The SC Department of Insurance does not support Internet Explorer for Online Applications

Third Party Administrator Licensing Information

S.C. Code 38-51-10/120(Supp. 1995) requires insurance administrators for life and health insurance and annuities to be licensed and regulated by the Director of Insurance. This memorandum is intended to set forth the Department's requirements of those persons making application for an administrator's license.

Application for license is made on (Form No. 1030). The application must be signed by the President if the administrators is a corporation; a partner if the administrator is a partnership, and the individual proprietor in the case of a sole proprietorship. The information furnished on the application must be given under oath.

In addition, the items shown below must be furnished with the application. They are as follows:

  • Request an application packet for a TPA license from the Department of Insurance (SCDOI) at 803.737.6134.

  • Review Chapter 51 of the SC Code of Laws to determine if you are required to register. If no, complete TPA exemption form (Form No#1200). If yes, go to Item#3

  • Complete Application (Form No#1030). Application must disclose a contact person.

  • Submit all applicable organizational documents. Documents must be original or certified copies. Include partnership agreements; articles of incorporation, certified by your Secretary of State; Certificate of Good Standing/Certificate of Authority from the SC Secretary of State; trade name certificate; trust agreement; shareholder agreement; and other applicable documents and all amendments to those documents. You contact the SC Secretary of State Office at 803.734.2158.
  • List the names, addresses, and official titles of positions held by individuals who are responsible for the conduct of the affairs of the Administrator.

  • Submit one copy of individual biographical affidavit (Form No# 1000c) on each officer/director listed in item #5.

  • Indicate if the Administrator plans to utilize a fictitious or “d.b.a” name. If so attach a certified copy of the Certificate from the Clerk of the Circuit Court in the county where domiciled.

  • Submit the original copy of a surety bond ($75,000 Form No#1029) issued by an insurer licensed in South Carolina. In addition, you may pledge a Letter of Credit (LOC), Certificate of Deposit (CD) or Corporate Guaranty Letter of Credit (all in the amount of $75,000) CDs and LOC must be with a South Carolina bank Note: Under no circumstances will this requirement be waived. The bond must include a 30-day notice of cancellation to the SCDOI.
  • Submit a copy of your financial statement (two most recent calendar years). Include Balance Sheet and Income Statement. An officer of the company must sign financial Statement.
  • Submit a copy of written service agreement between administrator and insurer, or client. If applicant is not currently acting as an administrator, submit a statement indicating no written agreement has not been executed.

All inquires concerning the licensing matter of this application should be referred to the Special Services Division, Post Office Box 100105, Columbia, South Carolina 29202-3105. Phone (803) 737-6134.