Ins 6.17 HistoryHistory: Cr. Register, December, 1973, No. 216, eff. 1-1-74; am. (1), Register, May, 1975, No. 233, eff. 6-1-75; emerg. am. (2) (a) and (b), eff. 6-22-76; am. (2) (a) and (b), Register, September, 1976, No. 249, eff. 10-1-76; am. (2) (a) and (b), Register, March, 1979, No. 279, eff. 4-1-79; r. (3) (c), renum. (3) (d) and (e) to be (3) (c) and (d), am. (4), (6) and appendix 1, Register, August, 1982, No. 320, eff. 9-1-82; corrections in (3) (c) (intro.) made under s. 13.93 (2m) (b) 5., Stats., Register, April, 1992, No. 436, eff. 5-1-92; CR 22-076: am. (5), r. appendix 2 Register July 2023 No. 811, eff. 8-1-23. Ins 6.17 Appendix 1
SURPLUS LINES INSURANCE PROPOSAL
Name and address of applicant Date
Dear: Proposal No.
You have asked that I procure the following insurance coverage on your behalf:
Type of Insurance Limits of Coverage
I can procure the coverage desired from the following insurer(s) at the premium listed:
Insurer(s) — Name and Address % of Total Risk
Premium Quoted
This insurance is with an insurer which has not obtained a certificate of authority to transact a regular insurance business in the state of Wisconsin, and will be issued and delivered as a surplus lines coverage pursuant to s. 618.41, Stats. The insurance is regulated by the Commissioner of Insurance only as provided in ss. 618.41 and 618.43, Stats. Section 618.43 (1), Stats., requires payment by the policyholder of a 3% tax on gross premium (except for Ocean Marine Insurance on which the tax is one-half of 1%). The tax in this instance amounts to $ . If the above transaction is not satisfactory, please advise immediately. Sincerely yours,
______________________________________________
Name and address of licensed surplus lines agent
Ins 6.17 NoteNote: 2011 Wisconsin Act 224 changed the tax rate for surplus lines insurance which is ocean marine insurance to the same 3% rate for all other surplus lines insurance. Any previous reference to a ½ of 1% rate for ocean marine insurance in this rule is not enforceable as that insurance is now taxed at the same 3% rate for all surplus lines insurance. Ins 6.18Ins 6.18 Reporting and payment of tax by unauthorized insurers transacting business in violation of law. Ins 6.18(1)(1) Purpose. This rule implements and interprets ss. 601.42, 610.11 and 618.43, Stats., for the purpose of facilitating the reporting and collection of tax due the state of Wisconsin from unauthorized insurers transacting business in violation of Wisconsin law. Ins 6.18(2)(2) Reporting and payment of tax by unauthorized insurers transacting business in violation of law. All premium tax shall be reported and forwarded to the commissioner on or before March 1, for all insurance which applies to exposures located wholly or partially within this state written, renewed or continued during the preceding calendar year by an unauthorized insurer. The report and the premium taxes owed shall be submitted through an electronic filing system, a link to which may be found on the office’s website. Ins 6.18(3)(3) Penalty. Any violation of this rule shall subject the person violating the same to s. 601.64, Stats. Ins 6.18 HistoryHistory: Cr. Register, December, 1973, No. 216, eff.1-1-74; CR 22-076: am. (2), r. appendix 1 Register July 2023 No. 811, eff. 8-1-23. Ins 6.19Ins 6.19 Reporting and taxation of directly placed unauthorized insurance. Ins 6.19(1)(1) Purpose. This rule implements and interprets ss. 601.42, 618.42 and 618.43, Stats., for the purpose of facilitating the reporting and collection of tax due the state of Wisconsin from persons who directly procure or renew insurance in an unauthorized insurer. Ins 6.19(2)(2) Reporting directly placed unauthorized insurance. The procurement or renewal of insurance from any unauthorized insurer shall be reported within 60 days to the commissioner on a form substantially the same as Appendix 1 to this rule. Ins 6.19(3)(3) Reporting and payment of tax for directly placed unauthorized insurance. All premium tax shall be reported and forwarded to the commissioner on or before March 1, for all insurance which applies to exposures located wholly or partially within this state procured, renewed or continued during the preceding calendar year in an unauthorized insurer. The report and the premium taxes owed shall be submitted through an electronic filing system, a link to which may be found on the office’s website. Ins 6.19(4)(4) Penalty. Any violation of this rule shall subject the person violating the same to s. 601.64, Stats. Ins 6.19 HistoryHistory: Cr. Register, December, 1973, No. 216, eff. 1-1-74; CR 22-076: am. (3), r. appendix 2 Register July 2023 No. 811, eff. 8-1-23. Ins 6.19 Appendix 1
NOTICE OF DIRECTLY PLACED UNAUTHORIZED INSURANCE
To: Commissioner of Insurance
State of Wisconsin
P.O. Box 7873
Madison, WI 53707-7873
1. Name of Person or Organization Insured
2. Address of Insured