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Third Party Administrator
TPA" means a Third Party Administrator who, for the time being, is licensed by the Authority, and is engaged, for a fee or remuneration, by whatever name called as may be specified in the agreement with an insurance company, for the provision of health services;
Conditions of and Procedure for Licensing of TPA
1) Only a company with a share capital and registered under the Companies Act, 1956 can function as a TPA.
(2) The main or primary object of the company shall be to carry on business in India as a TPA in the health services, and on being licensed by the Authority, the company shall not engage itself in any other business.
3. The minimum paid up capital of the company shall be in equity shares amounting to Rs. 1 crore(Rupees One crore only);
4. At no point of time of its functioning the TPA shall have a working capital of less than Rs. 1 crore;
5. At least one of the directors of the TPA shall be a qualified medical doctor registered with the Medical Council of India;
6. The aggregate holdings of equity shares by a foreign company shall not at any time exceed twenty-six percent of the paid up equity capital of a third party administrator.
7. Any transfer of shares exceeding 5% of the paid up share capital shall be intimated by the TPA to the Authority within 15 days of the transfer indicating the names and particulars of the transferor and transferee.
4. (1) The TPA shall obtain from the Authority a licence to function as a TPA for rendering health services.
2. The application for licen ...