| Home > Insurance Division > Managed Care > Third Party Administrators > Certificate of Compliance |
| Third Party Administrator - Certificate of Compliance |
In order to issue a Certificate of Compliance the Department will need the following information:
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Name of Third Party Administrator (TPA) |
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Home Address of the TPA |
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Date of Formation |
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Domestic State |
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Number of Certificates needed |
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Name of the person requesting the Certificate |
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Phone number or e-mail of requestor in case the Department needs to contact you |
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Address or e-mail where the Certificate(s) should be sent (If Certificate is e-mailed, there will not be a raised Seal) |
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Do you want the Certificate mailed, e-mailed or both? |
There is no fee for a Certificate(s) of Compliance.
The request can be sent in by e-mail to Tim.Stroud@dobi.nj.gov or requested by phone at 609-940-7452.
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OPRA is
a state law that was enacted to give the public greater access to government
records maintained by public agencies in New Jersey. |
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You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site. |
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Copyright © State of New Jersey, 1996 -
State of New Jersey
New Jersey Department of Banking and Insurance
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