Third Party Administrator (or “TPA”)
Before submitting your application:
An individual applicant must obtain fingerprints, schedule an appointment online at http://www.fieldprinthawaii.com. Fees collected by Fieldprint include state and federal submission fees. Effective September 1, 2018, all applicants must enter the code “HI-DCCA-INS” that identifies the Insurance Division as the intended recipient of your fingerprint result, when scheduling an online appointment with Fieldprint.
Effective March 12, 2021, you may apply electronic and pay fees with a credit card at http://nipr.com/ or submit paper application (see instructions below). For more information, please refer to Commissioner’s Memorandum 2021-2 LIC)
To apply electronically:
- Go to http://nipr.com/ and apply for the license.
- Submit TPA CHECKLIST through NIPR’s Attachments Warehouse. TPA CHECKLIST (including Surety bond form) can be obtained at https://cca.hawaii.gov/ins/producers/forms/. Check appropriate boxes on the form and complete the checklist to assure completion of application filing. A completed checklist must be accompanied with all documents required on the checklist and submitted through NIPR’s Attachments Warehouse.. Incomplete TPA checklist will not be processed.
To submit by paper (mail in):
- TPA CHECKLIST/APPLICATION PACKET– one with original signature(s) on the application
- Licensing Fees for business entities, or Licensing Fees for individuals. Contact the Hawaii Insurance Division at 808-586-2788 to verify the applicable fees. Make check payable to the Department of Commerce & Consumer Affairs.
NOTE: All of the items listed in the TPA CHECKLIST/APPLICATION PACKET must be submitted together as an application packet. Incomplete application packet will not be processed.
You may renew electronic at http://nipr.com/ or submit by paper.
To renew by paper (mail in):
- Renewal fee: make $300 check payable to Department of Commerce and Consumer Affairs
- Mail renewal notice and check to: Insurance Division, 335 Merchant Street, Room 213, Honolulu, HI 96813
TPA shall file an annual report separately for the preceding calendar year with the Commissioner on or before March 1 of each year, starting the year of 2020. The TPA annual report form is available in https://cca.hawaii.gov/ins/producers/forms/ and the form shall be filed electronically at [email protected].
LICENSE REINSTATEMENT – If you held a HI resident or nonresident TPA license that has been inactive for not more than thirty days, due to nonrenewal.
You may reinstate electronic at http://nipr.com/ or submit by paper.
To reinstate by paper (mail in):
- Reinstatement fee: make $450 check payable to Department of Commerce and Consumer Affairs.
- Mail renewal notice and check to: Insurance Division, 335 Merchant Street, Room 213, Honolulu, HI 96813.
LICENSE REACTIVATION – If you held a HI resident or nonresident TPA license that was inactivated within two years.
Electronic submission is not available for reactivation. To reactivate your license, you must submit a paper application.
A complete paper application includes (must submit by paper and mail in):
- TPA CHECKLIST/APPLICATION PACKET – A complete application packet and one with original signature(s) on the application
- Licensing Fees. Contact the Hawaii Insurance Division at 808-586-2788 to verify the applicable fees. Make check payable to the Department of Commerce & Consumer Affairs.