N.M. Code R. § 13.19.2.17
C. Each surplus lines broker shall comply with the reporting and affidavit requirements of Section 59A-14-11 NMSA 1978 and shall file the following documents using the forms and electronic format prescribed in this rule:
(1) the quarterly summary report form prescribed in 13 NMAC 19.2.20 [now 13.19.2.20 NMAC];
(2) a diskette containing the following information in the following format:
Item No. Information required Type of field Number of characters or format 1 Name of insurer Text 80 2 NAIC company code or alien listing code Text 12 3 Policy number Text 40 4 Effective date of policy Date mm/dd/yyyy 5 Termination date of policy Date mm/dd/yyyy 6 Specific description of coverage Text 160 7 Premium Number 2 decimal places 8 Additional premium Number 2 decimal places 9 Cancellation or return premium Number 2 decimal places 10 Additional fees Number 2 decimal places 11 Total Number 2 decimal places 12 State tax (3% of Total) Number 2 decimal places
Item No.
Information required
Type of field
Number of characters or format
1
Name of insurer
Text
80
2
NAIC company code or alien listing code
Text
12
3
Policy number
Text
40
4
Effective date of policy
Date
mm/dd/yyyy
5
Termination date of policy
Date
mm/dd/yyyy
6
Specific description of coverage
Text
160
7
Premium
Number
2 decimal places
8
Additional premium
Number
2 decimal places
9
Cancellation or return premium
Number
2 decimal places
10
Additional fees
Number
2 decimal places
11
Total
Number
2 decimal places
12
State tax (3% of Total)
Number
2 decimal places
(3) two copies of a printout made from the diskette, one of which will be returned to the surplus lines broker as proof of filing the report; the printout shall show totals in each number column;
(4) the declarations page of the policy attached to the producing broker affidavit for each surplus lines insurance policy written, in the order in which they appear on the diskette and printout;
(5) a check for the amount of taxes due.
D. Each surplus lines insurer shall file the following documents with the superintendent on or before March 1 of each year, using the form and the electronic format prescribed in this rule:
(1) The annual summary report prescribed in 13 NMAC 19.2.21 [now 13.19.2.21 NMAC], listing all surplus lines insurance policies written for risks in New Mexico in the preceding calendar year and indicating the surplus lines broker through whom they were placed.
(2) A diskette containing the following information in the following format:
Item No. Information required Type of field Number of characters 1 Policy number Text 12 2 Effective date of policy Date mm/dd/yyyy 3 Termination date of policy Date mm/dd/yyyy 4 Kind of insurance Text 100 5 Zip code of insured Text 10 6 Premium Number 2 decimal places 7 Additional premium Number 2 decimal places 8 Cancellation or return premium Number 2 decimal places 9 Additional fees Number 2 decimal places 10 Total Number 2 decimal places 11 State tax (3% of Total) Number 2 decimal places
Item No.
Information required
Type of field
Number of characters
1
Policy number
Text
12
2
Effective date of policy
Date
mm/dd/yyyy
3
Termination date of policy
Date
mm/dd/yyyy
4
Kind of insurance
Text
100
5
Zip code of insured
Text
10
6
Premium
Number
2 decimal places
7
Additional premium
Number
2 decimal places
8
Cancellation or return premium
Number
2 decimal places
9
Additional fees
Number
2 decimal places
10
Total
Number
2 decimal places
11
State tax (3% of Total)
Number
2 decimal places
(3) Two copies of a printout made from the diskette, one of which will be returned to the surplus lines insurer as proof of filing the report; the printout shall show totals in each number column.
[1/1/99; Recompiled 11/30/01]