Surplus Lines Working Group January, 2018 Agenda

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1 Surplus Lines Working Group January, 2018 Agenda 1. Review TRIA Form 2. Discuss IID Plan of Operation Revision Timeline 3. Discuss Cybersecurity Form in IID Financial Filing Format 4. Discuss Any Other Matters Brought Before Working Group

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3 TRIA SCHEDULE OF PREMIUMS AND LOSSES (LLOYD S) JURAT (Name of Syndicate & Alien Identification Number) Managing Agent: Report Year Ended: The undersigned being duly sworn, state that they are officers of the said managing agent, and that this TRIA schedule of premiums and losses presents a full and true statement of the condition and affairs of the said syndicate and of its relevant income and deductions therefrom for the year ended on that date, according to the best of their information, knowledge and belief respectively. Finance Director Other Director or Compliance Officer Subscribed and sworn to before me this day of. Footnote: The TRIA Schedule of Premiums and Losses must be attested before a notary public, or person competent and authorized to administer oaths and confirm that the deponent has acknowledged the truth and correctness of the subscription document.

4 TRIA Schedule of Premiums and Losses by Line of Business Alien Identification Number: AA- Syndicate Number: US Dollars Total Direct TRIA Direct COMMERCIAL LINES ONLY Premiums Premiums TRIA Direct Insured Losses Earned Earned Paid Case Reserves IBNR Incurred in year in year in year Start of year End of year Start of year End of year Sect 1.0 US business covered by TRIA requirements Surplus lines, licensed and all other direct (non-reinsurance) [Lloyd's LOB, by Solvency II Class, to be included in Terrorism data call] Fire [Fire and other damage to property/miscellaneous financial loss] Allied Lines [Fire and other damage to property] Commercial Multi-Peril (non-liability portion) [Fire and other damage to property] Commercial Multi-Peril (liability portion) [General Liability] Ocean Marine [Marine, aviation and transport] Inland Marine [Marine, aviation and transport. Fire and other damage to property. Miscellaneous Financial Loss] Workers' Compensation [Excess Workers' Compensation] Other Liability [General Liability, Miscellaneous Financial Loss] Products Liability [General Liability. Miscellaneous Financial Loss] Aircraft (all perils) [Marine, aviation and transport] Boiler and Machinery [Fire and other damage to property] Totals for US business covered by TRIA Sect 2.0 Non US business covered by TRIA requirements: Total for Business within the scope of TRIA ( )

5 TRIA Schedule of Premiums and Losses by Geographic Location Alien Identification Number: AA- COMMERCIAL LINES ONLY Sect 1.0 US business covered by TRIA requirements Surplus lines, licenced and all other direct (non-reinsurance) by State or Territory Alabama AL Alaska AK Arizona AZ Arkansas AR California CA Colorado CO Connecticut CT Delaware DE Dist. Columbia DC Florida FL Georgia GA Hawaii HI Idaho ID Illinois IL Indiana IN Iowa IA Kansas KS Kentucky KY Louisiana LA Maine ME Maryland MD Massachusetts MA Michigan MI Minnesota MN Mississippi MS Missouri MO Montana MT Nebraska NE US Dollars Total Direct TRIA Direct Premiums Premiums TRIA Direct Insured Losses Earned Earned Paid Case Reserves IBNR Incurred in year in year in year Start of year End of year Start of year End of year

6 TRIA Schedule of Premiums and Losses by Geographic Location Alien Identification Number: AA- US Dollars Total Direct TRIA Direct COMMERCIAL LINES ONLY Premiums Premiums TRIA Direct Insured Losses Earned Earned Paid Case Reserves IBNR Incurred in year in year in year Start of year End of year Start of year End of year Nevada NV New Hampshire NH New Jersey NJ New Mexico NM New York NY North Carolina NC North Dakota ND Ohio OH Oklahoma OK Orgon OR Pennsylvania PA Rhode Island RI South Carolina SC South Dakota SD Tennessee TN Texas TX Utah UT Vermont VT Virginia VA Washington WA West Virginia WV Wisconsin WI Wyoming WY Other Territories Totals for US business covered by TRIA Sect 2.0 Non US business covered by TRIA requirements: Total for Business within the scope of TRIA ( )

7 TRIA Schedule of Coverage Amounts by Jurisdiction Alien Identification Number: AA- COMMERCIAL LINES ONLY US Dollars Jurisdiction Atlanta, GA Description All zip codes within the four counties of Fulton, DeKalb, Clayton, and Cobb. Total 2016 Payroll Subject to TRIA Coverage under Primary WC Coverage Total 2016 Payroll Subject to TRIA Coverage under Excess WC Coverage 2016 Total Insurance Values Subject to TRIA Property Coverage 2016 Total Insurance Values Not Subject to TRIA Property Coverage Baltimore, MD All zip codes in Baltimore City, all zip codes in Baltimore County excluding 21013, 21020,21023,21030, 21031, 21051, 21053, 21057, 21065, 21071, 21074, 21082, 21087, 21092, 21102, 21105, 21111, 21120, 21131, 21136, 21152, 21155, 21161; include the following zip codes from Anne Arundel County 21060, 21061, 21062, 21076, 21077, 21090, 21098, 21122, 21123, 21144, 21225, 21226, Boston, MA All zip codes from Suffolk county; for Essex County only include zip codes thru 01908, 01910, 01945, 01960, 01961, 01970, 01971; for Norfolk County only include zip codes 02026, 02027, 02030, 02062, 02090, 02169, 02170, 02171, thru 02191, 02269, 02445, 02446, 02447, 02457, 02467, 02481, 02482, 02492, 02494; for Middlesex County only include zip codes thru 01705, 01760, 01770, 01776, 01778, 01801, 01803, thru 01808, 01813, 01815, 01866, 01867, 01880, 01888, 01890, thru 02145, 02148, 02149, 02153, 02155, 02156, 02176, 02180, 02212, 02238, 02239, 02420, 02421, thru 02456, thru 02462, thru 02468, 02471, 02472, thru 02479, 02493, Charlotte, NC Chicago, IL Dallas/Ft. Worth, TX Denver, CO Detroit, MI Houston, TX Las Vegas, NV Los Angeles, CA Miami, FL Minneapolis/St. Paul, MN All zip codes within the five counties of Mecklenburg, Gaston, York, Union and Cabarrus. All zip codes within the four counties of Cook, DuPage, Lake, and Will. All zip codes in the two counties of Dallas and Tarrant (Fort Worth). All zip codes in the counties of Denver, Adams, and Arapahoe. All zip codes in the counties of Wayne, Oakland, and Macomb. All zip codes in Harris County. All zip codes in Clark County. All zip codes within the two counties of Los Angeles and Orange. All zip codes in Miami-Dade County. All zip codes in the two counties of Hennepin and Ramsey. New York, NY All zip codes within the five counties of Kings (Brooklyn), Queens, New York (Manhattan), Bronx, and Richmond (Staten Island). Newark, NJ All zip codes for the cities of Newark (07101 thru 07108, 07112, 07114, 07175, 07182, 07184, 07188, 07189, 07191, 07192, 07193, 07194, 07195, 07198, 07199) and Elizabeth (07201, 07202, 07206, 07207, 07208). Philadelphia, PA All zip codes in Philadelphia County.

8 TRIA Schedule of Coverage Amounts by Jurisdiction Alien Identification Number: AA- COMMERCIAL LINES ONLY US Dollars Jurisdiction Description Total 2016 Payroll Subject to TRIA Coverage under Primary WC Coverage Total 2016 Payroll Subject to TRIA Coverage under Excess WC Coverage 2016 Total Insurance Values Subject to TRIA Property Coverage 2016 Total Insurance Values Not Subject to TRIA Property Coverage Phoenix, AZ All zip codes in Maricopa County. Pittsburgh, PA All zip codes in Allegheny County. Portland, OR All zip codes in Multnomah County, OR and Clark County, WA. Providence, RI All zip codes in Providence County. Riverside/San Bernardino, CA All zip codes in the counties of Riverside and San Bernardino. San Diego, CA San Francisco, CA All zip codes in San Diego County. All zip codes with the two counties of San Francisco and San Mateo. Seattle, WA All zip codes in King County. St. Louis, MO All zip codes in the two counties of St. Louis City and St. Louis. Tampa/St. Petersburg, FL All zip codes in the two counties of Hillsborough and Pinellas. Washington, DC All zip codes within Washington D.C. and all zip codes within the two cities of Arlington VA and Alexandria City VA. TOTALS:

9 Draft Timeline for Revision of the Plan of Operation for Listing of Alien Non-admitted Insurers Revisions to the Plan of Operation (Plan) will be proposed in sections by the International Insurers Department (IID) staff and presented to the Surplus Lines Working Group (SLWG), interested regulators, and interested parties for review and comment. A complete revised document is envisioned for presentation to the Surplus Lines Task Force for its approval at the Fall National Meeting in December Below is a tentative timeline for Working Group consideration of proposed Plan revisions: March Expose rewrite of Introduction and Sections: I IID will Procure Information; II IID will Publish Quarterly Listing; III Application Procedure; and, IV IID Evaluation and Recommendation. May Review comments to exposed Sections I - IV and expose Sections: V Standards for Inclusion on List; VI - Reconsideration Procedure (Application); and, IX Reconsideration Procedure (in respect of Removal). July Review comments to exposed Sections V, VI and IX and expose Sections: VII Continuing Compliance and VIII Change of Control and/or Merger of Insurer. September October November December Review comments to exposed Sections VII and VIII and expose remaining Sections: X English Language/Accounting Practices; XI Financial Statements; XII Exemption Provision; XIII Persons Who May Subscribe; and, XIV Supplementary Information. Review comments to exposed Sections X, XI, XII, XIII, and XIV and make any additional comments/revisions to Plan. Review revised Plan in its entirety, obtain sign-off by SLWG to completed document, and recommend to Surplus Lines Task Force (SLTF). Present revised Plan for approval by the SLTF at the NAIC Fall National Meeting.

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11 NAIC INTERNATIONAL INSURERS DEPARTMENT (IID) CYBERSECURITY INSURANCE COVERAGE SUPPLEMENT For The 2016 Reporting Year NAIC Alien Identification Number AA-.. Company Name... Cybersecurity Insurance Coverage: PART 1 INTERROGATORIES 1. Does the IID reporting entity write any stand-alone cybersecurity insurance coverage in the United States? Yes [ ] No [ ] If yes, complete Column 1 for Part Does the IID reporting entity write any cybersecurity coverage provided as part of a package policy in the United States? Yes [ ] No [ ] If yes, complete Column 2 for Part 2 PART 2 POLICY AND CLAIMS DATA (U.S. Dollars) 1 Stand-Alone Coverage U.S. Cybersecurity Insurance 2 Coverage Provided as Part of a Package Policy Direct Premiums 1. Written... $... $ Earned... $... $... Direct Losses 3. Paid... $... $ Incurred... $... $... Direct Adjusting and Other Expenses 5. Paid... $... $ Incurred... $... $... Direct Defense and Cost Containment 7. Paid... $... $ Incurred... $... $... Number of Policies in Force 9. Claims-Made Occurrence Total (9 + 10) Number of Claims Reported 12. First Party Third Party Total ( )

12 CYBERSECURITY INSURANCE COVERAGE SUPPLEMENT INSTRUCTIONS This supplement should be completed by those reporting entities listed in the January 1, 2017 edition of the Quarterly Listing of Alien Insurers that provide cybersecurity insurance in a stand-alone policy or as part of a package policy in the United States. The supplement should be reported on a direct basis (before assumed and ceded reinsurance) and presented in U.S. dollars. Cybersecurity Insurance For the purposes of this reporting form, cybersecurity insurance applies to commercial insurance through a single policy or multi-peril coverage part solely intended to assist in helping manage risks associated with exposures arising out of network intrusions and improper handling of electronic data, including data such as personally identifiable information and other sensitive information in electronic form. The risks covered may include one or more of the following: Business interruption and extra expense from an unauthorized person preventing access to the Internet, the policyholder s website or other parts of the policyholder s network. Costs associated with restoring data from electronic or paper records that have been damaged by an unauthorized person. Costs related to a data breach such as forensic investigations, legal advice, public relations, notification and regulatory expenses. Exposure arising out of theft or loss of client s or customer s digital assets. Introduction of malware, worms and other malicious computer code to third parties. Cyber extortion against the policyholder. Liability and damages resulting from network failures.

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