TPA Approval and Carrier Appointment Process

TPA Approval

  • Complete SIIA Questionnaire and attach all applicable requested documents
    Email or Fax submissions to Steve Santacroce
    610.280.4299 (fax)
  • Provide Disaster Recovery Plan

Carrier Appointment

  • Complete Independent Broker’s Agreement Form
  • Provide a copy of your resident state‚Äôs agent and/or agency license, as well for any other states.
  • Complete W-9 Form (if commissions are payable)
    Email or Fax submissions to Theresa Morris
    610.280.4298 (fax)

If you are not a currently approved TPA or if you have any questions, please contact Steve Santacroce, 610.280.4306

Regional Corporate and Sales Offices To Serve You
HIIG Accident & Health Malvern, PA
75 Valley Stream Parkway Suite 250
Malvern, PA 19355

P: 800.796.9165
F: 610.280.4298
HIIG Accident & Health Indianapolis, IN
251 North Illinois Street Suite 940
Indianapolis, IN 46204

P: 317.829.7270
F: 317.829.7277
HIIG Accident & Health Wakefield, MA
401 Edgewater Place Suite 180
Wakefield, MA 01880

P: 888.658.3350
F: 888.340.4577

HIIG Accident & Health Atlanta, GA
600 Galleria Parkway Suite 770
Atlanta, GA 30339

P: 770.933.3420
F: 770.933.3419

HIIG Accident & Health Scottsdale, AZ
8800 East Raintree Drive Suite 260
Scottsdale, AZ 85260

P: 480.707.0330
F: 610.280.4298

HIIG Accident & Health Dallas, TX
13355 Noel Road
Suite 1950
Dallas, TX 75240

P: 713.935.4800
Putting Substance into the Abstract

Our professionals partner with you to make sense of a chaotic world of stop-loss claims