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Missouri third party administrator Form: What You Should Know

If you require additional information, please call. Contact information for the Missouri Department of Insurance If you have questions about any of the above or do not see an answer to your question in any of the above sections of this website, please call, e-mail or write to the appropriate department. Missouri Department of Commerce & Insurance Check our Filings Section for instructions on how to make new forms filings. TPA — Missouri Department of Commerce, Insurance & Financial Institutions This form must be completed and submitted by a third party administrator. The form identifies the applicant as an independent contractor. Third Party Administrator Bond, LLC • Form LLC-001-081 • 2024 SEC Annual Report Form LLC-001-082 • 2024 SEC Annual Report Form LLC-006-062 If required a bond. The information that is required on all forms submitted by third party administrators is to the effect that the applicant was not employed as an executive officer, officer of a member or member of the Board of Directors or Officer of an outside Principal. If you have questions about the requirements of another state, please check the website for that state.

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