NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICES …

[Pages:27]NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICES FINANCIAL CONDITION REPORT ON EXAMINATION OF THE

AMERICAN PROGRESSIVE LIFE AND HEALTH INSURANCE COMPANY OF NEW YORK

CONDITION: DATE OF REPORT:

DECEMBER 31, 2017 MAY 23, 2019

NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICES FINANCIAL CONDITION REPORT ON EXAMINATION OF THE

AMERICAN PROGRESSIVE LIFE AND HEALTH INSURANCE COMPANY OF NEW YORK AS OF

DECEMBER 31, 2017

DATE OF REPORT: EXAMINER:

MAY 23, 2019 LESTER C. SCHOTT, CFE

TABLE OF CONTENTS

ITEM 1. 2. 3.

4.

5. 6.

7. 8.

Executive summary Scope of examination Description of Company A. History B. Holding company C. Organizational chart D. Service agreements E. Management Territory and plan of operations A. Statutory and special deposits B. Direct operations C. Reinsurance Significant operating results Financial statements A. Independent accountants B. Net admitted assets C. Liabilities, capital and surplus D. Condensed summary of operations E. Capital and surplus account Subsequent Event Prior report summary and conclusions

PAGE NO. 2 3 6 6 7 7 8 9 11 11 11 12 13 16 16 16 17 18 19 20 21

Andrew M. Cuomo Governor

Linda A. Lacewell Acting Superintendent

May 29, 2019

The Honorable Linda Lacewell Acting Superintendent of Financial Services New York, New York 10004

Madam: In accordance with instructions contained in Appointment No. 31767, dated April 12, 2018,

and annexed hereto, an examination has been made into the condition and affairs of American Progressive Life and Health Insurance Company of New York, hereinafter referred to as "the Company," at its main administrative office located at 8735 Henderson Road, Tampa, FL 33634. The Company's statutory home office is located at One New York Plaza, New York, NY 10004.

Wherever "Department" appears in this report, it refers to the New York State Department of Financial Services.

The report indicating the results of this examination is respectfully submitted.

ONE STATE STREET, 2ND FLOOR, NEW YORK, NY 10004-1511 | WWW.DFS.

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1. EXECUTIVE SUMMARY

The material comments contained in this report are summarized below. ? Effective August 3, 2016, the Company ceded all its remaining traditional life insurance

in force and accident and health business to Constitution Life Insurance Company ("Constitution Life"), a former affiliate, on a 100% coinsurance basis reinsurance agreement. This arrangement was part of a larger transaction in which Universal American Corp. ("Universal American"), the Company's parent, divested its entire traditional insurance block of business by selling all of the outstanding shares of Constitutional Life and Pyramid Life Insurance Company ("Pyramid"), former affiliates of the Company, to Nassau Reinsurance Group Holdings L.P. Under the terms of the agreement, Nassau acquired all outstanding shares of Constitution Life and Pyramid and the remaining portion of the Company's traditional insurance business for approximately $43 million in cash. (See item 3A of this report.) ? On April 28, 2017, WellCare Health Plans, Inc. ("WellCare") completed the acquisition of Universal American in an all cash transaction which resulted in Universal American becoming a wholly-owned subsidiary of WellCare. WellCare is a healthcare insurer focused on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. (See item 3A of this report.) ? On March 27, 2019, WellCare entered into an agreement and a plan of merger (the "Merger Agreement") with Centene Corporation ("Centene"), Wellington Merger Sub I, Inc. ("Merger Sub I") and Wellington Merger Sub II, Inc. ("Merger Sub II"), a Delaware corporations and direct, wholly owned subsidiaries of Centene. Pursuant to the Merger Agreement, subject to the terms and conditions thereof, Centene will acquire all of the outstanding shares of WellCare through a series of transactions: (1) First, Merger Sub I will merge with and into WellCare, with WellCare being surviving and the direct, wholly owned subsidiary of Centene, and (2) WellCare will then merge with and into Merger Sub II, with Merger Sub II being the surviving corporation. Subject to the terms and conditions set out in the Merger Agreement, WellCare's stockholders will receive cash and shares of Centene. The completion of the transactions under the Merger Agreement remains subject to certain closing conditions. (See item 8 of this report.)

3 2. SCOPE OF EXAMINATION

The examination of the Company was a full-scope examination as defined in the NAIC

Financial Condition Examiners Handbook, 2018 Edition (the "Handbook"). The examination

covers the three-year period from January 1, 2015, to December 31, 2017. The examination was

conducted observing the guidelines and procedures in the Handbook and, where deemed

appropriate by the examiner, transactions occurring subsequent to December 31, 2017, but prior

to the date of this report (i.e., the completion date of the examination) were also reviewed.

The examination was conducted on a risk-focused basis in accordance with the provisions

of the Handbook published by the National Association of Insurance Commissioners ("NAIC").

The Handbook guidance provides for the establishment of an examination plan based on the

examiner's assessment of risk in the insurer's operations and utilizing that evaluation in

formulating the nature and extent of the examination. The examiner planned and performed the

examination to evaluate the current financial condition as well as identify prospective risks that

may threaten the future solvency of the insurer. The examiner identified key processes, assessed

the risks within those processes and evaluated the internal control systems and procedures used to

mitigate those risks. The examination also included assessing the principles used and significant

estimates made by management, evaluating the overall financial statement presentation, and

determining management's compliance with New York statutes and Department guidelines,

Statutory Accounting Principles as adopted by the Department, and annual statement instructions.

The examination of the Company was conducted and coordinated with the examination of

11 other affiliated entities domiciled in ten jurisdictions. The affiliated entities and their state of

domicile are listed in the table below:

Company Name

Domiciliary State

WellCare of Florida, Inc.

Florida

WellCare Prescription Insurance, Inc.

Florida

WellCare Health Insurance of Arizona, Inc.

Arizona

WellCare of Connecticut, Inc.

Connecticut

WellCare of Georgia, Inc.

Georgia

Harmony Health Plan, Inc.

Illinois

Missouri Care, Inc.

Missouri

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Company Name WellCare of Nebraska, Inc. WellCare Health Plans of New Jersey, Inc. WellCare of Ohio, Inc. WellCare of Oklahoma, Inc.

Domiciliary State Nebraska New Jersey Ohio Oklahoma

The coordinated examination was led and facilitated by the State of Florida, with participation from the other states. Since the lead and participating states are all accredited by the NAIC, all states deemed it appropriate to rely on each other's work.

Information about the Company's organizational structure, business approach and control environment were utilized to develop the examination approach. The Company's risks and management activities were evaluated incorporating the NAIC's nine branded risk categories. These categories are as follows:

? Pricing/Underwriting ? Reserving ? Operational ? Strategic ? Credit ? Market ? Liquidity ? Legal ? Reputational The Company was audited annually, for the years 2015 through 2017, by the accounting firm of Deloitte & Touche LLP. The Company received an unmodified opinion in all years. Certain audit workpapers of the accounting firm were reviewed and relied upon for this examination. The Company is under the oversight of the internal audit department of the holding company which was given the task of assessing the internal control structure and compliance with the Sarbanes-Oxley Act of 2002 ("SOX") and the Model Audit Rule ("MAR"). Where applicable, SOX and MAR workpapers and reports were reviewed and portions were relied upon for this examination. The examiner reviewed the corrective action taken by the Company with respect to the financial condition recommendation contained in the prior report on examination. The result of the examiner's review is contained in item 8 of this report.

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This report on examination is confined to financial statements and comments on those matters which involve departure from laws, regulations or rules, or which require explanation or description.

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