The State of New Jersey
NJ Department of Banking and Insurance
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Home > Insurance Division > Managed Care > Third Party Administrators > Name Change
Name Change for Third Party Administrators


The company shall submit the following to the Department:

  • A certified copy (full and complete set) of the amended Articles of Incorporation, Certificate of Formation, or similar as restated to reflect the new name;

  • A copy (full and complete set) of the company's By-Laws, Operating Agreement or similar as restated to reflect the name change;

  • A brief description of any other material change in the company's corporate existence prior or subsequent to the proposed name change (ie. merger, acquisition, redomestication, etc.). If none occurred, so state in the letter.

  • Form for the appointment of the Commissioner of Insurance and his or her successors in office as Attorney for Service of Process, upon whom all original process in any action or legal proceeding against it may be served.

  • Biographical Affidavits for any Officer and/or Director not currently on file with the Department.

  • In view of the name change, confirm the following information concerning the company:
      • Federal Employer's Identification Number
      • Home Office Address
      • Mail Address
      • Telephone Number (general operator's number)
      • Effective Date of Name Change
      • Company President
      • Company Secretary


This information must be sent directly to the:

Department of Banking and Insurance
Attention: Third Party Administrators, 11th Floor
P.O. Box 325
Trenton, NJ 08625-0325

 
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New Jersey Department of Banking and Insurance