Review Policy History before Creating an Endorsement
View and Search for 1620 Summary Report
Revise Submitted 1620 Summary Report
New GPT/RCT-123 Annual Tax Report
Revise Submitted GPT/RCT-123 Summary
View or Search for GPT/RCT-123 Summary
PSLA Connect Search (Internal-only)
Main Agency View (Internal-only)
Licensed Individual View (Internal-only)
Eligible Insurer View (Internal-only)
Declining Company View (Internal-only)
Purchasing Group View (Internal-only)
Build Statement of Account Reports (Internal-only)
Report Generation (Internal-only)
Paper Received Date (Internal-only)
Type of Coverage (also known as Kinds)
Description of Insured’s Operation (also known as Classes)
Ineligible Insurer Property Limit
Ineligible Insurer Casualty Limit
Ineligible Insurer Explanation
Total Multi-state Policy Premium
Surplus Lines Individual Licensee
Signature of Licensee Provided (Internal-only)
Pennsylvania Insurance Department (PID)
1609-PR Image Legible Indicator (Internal-only)
1609 PR Image Insured Name Matches Indicator (Internal-only)
Producer Signature Indicator (Internal-only)
Enter Policy/Binder Number Again
Enter the Policy or Binder Number Again
Resident State (Internal-only)
Endorsement Effective Date of Change
Cancel Policy Reference Number
Inactivation Policy Reference Number
Search for 1620 Report and Search for RCT-123 Report Pages
GPT/RCT-123 Annual Report Page
Gross Premium Taxable (Total Taxable Premium)
Tax (@ 3% of Gross Premium Taxable)
After log-in the End User Terms and Conditions page will be displayed. The user must accept the Terms and Condition to continue. After the page is accepted, the user will be prompted to change the system-generated temporary password.
Enter the Current Password (the password supplied in the email) and then enter a New Password that complies that is between 7 and than 32 characters (case sensitive) and contains at least one letter and one number.
The Home Page is divided into four areas – Filings, 1620 Reports, RCT Reports, and User Profile. Functions and links are enabled based on permissions set in the User Profile. Click “Edit My Profile” to your permissions. Contact your Agency Administrator if you would like to change permissions.
Clicking on a link will call up a new page. Each page has a “help” link at the top right corner that describes that page.
There is a message window at the top of the page that indicates if you have filings to fix.
Below are tips on how to use Electronic Filing System forms and fields.
· PSLA Icon: clicking the PSLA icon at the top left corner of each page will call up the Home Page.
· Tab: pressing the Tab Key will advance you to the next editable field.
· Shift-Tab: holding down the Shift Key while pressing the Tab Key will move the cursor to the previous editable field.
· Lists: if a field has a drop-down list of items, pressing a letter key once will go to the first item that starts with that letter. Pressing the same letter key a second time will go to the next item that starts with that letter. Example: the “Type of Coverage” list contains “Law Enforcement Liability”, “Lead Abatement Liability”, and “Lead Liability”…
○ Press “L” once calls up “Law Enforcement Liability”
○ Press “L” a second time calls up “Lead Abatement Liability”
○ Press “L” a third time calls up “Lead Liability”
· Down-Arrow: if a field has a drop-down list of items, pressing the down-arrow key will scroll to the next item on the list.
· Up-Arrow: if a field has a drop-down list of items, pressing the up-arrow key will scroll to the previous item on the list.
The Affidavit Filing Form is used to submit an original SLL Affidavit/Declaration filing. Filings submitted through the Electronic Filing System do not require an attached image of the Affidavit. The submittal through Electronic Filing is in lieu of the paper Affidavit form. For Filing Type 1609-SLL/1609-PR, an attached image of a signed PR form is required.
Refer to the PSLA Procedures Manual or Electronic Filing System User Manual for External Agency Users for additional information. The Affidavit Filing Form contains fields for all filing types and attachments and will selectively hide/show information depending on your selections. The single Form covers the following filing types and attachments.
· 1609-SLL/1609-PR
· 1609-B
· 1610-A
· 1610-B
· 1604-E
· 1609-X
· Attachment 1606-A for Ineligible Insurers
· Attachment 1609/1610-SH for Multiple Carriers or Insurers
· Upload 1609-PR Image file (for 1609-SLL/1609-PR filing type)
· 1625 (only available to internal PSLA Users)
The Save as a Draft button saves entered data so it can be completed at a future date. The Save as a Draft will save a filing with validation errors as long as it has a Customer ID. Draft filings are retrieved by using the Search Display, setting the “Filing Status” criteria to “Save/Draft”, selecting the draft filing, and clicking “View/Revise” filing button
The Validate the Policy button checks entries and validates them for consistency. Critical errors that must be fixed before submittal are highlighted in red. Warning errors that don’t need to be fixed before submittal are highlighted in yellow. Refer to the section on Validation in the EFS User Manual for additional information or to the List of Validation Errors for additional information.
The Cancel button will exit the form without saving entered data.
This brings up an SLL Affidavit Form populated with data from the specified Policy or Affidavit Number. This form is used to correct typographical errors for a filing that was previously submitted. The User must have read/write permission for Affidavit/Endorsements.
· A submitted filing may be modified one or more times; all modifications are tracked and can be seen within the “Policy History” screen.
· Note: if a filing is in the “Filing Return Sent” status, the user must have Affidavit “Read” permission and Filing Return “Read/Write” permission to fix the filing.
The Renew filing function calls up a new filing and pre-populates most of the fields based on the selected filing. Please note the following.
· The Policy Effective Date of the renewal filing is set to the Policy Expiration Date of the selected filing.
· The Policy Expiration Date of the renewal filing is set to 1 calendar year after the Policy Effective Date.
· The PA Premium field is left blank since premium often changes on a renewal.
· The Policy Premium field is left blank if it is a multi-state risk since premium often changes on a renewal.
· The Revenue Recognition field is left blank since it is determined by the agency’s surplus lines tax reporting procedure.
Each of the fields may be changed prior to clicking the Validate button.
A filing must have a filing status of Submitted/Approved before an Endorsement can be submitted against it. Endorsements cannot be submitted against filings with a status of “Pending Review”, “Filing Return”, “Saved/Draft”, “Cancelled”, and “Inactive”.
A filing must have a filing status of Cancelled before the After Cancel Adjustment can be used.
Endorsement Number is an optional text field and Effective Date of Change is a mandatory field. The Endorsement Effective Date of Change of must be between the current policy’s effective and expiration dates. If the endorsement is changing the policy’s effective or expiration dates, the Endorsement Effective Date of Change must also be between the proposed policy effective and expiration dates.
If the endorsement or adjustment is increasing the Property Limit, Casualty Limit, or Premium, enter a positive number into the change field. If it is decreasing them than enter a negative number into the change field. The Current field displays the current amount, the Change field displays the requested change, and the New field displays the current plus changed amount.
Refer to the PSLA Procedures Manual for additional information on Endorsements and Adjustments. Once an Original Filing has been submitted to PSLA, Surplus Lines Licensees must report two primary types of changes made to that Original Filing to PSLA. These include:
· The replacement of a Binder number with a Policy number. If an Original Filing is made using a Binder number, it is critical that Surplus Lines Licensees later provide the Policy number which replaces the Binder number. This is to assist the Licensee in proper record keeping, reconciling, and reporting, as the Policy number creates the unique number used to lookup and track all filings, as required by the Pennsylvania Insurance Department.
· Premium bearing endorsements to a policy (as well as specific non-premium bearing changes indicated below).
An Endorsement should be submitted when any one of the following changes to a policy (the original placement) has occurred:
· A change in Policy Premium (additional or returned)
· A change in Named Insured
· A change to the Location of Risk (for placements with multiple locations in Pennsylvania, the change endorsement should indicate if the location with the most exposure has been changed)
· A change in Limits
· A change or revision to the Policy Number (other than a policy rewrite)
· A change to the Policy Period
An Adjustment should be submitted if any of the above information changes after the filing was cancelled.
The following items must also be included on an Endorsement or Adjustment.
· Effective Date of Change (stated separately from any date of endorsement preparation)
· Specify Additional or Returned Premium (in the case of there being no premium involved, clearly indicate what change is being put into effect, and specify that there is no change to the Policy’s Premium). If you are listing multiple Additional and Return premiums on the same endorsement, calculate the total net A/P or R/P and clearly list it on the endorsement. Additional Premium is entered as a positive number and Returned Premium is entered as a negative number.
· Endorsement Number
Enter the Policy or Binder Number plus the Effective Year to find the Policy for the Endorsement.
Policy History is displayed to confirm it is the correct policy before submitting an Endorsement. The Policy History displays current policy information at the top and the history of changes at the bottom.
The Search Affidavit Display enables a user to search for a policy based on optional search criteria. Policy Number, Binder Number, and Customer Reference Number will search for entries starting with the entered text (e.g. search for all policies that start with the letter “a”). Once a policy is found and selected, several other functions may be initiated from the Search Display.
· View or Revise Policy: displays current policy information on the Affidavit Form and enables a user with read/write permission to revise information. Note: an Agency User must have Filing Return Read/Write permission to revise a returned filing (filing status is “Filing Return Sent”).
· History: displays a summary of current policy information and each transaction to-date starting with the original filing.
· After CN: the After Cancel Adjustment displays current policy information and enables a user to change selected information after a filing has been cancelled (e.g. add premium or return premium). The After Cancel function can only be used on a cancelled filing.
· Submit Endorsement: displays current policy information on the Endorsement Form and enables a user to change selected information (e.g. increase limits and add premium or decrease limits and return premium). Note an endorsement cannot be submitted if a filing has a status of “pending review” or “filing return sent”.
· Submit Original Filing: calls up a new affidavit form.
· Inactivate: displays current policy information and enables a user to inactive a filing and reuse the policy number.
· Cancel: displays current policy information and enables a user to cancel a filing.
· Reinstate: displays current policy information and enables a user to reinstate a cancelled filing or reinstate an inactivated filing.
· Renew: calls up a new affidavit form and pre-populates fields based on the selected filing. Each field may be modified prior to validating and submitting the filing.
· View Renewal: displays the selected filing’s renewal history.
· Create PR: calls up a 1609-PR form and pre-populates fields based on the selected filing.
· Delete DR: enables a user to delete a draft filing.
· Export Results: saves search results into an Excel-compatible format.
Each row at the bottom of the display represents a transaction. The values displayed in the Property Limit, Casualty Limit, and Premium columns are the filing’s value at the end of the transaction. For example, if a new filing is submitted with a Premium of $1,000 than the amount on the first row will show $1,000. If an endorsement is submitted that increases the premium by $500, from $1,000 to $1,500, the amount shown on the History Display on the Endorsement row is $1,500.
The top of the Policy History page displays current policy information. The column labeled “Type” is the “type of change”.
· NW – New: new original filing
· CO – Correction/revision: “Revise Filing” was used to correct the filing.
· EN – Endorsement: “Submit Endorsement” was used.
· RV – Pending Filing Review: the filing either has a 1609-PR image that needs to be reviewed by PSLA or a paper affidavit was mailed to PSLA and it has errors that need to be reviewed.
· RT – Filing Return Sent: the filing either needs a corrected 1609-PR image or errors that need to be fixed by the agency.
· CN – Cancel: The policy was cancelled.
· AC – After Cancel Adjustment: An Adjustment was submitted after the filing was cancelled.
· RI – Reinstate. A cancelled policy was reinstated.
· IN – Inactivate: The policy was inactivated.
The column labeled “AS”, Accounting Status, describes whether information is ready to be exported to PSLA’s accounting system:
· NR – Not ready: not ready for export.
· RS – Ready-to-send: the information is ready to be exported. PSLA Data Services Supervisor will manually initiate the export.
· S – Sent: the information was exported to PSLA’s accounting system. The column labeled “Sent to Acct.” lists the date information was exported.
A filing must have a filing status of Submitted/Approved before it can be cancelled. Filings with a status of “Pending Review”, “Filing Return”, “Saved/Draft”, “Cancelled”, and “Inactive”, cannot be cancelled.
Cancel Policy will display a summary of the policy and request the following information. The policy number for a cancelled policy may not be reused in the same effective year.
· Cancellation reference number (optional)
· Cancellation Effective Date (required)
· Returned Premium (required)
Note that the Stamping Fee is not returned if a policy is cancelled.
A filing must have a filing status of “Cancelled” before the After Cancel Adjustment can be used. The Adjustment can modify:
· Property Limit
· Casualty Limit
· PA Premium
· Policy Premium
WARNING! Inactivating a policy is permanent. An inactivated policy cannot be re-activated.
Inactivate Policy will display a summary of the policy and request confirmation of inactivation. This is equivalent to deleting a policy from the Electronic Filing Database. The policy number for an inactivated policy may be reused in the same effective year.
· EFS will submit a transaction to PSLA’s accounting software to return the premium for an Inactivated Policy.
· Internal-only: PSLA users will have the option to check a box to “return Stamping Fee”. If checked, EFS will submit a transaction to PSLA accounting software to return the Stamping Fee.
The Reinstate Policy function allows an Agency to change the state of a filing from “Cancelled” back to “Submitted”. Use the Search Display with Filing Status set to “Cancelled” to find the policy to be reinstated.
The View Renewal function displays the renewal history for the selected filing. Only renewals that were created with the EFS Renew function will be displayed. Clicking on the PSLA ID hyperlink will display the Policy History for the filing.
The Refund Stamping Fee function allows a PSLA User with Solomon Export permission to refund all, or a portion, of the stamping fee. A refund must be approved by the Executive Director of PSLA or his designee.
The Search Transaction page enables a user to search for transactions based on optional search criteria including Login ID, Entry Date Range, Effective Date Range, Sent to Accounting Date Range, Filing Type, and Omissions. Once a transaction is found and selected, several other functions may be initiated from the page.
· Click on the hyperlink in the Trans ID column to display a copy of the Endorsement, Cancellation, Inactivation, or Reinstatement page.
· Click on the hyperlink in the PSLA ID column to display the Policy History for the filing.
· Export Complete Results to Excel
· Export Results in 1620 Format to Excel
· Export Results in RCT-123 Format to Excel
As required by Section 1620 of the Pennsylvania Surplus Lines Law, within thirty (30) days following the end of each month, each Surplus Lines Licensee (by Agency Customer ID) shall file with PSLA, on Form 1620, a signed verified report of all surplus lines insurance premium activity transacted during the said month. Refer to the PSLA Procedures Manual for additional information.
Submitting the summary information, along with uploading an image of the report, satisfies the filing requirement to PSLA.
View a submitted 1620 Summary Report by using the Search Display to list the summary reports for a Customer ID and then using the View function. The User must have view or read/write permission for 1620 Summary Report.
This brings up a 1620 Summary Form populated with data from the selected Summary Report. This form is used to correct data for a 1620 Summary that was submitted. The User must have read/write permission for 1620 Summary Report.
The surplus lines tax levied by the Commonwealth of Pennsylvania is three percent (3%) of taxable gross premiums charged less return premium for insurance placed with either an eligible surplus lines insurer or other non-admitted insurer. A Gross Premium Tax Report (RCT-123) with your tax payment must be filed with the Pennsylvania Department of Revenue on or before January 31 of each year for the completed preceding calendar year whether or not any surplus lines business was produced in the preceding calendar year.
Summary information plus an image of the full copy (all pages) of the original Gross Premium Tax Report (RCT 123) must be submitted to PSLA and not the Pennsylvania Insurance Department.
Please note: the process for completion of the Gross Premium Tax report (RCT-123) as well as the process for remittance and/or return of premium tax funds are controlled exclusively by the Pennsylvania Department of Revenue. PSLA cannot assist with or answer any questions regarding the tax remittance process. These types of questions should be directed to the Pennsylvania Department of Revenue (www.revenue.state.pa.us). Refer to the PSLA Procedures Manual for additional information.
This brings up a GPT/RCT-123 Summary Form populated with data from the selected year. This form is used to correct data for a GPT/RCT-123 that was submitted. The User must have read/write permission for GPT/RCT-123 Summary Report.
View a submitted GPT/RCT-123 Summary by using the Search Display to list the summary reports for a Customer ID and then using the View function. The User must have view or read/write permission for GPT/RCT-123 Summary Report.
The User Profile defines Login ID information (roles), Customer Assignments, and Permissions. The combination of the three provides the foundation for data security. The objective for data security is to ensure data is only available to those authorized to view and change it. An Agency Administrator may create new Agency Users. Only a PSLA Administrator may create new Agency Administrators.
The Role identifies who can create and manage Login IDs. Roles include:
· PSLA Administrator
○ Create and manage Agency Administrator IDs
○ Assign Customer IDs to each Agency Administrator
○ Create and manage PSLA Login IDs
· PSLA User
○ Submit and view Affidavit and Endorsement data
○ Submit and view monthly 1620 Report data
○ Submit and view annual GPT/RCT-123 Report data
○ Submit XML Import files for Affidavit and Endorsements
○ Review images provided by Agency Users
· Agency Administrator (created by a PSLA Administrator based on the “Responsibility for E-filing Authority” signed by the licensee)
○ Create and manage Agency Login IDs
○ Assign Customer IDs and Permissions to each Agency User
· Agency User (created by the Agency Administrator)
○ Read/write data based on the assigned Customer IDs and Permissions
The Customer Assignment section identifies the assigned Customer IDs. A user can only view or edit information from a Customer ID that is on the assigned list.
Within the assigned Customer IDs, permissions determine the categories of information a user may view or change. Permission types include “none”, “read-only”, and “read/write”. Permission categories include:
· New Affidavit Filings and Endorsements
· Correcting errors on Returned Filings
· XML Import
· 1620 Reports
· GPT/RCT-123 Reports
The combination of Role, Customer Assignment, and Permissions provide data security.
· “Role” defines who has access to the Electronic Filing System.
· “Customer Assignment” defines the Customer IDs assigned to the user.
· Permissions define the information within the assigned Customer IDs available.
The Search User function allows an Administrator to search for a used based on login ID, First Name, Last Name, Telephone, and Role. If a search field is left blank it is ignored.
The list of Customer IDs assigned to an individual appears. Click on the Edit hyperlink to view/change contact information.
The Customer View page displays information about a Customer. Please note that License Information is downloaded from the Pennsylvania Insurance Department and customer contact information is entered by either the agency or by PSLA. An Agency User must have Read or R/W permission for Customer Edit to view or change information.
· Customer ID and Name
· PID ID and Main Agency Name (downloaded from the Pennsylvania Insurance Department)
· License Information
· Associated Licensed Individuals
· Contact Information
A Customer may designate a single contact to PSLA or up to six different contacts for the following functions.
· Business administration
· Filing
· 1620 Monthly Reports
· GPT/RCT-123 Annual Tax Reports
· Statement of Account
· Bulletins, Change Notices, and general mailing
PSLA Connect Search (Internal-only)
PSLA Connect enables PSLA Users to search/display information downloaded from the Pennsylvania Insurance Department (PID), create/edit Customer IDs, add/remove affiliations between licensed individuals and Customer IDs, and create/view Sponsorship information. Downloaded data from PID includes:
· Agencies licensed for Surplus Lines
· Individuals licensed for Surplus Lines (Certificate of Eligibility or CE)
· Agencies and Individuals licensed as Producers (also known as Brokers)
· Insurers on PID’s Eligible Insurer list for Surplus Lines (also known as Key Carriers)
· Insurers that may be listed as “Declining Companies” on the 1609-PR form
· Purchasing Groups
The following fields may be used to search for information. If multiple fields have entries in them, the search criteria are “ANDED” together. For example, if Record Type is “Licensed Individual” and the Name is “Ken” the search will look for all licensed individuals with the text “Ken” in their name.
· Record Type (Customers, Main Agencies, Licensed Individuals, Producer, Declining Company, or Purchasing Group)
· Name
· Business Type (Agency or Individual)
· License No.
· Customer ID
· NAIC No.
· PID ID (this is also the Eligible Insurer ID)
· Old Carrier ID (this is the old 4-digit key carrier number)
· Customer ID Assigned (yes, no, either)
· License Statue (Active, Inactive, Either)
Main Agency View (Internal-only)
The Main Agency View page displays information downloaded from PID about an agency licensed for surplus lines. The information is read-only and may not be edited by PSLA.
· PID Agency ID and Main Agency Name
· License Information
· Associated Indivduals
· Address
Licensed Individual View (Internal-only)
The Licensed Individual View page displays information about an individual licensed for surplus lines. The information is read-only and may not be edited by PSLA.
· PID Individual ID and Name
· License Information
· Associated Customers (this information was entered by PSLA and may be changed from the Customer View page)
· Address
Eligible Insurer View (Internal-only)
The Eligible Insurer View page displays information downloaded from PID about carriers that are on the PID website for Eligible Surplus Lines Insurers.
· PID ID, Old Key Carrier Number, and Carrier Name
· License Information
· Address
The Producer View page displays information downloaded from PID about agencies and individuals licensed as producers.
· PID ID and Producer Name
· License Information
· Address
Declining Company View (Internal-only)
The Declining Company View page displays information downloaded from PID about Pennsylvania Admitted Carriers.
· PID ID, NAIC No. and Company Name
· License Information
· Addresses
Purchasing Group View (Internal-only)
The Purchasing Group View page displays information downloaded from PID about Purchasing Groups.
· PID ID and Purchasing Group Name
· License Information
· Addresses
Build Statement of Account Reports (Internal-only)
This Build Statement of Account Reports page is used to create the draft Statement of Accounts (SOA). Only PSLA Accounting Users should create statements. Select the following criteria and then click the “Generate Reports” button.
· Month: this will be included in the report description and the last day of the selected month will be included in the title for each SOA
· Year: this will be included in the report description and the year will be included in the title for each SOA
· Customers: typically all customers should be selected by clicking the All ===> button
Report Generation (Internal-only)
The Report Generation Page heading displays a running total of the number of reports completed and a running total of the Stamping Fee Balance. The Report Generation table displays the following information for each Statement of Account (SOA).
· Customer ID
· Customer Name
· SOA Month and Year
· SOA Stamping Fee Balance
· Status (“generated PDF” is there is open A/R data or “no data” if there is not)
· Filename for the PDF file (click to view)
· SOA icon (the link to access the image from FDD is displayed after the draft SOA is “APPROVED” by Accounting
If the Total Stamping Fee balance in the header matches the information in Microsoft Dynamics SL, then click “Send Reports to Feith”. Each report will be imported into a Feith workflow for the Accounting Group to review and approve. The PDF files are not available to Users until Accounting “APPROVES” each one.
If the Total Stamping Fee balance in the header does not match the information in Microsoft Dynamics SL, then click “Discard Reports”.
The View Statement of Account displays a list of monthly statements. The default view will list all statements for Customer IDs assigned to you in descending order (the most recent statement first). The view may be modified by changing the search criteria.
· Customer: selecting a specific Customer ID will narrow the list to only that Customer ID (if you are assigned multiple Customer IDs).
· Month: selecting a month will narrow the list for statements for that month but in any year.
· Year: selecting a year will narrow the list for that calendar year.
The role describes who can create and manage User IDs. Changed bookmark to “role”
· PSLA Admin: create and manage PSLA Users and Agency Admin IDs.
· PSLA User: enter data for any Customer ID but cannot create User IDs
· Agency Admin: create and manage Agency User IDs for assigned Customer ID(s). This person was authorized by the surplus lines licensee to create and manage User IDs.
· Agency User: enter or view data for assigned Customer ID(s) but cannot create User IDs
The Login ID is a unique identifier for a user within the Electronic Filing System. A typical Login ID is a person’s email address since it is also unique. The Login ID must be between 7 and 32 characters and not include special characters such as “space”, “*”, “%”, “!”, “/”, and “\”. The Login ID may include periods (.) and underscores (_). Changed bookmark to “LoginId”.
The account status is either:
· Waiting: the Login ID was created but the user has not logged into EFS and accepted the terms and condition.
· Active: the account is active and the user may log into EFS.
· Disabled or Inactive: the account was automatically disabled after 5 incorrect login attempts or the Agency Administrator or PSLA User manually disabled the account.
PSLA enforces the following guidelines for passwords.
· Between 7 and than 32 characters
· Contains letters and at least one number
· Expire every 6 months
· When changing a password, the new password cannot be the same as the old password
· Disable after a maximum of 5 incorrect login attempts
The date the password expires and the number of days left before the password expires. Changing the password resets the date and the number of days left.
This is the email address that the Electronic Filing System will use to contact you.
Please enter your area code and telephone number using a format of 610-594-1340.
Please enter your first name.
Please enter the initial of your middle name (optional).
Please enter your last name or family name.
Please enter a security question so an Agency Administrator or PSLA User may confirm your identify over the telephone.
Please enter the associated answer to the security question so an Agency Administrator or PSLA User may confirm your identify over the telephone.
These are the Customer IDs that PSLA assigned to the Agency Administrator. Based on the permissions below, you will be able to view and change data for items for those Customer IDs. Contact your Agency Admin if you want to add or remove a Customer ID.
· Tip! Only the Agency Admin (or PSLA Admin) can add or remove Customer IDs
· Tip! The permissions are for all assigned Customer IDs.
These are the Customer IDs assigned to you. Based on the permissions below, you will be able to view and change data for items for those Customer IDs. Contact your Agency Admin if you want to add or remove a Customer ID.
· Tip! Only the Agency Admin (or PSLA Admin) can add or remove Customer IDs
· Tip! The permissions are for all assigned Customer IDs.
The types of permissions are:
· None: the user cannot access the data
· Read Only: the user can read data but cannot change data
· Read/Write: the user can read and write data
The Affidavit permission category determines who can:
· Enter and submit a New Affidavit Filing
· Revise/Correct a Submitted Filing
· Submit an Endorsement
· Cancel a Policy
· Search or View for a Policy
The Filing Return permission category determines who can correct and submit a returned filing.
The XML Import permission category determines who can post an XML file to the EFS.
The 1620 Report permission category determines who can view or submit a monthly 1620 Report summary.
The GPT/RCT-123 permission category determines who can view or submit the PSLA copy of an annual Gross Premium Tax report.
The social security number of the signing officer and the social security number of the tax preparer were added to the RCT-123 starting with calendar year 2012. Since social security number is personal information the following restrictions were added to view uploaded RCT-123 reports.
· Only the Agency User or Agency Administrator that originally uploaded the RCT-123 report image can view the image.
· In addition, the Agency User or Agency Administrator must also have RCT-123 Image Permission set to “On” to be able to view the RCT-123 image.
The Customer Edit permission category determines who can view or edit Customer ID contact information for Filing Return, 1620 Report, RCT-123 Tax Return Report, Statement of Account, and general mailing contacts.
Only PSLA may edit the Business contact since PSLA must have a signed EFS Enrollment Application on file from the Business contact.
View Statement of Account permission determines who can view monthly statements.
The Agency Report permission category determines who can view the Agency License Report. If an agency surplus lines license covers multiple locations, each location is assigned a PSLA Customer ID.
· The Customer ID License Report lists the individual surplus lines licensees associated with the agency surplus lines license that have also been associated with this Customer ID. Users that have Customer Edit permission can access the Customer ID License Report on the Customer Edit page.
· The Agency License Report lists the individual surplus lines licensees associated with the agency surplus lines license and the associated Customer ID. Caution, this report may contain information that spans multiple Customer IDs.
The Agency Profile permission determines which PSLA Users can view, edit, or create Agency Administrator and Agency User Login IDs.
· None – cannot search for Agency Administrators/Users and cannot view their profiles
· Read – can search for Agency Administrators/Users and view their profile
· Edit – can change permissions, can change password, cannot change Cust ID assignment, and cannot change Login Name
· Create – can change permissions, can change password, can change Cust ID assignment, and can change Agency User/Admin Login Name
· NOTE: Only a PSLA Administrator can search, view, edit, and create PSLA Users
The Solomon Export permission determines which PSLA Users can generate the Solomon Export file, which can refund a stamping fee, and which can force the Accounting Status of a filing from “Not Ready” to “Ready-to-send” and vice-versa.
· None – cannot generate Solomon Export file, cannot refund stamping fee, and cannot
· Read Only – can generate Solomon Export file but cannot refund stamping fee and cannot force the Accounting Status
· Read/Write – can generate Solomon Export file, can refund stamping fee, and can force the Accounting Status
PSLA Connect permission determines which PSLA Users can create, edit, and re-associate Customer IDs.
PSLA Sponsorship permission determines which PSLA Users can edit Sponsorship information on an Eligible Insurer.
Statement of Account Permission
Statement of Account permission determines which PSLA Users can generate monthly Statement of Accounts. Only the PSLA Financial Services department (accounting) should have permission.
Paper Received Date (Internal-only)
The date the item was received by PSLA via mail or fax. The date may be entered in MM/DD/YY or MMDDYY format or selected by clicking on the calendar icon.
The date the original filing was successfully submitted.
The date the original filing was correctly submitted. If a filing was submitted by an Agency User directly into EFS, the Correctly Received Date will be the same as the Entry Date. If a paper filing was mailed or faxed to PSLA and the paper filing can be successfully submitted by PSLA into EFS, the Correctly Received Date will be the same as the Paper Received Date. If a paper filing was mailed or faxed to PSLA and had to be returned to the Agency for correction, the Correctly Received Date will be the date the Agency corrects the returned filing.
A filing is late if the original filing is correctly received after 1/1/2008 and there are more than 45 days between the Correctly Received Date and the Policy Effective Date.
This is the four digit number assigned to the individual Surplus Lines Licensee’s Agency by PSLA. All filings, 1620 Reports, RCT-123 Reports, and user permissions are by Customer ID. The list of Customer IDs available to a user is identified in the User Profile. The Customer IDs are assigned to an Agency User by the Agency Administrator. Please contact your Agency Administrator if you need access to a Customer ID not on your list.
This is a read-only field. PSLA ID is an internal tracking number for the Electronic Filing System that is assigned when an Original Affidavit Filing is saved or submitted.
· Tip! This was previously called the Affidavit ID.
Provide the Policy Number but do not use the
following characters:
* ? + % “ ” ~ ! @ # $ , ^
( ) _ = [ ] { } \ ; : ‘ < > /.
· Tip! The Electronic Filing System does not require you to append the effective year to the Policy Number.
· Tip! For Filing Type 1610-B, please provide the participating member’s unique Certificate number in the Policy number field, and NOT the Master Policy number.
· Tip! If you submit a filing using a Binder number, you must update the filing with the policy number once it becomes available. Use the “Filing Correction” function in the Electronic Filing System.
Provide the Binder Number but do not use the
following characters:
* ? + % “ ” ~ ! @ # $ , ^
( ) _ = [ ] { } \ ; : ‘ < > /.
· Tip! The Electronic Filing System does not require you to append the effective year to the Policy Number.
· Tip! For Filing Type 1610-B, please provide the participating member’s unique Certificate number in the Binder number field, and NOT the Master Policy number.
· Tip! If you submit any filing using a Binder number, you must provide PSLA with the Policy number once it becomes available. Licensees should do this using the “Correction to Filing” function.
The Customer Reference Number is an optional free-form text field. Many customers use this field to enter their own internal tracking number.
The Affidavit Filing Form is used to submit an original SLL Affidavit/Declaration filing. Filings submitted through the Electronic Filing System do not require an attached image of the Affidavit. The submittal through Electronic Filing is in lieu of the paper Affidavit form. For Filing Type 1609-SLL/1609-PR, an attached image of a signed PR form is required.
As outlined in Sections 1609 and 1610 of Pennsylvania Surplus Lines Law, there is a selection of Affidavit/Declaration types available to the Surplus Lines Licensee. Once a filing is submitted the Filing Type cannot be changed since subsequent fields depend upon the filing type.
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. 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.
The 1609-PR form must be filled out by the producer within 30 days after the Surplus Lines Licensee has placed insurance with an Eligible Surplus Lines Insurer. 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 1609-PR image must be legible and the insured name must match the insured name listed on the electronic SLL Affidavit form or else the filing will be rejected by PSLA and returned.
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. 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 3-year period.
Filing Type 1610-A is for an exempt commercial purchaser. The diligent search requirements of section 1604(2), the reporting requirements of section 1609(a) and the twenty five per centum (25%) limitation of section 1606 shall not apply to placements of insurance with nonadmitted insurers for an exempt commercial purchaser if:
(1) the surplus lines licensee procuring or placing the surplus lines insurance has disclosed to the exempt commercial purchaser that the insurance may be available from the admitted market that may provide greater protection with more regulatory oversight; and
(2) the exempt commercial purchaser has subsequently requested in writing the surplus lines licensee to procure or place the insurance from a nonadmitted insurer.
An "Exempt commercial purchaser” is defined as any person purchasing commercial insurance that, at the time of placement, meets the following requirements:
(1) The person employs or retains a qualified risk manager to negotiate insurance coverage.
(2) The person has paid aggregate nationwide commercial property and casualty insurance premiums in excess of one hundred thousand ($100,000) dollars in the immediately preceding twelve (12) months.
(3) (i) The person meets at least one of the following criteria:
(A) The person possesses a net worth in excess of twenty million ($20,000,000) dollars, as adjusted under subparagraph (ii).
(B) The person generates annual revenues in excess of fifty million ($50,000,000) dollars, as adjusted under subparagraph (ii).
(C) The person employs more than five hundred (500) fulltime or full-time equivalent employees per individual insured or is a member of an affiliated group employing more than one thousand (1,000) employees in the aggregate.
(D) The person is a not-for-profit organization or public entity generating annual budgeted expenditures of at least thirty million ($30,000,000) dollars, as adjusted under subparagraph (ii).
(E) The person is a municipality with a population in excess of fifty thousand (50,000) persons.
A “Qualified risk manager” is defined as a person who meets all of the following requirements with respect to a policyholder of commercial insurance.
(1) The person is an employee of, or third-party consultant retained by, the commercial policyholder.
(2) The person provides skilled services in loss prevention, loss reduction or risk and insurance coverage analysis and purchase of insurance.
(3) The person:
(i) (A) has a bachelor's degree or higher from an accredited college or university in risk management, business administration, finance, economics or any other field determined by the commissioner to demonstrate minimum competence in risk management; and
(B) (I) has three (3) years of experience in risk financing, claims administration, loss prevention, risk and insurance analysis or purchasing commercial lines of insurance; or
(II) has:
(a) a designation as a Chartered Property and Casualty Underwriter issued by the American Institute for Chartered Property and Casualty Underwriter/Insurance Institute of America;
(b) a designation as an Associate in Risk Management issued by the American Institute for Chartered Property and Casualty Underwriter/Insurance Institute of America;
(c a designation as Certified Risk Manager issued by the National Alliance for Insurance Education & Research;
(d) a designation as a RIMS Fellow issued by the Global Risk Management Institute; or
(e) any other designation, certification or license determined by the commissioner to demonstrate minimum competency in risk management;
(ii) (A) has at least seven (7) years of experience in risk financing, claims administration, loss prevention, risk and insurance coverage analysis or purchasing commercial lines of insurance; and
(B) has any one of the designations specified under clauses (a), (b), (c), (d) and (e);
(iii) has at least ten (10) years of experience in risk financing, claims administration, loss prevention, risk and insurance coverage analysis or purchasing commercial lines of insurance; or
(iv) has a graduate degree from an accredited college or university in risk management, business administration, finance, economics or any other field determined by the commissioner to demonstrate minimum competence in risk management
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-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 is used by Surplus Lines Licensees who administer a Purchasing Groups(s). 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.
Only required for Filing Type 1610-B.
· Tip! The drop-down list includes active Purchasing Group Names. If the Purchasing Group Name is not on the drop-down list, please confirm that the Purchasing Group is active.
· Tip! If this is a new Purchasing Group that is not on the drop-down list, please contact PSLA to request an update to the Purchasing Group list. Use the “Save Draft” function to save the filing until the list is updated.
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 Section 1604(2)(ii) of the Pennsylvania Surplus Lines Law, the Insurance Commissioner may declare specific Kinds of insurance coverages 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.
CAUTION! The 1609-X should only be used to report reconciliation and examination discrepancies in accordance to the February 22, 2010 Bulletin. The form enables a surplus lines licensee to report a missing filing when information needed for other filing types is not available. This permits the surplus lines agency to make the required filings no matter the age of the filing. The 1609-X can only be used upon authorization by PSLA. Please contact PSLA Agency Services if you would like to use the 1609-X.
The Insured Name as you would like it to appear on
your monthly Statement of Account from PSLA (Stamping Fee Statement). Please
limit the insured name to 60 characters. Do not use any of the following
characters within the Insured Name.
* ? + % “ ” ~ ! @ # $ , ^ ( ) _
= [ ] { } \ ; : ‘ < > /.
The Location of Risk is the physical address (street, city, and zip code) where the insured risk is located in Pennsylvania. If more than one location exists for the specified policy, please provide the address with the most exposure that Is in Pennsylvania. A Post Office Box is not a valid Location of Risk.
Entering a zip code will select the city if there is only one city. If multiple cities have the same zip code then a list of cities will appear. When the focus is on the city, clicking the down arrow will scroll through the list of cities.
Select the city (if the zip code was entered) or type in the city.
The state for the Location of Risk must be Pennsylvania since this is a filing to the Commonwealth of Pennsylvania.
Select the type or kind of coverage being reported (e.g. Accident & Health, Directors and Officers Liability, etc.). Please note the following abbreviations.
· PROP = Property
· CAS = Casualty
· EXP = Export
Select the industry or business which characterizes the Insured’s operations (e.g. Contracting-Electrical, Professional – Accountants, etc.).
This is the start or effective date of the policy in MM/DD/YYYY or MMDDYY format. Also see keyboard shortcuts.
This is the end or expiration date of the policy in MM/DD/YYYY or MMDDYY format. Also see keyboard shortcuts.
A Multi-state Risk is a risk with insured exposures in more than one state or territory. Select the “Yes” radio button if the policy covers risks in the Commonwealth of Pennsylvania plus one or more other state or territory. Select the “No” radio button if the policy only covers risks in the Commonwealth of Pennsylvania.
An Endorsement can only change Multi-state Risk from “No” to “Yes” because of the following factors.
· If Multi-state Risk was “No”, it may be changed to “Yes” to indicate that a new location outside of the Commonwealth of Pennsylvania was added to the policy. Please review the Change in Policy Premium to ensure it is correct.
· If Multi-state Risk is already “Yes”, it cannot be changed to “No” on an Endorsement because the change may impact the original tax calculation. The “Revise Filing” function may be used to change Multi-state Risk to “No”.
· If the original filing was entered prior to EFS Release 3.0, the Multi-state Risk field is blank. It cannot be selected on an Endorsement because the selection may impact the original tax calculation. The “Revise Filing” function may be used to set Multi-state Risk.
An Eligible Insurer is an insurer who is not admitted within the Commonwealth of PA, but who has been deemed eligible by the PA Insurance Department to place surplus lines coverage within PA. Please check the Pennsylvania Insurance Department (PID) website for the Eligible Surplus Lines Insurer List.
· Tip! An Eligible Insurer was previously called the Key Carrier.
Provide the Number of the Eligible Surplus Lines carrier providing coverage for the policy (from the most recent Eligible List). Please check the Pennsylvania Insurance Department (PID) website for the Eligible Surplus Lines Insurer List. Form 1606-A must be completed if Ineligible Insurers are used. Enter 0011 as the number for the first Ineligible Insurer, 0012 for the second Ineligible Insurer, and 0013 for the third Ineligible Insurer.
· Tip! Eligible Insurer Number was previously called the Key Carrier Number.
The Eligible Insurer Name will automatically populate based on the Eligible Insurer Number. Please check the Pennsylvania Insurance Department website for the Eligible Surplus Lines Insurer List.
· Tip! Eligible Insurer Name was previously called the Key Carrier Name.
If the Policy Effective Date is after 6/30/2011, provide the Insured Value of the U.S. portion of Property Coverage included within the policy in monetary ($) format for a carrier (exclude coverage outside of the United States). If there is only one Eligible Insurer the Property Limit is the same as the Total Property Limit. If no property coverage is included, enter $0. You may refer to the PSLA List of Types of Coverage to verify the types of limits required for the Type of Coverage (previously called Kind of Insurance) indicated on the Affidavit.
If the Policy Effective Date is before 7/1/2011, provide the Insured Value of the PA portion of Property Coverage included within the policy in monetary ($) format for a carrier. If there is only one Eligible Insurer the Property Limit is the same as the Total Property Limit. If no property coverage is included, enter $0. You may refer to the PSLA List of Types of Coverage to verify the types of limits required for the Type of Coverage (previously called Kind of Insurance) indicated on the Affidavit.
If the Policy Effective Date is after 6/30/2011, provide the General or Policy Aggregate amount of the U.S. portion of Casualty Coverage included within the policy in monetary ($) format for a carrier (exclude coverage outside of the United States). If there is only one insurer the Casualty Limit is the same as the Total Casualty Limit. If no Casualty Coverage is included, enter $0. You may refer to the PSLA List of Types of Coverage to verify the types of limits required for the Type of Coverage (previously called Kind of Insurance) indicated on the Affidavit.
If the Policy Effective Date is before 7/1/2011, this is the General or Policy Aggregate amount of the Pennsylvania portion of Casualty Coverage included within the policy in monetary ($) format for a carrier. If there is only one insurer the Casualty Limit is the same as the Total Casualty Limit. If no Casualty Coverage is included, enter $0. You may refer to the PSLA List of Types of Coverage to verify the types of limits required for the Type of Coverage (previously called Kind of Insurance) indicated on the Affidavit.
The full gross premium for the carrier for:
· The portion of the risk located in the Commonwealth of Pennsylvania.
· The full term of the policy period being reported (do not provide monthly or quarterly billing transaction amount).
If there is only one insurer, the PA Premium is equal to the Policy Premium.
The full gross premium for the carrier for:
· The portion of the risk located in the Commonwealth of Pennsylvania.
· If 100% of the risk is in the Commonwealth of Pennsylvania (“Multi-state Risk” is set to “no”), the PA Premium is the same as the Policy Premium and EFS will automatically set the Policy Premium.
· The full term of the policy period being reported (do not provide monthly or quarterly billing transaction amount).
· Tip! If you need to report a filing with $0 Premium, the Reporting-only Box must be checked before submittal. If the Reporting-only Box is not checked, a filing with $0 Total Premium will fail validation and cannot be submitted.
The full gross premium for the carrier for:
· All locations of risk within the United States where the Commonwealth of Pennsylvania is the Home State.
· If the policy covers risks outside of the United States, only enter the premium associated with risks within the United States and territories.
· If “Multi-state Risk” is set to “no”, the Policy Premium is automatically set to the PA Premium.
· The full term of the policy period being reported (do not provide monthly or quarterly billing transaction amount).
There are some instances where a filing must be reported with a premium of $0, in order for subsequent reporting endorsements to be filed (refer to the PSLA Procedures Manual for details). If you need to report a filing with $0 Total Premium, the Reporting-only box must be checked before submittal. If the Reporting-only Box is not checked, a filing with $0 Total Premium will not pass validation.
CAUTION! The Omissions box enables a surplus lines licensee to submit a missing filing or revise an incorrect filing without a late fee. The Pennsylvania Insurance Department temporarily waived the late fee between 3/1/2010 and 12/31/2010 to encourage licensees to update their records. The box is not valid after 12/31/2010.
A reason must be provided if the Omissions box is checked. The reason will be made available to the Pennsylvania Insurance Department. Typical reasons include:
· Submitted missing filing and have information for an existing filing type
· Submitted missing filing, did not have information for an existing filing type so used 1609-X reporting form
· Corrected filing type from 1609-B to 1609-SLL
· Corrected filing type from 1610-A to 1609-SLL
Revenue Recognition Date is the date that surplus line premium will be reported on a 1620 Monthly Report and recognized from a surplus lines tax reporting perspective. Contact your agency tax accountant for more information.
· Surplus lines premium from new filings, endorsements, and cancellations that will be reported on the 1620 Monthly Report for a calendar month should have a Revenue Recognition Date within the same month.
· Surplus lines premium from new filings, endorsements, and cancellations that will be reported on the Gross Premium Tax report for a calendar year should have a Revenue Recognition Date within the same year.
Also see keyboard shortcuts.
· If the Policy Effective Date is before 7/1/2011, tax is automatically calculated at 3% of the PA Premium if the tax-exempt box is unchecked and tax is set to $0 if the tax-exempt box is checked.
· If the Policy Effective Date is after 6/30/2011, tax is automatically calculated at 3% of the Policy Premium if the tax-exempt box is unchecked and tax is set to $0 if the tax-exempt box is checked.
· Tip! If a Form 1606-A is selected then total premium will include the premium amounts that are entered in that form.
Certain classes of business are exempt from the 3% surplus lines premium tax. The Department of Revenue has determined that premiums charged the commonwealth and its political subdivisions (counties, municipalities, school districts, etc.) are exempt from the tax.
This determination is made by the Department of Revenue and not the Insurance Department, and certainly not PSLA. For clarification or additional information regarding the tax exempt status of a particular placement, the Insured or the Insured’s representative should obtain a determination from the Department of Revenue, preferably in writing.
The “Tax Exempt” box should be checked if the placement is deemed tax exempt.
Attachment 1606-A is required on those (rare) occasions, when due to specific circumstances, a portion of said risk (not exceeding 25%) is forced to be placed with unapproved non-admitted insurance carriers which do not appear on the list of Eligible Surplus Lines Insurers published by the Pennsylvania Insurance Department. Attachment 1606-A must be completed and included with the completed Surplus Lines Affidavit (applicable to all filing types).
· Tip! Filing Type 1610-B should not have Ineligible Insurers. Ineligible Insurers used with Filing Type 1610-B will be reported to the Pennsylvania Insurance Department.
· Tip! The coverage from Ineligible Insurers must be less than 25% of the Total Property Limit and less than 25% of the Total Casualty Limit for filing types 1609-SLL/1609-PR, 1609-B, and 1604-E.
· Tip! Filing Type 1610-A may have up to 100% of the Property Limit and up to 100% of the Casualty Limit from Ineligible Insurers. The 25% limitation does not apply, however, the 1606-A information is still required.
An Ineligible Insurer is a non-admitted insurer who is also not on the list of Eligible Surplus Lines Insurers or updates to the list, published by the Pennsylvania Insurance Department. Please check the Pennsylvania Insurance Department website for the Eligible Surplus Lines Insurer List.
The Insured Value of the Pennsylvania portion of the Property Coverage included within the policy in monetary ($) format for the Ineligible Insurer. If no property coverage is included, enter $0.
The General or Policy Aggregate amount of the Pennsylvania portion of Casualty Coverage included within the policy in monetary ($) format for the Ineligible Insurer. If no Casualty Coverage is included, enter $0.
The full premium for the Non-admitted Insurer for:
· The portion of the risk located in the Commonwealth of Pennsylvania.
· The full term of the policy period being reported (do not provide monthly or quarterly billing transaction amount).
A description of why the risk was placed with an Ineligible Insurer(s).
A Multi-state Risk is a risk with insured exposures in more than one state or territory. Select the “Yes” radio button if the policy covers risks in the Commonwealth of Pennsylvania plus one or more other state or territory. Select the “No” radio button if the policy only covers risks in the Commonwealth of Pennsylvania.
(A) IN GENERAL. Except as provided in subparagraph (B), the term ‘‘Home State’’ means, with respect to an insured:
(i) The State in which an insured maintains its principal place of business or, in the case of an individual, the individual’s principal residence; or
(ii) If 100 percent of the insured risk is located out of the State referred to in clause (A)(i), the State to which the greatest percentage of the insured’s taxable premium for that insurance contract is allocated.
(B) AFFILIATED GROUPS. If more than one insured from an affiliated group are named insureds on a single Non-admitted Insurance contract, the term ‘‘Home State’’ means the Home State, as determined pursuant to subparagraph (A), of the member of the affiliated group that has the largest percentage of premium attributed to it under such insurance contract.
The term ‘‘State’’ includes any State of the United States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the Northern Mariana Islands, the Virgin Islands, and American Samoa.
Multi-state Premium is the total premium for a policy that covers risks in the Commonwealth of Pennsylvania plus one or more other state or territory. Total Multi-state Policy Premium must be greater than the premium for the portion of the risk located in the Commonwealth of Pennsylvania.
The term “Surplus”, as used in the financial requirements of section 1605, means funds over and above liabilities and capital of the company for the protection of its policyholders.
Any insurance of risks resident, located or to be performed in this Commonwealth, permitted to be placed through a surplus lines licensee with a non-admitted insurer eligible to accept such insurance, other than reinsurance, wet marine and transportation insurance, independently procured insurance, life and health insurance and annuities and coverage obtained from risk retention groups under the Risk Retention Amendments of 1986 (Public Law 99-563, 100 Stat. 3170).
A Surplus Lines Licensee (SLL) is an individual, partnership or corporation licensed under section 1615 to place surplus lines insurance with non-admitted insurers eligible to accept such insurance.
This is the name of the Agency that is a Surplus Lines Licensee.
Select the name of the licensed Surplus Lines individual who affected the insurance described within this filing.
This is the surplus lines license number for the individual that is a Surplus Lines Licensee.
Signature of Licensee Provided (Internal-only)
This box should be checked if the paper SLL Affidavit form was signed by the Licensee.
PID is the Insurance Department for the Commonwealth of Pennsylvania.
The NAIC number is a five-digit identification number from the National Association of Insurance Commissioners (NAIC). The 1609-PR form requires NAIC numbers for three licensed admitted carriers who declined to insure the risk. A minimum of three declinations from Companies Licensed (Admitted) in the Commonwealth of Pennsylvania who write coverage comparable to the coverage sought is required. Electronic Filing will accept fewer than three declinations but the submitter will be reported to the Pennsylvania Insurance Department. Click here to Search for an NAIC Number.
The name of the Licensed Company associated with the selected NAIC number.
The first name and last name of the representative at the Licensed Company who declined the risk.
The Producer is the broker dealing directly with the party seeking insurance. Click here to search for a producer on the Pennsylvania Insurance Department website. The Producer may also be described as the “Producing Broker”
On the Affidavit form if the License Number of the Individual Producer was previously entered, the Name of the Individual Producer will automatically be populated. The Producer may also be described as the “Producing Broker”. Click here to search for a producer on the Pennsylvania Insurance Department website.
This function will allow you to select and upload an image file. The file should be a scanned image of a completed/signed 1609-PR form. Recommended file formats are:
· Uncompressed TIF
· JPG
While revising a filing, the “Re-submit” radio button should be selected if you want EFS to automatically upload the most recent 1609-PR image file for the same filing. If you want to upload a revised 1609-PR image file than the “Upload” radio button should be selected. After the revised filing is submitted, PSLA will review the uploaded or re-submitted PR image file and compare it against data entered in the revised filing.
1609-PR Image Legible Indicator (Internal-only)
This field should be checked if the PR image is legible. If it is not checked, the filing will be returned to the external user since this is a critical error.
1609 PR Image Insured Name Matches Indicator (Internal-only)
This field should be checked if the named insured on the 1609-PR image matches the named insured on the Affidavit Form. If it is not checked, the filing will be returned to the external user since this is a critical error.
Producer Signature Indicator (Internal-only)
This field should be checked if the PR image was signed. If the image was not signed, the filing will be returned to the external user since this is a critical error.
This field should be checked if the Surplus Lines Licensee was unable to obtain a completed 1609-PR form from the Producer. The Producer Name and Producer Address must then be supplied. 1609-SLL/1609-PR filings where the agency was unable to obtain the PR Form will be reported to the Department of Insurance.
If the 1609-PR form was not supplied, fill in the Producer Name. The “Producer Name” is sometimes described as the “Producing Broker”.
If the 1609-PR form was not supplied, fill in the Producer Address.
Enter Policy/Binder Number Again
Type in the Policy/Binder number again to confirm double check the policy/binder number entered at the beginning.
The services performed by PSLA are funded by a non-refundable processing fee (stamping fee) assessed for each filing submitted to PSLA. The processing fee is established by the Board of Governors of PSLA on a yearly basis and approved by the Pennsylvania Insurance Department. The Surplus Lines Licensee must bill and collect the processing fee from the insured and said fee should be stated on the declaration page of the policy or other evidence of coverage, as a separate item, below the surplus lines tax amount.
If the “Unable to Obtain PR” box is checked, there is a non-refundable Missing PR Stamping Fee effective as of January 1, 2011. Refer to the 10/13/2010 Bulletin for additional information.
The Total Stamping Fee is the standard Stamping Fee plus the Missing PR Stamping Fee.
An entity formed to purchase liability insurance under the Risk Retention Amendments of 1986 (Public Law 99-563, 100 Stat. 3170). Only required for Filing Type 1610-B.
The Commissioner is responsible for the Insurance Department of the Commonwealth of Pennsylvania.
The Policy/Binder number is often entered incorrectly. Please re-enter the Policy/Binder number that was entered at the top of the form so we can double check the number.
Resident State (Internal-only)
This is the state of the SLL Agency Address. Selecting “Resident” should filter results by PA residents.
The Endorsement Number is an optional alphanumeric text field that should be used by agencies to track their endorsements. If there is an endorsement number printed on the endorsement being reported, it should be provided here.
The Endorsement Effective Date of Change is the date the endorsement becomes effective. Also see keyboard shortcuts.
This is the current Property Limit, Casualty Limit, Premium, or Tax. It is a read-only field that is the original filing limit plus revisions from Revisions to Submitted Filings plus changes from Endorsements.
This is the change to the Property Limit, Casualty Limit, Premium, or Tax from this endorsement. It is an editable field. A positive number increases the amount (additional premium), a negative number decreases the amount (returned premium), and zero or a blank field indicates no change to the amount.
· Tip! – enter a negative number for a Returned Premium (e.g. -100 is a returned premium of $100).
This is the sum of the Current plus Change and is a read-only field.
These fields are the New Totals for Property Limit, Casualty Limit, Premium, and Tax.
The Cancellation Reference Number is an optional alphanumeric text field that may be used by agencies to track their cancellations.
The date cancellation of the policy becomes effective. Also see keyboard shortcuts.
Typically PSLA does not return the stamping fee so the amount should be $0. PSLA management should approve any other amount.
Returned Premium is the amount of premium returned as a result of the cancellation.
The amount of tax returned as a result of the cancellation.
Checking the Flat Cancel box will automatically set the Returned Premium to the current amount.
The Cancellation Reference Number is an optional alphanumeric text field that may be used by agencies to track their cancellations.
The inactivation effective date is typically the policy effective date. Also see keyboard shortcuts.
The Reinstate Reference Number is an optional alphanumeric text field that may be used by agencies to track their reinstatement.
The date the policy was reinstated. Please use the Endorsement Form to make any other changes. Also see keyboard shortcuts.
Enter the fee to be refunded as a positive number. The refund amount must be less than or equal to the total stamping fee.
Describe the reason for the reason and include the initials of the person who approved the refund. Enter a maximum of 1000 characters.
Check the box if the refund is to return the late portion of the stamping fee. A checked box will clear the late portion of the stamping fee in the EFS database for reports.
The Report Type defines whether the user is submitting a “new” report or “revising” an existing report.
This is the month for the 1620 Report.
This is the year for either the1620 Monthly Report or the GPT/RCT-123 Annual Report.
This is the total non-taxable Premium for the month for the selected Customer ID. This is the total for the column titled “Non-taxable Premium” on the 1620 Monthly Report. Refer to the PSLA Procedures Manual for additional information.
This is the total taxable premium for the month for the selected Customer ID.
This is the total tax for the month for the selected Customer ID.
When submitting either a 1620 Monthly Report or a GPT/RCT-123 Annual Report, an image file of the report must be uploaded along with the summary information.
Check yes if the image is legible and no if it is not.
The Organization ID is assigned by the Pennsylvania Insurance Department. It is a confidential, unique identifier for each company similar to an Employer Identification Number (EIN). A single Org ID may have multiple Customer IDs since PSLA assigns a Customer ID to each location. A search by Org ID will return reports for all Customer IDs that belong to a single Org ID.
The Resident State is the state where the surplus lines licensee is located.
1620 Monthly Reports and RCT-123 Annual Tax Reports have a status associated with the report.
· An Agency User submits a 1620 Monthly Report that includes an uploaded report image. After the report is submitted, the status is “Report Review Pending”.
· PSLA reviews the uploaded report image to confirm it is legible and matches the information submitted.
○ If the image is legible and matches the submitted information, PSLA approves the report and the report status changes to “Submitted/Approved”.
○ If the image is either not legible or does not match the submitted information, PSLA returns the report, an email describing the return reasons is sent to the 1620 contact and the Business contact, and the report status changes to “Report Returned”.
· The header on the home page informs Agency Users if there are returned reports. An Agency User should revise the Report and upload a corrected image. After the revision is submitted, the report status is changed back to “Report Review Pending”.
Each report has a unique identifier. If a report is revised, it receives a new unique identifier. Only the latest version of a report is active. Older versions that have been revised are inactive and will not show up in a search.
This is the total gross premium for the selected year. It includes premium returned on cancelled policies and tax-exempt premium. It should be equal to the sum of all Gross Premium items on the GPT/RCT-123 Report. Refer to the PSLA Procedures Manual for additional information.
This is the total premium returned on cancelled policies.
This is the total premium from tax-exempt policies.
This is Total Gross Premium less Total Returned Premium less Total Tax-exempt Premium.
This is the tax on Total Taxable Premium (3% of the Total Taxable Premium). Enter an amount.
Each Filing has a “status” that defines the allowable actions on the filing. Filing Status is one of the Search Display’s criteria for searching.
· Saved/Draft: information was entered into the Affidavit Form but the Original Filing was not submitted to the Electronic Filing System. The Save as a Draft function enables a user to complete an Original Filing at a later date. The Save as a Draft button is only available on new filings that have not been submitted.
○ The filing must have a Customer ID before saving but it may contain blank fields and errors.
○ The filing may be opened and saved as a draft multiple times by multiple users.
· Submitted/Approved: the Original Filing or Revised Filing was successfully submitted to the Electronic Filing System (EFS). Filings with warning errors may be successfully submitted but errors may be reported to the Pennsylvania Insurance Department.
○ Filing Types 1609-B, 1610-A, 1610-B, and 1604-E: when the Submit Filing button is clicked, the status is set to Submitted/Approved.
○ Filing Type 1609-SLL/1609-PR: when the Submit Filing button is clicked by an Agency User, the status is set to Submitted/Approved if it doesn’t have an attached image. If it has an image, the status is set to Pending Filing Review since PSLA must review the image and enter PR information. An Original 1609-SLL/1609 Filing must have an image to pass validation. A Revision may, or may not have an image.
○ ○ If an Internal PSLA User submits Filing Type 1609-SLL/1609-PR the filing does not require an attached image since FDD is used to scan in the image.
· Filing Review Pending: the filing requires review by a PSLA User.
○ Filing Type 1609-SLL/1609-PR originally submitted by an Agency User: the attached 1609-PR image must be reviewed. If the image has critical errors the Filing Status will be set to Filing Return Sent and returned to the Agency.
○ Filings submitted by paper/fax and entered by an internal PSLA User: the filing has errors that need review within PSLA.
○ Internal-only: if errors prevent a filing from being submitted, use the Save for Filing Review button to put the filing in Filing Review Pending.
○ Internal-only: use FDD to route the filing to one of the review tasks.
· Filing Return Sent: the filing needs to be fixed by the Agency User. See section on Fix Filing Return Errors.
○ Filing Type 1609-SLL/1609-PR originally submitted by an Agency User: the attached image contained an error(s) that must be corrected. The Agency User should use the Revise Filing function to attach a corrected image and resubmit it. Errors that result in a returned filing are: illegible image, mismatch between the Named Insured on the image and the Named Insured entered on the Affidavit Form, missing Producer signature, and missing Producer Name/Address.
○ Filings submitted by paper/fax and entered by an internal PSLA User: PSLA entered the new filing into the EFS but there are errors that must be fixed. If the filing is type 1609-SLL/1609-PR it may require a new image to correct the error.
○ Internal-only: if a filing is in the Filing Review Pending status, the Return to Agency button is enabled and if used it will set the document status to Filing Return Sent. EFS will set a flag so an email is sent to the Customer’s Filing Return Contact person and a message is displayed on the home page.
○ Internal-only: use FDD to route the filing to the Agency.
· Cancelled: the filing was cancelled. The policy number is retained so it may not be reused.
· Inactive: the filing was inactivated. The policy number was removed so it may be reused.
The state contained in the business address of the Customer ID.
If an organization has multiple Customer IDs, the Customer Org ID will search for data for within all of the associated Customer IDs.
Filing Source identifies who or what submitted the original filing.
· Internal: a user with a role of PSLA User or PSLA Admin submitted the filing.
· External: a user with a role of Agency User or Agency Admin submitted the filing.
· XML: an external Agency User imported an XML file that automatically submitted the filing..
Each transaction (new filing, revise filing, endorsement...) has a unique identifier within the Electronic Filing System. The Transaction ID is used to link filing data to images stored in the Feith Document Database.
Transaction types are the following.
· NW – New: new original filing
· CO – Correction/revision: “Revise Filing” was used to correct the filing.
· EN – Endorsement: “Submit Endorsement” was used.
· RV – Pending Filing Review: the filing either has a 1609-PR image that needs to be reviewed by PSLA or a paper affidavit was mailed to PSLA and it has errors that need to be reviewed.
· RT – Filing Return Sent: the filing either needs a corrected 1609-PR image or errors that need to be fixed by the agency.
· CN – Cancel: The policy was cancelled.
· RI – Reinstate. A cancelled policy was reinstated.
· IN – Inactivate: The policy was inactivated.
Accounting Status describes whether information was sent to PSLA’s accounting system.
· NR – Not ready: not ready to send.
· RS – Ready-to-send: the information is ready to be exported. PSLA Data Services Supervisor will manually initiate the export.
· S – Sent: the information was exported to PSLA’s accounting system.
The date information from Electronic Filing System was sent to PSLA’s accounting system.
1609-PR images submitted by external Agency Users via the Electronic Filing System are stored in PSLA’s document management system called Feith Document Database (FDD). Paper filings mailed/faxed by external Agency Users are also stored in FDD. If a transaction is linked to an image in FDD a filing icon is displayed. N/A means an image is not available.
Record Types are:
· Customers
· Main Agencies
· Licensed Individuals
· Eligible Insurers
· Producers
· Declining Companies
· Purchasing Groups
The Name is the agency name, company name, individual last name, and/or individual first name. A space separating two text strings in Name field is equivalent to putting an “AND” in the search. For example, entering “John Smith” will return individuals and agencies with both “John” AND “Smith” in the name field.
The business type identifies whether a license is for an individual or an agency.
The surplus lines license number issued by the Pennsylvania Insurance Department to an individual or agency company.
The NAIC No. criterion filters the search by a partial or complete NAIC Number.
The PID ID is also used as the Eligible Insurer number. The Pennsylvania Insurance Department issues a unique identifier for each agency and a different unique identifier for each individual. The PID ID covers both the agency identifier and the individual identifier. This is also known as the COSMOS Org ID and COSMOS Individual ID.
The Old Carrier ID is the 4-digit number that is no longer used.
Customer ID Assigned options are: Yes, No, or Either. This enables a search for individuals that are sole proprietors and have been assigned a Customer ID.
License status options are: Active, Inactive, or Either. This narrows a search to only active licenses.
The name created by PSLA that is associated with the Customer ID.
The name downloaded from PID that is associated with the PID organization ID.
The Employer Identification Number (EIN) is downloaded from PID and is a unique identifier from the federal government.
Customer Status is used to filter email distribution lists at PSLA. “Inactive” customers are typically excluded from the email distribution.
The Pennsylvania Insurance Department instituted a moratorium period from 3/1/2010 to 12/31/2010 during which surplus lines licensees have been permitted to waive the late stamping fee by checking an “Omissions” box. The 1609-X filing type enabled agencies to submit filings during this period if the agency didn’t have the required information for the standard filing types. This permission identifies whether the Customer ID may submit a 1609-X filing type.
The last name and first name of individuals associated with a Customer ID.
The associated individual surplus lines license number.
The associated individual surplus lines license type - Resident Surplus Lines (RSL) or Non-resident Surplus Lines (NSL).
The status of the individual surplus lines license – Active (AC) or Inactive (IN).
The date PID associated the individual with the Main Agency. This is downloaded from PID.
The date PID unassociated the individual with the Main Agency. This is downloaded from PID.
Alternative names for the Main Agency downloaded from PID.
The contact’s first and last name.
· Only PSLA may edit the Business contact information.
· The agency should identify and maintain the information for Filing Return, 1620 Report, RCT Tax Return, Statement of Account, and general information contacts.
This is the email address for the contact.
This is the first line of the address for the contact.
This is the second line of the address for the contact.
This is the city for the contact.
This is the state for the contact.
This is the postal zip code for the contact.
This is the postal code for the contact.
This is the county code for the contact.
This is the telephone number for the contact.
The telephone number extension .
This is the facsimile number for the contact.
The license status date is provided by the Pennsylvania Insurance Department.
The license type is provided by the Pennsylvania Insurance Department. The type is SL or SLM for a surplus lines license.
This is the last and first name of the licensed individual.
If the individual licensee is a sole proprietor, this is the Customer ID assigned to the individual.
The company name of the Eligible Insurer, Declining Company, or Purchasing Group.
The agency or individual name of the Producer
This is the four digit number assigned to the individual Surplus Lines Licensee’s Agency by PSLA. The list of Customer IDs available to a user is identified in the User Profile. The Customer IDs are assigned by the Agency Administrator. Please contact your Agency Administrator if you need access to Statement of Accounts (SOA) for a Customer ID not on your list.
This is the month for the Statement of Account (SOA).
This is the year for the Statement of Account (SOA).
In a date field, the following keyboard shortcuts are available.
· T: enters today’s date
· Y: enters 1 year after the Policy Effective Date
· E: enters the Policy Effective Date (if known)
· X: enters the Policy Expiration Date (if known)
Please refer to the Appendix in the PSLA Procedures Manual for a list of error codes.