ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2017 OF THE CONDITION AND AFFAIRS OF THE. The State Life Insurance Company

Transcription

1 LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER, 07 OF THE CONDITION AND AFFAIRS OF THE The State Life Insurance Company * * NAIC Group Code NAIC Company Code 696 Employer's ID Number (Current) (Prior) Organized under the Laws of Indiana, State of Domicile or Port of Entry IN Country of Domicile United States of America Incorporated/Organized /0/004 Commenced Business 09/4/894 Statutory Home Office One American Square, Indianapolis, IN, US (Street and Number) (City or Town, State, Country and Zip Code) Main Administrative Office One American Square (Street and Number) Indianapolis, IN, US , (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Mail Address P O Box 68, Indianapolis, IN, US (Street and Number or P.O. Box) (City or Town, State, Country and Zip Code) Primary Location of Books and Records One American Square (Street and Number) Indianapolis, IN, US , (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Internet Website Address Statutory Statement Contact Emilie E. Bolster, (Name) (Area Code) (Telephone Number) FinRpt.CorpFin@OneAmerica.com, ( Address) (FAX Number) OFFICERS Chairman, President & CEO James Scott Davison Chief Financial Officer Jeffrey David Holley Secretary Thomas Michael Zurek Actuary Todd Spencer Kennedy OTHER Christopher Gerard Coudret, Executive Vice President Richard Michael Ellery #, Senior Vice President Dennis Cameron Martin #, Senior Vice President Andrew John Michie, Senior Vice President James Charles Crampton, Vice President Jeffrey Scott Drake, Vice President George Granville Graessle IV, Vice President Bruce Erin Moon, Vice President Nancy Brady Moore, Vice President Jay Brian Williams, Vice President DIRECTORS OR TRUSTEES James Scott Davison Patrick Michael Foley Jeffrey David Holley Kelly Michelle Huntington John Charles Mason Mark Cameron Roller Karin Wyvette Sarratt Thomas Michael Zurek State of County of Indiana Marion 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. J. Scott Davison Thomas M. Zurek Jeffrey D. Holley Chairman, President & CEO Secretary Chief Financial Officer a. Is this an original filing? Yes [ X ] No [ ] Subscribed and sworn to before me this b. If no, 5th day of February, 08. State the amendment number. Date filed. Number of pages attached Rachelle Richey Notary Public 0/0/00

2 ASSETS Assets Current Year Nonadmitted Assets Net Admitted Assets (Cols. - ) Prior Year 4 Net Admitted Assets. Bonds (Schedule D) 6,677,8,6 6,677,8,6 5,947,88,096. Stocks (Schedule D):. Preferred stocks 5,50,660 5,50,660 5,50,660. Common stocks 40,578,500 40,578,500 4,744,00. Mortgage loans on real estate (Schedule B):. First liens 770,66,07 770,66,07 6,069,740. Other than first liens 4. Real estate (Schedule A): 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 ($ 57,0,6, Schedule E - Part ), cash equivalents ($, Schedule E - Part ) and short-term investments ($,09,695, Schedule DA) 60,97,8 60,97,8 7,40, Contract loans (including $ premium notes) 4,899,88 4,899,88 4,4, Derivatives (Schedule DB) 6,946,875 6,946,875,885,67 8. Other invested assets (Schedule BA),408,90 66,05,4,850 6,76,6 9. Receivables for securities,96,4,96,4,000, Securities lending reinvested collateral assets (Schedule DL) 97,80,48 97,80,48. Aggregate write-ins for invested assets. Subtotals, cash and invested assets (Lines to ) 7,79,7,6 66,05 7,78,95,09 6,65,59,895. Title plants less $ charged off (for Title insurers only) 4. Investment income due and accrued 65,44,7 65,44,7 59,0,7 5. Premiums and considerations: 5. Uncollected premiums and agents' balances in the course of collection,494,544,494,544,740,40 5. Deferred premiums and agents' balances and installments booked but deferred and not yet due (including $ earned but unbilled premiums) 0,90,98 0,90,98 7,07,05 5. Accrued retrospective premiums ($ ) and 6. Reinsurance: contracts subject to redetermination ($ ) 6. Amounts recoverable from reinsurers,8,9,8,9,498, Funds held by or deposited with reinsured companies 6. Other amounts receivable under reinsurance contracts 4, 4, 4,6 7. Amounts receivable relating to uninsured plans 8. Current federal and foreign income tax recoverable and interest thereon 8. Net deferred tax asset,9,6,98,76 8,409,90 0,778,75 9. Guaranty funds receivable or on deposit 447,40 447,40 4, 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,049,794,049, Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines to 5) 7,85,4,75 7,99,57 7,88,05,79 6,754,4, From Separate Accounts, Segregated Accounts and Protected Cell Accounts 8. Total (Lines 6 and 7) 7,85,4,75 7,99,57 7,88,05,79 6,754,4, DETAILS OF WRITE-INS 98. Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 0 plus 98)(Line above) 50. Other assets,045,908,045, Prepaid expenses,886, Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598)(Line 5 above),049,794,049,794

3 LIABILITIES, SURPLUS AND OTHER FUNDS Prior Year Current Year. Aggregate reserve for life contracts $ 6,49,598,55 (Exh. 5, Line ) less $ included in Line 6. (including $ 784,79,6 Modco Reserve) 6,49,598,55 5,67,048,00. Aggregate reserve for accident and health contracts (including $ Modco Reserve) 7,8 56,5. Liability for deposit-type contracts (Exhibit 7, Line 4, Col. ) (including $ Modco Reserve) 906,70,6 57,009,74 4. Contract claims: 4. Life (Exhibit 8, Part, Line 4.4, Col. less sum of Cols. 9, 0 and ),844,8,60,9 4. Accident and health (Exhibit 8, Part, Line 4.4, sum of Cols. 9, 0 and ) 5. Policyholders dividends $ and coupons $ due and unpaid (Exhibit 4, Line 0) 6. Provision for policyholders dividends and coupons payable in following calendar year - estimated amounts: 6. Dividends apportioned for payment (including $ Modco),045,864,0,0 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 $ 55 accident and health premiums (Exhibit, Part, Col., sum of lines 4 and 4) 80,48 98,49 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 $ 7,000 assumed and $ 85,876 ceded 40,876 5, Interest maintenance reserve (IMR, Line 6) 6,488, 8,775, 0. Commissions to agents due or accrued-life and annuity contracts $ 99,045 accident and health $ and deposit-type contract funds $ 99,045 08,09. Commissions and expense allowances payable on reinsurance assumed 64, ,484. General expenses due or accrued (Exhibit, Line, Col. 6). 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 (Exhibit, Line 9, Col. 5),757,5,, Current federal and foreign income taxes, including $ 966,8 on realized capital gains (losses),40,775,77,07 5. Net deferred tax liability 6. Unearned investment income 694,47 67,0 7. Amounts withheld or retained by company as agent or trustee 97,075 9, Amounts held for agents' account, including $ 9 agents' credit balances Remittances and items not allocated 6,88,66 6,855, 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 $. Dividends to stockholders declared and unpaid 4. Miscellaneous liabilities: 4.0 Asset valuation reserve (AVR, Line 6, Col. 7) 45,685,804 9,64, Reinsurance in unauthorized and certified ($ ) companies 5, Funds held under reinsurance treaties with unauthorized and certified ($ ) reinsurers 4.04 Payable to parent, subsidiaries and affiliates,779,96,59, Drafts outstanding 4.06 Liability for amounts held under uninsured plans 4.07 Funds held under coinsurance 4.08 Derivatives 5,444,750,054, Payable for securities 0,067,00 99,7 4.0 Payable for securities lending 97,80,48 4. Capital notes $ and interest thereon $ 5. Aggregate write-ins for liabilities 7,888,879 4,88, Total liabilities excluding Separate Accounts business (Lines to 5) 7,89,4,78 6,94,97, From Separate Accounts Statement 8. Total liabilities (Lines 6 and 7) 7,89,4,78 6,94,97, Common capital stock,000,000,000, Preferred capital stock. Aggregate write-ins for other than special surplus funds. Surplus notes 0,000,000 0,000,000. Gross paid in and contributed surplus (Page, Line, Col. plus Page 4, Line 5., Col. ) 0,550,000 0,550, Aggregate write-ins for special surplus funds 5. Unassigned funds (surplus) 95,60,80 6,67,7 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) 45,80,80 456,87,7 8. Totals of Lines 9, 0 and 7 (Page 4, Line 55) 48,80,80 459,87,7 9. Totals of Lines 8 and 8 (Page, Line 8, Col. ) 7,88,05,79 6,754,4,809 DETAILS OF WRITE-INS 50. Accounts payable 4,586,688,50, Reserve on unclaimed funds,94,508,9, Accrued interest on policy funds 7,68 6, Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598)(Line 5 above) 7,888,879 4,88, Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 0 plus 98)(Line above) Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above)

4 SUMMARY OF OPERATIONS Prior Year Current Year. Premiums and annuity considerations for life and accident and health contracts (Exhibit, Part, Line 0.4, Col., less Col. ),75, ,7,50. Considerations for supplementary contracts with life contingencies 45,47 8,0. Net investment income (Exhibit of Net Investment Income, Line 7) 04,66,7 84,78,06 4. Amortization of Interest Maintenance Reserve (IMR, Line 5) 4,0,75,67,96 5. Separate Accounts net gain from operations excluding unrealized gains or losses 6. Commissions and expense allowances on reinsurance ceded (Exhibit, Part, Line 6., Col. ) 6,99,849,6, Reserve adjustments on reinsurance ceded 784,79,6 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,445,49 9. Total (Lines to 8.),,897,079,080,450,4 0. Death benefits 96,65,665 89,756,84. Matured endowments (excluding guaranteed annual pure endowments) 67,985 66,868. Annuity benefits (Exhibit 8, Part, Line 6.4, Cols ) 89,65,6 74,06,6. Disability benefits and benefits under accident and health contracts 7,945 04,66 4. Coupons, guaranteed annual pure endowments and similar benefits 5. Surrender benefits and withdrawals for life contracts 4,907,708 8,705, Group conversions 7. Interest and adjustments on contract or deposit-type contract funds 4,5,74 0,64,70 8. Payments on supplementary contracts with life contingencies 6,485 66, Increase in aggregate reserves for life and accident and health contracts 578,566,8 579,68,45 0. Totals (Lines 0 to 9) 9,9,56 89,74,76. Commissions on premiums, annuity considerations, and deposit-type contract funds (direct business only) (Exhibit, Part, Line, Col. ) 8,00,0 74,09,4. Commissions and expense allowances on reinsurance assumed (Exhibit, Part, Line 6., Col. ) 890,4,64,57. General insurance expenses (Exhibit, Line 0, Cols.,, and 4) 64,7,5 50,607,78 4. Insurance taxes, licenses and fees, excluding federal income taxes (Exhibit, Line 7, Cols. + + ),6,4,89,4 5. Increase in loading on deferred and uncollected premiums (8,4) 44,89 6. Net transfers to or (from) Separate Accounts net of reinsurance 7. Aggregate write-ins for deductions, Totals (Lines 0 to 7),084,08,775,00,489, 9. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 8) 47,788,05 49,96, Dividends to policyholders,506,08,78,949. Net gain from operations after dividends to policyholders and before federal income taxes (Line 9 minus Line 0) 46,8,097 48,,. Federal and foreign income taxes incurred (excluding tax on capital gains) 7,09,6 7,85,07. Net gain from operations after dividends to policyholders and federal income taxes and before realized capital gains or (losses) (Line minus Line ) 9,4,75 0,70, Net realized capital gains (losses) (excluding gains (losses) transferred to the IMR) less capital gains tax of $ (4,809) (excluding taxes of $,00,047 transferred to the IMR) 806,8 (,448,505) 5. Net income (Line plus Line 4) 0,049,06 6,9,555 CAPITAL AND SURPLUS ACCOUNT 6. Capital and surplus, December, prior year (Page, Line 8, Col. ) 459,87,7 46,867, Net income (Line 5) 0,049,06 6,9, Change in net unrealized capital gains (losses) less capital gains tax of $,864 79,059,46, Change in net unrealized foreign exchange capital gain (loss) 40. Change in net deferred income tax (9,7,96) 7,849, 4. Change in nonadmitted assets,04,6 (,860,0) 4. Change in liability for reinsurance in unauthorized and certified companies 5,406, Change in reserve on account of change in valuation basis, (increase) or decrease 44. Change in asset valuation reserve (6,04,058) (,96,05) 45. Change in treasury stock (Page, Lines 6. and 6., Col. minus Col. ) 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,7, 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 (0,000,000) 5. Aggregate write-ins for gains and losses in surplus,898, Net change in capital and surplus for the year (Lines 7 through 5) (,006,9),950, Capital and surplus, December, current year (Lines ) (Page, Line 8) 48,80,80 459,87,7 DETAILS OF WRITE-INS Legal settlement,444, Miscellaneous income Summary of remaining write-ins for Line 8. from overflow page Totals (Lines 08.0 thru 08.0 plus 08.98)(Line 8. above),445, Fines and penalties, Summary of remaining write-ins for Line 7 from overflow page 799. Totals (Lines 70 thru 70 plus 798)(Line 7 above), Prior year reserve adjustment,898, Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598)(Line 5 above),898,58 4

5 CASH FLOW Current Year Prior Year Cash from Operations. Premiums collected net of reinsurance 8,8, ,9,874. Net investment income 0,099,094 75,9,799. Miscellaneous income,99,85,606, Total (Lines through ),6,409,975,067,9,55 5. Benefit and loss related payments 46,86,69 0,6, Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts 7. Commissions, expenses paid and aggregate write-ins for deductions 6,60, 5,968,99 8. Dividends paid to policyholders,590,674,785, 9. Federal and foreign income taxes paid (recovered) net of $ 966,8 tax on capital gains (losses) 6,859,89,96, Total (Lines 5 through 9) 57,95,48 470,9,79. Net cash from operations (Line 4 minus Line 0) 578,494, ,60,7 Cash from Investments. Proceeds from investments sold, matured or repaid:. Bonds 89,774,58 565,07,8. Stocks,0,58. Mortgage loans 64,506,4 46,7,069.4 Real estate.5 Other invested assets.6 Net gains or (losses) on cash, cash equivalents and short-term investments.7 Miscellaneous proceeds 6,96,074.8 Total investment proceeds (Lines. to.7) 9,07,067 6,87,890. Cost of investments acquired (long-term only):. Bonds,54,70,099,09,079,440. Stocks 5,84,00,7,600. Mortgage loans 4,06,000 07,650,000.4 Real estate.5 Other invested assets 6,4,678.6 Miscellaneous applications 0,906,96,9,749.7 Total investments acquired (Lines. to.6),899,96,7,,75, Net increase (decrease) in contract loans and premium notes 467,06 647,94 5. Net cash from investments (Line.8 minus Line.7 minus Line 4) (988,656,6) (708,565,09) Cash from Financing and Miscellaneous Sources 6. Cash provided (applied): 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 79,69,57 6,557, Dividends to stockholders 0,000, Other cash provided (applied) 0,5,0,89,06 7. Net cash from financing and miscellaneous sources (Lines 6. to 6.4 minus Line 6.5 plus Line 6.6) 45,08,847 0,76,47 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) 4,856,79 (80,585,8) 9. Cash, cash equivalents and short-term investments: 9. Beginning of year 7,40,590 97,95,87 9. End of year (Line 8 plus Line 9.) 60,97,8 7,40,590 Note: Supplemental disclosures of cash flow information for non-cash transactions: Capitalized interest on bonds,9,578,97, Affiliate asset exchange 8,56,5 5

6 6 ANALYSIS OF OPERATIONS BY LINES OF BUSINESS Ordinary 6 Group Accident and Health Aggregate of All Total Industrial Life Life Insurance Individual Annuities Supplementary Contracts Credit Life (Group and Individual) Life Insurance (a) Annuities Group Credit (Group and Individual) Other Other Lines of Business. Premiums and annuity considerations for life and accident and health contracts,75,058 (9,606,485),86,548 5,64 4,6. Considerations for supplementary contracts with life contingencies 45,47 45,47. Net investment income 04,66,7 66,45,548 8,7,97 567,0 6,40 48,5 8,99,5 4. Amortization of Interest Maintenance Reserve (IMR) 4,0,75,07,49,545,04 9,99,45 5,904 50, Separate Accounts net gain from operations excluding unrealized gains or losses 6. Commissions and expense allowances on reinsurance ceded 6,99,849 6,70, ,58 7. Reserve adjustments on reinsurance ceded 784,79,6 784,79,6 8. Miscellaneous Income: 8. Fees associated with income from 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.),,897, ,096,66 44,780,86 7,794 5,64 8,79 64,44 9,50,5 0. Death benefits 96,65,665 96,65,665. Matured endowments (excluding guaranteed annual pure endowments) 67,985 67,985. Annuity benefits 89,65,6 88,98,660 8,50. Disability benefits and benefits under accident and health contracts 7,945 6,98 0, Coupons, guaranteed annual pure endowments and similar benefits 5. Surrender benefits and withdrawals for life contracts 4,907,708 6,9,67 06,994,07 6. Group conversions 7. Interest and adjustments on contract or deposit-type contract funds 4,5,74 70,8 49,665 48,56,76,68 8. Payments on supplementary contracts with life contingencies 6,485 6, Increase in aggregate reserves for life and accident and health contracts 578,566,8 40,758,64 76,788,07 (,08) 6,4 6,09 0. Totals (Lines 0 to 9) 9,9,56 56,9, 7,04,79 677,967 88,95 7,856,76,68. Commissions on premiums, annuity considerations and deposit-type contract funds (direct business only) 8,00,0 56,5,785 6,5, 6,44. Commissions and expense allowances on reinsurance assumed 890,4 86,9 55,079 (,57). General insurance expenses 64,7,5 8,788,05 5,794,666 40, Insurance taxes, licenses and fees, excluding federal income taxes,6,4,864,8 7,59 (9),8,9 5. Increase in loading on deferred and uncollected premiums (8,4) (8,4) 6. Net transfers to or (from) Separate Accounts net of reinsurance 7. Aggregate write-ins for deductions,500, Totals (Lines 0 to 7),084,08, ,6,668 45,4,87 677,967 88, ,890,985, Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 8) 47,788,05,869,698 8,56,549 44,87 5,64 (50,5) 5,54 6,56,68 0. Dividends to policyholders,506,08,506,08. Net gain from operations after dividends to policyholders and before federal income taxes (Line 9 minus Line 0) 46,8,097,6,490 8,56,549 44,87 5,64 (50,5) 5,54 6,56,68. Federal income taxes incurred (excluding tax on capital gains) 7,09,6 0,6,078 4,9,0 8,8 5,77 (5,9),899,6,49. Net gain from operations after dividends to policyholders and federal income taxes and before realized capital gains or (losses) (Line minus Line ) 9,4,75,07,4 4,06,9 6,545 9,987 (96,8) (98,545) 4,00,89 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 8. from overflow page Totals (Lines 08.0 thru 08.0 plus 08.98) (Line 8. above) 70. Fines and penalties,500, Summary of remaining write-ins for Line 7 from overflow page 799. Totals (Lines 70 thru 70 plus 798) (Line 7 above),500,500 (a) Includes the following amounts for FEGLI/SGLI: Line, Line 0, Line 6, Line, Line 4

7 ANALYSIS OF INCREASE IN RESERVES DURING THE YEAR Ordinary 6 Group Total Industrial Life Life Insurance Individual Annuities Supplementary Contracts Credit Life (Group and Individual) Life Insurance 8 Annuities Involving Life or Disability Contingencies (Reserves) (Net of Reinsurance Ceded). Reserve December, prior year 5,67,048,00,8,847,044,47,0,94,68,449,88,568. Tabular net premiums or considerations 77,808,95 470,58,096 0,066,99 45,47 5,64. Present value of disability claims incurred,04,98 9,48,59,60,559 XXX 4. Tabular interest 8,7,4 6,40,550 65,5,70 99,56 7, Tabular less actual reserve released 758,94 559,479 7,977 4,405,07 6. Increase in reserve on account of change in valuation basis 7 6. Change in excess of VM-0 deterministic/stochastic reserve over net premium reserve XXX XXX XXX XXX XXX XXX 7. Other increases (net) 8. Totals (Lines to 7) 6,66,875,00,85,856,58,795,587,79,940,85 5,64,474,59 9. Tabular cost 4,904,79 4,889,47 XXX 5,64 0. Reserves released by death 5,6,95 5,6,95 XXX XXX XXX. Reserves released by other terminations (net) 6,47,98 4,89,7,8,864. Annuity, supplementary contract and disability payments involving life contingencies 94,0, 4,59,78 89,6,94 6,487 8,50. Net transfers to or (from) Separate Accounts 4. Total Deductions (Lines 9 to ) 87,76,478 95,5,7 9,465,807 6,487 5,64 8,50 5. Reserve December, current year 6,49,598,55,640,605,,604,,9,679,66,9,06

8 EXHIBIT OF NET INVESTMENT INCOME Collected During Year Earned During Year. U.S. Government bonds (a) 8,,09 8,09,689. Bonds exempt from U.S. tax (a). Other bonds (unaffiliated) (a) 5,666,69 60,095,88. Bonds of affiliates (a). Preferred stocks (unaffiliated) (b),75,75. Preferred stocks of affiliates (b). Common stocks (unaffiliated),5,84,5,84. Common stocks of affiliates. Mortgage loans (c) 0,7,47 0,770,68 4. Real estate (d) 5 Contract loans,494,6,467,746 6 Cash, cash equivalents and short-term investments (e) 0,049,67 7 Derivative instruments (f) 8. Other invested assets,5,96,5,96 9. Aggregate write-ins for investment income 40,0 40,0 0. Total gross investment income 06,845,60,545,566. Investment expenses (g) 6,549,406. Investment taxes, licenses and fees, excluding federal income taxes (g) 99,468. Interest expense (h),4,96 4. Depreciation on real estate and other invested assets (i) 5. Aggregate write-ins for deductions from investment income 6. Total deductions (Lines through 5) 8,88,85 7. Net investment income (Line 0 minus Line 6) 04,66,7 DETAILS OF WRITE-INS 090. Miscellaneous investment income 40,0 40, Summary of remaining write-ins for Line 9 from overflow page Totals (Lines 090 thru 090 plus 0998) (Line 9, above) 40,0 40, Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598) (Line 5, above) (a) Includes $ 7,967,65 accrual of discount less $ 5,05,00 amortization of premium and less $ 5,804,86 paid for accrued interest on purchases. (b) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued dividends on purchases. (c) Includes $ 745 accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (d) Includes $ for company s occupancy of its own buildings; and excludes $ interest on encumbrances. (e) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (f) Includes $ accrual of discount less $ amortization of premium. (g) Includes $ investment expenses and $ investment taxes, licenses and fees, excluding federal income taxes, attributable to segregated and Separate Accounts. (h) Includes $,00,000 interest on surplus notes and $ interest on capital notes. (i) Includes $ depreciation on real estate and $ depreciation on other invested assets. EXHIBIT OF CAPITAL GAINS (LOSSES) 4 5 Total Realized Capital Gain (Loss) (Columns + ) Change in Unrealized Capital Gain (Loss) Realized Gain (Loss) On Sales or Maturity Other Realized Adjustments. U.S. Government bonds 960,85 960,85. Bonds exempt from U.S. tax. Other bonds (unaffiliated),086,7,086,7. Bonds of affiliates. Preferred stocks (unaffiliated). Preferred stocks of affiliates. Common stocks (unaffiliated). Common stocks of affiliates. Mortgage loans 4. Real estate 5. Contract loans 6. Cash, cash equivalents and short-term investments 7. Derivative instruments 540,78 540,78 90, Other invested assets,07 9. Aggregate write-ins for capital gains (losses) 0. Total capital gains (losses),587,94,587,94 4,9 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 9 from overflow page Totals (Lines 090 thru 090 plus 0998) (Line 9, above) Change in Unrealized Foreign Exchange Capital Gain (Loss) 8

9 9 EXHIBIT - PART - PREMIUMS AND ANNUITY CONSIDERATIONS FOR LIFE AND ACCIDENT AND HEALTH CONTRACTS Ordinary 5 Group Accident and Health Aggregate of All Total Industrial Life Life Insurance Individual Annuities Credit Life (Group and Individual) Life Insurance Annuities Group Credit (Group and Individual) Other Other Lines of Business FIRST YEAR (other than single). Uncollected,45,9. Deferred and accrued 9,05 9,05. Deferred, accrued and uncollected:. Direct 9,64 9,64. Reinsurance assumed,9,9. Reinsurance ceded.4 Net (Line + Line ),96 9,64,9 4. Advance 5. Line.4 - Line 4,96 9,64,9 6. Collected during year: 6. Direct 98,87,585 98,87, Reinsurance assumed () () 6. Reinsurance ceded Net 98,86,50 98,86,50 7. Line 5 + Line ,858,806 98,85,874,9 8. Prior year (uncollected + deferred and accrued - advance) 47,88 0,5 7,60 9. First year premiums and considerations: 9. Direct 98,86,74 98,86,74 9. Reinsurance assumed (4,99) () (4,67) 9. Reinsurance ceded Net (Line 7 - Line 8) 98,80,988 98,85,659 (4,67) SINGLE 0. Single premiums and considerations: 0. Direct 574,48,684 5,574,86,908, Reinsurance assumed 898,744 6,9 89, Reinsurance ceded 785,577,7 785,577,7 0.4 Net (0,94,899) (5,996,5),80,5 RENEWAL. Uncollected,8,8,8,8. Deferred and accrued 6,940,76 6,940,76. Deferred, accrued and uncollected:. Direct 4,8,90 4,,740 7,70. Reinsurance assumed 4,0,05 4,0,05. Reinsurance ceded 7,70 7,70.4 Net (Line + Line ) 8,,045 8,, Advance 80,48 79, Line.4 - Line 4 8,4,897 8,4,05 (55) 6. Collected during year: 6. Direct 44,7,06 4,086,0 45,5 5,64 0,70,5 6. Reinsurance assumed 8,656, 7,88,944,67,78 6. Reinsurance ceded 4,8,546,59,5 64,944 0,65, Net 9,050,89 7,955,7,074,966 5,64 4, Line 5 + Line ,9,76 46,098,775,074,966 5,64 4,6 8. Prior year (uncollected + deferred and accrued - advance) 4,54,767 4,54, Renewal premiums and considerations: 9. Direct 44,80,666 4,65,8 45,5 5,64 0,70, Reinsurance assumed,7,74 0,906,64,67,78 9. Reinsurance ceded 4,8,49,508,78 64,944 0,66,7 9.4 Net (Line 7 - Line 8) 4,658,969 4,564,008,074,966 5,64 4,6 TOTAL 0. Total premiums and annuity considerations: 0. Direct 88,4, ,567,9,60,80 5,64 0,70, Reinsurance assumed,057,494 0,9,8,45, 0. Reinsurance ceded 89,896,50 799,086,59 64,944 0,66,7 0.4 Net (Lines ),75,058 (9,606,485),86,548 5,64 4,6

10 0 DIVIDENDS AND COUPONS APPLIED (included in Part ) EXHIBIT - PART - DIVIDENDS AND COUPONS APPLIED, REINSURANCE COMMISSIONS AND EXPENSE ALLOWANCES AND COMMISSIONS INCURRED (Direct Business Only) Ordinary 5 Group Accident and Health Total Industrial Life Life Insurance. To pay renewal premiums 85,07 85,07. All other,8,,8, REINSURANCE COMMISSIONS AND EXPENSE ALLOWANCES INCURRED. First year (other than single):. Reinsurance ceded (7) (7) Individual Annuities Credit Life (Group and Individual) Life Insurance Annuities Group Credit (Group and Individual). Reinsurance assumed (8) (,57). Net ceded less assumed (79) (6) (705),57 4. Single: 4. Reinsurance ceded 5,000,000 5,000, Reinsurance assumed 57,06 57,06 4. Net ceded less assumed 4,64,794 4,64, Renewal: 5. Reinsurance ceded,994,66,70, ,58 5. Reinsurance assumed 5,46 478,77 54,74 5. Net ceded less assumed,46,00,,9 (5,477) 8,58 6. Totals: 6. Reinsurance ceded (Page 6, Line 6) 6,99,849 6,70, ,58 6. Reinsurance assumed (Page 6, Line ) 890,4 86,9 55,079 (,57) 6. Net ceded less assumed 6,0,75 5,874,0 (54,8) 8,65 COMMISSIONS INCURRED (direct business only) 7. First year (other than single) 0,58,858 0,47,90 05,657 4,0 8. Single 58,59,66,58,967 6,000, Renewal,890,80,5,68 45,770,40 0. Deposit-type contract funds. Totals (to agree with Page 6, Line ) 8,00,0 56,5,785 6,5, 6,44 Other Aggregate of All Other Lines of Business

11 EXHIBIT - GENERAL EXPENSES Insurance 5 6 Accident and Health 4 Life Cost Containment All Other All Other Lines of Business Investment Total. Rent 9,705,805 0,496,057,006. Salaries and wages 4,067,84 66,98 4,646,0 8,78,5. Contributions for benefit plans for employees 5,95,7 7,68 447,644 6,400,7. 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 0, , 04,075. Other agent welfare 4. Legal fees and expenses 97,77,74 5, 44,68 4. Medical examination fees,4,907,4, Inspection report fees,504,478 64,504, Fees of public accountants and consulting actuaries 44, , Expense of investigation and settlement of policy claims,4,4 5. Traveling expenses,44,57,4,45, Advertising, ,99 5. Postage, express, telegraph and telephone 697,8,79,400 70,0 5.4 Printing and stationery 46,560,4 47, Cost or depreciation of furniture and equipment, , Rental of equipment 7, , Cost or depreciation of EDP equipment and software,849,07 8,04,857,04 6. Books and periodicals 6, ,07 9,4 6. Bureau and association fees 74, ,049 8, Insurance, except on real estate 9, , Miscellaneous losses 05,74 05, Collection and bank service charges 6,64 6 6, Sundry general expenses 0,06,547,56 47,664 0,97, Group service and administration fees 6.8 Reimbursements by uninsured plans 7. Agency expense allowance 7. Agents balances charged off (less $ 0 recovered) Agency conferences other than local meetings,6,65,055,64, Real estate expenses 9. Investment expenses not included elsewhere 656, , Aggregate write-ins for expenses 6, , General expenses incurred 64,58,79 40,596 6,549,406 (a) 7,7,7. General expenses unpaid December, prior year. General expenses unpaid December, current year. Amounts receivable relating to uninsured plans, prior year 4. Amounts receivable relating to uninsured plans, current year 5. General expenses paid during year (Lines ) 64,58,79 40,596 6,549,406 7,7,7 DETAILS OF WRITE-INS Other agency expense 6, , Summary of remaining write-ins for Line 9. from overflow page Totals (Lines 09.0 thru 09.0 plus 09.98) (Line 9. above) 6, ,700 (a) Includes management fees of $ 8,6,665 to affiliates and $ to non-affiliates. EXHIBIT - TAXES, LICENSES AND FEES (EXCLUDING FEDERAL INCOME TAXES) Insurance 4 5 Life Accident and Health All Other Lines of Business Investment Total. Real estate taxes. State insurance department licenses and fees,84,757,7 09,78,97,6. State taxes on premiums 8,98,9,4 8,9,58 4. Other state taxes, including $ for employee benefits,04, ,04,9 5. U.S. Social Security taxes 94,76,50 89,645,0, All other taxes (04,66),67,9,49 7. Taxes, licenses and fees incurred,98,800,8,9 99,468,45, Taxes, licenses and fees unpaid December, prior year,08,68,74,5,, Taxes, licenses and fees unpaid December, current year,46,5 6,596 0,768 0,94,757,5 0. Taxes, licenses and fees paid during year (Lines ),87,9 (48,600) 0,57 99,697,979,86 EXHIBIT 4 - DIVIDENDS OR REFUNDS Life. Applied to pay renewal premiums 85,070. Applied to shorten the endowment or premium-paying period. Applied to provide paid-up additions,8, 4. Applied to provide paid-up annuities 5. Total Lines through 4,0,8 6. Paid in cash 0,70 7. Left on deposit 67, 8. Aggregate write-ins for dividend or refund options 9. Total Lines 5 through 8,590, Amount due and unpaid. Provision for dividends or refunds payable in the following calendar year,045,864. Terminal dividends. Provision for deferred dividend contracts 4. Amount provisionally held for deferred dividend contracts not included in Line 5. Total Lines 0 through 4,045, Total from prior year,0,0 7. Total dividends or refunds (Lines ),506,08 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 8 from overflow page Totals (Lines 080 thru 080 plus 0898) (Line 8 above) Accident and Health

12 EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS Valuation Standard Total Industrial 4 Ordinary 5 Credit (Group and Individual) 6 Group LIFE INSURANCE: AE.50% NLP,07,850,07, AE CRAIG % IS,065, CSO.00% NLP,098,76,098, CSO.00% CRVM,507,0,507, CSO.50% NLP,796,74,796, CSO.50% CRVM,074,505,074, CSO.00% CRVM 7,9 7, CSO.50% CRVM 5,4 5, CSO.00% NLP 40,906 40, CSO.50% NLP 8,,5 8,, CSO.50% CRVM 5,670,880 5,670, CSO.00% NLP CSO.00% CRVM,90,589,90, CSO.50% NLP,495,6,495, CSO.50% CRVM,76,74,76, CSO 4.00% CRVM,487, CSO 4.50% NLP 7,9,00 7,9, CSO 4.50% CRVM 6,09,5 6,09, CSO 5.00% CRVM 0,79 0, CSO 5.50% CRVM 44,905 44, CSO 6.00% NLP 8,5 8, CET.00% NLP 44,40 44, CSO.50% CRVM 6,59 6, CSO 4.00% NLP 7,94,48 7,94, CSO 4.00% CRVM 08,56,4 08,56, CSO 4.50% NLP 5,96,7 5,96, CSO 4.50% CRVM,04,674,477,04,674, CSO 5.00% NLP,55,07,55, CSO 5.00% CRVM 4,9,685 4,9, CSO 5.50% NLP,954,768,954, CSO 5.50% CRVM,,56,, CSO 6.00% NLP 8,00,797 8,00, CSO 6.00% CRVM,4,90,4, CSO.50% CRVM NB,44,706,94,44,706, CSO 4.00% CRVM 76,84,467 76,84, UNEARNED PREMIUM RESERVE 05,86 05, Totals (Gross),694,84,650,694,84, Reinsurance ceded 5,9,889 5,9, Life Insurance: Totals (Net),54,60,76,54,60,76 ANNUITIES (excluding supplementary contracts with life contingencies): GAM 6% 7,665 XXX XXX 7, IAM 5.5% IMM,76 XXX,76 XXX IAM 5.50% IMM 9,07 XXX 9,07 XXX IAM 6.00% IMM 55,4 XXX 55,4 XXX IAM 6.5% IMM 76,780 XXX 76,780 XXX IAM 6.50% IMM 78,58 XXX 78,58 XXX IAM 6.75% IMM 46,7 XXX 46,7 XXX IAM 7.00% IMM 4,899 XXX 4,899 XXX Table 'a' 5.50% IMM,74 XXX,74 XXX Table 'a' 5.90% IMM,46 XXX,46 XXX Table 'a' 6.5% IMM 67,48 XXX 67,48 XXX Table 'a' 6.50% IMM 57,49 XXX 57,49 XXX Table 'a' 6.75% IMM 88,80 XXX 88,80 XXX Table 'a' 7.00% IMM 6,5 XXX 6,5 XXX Table 'a' 7.60% IMM 9,870 XXX 9,870 XXX Table 'a' 7.75% IMM 8,44 XXX 8,44 XXX Table 'a' 8.5% IMM 9,4 XXX 9,4 XXX Table 'a' 8.75% IMM 5,008 XXX 5,008 XXX GAR 6.60% IMM & DEF,889,909 XXX XXX,889, A Table.50% 0,88 XXX 0,88 XXX A Table.00% 4,0 XXX 4,0 XXX A Table.50% 97,98 XXX 97,98 XXX A Table.00% 6,76 XXX 6,76 XXX A Table.5% 845,595 XXX 845,595 XXX A Table.50% 86,956 XXX 86,956 XXX A Table.90% 5,7 XXX 5,7 XXX A Table.95% 0,099 XXX 0,099 XXX A Table 4.00%,86,4 XXX,86,4 XXX A Table 4.0% 5,5 XXX 5,5 XXX A Table 4.5% 85,786 XXX 85,786 XXX A Table 4.0% 78,570 XXX 78,570 XXX A Table 4.5% 8,456 XXX 8,456 XXX A Table 4.40% 74, XXX 74, XXX A Table 4.50% 455,65 XXX 455,65 XXX A Table 4.55% 69,58 XXX 69,58 XXX A Table 4.60%,94 XXX,94 XXX A Table 4.65%,84 XXX,84 XXX A Table 4.75% 57,90 XXX 57,90 XXX A Table 4.85% 4,995 XXX 4,995 XXX A Table 4.90%,767 XXX,767 XXX A Table 4.9%,7 XXX,7 XXX A Table 5.00%,,960 XXX,,960 XXX A Table 5.08%,70 XXX,70 XXX A Table 5.5% 5,74 XXX 5,74 XXX A Table 5.5% 7,87 XXX 7,87 XXX A Table 5.75% 7,5 XXX 7,5 XXX A Table 6.00%,5,888 XXX,5,888 XXX A Table 6.5%,479,96 XXX,479,96 XXX A Table 6.50% 698,6 XXX 698,6 XXX A Table 6.75% 85,7 XXX 85,7 XXX

13 EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS Valuation Standard Total Industrial 4 Ordinary 5 Credit (Group and Individual) 6 Group A Table 7.00%,04,557 XXX,04,557 XXX IAR G Proj Scale 0.5% NB 68,690 XXX 68,690 XXX IAR G Proj Scale.5% NB 579,6 XXX 579,6 XXX IAR G Proj Scale.00% NB 94,98 XXX 94,98 XXX IAR G Proj Scale.50% NB 55,7 XXX 55,7 XXX IAR G Proj Scale.75% NB 00,94 XXX 00,94 XXX IAR G Proj Scale.00% NB 9,458 XXX 9,458 XXX IAR G Proj Scale.5% NB 5,57 XXX 5,57 XXX IAR G Proj Scale.50% NB 80,570 XXX 80,570 XXX IAR G Proj Scale.75% NB,597,47 XXX,597,47 XXX IAR G Proj Scale 4.00% NB,6,70 XXX,6,70 XXX Dep Adm. Funds at Various Rates NB,599,6,79 XXX,599,40,5 XXX 0, Totals (Gross),6,77, XXX,68,85,5 XXX,9, Reinsurance ceded,69,865 XXX,69,865 XXX Annuities: Totals (Net),68,68,66 XXX,65,49,50 XXX,9,06 SUPPLEMENTARY CONTRACTS WITH LIFE CONTINGENCIES: SA (-).50% SA (-).00%,96, SA (-).50%,896, IAM (-) 7.00%,776, IAM (-) 8.50%/0 7.50% 7,7 7, Table 'a' 5.5% 98,00 98, Table 'a' 5.50% 0,85 0, Table 'a' 6.00%,0, Table 'a' 6.5% 86, 86, Table 'a' 6.50% 0,69 0, Table 'a' 6.75% 478,04 478, Table 'a' 7.00% 96,48 96, Table 'a' 8.00% 0,008 0, Table 'a' 8.5% 0,4 0, Table 'a' 8.75%,44, A Table 4.50% 9,55 9, A Table 4.70%,067, IAR G Proj Scale.75% 7,404 7, IAR G Proj Scale.75% NB 5,0 5, Totals (Gross),679,66,679, Reinsurance ceded SCWLC: Totals (Net),679,66,679,66 ACCIDENTAL DEATH BENEFITS: INTERCO ADB W/4CSO.50% ADB W/58CSO.50% ADB W/58CSO.00% 44,0 44, ADB W/58CSO.50% 7,6 7, Totals (Gross) 4,44 4, Reinsurance ceded Accidental Death Benefits: Totals (Net) 4,44 4,44 DISABILITY-ACTIVE LIVES: INTERCO DISA W/58CSO.50% 08,7 08, DISA W/58CSO.00%,05, DISA W/80CSO 4.50% 69,669 69, INTERCO DISA W/0VBT.50% NB,4,50,4, Totals (Gross),6,98,6, Reinsurance ceded Disability-Active Lives: Totals (Net),6,469,6,469 DISABILITY-DISABLED LIVES: CLASS () W/4CS0.50%,98, INTERCO DISA W/58CSO.50% 6,558 6, INTERCO DISA W/58CSO.50%,484, DISA W/58CSO.00% 56,408 56, DISA W/80CSO 4.50% 48,46,60 48,46, Totals (Gross) 49,05,06 49,05, Reinsurance ceded,86, Disability-Disabled Lives: Totals (Net) 49,0,00 49,0,00 MISCELLANEOUS RESERVES: For excess of valuation net premiums over corresponding gross premiums on respective policies, computed according to the standard of valuation required by this state... 5,,009 5,, For surrender values in excess of reserves otherwise required and carried in this schedule...,85, Totals (Gross) 5,4,86 5,4, Reinsurance ceded 5,9 5, Miscellaneous Reserves: Totals (Net) 4,998,99 4,998, Totals (Net) - Page, Line 6,49,598,55 6,46,406,509,9,06.

14 EXHIBIT 5 - INTERROGATORIES. Has the reporting entity ever issued both participating and non-participating contracts? Yes [ X ] No [ ]. If not, state which kind is issued.. Does the reporting entity at present issue both participating and non-participating contracts? Yes [ ] No [ X ]. If not, state which kind is issued. Participating. Does the reporting entity at present issue or have in force contracts that contain non-guaranteed elements? Yes [ X ] No [ ] If so, attach a statement that contains the determination procedures, answers to the interrogatories and an actuarial opinion as described in the instructions. 4. Has the reporting entity any assessment or stipulated premium contracts in force? Yes [ ] No [ X ] If so, state: 4. Amount of insurance? $ 4. Amount of reserve? $ 4. Basis of reserve: 4.4 Basis of regular assessments: 4.5 Basis of special assessments: 4.6 Assessments collected during the year $ 5. If the contract loan interest rate guaranteed in any one or more of its currently issued contracts is less than 5%, not in advance, state the contract loan rate guarantees on any such contracts. 6. Does the reporting entity hold reserves for any annuity contracts that are less than the reserves that would be held on a standard basis? Yes [ ] No [ X ] 6. If so, state the amount of reserve on such contracts on the basis actually held: $ 6. That would have been held (on an exact or approximate basis) using the actual ages of the annuitants; the interest rate(s) used in 6.; and the same mortality basis used by the reporting entity for the valuation of comparable annuity benefits issued to standard lives. If the reporting entity has no comparable annuity benefits for standard lives to be valued, the mortality basis shall be the table most recently approved by the state of domicile for valuing individual annuity benefits: $ Attach statement of methods employed in their valuation. 7. Does the reporting entity have any Synthetic GIC contracts or agreements in effect as of December of the current year? Yes [ ] No [ X ] 7. If yes, state the total dollar amount of assets covered by these contracts or agreements $ 7. Specify the basis (fair value, amortized cost, etc.) for determining the amount: 7. State the amount of reserves established for this business: $ 7.4 Identify where the reserves are reported in the blank: 8. Does the reporting entity have any Contingent Deferred Annuity contracts or agreements in effect as of December of the current year? Yes [ ] No [ X ] 8. If yes, state the total dollar amount of account value covered by these contracts or agreements: $ 8. State the amount of reserves established for this business: $ 8. Identify where the reserves are reported in the blank: 9. Does the reporting entity have any Guaranteed Lifetime Income Benefit contracts, agreements or riders in effect as of December of the current year? Yes [ ] No [ X ] 9. If yes, state the total dollar amount of any account value associated with these contracts, agreements or riders: $ 9. State the amount of reserves established for this business: $ 9. Identify where the reserves are reported in the blank: EXHIBIT 5A - CHANGES IN BASES OF VALUATION DURING THE YEAR Valuation Basis 4 Description of Valuation Class Changed From Changed To Increase in Actuarial Reserve Due to Change Total (Column 4, only) NONE

15 4 EXHIBIT 6 - AGGREGATE RESERVES FOR ACCIDENT AND HEALTH CONTRACTS 4 Other Individual Contracts Credit Accident Total Group Accident and Health and Health (Group and Individual) Collectively Renewable Non-Cancelable Guaranteed Renewable Non-Renewable for Stated Reasons Only Other Accident Only ACTIVE LIFE RESERVE. Unearned premium reserves,6,755 9,56,,9. Additional contract reserves (a) 495,00,80,080,67 49,950,. Additional actuarial reserves-asset/liability analysis 4. Reserve for future contingent benefits 5. Reserve for rate credits 6. Aggregate write-ins for reserves 7. Totals (Gross) 498,9,5,09,80 497,8,05 8. Reinsurance ceded 497,98,68 76, ,76,0 9. Totals (Net) 5,45 47,50 6,0 CLAIM RESERVE 0. Present value of amounts not yet due on claims 6,5, 68,08 6,470,9. Additional actuarial reserves-asset/liability analysis. Reserve for future contingent benefits. Aggregate write-ins for reserves 4. Totals (Gross) 6,5, 68,08 6,470,9 5. Reinsurance ceded 6,,8 68,08 6,450, Totals (Net) 9,8 9,8 7. TOTAL (Net) 7,8 47,50 5,48 8. TABULAR FUND INTEREST,05 0,4 604 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 6 from overflow page TOTALS (Lines 060 thru 060 plus 0698) (Line 6 above) Summary of remaining write-ins for Line from overflow page 99. TOTALS (Lines 0 thru 0 plus 98) (Line above) (a) Attach statement as to valuation standard used in calculating this reserve, specifying reserve bases, interest rates and methods. 9 All Other

16 State Life Insurance Company Supplemental Statement Regarding Additional Reserves Accident and Health December, 07 Additional reserves are calculated as mid-terminal reserves on the following basis: () (a) Disability Income Policies issued prior to Commissioners Disability with 958 CSO; Net Level Premium Method for group and year Preliminary Term for individual Policies. (b) Disability Income Policies issued 989 and after CIDA with 980 CSO; Year Preliminary Term. (c) NAIC maximum rate of interest by year of issue ranging from.5% to 6.0%. () Major Medical - Year Preliminary Term; mean reserve computed from claim cost factors (combined with 958 CSO at %) based on projected intercompany experience as contained in Nelson and Warren Major Medical Expense Benefit book, Volume II, pages 70 ff. () Accidental Death and Dismemberment ADB with 958 CSO, %. (4) Hospital Indemnity - Year Preliminary Term, based upon 956 Intercompany Hospital Table with 958 CSO, %. (5) (a) Long Term Care Issued Before //000 - Year Preliminary Term, based upon anticipated experience combined with 980 CSO, 4%. (b) Long Term Care Issued After //000 (i) Claim Reserves at 4.50% using 985 Nursing Home Study (ii) Active Life Reserves 98 GAM at 4.50% (c) Long Term Care Issued After //005 (i) Claim Reserves at 4.50% using 985 Nursing Home Study (ii) Active Life Reserves 994 GAM at 4.50% (d) Long Term Care Issued After //006 (i) Claim Reserves at 4.00% using 985 Nursing Home Study (ii) Active Life Reserves 994 GAM at 4.00% 4.

17 EXHIBIT 7 - DEPOSIT TYPE CONTRACTS Total Guaranteed Interest Contracts Annuities Certain 4 Supplemental Contracts 5 Dividend Accumulations or Refunds 6 Premium and Other Deposit Funds. Balance at the beginning of the year before reinsurance 54,64,044 48,49,706 9,684,59 0,965,0 0,54, 9,745. Deposits received during the year 7,077,60 70,79,999 5,75,88,8,60 88,99 4,6. Investment earnings credited to the account,9,08,76,68 4,469 4,00, Other net change in reserves (,8) (,8) 5. Fees and other charges assessed 6. Surrender charges 7. Net surrender or withdrawal payments 56,084,947 4,975,54,9,060 0,86, ,48 7,77 8. Other net transfers to or (from) Separate Accounts 5 9. Balance at the end of current year before reinsurance (Lines ) 904,44, ,967,59,940,649,49,756 0,79,46 6,55 0. Reinsurance balance at the beginning of the year,68,690 46,045 45,460,77,85. Net change in reinsurance assumed (09,08) (,48) (4,45) (46,55). Net change in reinsurance ceded. Reinsurance balance at the end of the year (Lines 0+-),59,48 4,607 04,5,0, Net balance at the end of current year after reinsurance (Lines 9 + ) 906,70,6 857,967,59,965,56,5,97,40, 6,55