PROCEDURE FOR FILING NEW MEXICO SURPLUS LINES TAX
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1 PROCEDURE FOR FILING NEW MEXICO SURPLUS LINES TAX These guidelines apply to policies and premium-bearing endorsements (including cancellations and audits) effective after January 1, Filing is required quarterly, unless there is no activity, and must be received by the New Mexico Public Regulation Commission Insurance Division within 60 days of the end of the quarter. Refer to Exhibit C for filing dates. What must be sent: A. A CD containing an Excel spreadsheet with the following information: 1. Name of Insurer (Company) 2. NAIC Company Code (available in the Best Guide and from the Insurance Department) 3. Policy Number 4. Effective Date of Policy 5. Termination Date of Policy 6. Specific description of coverage in some detail this would also include the reason for the endorsement, (i.e. additional insured, increasing limits, etc) 7. Premium (on initial policy) 8. Additional Premium (endorsements or audits) 9. Cancellation or Return Premium 10. Additional Fees (policy fees, inspection fees, risk purchasing group fee, etc) 11. Total 12. State Tax (3.003% of total) * A New Mexico Surplus Lines Tax filing form (formerly referred to as the Diskette ) containing the specified fields listed above can be obtained from the NM Surplus Lines Brokers Association webpage at no cost for information. B. Two printed copies of the spreadsheet that is saved to the CD. One of the copies will be returned to the Surplus Lines Broker as confirmation that your premium tax fees were received and paid. C. A copy of the documentation (i.e. declarations page, endorsement, audit and/or cancellation) for each of the surplus lines insurance policies listed on the spreadsheet. The declarations page must be stamped with the required wording (see below), but an endorsement will be accepted if the required wording will not fit on the declarations page. D. A copy of the required Producing Broker Affidavit must be attached to the declarations page of each policy. (See exhibit A.) The licensed individual (not agency) that conducted the diligent search must be named at the top of the form and must sign the affidavit. Notarization is no longer required. E. A check made payable to Office of Superintendent of Insurance for the amount of taxes due (should match total on spreadsheet).
2 F. The Surplus Lines Broker Quarterly Summary Report Form (see exhibit B) must be completed, signed by the Surplus Lines Broker, and notarized. G. A self-addressed, postage paid envelope so that your verification form can be returned to you. Surplus Lines Tax Filings are sent to: Victoria A. Baca, Financial Analyst Company Licensing Bureau Office of Superintendent of Insurance 1120 Paseo de Peralta PO Box 1689 Santa Fe, NM Stamping of the Policy Declarations: The New Surplus Lines Law and Regulation requires that all policies delivered in New Mexico contain the following wording stamped, printed, or otherwise displayed on the Declarations Page in boldface, 10 point, or larger type. THIS POLICY PROVIDES SURPLUS LINES INSURANCE BY AN INSURER NOT OTHERWISE AUTHORIZED TO TRANSACT BUSINESS IN NEW MEXICO. THIS POLICY IS NOT SUBJECT TO SUPERVISION, REVIEW, OR APPROVAL BY THE SUPERINTENDENT OF INSURANCE. THE INSURANCE SO PROVIDED IS NOT WITHIN THE PROTECTION OF ANY GUARANTY FUND LAW OF NEW MEXICO DESIGNED TO PROTECT THE PUBLIC IN THE EVENT OF THE INSURER S INSOLVENCY. Affidavit The Producing Broker Affidavit (exhibit A attached) must be provided to the Surplus Lines Broker by the Producing Broker (agent) dealing directly with the Insured. The original affidavit (facsimile is okay) must be placed in the policy file in the Surplus Lines Broker s Office. A copy must be attached to the copy of the Declarations Page included in the quarterly report to the State as outlined above. The Department of Insurance has waived the requirement that the affidavit be notarized. It is the responsibility of the Surplus Lines Broker to notify the Department of Insurance of any Producing Broker who fails or refuses to supply the properly executed affidavit. Should you have any questions regarding Surplus Lines Broker premium taxes, contact: Suzie Dodds, CIC, Independent Insurance Agents of NM / NM Surplus Lines Brokers Association suzie@iianm.org or Victoria A. Baca, Office of Superintendent of Insurance Victoriaa.baca@state.nm.us or
3 Exhibit A PRODUCING BROKER AFFIDAVIT (Required by NMSA 1978 Section 59A-14-11B) Name of Producing Broker: _ Address of Producing Broker: _ Being duly sworn, I affirm that: 1. I was engaged to obtain the following policy: Insurer: Policy Number: Type of Coverage: Effective Date: 2. Check either A or B below, as appropriate. A After making a diligent search I found that the full amount or type of insurance requested could not be obtained from authorized insurers in New Mexico. B Within the last year, I have tried to place this type of coverage with at least four insurers authorized in New Mexico, including insurers by whom I am not appointed and therefore know from substantial recent experience this coverage cannot be obtained from any authorized insurer in New Mexico. 3. I expressly advised the insured prior to placing the insurance; and the insurance policy states that: A. the insurer with whom the insurance is placed is not an authorized insurer in New Mexico and is not subject to the supervision of the Superintendent of Insurance, and; B. in the event the insurer becomes insolvent, claims will not be paid by the New Mexico Guaranty Association. 4. I have asked the insured and, to the best of my knowledge, this coverage is not replacing existing coverage from an authorized insurer who was willing to continue providing coverage. 5. I certify I am licensed by the New Mexico Department of Insurance for the type of coverage provided and the information in this form is true and correct and is in compliance with the applicable provisions of the New Mexico Insurance Code and this rule. Signature Date
4 Exhibit B SURPLUS LINES BROKER QUARTERLY SUMMARY REPORT FORM (Required by NMSA A C & D) Name of broker: Address of broker: License Number: I hereby submit to the New Mexico Department of Insurance this summary of all surplus lines insurance I placed during the quarter beginning and ending. All documents required by NMSA 1978 Section 59A and 13 NMAC to be filed with the Superintendent are attached. I certify that the information on this form is true and correct and is in compliance with the applicable provisions of the New Mexico Insurance code and that the information on the diskette filed with this form is identical to the information on the printouts made from the diskette and filed with this form. Signature Date SUBSCRIBED AND SWORN TO before me This day of, Notary Public My commission expires:
5 Exhibit C Filing Deadlines to the New Mexico Public Regulation Commission Insurance Division Filings are required quarterly, unless there is no activity, and must be received by the New Mexico Public Regulation Commission Insurance Division within 60 days of the end of the quarter. The filing schedule: 1 st Quarter January 1 st - March 31 st Filing Due - May 30 th 2 nd Quarter April 1 st - June 30 th Filing Due August 29 th 3 rd Quarter July 1 st September 30 th Filing Due - November 29 th 4 th Quarter October 1 st December 31 st Filing Due - March 1st
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