TPA Approval Forms

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TPA Approval Forms

• Provisional Approval
  SIIA TPA Questionnaire with Attachments
  Signed HIPAA Business Associate Agreement
• Final Approval
  Commission Agreement
  Agent Appointment

Please return by mail, fax or email TPA approval information to:

BEST Re
Attention: Underwriting Department
PO Box 19721
Irvine, CA 92623-9721
(877) 868-5775 business
(949) 222-1004 fax
email