Utah Third Party Administrators (TPA) Survey Instructions & Form
Who is required to file?
How to get the survey?
How to file the survey?
The Utah Third Party Administrator Survey is a new state specific annual filing for licensed Third Party Administrators. Currently, there is no annual source of information on the business activity of Utah’s licensed third party administrators. This information will be used to assist the Utah Insurance Department in its current regulatory responsibilities. The purpose of this survey is to provide more detailed information on Utah’s third party administrator business than is currently reported to any Utah government agency.
Who is required to file?
All licensed third party administrators in Utah are required to file this survey. The completed survey is due September 9, 2009. Failure to file by the deadline may subject your company to the enforcement penalties under Utah Code Annotated § 31A-2-308.
How to get the survey?
Please download the survey form using the link available below. The survey instructions are included in the survey form. The survey form with instructions is available in Microsoft Excel format. The signature form is available in Adobe PDF format.
Right Click on the web links below to download the file to your computer. Do not attempt to enter the data as an online form as it will not be saved.
Survey Form (with Instructions) in Microsoft Excel format: <TPA Survey form>
Signature Form in Adobe PDF form: <TPA Signature form>
How to file the survey?
Once the survey is completed, send the survey file via email to boscarson@utah.gov.
If you have any questions, please contact:
Brent Oscarson at (801)538-3195 or boscarson@utah.gov)