NAIC BLANKS (E) WORKING GROUP

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1 NAIC BLANKS (E) WORKING GROUP Blanks Agenda Item Submission Form CONTACT PERSON: TELEPHONE: ADDRESS: ON BEHALF OF: NAME: DATE: 09/10/2015 Investment Reporting Subgroup Cindy Donovan FOR NAIC USE ONLY Agenda Item # BWG Year 2016 Changes to Existing Reporting [ X ] New Reporting Requirement [ ] REVIEWED FOR ACCOUNTING PRACTICES AND PROCEDURES IMPACT No Impact [ X ] Modifies Required Disclosure [ ] DISPOSITION TITLE: Chair, Investment Reporting Subgroup AFFILIATION: Indiana Department of Insurance ADDRESS: 311 W. Washington St., Ste. 103 Indianapolis, IN [ ] Rejected For Public Comment [ ] Referred To Another NAIC Group [ ] Received For Public Comment [ X ] Adopted Date 04/03/2016 [ ] Rejected Date [ ] Deferred Date [ ] Other (Specify) BLANK(S) TO WHICH PROPOSAL APPLIES [ X ] ANNUAL STATEMENT [ X ] QUARTERLY STATEMENT [ X ] INSTRUCTIONS [ X ] CROSSCHECKS [ X ] BLANK [ X ] Life and Accident & Health [ X ] Property/Casualty [ X ] Health [ ] Separate Accounts [ X ] Fraternal [ X ] Title [ ] Other Specify Anticipated Effective Date: Annual 2016 IDENTIFICATION OF ITEM(S) TO CHANGE For Schedule D, Part 1A, Section 1and Schedule D, Part 1B, remove the reference to non-rated from the instructions and provide instructions for Footnote d of Schedule D, Part 1A, Section 1and Footnote a of Schedule D, Part 1B. REASON, JUSTIFICATION FOR AND/OR BENEFIT OF CHANGE** The purpose of this proposal is to remove references to non-rated and clarify what is to be reported for Cash and Cash Equivalents in the footnote for Schedule D, Part 1A, Section 1 of the annual filing and Schedule D, Part 1B of the quarterly filing. Comment on Effective Reporting Date: Other Comments: NAIC STAFF COMMENTS ** This section must be completed on all forms. Revised 6/13/ National Association of Insurance Commissioners 1

2 ANNUAL STATEMENT INSTRUCTIONS LIFE, HEALTH, PROPERTY, FRATERNAL AND TITLE SCHEDULE D PART 1A SECTION 1 QUALITY AND MATURITY DISTRIBUTION OF ALL BONDS OWNED DECEMBER 31 BY MAJOR TYPE AND NAIC DESIGNATION The schedule summarizes the aggregate book/adjusted carrying value of all bond holdings, including those in Schedule DA and Schedule E, Part 2 by quality, designation, maturity and bond categories. Include non-rated short-term and cash equivalent bonds in the category that most closely resembles their credit risk. The maturity category for a particular holding is determined by the following criteria: Detail Eliminated To Conserve Space The quality designation used is the NAIC Designation that appear with each bond as listed in the Valuations of Securities. Include non-rated short-term and cash equivalent bonds in the category that most closely resembles their credit risk. For each Section 1 through 12, seven lines of information are shown, which are numbered in a format X.Y where the number X is the number of the section and the number Y is the order of the line within the section. The lines within each section are categorized as follows for Section X. X.1 Highest Quality (NAIC 1) X.2 High Quality (NAIC 2) X.3 Medium Quality (NAIC 3) X.4 Low Quality (NAIC 4) X.5 Lower Quality (NAIC 5) X.6 In or near default (NAIC 6) X.7 Total for section Column 10 is to contain publicly traded securities; i.e., those securities that have been assigned a CUSIP/CINS number in the Valuations of Securities. Any securities outside the CUSIP/PPN/CINS coding system will be considered to be publicly traded for Annual Statement purposes (e.g., short-term investments). Exclude bonds that are qualified for resale under SEC Rule 144A or freely tradable under SEC Rule 144. Column 11 is to contain privately placed securities as identified with Private Placement Numbers (PPN) in the Valuations of Securities. A PPN can be differentiated by the presence of a *, #, sign appearing in either the sixth, seventh or eighth digit of the nine-digit CUSIP-like number. Include bonds that are qualified for resale under SEC Rule 144A or freely tradable under SEC Rule 144 that have been assigned a CUSIP/CINS number in the Valuations of Securities. Column 11 Footnote Include bonds that are qualified for resale under SEC Rule 144A. Include bonds that are freely tradable under SEC Rule 144 (e.g., that are presently held by, and for the immediately preceding three year period have been held by, persons unrelated to the issuer); however, there shall be excluded any such security containing a contractual restriction against resale (a right of first refusal provision is not considered a restriction against resale). Footnote (d) Provide the total book/adjusted carrying value amount reported in Section 9, Column 1 by NAIC designation that represents the amount of securities reported in Schedule DA and Schedule E, Part 2. The sum of the amounts by NAIC designation (NAIC 1, NAIC 2, NAIC 3, NAIC 4, NAIC 5 and NAIC 6) reported in the footnote should equal the sum of Schedule DA, Part 1, Column 8, Lines , and plus Schedule E, Part 2, Column 6, Line National Association of Insurance Commissioners 2

3 QUARTERLY STATEMENT INSTRUCTIONS LIFE, HEALTH, PROPERTY, FRATERNAL AND TITLE SCHEDULE D PART 1B ACQUISITIONS, DISPOSITIONS AND NON-TRADING ACTIVITY DURING THE CURRENT QUARTER FOR ALL BONDS AND PREFERRED STOCK BY NAIC DESIGNATION Report the summarized amounts of all bonds and preferred stock by NAIC designation. Include non-rated short-term and cash equivalent bonds in the category that most closely resembles their credit risk. Show all the acquisitions, dispositions and non-trading activities of bonds (long-term, short-term and cash equivalents) and preferred stock for each quarter. The Schedule is sorted by NAIC designation and includes Carrying Values for each quarter of the year. Detail Eliminated To Conserve Space Line 14 Total Preferred Stock Total of Line 8 to Line 13. Line 15 Total Bonds & Preferred Stock Footnote (a) Line 7 plus Line 14. Provide the total book/adjusted carrying value amount reported in Section 1, for the current quarterly statement filing by NAIC designation that represents the amount of securities reported in Schedule DA and Schedule E, Part 2 for the current quarterly statement filing. The sum of the amounts by NAIC designation (NAIC 1, NAIC 2, NAIC 3, NAIC 4, NAIC 5 and NAIC 6) reported in the footnote should equal the sum of Schedule DA, Part 1, Column 8, Lines , and plus Schedule E, Part 2, Column 6, Line for the current quarter statement National Association of Insurance Commissioners 3

4 ANNUAL STATEMENT BLANK LIFE, HEALTH, PROPERTY, FRATERNAL AND TITLE SCHEDULE D PART 1A SECTION 1 (Continued) Quality and Maturity Distribution of All Bonds Owned December 31, at Carrying Values by Major Types of Issues and NAIC Designations NAIC Designation 9. Total Bonds Current Year 9.1 NAIC NAIC NAIC NAIC NAIC NAIC Totals Line 9.7 as a % of Col Total Bonds Prior Year 10.1 NAIC NAIC NAIC NAIC NAIC NAIC Totals Line 10.7 as a % of Col Total Publicly Traded Bonds 11.1 NAIC NAIC NAIC NAIC NAIC NAIC Totals Line 11.7 as a % of Col Line 11.7 as a % of Line 9.7, Col. 6, Section Total Privately Placed Bonds 12.1 NAIC NAIC NAIC NAIC NAIC NAIC Totals Line 12.7 as a % of Col Line 12.7 as a % of Line 9.7, Col. 6, Section Year or Less (d) 2 Over 1 Year Through 5 Years 3 Over 5 Years Through 10 Years 4 Over 10 Years Through 20 Years 5 Over 20 Years 6 Total Current Year (c)... (c) 7 Col. 6 as a % of Line 9.7. (b) Total from Col. 6 Prior Year (c)... (c) 9 % From Col. 7 Prior Year (b)... (a) Includes $ freely tradable under SEC Rule 144 or qualified for resale under SEC Rule 144A. (b) Includes $ current year, $ prior year of bonds with Z designations and $ current year, $ prior year of bonds with Z* designations. The letter "Z" means the NAIC designation was not assigned by the Securities Valuation Office (SVO) at the date of the statement. Z* means the SVO could not evaluate the obligation because valuation procedures for the security class is under regulatory review. (c) Includes $ current year, $ prior year of bonds with 5* designations and $ current year, $ prior year of bonds with 6* designations. 5* means the NAIC designation was assigned by the SVO in reliance on the insurer s certification that the issuer is current in all principal and interest payments. 6* means the NAIC designation was assigned by the SVO due to inadequate certification of principal and interest payments. (d) Includes the following amount of non-rated short-term and cash equivalent bonds by NAIC designation: NAIC 1 $ ; NAIC 2 $ ; NAIC 3 $ ; NAIC 4 $ ; NAIC 5 $ ; NAIC 6 $. 10 Total Publicly Traded 11 Total Privately Placed (a) 2016 National Association of Insurance Commissioners 4

5 QUARTERLY STATEMENT BLANK LIFE, HEALTH, PROPERTY, FRATERNAL AND TITLE SCHEDULE D PART 1B Showing the Acquisitions, Dispositions and Non-Trading Activity During the Current Quarter for all Bonds and Preferred Stock by NAIC Designation NAIC Designation BONDS 1. NAIC 1 (a) NAIC 2 (a) NAIC 3 (a) NAIC 4 (a) NAIC 5 (a) NAIC 6 (a) Total Bonds PREFERRED STOCK 8. NAIC NAIC NAIC NAIC NAIC NAIC Total Preferred Stock Total Bonds & Preferred Stock 1 Carrying Value Beginning of Current Quarter 2 Acquisitions During Current Quarter Dispositions During Current Quarter Non-Trading Activity During Current Quarter Carrying Value End of First Quarter Carrying Value End of Second Quarter Carrying Value End of Third Quarter (a) Carrying Value column for the end of the current reporting period includes the following amount of non-rated short-term and cash equivalent bonds by NAIC designation: NAIC 1 $...; NAIC 2 $...; NAIC 3 $...; NAIC 4 $...; NAIC 5 $...; NAIC 6 $... W:\QA\BlanksProposals\ BWG.doc 2016 National Association of Insurance Commissioners 5 8 Carrying Value December 31 Prior Year

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