Urb. Ind. Tres Monjitas 297 Ave. Chardón.. San Juan... PR P

Transcription

1 LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION * * ANNUAL STATEMENT For the Year Ended December 31, 2016 of the Condition and Affairs of the NAIC Group Code...411, 411 NAIC Company Code Employer's ID Number Organized under the Laws of PR State of Domicile or Port of Entry PR Country of Domicile US Incorporated/Organized... June 15, 1971 Commenced Business... February 3, 1984 Statutory Home Office Urb. Ind. Tres Monjitas 297 Ave. Chardón.. San Juan... PR Main Administrative Office Urb. Ind. Tres Monjitas 297 Ave. Chardón.. San Juan... PR P Mail Address P.O Box San Juan... PR Primary Location of Books and Records Urb. Ind. Tres Monjitas 297 Ave. Chardón.. San Juan... PR P Internet Web Site Address Statutory Statement Contact Pedro E. Rosario Meléndez P prosario@mapfrepr.com F OFFICERS Name Title Name Title 1. Joaquín A. Castrillo President 2. Hilda M. Surillo Secretary 3. Sheila A. Quiñones Treasurer OTHER Alexis Sánchez Executive Vice President Diego Maldonado Senior Vice President José De La Mata Senior Vice President Leopoldo García Vice President Heriberto Crespo Vice President Alex Negrón Vice President Pedro E. Rosario Vice President & Controller Gloria Medina Vice President Compliance (Life) Karla Gnocchi Vice President Iraida Meléndez Senior Vice President Orlando Ríos Senior Vice President Sergio Castañeda Vice President DIRECTORS OR TRUSTEES Joaquín A. Castrillo Manuel R. Pietrantoni Jorge Fernández-Silva Federico Sánchez Jaime Tamayo Alexis Sánchez State of... County of... Puerto Rico San Juan 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: (1) state law may differ; or, (2) 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. Joaquín A. Castrillo Hilda M. Surillo Sheila A. Quiñones President Secretary Treasurer Subscribed and sworn to before me a. Is this an original filing? Yes [ X ] No [ ] This day of 2017 b. If no 1. State the amendment number 2. Date filed 3. Number of pages attached

2 ASSETS Current Year Prior Year Net Admitted Nonadmitted Assets Net Assets Assets (Cols. 1-2) Admitted Assets 1. Bonds (Schedule D) ,261, ,261, ,938, Stocks (Schedule D): 2.1 Preferred stocks , , , Common stocks , , , Mortgage loans on real estate (Schedule B): 3.1 First liens Other than first liens Real estate (Schedule A): 4.1 Properties occupied by the company (less $...0 encumbrances) Properties held for the production of income (less $...0 encumbrances) Properties held for sale (less $...0 encumbrances) Cash ($...14,181,539, Schedule E-Part 1), cash equivalents ($...2,998,794, Schedule E-Part 2) and short-term investments ($...3,136, Schedule DA) ,183, ,183, ,008, Contract loans (including $...0 premium notes) , , , , Derivatives (Schedule DB) Other invested assets (Schedule BA) Receivables for securities Securities lending reinvested collateral assets (Schedule DL) Aggregate write-ins for invested assets Subtotals, cash and invested assets (Lines 1 to 11) ,162, , ,134, ,940, Title plants less $...0 charged off (for Title insurers only) Investment income due and accrued , , , Premiums and considerations: 15.1 Uncollected premiums and agents' balances in the course of collection ,620, ,813, ,806, ,005, Deferred premiums, agents' balances and installments booked but deferred and not yet due (including $...0 earned but unbilled premiums) , , , Accrued retrospective premiums ($...0) and contracts subject to redetermination ($...0) Reinsurance: 16.1 Amounts recoverable from reinsurers , , ,519, Funds held by or deposited with reinsured companies Other amounts receivable under reinsurance contracts Amounts receivable relating to uninsured plans , , , , Current federal and foreign income tax recoverable and interest thereon Net deferred tax asset , , , , Guaranty funds receivable or on deposit Electronic data processing equipment and software , , , Furniture and equipment, including health care delivery assets ($...0) , , Net adjustment in assets and liabilities due to foreign exchange rates Receivables from parent, subsidiaries and affiliates , , , Health care ($...1,630,861) and other amounts receivable ,630, , , , Aggregate write-ins for other-than-invested assets ,209, ,183, , , Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) ,243, ,775, ,468, ,533, From Separate Accounts, Segregated Accounts and Protected Cell Accounts TOTAL (Lines 26 and 27) ,243, ,775, ,468, ,533,900 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 11 from overflow page Totals (Lines 1101 through 1103 plus 1198) (Line 11 above) OTHER ACCOUNTS RECEIVABLES , , , , AGENT BALANCE ,031, ,031, PREPAID EXPENSES , , Summary of remaining write-ins for Line 25 from overflow page Totals (Lines 2501 through 2503 plus 2598) (Line 25 above) ,209, ,183, , ,896 2

3 LIABILITIES, SURPLUS AND OTHER FUNDS 1 2 Current Year Prior Year 1. Aggregate reserve for life contracts $...8,117,726 (Exhibit 5, Line ) less $...0 included in Line 6.3 (including $...0 Modco Reserve) ,117, ,442, Aggregate reserve for accident and health contracts (including $...0 Modco Reserve) ,958, ,894, Liability for deposit-type contracts (Exhibit 7, Line 14, Col. 1) (including $...0 Modco Reserve) ,168, ,288, Contract claims: 4.1 Life (Exhibit 8, Part 1, Line 4.4, Col. 1 less sum of Cols. 9, 10 and 11) , ,134, Accident and health (Exhibit 8, Part 1, Line 4.4, sum of Cols. 9, 10 and 11) ,742, ,321, Policyholders' dividends $...0 and coupons $...0 due and unpaid (Exhibit 4, Line 10) Provision for policyholders' dividends and coupons payable in following calendar year - estimated amounts: 6.1 Dividends apportioned for payment (including $...0 Modco) Dividends not yet apportioned (including $...0 Modco) Coupons and similar benefits (including $...0 Modco) Amount provisionally held for deferred dividend policies not included in Line Premiums and annuity considerations for life and accident and health contracts received in advance less $...0 discount; including $...174,108 accident and health premiums (Exhibit 1, Part 1, Col. 1, sum of Lines 4 and 14) , , Contract liabilities not included elsewhere: 9.1 Surrender values on canceled contracts Provision for experience rating refunds, including the liability of $...0 accident and health experience rating refunds of which $...0 is for medical loss ratio rebate per the Public Health Service Act , , Other amounts payable on reinsurance, including $...0 assumed and $...674,534 ceded , , Interest Maintenance Reserve (IMR, Line 6) ,254, ,481, Commissions to agents due or accrued - life and annuity contracts $...0, accident and health $...0 and deposit-type contract funds $ ,654, ,156, Commissions and expense allowances payable on reinsurance assumed , , General expenses due or accrued (Exhibit 2, Line 12, Col. 6) ,763, ,163, Transfers to Separate Accounts due or accrued (net) (including $...0 accrued for expense allowances recognized in reserves, net of reinsured allowances) Taxes, licenses and fees due or accrued, excluding federal income taxes (Exhibit 3, Line 9, Col. 5) ,443, ,622, Current federal and foreign income taxes, including $...0 on realized capital gains (losses) Net deferred tax liability Unearned investment income Amounts withheld or retained by company as agent or trustee Amounts held for agents' account, including $...0 agents' credit balances Remittances and items not allocated , ,402, Net adjustment in assets and liabilities due to foreign exchange rates Liability for benefits for employees and agents if not included above Borrowed money $...0 and interest thereon $ Dividends to stockholders declared and unpaid Miscellaneous liabilities: Asset valuation reserve (AVR Line 16, Col. 7) , , Reinsurance in unauthorized and certified ($...0) companies Funds held under reinsurance treaties with unauthorized and certified ($...0) reinsurers Payable to parent, subsidiaries and affiliates , , Drafts outstanding Liability for amounts held under uninsured plans , , Funds held under coinsurance Derivatives Payable for securities Payable for securities lending Capital notes $...0 and interest thereon $ Aggregate write-ins for liabilities ,659, ,456, Total liabilities excluding Separate Accounts business (Lines 1 to 25) ,990, ,914, From Separate Accounts Statement Total liabilities (Line 26 and 27) ,990, ,914, Common capital stock ,032, ,032, Preferred capital stock Aggregate write-ins for other-than-special surplus funds ,370, Surplus notes Gross paid in and contributed surplus (Page 3, Line 33, Col. 2 plus Page 4, Line 51.1, Col. 1) ,413, ,413, Aggregate write-ins for special surplus funds Unassigned funds (surplus)......(23,967,156)...(23,195,515) 36. Less treasury stock, at cost: shares common (value included in Line 29 $...0) shares preferred (value included in Line 30 $...0) Surplus (Total Lines ) (including $...0 in Separate Accounts Statement) ,445, ,587, Totals of Lines 29, 30 and 37 (Page 4, Line 55) ,477, ,619, Totals of Lines 28 and 38 (Page 2, Line 28, Col. 3) ,468, ,533,900 DETAILS OF WRITE-INS ACCOUNTS PAYABLE POLICYHOLDERS & OTHERS ,220, ,221, CONTIGENT LIABILITY ,439, , Summary of remaining write-ins for Line 25 from overflow page Totals (Lines 2501 through 2503 plus 2598) (Line 25 above) ,659, ,456, Health Insurance Providers Fee ,370, Summary of remaining write-ins for Line 31 from overflow page Totals (Lines 3101 through 3103 plus 3198) (Line 31 above) ,370, Summary of remaining write-ins for Line 34 from overflow page Totals (Lines 3401 through 3403 plus 3498) (Line 34 above)

4 SUMMARY OF OPERATIONS 1 2 Current Year Prior Year 1. Premiums and annuity considerations for life and accident and health contracts (Exhibit 1, Part 1, Line 20.4, Col. 1, less Col. 11)...117,118, ,388, Considerations for supplementary contracts with life contingencies Net investment income (Exhibit of Net Investment Income, Line 17) ,061, ,333, Amortization of Interest Maintenance Reserve (IMR) (Line 5) , , Separate Accounts net gain from operations excluding unrealized gains or losses Commissions and expense allowances on reinsurance ceded (Exhibit 1, Part 2, Line 26.1, Col. 1) , , Reserve adjustments on reinsurance ceded Miscellaneous Income: 8.1 Income from fees associated with investment management, administration and contract guarantees from Separate Accounts Charges and fees for deposit-type contracts Aggregate write-ins for miscellaneous income , , Totals (Lines 1 to 8.3) ,143, ,619, Death benefits ,000, ,648, Matured endowments (excluding guaranteed annual pure endowments) Annuity benefits (Exhibit 8, Part 2, Line 6.4, Cols ) , , Disability benefits and benefits under accident and health contracts ,901, ,352, Coupons, guaranteed annual pure endowments and similar benefits Surrender benefits and withdrawals for life contracts , , Group conversions Interest and adjustments on contract or deposit-type contract funds Payments on supplementary contracts with life contingencies Increase in aggregate reserves for life and accident and health contracts......(381,301)...5,181, Totals (Lines 10 to 19) ,749, ,403, Commissions on premiums, annuity considerations and deposit-type contract funds (direct business only) (Exhibit 1, Part 2, Line 31, Col. 1) ,889, ,898, Commissions and expense allowances on reinsurance assumed (Exhibit 1, Part 2, Line 26.2, Col. 1) , , General insurance expenses (Exhibit 2, Line 10, Columns 1, 2, 3 and 4) ,996, ,322, Insurance taxes, licenses and fees, excluding federal income taxes (Exhibit 3, Line 7, Cols ) ,755, ,978, Increase in loading on deferred and uncollected premiums Net transfers to or (from) Separate Accounts net of reinsurance Aggregate write-ins for deductions ,264, , Totals (Lines 20 to 27) ,908, ,030, Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 28)......(2,764,749)...(13,410,842) 30. Dividends to policyholders Net gain from operations after dividends to policyholders and before federal income taxes (Line 29 minus Line 30)......(2,764,749)...(13,410,842) 32. 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 31 minus Line 32)......(2,799,752)...(13,418,040) 34. Net realized capital gains (losses) (excluding gains (losses) transferred to the IMR) less capital gains tax of $...13,859 (excluding taxes of $...54,150 transferred to the IMR)......(44,561)...(403,936) 35. Net income (Line 33 plus Line 34)......(2,844,313)...(13,821,976) CAPITAL AND SURPLUS ACCOUNT 36. Capital and surplus, December 31, prior year (Page 3, Line 38, Col. 2) ,619, ,849, Net income (Line 35)......(2,844,313)...(13,821,976) 38. Change in net unrealized capital gains (losses) less capital gains tax of $ ,789...(159,103) 39. Change in net unrealized foreign exchange capital gain (loss) Change in net deferred income tax......(264,422)...1,076, Change in nonadmitted assets , ,704, Change in liability for reinsurance in unauthorized and certified companies Change in reserve on account of change in valuation basis, (increase) or decrease Change in asset valuation reserve , , Change in treasury stock, (Page 3, Lines 36.1 and 36.2 Col. 2 minus Col. 1) Surplus (contributed to) withdrawn from Separate Accounts during period Other changes in surplus in Separate Accounts Statement Change in surplus notes Cumulative effect of changes in accounting principles Capital changes: 50.1 Paid in Transferred from surplus (Stock Dividend) Transferred to surplus Surplus adjustment: 51.1 Paid in ,000, Transferred to capital (Stock Dividend) Transferred from capital Change in surplus as a result of reinsurance Dividends to stockholders Aggregate write-ins for gains and losses in surplus , Net change in capital and surplus for the year (Lines 37 through 53) ,858,363...(7,230,297) 55. Capital and surplus, December 31, current year (Lines ) (Page 3, Line 38) ,477, ,619,628 DETAILS OF WRITE-INS Miscellaneous Income , , Summary of remaining write-ins for Line 8.3 from overflow page Totals (Lines through plus ) (Line 8.3 above) , , Good Experience Refund......(64,296)...209, Accrued Fines with Regulatory Authorities ,329, Summary of remaining write-ins for Line 27 from overflow page Totals (Lines 2701 through 2703 plus 2798) (Line 27 above) ,264, , Adjustment to Beginning Capital , Summary of remaining write-ins for Line 53 from overflow page Totals (Lines 5301 through 5303 plus 5398) (Line 53 above) ,140 4

5 CASH FROM OPERATIONS CASH FLOW 1 2 Current Year Prior Year 1. Premiums collected net of reinsurance ,098, ,627, Net investment income ,260, ,554, Miscellaneous income , , Total (Lines 1 through 3) ,879, ,622, Benefit and loss related payments ,465, ,535, Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts Commissions, expenses paid and aggregate write-ins for deductions ,964, ,236, Dividends paid to policyholders Federal and foreign income taxes paid (recovered) net of $...0 tax on capital gains (losses) Total (Lines 5 through 9) ,429, ,771, Net cash from operations (Line 4 minus Line 10) ,068...(8,148,777) CASH FROM INVESTMENTS 12. Proceeds from investments sold, matured or repaid: 12.1 Bonds ,376, ,697, Stocks , , Mortgage loans Real estate Other invested assets Net gains or (losses) on cash, cash equivalents and short-term investments Miscellaneous proceeds Total investment proceeds (Lines 12.1 to 12.7) ,589, ,946, Cost of investments acquired (long-term only): 13.1 Bonds ,655, ,987, Stocks Mortgage loans Real estate Other invested assets Miscellaneous applications Total investments acquired (Lines 13.1 to 13.6) ,655, ,987, Net increase (decrease) in contract loans and premium notes......(145,553) Net cash from investments (Line 12.8 minus Lines 13.7 minus Line 14)......(5,920,230)...15,959, Cash provided (applied): CASH FROM FINANCING AND MISCELLANEOUS SOURCES 16.1 Surplus notes, capital notes Capital and paid in surplus, less treasury stock ,000, Borrowed funds Net deposits on deposit-type contracts and other insurance liabilities......(195,881)...(122,880) 16.5 Dividends to stockholders Other cash provided (applied)......(158,422)...950, Net cash from financing and miscellaneous sources (Lines 16.1 to 16.4 minus Line 16.5 plus Line 16.6) ,645, ,118 RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 18. Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17)......(825,465)...8,638, Cash, cash equivalents and short-term investments: 19.1 Beginning of year ,008, ,370, End of year (Line 18 plus Line 19.1) ,183, ,008,934 Note: Supplemental disclosures of cash flow information for non-cash transactions:

6 6 Annual Statement for the year 2016 of the ANALYSIS OF OPERATIONS BY LINES OF BUSINESS 1 2 Ordinary 6 Group Accident and Health Credit Life Aggregate of Industrial Life Individual Supplementary (Group and Life Credit (Group All Other Lines Total Life Insurance Annuities Contracts Individual) Insurance(a) Annuities Group and Individual) Other of Business 1. Premiums and annuity considerations for life and accident and health contracts ,118, , , ,460, , ,003, ,248, ,262, Considerations for supplementary contracts with life contingencies Net investment income ,061, , , , , , , , Amortization of Interest Maintenance Reserve (IMR) , , , , , , , , Separate Accounts net gain from operations excluding unrealized gains or losses Commissions and expense allowances on reinsurance ceded , , , , Reserve adjustments on reinsurance ceded Miscellaneous Income: 8.1 Fees associated with income from investment management, administration and contract guarantees from S/A Charges and fees for deposit-type contracts Aggregate write-ins for miscellaneous income , (58,977)...(6,228) ,791...(392) ,041...(230)...(5,347) Totals (Lines 1 to 8.3) ,143, , , ,754, , ,166, ,347, ,437, Death benefits ,000, , , , Matured endowments (excluding guaranteed annual pure endowments) Annuity benefits , , Disability benefits and benefits under accident and health contracts ,901, ,224, , ,613, Coupons, guaranteed annual pure endowments and similar benefits Surrender benefits and withdrawals for life contracts , , Group conversions Interest and adjustments on contract or deposit-type contract funds Payments on supplementary contracts with life contingencies Increase in aggregate reserves for life and accident and health contracts......(381,301) ,344...(120,123) ,024...(11,705)......(1,642,881)...257, , Totals (Lines 10 to 19) ,749, , , ,103, , ,581, , ,069, Commissions on premiums, annuity considerations and deposit-type contract funds (direct business only) ,889, , ,287, , ,434, , ,311, Commissions and expense allowances on reinsurance assumed , , General insurance expenses ,996, , , , , ,099, , ,261, Insurance taxes, licenses and fees, excluding federal income taxes ,755, , , , ,534, , , Increase in loading on deferred and uncollected premiums Net transfers to or (from) Separate Accounts net of reinsurance Aggregate write-ins for deductions ,264, (64,296) ,329, Totals (Lines 20 to 27) ,908, , , ,347, , ,902, ,132, ,067, Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 28)......(2,764,749) (292,606)...16, , , (1,736,956)...215,083...(1,629,822) Dividends to policyholders Net gain from operations after dividends to policyholders and before federal income taxes (Line 29 minus Line 30)......(2,764,749) (292,606)...16, , , (1,736,956)...215,083...(1,629,822) Federal 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 31 minus Line 32)......(2,799,752) (293,065)...15, , , (1,768,885)...214,710...(1,630,491)...0 DETAILS OF WRITE-INS Miscellaneous Income , (58,977)...(6,228) ,791...(392) ,041...(230)...(5,347) Summary of remaining write-ins for Line 8.3 from overflow page Total (Lines through plus ) (Line 8.3 above) , (58,977)...(6,228) ,791...(392) ,041...(230)...(5,347) Good Experience Refund......(64,296) (64,296) Accrued Fines with Regulatory Authorities ,329, ,329, Summary of remaining write-ins for Line 27 from overflow page Total (Lines 2701 through 2703 plus 2798) (Line 27 above) ,264, (64,296) ,329, (a) Includes the following amounts for FEGLI/SGLI: Line Line Line Line Line

7 Involving Life or Disability Contingencies (Reserves) (Net of Reinsurance Ceded) ANALYSIS OF INCREASE IN RESERVES DURING THE YEAR 1 2 Ordinary 6 Group Credit Life 7 8 Industrial Supplementary (Group and Total Life Life Insurance Individual Annuities Contracts Individual) Life Insurance Annuities 1. Reserve December 31, prior year ,796, ,688, ,937, , Tabular net premiums or considerations ,211, , ,617, ,479, Present value of disability claims incurred xxx Tabular interest , , , Tabular less actual reserve released , , Increase in reserve on account of change in valuation basis Other increases (net) Totals (Lines 1 to 7) ,459, ,913, ,810, ,735, Tabular cost ,037, , xxx ,101, ,577, Reserves released by death , xxx......xxx , xxx Reserves released by other terminations (net) , , , Annuity, supplementary contract, and disability payments involving life contingencies Net transfers to or (from) Separate Accounts Total deductions (Lines 9 to 13) ,341, , ,281, ,577, Reserve December 31, current year ,117, ,430, ,528, ,

8 EXHIBIT OF NET INVESTMENT INCOME 1 2 Collected Earned During Year During Year 1. U.S. government bonds... (a)...27, , Bonds exempt from U.S. tax... (a) Other bonds (unaffiliated)... (a)...976, , Bonds of affiliates... (a) Preferred stocks (unaffiliated)... (b)...32, , Preferred stocks of affiliates... (b) Common stocks (unaffiliated) , , Common stocks of affiliates Mortgage loans... (c) Real estate... (d) Contract loans Cash, cash equivalents and short-term investments... (e)...62, , Derivative instruments... (f) Other invested assets Aggregate write-ins for investment income Total gross investment income ,105, ,080, Investment expenses... (g)...19, Investment taxes, licenses and fees, excluding federal income taxes... (g) Interest expense... (h) Depreciation on real estate and other invested assets... (i) Aggregate write-ins for deductions from investment income Total deductions (Lines 11 through 15) , Net investment income (Line 10 minus Line 16) ,061,060 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 9 from overflow page Totals (Lines 0901 through 0903 plus 0998) (Line 9 above) Summary of remaining write-ins for Line 15 from overflow page Totals (Lines 1501 through 1503 plus 1598) (Line 15 above) (a) Includes $...6,098 accrual of discount less $...180,278 amortization of premium and less $...89,148 paid for accrued interest on purchases. (b) Includes $...0 accrual of discount less $...0 amortization of premium and less $...0 paid for accrued dividends on purchases. (c) Includes $...0 accrual of discount less $...0 amortization of premium and less $...0 paid for accrued interest on purchases. (d) Includes $...0 for company's occupancy of its own buildings; and excludes $...0 interest on encumbrances. (e) Includes $...0 accrual of discount less $...0 amortization of premium and less $...0 paid for accrued interest on purchases. (f) Includes $...0 accrual of discount less $...0 amortization of premium. (g) Includes $...0 investment expenses and $...0 investment taxes, licenses and fees, excluding federal income taxes, attributable to segregated and Separate Accounts. (h) Includes $...0 interest on surplus notes and $...0 interest on capital notes. (i) Includes $...0 depreciation on real estate and $...0 depreciation on other invested assets. EXHIBIT OF CAPITAL GAINS (LOSSES) Realized Change in Gain (Loss) Other Total Realized Change in Unrealized on Sales Realized Capital Gain (Loss) Unrealized Foreign Exchange or Maturity Adjustments (Columns 1 + 2) Capital Gain (Loss) Capital Gain (Loss) 1. U.S. government bonds Bonds exempt from U.S. tax Other bonds (unaffiliated) ,749...(100,000)...170, , Bonds of affiliates Preferred stocks (unaffiliated) (5,194) Preferred stocks of affiliates Common stocks (unaffiliated) , ,298...(37,843) Common stocks of affiliates Mortgage loans Real estate Contract loans Cash, cash equivalents and short-term investments Derivative instruments Other invested assets Aggregate write-ins for capital gains (losses) Total capital gains (losses) ,047...(100,000)...240, , DETAILS OF WRITE-INS Summary of remaining write-ins for Line 9 from overflow page Totals (Lines 0901 through 0903 plus 0998) (Line 9 above)

9 9 Annual Statement for the year 2016 of the EXHIBIT 1 - PART 1 - PREMIUMS AND ANNUITY CONSIDERATIONS FOR LIFE AND ACCIDENT AND HEALTH CONTRACTS 1 2 Ordinary 5 Group Accident and Health Credit Life Aggregate of Industrial Individual (Group and Credit All Other Lines Total Life Life Insurance Annuities Individual) Life Insurance Annuities Group (Group & Individual) Other of Business FIRST YEAR (other than single) 1. Uncollected ,431, , , ,901, , Deferred and accrued Deferred, accrued and uncollected: 3.1 Direct ,431, , , ,901, , Reinsurance assumed Reinsurance ceded Net (Line 1 + Line 2) ,431, , , ,901, , Advance , , Line Line ,257, , , ,727, , Collected during year: 6.1 Direct ,612, , , ,199, ,266, Reinsurance assumed Reinsurance ceded , , , , Net ,365, , , ,987, ,266, Line 5 + Line ,623, , , ,715, ,715, Prior year (uncollected + deferred and accrued - advance) ,979, , ,643, , First year premiums and considerations: 9.1 Direct ,891, , , ,283, ,433, Reinsurance assumed Reinsurance ceded , , , , Net (Line 7 - Line 8) ,644, , , ,072, ,433, SINGLE 10. Single premiums and considerations: 10.1 Direct ,708, ,460, ,248, Reinsurance assumed Reinsurance ceded Net ,708, ,460, ,248, RENEWAL 11. Uncollected ,823, , , ,604, , Deferred and accrued Deferred, accrued and uncollected: 13.1 Direct ,677, , , ,458, , Reinsurance assumed , , Reinsurance ceded Net (Line 11 + Line 12) ,823, , , ,604, , Advance Line Line ,823, , , ,604, , Collected during year: 16.1 Direct ,774, , , ,373, ,448, ,533, Reinsurance assumed ,035, ,035, Reinsurance ceded ,133, , , ,434, , Net ,676, , , , ,048, ,522, Line 15 + Line ,500, , , , ,653, ,413, Prior year (uncollected + deferred and accrued - advance) ,734, , , ,722, ,584, Renewal premiums and considerations: 19.1 Direct ,718, , , ,287, ,184, ,840, Reinsurance assumed ,181, ,181, Reinsurance ceded ,133, , , ,434, , Net (Line 17 - Line 18) ,765, , , , ,930, ,828, TOTAL 20. Total premiums and annuity considerations: 20.1 Direct ,317, , , ,460, ,341, ,467, ,248, ,273, Reinsurance assumed ,181, ,181, Reinsurance ceded ,380, , , ,646, , Net (Lines ) ,118, , , ,460, , ,003, ,248, ,262,

10 DIVIDENDS AND COUPONS APPLIED (included in Part 1) EXHIBIT 1 - PART 2 - DIVIDENDS AND COUPONS APPLIED, REINSURANCE COMMISSIONS AND EXPENSE ALLOWANCES AND COMMISSIONS INCURRED (direct business only) 1 2 Ordinary 5 Group Accident and Health Credit Life Aggregate of Industrial Individual (Group and Credit All Other Lines Total Life Life Insurance Annuities Individual) Life Insurance Annuities Group (Group & Individual) Other of Business 21. To pay renewal premiums All other REINSURANCE COMMISSIONS AND EXPENSE ALLOWANCES INCURRED 23. First year (other than single): 23.1 Reinsurance ceded , , Reinsurance assumed Net ceded less assumed , , Single: 24.1 Reinsurance ceded Reinsurance assumed Net ceded less assumed Renewal: 25.1 Reinsurance ceded , , , , Reinsurance assumed , , Net ceded less assumed , , , , Totals: 26.1 Reinsurance ceded (Page 6, Line 6) , , , , Reinsurance assumed (Page 6, Line 22) , , Net ceded less assumed , , , , COMMISSIONS INCURRED (direct business only) 27. First year (other than single) ,009, , , ,037, , Single ,970, ,287, , Renewal ,908, , , ,397, , Deposit-type contract funds Totals (to agree with Page 6, Line 21) ,889, , ,287, , ,434, , ,311,

11 EXHIBIT 2 - GENERAL EXPENSES Insurance Accident and Health All Other Lines Life Cost Containment All Other of Business Investment Total 1. Rent , , , Salaries and wages , ,575, , ,093, Contributions for benefit plans for employees , , , Contributions for benefit plans for agents Payments to employees under non-funded benefit plans Payments to agents under non-funded benefit plans Other employee welfare , , , Other agent welfare Legal fees and expenses , , , Medical examination fees Inspection report fees Fees of public accountants and consulting actuaries , , , Expense of investigation and settlement of policy claims Traveling expenses , , , Advertising , , , Postage, express, telegraph and telephone , , , Printing and stationery , , , Cost or depreciation of furniture and equipment Rental of equipment Cost or depreciation of EDP equipment and software , , , Books and periodicals , , Bureau and association fees , , , Insurance, except on real estate , , , Miscellaneous losses Collection and bank service charges , , , Sundry general expenses Group service and administration fees , , , Reimbursements by uninsured plans (81,597) (81,597) 7.1 Agency expense allowance Agents' balances charged off (less $...0 recovered) Agency conferences other than local meetings Real estate expenses Investment expenses not included elsewhere Aggregate write-ins for expenses , ,612, ,812, General expenses Incurred ,522, ,473, ,200 (a)...13,015, General expenses unpaid December 31, prior year , ,867, ,163, General expenses unpaid December 31, current year , ,481, ,763, Amounts receivable relating to uninsured plans, prior year , , Amounts receivable relating to uninsured plans, current year , , General expenses paid during year (Lines ) ,536, ,887, , ,442,660 DETAILS OF WRITE-INS Management Fees , ,684, ,813, Sofware Expenses , , , Consulting Fees , ,202, ,237, Summary of remaining write-ins for Line 9.3 from overflow page , , , Totals (Lines through plus )(Line 9.3 above) , ,612, ,812,975 (a) Includes management fees of $...2,365,703 to affiliates and $...0 to non-affiliates. EXHIBIT 3 - TAXES, LICENSES AND FEES (EXCLUDING FEDERAL INCOME TAXES) Insurance Accident All Other Lines Life and Health of Business Investment Total 1. Real estate taxes , , , State insurance department licenses and fees , ,345, ,404, State taxes on premiums , , , Other state taxes, including $...0 for employee benefits , , , U.S. Social Security taxes , ,704, ,707, All other taxes Taxes, licenses and fees incurred , ,645, ,755, Taxes, licenses and fees unpaid December 31, prior year , ,561, ,622, Taxes, licenses and fees unpaid December 31, current year , ,339, ,443, Taxes, licenses and fees paid during year (Lines ) , ,866, ,934,394 EXHIBIT 4 - DIVIDENDS OR REFUNDS 1 2 Life Accident and Health 1. Applied to pay renewal premiums Applied to shorten the endowment or premium-paying period Applied to provide paid-up additions Applied to provide paid-up annuities Total Lines 1 through Paid-in cash Left on deposit Aggregate write-ins for dividend or refund options Total Lines 5 through 8... NONE Amount due and unpaid Provision for dividends or refunds payable in the following calendar year Terminal dividends Provision for deferred dividend contracts Amount provisionally held for deferred dividend contracts not included in Line Total Lines 10 through Total from prior year Total dividends or refunds (Lines ) DETAILS OF WRITE-INS Summary of remaining write-ins for Line 8 from overflow page Totals (Line 0801 through 0803 plus 0898) (Line 8 above)

12 EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS Credit (Group and Valuation Standard Total Industrial Ordinary Individual) Group Life Insurance: CSO 3% NLP-CRVM CSO 3% CSO 3 1/2 % CSO 3% , , CSO 3 1/2 % , , CSO 4% CET 3% CSO VARIABLE 5% NLP CSO VARIABLE 5% NLP (Archiever) , , CSO 5 1/2 % NLP CSO 6% NLP USSI Single Premium CSO 4% , , CSO 4.5% , , CSO 4% , , CSO 4.5% ,437, ,437, CSO 3% , , CSO 3.5% , , Totals (Gross) ,595, ,157, ,437, Reinsurance ceded , , Totals (Net) ,577, ,140, ,437, Accidental Death Benefits: ADB WITH 1958 CSO 3 1/2% , , Totals (Gross) , , Totals (Net) , , Disability - Active Lives: DISABILITY STUDY - PERIOD 2 WITH 1958 CSO 3 1/2% COMMISSIONERS CSO 3% Totals (Gross) Totals (Net) Disability - Disabled Lives: DISABILITY STUDY - PERIOD CSO 3 1/2 % KRIEGER 120% MORT 50% RECOV 3.5% , , KRIEGER 120% MORT 50% RECOV 4% ,049, ,049, KRIEGER 120% MORT 50% RECOV 4.5% , , KRIEGER 120% MORT 50% RECOV 5% , , KRIEGER 120% MORT 50% RECOV 5.5% , , Totals (Gross) ,197, ,197, Reinsurance ceded ,039, ,039, Totals (Net) , ,410 Miscellaneous Reserves: FOR NON-DEDUCTION OF DEFERRED FRACTIONAL PREMIUMS OR RETURN OF PREMIUMS AT THE DEATH OF THE INSURED...1, , FOR SURRENDER VALUES IN EXCESS OF RESERVES OTHERWISE REQUIRED AND CARRIED IN THIS SCHEDULE SUBSTANDARD EXTRA AT 1/2 ANNUAL PREMIUM PAYOR BENEFIT - AT 1/2 ANNUAL PREMIUM ADITIONAL ACTUARIAL RESERVE , , UNEANED PREMIUM , , IPC , , , FOR EXCESS OF VALUATION NET PREMIUMS OVER CORRESPONDING GROSS PREMIUMS...41, , Totals (Gross) , , , Totals (Net) , , , Totals (Net) - Page 3, Line ,117, ,430, ,528, ,410 12