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Maine.gov > PFR Home > Insurance Regulation > Producer Services > Licensing and Registration - Forms & Information

Licensing and Registration - Forms & Information

On this page: Adjusters | Agencies/Business Entities | Consultants | Employee Leasing | Managing General Agent | Medical Utilization Review | Multiple-Employer Welfare Arrangements | Pharmacy Benefits Manager | Portable Electronic Device Insurance Vendor Preferred Provider Arrangement | Producer | Reinsurance Intermediary | Risk Purchasing Group | Risk Retention Group | Self Insurance for Workers' Comp | Service Contract Provider/Administrator | Special Purpose Reinsurance Vehicles | Structured Settlement Transferee | Third Party Administrator | Viatical and Life Settlement |

 

The following documents have been developed in either Microsoft Word, Microsoft Excel, or Adobe PDF format.

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Adjusters

Agencies/Business Entities

Consultants

Employee Leasing Company (PEO)

  • Employee Leasing Companies – As a result of LD 1017, the administration of employee leasing companies has transferred from the Bureau of Insurance to the Bureau of Consumer Credit Protection. Please reference the link provided for further details. http://www.maine.gov/pfr/consumercredit/index.shtml

Managing General Agent

Medical Utilization Review

Multiple-Employer Welfare Arrangements

  • Application Requirements - Word or Adobe PDF
  • Application Requirements Specific to Employee Leasing Companies - Word or Adobe PDF

Pharmacy Benefits Manager

Portable Electronic Device Insurance Vendor

Preferred Provider Arrangement

Producer

Reinsurance Intermediary

Risk Purchasing Groups

Risk Retention Groups

Self Insurance for Workers' Compensation

Service Contract Provider/Administrator

Special Purpose Reinsurance Vehicles

Structured Settlement Transferee

Third Party Administrator

The following items must be submitted when applying for a TPA license:

Information about TPA license renewal:

  • TPA license renewals are due May 1st of each year and the renewal notices are generally mailed by the end of March. Renewals cannot be completed online at this time and must be returned to the address indicated on the renewal notice. Included within the renewal notice is a bond calculation that must be completed, signed and returned to the Bureau of Insurance. Complete instructions for renewal payment and bond calculation are included within the renewal notice.

General Information for Third Party Administrators:

  • A List of Possible Additional Licenses Required - Word or PDF
  • Instructions for Requesting Confidential Treatment of Documents Filed - PDF

Data Reporting Requirement:

  • Third Party Administrator (TPA) Report -- Health Claims Paid by Plan Sponsor (Note: This TPA report form is different than the annual TPA license renewal that requires a fee). The report is due annually by April 30th. This report must be filed by all TPAs with authority to administer Health claims in Maine.

Viatical and Life Settlement Provider

Last Updated: November 24, 2014