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ANNUAL STATEMENT BLANKALPHABETICAL INDEXAnalysis of Increase in Reserves During The Year 7Analysis of Operations By Lines of Business 6Asset Valuation Reserve Default Component 30Asset Valuation Reserve Equity 32Asset Valuation Reserve Replications (Synthetic) Assets 35Asset Valuation Reserve 29Assets 2Cash Flow 5Exhibit 1 - Part 1 - Premiums and Annuity Considerations for Life and Accident and Health Contracts 9Exhibit 1 - Part 2 - Dividends and Coupons Applied, Reinsurance Commissions and Expense 10Exhibit 2 - General Expenses 11Exhibit 3 - Taxes, Licenses and Fees (Excluding Federal Income Taxes) 11Exhibit 4 - Dividends or Refunds 11Exhibit 5 - Aggregate Reserve for Life Contracts 12Exhibit 5 - Interrogatories 13Exhibit 5A - Changes in Bases of Valuation During The Year 13Exhibit 6 - Aggregate Reserves for Accident and Health Contracts 14Exhibit 7 - Deposit-Type Contracts 15Exhibit 8 - Claims for Life and Accident and Health Contracts - Part 1 16Exhibit 8 - Claims for Life and Accident and Health Contracts - Part 2 17Exhibit of Capital Gains (Losses) 8Exhibit of Life Insurance 25Exhibit of Net Investment Income 8Exhibit of Nonadmitted Assets 18Exhibit of Number of Policies, Contracts, Certificates, Income Payable and Account Values 27Five-Year Historical Data 22Form for Calculating the Interest Maintenance Reserve (IMR) 28General Interrogatories 20Jurat Page 1Liabilities, Surplus and Other Funds 3Life Insurance (State Page) 24Notes To Financial Statements 19Overflow Page For Write-ins 54Schedule A - Part 1E01Schedule A - Part 2E02Schedule A - Part 3E03Schedule A - Verification Between YearsSI02Schedule B - Part 1E04Schedule B - Part 2E05Schedule B - Part 3E06Schedule B - Verification Between YearsSI02Schedule BA - Part 1E07Schedule BA - Part 2E08Schedule BA - Part 3E09Schedule BA - Verification Between YearsSI03Schedule D - Part 1E10Schedule D - Part 1A - Section 1SI05Schedule D - Part 1A - Section 2SI08Schedule D - Part 2 - Section 1E11Schedule D - Part 2 - Section 2E12Schedule D - Part 3E13Schedule D - Part 4E14Schedule D - Part 5E15Schedule D - Part 6 - Section 1E16Schedule D - Part 6 - Section 2E16Schedule D - Summary By CountrySI04Schedule D - Verification Between YearsSI03Schedule DA - Part 1E17Schedule DA - Verification Between YearsSI10Index 1
ANNUAL STATEMENT BLANK (Continued)Schedule DB - Part A - Section 1E18Schedule DB - Part A - Section 2E19Schedule DB - Part A - Verification Between YearsSI11Schedule DB - Part B - Section 1E20Schedule DB - Part B - Section 2E21Schedule DB - Part B - Verification Between YearsSI11Schedule DB - Part C - Section 1SI12Schedule DB - Part C - Section 2SI13Schedule DB - Part DE22Schedule DB - VerificationSI14Schedule DL - Part 1E23Schedule DL - Part 2E24Schedule E - Part 1 - CashE25Schedule E - Part 2 - Cash EquivalentsE26Schedule E - Part 3 - Special DepositsE27Schedule E - Verification Between YearsSI15Schedule F 36Schedule H - Accident and Health Exhibit - Part 1 37Schedule H - Part 2, Part 3 and Part 4 38Schedule H - Part 5 - Health Claims 39Schedule S - Part 1 - Section 1 40Schedule S - Part 1 - Section 2 41Schedule S - Part 2 42Schedule S - Part 3 - Section 1 43Schedule S - Part 3 - Section 2 44Schedule S - Part 4 45Schedule S - Part 5 46Schedule S - Part 6 47Schedule T - Part 2 Interstate Compact 49Schedule T - Premiums and Annuity Considerations 48Schedule Y - Information Concerning Activities of Insurer Members of a Holding Company Group 50Schedule Y - Part 1A - Detail of Insurance Holding Company System 51Schedule Y - Part 2 - Summary of Insurer’s Transactions With Any Affiliates 52Summary Investment ScheduleSI01Summary of Operations 4Supplemental Exhibits and Schedules Interrogatories 53Index 1.1
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