Licensing requirements for Third Party Administrator for Health Insurance (TPA)

  • Registration as private or public limited company under Companies Ordinance, 1984
  • Paid up capital of Rs.50 million
  • Shareholder’s equity of Rs.30 million
  • Application as per Form – I of the TPA for Health Insurance Regulations, 2014
  • Evidence of payment of fee of Rs.50,000/- for initial registration and Rs.25,000/- for renewal
  • Documents/ information required to be submitted along with application include
    • Memorandum and Articles of Association
    • Details of sponsors/ promoters including names, address, nationality, contribution of number of shares proposed to be held by each sponsor, the proposed positions they’ll hold, educational qualifications and work experience
    • Proposed business plan for initial three financial years including description of services and facilities proposed to be provided
    • Copy of draft agreement to be entered into between TPA and the insurance company/ self-funded pool/ medical service provider
    • An undertaking that all information provided is complete and correct
    • Any other information/ documents as may be required by the Commission