exemptions from TPA licensure for administrators that solely administer self-funded employer plans where no insurance carrier is involved, while other states do require TPA licensure of those same administrators in their states. The impact of ERISA licensing preemptions, COBRA administration, stop loss insurance, and other factors can impact whether a particular TPA is required to be licensed in a given state. This is an area that is changing constantly and in which many of my firm's TPA clients come to us with questions and requests for research, etc..
Hope this is helpful.
Joe Patton
CRS Licensing