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STATE OF NEW JERSEYEXM (124)2023FOREIGN OR ALIEN COMPANIESType or print the requested informationFederal Employer I.D. Number Insurer NAIC Code NumberCompany NameInsurer NAIC Group Code NumberMailing
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How to fill out surplus lines company list

01
Obtain a copy of the surplus lines company list form from the appropriate regulatory agency.
02
Provide all required information, such as company name, address, contact information, and lines of business written.
03
Ensure that the form is completed accurately and all mandatory fields are filled out.
04
Submit the completed form to the regulatory agency according to their guidelines and deadlines.

Who needs surplus lines company list?

01
Insurance companies looking to write policies in the surplus lines market.
02
Regulatory agencies overseeing insurance operations.
03
Insurance brokers and agents working with clients who require coverage from non-admitted insurers.
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A surplus lines company list is a compilation of insurers that are authorized to provide insurance coverage in the surplus lines market, typically for risks that are not covered by standard insurance policies.
Typically, surplus lines brokers or agents are required to file the surplus lines company list to ensure compliance with state regulations regarding surplus lines insurance.
To fill out a surplus lines company list, one must provide details such as the name of the insurer, its address, and the types of coverage it offers. This information is often submitted through state-specific forms.
The purpose of the surplus lines company list is to provide a reference for brokers and agents to identify which insurers are approved for writing surplus lines insurance, ensuring that they are dealing with legitimate and compliant companies.
Information that must be reported includes the insurer's name, NAIC number, contact information, and the types of insurance coverage that the insurer offers.
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