Minnesota Administrative Rules

2770.1900 SURCHARGE PLAN FORMATS.

The formats contained in this part must be used, but additional information may be included.

A.

One vehicle insured.

Coverage	Premium with no accidents	Premium including surcharge for one chargeable accident	Premium including surcharge for two chargeable accidents
Bodily injury, property damage	$ 80 .	$ _	$ _
Uninsured motorist	$ 5 .	$ _	$ _
Personal injury protection	$ 40 .	$ _	$ _
Comprehensive	$ 25 .	$ _	$ _
Collision	$ 50 .	$ _	$ _
Total Premium	$200	$	$

B.

Two vehicles insured. Accidents chargeable to the principal operator of vehicle number one, while operating vehicle number one.

(1)

Vehicle number one.

Coverage	Premium with no accidents	Premium including surcharge for one chargeable accident	Premium including surcharge for two chargeable accidents
Bodily injury, property damage	$ 80 .	$ _	$ _
Uninsured motorist	$ 5 .	$ _	$ _
Personal injury protection	$ 40 .	$ _	$ _
Comprehensive	$ 25 .	$ _	$ _
Collision	$ 50 .	$ _	$ _
Total Premium	$200	$	$

(2)

Vehicle number two.

Coverage	Premium with no accidents	Premium including surcharge for one chargeable accident	Premium including surcharge for two chargeable accidents
Bodily injury, property damage	$120 .	$ _	$ _
Uninsured motorist	$ 5 .	$ _	$ _
Personal injury protection	$ 60 .	$ _	$ _
Comprehensive	$ 40 .	$ _	$ _
Collision	$ 75 .	$ _	$ _
Total Premium	$300	$	$

Statutory Authority:

MS s 65B.133

Published Electronically:

September 14, 2007