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’s 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


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Three Offices To Serve You
Elite Underwriting Services Exton, PA
191 Sheree Boulevard, Suite 201
Exton, PA 19341

P: 800.796.9165 F: 610.280.4298
Elite Underwriting Services Indianapolis, IN
251 North Illinois Street, Suite 820
Indianapolis, IN 46204

P: 317.829.7270 F: 317.829.7277
Elite Underwriting Services Burlington, MA
15 New England Executive Park
Burlington, MA 01803

P: 888.658.3350 F: 888.340.4577
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