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The document is a Biographical Statement and Affidavit Form for non-traditional entities issued by the Office of Commissioner of Insurance in Georgia. It requires detailed personal, educational, and employment information from individuals associated with such entities, including questions about past affiliations with regulated insurance entities, ownership interests, licenses held, and any legal or disciplinary actions. The form emphasizes non-discrimination policies and provides contact information for assistance.
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A temporary license is available only to applicants for licensure by endorsement. See Chapter entitled Licensure by Endorsement. The applicant for a temporary license must submit a written request for a temporary license along with their application for licensure by endorsement and the appropriate fee.
A third-party administrator (TPA) company provides operational services under contract to another company. For example, health insurance companies tend to outsource their claims operations to third parties. TPAs also handle liability insurance claims.
A temporary license is available only to applicants for licensure by endorsement. See Chapter entitled Licensure by Endorsement. The applicant for a temporary license must submit a written request for a temporary license along with their application for licensure by endorsement and the appropriate fee.

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People also ask

TPA stands for Third Party Administrator and as such is defined as an organization or individual that handles the claims, processing, and reporting components of a self-funded health benefits plan. As an employer considers or maintains a self-funded health plan program they typically will engage the services of a TPA.
Section 33-23-100. Regulating insurance administrators practices in conformity with the general purposes of the Georgia Insurance Code.
tPA is a type of systemic thrombolytic agent. Also called tissue plasminogen activator.
What are the requirements in order to be Third Party Administrator in the State of Georgia? In order to obtain a Third Party Administrator License in Georgia, the applicant must complete an Application for License as an Administrator form, along with $500 for the application fee.
Third party administrators make a commission once premiums are paid to an insurer for health insurance coverage. Third party administrators can also request money for specific fees, while also making money through both fees and commission, based on the scope and number of services that they offer.

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