Electronic Filing

Related Information

Filing Types

Filing requirements are described in the Surplus Lines Law. Refer to Sections 1604, 1606, 1609, and 1610 for more information. The Pennsylvania Insurance Department (PID) has developed affidavits/declaration types to comply with the different sections.

Filing Type 1609-SLL/1609-PR

Filing Type 1609-SLL/1609-PR is the most commonly used filing type, as it must be used when the criteria for use of all other filing types is not met. Refer to Section 1609.

  • The SLL Affidavit filing must be accompanied by an image file of a completed and signed Producer Affidavit 1609-PR.
  • The Surplus Lines Licensee is obligated to file both the SLL Affidavit (with 1609-SLL/1609-PR selected) and the 1609-PR affidavit within 45 days of the effective date of the policy.

1609-PR Form

The 1609-PR form must be filled out by the producer, who represents the insured within 30 days after the Surplus Lines Licensee has placed insurance with an Eligible Surplus Lines Insurer. Refer to Section 1609.

  • The Producer must forward this form to the Surplus Lines Licensee and the licensee must upload an image of the 1609-PR form when submitting Filing Type 1609-SLL/1609-PR.
  • The Surplus Lines Licensee must ensure all information on the 1609-PR image matches the information entered in EFS on the 1609-SLL filing form.
  • Refer to the section on Producer Declaration/Affidavit (1609-PR) in the Procedures Manual.

Filing Type 1609-B

Filing Type 1609-B may be used when the same coverage, as described, has been placed continuously with an eligible surplus lines carrier for a period of at least three consecutive years immediately preceding the current placement. Refer to Section 1609, Subsection (b).

  • This form recognizes that this is, in fact, a Surplus Lines placement, precludes the diligent search requirement and no longer requires a Producer declaration/affidavit 1609-PR.
  • It should be noted that the insured need not be with the same Eligible Surplus Lines Carrier over the said minimum 3-year period.

Filing Type 1610-A

Filing Type 1610-A is designed for the large corporate account. This filing type may be used when the insured is able to satisfy at least 3 of the 6 requirements defined by Section 1610, Subsection (a) of the Pennsylvania Surplus Lines Law. These requirements include:

  • The insured employs a full-time risk manager or contracts for services from a qualified risk management service.
  • The insured has gross sales in excess of one hundred million ($100,000,000) dollars.
  • The insured regularly employs in excess of two hundred and fifty (250) full-time employees.
  • The insured has assets in excess of one hundred million ($100,000,000) dollars.
  • The insured has insurance premiums for property and casualty insurance, excluding employee benefits, in excess of two hundred and fifty thousand ($250,000) dollars.
  • The insured is seeking insurance for risks resident, located or to be performed in one or more states other than Pennsylvania and the portion of the total risk ascribable to states other than Pennsylvania exceeds fifty percent (50%).

If the Surplus Lines Licensee is able to declare under penalties provided for perjury that the described risk satisfies at least three of these requirements, filing type 1610-A may be used. Use of filing type 1610-A precludes the diligent search requirement and therefore, the Producer declaration/affidavit 1609-PR is not needed.

 

Filing Type 1610-B

Filing Type 1610-B is used by Surplus Lines Licensees who administer a Purchasing Groups(s). Refer to Section 1610, Subsection (b).

  • Submission of this filing type is required for placements for each Pennsylvania member of a Purchasing Group created under the Risk Retention Act amendments of 1986 regardless of the Purchasing Group's state of domicile.
  • Use of filing type 1610-B precludes the diligent search requirement and therefore, the Producer declaration/affidavit 1609-PR is not needed.

Form 1604-E (Export)

Form 1604-E is intended for use when reporting a placement of a Type of Coverage or a Description of Insured’s Operation found on the Export List.

  • Under The Pennsylvania Code Section 124.6, the Insurance Commissioner may declare specific Kinds of insurance coverage or Classes of Operations to be generally unavailable in the authorized market at present, and thus exportable.
  • These types of placements are currently “affidavit free.” Accordingly, for those insurance coverages which are included on the Export List, a diligent search among insurers admitted to do business in this Commonwealth is not required before placement of the coverage in the Surplus Lines market.

Form 1609-X (Reconciliation and Examination Discrepancy)

Form 1609-X should only be used to report reconciliation and examination discrepancies in accordance to the 2/22/2010 Bulletin. Please review the Surplus Lines Law, the filing types listed above, and the Bulletin before using Form 1609-X.

  • This form should only be used to report missing 1609-SLL filings when a completed 1609-PR form is not available.
  • The Omissions box must be checked to avoid a late fee.
  • A list of 1609-X filing will be made available to the Pennsylvania Insurance Deparment.