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Life & Health Division
LICENSING, RENEWALS AND OTHER
TPA
License Renewal
General Information
Statutes and Regulations:
NC General Statutes - Article 56 of Chapter 58 of NCGS
NC Administrative Code - T11 NCAC Chapter 21 Section .0100
Forms Required for Renewal Licensure Submission:
TPA License Transmittal (TPRTRN)
TPA License Application (TPAAPP)
TPA License Questionnaire (TPAQSN)
Additional Forms For Renewal Licensure – Submit When Changes Have Been Made:
TPA License Internal Control (TPAICT)
TPA Power of Attorney for Company (TPAPOA)
TPA Power of Attorney for Partnership (TPAPPA)
TPA Biographical Affidavit (TPABIO)
Click here for Initial License Information