AS 21.27.630: License required.

(a) A person may not act as or represent to be a third-party administrator in this state or relative to a subject resident, located, or to be performed in this state, unless licensed under this chapter or in another jurisdiction under AS 21.27.650. A person may not act as or represent to be a third-party administrator representing an insurer domiciled in this state regarding a risk located outside this state unless licensed by this state under the provisions of this chapter.

(b) A third-party administrator may not transact business for a kind or class of authority for which the person is not licensed .

(c) Except as otherwise provided in this chapter, a third-party administrator shall be licensed under this chapter unless the third-party administrator only investigates and adjusts claims and is licensed under this chapter as an independent adjuster.

(d) A third-party administrator may not use a fictitious name or alias unless the third-party administrator's legal name and fictitious name or alias are on the license.

(e) A person who is an employee of an admitted insurer, who acts within the course and scope of that employment, and within the scope of the insurer's certificate of authority is not required to be licensed under this chapter.

(f) [Repealed, § 98 ch 17 SLA 2025.]

(g) A credit union or a financial institution subject to supervision or examination by federal or state banking authorities, or a mortgage lender, that performs no functions other than advancing premiums to the insurer and collecting a debt from the insured is not required to be licensed as a third-party administrator.

(h) A credit card issuing company that performs no functions, including adjustment or settlement of claims, other than advancing and collecting premiums from its credit card holders who have authorized collection is not required to be licensed as a third-party administrator.

(i) A person who only provides services to bona fide employee benefit plans that are established by an employer or an employee organization, or both, for which the insurance laws of this state are preempted under the Employee Retirement Income Security Act of 1974, is not required to be additionally licensed as a third-party administrator if the person certifies to the director on or before February 1 of each year its exempt status.

(j) A third-party administrator is subject to hearings and orders on violations; denial, nonrenewal, suspension, or revocation of license; penalties; and surrender of license under the procedures set out in AS 21.27.405 — 21.27.460.

(k) An insurer that holds a certificate of authority issued by the director and is in good standing under this title is not required to be licensed as a third-party administrator in this state.

(l) A person that is not required to be licensed as a third-party administrator under (e) — (k) of this section must file an annual certification with the director that the person meets the requirements for exemption on or before February 1 of each year.

(m) A person who is an employee of a third-party administrator and who acts within the course and scope of that employment and within the scope of the written contract required under AS 21.27.650(a)(4) is not required to be licensed as a third-party administrator under this section unless that person is the designated compliance officer under AS 21.27.640(b)(6). The third-party administrator is responsible for the acts of its employees regulated under this title.