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Bulletin No. 90-02

Forms and instructions for purchasing groups pursuant to public act 214 of 198

Issued and entered March 30, 1990 by Dhiraj N. Shah, Acting Commissioner of Insurance

The attached forms, together with the $25 registration fee, must be submitted to the Michigan Insurance Bureau by all purchasing groups wishing to do business in Michigan. These forms have been promulgated pursuant to the Risk Retention Act, Public Act 214 of 1989. The forms include:




{Footnote 1} Not reproduced herein.


The Risk Retention Act regulates, to the extent allowed by the federal law, risk retention and purchasing groups in Michigan. The act provides that purchasing groups may only purchase insurance for their Michigan risks from admitted insurers, eligible surplus lines insurers or risk retention groups.

For Registration of Purchasing Groups

NOTICE: These forms must be complete when submitted to the Insurance Bureau. Incomplete forms will be returned to the originator. Instructions for completing forms:

1. A check for $25 payable to "State of Michigan" to cover the registration fee should accompany the application, clipped (not stapled) to the appropriate Registration Fee Card.

2. Complete the purchasing group application for registration.

a. Item 12: The "Line Code" is a number that identifies the line of insurance. Select the number which most closely corresponds to the line purchased. If one cannot be found, indicate "other commercial liability."

Types of Commercial Liability Insurance Line Code
Medical Malpractice 110
Comprehensive General 174
Director's & Officer's 175
Environmental Impairment & Pollution 176
Errors & Omissions 177
Legal Liability 178
Liquor Liability 173
Municipal Liability 172
Products & Completed Operations 171
Professional Liability 179
Other Commercial Liability 170

b. Item 13: The "Agent Code" indicates the type of insurance placement. That is, whether the purchase is through a resident agent, a surplus lines agent or by direct placement. For the response to item 13, determine the Agent Code and the respective name and address information as follows:

Type of Placement Code Agent Code Name and Address
Direct Placement 0 Person in Group making arrangements
Resident Agent 1 Name and address of agent
Surplus Lines Agent 2 Name and address of agent

3. Complete the "Appointment of Attorney to Accept Service."

4. If a purchasing group is incorporated in Michigan, please also submit a copy of the group's articles of incorporation and all amendments as filed with Michigan's Corporation and Securities Bureau.

5. Purchasing groups must provide notification to the Bureau of their intent to continue operations by February 1st of each year and of changes in registration information within 10 days of changes.


The State of Michigan requires the payment of premium, retaliatory and/or single business taxes on all insurance transactions. The appropriate tax forms and instructions will be sent to registrants when they are notified that they are registered.

The entity responsible for paying premium taxes shall be determined as follows:

Insurance purchase is through a: Taxes are paid by the:
Direct Placement with:
a. Approved Surplus Lines Insurer
b. Risk Retention Group
c. Admitted Insurer

a. Purchasing Group
b. Risk Retention Group
c. Admitted Insurer


Resident Agent: Admitted Insurer
Surplus Lines Agent with:
a. Approved Surplus Lines Insurer
b. Risk Retention Group

a. Surplus Lines Agent
b. Risk Retention Group



Questions regarding the forms should be addressed to the Company Admissions Division of the Insurance Bureau at the address below or call: 517/373-6854. All groups will be notified as to whether they are registered or not.

Completed forms and questions regarding their completion should be submitted in writing to:

Company Admissions Division
Insurance Bureau
Post Office Box 30210
Lansing, MI 48909-771