A Texas third party administrator (TPA) certificate of authority is the authorization the Texas Department of Insurance (TDI) issues under Insurance Code Chapter 4151 before an entity may act as an administrator, meaning one that collects premiums or contributions from, or adjusts or settles claims for, Texas residents in connection with health, pharmacy and other listed benefits. It is for organizations that administer benefits and are applying for a Texas certificate of authority. Integral Healthcare Solutions (IHS) assembles your TPA application packet and drafts the operating procedures behind it; your counsel and finance team own classification and solvency.

Last reviewed: October 2026.

This work sits within IHS's Compliance Services. This page covers Texas. Other states are scoped separately.

What is a Texas TPA certificate of authority?

It is the license Chapter 4151 of the Texas Insurance Code requires of administrators. The statute defines the term: “‘Administrator’ means a person who, in connection with annuities or life benefits, health benefits, accident benefits, pharmacy benefits, or workers' compensation benefits, collects premiums or contributions from or adjusts or settles claims for residents of this state.” (Sec. 4151.001(1), source)

The duty to hold a certificate is in Sec. 4151.051(a): an entity “may not act as or hold itself out as an administrator unless the entity is covered by and is engaging in business under a certificate of authority issued under this chapter.” (source)

The governing texts, as read in October 2026:

• Texas Insurance Code Chapter 4151, Third-Party Administrators (statute).
• 28 TAC §7.1605, which TDI cites on its form page (TDI form page). IHS has not reviewed the rule text for this page.
• TDI form FIN489, “Application for Certificate of Authority”, for “entities wishing to obtain a certificate of authority to do business as an Administrator (TPA) in Texas” (source).

What the statute asks of an applicant

• Financial statements: the application must include “an audited financial statement of the applicant covering the preceding three calendar years or any lesser period that the applicant and any predecessors of the applicant have been in existence”, with an unaudited-statement alternative in the statute (Sec. 4151.052(a)(4), source).
• A fidelity bond: before the certificate issues, the applicant must “obtain and maintain a fidelity bond”, and the bond “may not be less than $10,000” (Sec. 4151.055, source).
• Written agreements: “An administrator may provide services only under a written agreement with an insurer or plan sponsor.” (Sec. 4151.101(a), source)
• Deficiencies: if the commissioner cannot approve, the commissioner shall “provide the applicant with written notice specifying each deficiency in the application” and “offer the applicant the opportunity for a hearing” (Sec. 4151.054(a), source).

How the application is filed

TDI says: “Apply online at www.Sircon.com. Review the Resident TPA or Non-Resident TPA tutorial” (source). TDI lists the required documents as the “Application for a Certificate of Authority - FIN489”; “Officers and Directors Page - FIN306”; “Use UCAA form 11 or TPA Biographical Affidavit - FIN484”; and “TPA Service of Process - FIN485 (foreign and alien applicants)” (source).

After licensure, TDI lists two recurring filings: “TPAs must file an annual report on or before June 30” and “Administrators must file a Texas Annual Insurance Maintenance, Assessment and Retaliatory Report with the Texas Comptroller on or before March 1” (source).

Who needs it and what triggers it?

An organization needs the certificate when what it does fits the statutory definition of an administrator and no exemption applies. The definition covers collecting premiums or contributions, or adjusting or settling claims, for Texas residents in connection with annuities or life, health, accident, pharmacy or workers' compensation benefits (Sec. 4151.001(1), source).

Exemptions are listed in the statute. TDI's 2007 FAQ, written when House Bill 472 took effect, said: “HB 472 excludes governmental entities, workers' compensation self-insurance groups, and processing agents meeting certain conditions. Twenty exemptions are specifically listed in §4151.002.” (source) That FAQ is dated 2007; read the current Sec. 4151.002 with your counsel. Whether an exemption fits your organization is counsel's call.

Triggers for this work: an initial certificate of authority or entry into Texas as an additional jurisdiction.

How IHS helps

IHS assembles your TPA application packet and drafts the operating procedures behind it; your counsel and finance team own classification and solvency. The work runs in this order:

1. Gap assessment against the state application: FIN489, its attachments and the Chapter 4151 application requirements.
2. Questionnaires on ownership, officers, delegated functions and complaints.
3. Document and evidence mapping: a crosswalk from each application item to the exhibit that answers it.
4. Drafting: complaint, delegation oversight, records and ongoing-filing procedures behind the application, for your leaders to review and approve.
5. Packet review: the assembled application read against the crosswalk before you file.
6. Readiness support: drafted cover correspondence, and drafted responses if TDI sends a deficiency notice, for your organization to send.

What your organization supplies: ownership and officer records, financial statements, service agreements, benefits counsel, and claims leadership.

The limits: solvency, legal classification (including whether an exemption applies) and claims decisions belong to your counsel and finance team. IHS does not file. Your organization files its own application on Sircon.

What to have ready

Each item ties to Texas Insurance Code Chapter 4151 or to TDI's TPA pages, as read in October 2026. The current statute and TDI's current instructions govern.

1. A completed FIN489, Application for a Certificate of Authority (TDI requirements).
2. A completed FIN306, Officers and Directors Page (TDI requirements).
3. A biographical affidavit for each required individual, on UCAA form 11 or TDI form FIN484 (TDI requirements).
4. FIN485, TPA Service of Process, if your organization is a foreign or alien applicant (TDI requirements).
5. Audited financial statements for the preceding three calendar years, or the shorter period your organization and its predecessors have existed (Sec. 4151.052(a)(4), statute). The statute also provides an unaudited-statement alternative; read Sec. 4151.052(a)(4) with counsel.
6. A fidelity bond of at least $10,000, in place before the certificate issues (Sec. 4151.055, statute).
7. Written agreements with each insurer or plan sponsor you serve (Sec. 4151.101(a), statute, governs providing services; this page did not confirm that the application requires copies).
8. A Sircon account and a review of TDI's Resident or Non-Resident TPA tutorial (TDI).
9. A counsel memo on whether your organization fits the administrator definition or an exemption (Secs. 4151.001 and 4151.002, statute).
10. A filing calendar for the annual report due June 30 and the Comptroller maintenance tax report due March 1 (TDI).
11. If your organization is an insurer or HMO already licensed in Texas, form FIN482 instead of a full application (TDI).

To walk through this list against your own records, start with the introductory call.

How it compares

Texas law and TDI describe more than one route for an organization that administers benefits. What the sources say about each:

Which route fits depends on your organization's licenses, structure and activities, and on your counsel's reading of the statute. IHS's process applies to whichever filing your organization makes. Related IHS work: compliance program development.

What does a Texas TPA certificate of authority cost?

The statute sets ceilings on TDI's fees, and TDI publishes the annual report fee. Sec. 4151.206(a) authorizes “a filing fee not to exceed $1,000 for processing an original application for a certificate of authority for an administrator”, “a fee not to exceed $500 for an examination” and “a filing fee not to exceed $200 for an annual report” (source). TDI's TPA page lists a “$200.00 filing fee” for the annual report (source).

The statute gives only a ceiling for the original application fee; IHS did not find the amount TDI currently charges on the pages reviewed. Other costs on your side include the fidelity bond (at least $10,000 in coverage, under Sec. 4151.055) and audited financial statements. Verify current fees with TDI.

IHS scopes each engagement after a free introductory call.

What this is not

• This page is not legal advice. Whether your organization is an administrator, or exempt, is a question for your counsel.
• IHS does not file with TDI or correspond with TDI. IHS drafts; your organization files and sends.
• IHS does not assess solvency, make claims decisions, or guarantee that TDI will issue a certificate.

Frequently asked questions

What is a third party administrator certificate of authority in Texas?

It is the authorization TDI issues under Texas Insurance Code Chapter 4151. Under Sec. 4151.051(a), an entity may not act as or hold itself out as an administrator unless it is covered by a certificate of authority issued under that chapter.

Does my company need a TPA license if we only process pharmacy or health claims for self-funded employers?

The statute defines an administrator as a person who, in connection with health, pharmacy and other listed benefits, collects premiums or contributions from or adjusts or settles claims for Texas residents. Sec. 4151.002 lists exemptions. Whether your activities fit the definition or an exemption is your counsel's call.

Who is exempt from Texas TPA licensing?

The exemptions are listed in Sec. 4151.002 of the Texas Insurance Code. TDI's 2007 FAQ on HB 472 said the law excludes governmental entities, workers' compensation self-insurance groups and processing agents meeting certain conditions, and counted twenty listed exemptions. That FAQ is dated, so read the current statute with counsel.

What forms are in a Texas TPA application?

TDI lists FIN489 (Application for a Certificate of Authority), FIN306 (Officers and Directors Page), UCAA form 11 or FIN484 (biographical affidavit), and FIN485 (TPA Service of Process) for foreign and alien applicants. The statute also requires audited financial statements, and a fidelity bond of at least $10,000 before the certificate issues.

How do I apply for a Texas TPA certificate of authority on Sircon?

TDI says to apply online at www.Sircon.com and to review the Resident TPA or Non-Resident TPA tutorial first. Your organization files; IHS drafts and reviews the packet before you do.

How long does Texas TDI take to approve a TPA application?

TDI does not publish a review timeline on the pages IHS reviewed. The statute says that if the commissioner cannot approve, the applicant receives written notice of each deficiency and an opportunity for a hearing.

What ongoing filings does a licensed Texas TPA have?

TDI lists an annual report due on or before June 30, with a $200.00 filing fee, and a Texas Annual Insurance Maintenance, Assessment and Retaliatory Report filed with the Texas Comptroller on or before March 1.

Can a licensed insurer or HMO act as a TPA without a separate certificate?

TDI says insurers or HMOs already licensed in Texas that want to act as a TPA should complete FIN482, Notification that an Insurer or HMO will be acting as an Administrator. Check the current TDI instructions with counsel before relying on that route.

What written agreements and records does a TPA need?

Sec. 4151.101(a) says an administrator may provide services only under a written agreement with an insurer or plan sponsor. The application statute requires audited financial statements for up to the preceding three calendar years, officer and director information, and biographical affidavits. The statute also provides an unaudited-statement alternative; read Sec. 4151.052(a)(4) with counsel.

Do we need a TPA license in every state where members live?

This page covers Texas only, and IHS has not reviewed other states' laws for it. Texas's definition turns on activity for residents of Texas. Each additional state is scoped separately, with your counsel.