QUARTERLY STATEMENT OF THE. Massachusetts Mutual Life Insurance Company TO THE. Insurance Department OF THE STATE OF

Transcription

1 QUARTERLY STATEMENT OF THE Massachusetts Mutual Life Insurance Company TO THE Insurance Department OF THE STATE OF FOR THE QUARTER ENDED SEPTEMBER 0, 04 LIFE AND ACCIDENT AND HEALTH 04

2 LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION QUARTERLY STATEMENT AS OF SEPTEMBER 0, 04 OF THE CONDITION AND AFFAIRS OF THE Massachusetts Mutual Life Insurance Company NAIC Group Code NAIC Company Code 6595 Employer's ID Number (Current) (Prior) Organized under the Laws of Massachusetts, State of Domicile or Port of Entry Massachusetts Country of Domicile United States of America Incorporated/Organized 05/5/85 Commenced Business 08/0/85 Statutory Home Office 95 State Street, Springfield, MA, US 0 (Street and Number) (City or Town, State, Country and Zip Code) Main Administrative Office 95 State Street (Street and Number) Springfield, MA, US 0, (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Mail Address 95 State Street, Springfield, MA, US 0 (Street and Number or P.O. Box) (City or Town, State, Country and Zip Code) Primary Location of Books and Records 95 State Street (Street and Number) Springfield, MA, US 0, (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Internet Website Address Statutory Statement Contact Tammy A. Peatman, (Name) (Area Code) (Telephone Number) tpeatman@massmutual.com, ( Address) (FAX Number) OFFICERS President and Chief Executive Officer Roger William Crandall Treasurer Todd Garett Picken Secretary Christine Carole Peaslee Actuary Isadore Jermyn OTHER Michael Thomas Rollings Executive Vice President and Chief Financial Officer Michael Robert Fanning Executive Vice President Robert Joseph Casale Executive Vice President and Chief Information Officer Debra Ann Palermino Executive Vice President Elizabeth Ward Chicares Executive Vice President and Elaine Anne Sarsynski Executive Vice President Chief Risk Officer Melvin Timothy Corbett Executive Vice President and Chief Investment Officer Mark Douglas Roellig Executive Vice President and General Counsel DIRECTORS OR TRUSTEES Roger William Crandall - Chairman Cristóbal Ignacio Conde Kathleen Ann Corbet James Henry DeGraffenreidt Jr - Lead Director Patricia Diaz Dennis Robert Alan Essner Raymond Walter LeBoeuf Cathy Elizabeth Minehan Marc Francis Racicot Laura Jeanne Sen William Taylor Spitz Howard Todd Stitzer State of County of Massachusetts Hampden SS: The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: () state law may differ; or, () that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement. Roger William Crandall Christine Carole Peaslee Todd Garett Picken President and Chief Executive Officer Secretary Treasurer a. Is this an original filing? Yes [ X ] No [ ] Subscribed and sworn to before me this b. If no, day of. State the amendment number. Date filed. Number of pages attached

3 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company ASSETS Assets Current Statement Date 4 December Net Admitted Assets Prior Year Net Nonadmitted Assets (Cols. - ) Admitted Assets. Bonds. Stocks:. Preferred stocks. Common stocks. Mortgage loans on real estate:. First liens. Other than first liens 4. Real estate: 4. Properties occupied by the company (less $ encumbrances) 4. Properties held for the production of income (less $ encumbrances) 4. Properties held for sale (less $ encumbrances) 5. Cash ($ ), cash equivalents ($ ) and short-term investments ($ ) 6. Contract loans (including $ premium notes) 7. Derivatives 8. Other invested assets 9. Receivables for securities 0. Securities lending reinvested collateral assets. Aggregate write-ins for invested assets. Subtotals, cash and invested assets (Lines to ). Title plants less $ charged off (for Title insurers only) 4. Investment income due and accrued 5. Premiums and considerations: 5. Uncollected premiums and agents' balances in the course of collection 5. Deferred premiums, agents' balances and installments booked but deferred and not yet due (including $ earned but unbilled premiums) 5. Accrued retrospective premiums 6. Reinsurance: 6. Amounts recoverable from reinsurers 6. Funds held by or deposited with reinsured companies 6. Other amounts receivable under reinsurance contracts 7. Amounts receivable relating to uninsured plans 8. Current federal and foreign income tax recoverable and interest thereon 8. Net deferred tax asset 9. Guaranty funds receivable or on deposit 0. Electronic data processing equipment and software. Furniture and equipment, including health care delivery assets ($ ). Net adjustment in assets and liabilities due to foreign exchange rates. Receivables from parent, subsidiaries and affiliates 4. Health care ($ ) and other amounts receivable 5. Aggregate write-ins for other than invested assets 6. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines to 5) 7. From Separate Accounts, Segregated Accounts and Protected Cell Accounts 8. Total (Lines 6 and 7) DETAILS OF WRITE-INS Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 through 0 plus 98)(Line above) Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 through 50 plus 598)(Line 5 above)

4 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company LIABILITIES, SURPLUS AND OTHER FUNDS Current Statement Date December Prior Year. Aggregate reserve for life contracts $ less $ included in Line 6. (including $ Modco Reserve). Aggregate reserve for accident and health contracts (including $ Modco Reserve). Liability for deposit-type contracts (including $ Modco Reserve) 4. Contract claims: 4. Life 4. Accident and health 5. Policyholders dividends $ and coupons $ due and unpaid 6. Provision for policyholders dividends and coupons payable in following calendar year - estimated amounts: 6. Dividends apportioned for payment (including $ Modco) 6. Dividends not yet apportioned (including $ Modco) 6. Coupons and similar benefits (including $ Modco) 7. Amount provisionally held for deferred dividend policies not included in Line 6 8. Premiums and annuity considerations for life and accident and health contracts received in advance less $ discount; including $ accident and health premiums 9. Contract liabilities not included elsewhere: 9. Surrender values on canceled contracts 9. Provision for experience rating refunds, including the liability of $ accident and health experience rating refunds of which $ is for medical loss ratio rebate per the Public Health Service Act 9. Other amounts payable on reinsurance, including $ assumed and $ ceded 9.4 Interest Maintenance Reserve 0. Commissions to agents due or accrued-life and annuity contracts $, accident and health $ and deposit-type contract funds $. Commissions and expense allowances payable on reinsurance assumed. General expenses due or accrued. Transfers to Separate Accounts due or accrued (net) (including $ accrued for expense allowances recognized in reserves, net of reinsured allowances) 4. Taxes, licenses and fees due or accrued, excluding federal income taxes 5. Current federal and foreign income taxes, including $ on realized capital gains (losses) 5. Net deferred tax liability 6. Unearned investment income 7. Amounts withheld or retained by company as agent or trustee 8. Amounts held for agents'account, including $ agents'credit balances 9. Remittances and items not allocated 0. Net adjustment in assets and liabilities due to foreign exchange rates. Liability for benefits for employees and agents if not included above. Borrowed money $ and interest thereon $. Dividends to stockholders declared and unpaid 4. Miscellaneous liabilities: 4.0 Asset valuation reserve 4.0 Reinsurance in unauthorized and certified ($ ) companies 4.0 Funds held under reinsurance treaties with unauthorized and certified ($ ) reinsurers 4.04 Payable to parent, subsidiaries and affiliates 4.05 Drafts outstanding 4.06 Liability for amounts held under uninsured plans 4.07 Funds held under coinsurance 4.08 Derivatives 4.09 Payable for securities 4.0 Payable for securities lending 4. Capital notes $ and interest thereon $ 5. Aggregate write-ins for liabilities 6. Total liabilities excluding Separate Accounts business (Lines to 5) 7. From Separate Accounts Statement 8. Total liabilities (Lines 6 and 7) 9. Common capital stock 0. Preferred capital stock. Aggregate write-ins for other than special surplus funds. Surplus notes. Gross paid in and contributed surplus 4. Aggregate write-ins for special surplus funds 5. Unassigned funds (surplus) 6. Less treasury stock, at cost: 6. shares common (value included in Line 9 $ ) 6. shares preferred (value included in Line 0 $ ) 7. Surplus (Total Lines ) (including $ in Separate Accounts Statement) 8. Totals of Lines 9, 0 and 7 9. Totals of Lines 8 and 8 (Page, Line 8, Col. ) DETAILS OF WRITE-INS "" 50. ""# 598. Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 through 50 plus 598)(Line 5 above) Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 through 0 plus 98)(Line above) 40. $## 40. $## Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 through 40 plus 498)(Line 4 above)

5 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company SUMMARY OF OPERATIONS Current Year Prior Year To Date Prior Year Ended December To Date. Premiums and annuity considerations for life and accident and health contracts. Considerations for supplementary contracts with life contingencies. Net investment income 4. Amortization of Interest Maintenance Reserve (IMR) 5. Separate Accounts net gain from operations excluding unrealized gains or losses 6. Commissions and expense allowances on reinsurance ceded 7. Reserve adjustments on reinsurance ceded 8. Miscellaneous Income: 8. Income from fees associated with investment management, administration and contract guarantees from Separate Accounts 8. Charges and fees for deposit-type contracts 8. Aggregate write-ins for miscellaneous income 9. Totals (Lines to 8.) 0. Death benefits. Matured endowments (excluding guaranteed annual pure endowments). Annuity benefits. Disability benefits and benefits under accident and health contracts 4. Coupons, guaranteed annual pure endowments and similar benefits 5. Surrender benefits and withdrawals for life contracts 6. Group conversions 7. Interest and adjustments on contract or deposit-type contract funds 8. Payments on supplementary contracts with life contingencies 9. Increase in aggregate reserves for life and accident and health contracts 0. Totals (Lines 0 to 9). Commissions on premiums, annuity considerations, and deposit-type contract funds (direct business only). Commissions and expense allowances on reinsurance assumed. General insurance expenses 4. Insurance taxes, licenses and fees, excluding federal income taxes 5. Increase in loading on deferred and uncollected premiums 6. Net transfers to or (from) Separate Accounts net of reinsurance 7. Aggregate write-ins for deductions 8. Totals (Lines 0 to 7) 9. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 8) 0. Dividends to policyholders. Net gain from operations after dividends to policyholders and before federal income taxes (Line 9 minus Line 0). Federal and foreign income taxes incurred (excluding tax on capital gains). Net gain from operations after dividends to policyholders and federal income taxes and before realized capital gains or (losses) (Line minus Line ) 4. Net realized capital gains (losses) (excluding gains (losses) transferred to the IMR) less capital gains tax of $ (excluding taxes of $ transferred to the IMR) 5. Net income (Line plus Line 4) CAPITAL AND SURPLUS ACCOUNT 6. Capital and surplus, December, prior year 7. Net income (Line 5) 8. Change in net unrealized capital gains (losses) less capital gains tax of $ 9. Change in net unrealized foreign exchange capital gain (loss) 40. Change in net deferred income tax 4. Change in nonadmitted assets 4. Change in liability for reinsurance in unauthorized and certified companies 4. Change in reserve on account of change in valuation basis, (increase) or decrease 44. Change in asset valuation reserve 45. Change in treasury stock 46. Surplus (contributed to) withdrawn from Separate Accounts during period 47. Other changes in surplus in Separate Accounts Statement 48. Change in surplus notes 49. Cumulative effect of changes in accounting principles 50. Capital changes: 50. Paid in 50. Transferred from surplus (Stock Dividend) 50. Transferred to surplus 5. Surplus adjustment: 5. Paid in 5. Transferred to capital (Stock Dividend) 5. Transferred from capital 5.4 Change in surplus as a result of reinsurance 5. Dividends to stockholders 5. Aggregate write-ins for gains and losses in surplus 54. Net change in capital and surplus for the year (Lines 7 through 5) 55. Capital and surplus, as of statement date (Lines ) DETAILS OF WRITE-INS Summary of remaining write-ins for Line 8. from overflow page Totals (Lines 08.0 through 08.0 plus 08.98) (Line 8. above) " ##$%& 70. $$ # 798. Summary of remaining write-ins for Line 7 from overflow page 799. Totals (Lines 70 through 70 plus 798)(Line 7 above) 50. ' #$ 50. $#(# Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 through 50 plus 598)(Line 5 above) 4

6 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company Cash from Operations CASH FLOW Current Year To Date Prior Year To Date Prior Year Ended December. Premiums collected net of reinsurance. Net investment income. Miscellaneous income 4. Total (Lines to ) 5. Benefit and loss related payments 6. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts 7. Commissions, expenses paid and aggregate write-ins for deductions 8. Dividends paid to policyholders 9. Federal and foreign income taxes paid (recovered) net of $ tax on capital gains (losses) 0. Total (Lines 5 through 9). Net cash from operations (Line 4 minus Line 0) Cash from Investments. Proceeds from investments sold, matured or repaid:. Bonds. Stocks. Mortgage loans.4 Real estate.5 Other invested assets.6 Net gains or (losses) on cash, cash equivalents and short-term investments.7 Miscellaneous proceeds.8 Total investment proceeds (Lines. to.7). Cost of investments acquired (long-term only):. Bonds. Stocks. Mortgage loans.4 Real estate.5 Other invested assets.6 Miscellaneous applications.7 Total investments acquired (Lines. to.6) 4. Net increase (or decrease) in contract loans and premium notes 5. Net cash from investments (Line.8 minus Line.7 and Line 4) 6. Cash provided (applied): Cash from Financing and Miscellaneous Sources 6. Surplus notes, capital notes 6. Capital and paid in surplus, less treasury stock 6. Borrowed funds 6.4 Net deposits on deposit-type contracts and other insurance liabilities 6.5 Dividends to stockholders 6.6 Other cash provided (applied) 7. Net cash from financing and miscellaneous sources (Line 6. through Line 6.4 minus Line 6.5 plus Line 6.6) RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 8. Net change in cash, cash equivalents and short-term investments (Line, plus Lines 5 and 7) 9. Cash, cash equivalents and short-term investments: 9. Beginning of year 9. End of period (Line 8 plus Line 9.) Note: Supplemental disclosures of cash flow information for non-cash transactions: "#$% & ' #( %%& )*& ,(* &#%(# + 5

7 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company Note: Supplemental disclosures of cash flow information for non-cash transactions: "# $ %

8 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company EXHIBIT DIRECT PREMIUMS AND DEPOSIT-TYPE CONTRACTS Current Year To Date Prior Year To Date Prior Year Ended December. Industrial life. Ordinary life insurance. Ordinary individual annuities 4. Credit life (group and individual) 5. Group life insurance 6. Group annuities 7. A & H - group 8. A & H - credit (group and individual) 9. A & H - other 0. Aggregate of all other lines of business. Subtotal. Deposit-type contracts. Total DETAILS OF WRITE-INS Summary of remaining write-ins for Line 0 from overflow page 099. Totals (Lines 00 through 00 plus 098)(Line 0 above) 6

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26 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company GENERAL INTERROGATORIES PART - COMMON INTERROGATORIES GENERAL. Did the reporting entity experience any material transactions requiring the filing of Disclosure of Material Transactions with the State of Domicile, as required by the Model Act?. If yes, has the report been filed with the domiciliary state?. Has any change been made during the year of this statement in the charter, by-laws, articles of incorporation, or deed of settlement of the reporting entity?. If yes, date of change:. Is the reporting entity a member of an Insurance Holding Company System consisting of two or more affiliated persons, one or more of which is an insurer? If yes, complete Schedule Y, Parts and A.. Have there been any substantial changes in the organizational chart since the prior quarter end?. If the response to. is yes, provide a brief description of those changes. 4. Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? 4. If yes, provide the name of the entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that has ceased to exist as a result of the merger or consolidation. Name of Entity NAIC Company Code State of Domicile 5. If the reporting entity is subject to a management agreement, including third-party administrator(s), managing general agent(s), attorneyin-fact, or similar agreement, have there been any significant changes regarding the terms of the agreement or principals involved? If yes, attach an explanation. 6. State as of what date the latest financial examination of the reporting entity was made or is being made. 6. State the as of date that the latest financial examination report became available from either the state of domicile or the reporting entity. This date should be the date of the examined balance sheet and not the date the report was completed or released. 6. State as of what date the latest financial examination report became available to other states or the public from either the state of domicile or the reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheet date). 6.4 By what department or departments? Commonwealth of Massachusetts Division of Insurance 6.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? 6.6 Have all of the recommendations within the latest financial examination report been complied with? 7. Has this reporting entity had any Certificates of Authority, licenses or registrations (including corporate registration, if applicable) suspended or revoked by any governmental entity during the reporting period? 7. If yes, give full information: 8. Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? 8. If response to 8. is yes, please identify the name of the bank holding company. 8. Is the company affiliated with one or more banks, thrifts or securities firms? 8.4 If response to 8. is yes, please provide below the names and location (city and state of the main office) of any affiliates regulated by a federal regulatory services agency [i.e. the Federal Reserve Board (FRB), the Office of the Comptroller of the Currency (OCC), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identify the affiliate's primary federal regulator. Affiliate Name Location (City, State) FRB 4 OCC 5 FDIC 6 SEC " ##$%& $' (#)# " #**+$ $' ',) " - ".'/ " *+$'+ ".'/ " *++ #.' " #- #.' " **0 #.' " $0'-* 45 " //$60 ".'/ " 8

27 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company GENERAL INTERROGATORIES 9. Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions) of the reporting entity subject to a code of ethics, which includes the following standards? (a) Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional relationships; (b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity; (c) Compliance with applicable governmental laws, rules and regulations; (d) The prompt internal reporting of violations to an appropriate person or persons identified in the code; and (e) Accountability for adherence to the code. 9. If the response to 9. is No, please explain: 9. Has the code of ethics for senior managers been amended? 9. If the response to 9. is Yes, provide information related to amendment(s). The code was revised in January 04. The revisions to the code are not material in nature. The revisions clarify or heighten awareness of certain information already incorporated in the Code of Conduct. 9. Have any provisions of the code of ethics been waived for any of the specified officers? 9. If the response to 9. is Yes, provide the nature of any waiver(s). FINANCIAL 0. Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page of this statement? 0. If yes, indicate any amounts receivable from parent included in the Page amount: $ INVESTMENT. Were any of the stocks, bonds, or other assets of the reporting entity loaned, placed under option agreement, or otherwise made available for use by another person? (Exclude securities under securities lending agreements.). If yes, give full and complete information relating thereto: Repurchase Agreements. Amount of real estate and mortgages held in other invested assets in Schedule BA: $. Amount of real estate and mortgages held in short-term investments: $ 4. Does the reporting entity have any investments in parent, subsidiaries and affiliates? 4. If yes, please complete the following: Prior Year-End Book/Adjusted Carrying Value Current Quarter Book/Adjusted Carrying Value 4. Bonds $ $ 4. Preferred Stock $ $ 4. Common Stock $ $ 4.4 Short-Term Investments $ $ 4.5 Mortgage Loans on Real Estate $ $ 4.6 All Other $ $ 4.7 Total Investment in Parent, Subsidiaries and Affiliates (Subtotal Lines 4. to 4.6) $ $ 4.8 Total Investment in Parent included in Lines 4. to 4.6 above $ $ 5. Has the reporting entity entered into any hedging transactions reported on Schedule DB? 5. If yes, has a comprehensive description of the hedging program been made available to the domiciliary state? If no, attach a description with this statement. 8.

28 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company GENERAL INTERROGATORIES 6. For the reporting entity s security lending program, state the amount of the following as of the current statement date: 6. Total fair value of reinvested collateral assets reported on Schedule DL, Parts and. $ 6. Total book adjusted/carrying value of reinvested collateral assets reported on Schedule DL, Parts and $ 6. Total payable for securities lending reported on the liability page. $ 7. Excluding items in Schedule E - Part - Special Deposits, real estate, mortgage loans and investments held physically in the reporting entity s offices, vaults or safety deposit boxes, were all stocks, bonds and other securities, owned throughout the current year held pursuant to a custodial agreement with a qualified bank or trust company in accordance with Section, III - General Examination Considerations, F. Outsourcing of Critical Functions, Custodial or Safekeeping Agreements of the NAIC Financial Condition Examiners Handbook? 7. For all agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following: Name of Custodian(s) &' -.) Custodian Address "#$ % % '()* +(,, /0.0,% 7. For all agreements that do not comply with the requirements of the NAIC Financial Condition Examiners Handbook, provide the name, location and a complete explanation: Name(s) Location(s) Complete Explanation(s) 7. Have there been any changes, including name changes, in the custodian(s) identified in 7. during the current quarter? 7.4 If yes, give full information relating thereto: Old Custodian New Custodian Date of Change 4 Reason 7.5 Identify all investment advisors, brokers/dealers or individuals acting on behalf of broker/dealers that have access to the investment accounts, handle securities and have authority to make investments on behalf of the reporting entity: Central Registration Depository Name(s) Address & 4$)55%(0 5/6/, $++' *+),, 7*(( %7*84% %9 $4.+) $0 #6#, 59 & 74. (( %%'( 4,,5 %%# +6)8)+.* 70 (( /7 :.'7 ) #5,, 9#5, ;(( /);'5-# 9 $'44. (( /$ < ' &995 (.5# 45( 4 ',59% +$+. 0(4 =+ /%5 +.*(4,40)( 4 5 ; 8. Have all the filing requirements of the Purposes and Procedures Manual of the NAIC Securities Valuation Office been followed? 8. If no, list exceptions: At 09/0/04, 66 issues for 66 issuers did not meet the filing requirements of the Purposes and Procedures Manual. The majority of these issues currently lack one or more of the following: Valid cusip/ppn, audited financials and/or executed legal documentation. Exceptions totaled $ 4,494,4.7 or 0.50% of all assets. 8.

29 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company GENERAL INTERROGATORIES PART - LIFE & HEALTH. Report the statement value of mortgage loans at the end of this reporting period for the following categories: Amount. Long-Term Mortgages In Good Standing. Farm Mortgages $. Residential Mortgages $. Commercial Mortgages $.4 Total Mortgages in Good Standing $. Long-Term Mortgages In Good Standing with Restructured Terms. Total Mortgages in Good Standing with Restructured Terms $. Long-Term Mortgage Loans Upon which Interest is Overdue more than Three Months. Farm Mortgages $. Residential Mortgages $. Commercial Mortgages $.4 Total Mortgages with Interest Overdue more than Three Months $.4 Long-Term Mortgage Loans in Process of Foreclosure.4 Farm Mortgages $.4 Residential Mortgages $.4 Commercial Mortgages $.44 Total Mortgages in Process of Foreclosure $.5 Total Mortgage Loans (Lines ) (Page, Column, Lines. +.) $.6 Long-Term Mortgages Foreclosed, Properties Transferred to Real Estate in Current Quarter.6 Farm Mortgages $.6 Residential Mortgages $.6 Commercial Mortgages $.64 Total Mortgages Foreclosed and Transferred to Real Estate $. Operating Percentages:. A&H loss percent. A&H cost containment percent. A&H expense percent excluding cost containment expenses. Do you act as a custodian for health savings accounts?. If yes, please provide the amount of custodial funds held as of the reporting date $. Do you act as an administrator for health savings accounts?.4 If yes, please provide the balance of the funds administered as of the reporting date $ 9

30 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company SCHEDULE S - CEDED REINSURANCE 4 Showing All New Reinsurance Treaties - Current Year to Date 5 6 NAIC Company Code ID Number Effective Date Name of Reinsurer Domiciliary Jurisdiction Type of Reinsurance Ceded Type of Reinsurer ( through 6) "# $%&' 7 8 Certified Reinsurer Rating 9 Effective Date of Certified Reinsurer Rating 0

31 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company SCHEDULE T - PREMIUMS AND ANNUITY CONSIDERATIONS Current Year To Date - Allocated by States and Territories Direct Business Only Life Contracts Accident and Health Insurance Premiums, Including Policy, Total Life Insurance Annuity Membership Other Columns Premiums Considerations and Other Fees Considerations Through 5 States, Etc. Active Status Deposit-Type Contracts. Alabama AL. Alaska AK. Arizona AZ 4. Arkansas AR 5. California CA 6. Colorado CO 7. Connecticut CT 8. Delaware DE 9. District of Columbia DC 0. Florida FL. Georgia GA. Hawaii HI. Idaho ID 4. Illinois IL 5. Indiana IN 6. Iowa IA 7. Kansas KS 8. Kentucky KY 9. Louisiana LA 0. Maine ME. Maryland MD. Massachusetts MA. Michigan MI 4. Minnesota MN 5. Mississippi MS 6. Missouri MO 7. Montana MT 8. Nebraska NE 9. Nevada NV 0. New Hampshire NH. New Jersey NJ. New Mexico NM. New York NY 4. North Carolina NC 5. North Dakota ND 6. Ohio OH 7. Oklahoma OK 8. Oregon OR 9. Pennsylvania PA 40. Rhode Island RI 4. South Carolina SC 4. South Dakota SD 4. Tennessee TN 44. Texas TX 45. Utah UT 46. Vermont VT 47. Virginia VA 48. Washington WA 49. West Virginia WV 50. Wisconsin WI 5. Wyoming WY 5. American Samoa AS 5. Guam GU 54. Puerto Rico PR 55. U.S. Virgin Islands VI 56. Northern Mariana Islands MP 57. Canada CAN 58. Aggregate Other Aliens OT XXX 59. Subtotal (a) 90. Reporting entity contributions for employee benefits plans XXX 9. Dividends or refunds applied to purchase paid-up additions and annuities XXX 9. Dividends or refunds applied to shorten endowment or premium paying period XXX 9. Premium or annuity considerations waived under disability or other contract provisions XXX 94. Aggregate or other amounts not allocable by State XXX 95. Totals (Direct Business) XXX 96. Plus Reinsurance Assumed XXX 97 Totals (All Business) XXX 98. Less Reinsurance Ceded XXX 99. Totals (All Business) less Reinsurance Ceded XXX DETAILS OF WRITE-INS XXX XXX XXX Summary of remaining write-ins for Line 58 from overflow page XXX Totals (Lines 5800 through 5800 plus 58998)(Line 58 above) XXX 940. XXX 940. XXX 940. XXX Summary of remaining write-ins for Line 94 from overflow page XXX Totals (Lines 940 through 940 plus 9498)(Line 94 above) XXX (L) Licensed or Chartered - Licensed Insurance Carrier or Domiciled RRG; (R) Registered - Non-domiciled RRGs; (Q) Qualified - Qualified or Accredited Reinsurer; (E) Eligible - Reporting Entities eligible or approved to write Surplus Lines in the state; (N) None of the above - Not allowed to write business in the state. (a) Insert the number of L responses except for Canada and Other Alien.

32 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company "# $"% & "#$$% '&()' $ %#% "%%* ' &&(+ ()' % #%,$ ' '&(&--). /((' $ %#% 0 '&(&--). (/((' $ %#% 0 '&(&--). )))/((' $ %#% 0 '&(((' $ %#% 0 &&(&--). (/((' "# 0 +4 ((' "# 0 4 '/((' *$ ", 0 & '/((' "# 0 ' '5-((' *, %$"* 0 ((' %,,%*"% 0 &&./((' "# 0 &&(0 ((' %%$## & &&()../((' 6 0 &&(&--). /((' "# 0 &&( 0 /((' $ %*%#% 0 && '/+ $ $%% 7 &&'89 ((' "# 0 && ((' *$,%$ 0 4 ( /((' * *," 0 &&89 (('*" *, %,"*# 0 &&89 (('* *#"" 0 &&(. ). ')/((' "# 0 &':'/((' %,$,,, 0 && :&'/) %%,$, & && :((' *#%" 0 && ' $ ",*# 6 ' && ' ((' "# 0 && ; ((', *"$ 0 &&':7((' 6 0 && :7((' "# 0 &&()../((' "# & &&()/((' "# & &&())/((' *$% 0 && ) ((' %%%,#* 0 && ( 6 :< && ). ( 6 :<

33 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company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

34 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company. 7:((' " #", 0 4' :7))/((' $ %%,## 0 4 ' :)/( 6 ') +' )& /((' "# 0 +' 'A)& ((' *, %*%"$ 0 +' & ((' *, %**% 0 +./) "# %$*%% ') 0'5& ((' "# 0 ' & ((' "# 0 = ()))=/((' "# 0 ( & ((' "# 0 &--((' "# 0 &--))((' *,$, 0 &--)))((' **#*$ 0 &--);((' # "**# 0 &-- ((' " $$$%*$ 0 5 & ((' "# 0 4 & ((' "# 0 59 ' # "*$ 0 5/) % **,, ' 50 /) % *"% 6 5 & /) # $*" 0 5)=) /) % $ 6 5)= ' % %"," 6 :; & ' ** *$", 6 ). & ' * "$%*. 5) /) # *#%", 0./) # $$# ' 5)= & /) #,$$% 0 5). ). ) " *%$ 6 =:/) $* *%* 6 /) $ *#$ ' ' & >)?( 6 ) =/) * #*%* 0 ((' " #, 0 >+?( 6 + && +:((' "# 0 +6 ((' "# *"% &

35 STATEMENT AS OF SEPTEMBER 0, 04 OF THE Massachusetts Mutual Life Insurance Company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