PROPERTY AND CASUALTY COMPANIES - ASSOCIATION EDITION ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER, 04 OF THE CONDITION AND AFFAIRS OF THE Veterinary Pet Insurance Company NAIC Group Code 040 040 NAIC Company Code 485 Employer's ID Number 95-750 (Current) (Prior) Organized under the Laws of California, State of Domicile or Port of Entry California Country of Domicile United States of America Incorporated/Organized 09/8/98 Commenced Business 04/07/98 Statutory Home Office 800 E. Imperial Highway, Suite 45, Brea, CA, US 98 (Street and Number) (City or Town, State, Country and Zip Code) Main Administrative Office 800 E. Imperial Highway, Suite 45 (Street and Number) Brea, CA, US 98, 74-989-0555 (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Mail Address One West Nationwide Blvd., -04-70, Columbus, OH, US 45-0 (Street and Number or P.O. Box) (City or Town, State, Country and Zip Code) Primary Location of Books and Records One West Nationwide Blvd., -04-70 (Street and Number) Columbus, OH, US 45-0, 64-49-545 (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Internet Website Address www.petinsurance.com Statutory Statement Contact Cheryl M. Dennis, 64-49-545 (Name) (Area Code) (Telephone Number) FinRpt@nationwide.com, 866-5-40 (E-mail Address) (FAX Number) OFFICERS Pres & Chief Pet Ins Off Scott Day Liles CFO & Treasurer Keith Edward Graham VP & Secretary Robert William Horner III OTHER Pamela Ann Biesecker # Sr VP-Head of Taxation Harry Hansen Hallowell SVP-Chief Investment Officer Jennifer Marie Hanley # Sr VP DIRECTORS OR TRUSTEES Anne Lousie Arvia # Terri Lynn Hill Michael Patrick Leach # Scott Day Liles State of County of Ohio Franklin 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. Scott Day Liles Robert William Horner III Keith Edward Graham Pres & Chief Pet Ins Off VP & Secretary CFO & Treasurer a. Is this an original filing? Yes [ X ] No [ ] Subscribed and sworn to before me this b. If no, day of February, 05. State the amendment number. Date filed. Number of pages attached
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY ASSETS Assets Current Year Nonadmitted Assets Net Admitted Assets (Cols. - ) Prior Year 4 Net Admitted Assets. Bonds (Schedule D). Stocks (Schedule D):. Preferred stocks. Common stocks. Mortgage loans on real estate (Schedule B):. First liens. 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 (, Schedule E - Part ), cash equivalents (, Schedule E - Part ) and short-term investments (, Schedule DA) 6. Contract loans (including premium notes) 7. Derivatives (Schedule DB) 8. Other invested assets (Schedule BA) 9. Receivable for securities 0. Securities lending reinvested collateral assets (Schedule DL). 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) 0. 0. 0. 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. 50. 50. 598. Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598)(Line 5 above)
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY LIABILITIES, SURPLUS AND OTHER FUNDS Current Year Prior Year. Losses (Part A, Line 5, Column 8). Reinsurance payable on paid losses and loss adjustment expenses (Schedule F, Part, Column 6). Loss adjustment expenses (Part A, Line 5, Column 9) 4. Commissions payable, contingent commissions and other similar charges 5. Other expenses (excluding taxes, licenses and fees) 6. Taxes, licenses and fees (excluding federal and foreign income taxes) 7. Current federal and foreign income taxes (including on realized capital gains (losses)) 7. Net deferred tax liability 8. Borrowed money and interest thereon 9. Unearned premiums (Part A, Line 8, Column 5) (after deducting unearned premiums for ceded reinsurance of and including warranty reserves of and accrued accident and health experience rating refunds including for medical loss ratio rebate per the Public Health Service Act) 0. Advance premium. Dividends declared and unpaid:. Stockholders. Policyholders. Ceded reinsurance premiums payable (net of ceding commissions). Funds held by company under reinsurance treaties (Schedule F, Part, Column 9) 4. Amounts withheld or retained by company for account of others 5. Remittances and items not allocated 6. Provision for reinsurance (including certified) (Schedule F, Part 8) 7. Net adjustments in assets and liabilities due to foreign exchange rates 8. Drafts outstanding 9. Payable to parent, subsidiaries and affiliates 0. Derivatives. Payable for securities. Payable for securities lending. Liability for amounts held under uninsured plans 4. Capital notes and interest thereon 5. Aggregate write-ins for liabilities 6. Total liabilities excluding protected cell liabilities (Lines through 5) 7. Protected cell liabilities 8. Total liabilities (Lines 6 and 7) 9. Aggregate write-ins for special surplus funds 0. Common capital stock. Preferred capital stock. Aggregate write-ins for other than special surplus funds. Surplus notes 4. Gross paid in and contributed surplus 5. Unassigned funds (surplus) 6. Less treasury stock, at cost: 6. shares common (value included in Line 0 ) 6. shares preferred (value included in Line ) 7. Surplus as regards policyholders (Lines 9 to 5, less 6) (Page 4, Line 9) 8. TOTALS (Page, Line 8, Col. ) DETAILS OF WRITE-INS 50. 50. 50. 598. Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598)(Line 5 above) 90. 90. 90. 998. Summary of remaining write-ins for Line 9 from overflow page 999. Totals (Lines 90 thru 90 plus 998)(Line 9 above) 0. 0. 0. 98. Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 0 plus 98)(Line above)
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY STATEMENT OF INCOME UNDERWRITING INCOME Current Year Prior Year. Premiums earned (Part, Line 5, Column 4) DEDUCTIONS:. Losses incurred (Part, Line 5, Column 7). Loss adjustment expenses incurred (Part, Line 5, Column ) 4. Other underwriting expenses incurred (Part, Line 5, Column ) 5. Aggregate write-ins for underwriting deductions 6. Total underwriting deductions (Lines through 5) 7. Net income of protected cells 8. Net underwriting gain or (loss) (Line minus Line 6 plus Line 7) INVESTMENT INCOME 9. Net investment income earned (Exhibit of Net Investment Income, Line 7) 0. Net realized capital gains or (losses) less capital gains tax of (Exhibit of Capital Gains (Losses) ). Net investment gain (loss) (Lines 9 + 0) OTHER INCOME. Net gain (loss) from agents or premium balances charged off (amount recovered amount charged off ). Finance and service charges not included in premiums 4. Aggregate write-ins for miscellaneous income 5. Total other income (Lines through 4) 6. Net income before dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Lines 8 + + 5) 7. Dividends to policyholders 8. Net income, after dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Line 6 minus Line 7) 9. Federal and foreign income taxes incurred 0. Net income (Line 8 minus Line 9)(to Line ) CAPITAL AND SURPLUS ACCOUNT. Surplus as regards policyholders, December prior year (Page 4, Line 9, Column ). Net income (from Line 0). Net transfers (to) from Protected Cell accounts 4. Change in net unrealized capital gains or (losses) less capital gains tax of 5. Change in net unrealized foreign exchange capital gain (loss) 6. Change in net deferred income tax 7. Change in nonadmitted assets (Exhibit of Nonadmitted Assets, Line 8, Col. ) 8. Change in provision for reinsurance (Page, Line 6, Column minus Column ) 9. Change in surplus notes 0. Surplus (contributed to) withdrawn from protected cells. Cumulative effect of changes in accounting principles. Capital changes:. Paid in. Transferred from surplus (Stock Dividend). Transferred to surplus. Surplus adjustments:. Paid in. Transferred to capital (Stock Dividend). Transferred from capital 4. Net remittances from or (to) Home Office 5. Dividends to stockholders 6. Change in treasury stock (Page, Lines 6. and 6., Column minus Column ) 7. Aggregate write-ins for gains and losses in surplus 8. Change in surplus as regards policyholders for the year (Lines through 7) 9. Surplus as regards policyholders, December current year (Line plus Line 8) (Page, Line 7) 050. 050. 050. DETAILS OF WRITE-INS 0598. Summary of remaining write-ins for Line 5 from overflow page 0599. Totals (Lines 050 thru 050 plus 0598)(Line 5 above) 40. 40. 40. 498. Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above) 70. 70. 70. 798. Summary of remaining write-ins for Line 7 from overflow page 799. Totals (Lines 70 thru 70 plus 798)(Line 7 above) 4
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY CASH FLOW Current Year Prior Year Cash from Operations. Premiums collected net of reinsurance. Net investment income. Miscellaneous income 4. Total (Lines through ) 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 (decrease) in contract loans and premium notes 5. Net cash from investments (Line.8 minus Line.7 minus Line 4) 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 6.5 Dividends to stockholders 6.6 Other cash provided (applied) 7. Net cash from financing and miscellaneous sources (Lines 6. to 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
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY UNDERWRITING AND INVESTMENT EXHIBIT Line of Business PART - PREMIUMS EARNED Net Premiums Written per Column 6, Part B Unearned Premiums Dec. Prior Year - per Col., Last Year s Part Unearned Premiums Dec. Current Year - per Col. 5 Part A 4 Premiums Earned During Year (Cols. + - ). Fire. Allied lines. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident and health 4. Credit accident and health (group and individual) 5. Other accident and health 6. Workers'compensation 7. Other liability - occurrence 7. Other liability - claims-made 7. Excess workers'compensation 8. Products liability - occurrence 8. Products liability - claims-made 9., 9. Private passenger auto liability 9., 9.4 Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity 4. Surety 6. Burglary and theft 7. Boiler and machinery 8. Credit 9. International 0. Warranty. Reinsurance - nonproportional assumed property. Reinsurance - nonproportional assumed liability. Reinsurance - nonproportional assumed financial lines 4. Aggregate write-ins for other lines of business 5. TOTALS 40. 40. 40. DETAILS OF WRITE-INS 498. Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above) 6
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY UNDERWRITING AND INVESTMENT EXHIBIT Line of Business PART A - RECAPITULATION OF ALL PREMIUMS Amount Unearned (Running One Year or Less from Date of Policy) (a) Amount Unearned (Running More Than One Year from Date of Policy) (a) Earned But Unbilled Premium 4 Reserve for Rate Credits and Retrospective Adjustments Based on Experience 5 Total Reserve for Unearned Premiums Cols. + + + 4. Fire. Allied lines. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident and health 4. Credit accident and health (group and individual) 5. Other accident and health 6. Workers'compensation 7. Other liability - occurrence 7. Other liability - claims-made 7. Excess workers'compensation 8. Products liability - occurrence 8. Products liability - claims-made 9., 9. Private passenger auto liability 9., 9.4 Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity 4. Surety 6. Burglary and theft 7. Boiler and machinery 8. Credit 9. International 0. Warranty. Reinsurance - nonproportional assumed property. Reinsurance - nonproportional assumed liability. Reinsurance - nonproportional assumed financial lines 4. Aggregate write-ins for other lines of business 5. TOTALS 6. Accrued retrospective premiums based on experience 7. Earned but unbilled premiums 8. Balance (Sum of Line 5 through 7) 40. 40. 40. DETAILS OF WRITE-INS 498. Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above) (a) State here basis of computation used in each case 7
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY UNDERWRITING AND INVESTMENT EXHIBIT PART B - PREMIUMS WRITTEN Line of Business Reinsurance Assumed Reinsurance Ceded 6 4 5 Net Premiums Written Direct Business (a) From Affiliates From Non-Affiliates To Affiliates To Non-Affiliates Cols. ++-4-5. Fire. Allied lines. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident and health 4. Credit accident and health (group and individual) 5. Other accident and health 6. Workers'compensation 7. Other liability - occurrence 7. Other liability - claims-made 7. Excess workers'compensation 8. Products liability - occurrence 8. Products liability - claims-made 9., 9. Private passenger auto liability 9., 9.4 Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity 4. Surety 6. Burglary and theft 7. Boiler and machinery 8. Credit 9. International 0. Warranty. Reinsurance - nonproportional assumed property XXX. Reinsurance - nonproportional assumed liability XXX. Reinsurance - nonproportional assumed financial lines XXX 4. Aggregate write-ins for other lines of business 5. TOTALS 40. 40. 40. DETAILS OF WRITE-INS 498. Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above) (a) Does the company's direct premiums written include premiums recorded on an installment basis? If yes:. The amount of such installment premiums. Amount at which such installment premiums would have been reported had they been reported on an annualized basis 8
9 ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY UNDERWRITING AND INVESTMENT EXHIBIT PART - LOSSES PAID AND INCURRED Losses Paid Less Salvage 5 6 7 8 4 Net Losses Unpaid Current Year (Part A, Col. 8) Losses Incurred Current Year (Cols. 4 + 5-6) Percentage of Losses Incurred (Col. 7, Part ) to Premiums Earned (Col. 4, Part ) Reinsurance Reinsurance Net Payments Net Losses Unpaid Line of Business Direct Business Assumed Recovered (Cols. + - ) Prior Year. Fire. Allied lines. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident and health 4. Credit accident and health (group and individual) 5. Other accident and health 6. Workers'compensation 7. Other liability - occurrence 7. Other liability - claims-made 7. Excess workers'compensation 8. Products liability - occurrence 8. Products liability - claims-made 9., 9. Private passenger auto liability 9., 9.4 Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity 4. Surety 6. Burglary and theft 7. Boiler and machinery 8. Credit 9. International 0. Warranty. Reinsurance - nonproportional assumed property XXX. Reinsurance - nonproportional assumed liability XXX. Reinsurance - nonproportional assumed financial lines XXX 4. Aggregate write-ins for other lines of business 5. TOTALS DETAILS OF WRITE-INS 40. 40. 40. 498. Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above)
0 ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY UNDERWRITING AND INVESTMENT EXHIBIT PART A - UNPAID LOSSES AND LOSS ADJUSTMENT EXPENSES Reported Losses Incurred But Not Reported 8 9 4 5 6 7 Deduct Reinsurance Recoverable Net Losses Excl. Incurred But Not Reported (Cols. + - ) Net Unpaid Loss Adjustment Expenses Reinsurance Reinsurance Reinsurance Net Losses Unpaid Line of Business Direct Assumed Direct Assumed Ceded (Cols. 4 + 5 + 6-7). Fire. Allied lines. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident and health (a) 4. Credit accident and health (group and individual) 5. Other accident and health (a) 6. Workers'compensation 7. Other liability - occurrence 7. Other liability - claims-made 7. Excess workers'compensation 8. Products liability - occurrence 8. Products liability - claims-made 9., 9. Private passenger auto liability 9., 9.4 Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity 4. Surety 6. Burglary and theft 7. Boiler and machinery 8. Credit 9. International 0. Warranty. Reinsurance - nonproportional assumed property XXX XXX. Reinsurance - nonproportional assumed liability XXX XXX. Reinsurance - nonproportional assumed financial lines XXX XXX 4. Aggregate write-ins for other lines of business 5. TOTALS DETAILS OF WRITE-INS 40. 40. 40. 498. Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above) (a) Including for present value of life indemnity claims.
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY UNDERWRITING AND INVESTMENT EXHIBIT PART - EXPENSES 4. Claim adjustment services: Loss Adjustment Expenses Other Underwriting Expenses Investment Expenses. Direct. Reinsurance assumed. Reinsurance ceded.4 Net claim adjustment service (. +. -.). Commission and brokerage:. Direct excluding contingent. Reinsurance assumed, excluding contingent. Reinsurance ceded, excluding contingent.4 Contingent - direct.5 Contingent - reinsurance assumed.6 Contingent - reinsurance ceded.7 Policy and membership fees.8 Net commission and brokerage (. +. -. +.4 +.5 -.6 +.7). Allowances to managers and agents 4. Advertising 5. Boards, bureaus and associations 6. Surveys and underwriting reports 7. Audit of assureds records 8. Salary and related items: 8. Salaries 8. Payroll taxes 9. Employee relations and welfare 0. Insurance. Directors fees. Travel and travel items. Rent and rent items 4. Equipment 5. Cost or depreciation of EDP equipment and software 6. Printing and stationery 7. Postage, telephone and telegraph, exchange and express 8. Legal and auditing 9. Totals (Lines to 8) 0. Taxes, licenses and fees: 0. State and local insurance taxes deducting guaranty association credits of 0. Insurance department licenses and fees 0. Gross guaranty association assessments 0.4 All other (excluding federal and foreign income and real estate) 0.5 Total taxes, licenses and fees (0. + 0. + 0. + 0.4). Real estate expenses. Real estate taxes. Reimbursements by uninsured plans 4. Aggregate write-ins for miscellaneous expenses 5. Total expenses incurred (a) 6. Less unpaid expenses - current year 7. Add unpaid expenses - prior year 8. Amounts receivable relating to uninsured plans, prior year 9. Amounts receivable relating to uninsured plans, current year 0. TOTAL EXPENSES PAID (Lines 5-6 + 7-8 + 9) DETAILS OF WRITE-INS 40. 40. 40. 498. Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above) (a) Includes management fees of to affiliates and to non-affiliates. Total
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY EXHIBIT OF NET INVESTMENT INCOME Collected During Year Earned During Year. U.S. Government bonds (a). Bonds exempt from U.S. tax (a). Other bonds (unaffiliated) (a). Bonds of affiliates (a). Preferred stocks (unaffiliated) (b). Preferred stocks of affiliates (b). Common stocks (unaffiliated). Common stocks of affiliates. Mortgage loans (c) 4. Real estate (d) 5 Contract loans 6 Cash, cash equivalents and short-term investments (e) 7 Derivative instruments (f) 8. Other invested assets 9. Aggregate write-ins for investment income 0. Total gross investment income. Investment expenses (g). Investment taxes, licenses and fees, excluding federal income taxes (g). Interest expense (h) 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) 7. Net investment income (Line 0 minus Line 6) DETAILS OF WRITE-INS 090. 090. 090. 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 090 thru 090 plus 0998) (Line 9, above) 50. 50. 50. 598. Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598) (Line 5, above) (a) Includes accrual of discount less amortization of premium and less 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 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 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) Change in Unrealized Foreign Exchange Capital Gain (Loss) Realized Gain (Loss) On Sales or Maturity Other Realized Adjustments. U.S. Government bonds. Bonds exempt from U.S. tax. Other bonds (unaffiliated). 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 8. Other invested assets 9. Aggregate write-ins for capital gains (losses) 0. Total capital gains (losses) DETAILS OF WRITE-INS 090. 090. 090. 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 090 thru 090 plus 0998) (Line 9, above)
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY EXHIBIT OF NON-ADMITTED ASSETS Current Year Total Nonadmitted Assets Prior Year Total Nonadmitted Assets Change in Total Nonadmitted Assets (Col. - Col. ). Bonds (Schedule D). Stocks (Schedule D):. Preferred stocks. Common stocks. Mortgage loans on real estate (Schedule B):. First liens. Other than first liens 4. Real estate (Schedule A): 4. Properties occupied by the company 4. Properties held for the production of income 4. Properties held for sale 5. Cash (Schedule E - Part ), cash equivalents (Schedule E - Part ) and short-term investments (Schedule DA) 6. Contract loans 7. Derivatives (Schedule DB) 8. Other invested assets (Schedule BA) 9. Receivables for securities 0. Securities lending reinvested collateral assets (Schedule DL). Aggregate write-ins for invested assets. Subtotals, cash and invested assets (Lines to ). Title plants (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 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) 0. 0. 0. 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. 50. 50. 598. Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598)(Line 5 above)
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY " # % &' ( # ##) *+,- *+,. / &/, -0 *+0,. 50--*0.-4 5607*,0844 * 9 : :. 9 : : -,:*:.;- 50--*0.-4 5607*,0844 <=< 4.0.70,* 5,+.0-60846 5+080+8 8 9 : : 7 9 : : 6 4:8:7;6 5,+.0-60846 5+080+8 ></ "? " @ < @ # /@ # " # 0 " 0 @ A A@: A A # 0# = A # :# 0# ) : # # " A0# @ >0@ :? 0 A@# B.C B8C# # A A <? =? & :? 0 :? A # A # -.:= & ' :? # # D :? 0 ' #) : 0&0& 00 # 7 ' 4
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0+ +# @ #,6+ >.,0*+,- (++ @9.,#) ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY,*9.,9*+,-,G@ 5,+0+-80*6 5 *.0.6 5,+0+7+0**7, # ' 5 : 5 : 5:,'@ 5,+0+-80*6 5 *.0.6 5,+0+7+0**7,@ 58++0,. 540*-, 58+40-.-, @ 5 0--80+8 5,6087 50-8-07.,@ 5 *- 5,-06, 5,-0,4, @9@ 5 0--80+7* 5.06+8 50--0676,*9.,9*+,.,G@ 5,*04*70*7* 5.,0.66 5,*0446088+, # ' 5 : 5 : 5:,'@ 5,*04*70*7* 5.,0.66 5,*0446088+,@ 5.0840-.. 5 *-0+*6 5.07,0-8,, @ 5606.,06. 570.8+ 5606.0,,@ 5 48.06.4 5*07 548806.*, @9@ 560*860++- 5-0.8. 560*7*0.87,G@ 5*0-6+06. 570-4+ 5*0-660-.., # ' 5 : 5 : 5:,'@ 5*0-6+06. 570-4+ 5*0-660-..,@ 5.0+40*-+ 5,60767 5.0,,-0+*7, @ 5 8,-0*47 5,,0..7 58*404-,@ 5 48.06,, 5,,06-544,0,7, @9@ 5,0,760+86 5 447 5,0,7704,, ) 45,*9.,9*+,- *D @? 5 : 5 : 5: *'@@ A@ @* *,**# 5 0--80+7* 5.06+8 50--0676,'@@ A# 5 08+80+-6 5.06+8 508+064- *'@ # JJJ JJJ 5 04*0.. *'@@ @**@ *@,+, *K*K*,*9.,9*+,. *D @? 5 : 5 : 5: *'@@ A@ @* *,**# 560*860++- 5-0.8. 560*7*0.87,'@@ A# 5607*0*-+ 5-0.8. 5607..08+. *'@ # JJJ JJJ 5 60*7*0.87 *'@@ @**@ *@,+, *K*K* 5 *- 5,-06, 5,-0,4 5 0--80+8 5,6087 50-8-07. 5 48.06.4 5 *07 548806.* 5606.,06. 5 70.8+ 5606.0, 4.
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY *D @? 5 : 5 : 5: *'@@ A@ @* *,**# 5,0,760+86 5 447 5,0,7704,,,'@@ A# 567806+6 5447 56780*4, *'@ # JJJ JJJ 5,0.*+0+*8 *'@@ @**@ *@,+, *K*K* 5 48.06,, 5,,06-544,0,7 5 8,-0*47 5,,0..7 58*404-,*9.,9*+,-,*9.,9*+,..= *647-4H *87*-.H @ +++H +++H +++H. 'G, 5 8,-0*47 5,,0..7 58*404- - '@ @ +++H :++,H :++,H.' ** 540*.0*6 56*07*.07+* ),*9.,9*+,- - '@ @0@,'G,L 5,+0+-80*6 5 *.0.6 5,+0+7+0**7 *'@ @ +++H +++H +++H. 'G, 5 0--80+8 5,6087 50-8-07. - '@ @ +++H ++-H ++-H,*9.,9*+,. - '@ @0@,'G,L 5,*04*70*7* 5.,0.66 5,*0446088+ *'@ @ +++H +++H +++H. 'G, 5606.,06. 570.8+ 5606.0, - '@ @ +++H ++4H ++4H - '@ @0@,'G,L *'@ 5*0-6+06. 570-4+ 5*0-660-.. - %@: M NOP OJP > # @ A @ # '),*9.,9*+,-,*9.,9*+,. 4 D 5-0886066, 540,407+ 54*80+ D 5 : 5 : 5: 5-0886066, 540,407+ 54*80+ D @ 5,-07-. 5: 5,-07-. < A :# 5 : 5 : 5: 5 : 5 : 5: D @ 5-084-0,.6 540,407+ 54-,084* 4.
4(,*9.,9*+,-,*9.,9*+,. ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY ), 5,.70.4 5-.60,44 5.++078+ *< 50,-40,*+ 560.+.0888 56-,0-4-. 5 : 5 : 5: - 5 : 5 : 5: 4" 5 : 5 : 5: 8 5 : 5 : 5: 7D @ 5 : 5*0-6,0.8* 5*0-6,0.8* 6 5 : 5,+40-+ 5,+40-+ 5 7*04+4 5: 57*04+4,+= : 5 : 5 : 5:,, :# 5 : 5 : 5:,*@ :# 5 : 5 : 5:,. Q4H @ 5 8,0*8 5.480+74 5..40,-,- 5: 56-*08+4 56-*08+4 5,+0+-80*6 5,*04*70*7* 5*0-6+06. # ' 5 : 5 : 5: 5 8++0,. 5.0840-.. 5.0+40*-+ @*:*:* 50--80+8 5606.,06. 58,-0*47 ), 5 *.0.6 5.,0.66 570-4+ * :# 5 : 5 : 5:.= 5 : 5 : 5: - Q4H @ 5 : 5 : 5: 5 *.0.6 5.,0.66 570-4+ # ' 5 : 5 : 5: 5 40*-, 5*-0+*6 5,60767 @*:*:* 5,6087 5 70.8+ 5,,0..7 @*K* 50-8-07. 5606.0, 58*404- "4( ),*9.,9*+,-,*9.,9*+,., 5 *- 5 : 5*- *D @ 5 : 5 : 5:. 5 : 5 : 5: - 5 : 5 : 5: 4 Q4H @ 5 : 5 : 5: 8 @ 5: 548.06.4 548.06.4 5*- 548.06.4 548.06,, ), 5,-06, 5 *07 5,,06- *= 5 : 5 : 5:. Q4H @ 5 : 5 : 5: 5,-06, 5 *07 5,,06- @.K. 5,-0,4 548806.* 544,0,7 '46787"8 50--0676 5 60*7*0.87 5,0,7704,, *4 @ # @ @ ),*9.,9*+,-,*9.,9*+,. '@ 5,+0+7+0**7 5,*0446088+ 5*0-660-.. @,-0,4 48806.* 44,0,7 @ 5,+0+440.,* 5,,0,06*6 5,0.804,8 @ A @,,06. 5,0*-08*. 4.4
@ # # D @:@?@' #) ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY 6"65' 6"65" @ 5-084-0,.6 540,407+ @ 5,0*-08*. 5*808.* @ 5 80476078, 5-0*80,46 @ 5,-0+80-6* 5,.0,70--4 D@.4H.4H /@ @@.4H 5-0..078 5-067,0,+8,@:@ 5.,8074 5..70,.- * @ 5.70*86 5-,0*-6.@ 5,0*-048, 5.4+0.6 - @ 5 76 5: 580476078, 5-0*80,46 / @ # @ ) # 5: &@ 5: > 5: *D @ ) *+,- 5: *+,. 5:. @ 88+.= D D@=,( @ # # ) G&= 0 # G G0 R # 0 @0 & & <# 0? &0 D R G0 R R # S # # D # # & # # = 0 # = 0 A # = 0 # = 0@ # = 0 # 0 D 0 I &R 0 I &0 R # N? N # 0 R? R R I 0 G0 # & # # # # >? # & # # D G0 # D 0 # D 0 # G # GR 0 # G0 0 = 0 = # G0 RR # 0 # &@ 0 0 0 D I R 4.5
* ' > : # D @ # @ ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY GDD D@ @ # # # # 5 // 9 0>0= # # )&0 &0 0 & #:# # &0 0 0 # # 0# #,++H # & # # #,++H,++H &/ S,0*+,,0,++H : & 0 6+H : & & 00 & & & 00 & & @ 546. 54*.,0*+,-*+,.0 0 # @ @ 0 # @0 @ 58-- 5466.,0*+,- *+,.0 # 70 &" &&0" *++.0 " @ 5,6.,0*+,-*+,. : G @ 0 0 @ # # > *+,*0 # #.,0*+,- *+,.0 5.* 5.4 0 0 S,0*+,-0#%.,0*+,.0 @ 5,8 0# # @> 0S,0*+,-0 #? A.,0*+,-05,* # *++40%0 00# 0# " # 70 G " 5,8 54. ".,0*+,-*+,.0 # (## 0&0.,) *+,- *+,. & & 5 740.6-07+, 5*0+,+06-5 860+*0-., 5*0*404*7 5 770*,.0+.- 5.88088 580*,078-544.0++4 /" 5,06*60... 5,08--0,48 5,06*60... 540.+70+*+ 5 : 5-0-+-0.78 5 : 5 *0-470-66 #:# #:# # && ( 0' 0& D= # # # 56 567.,0*+,-*+,.0 5*7.,0*+,-.,0*+,.0 " # -4 /G<? = 4.6
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY D 0 0 " 0 # 0 # ' " " # & 0 0 0 0 # 0 0 0 A ## A : GE = ( 9 / ( )/ ) # ) # > > D == / % " -+,?? 4+H ( 0 @.H ( ( *+,- *+,.# @ 58-7 57+- D& G 9R R>? 0? & & A > "))/ :(+9;9<,+0+++0+++ 5+,6? A 80.40.67.,0*+,-*+,.? A0 > =? = @ #,+H :,++H / D= < D # %0 # G& 4.7
R?R ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY D S < D A 58 @5,-58 F &T = A ' >GD G /@ >D /I DS G 5*+ 56,4.,0*+,-*+,.0 > @ 0,H % # ( 0 @ * # ::,0*+,,0# : #? : :,0*+,,0# :# 4H? " @ *+,- @*+,-*+,.#@ 5,8 5,4 0.,) = *+,4 5.0.660-4. *+,8,068+0-.+ *+,7,0+80+46 *+,6,0764048+ *+, : : 5 60-+04+, :? > 4.8
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY, > # 9? > 9? 0/+ % 9) @ @ ( > 6% 6 5. :D & &=D,0*0. D # #? D? # ( #?? A "@ A A 0?0 A : " "?,#. # 0 # A #),<'"? # *<'"? "? " 0 9?0 0< 0 < > =0 0 #0 0 0 9. "" (? #? "?" # " # = #?#?" 0 A D?0 ( 0 @ @ # # " # " @ <?? :?" A #" 0 @?" 0 @0 9?? " >?" ' " (&?#? ( D "? #0 0 0?0" " @ # 0 # A :?" #.,0*+,- 4.9
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY # A 0 0 0 @ 0.,0*+,-). 55. 7+8 7+8 7+"8 7.8 > 5,7.0**404-7 5,870+60, 5..0+4+06*8 5,-+0,7-07*, 5 : 5:? : : : : : & : : : : : : 70-7804.7 70-7804.7 70-7804.7 : : : : : : : : : : : : : : : : : 5,6+07+*0+6-5,740.6404*6 5 -+04*70.8. 5,-+0,7-07*, 5 : 5: 5 : 5 : 5 : 5 : 5: 5 : 5 : 5 : 5 : 5: /@ >= > = /@ D &==?/@ G # 8-0 RS +A E= A"/) " D*.0*+,4 D*-0*+,4 E A"/) " D*.0*+,4 D*-0*+,4 "9 <= = >= = =, & # 0 #:# # &0 #& &*64H : & / S,0*+,,0,++H &.,4H &# S,0*+,, " 0 " 6+H*+H<..4H &# S,0*++..,0*+,+ 4.0
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY +++% < < < /" /" /" 5,+40+6* 5.-0+86 5+ 5+ 5,+40+6* 5.-0+86 + + + + 5+ 5+ 5,+40+6* 5.-0+86 5+ 5+ 5,+40+6* 5.-0+86 < = 5*-06-* * @. < = / = D= = G= R=: = = #'= '9)+9BC9 * C ) '@ # ) 7555D8 5'= 5' B( ) = 798 798 # 798 R# 9D# 5 : 5 : 5 : 5 : 5 : 5 : 5: & 5 : 5 : 5 : 5 : 5 : 5 : 5: I?% 5 : 5 : 5 : 5 : 5 : 5 : 5: 5 : 5 : 5 : 5 : 5 : 5 : 5: 5 : 5 : 5 : 5 : 5 : 5 : 5: 5 : 5 : 5 : 5 : 5 : 5 : 5: & 5,4,0888 5 0.7, 5,8,0+.7 5,8,0,- E*/,,, E/"0 E,/5"0 E,/' 5,,* 56+* E78,) 0 F 9+ ) "5 (9+ (.,0*+,- #), 5+++ * S60*+,4.I A M N "F ( E5 5,- E7'8 4.
"(@)@) C ) "" 6+ 9+ "'+ "*)) ",% ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY 4.
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY GENERAL INTERROGATORIES PART - COMMON INTERROGATORIES GENERAL. 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, A and. If yes, did the reporting entity register and file with its domiciliary State Insurance Commissioner, Director or Superintendent, or with such regulatory official of the state of domicile of the principal insurer in the Holding Company System, a registration statement providing disclosure substantially similar to the standards adopted by the National Association of Insurance Commissioners (NAIC) in its Model Insurance Holding Company System Regulatory Act and model regulations pertaining thereto, or is the reporting entity subject to standards and disclosure requirements substantially similar to those required by such Act and regulations?. State Regulating?. 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:. State as of what date the latest financial examination of the reporting entity was made or is being made.. 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.. 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)..4 By what department or departments? CA.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments?.6 Have all of the recommendations within the latest financial examination report been complied with? 4. During the period covered by this statement, did any agent, broker, sales representative, non-affiliated sales/service organization or any combination thereof under common control (other than salaried employees of the reporting entity), receive credit or commissions for or control a substantial part (more than 0 percent of any major line of business measured on direct premiums) of: 4. sales of new business? 4. renewals? 4. During the period covered by this statement, did any sales/service organization owned in whole or in part by the reporting entity or an affiliate, receive credit or commissions for or control a substantial part (more than 0 percent of any major line of business measured on direct premiums) of: 4. sales of new business? 4. renewals? 5. Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? 5. 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 6. Has the 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? 6. If yes, give full information: 7. Does any foreign (non-united States) person or entity directly or indirectly control 0% or more of the reporting entity? 7. If yes, 7. State the percentage of foreign control; 7. State the nationality(s) of the foreign person(s) or entity(s) or if the entity is a mutual or reciprocal, the nationality of its manager or attorney-in-fact; and identify the type of entity(s) (e.g., individual, corporation or government, manager or attorney in fact). Nationality Type of Entity 5
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY GENERAL INTERROGATORIES 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 " "# ## #%#&& && ' "%# ()*++% "'&& ()*++% %)&& 9. What is the name and address of the independent certified public accountant or accounting firm retained to conduct the annual audit? KPMG, LLP 55 South Grand Avenue, Los Angeles, CA 9007-568 0. Has the insurer been granted any exemptions to the prohibited non-audit services provided by the certified independent public accountant requirements as allowed in Section 7H of the Annual Financial Reporting Model Regulation (Model Audit Rule), or substantially similar state law or regulation? 0. If the response to 0. is yes, provide information related to this exemption: 0. Has the insurer been granted any exemptions related to the other requirements of the Annual Financial Reporting Model Regulation as allowed for in Section 7A of the Model Regulation, or substantially similar state law or regulation? 0.4 If the response to 0. is yes, provide information related to this exemption: 0.5 Has the reporting entity established an Audit Committee in compliance with the domiciliary state insurance laws?,% 0.6 If the response to 0.5 is no or n/a, please explain. What is the name, address and affiliation (officer/employee of the reporting entity or actuary/consultant associated with an actuarial consulting firm) of the individual providing the statement of actuarial opinion/certification? Kevin G. Donovan, Associate Vice President-Scottsdale Group Reserving for Scottsdale Insurance Company, the parent company of Veterinary Pet Insurance Company 8877 N. Gainey Center Drive, Scottsdale, AZ 8558. Does the reporting entity own any securities of a real estate holding company or otherwise hold real estate indirectly?. Name of real estate holding company. Number of parcels involved. Total book/adjusted carrying value. If, yes provide explanation:. FOR UNITED STATES BRANCHES OF ALIEN REPORTING ENTITIES ONLY:. What changes have been made during the year in the United States manager or the United States trustees of the reporting entity?. Does this statement contain all business transacted for the reporting entity through its United States Branch on risks wherever located?. Have there been any changes made to any of the trust indentures during the year?.4 If answer to (.) is yes, has the domiciliary or entry state approved the changes?,% 4. 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. 4. If the response to 4. is No, please explain: 4. Has the code of ethics for senior managers been amended? 4. If the response to 4. is yes, provide information related to amendment(s). 4. Have any provisions of the code of ethics been waived for any of the specified officers? 4. If the response to 4. is yes, provide the nature of any waiver(s). 5.
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY GENERAL INTERROGATORIES 5. Is the reporting entity the beneficiary of a Letter of Credit that is unrelated to reinsurance where the issuing or confirming bank is not on the SVO Bank List? 5. If the response to 5. is yes, indicate the American Bankers Association (ABA) Routing Number and the name of the issuing or confirming bank of the Letter of Credit and describe the circumstances in which the Letter of Credit is triggered. American Bankers Association (ABA) Routing Number Issuing or Confirming Bank Name Circumstances That Can Trigger the Letter of Credit 4 Amount BOARD OF DIRECTORS 6. Is the purchase or sale of all investments of the reporting entity passed upon either by the board of directors or a subordinate committee thereof? 7. Does the reporting entity keep a complete permanent record of the proceedings of its board of directors and all subordinate committees thereof? 8. Has the reporting entity an established procedure for disclosure to its board of directors or trustees of any material interest or affiliation on the part of any of its officers, directors, trustees or responsible employees that is in conflict with the official duties of such person? FINANCIAL 9. Has this statement been prepared using a basis of accounting other than Statutory Accounting Principles (e.g., Generally Accepted Accounting Principles)? 0. Total amount loaned during the year (inclusive of Separate Accounts, exclusive of policy loans): 0. To directors or other officers 0. To stockholders not officers 0. Trustees, supreme or grand (Fraternal Only) 0. Total amount of loans outstanding at the end of year (inclusive of Separate Accounts, exclusive of policy loans): 0. To directors or other officers 0. To stockholders not officers 0. Trustees, supreme or grand (Fraternal Only). Were any assets reported in this statement subject to a contractual obligation to transfer to another party without the liability for such obligation being reported in the statement?. If yes, state the amount thereof at December of the current year:. Rented from others. Borrowed from others. Leased from others.4 Other. Does this statement include payments for assessments as described in the Annual Statement Instructions other than guaranty fund or guaranty association assessments?. If answer is yes:. Amount paid as losses or risk adjustment. Amount paid as expenses. Other amounts paid. Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page of this statement?. If yes, indicate any amounts receivable from parent included in the Page amount: INVESTMENT 4.0 Were all the stocks, bonds and other securities owned December of current year, over which the reporting entity has exclusive control, in the actual possession of the reporting entity on said date? (other than securities lending programs addressed in 4.0) 4.0 If no, give full and complete information relating thereto 4.0 For security lending programs, provide a description of the program including value for collateral and amount of loaned securities, and whether collateral is carried on or off-balance sheet. (an alternative is to reference Note 7 where this information is also provided) N/A 4.04 Does the Company's security lending program meet the requirements for a conforming program as outlined in the Risk-Based Capital Instructions? 4.05 If answer to 4.04 is yes, report amount of collateral for conforming programs. 4.06 If answer to 4.04 is no, report amount of collateral for other programs. 4.07 Does your securities lending program require 0% (domestic securities) and 05% (foreign securities) from the counterparty at the outset of the contract? 4.08 Does the reporting entity non-admit when the collateral received from the counterparty falls below 00%? 4.09 Does the reporting entity or the reporting entity s securities lending agent utilize the Master Securities lending Agreement (MSLA) to conduct securities lending? 5.
ANNUAL STATEMENT FOR THE YEAR 04 OF THE VETERINARY PET INSURANCE COMPANY GENERAL INTERROGATORIES 4.0 For the reporting entity s security lending program state the amount of the following as December of the current year: 4.0 Total fair value of reinvested collateral assets reported on Schedule DL, Parts and. 4.0 Total book adjusted/carrying value of reinvested collateral assets reported on Schedule DL, Parts and 4.0 Total payable for securities lending reported on the liability page. 5. Were any of the stocks, bonds or other assets of the reporting entity owned at December of the current year not exclusively under the control of the reporting entity, or has the reporting entity sold or transferred any assets subject to a put option contract that is currently in force? (Exclude securities subject to Interrogatory. and 4.0). 5. If yes, state the amount thereof at December of the current year: 5. Subject to repurchase agreements 5. Subject to reverse repurchase agreements 5. Subject to dollar repurchase agreements 5.4 Subject to reverse dollar repurchase agreements 5.5 Placed under option agreements 5.6 Letter stock or securities restricted as to sale - excluding FHLB Capital Stock 5.7 FHLB Capital Stock 5.8 On deposit with states 5.9 On deposit with other regulatory bodies 5.0 Pledged as collateral - excluding collateral pledged to an FHLB 5. Pledged as collateral to FHLB - including assets backing funding agreements 5. Other 5. For category (5.6) provide the following: Nature of Restriction Description Amount 6. Does the reporting entity have any hedging transactions reported on Schedule DB? 6. 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. 7. Were any preferred stocks or bonds owned as of December of the current year mandatorily convertible into equity, or, at the option of the issuer, convertible into equity? 7. If yes, state the amount thereof at December of the current year. 8. 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? 8.0 For agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following: Name of Custodian(s) Custodian's Address 8.0 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) 8.0 Have there been any changes, including name changes, in the custodian(s) identified in 8.0 during the current year? 8.04 If yes, give full and complete information relating thereto: Old Custodian New Custodian Date of Change 4 Reason 8.05 Identify all investment advisors, brokers/dealers or individuals acting on behalf of brokers/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 Number(s) Name Address "#%#&%"' (#)#*%#%#(+,-# ##%%.(-"-/0 5.