"Purchasing Group Notice and Registration Form" - Nebraska

Purchasing Group Notice and Registration Form is a legal document that was released by the Nebraska Department of Insurance - a government authority operating within Nebraska.

Form Details:

  • Released on October 1, 2011;
  • The latest edition currently provided by the Nebraska Department of Insurance;
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MEMORANDUM
TO:
All Purchasing Groups Proposing to Transact Business in Nebraska
FROM:
Department of Insurance
SUBJECT:
Requirements Under Liability Risk Retention Act of 1986 and Nebraska Risk Retention
Act
The Nebraska Risk Retention Act, hereafter "NRRA" and codified under Neb.Rev.Stat. §44-
4401 et seq., became effective May 6, 1987, and is intended to be consistent with and
complementary to the Federal Liability Risk Retention Act of 1986, hereafter "LRRA". NRRA is
substantially the same as the December 10, 1986 NAIC Model Risk Retention Act draft. The
following outlines Nebraska's requirements regarding purchasing groups.
Notice of Intent to do Business
I.
A purchasing group which intends to do business in Nebraska shall furnish notice of such
intention to the Director of Insurance using the National Association of Insurance Commissioners
standard purchasing group registration form. Such notice shall, among other things:
Identify the state in which the purchasing group is domiciled;
(1)
Specify the lines and classifications of liability insurance which the purchasing
(2)
group intends to purchase;
(3)
Identify the insurance company from which the group intends to purchase its
insurance and the domicile of such company;
Identify the principal place of business of the group;
(4)
Provide a general description of business or activities engaged in by group members;
(5)
Provide copies of any organizational documents of the purchasing group, such as
(6)
Articles of Incorporation/Association or By-Laws;
Written verification from the State Department of Insurance where the purchasing
(7)
group is domiciled that the purchasing group is properly registered in that state;
Provide name and address of agents or brokers licensed by the Nebraska
(8)
Department of Insurance through whom purchases in Nebraska will be effected;
Designate the Director of Insurance of Nebraska as agent solely for purposes of
(9)
receiving service of legal process in accordance with the requirements of LRRA;
An initial registration fee of $100.00 will be required and a $100.00 annual renewal
(10)
due October 1 of each year will be required to continue the registration.
MEMORANDUM
TO:
All Purchasing Groups Proposing to Transact Business in Nebraska
FROM:
Department of Insurance
SUBJECT:
Requirements Under Liability Risk Retention Act of 1986 and Nebraska Risk Retention
Act
The Nebraska Risk Retention Act, hereafter "NRRA" and codified under Neb.Rev.Stat. §44-
4401 et seq., became effective May 6, 1987, and is intended to be consistent with and
complementary to the Federal Liability Risk Retention Act of 1986, hereafter "LRRA". NRRA is
substantially the same as the December 10, 1986 NAIC Model Risk Retention Act draft. The
following outlines Nebraska's requirements regarding purchasing groups.
Notice of Intent to do Business
I.
A purchasing group which intends to do business in Nebraska shall furnish notice of such
intention to the Director of Insurance using the National Association of Insurance Commissioners
standard purchasing group registration form. Such notice shall, among other things:
Identify the state in which the purchasing group is domiciled;
(1)
Specify the lines and classifications of liability insurance which the purchasing
(2)
group intends to purchase;
(3)
Identify the insurance company from which the group intends to purchase its
insurance and the domicile of such company;
Identify the principal place of business of the group;
(4)
Provide a general description of business or activities engaged in by group members;
(5)
Provide copies of any organizational documents of the purchasing group, such as
(6)
Articles of Incorporation/Association or By-Laws;
Written verification from the State Department of Insurance where the purchasing
(7)
group is domiciled that the purchasing group is properly registered in that state;
Provide name and address of agents or brokers licensed by the Nebraska
(8)
Department of Insurance through whom purchases in Nebraska will be effected;
Designate the Director of Insurance of Nebraska as agent solely for purposes of
(9)
receiving service of legal process in accordance with the requirements of LRRA;
An initial registration fee of $100.00 will be required and a $100.00 annual renewal
(10)
due October 1 of each year will be required to continue the registration.
MEMO TO:
All Purchasing Groups Proposing to Transact Business in
Nebraska Page Two
II.
Agents and Brokers
Persons, other than licensed surplus lines agents, acting or offering to act as an agent or
broker for a purchasing group which solicits members, sells insurance coverage, purchases
insurance coverage for its members located within this State or otherwise does business in this
State shall, before commencing any such activity, obtain a license from the Director pursuant to the
Insurance Producer's Licensing Act, Neb.Rev.Stat.
§44-4001 et seq. The requirements imposed on non-resident agents and brokers shall be the same
as the requirements imposed on resident agents or brokers. In any event, there is no requirement
that any insurance policy issued to a purchasing group or any members of the group be
countersigned by an insurance agent or broker residing in Nebraska.
A purchasing group may not purchase insurance for risks or exposures located in Nebraska
from any risk retention group which does not meet the requirements of LRRA or NRRA. Moreover,
a purchasing group may not purchase insurance for any risk or exposure located in Nebraska from
an insurer not admitted to transact business in Nebraska, unless the purchase is effected through a
licensed surplus lines agent in accordance with the requirements of Nebraska law, Neb.Rev.Stat.
§44-139 et seq. However, such surplus lines agents and brokers need not be residents of
Nebraska. A purchasing group having members or exposures located in Nebraska shall be subject
to all applicable Nebraska laws which do not discriminate against a purchasing group or its
members.
Reporting Requirements and Taxes
III.
1.
Insurer Licensed in Nebraska:
If the purchasing group purchases insurance from an insurance company licensed in
Nebraska, such insurer shall report and pay premium taxes on insurance coverage it
provides to purchasing group risks resident or located in Nebraska. Such business
shall be disclosed on the insurer's annual statement and premium taxes thereon
shall be paid in accordance with regular procedures for insurance companies
admitted in Nebraska.
Insurer Not Licensed in Nebraska:
2.
If the purchasing group purchases insurance for risks resident or located in
Nebraska from an insurer not licensed in Nebraska, a surplus lines agent licensed by
the Nebraska Department
of Insurance must be utilized and such surplus lines
agent shall be responsible for reporting such business and paying taxes thereon in
accordance with Nebraska law (See II. above).
The annual surplus lines report and tax payment must be received by the Nebraska
Department of Insurance on or before February 15 of each year. The premium tax for
surplus lines insurance business in Nebraska is based on a rate of 3% of direct
written premiums on risks resident or located in Nebraska (retaliatory tax provisions
do not apply to surplus lines business).
The interest rate charged for late tax payments received is calculated on a 365 day
basis for the amount of tax due. Nebraska statutes do not provide for an extension
of time in filing the annual report.
MEMO TO:
All Purchasing Groups Proposing to Transact Business in
Nebraska Page Three
Quarterly surplus lines reports must be received by the Department of Insurance no
later than 30 days after the last day of the calendar quarter. The report must be
filed, even if no business was written during the quarter.
Questions regarding Nebraska's requirements for purchasing groups intending to do
business in Nebraska can be addressed to Lori Bruss, (402) 471-4045 or at
Lori.Bruss@nebraska.gov.
10/11
The following is the uniform registration form adopted in June 1991, by the NAIC.
Part A
STATE OF
Department of Insurance
PURCHASING GROUP-NOTICE AND REGISTRATION
(All information should be typed)
1.
Name of the Purchasing Group:
List any other name(s) by which the Purchasing Group is known or may be doing
2.
business in this State or any other state:
a)
Form of organization (i.e., corporation, partnership, association) and the
3.
state in which organized:
b)
Purpose(s) of organization:
4.
a)
The Purchasing Group is domiciled in the state of:
b)
Address:
Physical address of the administrative office of the Purchasing Group, if different
5.
from response to Item #4b above:
The Purchasing Group intends to purchase the following classifications of liability
6.
insurance and/or sub-classifications thereof:
1
Purchasing Group Users’ Handbook (Rev.7-94)
NAIC Forms
PURCHASING GROUP FORM
The Purchasing Group intends to purchase the liability insurance described in Item
7.
#6 above from the following insurance company or companies: (Give full name of
company, state of domicile, NAIC code and Federal Employer Identification Number
(FEIN) ).
State of
Name of Company
Domicile
NAIC Code
FEIN
8.
List the name, address and social security number (SS#) of each officer and
director of the Purchasing Group: (Attach additional pages if necessary.)
Position with
Name
Address
SS#
Purchasing Group
List the name, SS#, address and telephone number of the person within the
9.
Purchasing Group who is most knowledgeable about the Purchasing Group’s
insurance program, including membership criteria and coverages:
Name
SS#
Address
Telephone #
List the name, FEIN, address and telephone number of the company that manages
10.
or administers the insurance program for the Purchasing Group, and the name, SS#,
and telephone number of the person responsible for the Group’s insurance program:
(If none, answer none)
Name
FEIN/SS#
Address
Telephone #
2
Purchasing Group Users’ Handbook (Rev.7-94)
NAIC Forms
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