Official NAIC Annual Statement Instructions Not for ...

Official NAIC

Annual Statement Instructions

Life, Accident & Healtihb/Furattieornnal For the 2020 reporting year tr Adopted by the NAIC as of June 2020 for Dis UPDATES TO THESE INSTRUCTIONS

t There may be modifications to these instructions from year to year. As such, guidance is subject to the

maintenance process. Revision bars in the left margin identify changes from the previous year, and

o modifications that may occur during the current year are made available on the NAIC website at N .

CONTENT QUESTIONS

Questions regarding the content of these instructions should be directed to Calvin Ferguson, Senior Insurance Reporting Analyst, at cferguson@.

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Order inquiries may be addressed by an NAIC customer service representative at prodserv@.

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ISBN: 978-1-64179-080-2

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TABLE OF CONTENTS

Page #

Annual Statement General

Foreword...................................................................................................................................................................................... 1 General......................................................................................................................................................................................... 3 Actuarial Opinion ........................................................................................................................................................................ 9 Annual Audited Financial Reports............................................................................................................................................. 11 Management's Discussion and Analysis.................................................................................................................................... 15

Financial Statement

n Jurat Page................................................................................................................................................................................... 21 tio Assets......................................................................................................................................................................................... 26

Liabilities, Surplus and Other Funds ......................................................................................................................................... 35 Summary of Operations ............................................................................................................................................................. 44

u Cash Flow .................................................................................................................................................................................. 53

Analysis of Operations by Lines of Business

ib Summary........................................................................................................................................................... 67 tr Individual Life .................................................................................................................................................. 69

Group Life ........................................................................................................................................................ 72 Individual Annuities ......................................................................................................................................... 75

is Group Annuities................................................................................................................................................ 77

Accident and Health ......................................................................................................................................... 80

D Analysis of Increase in Reserves During the Year Individual Life .................................................................................................................................................. 84 r Group Life ........................................................................................................................................................ 89 Individual Annuities ......................................................................................................................................... 93 fo Group Annuities................................................................................................................................................ 97 Exhibit of Net Investment Income ........................................................................................................................................... 101

t Exhibit of Capital Gains (Losses) ............................................................................................................................................ 105

Exhibit 1

o Part 1 ? Premiums and Annuity Considerations for Life and Accident and Health Contracts ................... 108 NPart 2 ? Dividends and Coupons Applied, Reinsurance Commissions and Expense Allowances

and Commissions Incurred ........................................................................................................... 111 Exhibit 2 ? General Expenses ........................................................................................................................................... 112 Exhibit 3 ? Taxes, Licenses and Fees................................................................................................................................ 122 Exhibit 4 ? Dividends or Refunds ..................................................................................................................................... 124 Exhibit 5

Aggregate Reserve for Life Contracts ............................................................................................................ 125 Interrogatories................................................................................................................................................. 128 Exhibit 5A ? Changes in Bases of Valuation During the Year ........................................................................................... 132 Exhibit 6 ? Aggregate Reserve for Accident and Health Contracts .................................................................................. 133

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Exhibit 7 ? Deposit-Type Contracts .................................................................................................................................. 136 Exhibit 8 ? Claims for Life and Accident and Health Contracts

Part 1 ? Liability End of Current Year ....................................................................................................... 138 Part 2 ? Incurred During the Year .............................................................................................................. 140 Exhibit of Nonadmitted Assets ................................................................................................................................................ 141 Notes to Financial Statements.................................................................................................................................................. 143 General Interrogatories ............................................................................................................................................................ 311 Five-Year Historical Data ........................................................................................................................................................ 321 State Page ................................................................................................................................................................................ 337 Exhibit of Life Insurance ......................................................................................................................................................... 339 Exhibit of Number of Policies, Contracts, Certificates, Income Payable and Account Values In Force for Supplementary Contracts, Annuities, Accident and Health and Other Policies ............................................................... 343

n Interest Maintenance Reserve .................................................................................................................................................. 345

Asset Valuation Reserve

tio General Instructions........................................................................................................................................ 361

Default Component ? Basic Contribution, Reserve Objective and Maximum Reserve Calculations......... 367 Basic Contribution, Reserve Objective and Maximum Reserve Calculations for Unrated Multi-Class

u Securities Acquired by Conversion ........................................................................................................ 370

Equity and Other Invested Asset Component ? Basic Contribution, Reserve Objective and

ib Maximum Reserve Calculations................................... 371 tr Replication (Synthetic) Assets ? Basic Contribution, Reserve Objective and Maximum Reserve

Calculations .......................................................................................... 378 Schedule F ? Death Claims Resisted or Compromised ........................................................................................................ 383

is Schedule H Accident and Health Exhibit........................................................................................................................... 385 Part 1 ? Analysis of Underwriting Operations ........................................................................................... 386 D Part 2 ? Reserves and Liabilities ............................................................................................................... 388 Part 3 ? Test of Prior Year's Claim Reserves and Liabilities ..................................................................... 390 r Part 4 ? Reinsurance................................................................................................................................... 390 fo Part 5 ? Health Claims ............................................................................................................................... 391 Schedule S

General Instructions........................................................................................................................................ 395

t Part 1 oSection 1 Reinsurance Assumed for Life Ins, Annuities, Deposit Funds and Other

Liabilities Without Life or Disability Contingencies, and Related Benefits

N Listed by Reinsured Company as of December 31, Current Year ......................... 400 Section 2 Reinsurance Assumed Accident and Health Insurance Listed by Reinsured Company as of December 31, Current Year .......................................................... 404 Part 2 ? Reinsurance Recoverable on Paid and Unpaid Losses Listed by Reinsuring Company as

of December 31, Current Year ...................................................................................................... 407 Part 3

Section 1 ? Reinsurance Ceded Life Insurance, Annuities, Deposit Funds and Other Liabilities Without Life or Disability Contingencies, and Related Benefits Listed by Reinsuring Company as of December 31, Current Year........................ 409

Section 2 ? Reinsurance Ceded Accident and Health Insurance Listed by Reinsuring Company as of December 31, Current Year .......................................................... 415

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Part 4 ? Reinsurance Ceded to Unauthorized Companies .......................................................................... 421 Part 5 ? Reinsurance Ceded to Certified Reinsurers .................................................................................. 426 Part 6 ? Five-Year Exhibit of Reinsurance Ceded Business ...................................................................... 432 Part 7 ? Restatement of Balance Sheet to Identify Net Credit for Ceded Reinsurance .............................. 435 Schedule T Premium and Annuity Considerations ............................................................................................................ 437 Part 2 ? Interstate Compact ........................................................................................................................ 443 Schedule Y ? Information Concerning Activities of Insurer Members of a Holding Company Group Part 1 ? Organizational Chart ..................................................................................................................... 445 Part 1A ? Detail of Insurance Holding Company System ......................................................................... 446 Part 2 ? Summary of Insurer's Transactions with Any Affiliates ............................................................... 450

n Investment Schedules tio Investment Schedules General Instructions ............................................................................................................................. 453

Summary Investment Schedules and Verifications (SI Pages)

u Summary Investment Schedule ...................................................................................................................... 461

Schedule A ? Verification Between Years ? Real Estate...................................................................... 469

ib Schedule B ? Verification Between Years ? Mortgage Loans.............................................................. 471 tr Schedule BA ? Verification Between Years ? Long-Term Invested Assets............................................ 473

Schedule D Verification Between Years ? Bonds and Stocks ........................................................... 475

is Summary By Country ? Long-Term Bonds and Stocks Owned December 31 of Current Year ............................................................................ 477

D Part 1A Section 1 ? Quality and Maturity Distribution of All Bonds Owned r December 31 by Major Type and NAIC Designation ............. 478 Section 2 ? Maturity Distribution of All Bonds Owned fo December 31 by Major Type and Sub-Type ........................... 481 Schedule DA ? Verification Between Years ? Short-Term Investments ................................................. 484 Schedule DB

tPart A ? Verification Between Years ? Options, Caps, Floors, Collars, Swaps and Forwards .............................................. 486

oPart B ? Verification Between Years ? Futures Contracts ........................................ 487 N Part C

Section 1 ? Replication (Synthetic Asset) Transactions (RSAT) Open on December 31 of Current Year................................... 489

Section 2 ? Reconciliation of Replication (Synthetic Asset) Transactions Open................................................................... 491

Verification ........................................................................................................................ 492 Schedule E

Part 2 ? Verification Between Years ? Cash Equivalents ..................................... 493

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