Surplus Lines - Appendix 1

General information Excel Workbook (xls) (41 KB)
(xlsm for macros )

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• The surplus lines licensee is mandated to file the quarterly surplus lines report electronically as permitted by rule or order of the Director. This report must be filed even if zero business.
• The surplus lines licensee shall thereafter maintain in the licensee's files the original verified quarterly surplus lines report in its entirety for a period ending five years after the filing.
• An Appendix 1 with a Lloyds syndicate list, schedule of locations or allocation sheet can be submitted electronically by attaching the required documents to the email submission for approval either in a Word or PDF document. Carrier code for a Lloyd’s placement is 98.
• Filings submitted without a valid carrier code will be rejected.
• Filings submitted that are not Missouri risks will be rejected.
• Multiple filings can be submitted in the same email.
• Excel Workbook will create a formatted text file with a click of the "Create Text File" button. You can attach the Excel file or text: We will convert Excel files into text for you if you prefer.

Field identification

No field headings to be included in the text file.

• Filing type: For Appendix 1 filings, this will be 1. This will automatically populate when the SL# is entered into the appropriate column.
• Risk number: Unique risk number assigned by the Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP). If this is an original Appendix 1 filing, leave blank. If it is an amended Appendix 1 filing and you do not know risk number, contact Surplus Lines Section at 573-751-0669.
• Surplus lines licensee number: Surplus lines licensee number preceded with SL, which is assigned by DIFP. If you do not know the surplus lines licensee number, check SBS Licensee Look-up.
• Coverage type: Two-digit number for coverage type assigned by DIFP. Review list of valid coverage types.
• Carrier code: Three-digit number for each carrier assigned by DIFP. Review list of valid carrier codes.
• Name of insured: Complete name of insured.
• Premium amount debit: Dollar amount of premium charged. If no amount, submit as 0. Do not use dollar signs, commas or double quotation marks.
• Premium amount credit: Dollar amount of any premium reduction. If no amount, submit as 0. Do not include a negative sign. Do not use dollar signs, commas or double quotation marks.
• Tax year: Four-digit tax year for risk being reported.
• Fee: Dollar amount of any fee charged. If no amount, submit as 0. Do not use punctuation such as dollar sign, comma or double quotation marks.
• Policy number: Policy number assigned. Do not use special characters, dashes or spaces - even if it is part of policy number.
• Effective date: On originals, use the original effective date of the policy, use the endorsement or cancellation date on endorsements and cancellations. On audits, use the invoice date.
• Termination date: Date coverage is terminated for risk.
• Termination date: Date coverage is terminated for risk.
• Transaction code: One-letter code for transaction code. O for original. S for supplemental (amended).
• Producing Broker: The name of the producing broker.
• Insured Location Address - Street: The street address for the location of the risk.
• Insured Location Address - City: The city for the location of the risk.
• Insured Location Address - State: The two-letter state code for the location of the risk.
• Insured Location Address - Zip Code: The zip code for the location of the risk.
• Insured Home State Address - Street: The street address for the insured.
• Insured Home State Address - City: The city for the insured.
• Insured Home State Address - State: The two-letter state code for the insured. MUST BE MISSOURI, otherwise, do not submit filing.
• Insured Home State Address - Zip Code: The zip code for the insured.
• Reason: The reason for the placement of the risk in the surplus lines market.

Step 2

Email your Excel file attachment or text file to the Surplus Lines Section at surpluslines@insurance.mo.gov in the body of the message, identify the following:

• Filing type - Appendix 1.
• Producer's name and surplus lines licensee number.
• Producer's email address.
• Contact person's name, email address and phone number.

Step 3

DIFP will validate your submission and send the approved and rejected filings report to you via email. You will need to correct the rejected filings and resubmit.