Our office should be notified in writing immediately within 30 days of any of the following changes:

• Change of mailing address/change of name. The TPA must report a change of mailing address in writing within 30 days. If the TPA changes its name, it must report this in writing and include Amended Articles of Incorporation (or other applicable documents). There is no charge. A new Certificate of Authority will be created automatically if a name change occurs.
  
• Change of person or address designated to receive service of process. Notify our office in writing.
  
• Adoption of any assumed name/dba, accompanied by a true copy of the dba filing.
  
• Change in articles of incorporation or bylaws. Such amendments must be submitted in writing.
  
• Change of the corporate entity or federal identification number. Change of the corporate entity, such as a merger or re-incorporation, is deemed to be significant. If new officers, directors, or stockholders of 10% or more result from a merger, please inform us by having each new individual or entity complete a form FIS 0862. A change of FEIN requires a new FIS 0861 Third Party Administrator Application for Certificate of Authority, accompanied by new forms and fees for the new entity.
  
• Change in officers, directors, or shareholders holding 10% or more of the TPA's stock. An FIS 0862 Affiliation Statement will be required if one has not already been filed for the individual(s) or entities.
  
• Change in status of the business. For example, if you are going to cease acting as a TPA, you must inform this office in writing.