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Workers’ Compensation Board

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How to Become a Third Party Administrator


Applicants seeking a license to become a third-party administrator (TPA) to represent self-insured employers and/or insurance carriers must qualify under either §50(3-b) or §50(3-d) of the Workers' Compensation Law (WCL). Section 50(3-b) permits those businesses created under the laws of New York State to apply for a license. Businesses established outside of New York may apply for a license under §50(3-d) of the WCL provided they are: (1) an insurance company duly authorized to write workers' compensation insurance in New York; (2) an affiliate or subsidiary of (1); or (3) a licensed/authorized adjusting company in New York. The corporation must submit a certificate from the New York State Insurance Department indicating one of the three criteria listed above if they choose to file under §50(3-d) of the WCL. If the corporation files under WCL §50(3-d), the corporation must submit documentation from the New York State Department of State indicating that the corporation is a business formed in the State of New York.

§ 50 3-b/d of the New York State Workers' Compensation Law

A company or corporation applying for a TPA license must have a Qualifying Officer to represent the company or corporation. The individual is responsible for ensuring that the TPA is in compliance with the laws, rules, regulations, policies and procedures of the Board. Either the qualifying officer or the TPA must also have a residence or place of business in the State of New York. Finally, the qualifying officer must be designated an officer of the corporation through a corporate resolution as described in the application form (Form OC-403 adobe pdf).

Qualifying officers can be either:

It is important to note, however, that the Qualifying Officer must be designated as an "officer" of the company (e.g., President, Vice President, Secretary, or Treasurer) that is applying to represent self-insured employers and/or carriers. A resolution appointing the Qualifying Officer as an officer of the company must be submitted with the paperwork. The specific arrangements that are made between the company and the Qualifying Officer, with respect to official duties and compensation, if any, does not need to be disclosed to the Board.

Listed below are the forms that are required to be completed:

In addition to completing and submitting the above-mentioned forms, the Qualifying Officer will be required to appear before a Board Panel for an interview. Once the interview is complete, the Full Board will review the recommendation made by the Board Panel and determine if the license should be granted.

The completed forms should be submitted to the Workers' Compensation Board, Licensing Office, 328 State Street, Schenectady, NY 12305-2318. Please contact the Licensing Office at 1-800-664-2379 if you have any questions.

Licensed Representatives Regulations

Listing of Licensed Third Party Administrators adobe pdf