(1) The Commissioner may issue a license to an applicant or approve an application for registration as a TPA if the Commissioner finds that the applicant meets the standards established by this chapter including, but not limited to, the following:(1) All of the materials required by this chapter or by the Commissioner have been filed;(2) The persons responsible for conducting the applicant’s affairs are competent, trustworthy and possess good reputations, and have appropriate experience, training and education;(3) The applicant has demonstrated the ability to assure that its services will be performed in a manner which will ensure the efficient operation of its business, including appropriate financial controls;(4) The standard contract forms to be used by the applicant are acceptable;(5) The applicant has adequate financial arrangements with the benefits payors for which it will perform its services and adequate arrangements for complying with the provisions of this chapter;(6) The compensation arrangements made between the applicant and benefits payors do not result in the assumption of financial risk by the applicant;(7) The bond requirement in section 1534 is met; and(8) In the case of an applicant for registration, the provisions of § 1533 subsections (d), (e) and (f) apply only to services provided by the applicant to benefits payors other than an insurer.
(1) All of the materials required by this chapter or by the Commissioner have been filed;
(2) The persons responsible for conducting the applicant’s affairs are competent, trustworthy and possess good reputations, and have appropriate experience, training and education;
(3) The applicant has demonstrated the ability to assure that its services will be performed in a manner which will ensure the efficient operation of its business, including appropriate financial controls;
(4) The standard contract forms to be used by the applicant are acceptable;
(5) The applicant has adequate financial arrangements with the benefits payors for which it will perform its services and adequate arrangements for complying with the provisions of this chapter;
(6) The compensation arrangements made between the applicant and benefits payors do not result in the assumption of financial risk by the applicant;
(7) The bond requirement in section 1534 is met; and
(8) In the case of an applicant for registration, the provisions of § 1533 subsections (d), (e) and (f) apply only to services provided by the applicant to benefits payors other than an insurer.