67911 PIONEER MUTUAL LIFE INSURANCE COMPANY … 12.31.18.pdfPioneer Mutual Life Insurance Company...

*67911201820100100*LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION

ANNUAL STATEMENTFOR THE YEAR ENDED DECEMBER 31, 2018

OF THE CONDITION AND AFFAIRS OF THE

Pioneer Mutual Life Insurance Company NAIC Group Code 0619 0619 NAIC Company Code 67911 Employer's ID Number 45-0220640

(Current) (Prior)

Organized under the Laws of North Dakota , State of Domicile or Port of Entry ND

Country of Domicile United States of America

Incorporated/Organized 01/01/2002 Commenced Business 11/24/1947

Statutory Home Office P O Box 2167 , Fargo, ND, US 58107

(Street and Number) (City or Town, State, Country and Zip Code)

Main Administrative Office One American Square

(Street and Number)

Indianapolis, IN, US 46282-0001 , 800-437-4692

(City or Town, State, Country and Zip Code) (Area Code) (Telephone Number)

Mail Address P O Box 368 , Indianapolis, IN, US 46206-0368

(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 46282-0001 , 317-285-1877

(City or Town, State, Country and Zip Code) (Area Code) (Telephone Number)

Internet Website Address www.OneAmerica.com

Statutory Statement Contact Emilie E. Bolster , 317-285-1850

(Name) (Area Code) (Telephone Number)

[email protected] , 317-285-5114

(E-mail Address) (FAX Number)

OFFICERS

Chairman, President & CEO James Scott Davison

Executive Vice President, Finance, Operations and

Institutional Markets Jeffrey David Holley #

Secretary Thomas Michael Zurek Actuary Jonathan William Wilkins #

OTHER

David Allen Brentlinger #, Senior Vice President Richard Michael Ellery, Senior Vice President Dennis Cameron Martin #, President, Individual Life and

Financial Services Andrew John Michie, Senior Vice President James Charles Crampton, Vice President George Granville Graessle IV, Vice President

Nancy Brady Moore, Vice President Jay Brian Williams, Vice President

DIRECTORS OR TRUSTEESJames Scott Davison Jeffrey David Holley Kelly Michelle Huntington John Charles Mason Karin Wyvette Sarratt Thomas Michael Zurek

SS:State of Indiana

County of Marion

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: (1) state law may differ; or, (2) 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 Executive Vice President, Finance, Operations and Institutional Markets

a. Is this an original filing? Yes [ X ] No [ ]

Subscribed and sworn to before me this b. If no,

8th day of February, 2019 1. State the amendment number

2. Date filed

3. Number of pages attached Rachelle Richey Notary Public 03/20/2020

ANNUAL STATEMENT FOR THE YEAR 2018 OF THE PIONEER MUTUAL LIFE INSURANCE COMPANY

ASSETSCurrent Year Prior Year

1

Assets

2

Nonadmitted Assets

3Net Admitted Assets

(Cols. 1 - 2)

4Net Admitted

Assets

1. Bonds (Schedule D) 463,702,362 463,702,362 465,830,315

2. Stocks (Schedule D):

2.1 Preferred stocks

2.2 Common stocks

3. Mortgage loans on real estate (Schedule B):

3.1 First liens 10,597,324 10,597,324 13,532,793

3.2 Other than first liens

4. Real estate (Schedule A):

4.1 Properties occupied by the company (less $

encumbrances)

4.2 Properties held for the production of income (less

$ encumbrances)

4.3 Properties held for sale (less $

encumbrances)

5. Cash ($ 1,410,290 , Schedule E - Part 1), cash equivalents

($ , Schedule E - Part 2) and short-term

investments ($ , Schedule DA) 1,410,290 1,410,290 744,461

6. Contract loans (including $ premium notes) 23,156,516 23,156,516 23,003,094

7. Derivatives (Schedule DB)

8. Other invested assets (Schedule BA) 1,995,754 1,995,754 1,995,668

9. Receivables for securities

10. Securities lending reinvested collateral assets (Schedule DL)

11. Aggregate write-ins for invested assets

12. Subtotals, cash and invested assets (Lines 1 to 11) 500,862,246 500,862,246 505,106,331

13. Title plants less $ charged off (for Title insurers

only)

14. Investment income due and accrued 4,140,641 4,140,641 4,439,247

15. Premiums and considerations:

15.1 Uncollected premiums and agents' balances in the course of collection 126,553 126,553 109,406

15.2 Deferred premiums and agents' balances and installments booked but

deferred and not yet due (including $

earned but unbilled premiums) 1,170,997 1,170,997 1,471,930

15.3 Accrued retrospective premiums ($ ) and

contracts subject to redetermination ($ )

16. Reinsurance:

16.1 Amounts recoverable from reinsurers 473,511 473,511 2,770,284

16.2 Funds held by or deposited with reinsured companies

16.3 Other amounts receivable under reinsurance contracts 206,551

17. Amounts receivable relating to uninsured plans

18.1 Current federal and foreign income tax recoverable and interest thereon 1,041,625

18.2 Net deferred tax asset 7,970,115 5,305,699 2,664,416 2,584,624

19. Guaranty funds receivable or on deposit 127,756 127,756 128,471

20. Electronic data processing equipment and software

21. Furniture and equipment, including health care delivery assets

($ )

22. Net adjustment in assets and liabilities due to foreign exchange rates

23. Receivables from parent, subsidiaries and affiliates

24. Health care ($ ) and other amounts receivable

25. Aggregate write-ins for other than invested assets 349,394 349,394

26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 515,221,213 5,655,093 509,566,120 517,858,469

27. From Separate Accounts, Segregated Accounts and Protected Cell Accounts

28. Total (Lines 26 and 27) 515,221,213 5,655,093 509,566,120 517,858,469

DETAILS OF WRITE-INS

1101.

1102.

1103.

1198. Summary of remaining write-ins for Line 11 from overflow page

1199. Totals (Lines 1101 thru 1103 plus 1198)(Line 11 above)

2501. Interest maintenance reserve 342,612 342,612

2502. Miscellaneous assets 4,532 4,532

2503. Prepaid expenses 2,250 2,250


2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 349,394 349,394

2


LIABILITIES, SURPLUS AND OTHER FUNDS1

Current Year2

Prior Year1. Aggregate reserve for life contracts $ 443,716,209 (Exh. 5, Line 9999999) less $

included in Line 6.3 (including $ Modco Reserve) 443,716,209 458,067,178 2. Aggregate reserve for accident and health contracts (including $ Modco Reserve) 1,373 2,303 3. Liability for deposit-type contracts (Exhibit 7, Line 14, Col. 1) (including $ Modco Reserve) 12,504,319 13,574,270 4. Contract claims:

4.1 Life (Exhibit 8, Part 1, Line 4.4, Col. 1 less sum of Cols. 9, 10 and 11) 1,230,194 3,121,106 4.2 Accident and health (Exhibit 8, Part 1, Line 4.4, sum of Cols. 9, 10 and 11)

5. Policyholders’ dividends $ and coupons $ due and unpaid (Exhibit 4,

Line 10) 6. Provision for policyholders’ dividends and coupons payable in following calendar year - estimated amounts:

6.1 Dividends apportioned for payment (including $ Modco) 355,311 376,175 6.2 Dividends not yet apportioned (including $ Modco) 6.3 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 $ 105 accident and health premiums (Exhibit 1,

Part 1, Col. 1, sum of lines 4 and 14) 8,406 9,316 9. Contract liabilities not included elsewhere:

9.1 Surrender values on canceled contracts 9.2 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 9.3 Other amounts payable on reinsurance, including $ assumed and $ 203,000

ceded 203,000 200,000 9.4 Interest maintenance reserve (IMR, Line 6)

10. Commissions to agents due or accrued-life and annuity contracts $ accident and health

$ and deposit-type contract funds $ 44,068 11. Commissions and expense allowances payable on reinsurance assumed 12. General expenses due or accrued (Exhibit 2, Line 12, Col. 6) 13. Transfers to Separate Accounts due or accrued (net) (including $ accrued for expense

allowances recognized in reserves, net of reinsured allowances) 14. Taxes, licenses and fees due or accrued, excluding federal income taxes (Exhibit 3, Line 9, Col. 5) 152,346 254,430 15.1 Current federal and foreign income taxes, including $ 21,052 on realized capital gains (losses) 177,854 15.2 Net deferred tax liability 16. Unearned investment income 28,942 31,102 17. Amounts withheld or retained by company as agent or trustee 486 2,994 18. Amounts held for agents' account, including $ agents' credit balances 19. Remittances and items not allocated 1,549,354 992,713 20. Net adjustment in assets and liabilities due to foreign exchange rates 21. Liability for benefits for employees and agents if not included above 22. Borrowed money $ and interest thereon $ 23. Dividends to stockholders declared and unpaid 24. Miscellaneous liabilities:

24.01 Asset valuation reserve (AVR, Line 16, Col. 7) 1,990,602 2,093,347 24.02 Reinsurance in unauthorized and certified ($ ) companies 24.03 Funds held under reinsurance treaties with unauthorized and certified ($ ) reinsurers 24.04 Payable to parent, subsidiaries and affiliates 63,231 1,061,710 24.05 Drafts outstanding 24.06 Liability for amounts held under uninsured plans 24.07 Funds held under coinsurance 24.08 Derivatives 24.09 Payable for securities 25,480 24.10 Payable for securities lending 24.11 Capital notes $ and interest thereon $

25. Aggregate write-ins for liabilities 661,693 540,071 26. Total liabilities excluding Separate Accounts business (Lines 1 to 25) 462,668,800 480,370,783 27. From Separate Accounts Statement 28. Total liabilities (Lines 26 and 27) 462,668,800 480,370,783 29. Common capital stock 3,000,000 3,000,000 30. Preferred capital stock 31. Aggregate write-ins for other than special surplus funds 32. Surplus notes 33. Gross paid in and contributed surplus (, Line 33, Col. 2 plus Page 4, Line 51.1, Col. 1) 7,000,000 7,000,000 34. Aggregate write-ins for special surplus funds 700,000 700,000 35. Unassigned funds (surplus) 36,197,320 26,787,686 36. Less treasury stock, at cost:

36.1 shares common (value included in Line 29 $ ) 36.2 shares preferred (value included in Line 30 $ )

37. Surplus (Total Lines 31+32+33+34+35-36) (including $ in Separate Accounts Statement) 43,897,320 34,487,686 38. Totals of Lines 29, 30 and 37 (Page 4, Line 55) 46,897,320 37,487,686 39. Totals of Lines 28 and 38 (Page 2, Line 28, Col. 3) 509,566,120 517,858,469


2501. Reserve for unclaimed funds 549,731 451,951 2502. Accounts payable 110,949 84,218 2503. Interest on contract funds 1,013 3,902 2598. Summary of remaining write-ins for Line 25 from overflow page 2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 661,693 540,071 3101.

3102.

3103.

3198. Summary of remaining write-ins for Line 31 from overflow page 3199. Totals (Lines 3101 thru 3103 plus 3198)(Line 31 above) 3401. Permanent guaranty fund 700,000 700,000 3402.

3403.

3498. Summary of remaining write-ins for Line 34 from overflow page 3499. Totals (Lines 3401 thru 3403 plus 3498)(Line 34 above) 700,000 700,000

3


SUMMARY OF OPERATIONS1

Current Year2

Prior Year

1. Premiums and annuity considerations for life and accident and health contracts (Exhibit 1, Part 1, Line 20.4, Col. 1, less Col. 11) 14,216,958 19,129,925

2. Considerations for supplementary contracts with life contingencies

3. Net investment income (Exhibit of Net Investment Income, Line 17) 22,895,451 23,871,890

4. Amortization of Interest Maintenance Reserve (IMR, Line 5) 191,351 210,040

5. Separate Accounts net gain from operations excluding unrealized gains or losses

6. Commissions and expense allowances on reinsurance ceded (Exhibit 1, Part 2, Line 26.1, Col. 1) 103,825 129,007

7. Reserve adjustments on reinsurance ceded

8. Miscellaneous Income:

8.1 Income from fees associated with investment management, administration and contract guarantees from Separate Accounts

8.2 Charges and fees for deposit-type contracts

8.3 Aggregate write-ins for miscellaneous income

9. Total (Lines 1 to 8.3) 37,407,585 43,340,862

10. Death benefits 14,393,576 18,676,803

11. Matured endowments (excluding guaranteed annual pure endowments) 60,785 264,426

12. Annuity benefits (Exhibit 8, Part 2, Line 6.4, Cols. 4 + 8) 5,339,759 5,552,745

13. Disability benefits and benefits under accident and health contracts 93,745 96,338

14. Coupons, guaranteed annual pure endowments and similar benefits

15. Surrender benefits and withdrawals for life contracts 16,511,714 12,702,952

16. Group conversions

17. Interest and adjustments on contract or deposit-type contract funds 503,235 331,592

18. Payments on supplementary contracts with life contingencies 6,000 6,000

19. Increase in aggregate reserves for life and accident and health contracts (14,351,899) 5,774,053

20. Totals (Lines 10 to 19) 22,556,915 43,404,909

21. Commissions on premiums, annuity considerations, and deposit-type contract funds (direct business only) (Exhibit 1, Part 2, Line 31, Col. 1) 504,109 1,724,071

22. Commissions and expense allowances on reinsurance assumed (Exhibit 1, Part 2, Line 26.2, Col. 1)

23. General insurance expenses (Exhibit 2, Line 10, Cols. 1, 2, 3 and 4) 3,158,487 3,493,548

24. Insurance taxes, licenses and fees, excluding federal income taxes (Exhibit 3, Line 7, Cols. 1 + 2 + 3) 453,447 586,181

25. Increase in loading on deferred and uncollected premiums 455,538 222,882

26. Net transfers to or (from) Separate Accounts net of reinsurance

27. Aggregate write-ins for deductions 75

28. Totals (Lines 20 to 27) 27,128,496 49,431,666

29. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 28) 10,279,089 (6,090,804)

30. Dividends to policyholders 343,527 366,622

31. Net gain from operations after dividends to policyholders and before federal income taxes (Line 29 minus Line 30) 9,935,562 (6,457,426)

32. Federal and foreign income taxes incurred (excluding tax on capital gains) 848,591 350,205

33. Net gain from operations after dividends to policyholders and federal income taxes and before realized capital gains or (losses) (Line 31 minus Line 32) 9,086,971 (6,807,631)

34. Net realized capital gains (losses) (excluding gains (losses) transferred to the IMR) less capital gains tax of

$ (2,985) (excluding taxes of $ (18,067) transferred to the IMR) 2,985 167,589

35. Net income (Line 33 plus Line 34) 9,089,956 (6,640,042)

CAPITAL AND SURPLUS ACCOUNT

36. Capital and surplus, December 31, prior year (Page 3, Line 38, Col. 2) 37,487,686 46,459,297

37. Net income (Line 35) 9,089,956 (6,640,042)

38. Change in net unrealized capital gains (losses) less capital gains tax of $ (92)

39. Change in net unrealized foreign exchange capital gain (loss)

40. Change in net deferred income tax (1,313,350) (2,655,257)

41. Change in nonadmitted assets 1,670,356 646,856

42. Change in liability for reinsurance in unauthorized and certified companies

43. Change in reserve on account of change in valuation basis, (increase) or decrease

44. Change in asset valuation reserve 102,745 182,091

45. Change in treasury stock (Page 3, Lines 36.1 and 36.2, Col. 2 minus Col. 1)

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 454,711

50. Capital changes:

50.1 Paid in

50.2 Transferred from surplus (Stock Dividend)

50.3 Transferred to surplus

51. Surplus adjustment:

51.1 Paid in

51.2 Transferred to capital (Stock Dividend)

51.3 Transferred from capital

51.4 Change in surplus as a result of reinsurance

52. Dividends to stockholders

53. Aggregate write-ins for gains and losses in surplus (139,981) (959,970)

54. Net change in capital and surplus for the year (Lines 37 through 53) 9,409,634 (8,971,612)

55. Capital and surplus, December 31, current year (Lines 36 + 54) (Page 3, Line 38) 46,897,320 37,487,686


08.301.

08.302.

08.303.

08.398. Summary of remaining write-ins for Line 8.3 from overflow page

08.399. Totals (Lines 08.301 thru 08.303 plus 08.398)(Line 8.3 above)

2701. Miscellaneous expense 75

2702.

2703.


2799. Totals (Lines 2701 thru 2703 plus 2798)(Line 27 above) 75

5301. Reinsurance error correction 1,257,030

5302. Prior year reserve adjustment (2,217,000)

5303. Policy loan surrender error correction (139,981)


5399. Totals (Lines 5301 thru 5303 plus 5398)(Line 53 above) (139,981) (959,970)

4


CASH FLOW1

Current Year

2

Prior Year

Cash from Operations

1. Premiums collected net of reinsurance 14,250,847 19,388,771

2. Net investment income 23,599,778 22,894,605

3. Miscellaneous income 103,825 129,007

4. Total (Lines 1 through 3) 37,954,450 42,412,383

5. Benefit and loss related payments 36,499,953 37,802,562

6. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts

7. Commissions, expenses paid and aggregate write-ins for deductions 4,261,480 5,930,558

8. Dividends paid to policyholders 364,391 392,272

9. Federal and foreign income taxes paid (recovered) net of $ (21,052) tax on capital gains (losses) (429,150) 1,495,954

10. Total (Lines 5 through 9) 40,696,674 45,621,346

11. Net cash from operations (Line 4 minus Line 10) (2,742,223) (3,208,963)

Cash from Investments

12. Proceeds from investments sold, matured or repaid:

12.1 Bonds 33,938,019 64,886,782

12.2 Stocks

12.3 Mortgage loans 2,935,490 6,295,828

12.4 Real estate

12.5 Other invested assets

12.6 Net gains or (losses) on cash, cash equivalents and short-term investments

12.7 Miscellaneous proceeds 576,288 494,192

12.8 Total investment proceeds (Lines 12.1 to 12.7) 37,449,797 71,676,802

13. Cost of investments acquired (long-term only):

13.1 Bonds 32,318,690 68,026,544

13.2 Stocks

13.3 Mortgage loans

13.4 Real estate

13.5 Other invested assets 1,995,740

13.6 Miscellaneous applications 12,701

13.7 Total investments acquired (Lines 13.1 to 13.6) 32,318,690 70,034,985

14. Net increase (decrease) in contract loans and premium notes 330,613 (455,223)

15. Net cash from investments (Line 12.8 minus Line 13.7 minus Line 14) 4,800,494 2,097,040

Cash from Financing and Miscellaneous Sources

16. Cash provided (applied):

16.1 Surplus notes, capital notes

16.2 Capital and paid in surplus, less treasury stock

16.3 Borrowed funds

16.4 Net deposits on deposit-type contracts and other insurance liabilities (1,069,951) (385,143)

16.5 Dividends to stockholders

16.6 Other cash provided (applied) (322,491) 1,438,782

17. Net cash from financing and miscellaneous sources (Lines 16.1 to 16.4 minus Line 16.5 plus Line 16.6) (1,392,442) 1,053,639

RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS

18. Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) 665,829 (58,284)

19. Cash, cash equivalents and short-term investments:

19.1 Beginning of year 744,461 802,745

19.2 End of year (Line 18 plus Line 19.1) 1,410,290 744,461

Note: Supplemental disclosures of cash flow information for non-cash transactions:

20.0001. Capitalized interest on bonds 433,468 419,099

5


ANALYSIS OF OPERATIONS BY LINES OF BUSINESS1 2 Ordinary 6 Group Accident and Health 12

Total Industrial Life

3

Life Insurance

4

Individual Annuities

5Supplementary

Contracts

Credit Life (Group and Individual)

7Life Insurance

(a)

8

Annuities

9

Group

10Credit (Group and

Individual)

11

Other

Aggregate of All Other Lines of

Business

1. Premiums and annuity considerations for life and accident and health contracts 14,216,958 13,213,257 1,010,870 (7,169)

2. Considerations for supplementary contracts with life contingencies

3. Net investment income 22,895,451 17,639,760 5,251,846 3,724 121

4. Amortization of Interest Maintenance Reserve (IMR) 191,351 147,426 43,893 31 1

5. Separate Accounts net gain from operations excluding unrealized gains or losses

6. Commissions and expense allowances on reinsurance ceded 103,825 103,825

7. Reserve adjustments on reinsurance ceded

8. Miscellaneous Income:

8.1 Fees associated with income from investment management, administration and contract guarantees from Separate Accounts

8.2 Charges and fees for deposit-type contracts

8.3 Aggregate write-ins for miscellaneous income

9. Totals (Lines 1 to 8.3) 37,407,585 31,104,268 6,306,609 3,755 (7,047)

10. Death benefits 14,393,576 14,393,576

11. Matured endowments (excluding guaranteed annual pure endowments) 60,785 60,785

12. Annuity benefits 5,339,759 5,325,121 14,638

13. Disability benefits and benefits under accident and health contracts 93,745 81,505 12,240

14. Coupons, guaranteed annual pure endowments and similar benefits

15. Surrender benefits and withdrawals for life contracts 16,511,714 11,351,762 5,159,952

16. Group conversions

17. Interest and adjustments on contract or deposit-type contract funds 503,235 492,116 11,119

18. Payments on supplementary contracts with life contingencies 6,000 6,000

19. Increase in aggregate reserves for life and accident and health contracts (14,351,899) (7,310,171) (7,039,783) (1,015) (930)

20. Totals (Lines 10 to 19) 22,556,915 19,069,573 3,445,290 16,104 14,638 11,310

21. Commissions on premiums, annuity considerations and deposit-type contract funds (direct business only) 504,109 481,183 22,926

22. Commissions and expense allowances on reinsurance assumed

23. General insurance expenses 3,158,487 2,725,570 432,917

24. Insurance taxes, licenses and fees, excluding federal income taxes 453,447 434,663 18,841 (57)

25. Increase in loading on deferred and uncollected premiums 455,538 455,538

26. Net transfers to or (from) Separate Accounts net of reinsurance

27. Aggregate write-ins for deductions

28. Totals (Lines 20 to 27) 27,128,496 23,166,527 3,919,974 16,104 14,638 11,253

29. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 28) 10,279,089 7,937,741 2,386,635 (16,104) (10,883) (18,300)

30. Dividends to policyholders 343,527 343,527

31. Net gain from operations after dividends to policyholders and before federal income taxes (Line 29 minus Line 30) 9,935,562 7,594,214 2,386,635 (16,104) (10,883) (18,300)

32. Federal income taxes incurred (excluding tax on capital gains) 848,591 696,408 161,707 (3,397) (2,300) (3,827)

33. Net gain from operations after dividends to policyholders and federal income taxes and before realized capital gains or (losses) (Line 31 minus Line 32) 9,086,971 6,897,806 2,224,928 (12,707) (8,583) (14,473)


08.301.

08.302.

08.303.


08.399. Totals (Lines 08.301 thru 08.303 plus 08.398) (Line 8.3 above)

2701.

2702.

2703.


2799. Totals (Lines 2701 thru 2703 plus 2798) (Line 27 above)

(a) Includes the following amounts for FEGLI/SGLI: Line 1 , Line 10 , Line 16 , Line 23 , Line 24

6


ANALYSIS OF INCREASE IN RESERVES DURING THE YEAR

1 2 Ordinary 6 Group


3

Life Insurance

4


5Supplementary

ContractsCredit Life (Group and

Individual)

7

Life Insurance

8

Annuities

Involving Life or Disability Contingencies (Reserves)

(Net of Reinsurance Ceded)

1. Reserve December 31, prior year 458,067,176 348,881,043 109,088,570 22,981 74,582

2. Tabular net premiums or considerations 12,688,736 11,677,866 1,010,870

3. Present value of disability claims incurred XXX

4. Tabular interest 18,000,755 13,740,762 4,254,359 1,598 4,036

5. Tabular less actual reserve released (291,509) 17,827 (319,939) 10,603

6. Increase in reserve on account of change in valuation basis

6.1 Change in excess of VM-20 deterministic/stochastic reserve over net premium reserve XXX XXX XXX XXX XXX XXX

7. Other increases (net) (4,996,614) (3,500,000) (1,500,000) 3,386

8. Totals (Lines 1 to 7) 483,468,544 370,817,498 112,533,860 27,965 89,221

9. Tabular cost 9,464,849 9,464,849 XXX

10. Reserves released by death 6,927,621 6,927,621 XXX XXX XXX

11. Reserves released by other terminations (net) 17,932,990 12,773,038 5,159,952

12. Annuity, supplementary contract and disability payments involving life contingencies 5,426,875 81,116 5,325,121 6,000 14,638

13. Net transfers to or (from) Separate Accounts

14. Total Deductions (Lines 9 to 13) 39,752,335 29,246,624 10,485,073 6,000 14,638

15. Reserve December 31, current year 443,716,209 341,570,874 102,048,787 21,965 74,583

7


EXHIBIT OF NET INVESTMENT INCOME

1 2Collected During Year Earned During Year

1. U.S. Government bonds (a) 3,169,694 3,156,722

1.1 Bonds exempt from U.S. tax (a)

1.2 Other bonds (unaffiliated) (a) 17,930,013 17,659,240

1.3 Bonds of affiliates (a)

2.1 Preferred stocks (unaffiliated) (b)

2.11 Preferred stocks of affiliates (b)

2.2 Common stocks (unaffiliated)

2.21 Common stocks of affiliates

3. Mortgage loans (c) 752,695 737,837

4. Real estate (d)

5 Contract loans 1,675,359 1,674,310

6 Cash, cash equivalents and short-term investments (e) 14,390 14,390

7 Derivative instruments (f)

8. Other invested assets 77,941 77,941

9. Aggregate write-ins for investment income 1,084 1,084

10. Total gross investment income 23,621,176 23,321,524

11. Investment expenses (g) 410,728

12. Investment taxes, licenses and fees, excluding federal income taxes (g) 15,345

13. Interest expense (h)

14. Depreciation on real estate and other invested assets (i)

15. Aggregate write-ins for deductions from investment income

16. Total deductions (Lines 11 through 15) 426,073

17. Net investment income (Line 10 minus Line 16) 22,895,451


0901. Miscellaneous investment income 1,084 1,084

0902.

0903.


0999. Totals (Lines 0901 thru 0903 plus 0998) (Line 9, above) 1,084 1,084

1501.

1502.

1503.


1599. Totals (Lines 1501 thru 1503 plus 1598) (Line 15, above)

(a) Includes $ 495,577 accrual of discount less $ 470,097 amortization of premium and less $ 137,705 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 $ 21 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 $ 12,734 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 tosegregated 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)1

Realized Gain (Loss) On Sales or Maturity

2

Other Realized Adjustments

3

Total RealizedCapital Gain (Loss)

(Columns 1 + 2)

4

Change inUnrealized

Capital Gain (Loss)

5

Change in Unrealized Foreign Exchange Capital Gain (Loss)

1. U.S. Government bonds (260,689) (260,689)

1.1 Bonds exempt from U.S. tax

1.2 Other bonds (unaffiliated) 160,145 160,145 (92)

1.3 Bonds of affiliates

2.1 Preferred stocks (unaffiliated)

2.11 Preferred stocks of affiliates

2.2 Common stocks (unaffiliated)

2.21 Common stocks of affiliates

3. 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)

10. Total capital gains (losses) (100,544) (100,544) (92)


0901.

0902.

0903.


0999. Totals (Lines 0901 thru 0903 plus 0998) (Line 9, above)

8


EXHIBIT - 1 PART 1 - PREMIUMS AND ANNUITY CONSIDERATIONS FOR LIFE AND ACCIDENT AND HEALTH CONTRACTS1 2 Ordinary 5 Group Accident and Health 11


3

Life Insurance

4IndividualAnnuities


6

Life Insurance

7

Annuities

8

Group

9Credit (Group and

Individual)

10

Other


Business

FIRST YEAR (other than single)1. Uncollected

2. Deferred and accrued

3. Deferred , accrued and uncollected:3.1 Direct

3.2 Reinsurance assumed

3.3 Reinsurance ceded

3.4 Net (Line 1 + Line 2)

4. Advance

5. Line 3.4 - Line 4

6. Collected during year:6.1 Direct (273,610) (273,610)


6.3 Reinsurance ceded (1,377) (1,377)

6.4 Net (272,233) (272,233)

7. Line 5 + Line 6.4 (272,233) (272,233)

8. Prior year (uncollected + deferred and accrued - advance)

9. First year premiums and considerations:9.1 Direct (273,610) (273,610)


9.3 Reinsurance ceded (1,377) (1,377)

9.4 Net (Line 7 - Line 8) (272,233) (272,233)

SINGLE10. Single premiums and considerations:

10.1 Direct 137,121 137,121



10.4 Net 137,121 137,121

RENEWAL11. Uncollected 20,772 19,343 1,429

12. Deferred and accrued 1,377,959 1,377,509 450

13. Deferred, accrued and uncollected:13.1 Direct 1,601,732 1,599,853 450 1,429


13.3 Reinsurance ceded 203,000 203,000

13.4 Net (Line 11 + Line 12) 1,398,732 1,396,853 450 1,429

14. Advance 8,406 8,301 105

15. Line 13.4 - Line 14 1,390,326 1,388,552 450 1,324

16. Collected during year:16.1 Direct 19,925,579 18,917,500 1,010,870 (2,791)


16.3 Reinsurance ceded 6,311,694 6,311,694

16.4 Net 13,613,885 12,605,806 1,010,870 (2,791)

17. Line 15 + Line 16.4 15,004,211 13,994,358 1,011,320 (1,467)

18. Prior year (uncollected + deferred and accrued - advance) 652,140 645,988 450 5,702

19. Renewal premiums and considerations:19.1 Direct 20,098,241 19,094,540 1,010,870 (7,169)



19.4 Net (Line 17 - Line 18) 14,352,070 13,348,369 1,010,870 (7,169)

TOTAL20. Total premiums and annuity considerations:

20.1 Direct 19,961,752 18,958,051 1,010,870 (7,169)



20.4 Net (Lines 9.4 + 10.4 + 19.4) 14,216,958 13,213,257 1,010,870 (7,169)

9


EXHIBIT - 1 PART 2 - DIVIDENDS AND COUPONS APPLIED, REINSURANCE COMMISSIONS

AND EXPENSE ALLOWANCES AND COMMISSIONS INCURRED (Direct Business Only)1 2 Ordinary 5 Group Accident and Health 11


3

Life Insurance

4

IndividualAnnuities


6

Life Insurance

7

Annuities

8

Group

9

Credit (Group and Individual)

10

Other


Business

DIVIDENDS AND COUPONS APPLIED

(included in Part 1)

21. To pay renewal premiums 14,705 14,705

22. All other 137,121 137,121

REINSURANCE COMMISSIONS AND

EXPENSE ALLOWANCES INCURRED

23. First year (other than single):



23.3 Net ceded less assumed

24. Single:



24.3 Net ceded less assumed

25. Renewal:



25.3 Net ceded less assumed 103,825 103,825

26. Totals:

26.1 Reinsurance ceded (Page 6, Line 6) 103,825 103,825

26.2 Reinsurance assumed (Page 6, Line 22)

26.3 Net ceded less assumed 103,825 103,825

COMMISSIONS INCURRED

(direct business only)

27. First year (other than single) (60,110) (60,110)

28. Single

29. Renewal 564,219 541,293 22,926

30. Deposit-type contract funds

31. Totals (to agree with Page 6, Line 21) 504,109 481,183 22,926

10


EXHIBIT 2 - GENERAL EXPENSESInsurance 5 6

1 Accident and Health 4

Life2

Cost Containment3

All Other

All Other Lines of Business Investment Total

1. Rent 70,918 4,943 75,861

2. Salaries and wages 1,616,868 286,865 1,903,733

3.11 Contributions for benefit plans for employees 375,408 25,587 400,995

3.12 Contributions for benefit plans for agents

3.21 Payments to employees under non-funded benefit plans

3.22 Payments to agents under non-funded benefit plans

3.31 Other employee welfare 22,634 16 22,650

3.32 Other agent welfare

4.1 Legal fees and expenses 4,004 2,423 6,427

4.2 Medical examination fees 2,770 2,770

4.3 Inspection report fees 1,519 1,519

4.4 Fees of public accountants and consulting actuaries 189,980 189,980

4.5 Expense of investigation and settlement of policy claims 1,001 1,001

5.1 Traveling expenses 24,624 24,624

5.2 Advertising 2,605 210 2,815

5.3 Postage, express, telegraph and telephone 75,653 655 76,308

5.4 Printing and stationery 10,036 10,036

5.5 Cost or depreciation of furniture and equipment 19,611 34 19,645

5.6 Rental of equipment 10 10

5.7 Cost or depreciation of EDP equipment and software 222,619 222,619

6.1 Books and periodicals 9,840 20,003 29,843

6.2 Bureau and association fees 17,640 482 18,122

6.3 Insurance, except on real estate 11,167 11,167

6.4 Miscellaneous losses 2,419 2,419

6.5 Collection and bank service charges 2,690 2,690

6.6 Sundry general expenses 473,216 58,334 531,550

6.7 Group service and administration fees 469 469

6.8 Reimbursements by uninsured plans

7.1 Agency expense allowance

7.2 Agents’ balances charged off (less $

recovered)

7.3 Agency conferences other than local meetings 434 434

9.1 Real estate expenses

9.2 Investment expenses not included elsewhere 11,176 11,176

9.3 Aggregate write-ins for expenses 352 352

10. General expenses incurred 3,158,487 410,728 (a) 3,569,215

11. General expenses unpaid December 31, prior year

12. General expenses unpaid December 31, current year

13. Amounts receivable relating to uninsured plans, prior year

14. Amounts receivable relating to uninsured plans, current year

15. General expenses paid during year (Lines 10+11-12-13+14) 3,158,487 410,728 3,569,215


09.301. Other agency expense 352 352

09.302.

09.303.


09.399. Totals (Lines 09.301 thru 09.303 plus 09.398) (Line 9.3 above) 352 352

(a) Includes management fees of $ 3,410,103 to affiliates and $ to non-affiliates.

EXHIBIT 3 - TAXES, LICENSES AND FEES (EXCLUDING FEDERAL INCOME TAXES)Insurance 4 5

1

Life

2

Accident and Health

3All Other Lines of

Business Investment Total

1. Real estate taxes

2. State insurance department licenses and fees 115,887 15,345 131,232

3. State taxes on premiums 322,974 (59) 322,915

4. Other state taxes, including $

for employee benefits 10,617 2 10,619

5. U.S. Social Security taxes

6. All other taxes 4,026 4,026

7. Taxes, licenses and fees incurred 453,504 (57) 15,345 468,792

8. Taxes, licenses and fees unpaid December 31, prior year 243,796 (68) 10,701 254,430

9. Taxes, licenses and fees unpaid December 31, current year 145,010 (108) 7,444 152,346

10. Taxes, licenses and fees paid during year (Lines 7 + 8 - 9) 552,290 (17) 18,602 570,876

EXHIBIT 4 - DIVIDENDS OR REFUNDS1

Life2

Accident and Health

1. Applied to pay renewal premiums 14,704

2. Applied to shorten the endowment or premium-paying period

3. Applied to provide paid-up additions 137,119

4. Applied to provide paid-up annuities

5. Total Lines 1 through 4 151,823

6. Paid in cash 31,481

7. Left on deposit 181,086

8. Aggregate write-ins for dividend or refund options


10. Amount due and unpaid

11. Provision for dividends or refunds payable in the following calendar year 355,310

12. Terminal dividends

13. Provision for deferred dividend contracts

14. Amount provisionally held for deferred dividend contracts not included in Line 13


16. Total from prior year 376,175

17. Total dividends or refunds (Lines 9 + 15 - 16) 343,525


0801.

0802.

0803.


0899. Totals (Lines 0801 thru 0803 plus 0898) (Line 8 above)

11


EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS1

Valuation Standard

2

Total

3

Industrial

4

Ordinary

5Credit

(Group and Individual)

6

Group

LIFE INSURANCE:

0100001. AE 4% NLP Prior 1935 68,903 68,903 0100002. AE 3% NLP 1935-43 499,452 499,452 0100003. 41 CSO 2.75% 1944-47 505,686 505,686 0100004. 41 CSO 2.5% NLP 1948-64 1,928,538 1,928,538 0100005. 41 CSO 2.5% CRVM 1948-64 2,213,193 2,213,193 0100006. 58 CSO 5.5% NLP ALB CRF (SP INT SENS) 83-84 2,380,986 2,380,986 0100007. 58 CSO 5.5% NLP ALB CNF (SP INT SENS) 83-84 2,608,363 2,608,363 0100008. 58 CSO 4.5% NLP ALB CRF 1980-85 88,909 88,909 0100009. 58 CSO 4.5% CRVM ALB CRF 1982-86 271,145 271,145 0100010. 58 CSO 4.5% CRVM ALB CNF 1983-87 42,425,132 42,425,132 0100011. 58 CSO 4% NLP ALB CRF 1978-84 9,592 9,592 0100012. 58 CSO 4% CRVM ALB CRF 1977-84 150,499 150,499 0100013. 58 CSO 3% NLP ALB CRF 1965-87 509,375 509,375 0100014. 58 CSO 3% 5 CRVM - 20 NLP ALB CRF 1965-87 847,152 847,152 0100015. 58 CSO 3% 10 CRVM - 20 NLP ALB CRF 1965-84 486,737 486,737 0100016. 58 CSO 2.5% NLP ALB CRF 1965-87 2,700,669 2,700,669 0100017. 58 CS0 2.5% 5 CRVM - 20 NLP ALB CRF 1965-84 5,741,780 5,741,780 0100018. 58 CS0 2.5% CRVM ALB CRF 1965-87 67,001 67,001 0100019. 58 CET 4.5% ALB CRF 1983-87 65,922 65,922 0100020. 58 CET 3% ALB CRF 1965-87 11,441 11,441 0100021. 58 CET 2.5% ALB CRF 1965-84 88,052 88,052 0100022. 80 CSO 6% CRVM ALB CRF (Fl Pr UL) 1984-86 8,317,391 8,317,391 0100023. 80 CSO 6% S&U CRVM ALB CNF 1985-93 86,349 86,349 0100024. 80 CSO 5.5% NLP ALB CRF 1987-92 578 578 0100025. 80 CSO 5.5% CRVM ALB CNF (Fl Pr UL) 1987-89 2,721,459 2,721,459 0100026. 80 CSO 5.5% CRVM ALB CNF (Fx Pr UL) 1988-92 1,936,580 1,936,580 0100027. 80 CSO 5% NLP ALB CRF AFTER 1992 4,233 4,233 0100028. 80 CSO 5% CRVM ALB CNF (Fixed Prem UL) 1993 452,670 452,670 0100029. 80 CSO 5% S&U CRVM ALB CNF 1993-94 14,477 14,477 0100030. 80 CSO 4% NLP ALB CRF AFTER 1987 1,190 1,190 0100031. 80 CSO 4.5% NLP ALB CRF AFTER 1987 323 323 0100032. 80 CSO 4.5% CRVM ALB CNF (Fl Pr UL) AFTER 94 943,245 943,245 0100033. 80 CSO 4.5% S&U CRVM ALB CNF AFTER 1994 160,029,335 160,029,335 0100034. 80 CSO 4.5% S&U CRVM ANB CNF AFTER 1998 1,918,691 1,918,691 0100035. 80 CSO 4.0% S&U CRVM ALB CNF AFTER 2005 8,790,633 8,790,633 0100036. 80 CSO 4.0% NLP ANB CNF AFTER 1998 77 77 0100037. 80 CSO 4.0% CRVM ANB CNF (Fl Pr UL) AFTER 98 44,727,483 44,727,483 0100038. 80 CET 4.5% ALB CNF AFTER 1984 1,435 1,435 0100039. 2001 CSO 4.0% CRVM ANB CNF (Fl Pr UL) 56,031,198 56,031,198 0100040. 2001 CSO 3.5% CRVM ANB CNF (FI Pr UL) 7,518,191 7,518,191

0199997. Totals (Gross) 357,164,065 357,164,065

0199998. Reinsurance ceded 31,887,210 31,887,210

0199999. Life Insurance: Totals (Net) 325,276,855 325,276,855

ANNUITIES (excluding supplementary contracts with life contingencies):

0200001. 37 SA(-2) 2.5%; DEF PD 3% 1965-78 1,300 XXX 1,300 XXX 0200002. 37 SA(-2) 3.0%; DEF PD 3% 1969-78 (PTS) 159,564 XXX 159,564 XXX 0200003. 37 SA(-2) 3.0%; DEF PD 4% 78-82 (FPA/SPA) 104,838 XXX 104,838 XXX 0200004. A-1949 PROJ 10 YRS, 3.25% PRIOR 76 (SPIA) 2,609 XXX 2,609 XXX 0200005. 71 IAM 6.00% 1976-81 (SPIA) 9,977 XXX 9,977 XXX 0200006. 71 IAM 7.50% 1982-84 (SPIA) 32,679 XXX 32,679 XXX 0200007. 83A 6.25% 1998 (SPIA) 401,279 XXX 401,279 XXX 0200008. 83A 6.50% 1994 (SPIA) 96,335 XXX 96,335 XXX 0200009. 83A 6.75% 1996-97 (SPIA) 658,598 XXX 658,598 XXX 0200010. 83A 7.00% 1993 (SPIA) 211,174 XXX 211,174 XXX 0200011. 83A 7.25% 1995 (SPIA) 342,280 XXX 342,280 XXX 0200012. 83A 7.75% 1992 (SPIA) 108,411 XXX 108,411 XXX 0200013. 83A 8.00% 1987 (SPIA) 127,942 XXX 127,942 XXX 0200014. 83A 8.25% 1990-91 (SPIA) 264,731 XXX 264,731 XXX 0200015. 83A 8.75% 1988-89 (SPIA) 60,768 XXX 60,768 XXX 0200016. 83A 9.25% 1986 (SPIA) 217,021 XXX 217,021 XXX 0200017. 83A 11.00% 1986 (SPIA) 63,395 XXX 63,395 XXX 0200018. 2000A 6.00% 2003 (SPIA) 129,099 XXX 129,099 XXX 0200019. 2000A 6.25% 1999 (SPIA) 495,852 XXX 495,852 XXX 0200020. 2000A 6.50% 2002 (SPIA) 267,928 XXX 267,928 XXX 0200021. 2000A 6.75% 2001 (SPIA) 446,820 XXX 446,820 XXX 0200022. 2000A 7.00% 2000 (SPIA) 726,818 XXX 726,818 XXX 0200023. 71 GAM 6% - PREV PENS PLAN FOR AGENTS 74,583 XXX XXX 74,583 0200024. 37 SA(-2) 3.0%; DEF PD CI W/ 3% GUAR 26,669,105 XXX 26,669,105 XXX 0200025. 37 SA(-2) 3.0%; DEF PD CI W/ 4.5% GUAR 58,991,611 XXX 58,991,611 XXX 0200026. 1983 (F+1) 3.00% DEF PD. C1 W/4.00% GUAR 6,865,738 XXX 6,865,738 XXX 0200027. 1983 (F+1) 3.00% DEF PD. C1 W/3.00% GUAR 592,856 XXX 592,856 XXX

0299997. Totals (Gross) 98,123,311 XXX 98,048,728 XXX 74,583

0299998. Reinsurance ceded XXX XXX

0299999. Annuities: Totals (Net) 98,123,311 XXX 98,048,728 XXX 74,583

SUPPLEMENTARY CONTRACTS WITH LIFE CONTINGENCIES:

0300001. 83A 8.00%; GUAR PD 8.25% 21,966 21,966

0399997. Totals (Gross) 21,966 21,966

0399998. Reinsurance ceded

0399999. SCWLC: Totals (Net) 21,966 21,966

ACCIDENTAL DEATH BENEFITS:

0400001. 59 ADB W/ 58 CSO 2.50% 1965-87 34,265 34,265 0400002. 59 ADB W/ 80 CSO 4.50% AFTER 1984 10,083 10,083

0499997. Totals (Gross) 44,348 44,348

0499998. Reinsurance ceded 164 164

0499999. Accidental Death Benefits: Totals (Net) 44,184 44,184

DISABILITY-ACTIVE LIVES:

0500001. 150% MOD 26 CLASS (3) W/ 41CSO 2.50% 48-64 58 58 0500002. 52 DIS PD 2, BEN 5 W/ 58 CSO 2.50% 65-87 34,392 34,392 0500003. 52 DIS PD 2, BEN 5 W/ 80 CSO 4.50% AFTER 84 57,200 57,200

12


EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS1

Valuation Standard

2

Total

3

Industrial

4

Ordinary

5Credit

(Group and Individual)

6

Group

0500004. 52 DIS PD 2, BEN 5 W/ 2001 CSO 4.0% 39 39 0599997. Totals (Gross) 91,689 91,689 0599998. Reinsurance ceded 26,094 26,094 0599999. Disability-Active Lives: Totals (Net) 65,595 65,595 DISABILITY-DISABLED LIVES:

0600001. 52 INTERCO DISA (P2.2, BEN 5) 2.50% 733,344 717,934 15,410 0699997. Totals (Gross) 733,344 717,934 15,410 0699998. Reinsurance ceded 79,536 64,126 15,410 0699999. Disability-Disabled Lives: Totals (Net) 653,808 653,808 MISCELLANEOUS RESERVES:

0700001. For excess of valuation net premiums over

corresponding gross premiums on respective

policies, computed according to the standard

of valuation required by this

state................... 3,248,326 3,248,326 0700002. For non-deduction of deferred fractional

premiums or return of premiums at the death of

the insured........................ 50,182 50,182 0700003. For surrender values in excess of reserves

otherwise required and carried in this

schedule.......................................

281,412 281,412 0700004. Additional actuarial reserves-Asset/liability

analysis............... 16,000,000 16,000,000 0799997. Totals (Gross) 19,579,920 19,579,920 0799998. Reinsurance ceded 49,430 49,430 0799999. Miscellaneous Reserves: Totals (Net) 19,530,490 19,530,490 9999999. Totals (Net) - Page 3, Line 1 443,716,209 443,641,626 74,583

12.1


EXHIBIT 5 - INTERROGATORIES

1.1 Has the reporting entity ever issued both participating and non-participating contracts? Yes [ ] No [ X ]1.2 If not, state which kind is issued.

Participating 2.1 Does the reporting entity at present issue both participating and non-participating contracts? Yes [ ] No [ X ]2.2 If not, state which kind is issued.

Participating 3. 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:

4.1 Amount of insurance? $ 4.2 Amount of reserve? $ 4.3 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 ]

6.1 If so, state the amount of reserve on such contracts on the basis actually held: $ 6.2 That would have been held (on an exact or approximate basis) using the actual ages of the annuitants; the interest rate(s) used in 6.1; 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 31 of the current year? Yes [ ] No [ X ]7.1 If yes, state the total dollar amount of assets covered by these contracts or agreements $ 7.2 Specify the basis (fair value, amortized cost, etc.) for determining the amount:

7.3 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 31 of the current year? Yes [ ] No [ X ]

8.1 If yes, state the total dollar amount of account value covered by these contracts or agreements: $ 8.2 State the amount of reserves established for this business: $ 8.3 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 31 of the

current year? Yes [ ] No [ X ]9.1 If yes, state the total dollar amount of any account value associated with these contracts, agreements or riders: $ 9.2 State the amount of reserves established for this business: $ 9.3 Identify where the reserves are reported in the blank:

EXHIBIT 5A - CHANGES IN BASES OF VALUATION DURING THE YEAR1 Valuation Basis 4

Description of Valuation Class

2

Changed From

3

Changed To

Increase in Actuarial Reserve Due to

Change

9999999 - Total (Column 4, only) NONE

13


EXHIBIT 6 - AGGREGATE RESERVES FOR ACCIDENT AND HEALTH CONTRACTS1 2 3 4 Other Individual Contracts

TotalGroup Accident

and Health

Credit Accidentand Health

(Group and Individual)CollectivelyRenewable

5

Non-Cancelable

6Guaranteed Renewable

7Non-Renewable for

Stated Reasons Only

8

Other Accident Only

9

All Other

ACTIVE LIFE RESERVE

1. Unearned premium reserves

2. Additional contract reserves (a) 12,758 204 12,554

3. 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) 12,758 204 12,554

8. Reinsurance ceded 11,385 11,385

9. Totals (Net) 1,373 204 1,169

CLAIM RESERVE

10. Present value of amounts not yet due on claims

11. Additional actuarial reserves-Asset/Liability analysis

12. Reserve for future contingent benefits

13. Aggregate write-ins for reserves

14. Totals (Gross)


16. Totals (Net)

17. TOTAL (Net) 1,373 204 1,169

18. TABULAR FUND INTEREST 55 8 47


0601.

0602.

0603.


0699. TOTALS (Lines 0601 thru 0603 plus 0698) (Line 6 above)

1301.

1302.

1303.



(a) Attach statement as to valuation standard used in calculating this reserve, specifying reserve bases, interest rates and methods.

14


14.1

Pioneer Mutual Life Insurance Company

Supplemental Statement Regarding Additional Reserves – Accident and Health

December 31, 2018

Additional reserves are calculated as mid-terminal reserves on the following basis, if applicable:

(1) (a) Disability Income Policies issued prior to 1991 - 1964 Commissioners Disability with

1958 CSO, 3%; Net Level Premium Method for group and 2 year Preliminary Term for

individual Policies.

(b) Disability Income Policies issued 1991 and after - 1985 CIDA with 1980 CSO, 5.5%; 2

Year Preliminary Term.

(2) Major Medical - 2 Year Preliminary Term; mean reserve computed from claim cost

factors (combined with 1958 CSO at 3%) based on projected intercompany experience as

contained in Nelson and Warren Major Medical Expense Benefit book, Volume II, pages

70 ff.

(3) Accidental Death and Dismemberment - 1959 ADB with 1958 CSO, 3%.

(4) Hospital Indemnity - 2 Year Preliminary Term, based upon 1956 Intercompany Hospital

Table with 1958 CSO, 3%.

(5) (a) Long Term Care Issued Before 1/1/2000 - 2 Year Preliminary Term, based upon

anticipated experience combined with 1980 CSO, 4%.

(b) Long Term Care Issued After 1/1/2000

(i) Claim Reserves at 4.50% using 1985 Nursing Home Study

(ii) Active Life Reserves 1983 GAM at 4.50%


EXHIBIT 7 - DEPOSIT TYPE CONTRACTS1

Total

2

GuaranteedInterest Contracts

3

Annuities Certain

4

Supplemental Contracts

5Dividend

Accumulations or Refunds

6Premium and

OtherDeposit Funds

1. Balance at the beginning of the year before reinsurance 13,574,270 2,932,257 8,659,359 1,982,654

2. Deposits received during the year 1,034,782 692,270 181,087 161,425

3. Investment earnings credited to the account 343,847 27,560 263,106 53,181

4. Other net change in reserves (7,271) (7,271)

5. Fees and other charges assessed

6. Surrender charges

7. Net surrender or withdrawal payments 2,441,309 1,277,920 583,537 579,852

8. Other net transfers to or (from) Separate Accounts

9. Balance at the end of current year before reinsurance (Lines 1+2+3+4-5-6-7-8) 12,504,319 2,366,896 8,520,015 1,617,408

10. Reinsurance balance at the beginning of the year

11. Net change in reinsurance assumed

12. Net change in reinsurance ceded

13. Reinsurance balance at the end of the year (Lines 10+11-12)

14. Net balance at the end of current year after reinsurance (Lines 9 + 13) 12,504,319 2,366,896 8,520,015 1,617,408

15


EXHIBIT 8 - CLAIMS FOR LIFE AND ACCIDENT AND HEALTH CONTRACTSPART 1 - Liability End of Current Year

1 2 Ordinary 6 Group Accident and Health


3

Life Insurance

4


5Supplementary

ContractsCredit Life (Group

and Individual)

7

Life Insurance

8

Annuities

9

Group

10Credit (Group and

Individual)

11

Other

1. Due and unpaid:

1.1 Direct



1.4 Net

2. In course of settlement:

2.1 Resisted 2.11 Direct



2.14 Net (b) (b) (b) (b)

2.2 Other 2.21 Direct 1,253,909 1,253,909



2.24 Net 615,690 (b) 615,690 (b) (b) (b) (b) (b) (b)

3. Incurred but unreported:

3.1 Direct 1,200,546 1,200,546



3.4 Net 614,504 (b) 614,504 (b) (b) (b) (b) (b) (b)

4. TOTALS 4.1 Direct 2,454,455 2,454,455



4.4 Net 1,230,194 (a) (a) 1,230,194 (a)

(a) Including matured endowments (but not guaranteed annual pure endowments) unpaid amounting to $ in Column 2, $ in Column 3 and $ in Column 7.

(b) Include only portion of disability and accident and health claim liabilities applicable to assumed "accrued" benefits. Reserves (including reinsurance assumed and net of reinsurance ceded) for unaccrued benefits for Ordinary Life Insurance $ 653,808

Individual Annuities $ , Credit Life (Group and Individual) $ , and Group Life $ , are included in Page 3, Line 1, (See Exhibit 5, Section on Disability Disabled Lives); and for Group Accident and Health $

Credit (Group and Individual) Accident and Health $ , and Other Accident and Health $ are included in Page 3, Line 2 (See Exhibit 6, Claim Reserve).

16


EXHIBIT 8 - CLAIMS FOR LIFE AND ACCIDENT AND HEALTH CONTRACTSPART 2 - Incurred During the Year

1 2 Ordinary 6 Group Accident and Health

TotalIndustrial Life

(a)

3Life Insurance

(b)

4


5Supplementary

ContractsCredit Life (Group

and Individual)

7Life Insurance

(c)

8

Annuities

9

Group

10Credit (Groupand Individual)

11

Other

1. Settlements During the Year:

1.1 Direct 27,011,541 21,653,542 5,325,121 6,000 14,638 12,240



1.4 Net (d) 19,488,004 14,130,005 5,325,121 6,000 14,638 12,240

2. Liability December 31, current year from Part 1:

2.1 Direct 2,454,455 2,454,455



2.4 Net 1,230,194 1,230,194

3. Amounts recoverable from reinsurers December 31, current year 473,511 473,511

4. Liability December 31, prior year:

4.1 Direct 3,837,088 3,837,088



4.4 Net 3,121,106 3,121,106

5. Amounts recoverable from reinsurers December 31, prior year 2,770,284 2,770,284

6. Incurred Benefits

6.1 Direct 25,628,908 20,270,909 5,325,121 6,000 14,638 12,240



6.4 Net 19,893,865 14,535,866 5,325,121 6,000 14,638 12,240

(a) Including matured endowments (but not guaranteed annual pure endowments) amounting to $ in Line 1.1, $ in Line 1.4.

$ in Line 6.1, and $ in Line 6.4.

(b) Including matured endowments (but not guaranteed annual pure endowments) amounting to $ 60,785 in Line 1.1, $ 60,785 in Line 1.4.

$ 60,785 in Line 6.1, and $ 60,785 in Line 6.4.

(c) Including matured endowments (but not guaranteed annual pure endowments) amounting to $ in Line 1.1, $ in Line 1.4.

$ in Line 6.1, and $ in Line 6.4.

(d) Includes $ 17,088 premiums waived under total and permanent disability benefits.

17


EXHIBIT OF NON-ADMITTED ASSETS1

Current Year Total Nonadmitted Assets

2

Prior Year Total Nonadmitted Assets

3Change in Total

Nonadmitted Assets (Col. 2 - Col. 1)

1. Bonds (Schedule D)

2. Stocks (Schedule D):


2.2 Common stocks

3. Mortgage loans on real estate (Schedule B):

3.1 First liens

3.2 Other than first liens

4. Real estate (Schedule A):

4.1 Properties occupied by the company

4.2 Properties held for the production of income

4.3 Properties held for sale

5. Cash (Schedule E - Part 1), cash equivalents (Schedule E - Part 2) and short-term investments (Schedule DA)

6. Contract loans

7. Derivatives (Schedule DB)

8. Other invested assets (Schedule BA)

9. Receivables for securities

10. Securities lending reinvested collateral assets (Schedule DL)

11. Aggregate write-ins for invested assets

12. Subtotals, cash and invested assets (Lines 1 to 11)

13. Title plants (for Title insurers only)

14. Investment income due and accrued

15. Premiums and considerations:

15.1 Uncollected premiums and agents' balances in the course of collection

15.2 Deferred premiums, agents' balances and installments booked but deferred and not yet due

15.3 Accrued retrospective premiums and contracts subject to redetermination

16. Reinsurance:

16.1 Amounts recoverable from reinsurers

16.2 Funds held by or deposited with reinsured companies

16.3 Other amounts receivable under reinsurance contracts

17. Amounts receivable relating to uninsured plans

18.1 Current federal and foreign income tax recoverable and interest thereon

18.2 Net deferred tax asset 5,305,699 6,698,841 1,393,142

19. Guaranty funds receivable or on deposit

20. Electronic data processing equipment and software

21. Furniture and equipment, including health care delivery assets

22. Net adjustment in assets and liabilities due to foreign exchange rates

23. Receivables from parent, subsidiaries and affiliates

24. Health care and other amounts receivable

25. Aggregate write-ins for other than invested assets 349,394 626,608 277,214

26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 5,655,093 7,325,449 1,670,356

27. From Separate Accounts, Segregated Accounts and Protected Cell Accounts

28. Total (Lines 26 and 27) 5,655,093 7,325,449 1,670,356


1101.

1102.

1103.


1199. Totals (Lines 1101 thru 1103 plus 1198)(Line 11 above)

2501. Accrued group income 342,612 68,784 (273,828)

2502. Miscellaneous assets 4,532 555,574 551,042

2503. Prepaid expenses 2,250 2,250


2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 349,394 626,608 277,214

18


19

NOTES TO FINANCIAL STATEMENTS

Note # Description

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35 Loss/Claim Adjustment Expenses

Participating Policies

Premium Deficiency Reserves

Reserves for Life Contracts and Annuity Contracts

Analysis of Annuity Actuarial Reserves and Deposit Type Liabilities by Withdrawal Characteristics

Premium and Annuity Considerations Deferred and Uncollected

Separate Accounts

Intercompany Pooling Arrangements

Structured Settlements

Heath Care Receivables

Sale, Transfer and Servicing of Financial Assets and Extinguishments of Liabilities

Gain or Loss to the Reporting Entity from Uninsured Plans and the Uninsured Portion of Partially Insured Plans

Direct Premium Written/Produced by Managing General Agents/Third Party Administrators

Fair Value Measurement

Other Items

Events Subsequent

Reinsurance

Change in Incurred Losses and Loss Adjustment Expenses

Retrospectively Rated Contracts & Contracts Subject to Redetermination

Information About Financial Instruments With Off-Balance Sheet Risk and Financial Instruments With Concentrations of Credit Risk

Debt

Capital and Surplus, Shareholders’ Dividend Restrictions and Quasi-Reorganizations

Liabilities, Contingencies and Assessments

Summary of Significant Accounting Policies and Going Concern

Accounting Changes and Corrections of Errors

Business Combinations and Goodwill

Discontinued Operations

Investments

Joint Ventures, Partnerships and Limited Liability Companies

Leases

Investment Income

Derivative Instruments

Income Taxes

Information Concerning Parent, Subsidiaries and Affiliates

Retirement Plans, Deferred Compensation, Postemployment Benefits and Compensated Absences and Other Postretirement Benefit Plans

1. Summary of Significant Accounting Policies and Going Concern

A. Accounting Practices

The accompanying financial statements of Pioneer Mutual Life Insurance Company (the “Company”), have been prepared in conformity with the National Association of Insurance Commissioners (“NAIC”) Annual Statement Instructions and Accounting

Practices and Procedures manuals, except to the extent that state laws may differ. The statements are also prepared in conformity with accounting practices prescribed or permitted by the Insurance Department of North Dakota. The Company does not have any permitted practices.

SSAP# F/S Pg F/S Line # 12/31/2018 12/31/2017

(1) State basis (Page 4, line 35, Columns 1 & 2) XXX XXX XXX 9,089,956$ (6,640,042)$

(2) State prescribed practice that increases/(decreases) NAIC SAP - - - - -

(3) State permitted practice that increases/(decreases) NAIC SAP - - - - -

(4) NAIC SAP XXX XXX XXX 9,089,956$ (6,640,042)$

Surplus

(5) State basis (Page 3, line 38, Columns 1 & 2) XXX XXX XXX 46,897,320$ 37,487,686$

(6) State prescribed practice that increases/(decreases) NAIC SAP - - - - -

(7) State permitted practice that increases/(decreases) NAIC SAP - - - - -

(8) NAIC SAP XXX XXX XXX 46,897,320$ 37,487,686$

Net Income


19.1


B. Use of Estimates in the Preparation of the Financial Statements

The preparation of financial statements in conformity with the Statutory Accounting Principles prescribed or permitted by the Insurance Department of North Dakota requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. It also requires disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the period. Actual results could differ from those estimates.

C. Accounting Policy

Life premiums are recognized as income over the premium paying period of the related policies. Annuity considerations are recognized as revenue when received. Expenses incurred in connection with acquiring new insurance business, including acquisition costs such as sales commissions, are charged to operations as incurred.

The amount of dividends to be paid to policyholders is determined annually by the Company’s Board of Directors. The aggregate amount of policyholders’ dividends is related to actual interest, mortality, morbidity, and expense experience for the year and judgment as to the appropriate level of statutory surplus to be retained by the Company.

In addition, the Company uses the following accounting policies:

(1) Short-term investments are stated at amortized cost. (2) The Company holds fixed income ETFs that are classified as SVO-identified securities in the 2018 Annual Statement. The

Company made the election to use the systematic value approach to account for all of the SVO-identified investments beginning January 1, 2018, published in exhibit B of SSAP No. 26R.

(3) The Company has no common stock. (4) The Company has no preferred stock. (5) Mortgage loans on real estate are stated at amortized cost. (6) Loan-backed securities are stated at amortized cost using the interest method including anticipated prepayments at the date of

purchase. The retrospective adjustment method is used to value all mortgage-backed securities. (7) The Company does not have non-insurance subsidiaries. (8) The Company does not have ownership interests in joint ventures, partnerships or limited liability companies. (9) The Company has no derivative investments. (10) Anticipated investment income as a factor in the premium deficiency calculations - not applicable. (11) Unpaid losses and loss adjustment expenses include an amount determined from individual case estimates and loss reports and an

amount, based on past experience, for losses incurred but not reported. Such liabilities are necessarily based on assumptions and estimates and while management believes the amount is adequate, the ultimate liability may be in excess of or less than the amount provided. The methods for making such estimates and for establishing the resulting liability are continually reviewed and any adjustments are reflected in the period determined.

(12) The Company has not modified its capitalization policy from the prior period. (13) The Company does not have any pharmaceutical rebate receivables.

D. Going Concern – not applicable.

2. Accounting Changes and Corrections of Errors

A. Correction of Errors

In 2018, the Company identified and corrected an out of period error related to surrendered policies which were not fully accounted for at the time of surrender. As a result of this error, prior year surplus and current federal tax were overstated $139,981 and $37,210, respectively, and surrenders were understated $177,191 as of December 31, 2017. The error was corrected as a direct decrease to surplus, net of the current tax impact.

In 2017, the Company identified and corrected an out of period error of $654,037 in unbilled ceded death claims (Death Benefits), $568,523 of ceded premium overpayments (Premiums), and $711,332 of unbilled surrenders on ceded reinsurance (Surrender Benefits). The tax effect impacted current federal taxes incurred by $676,862 (Current Federal Income Tax). As a result of these errors, prior year surplus was understated $1,257,030. The errors were corrected as a direct increase to surplus.

In 2017, the Company identified and corrected an error in modeling the additional actuarial reserves for asset/liability analysis related to a block of universal life policies with secondary guarantees. As a result, the prior year reserve was understated by $2,217,000 as of December 31, 2016. The error was corrected as a direct decrease to surplus. There was no current tax impact.Cumulative Effect of Changes in Accounting Principles

B. Cumulative Effect of Changes in Accounting Principles

The Company elected the use of systematic value measurement method for SVO-identified investments as the statutory carrying value of these investments as of January 1, 2018. The change from the prior measurement method of carrying these investments at cost to systematic value, which is a new measurement concept, is a change in accounting principle under SSAP 3. This did not have an impact to surplus as of January 1, 2018.

During 2017, the Company refined its approach of estimating the realization of deferred tax assets which is treated as a change in accounting principle under SSAP 101. This change provides a better matching of the reported deferred tax asset and its recognition. This change resulted in a cumulative adjustment that increased surplus by $454,711 during 2017.

19.1


19.2

3. Business Combinations and Goodwill

A. Statutory Purchase Method – not applicable. B. Statutory Merger – not applicable. C. Assumption Reinsurance – not applicable. D. Impairment Loss – not applicable.

4. Discontinued Operations – not applicable.

5. Investments

A. Mortgage Loans, including Mezzanine Real Estate Loans 1) There were no new mortgage loans made during 2018. 2) There were no new mortgage loans made during 2018.

12/31/2018 12/31/2017

3) Taxes, assessments and any amounts advanced and not included in the mortgage loan total: -$ -$

4) Age Analysis of Mortgage Loans and Identification of Mortgage Loans in Which the Insurer is a Participant or Co-Lender in a Mortgage Loan Agreement:

Farm Insured All Other Insured All Other Mezzanine Total

a. Current year

1. Recorded Investment

a Current -$ -$ -$ -$ 10,597,324$ -$ 10,597,324$

b 30-59 days past due - - - - - - -

c 60-89 days past due - - - - - - -

d 90-179 days past due - - - - - - -

e 180+ days past due - - - - - - -

2. Accruing interest 90-179 days past due

a Recorded investment -$ -$ -$ -$ -$ -$ -$

b Interest accrued - - - - - - -

3. Accruing interest 180+ days past due



4. Interest reduced



c Percent reduced 0% 0% 0% 0% 0% 0% 0%

5.


b Prior year

1. Recorded Investment

a Current -$ -$ -$ -$ 13,532,793$ -$ 13,532,793$

b 30-59 days past due - - - - - - -

c 60-89 days past due - - - - - - -

d 90-179 days past due - - - - - - -

e 180+ days past due - - - - - - -

2. Accruing interest 90-179 days past due



3. Accruing interest 180+ days past due



4. Interest reduced



c Percent reduced 0% 0% 0% 0% 0% 0% 0%

5.


5)

a. Current year

1. Recorded InvestmentWith allowance for credit losses -$ -$ -$ -$ -$ -$ -$

2. No allowance for credit losses - - - - - - -

3. Total (1+2) - - - - - - -

4.

- - - - - - -

b Prior year

1. Recorded InvestmentWith allowance for credit losses -$ -$ -$ -$ -$ -$ -$

2. No allowance for credit losses - - - - - - -

3. Total (1+2) - - - - - - -

4.

- - - - - - -

6)

a. Current year

1. Recorded InvestmentAverage recorded investment -$ -$ -$ -$ -$ -$ -$

2. Interest income recognized - - - - - - -

3. - - - - - - -

4. - - - - - - -

b Prior year

1. Recorded InvestmentAverage recorded investment -$ -$ -$ -$ -$ -$ -$

2. Interest income recognized - - - - - - -

3. - - - - - - -

4. - - - - - - -

7) Allowance for Credit Losses: 12/31/2018 12/31/2017

a Balance at beginning of period -$ -$

b Additions charged to operations - -

c Direct write-downs charged against the allowance - -

d Recoveries amounts previously charges off - -

e Balance at end of period -$ -$

8) Mortgage Loans Derecognized as a Result of Foreclosure:

12/31/2018 12/31/2017

a Aggregate amount of mortgage loan derecognized -$ -$

b Real estate collateral recognized - -

c Other collateral recognized - -

d Receivable recognized from a government guarantee of the foreclosed mortgage loan -$ -$

Recorded investments on

nonaccrual statusAmount of interest income

recognized using a cash-basis

method of accounting

Residential

Invesment in Impaired Loans - Average Recorded Investment, Interest Income Recognized, Recorded Investment in Nonaccrual Status and Amount of Interest

Income Recognized Using a Cash-Basis Method of Accounting:

Commercial

Amount of interest income

recognized using a cash-basis

method of accounting

Recorded investments on

nonaccrual status

Investment in Impaired Loans With or Without Allowance for Credit Losses and Impaired Loans Subject to a Participant or Co-lender Mortgage Loan Agreement

for Which the Reporting Entity is Restricted from Unilaterally Foreclosing on the Mortgage Loan:

Subject to a participant or co-

lender mortgage loan agreement

for which the reporting is

restricted from unilaterally

foreclosing on the mortgage loan

Subject to a participant or co-

lender mortgage loan agreement

for which the reporting is

restricted from unilaterally

foreclosing on the mortgage loan

Participant or Co-lender in a

Mortgage Loan Agreement

Participant or Co-lender in a

Mortgage Loan Agreement


19.3

9) The Company would recognize income on impaired loans upon receipt, if applicable.

B) Debt Restructuring - the Company has no invested assets that are restructured debt.

C) Reverse Mortgages - the Company has no investment in reverse mortgages.

D) Loan-Backed Securities (1) Prepayment assumptions for mortgage-backed securities were obtained from BlackRock prepayment models.

(2)

Amortized Cost

Basis Before

Other-Than

Other-than-Temporary Impairment

Recognized in Loss

Temporary

Impairment 2a Interest 2b Non-Interest

Fair Value

1 - (2a + 2b)

OTTI recognized 1st Quarter

a. Intent to sell -$ -$ -$ -$

b. Inability or lack of intent to retain the

investment in the security for a

period of time sufficient to recover

the amortized cost basis

- - - -

c. Total 1st Quarter -$ -$ -$ -$

OTTI recognized 2nd Quarter

d. Intent to sell -$ -$ -$ -$

e. Inability or lack of intent to retain the




- - - -

f. Total 2nd Quarter -$ -$ -$ -$

OTTI recognized 3rd Quarter

g. Intent to sell -$ -$ -$ -$

h. Inability or lack of intent to retain the




- - - -

i. Total 3rd Quarter -$ -$ -$ -$

OTTI recognized 4th Quarter

j. Intent to sell -$ -$ -$ -$

k. Inability or lack of intent to retain the




- - - -

l. Total 4th Quarter -$ -$ -$ -$

m. Annual Aggregate Total -$ -$ -$ -$

In the aggregate, securities with a recognized other-than-temporary impairment – not applicable.

(3) For each security, with a recognized other-then-temporary impairment – not applicable.

CUSIP

Book/Adjusted

Carrying Value

Amortized Cost

Before Current

Period OTTI

Present Value

of Projected

Cash Flows

Recognized

Other-Than-

Temporary

Impairment

Amortized Cost

After Other-

Than-

Temporary

Impairment

Fair Value at

time of OTTI

Date of

Financial

Statement

Where Reported

-$ -$ -$ -$ -$ na

- - - - - na

Total -$ -$ -$ -$ -$ na

(4) Loan-backed securities owned at December 31, 2018 with a fair value lower than amortized cost for which an other-than-

temporary impairment has not been recognized in earnings as a realized loss are summarized below by length of time the

securities have been in a continuous unrealized loss position.

a. The aggregate amount of unrealized losses:

1. Less than 12 Months 280,923$

2. 12 Months or Longer 1,925,371$

b. The aggregate related fair value of securities with unrealized

losses:

1. Less than 12 Months 11,647,637$

2. 12 Months or Longer 42,392,750$

(5) In accordance with the Company’s investment impairment policy, factors considered in determining whether declines in the fair value of loan-backed securities are other-than-temporary include 1) the significance of the decline, 2) the intent to sell the investment and likelihood the Company will be required to sell the security before recovery of its amortized cost, 3) the time period during which there has been a significant decline in value, and 4) whether the Company expects to receive all contractual cash flows.


19.4

E) Dollar Repurchase Agreements and/or Securities Lending Transactions

The Company policy requires a minimum of 102% of the fair value of securities purchased under repurchase agreements to be maintained as collateral. The Company had no repurchase agreements at year end.

Securities Lending Transactions – not applicable.

F) Repurchase Agreements Transactions Accounted for as Secured Borrowing – not applicable.

G) Reverse Repurchase Agreements Transactions Accounted for as Secured Borrowing – not applicable.

H) Repurchase Agreements Transactions Accounted for as a Sale– not applicable.

I) Reverse Repurchase Agreements Transactions Accounted for as a Sale – not applicable.

J) Real Estate- not applicable

K) Low-income Housing Tax Credits – not applicable. L) Restricted Assets

(1) Restricted Assets (Including Pledged)

1 2 3 4 5 6 7

Restricted Asset Category

Total General

Account (G/A)

G/A Supporting

S/A Activity (a)

Total Separate

Account (S/A)

Restricted Assets

S/A Assets

Supporting (G/A)

Activity (b) Total (1 + 3)

Total from Prior

Year

Increase/

(Decrease)

(5 minus 6)

a

Subject to contractual obligation for which liability is not

shown -$ -$ -$ -$ -$ -$ -$

b Collateral held under security lending agreement - - - - - - -

c Subject to repurchase agreement - - - - - - -

d Subject to reverse repurchase agreement - - - - - - -

e Subject to dollar repurchase agreements - - - - - - -

f Subject to dollar reverse repurchase agreement - - - - - - -

g Placed under option contracts - - - - - - -

h Letter stock or securities restricted as to sale - - - - - - -

i FHLB capital stock - - - - - - -

j On deposit with states 4,170,619 - - - 4,170,619 4,104,481 66,138

k On deposit with other regulatory bodies - - - - - - -

l Pledged collateral to FHLB - - - - - - -

m Pledged as collateral not captured in other categories - - - - - - -

n Other restricted assets - - - - - - -

o Total Restricted Assets 4,170,619$ -$ -$ -$ 4,170,619$ 4,104,481$ 66,138$

(a) subset of column 1

(b) subset of column 3

8 9 10 11


Total Nonadmitted

Restricted

Total Admitted

Resricted (5 -8)

Gross (Admitted &

Nonadmitted)

Restricted to Total

Assets ( c)

Admitted Restricted

to Total Admitted

Assets (d)

a

Subject to contractual obligation for which liability is not

shown -$ -$ 0.0% 0.0%

b Collateral held under security lending agreement - - 0.0% 0.0%

c Subject to repurchase agreement - - 0.0% 0.0%

d Subject to reverse repurchase agreement - - 0.0% 0.0%

e Subject to dollar repurchase agreements - - 0.0% 0.0%

f Subject to dollar reverse repurchase agreement - - 0.0% 0.0%

g Placed under option contracts - - 0.0% 0.0%

h Letter stock or securities restricted as to sale - - 0.0% 0.0%

i FHLB capital stock - - 0.0% 0.0%

j On deposit with states - 4,170,619 0.8% 0.8%

k On deposit with other regulatory bodies - - 0.0% 0.0%

l Pledged collateral to FHLB - - 0.0% 0.0%

m Pledged as collateral not captured in other categories - - 0.0% 0.0%

n Other restricted assets - - 0.0% 0.0%

o Total Restricted Assets -$ 4,170,619$ 0.8% 0.8%

(c) column 5 divided by Asset Page, column 1, line 28

(d) column 9 divided by Asset Page, column 3, line 28

Gross Admitted & Nonadmitted Restricted

Current Year

Current Year

Percentage

(2) Details of assets pledged as collateral not captured in other categories

1 2 3 4 5 6 7 8 9 10


Total General

Account (G/A)

G/A Supporting

S/A Activity (a)

Total Separate

Account (S/A)

Restricted Activity

S/A Assets

Supporting (G/A)


Total from Prior

Year

Increase/

(Decrease)

(5 minus 6)

Total Current Year

Admitted Restricted

Gross Admitted &

Nonadmitted

Restricted to Total

Assets

Admitted Restricted

to Total Admitted

Assets

na -$ -$ -$ -$ -$ -$ -$ -$ 0% 0%

Total -$ -$ -$ -$ -$ -$ -$ -$ 0% 0%

(3) Detail of other restricted assets

1 2 3 4 5 6 7 8 9 10


Total General

Account (G/A)

G/A Supporting

S/A Activity (a)

Total Separate

Account (S/A)

Restricted Activity

S/A Assets

Supporting (G/A)


Total from Prior

Year

Increase/

(Decrease)

(5 minus 6)

Total Current Year

Admitted Restricted

Gross Admitted and

Nonadmitted

Restricted to Total

Assets

Admitted Restricted

to Total Admitted

Assets

na -$ -$ -$ -$ -$ -$ -$ -$

Total -$ -$ -$ -$ -$ -$ -$ -$ 0% 0%

Current Year

Gross Admitted & Nonadmitted Restricted Percentage

Current Year

Gross Admitted & Nonadmitted Restricted Percentage


19.5

(4) Collateral Received and Reflected as Assets Within the Reporting Entity's Financial Statements

1 2 3 4

Collateral Assets

Book/Adjusted

Carrying Value

(BACV) Fair Value

% of BACV to Total

Assets (Admitted

and Nonadmitted)*

% of BACV to Total

Admitted Assets **

a Cash, Cash Equivalents and Short-Term Investments -$ -$ 0.0% 0.0%

b Schedule D, Part 1 - - 0.0% 0.0%

c Schedule D, Part 2, Section 1 - - 0.0% 0.0%

d Schedule D, Part 2, Section 2 - - 0.0% 0.0%

e Schedule B - - 0.0% 0.0%

f Schedule A - - 0.0% 0.0%

g Schedule BA, Part 1 - - 0.0% 0.0%

h Schedule DL, Part 1 - - 0.0% 0.0%

i Other - - 0.0% 0.0%

j Total Collateral Assets (a+b+c+d+e+f+g+h+i) -$ -$ 0.0% 0.0%

* column 1 divided by Asset Page, Line 26 (column 1)

** column 1 divided by Asset Page, Line 26 (column 3)

1 2

Amount

% of Liability to

Total Liabilities*

k Recognized Obligation to Return Collateral Asset -$ 0%* column 1 divided by Liability Page, Line 26 (column 1)

M) Working Capital Finance Investments – not applicable. N) Offsetting and Netting of Assets and Liabilities – not applicable.

O) Structured Notes – not applicable.

P) 5*GI Securities

Investment Current Year Prior Year Current Year Prior Year Current Year Prior Year

(1) Bonds - AC - - -$ -$ -$ -$

(2) LB&SS - AC - - - - - -

(3) Preferred Stock - AC - - - - - -

(4) Preferred Stock - FV - - - - - -

(5) Total (1+2+3+4) - - -$ -$ -$ -$

AC - Amortized Cost FV - Fair Value

Number of 5* Securities Aggregate BACV Aggregate Fair Value

Q) Short Sales – not applicable. R) Prepayment Penalty and Acceleration Fees Sales

General Amount Separate Account

(1) Number of CUSIPs 13 -

(2) Aggregate Amount of Investment Income 157,201 -

6. Joint Ventures, Partnerships and Limited Liability Companies

A. The Company has no investments in Joint Ventures, Partnerships or Limited Liability Companies that exceed 10% of its admitted assets.

B. The Company did not recognize any impairment write down for its investments in Joint Ventures, Partnerships and Limited Liability Companies during the statements periods.

7. Investment Income

A. Due and accrued income was excluded from investment income on the following bases: Mortgage loans - on loans in foreclosure, delinquent more than one year (unless insured) or where collection is uncertain. Bonds - where interest is in default, accrued interest on bonds ineligible for amortization. Other Invested Assets – where interest on surplus note holdings has not been approved by the Commissioner.

B. The total amount excluded was $19,464.

8. Derivative Instruments - the Company has no derivative instruments.


19.6

9. Income Taxes

A. (1). The components of the net admitted deferred tax asset recognized in the Company’s Assets, Liabilities, Surplus and Other Funds are as follows:

(1) (2) (3) (4) (5) (6) (7) (8) (9)

Ordinary Capital Total Ordinary Capital Total Ordinary Capital Total

(a) Gross deferred tax assets 8,539,580$ 135,851$ 8,675,431$ 9,848,406$ 135,851$ 9,984,257$ (1,308,826)$ -$ (1,308,826)$

(b) Less: valuation allowance - - - - - - - - -

(c) Gross deferred tax asset (a-b) 8,539,580$ 135,851$ 8,675,431$ 9,848,406$ 135,851$ 9,984,257$ (1,308,826)$ -$ (1,308,826)$

(d) Deferred tax asset nonadmitted 5,305,699 - 5,305,699 6,698,841 - 6,698,841 (1,393,142) - (1,393,142)

(e) Subtotal (c-d) 3,233,881 135,851 3,369,732 3,149,565 135,851 3,285,416 84,316 - 84,316

(f) Deferred tax liabilities 704,759 557 705,316 700,235 557 700,792 4,524 - 4,524

(g) Net admitted deferred tax asset 2,529,122$ 135,294$ 2,664,416$ 2,449,330$ 135,294$ 2,584,624$ 79,792$ -$ 79,792$

Change12/31/201712/31/2018

(2) The admitted deferred tax asset is determined from the following components:

Ordinary Capital Total Ordinary Capital Total Ordinary Capital Total

Admission calculation components: SSAP 101 (Paragraph 11)

(a) -$ 135,294$ 135,294$ -$ 135,294$ 135,294$ -$ -$ -$

(b) 2,529,122 - 2,529,122 2,449,330 - 2,449,330 79,792 - 79,792

(1) 2,529,122 - 2,529,122 2,449,330 - 2,449,330 79,792 - 79,792

(2) - - 6,634,936 - - 5,235,459 - - 1,399,477

(c ) 704,759 557 705,316 700,235 557 700,792 4,524 - 4,524

(d) 3,233,881$ 135,851$ 3,369,732$ 3,149,565$ 135,851$ 3,285,416$ 84,316$ -$ 84,316$ Deferred tax assets admitted

as the result of the application

of SSAP No. 101 (a+b+c)

Adjusted gross deferred

tax assets expected to be

realized following the

balance sheet date

Adjusted gross deferred

tax assets allowed per

limitation threshold

Adjusted gross deferred tax

assets (excluding the amount

of deferred tax assets from

(a) and (b) above) offset by

gross deferred tax liabilities

Change12/31/2018 12/31/2017

Federal income taxes paid in

prior years recoverable

through loss carrybacks

Adjusted gross deferred tax

assets expected to be realized

after the application of the

threshold limitation

(3)

12/31/2018 12/31/2017

(a) 694% 665%

(b) 46,401,163$ 37,184,496$

Ratio percentage used to determine recovery period and threshold

Amount of adjusted capital and surplus used to determine recovery period and

threshold amount (4) The impact of tax-planning strategies is as follows:

Ordinary Capital Ordinary Capital Ordinary Capital

(a) Determination of adjusted gross deferred tax assets and net admitted deferred tax assets by tax character as a percentage

1 8,539,580$ 135,851$ 9,848,406$ 135,851$ (1,308,826)$ -$

2 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

3 3,233,881$ 135,851$ 3,149,565$ 135,851$ 84,316$ -$

4 0.0% 100.0% 0.0% 99.6% 0.0% 0.4%

(b) Does the Company's tax-planning strategies include the use of reinsurance? No

Change

Adjusted gross DTAs amount from note 9A1 (c)

Percentage of adjusted gross DTA by tax

character attributable to the impact of tax planning

strategies

Net admitted adjusted gross DTAs amount from

note 9A1(e)

Percentage of adjusted net admitted adjusted gross

DTAs by tax character admitted because of the

impact of tax planning strategies

12/31/2018 12/31/2017

B. Deferred tax liabilities are not recognized for the following amounts: None.


19.7

C. Current income taxes incurred consist of the following major components:

12/31/2018 12/31/2017 Change

1. Federal income tax-operating 848,591$ 350,205$ 498,386$

Federal income tax-capital gains (losses) (21,052) (66,542) 45,490

Federal income tax incurred 827,539$ 283,663$ 543,876$

2. Deferred tax assets

(a) Ordinary;

Policyholder reserves 6,002,432$ 7,100,491$ (1,098,059)$

Deferred acquisition costs 2,384,481 2,480,519 (96,038)

Policyholder dividend accrual 74,615 78,997 (4,382)

Receivables nonadmitted 952 116,670 (115,718)

Other 77,100 71,729 5,371

Ordinary deferred tax assets 8,539,580 9,848,406 (1,308,826)

(b) Statutory valuation allowance adjustment - - -

(c ) Nonadmitted deferred tax assets 5,305,699 6,698,841 (1,393,142)

(d) Admitted ordinary deferred tax assets (2a - 2b - 2c) 3,233,881$ 3,149,565$ 84,316$

(e) Capital

Investments 135,851 135,851 -

(f) Statutory valuation allowance adjustment - - -

(g) Nonadmitted - - -

(h) Admitted capital deferred tax assets (2e - 2f - 2g) 135,851 135,851 -

(i) Admitted deferred tax assets (2d + 2h) 3,369,732$ 3,285,416$ 84,316$

3. Deferred tax liabilities

(a) Ordinary;

Investments 458,732$ 410,120$ 48,612$

Fixed assets 0 34 (34)

Deferred and uncollected premium 229,856 290,081 (60,225)

Other 16,171 - 16,171

Ordinary deferred tax liabilities 704,759 700,235 4,524

(b) Capital - investments 557 557 -

(c ) Deferred tax liabilities (3a + 3b) 705,316$ 700,792$ 4,524$

2,664,416$ 2,584,624$ 79,792$ 4. Net admitted deferred tax asset (2i - 3c)

The above table reflects the impact of the Tax Cuts and Jobs Act (legislation) that was enacted on December 22, 2017. The reduction in gross deferred tax assets and deferred tax liabilities during 2017 related to the impact of this legislation was $6,656,171 and $467,195, respectively. The impact to nonadmitted deferred tax assets was a reduction of $4,464,966.

As of the filing date for the 2017 Annual Statement, the accounting for the income tax effects of the legislation was incomplete. The Company recorded a provisional amount for the temporary difference related to policy reserves of approximately $7,100,000 which included the transitional reserve adjustment of approximately $18,000 and the realization thereof as the Company was currently working through a final analysis of the implications of the tax reserve changes. The Company has completed its analysis which has not resulted in any material adjustments during 2018 to what was reported in 2017.The change in net deferred taxes is comprised of the following (exclusive of the change in nonadmitted assets reported as a component of the Change in Nonadmitted Assets):

12/31/2018 12/31/2017 Change

Gross deferred tax assets 8,675,431$ 9,984,257$ (1,308,826)$

Deferred tax liabilities 705,316 700,792 4,524

Net deferred tax asset 7,970,115 9,283,465 (1,313,350)

Tax effect of unrealized gains - - -

7,970,115$ 9,283,465$ (1,313,350)$ Net deferred income tax asset, excluding unrealized gains

D. The federal income tax incurred differs from the enacted rate due to the following:

Effective

12/31/2018 Tax Rate

Tax expense (benefit) at the federal statutory rate of 21% 2,065,354$ 21.0%

Change in interest maintenance reserve (40,185) -0.4%

Income (loss) reported in surplus 115,720 1.2%

Other - 0.0%

Total income tax expense incurred 2,140,889$ 21.8%

Federal and foreign income taxes incurred 827,539

Change in net deferred income taxes 1,313,350

Total statutory income tax 2,140,889$


19.8

E. At December 31, 2018, the Company had no losses or credits to carryforward to succeeding years.

Taxes paid and available for recoupment in the event of future losses are as follows:

21,507$

194,738

127,83212/31/2016

Year Taxes paid

12/31/2018

12/31/2017

The aggregate amount of deposits admitted under Section 6603 of the Internal Revenue Code was $0 as of December 31, 2018.

F. The Company’s Federal Income Tax return is consolidated with the following entities:

• American United Mutual Insurance Holding Company

• American United Life Insurance Company

• AUL Equity Sales Insurance Agency, Inc.

• McCready & Keene, Inc.

• NewOhio, LLC

• OneAmerica Financial Partners, Inc.

• OneAmerica Retirement Services, LLC

• OneAmerica Securities, Inc.

• OneAmerica Securities Insurance Agency

• The State Life Insurance Company

The method of allocation between the companies is subject to an executed Tax Sharing Agreement and is based upon separate return calculations with current credit for losses and tax credits. Intercompany tax balances are settled quarterly.

G. The Company has no tax loss contingency for which it is reasonably possible that the liability will increase significantly within the next twelve months.

10. Information Concerning Parent, Subsidiaries and Affiliates

A. The Company merged with American United Mutual Insurance Holding Company (AUMIHC) on January 1, 2002. The merger converted the Company from a mutual to a stock insurance company and the Company is now a subsidiary of an intermediate stock holding company, OneAmerica Financial Partners, Inc., (OneAmerica). Members approved this reorganization on December 20, 2001.

OneAmerica Asset Management (OAM), LLC, a limited liability company domiciled in Indiana, was organized on October 12, 2012 and is the registered investment advisor for the Company effective January 1, 2013.

B. There were no significant transactions by the Company with affiliates of subsidiaries referenced in A above.

C. Amount of transactions described above in 10 B – not applicable.

D. The Company reported a payable of $63,231 to American United Life Insurance Company (AUL) at December 31, 2018 and a payable of $1,061,710 to AUL at December 31, 2018. The settlement terms require these balances to be settled monthly.

E. AUL guarantees the insurance liabilities of the Company to its policyholders in the event the Company becomes unable to honor such insurance liabilities.

F. Under terms of an administrative agreement between the Company and AUL, the Company utilizes certain administrative and management services of AUL. The Company pays an annual administrative fee to AUL.

OAM is the registered investment advisor of the Company. The Company pays an investment management fee to OAM monthly.

G. All 30,000 shares issued and outstanding of the Company were issued to AUMIHC through OneAmerica. AUMIHC will at all times control at least a majority of the voting shares of the capital stock. Policyholder membership rights exist at AUMIHC while the policyholder contract rights remain with PML.

H. No shares of OneAmerica Financial Partners, Inc. are held by PML.

I. Investments in an SCA entity – not applicable.

J. Investments in an impaired SCA entity – not applicable.

K. The Company does not have an investment in a foreign insurance subsidiary.

L. The Company does not hold an investment in a downstream noninsurance holding company.

M. All SCA Investments – not applicable.

N. Investments in Insurance SCAs – not applicable.

O. SCA Loss Tracking – not applicable.

11. Debt

A. Capital Notes - the Company has no capital notes outstanding.

B. Federal Home Loan Bank agreements – not applicable.


19.9

12. Retirement Plans, Deferred Compensation, Postemployment Benefits and Compensated Absences and Other Postretirement Benefit

Plans

A. Defined Benefit Plan – the Company has no defined benefit plan.

B. Investment policy statement for Pension Plan – not applicable.

C. Fair value measurements of Plan Assets at Reporting Date – not applicable.

D. Expected long-term return on plan assets – not applicable.

E. Defined Contribution Plans – the Company has no defined contribution plan.

F. Multiemployer Plans – the Company does not participate in a multiemployer plan.

G. Consolidated/Holding Company Plans OAFP sponsors a qualified, noncontributory defined benefit pension plan covering substantially all of its employees. OAFP charges AUL and then AUL allocates to its affiliates a share of the total cost of the pension plan based on allocation and/or salary ratios. The Company has no legal obligation for benefits under this plan. AUL sponsors a defined contribution plan that covers substantially all employees. The plan is a profit-sharing arrangement under section 401(k) of the Internal Revenue Code, which also includes a salary/reduction saving feature. AUL contributes a match for participants who complete one full calendar year of employment. The match is 50 percent of a participant’s elective deferral amounts on the first 6 percent of eligible compensation. Matching contributions are capped at 3 percent of eligible compensation. The Company has no legal obligation for benefits under this plan.

AUL sponsors a post retirement benefit plan, which provides certain health, life, vision and dental benefits upon retirement. AUL allocates to the Company a share of the total accumulated costs of these postretirement benefits. The Company has no legal obligation for the benefits under this plan.

H. Postemployment Benefits and Compensated Absences – not applicable.

I. Impact of Medicare Modernization Act on Postretirement Benefits – not applicable.

J. Deferred Compensation – not applicable.

13. Capital and Surplus, Shareholders’ Dividend Restrictions and Quasi-Reorganizations

(1) The Company has 30,000 shares of common stock at $100 par value authorized. All 30,000 shares issued and outstanding are held by OneAmerica Financial Partners, Inc. All shares are Class A shares.

(2) The Company has no preferred stock outstanding.

(3) Under North Dakota law, the amount of dividends a domestic insurer is permitted to pay without prior approval of the Insurance Department is limited to an amount not exceeding the greater of 10% of the Company’s statutory surplus as of the most recently preceding December 31 or 100% of the Company’s statutory gain from operations for the twelve month period ending on the most recently preceding December 31 but shall not include pro rata distributions of any class of the insurance company’s own securities.

(4) The Company did not pay any dividends to its sole shareholder, OneAmerica Financial Partners, Inc. in 2018.

(5) Company profits that may be paid as ordinary dividends to stockholders are limited as noted in (3) above.

(6) Unassigned surplus funds are not restricted.

(7) There have been no advances to surplus.

(8) There are no shares of stock held for special purposes.

(9) The Company had no changes to the prior period special surplus funds.

(10) The portion of unassigned funds (surplus) represented or reduced by cumulative unrealized gains and losses: $92.

(11) The Company does not have a surplus note.

(12) The Company had no quasi-reorganizations.

(13) Quasi-reorganization - not applicable.

14. Liabilities, Contingencies and Assessments

A. Contingent Commitments – the Company has no material contingent liabilities.

B. Assessments – the Company has no material outstanding assessments.

C. Gain Contingencies – not applicable.


19.10

D. Claims Related Extra Contractual Obligation and Bad Faith Losses Stemming from Lawsuits

The Company did not make any payments for extra contractual and bad faith claims during the year.

E. Joint and Several Liabilities – not applicable.

F. All Other Contingencies

Various lawsuits have arisen in the ordinary course of the Company’s business. In each of the matters and collectively, the Company believes the ultimate resolution of such litigation will not result in any material adverse impact to operations or financial condition of the Company.

15. Leases – the Company does not have any material lease obligations.

16. Information About Financial Instruments With Off-Balance Sheet Risk And Financial Instruments With Concentrations of Credit

Risk – not applicable.

17. Sale, Transfer and Servicing of Financial Assets and Extinguishments of Liabilities

A. Transfers of Receivables reported as Sales - not applicable.

B. Transfer and Servicing of Financial Assets - not applicable.

C. Wash Sales - the Company has no wash sales.

18. Gain or Loss to the Reporting Entity from Uninsured Plans and the Uninsured Portion of Partially Insured Plans – the Company is not engaged in any business using uninsured A&H plans.

19. Direct Premium Written/Produced by Managing General Agents/Third Party Administrators– the Company does not contract Managing General Agents as defined in the Managing General Agent Act. The Company does not have third party administrators with direct written premium greater than or equal to 5% of surplus.

20. Fair Value Measurements

A. (1) Fair Value Measurements at Reporting Date

Quoted Prices in Significant Significant Total Net Asset Value

Active Markets Observable Unobservable Fair (NAV) Included in

Level 1 Level 2 Level 3 Value Level 2

a. Bonds at fair value -$ 44,121$ -$ 44,121$ -$

b. Total Assets at fair value -$ 44,121$ -$ 44,121$ -$

c. Liabilities at fair value - - - - -

Quoted Prices in Significant Significant Total Net Asset Value

Active Markets Observable Unobservable Fair (NAV) Included in

Level 1 Level 2 Level 3 Value Level 2

a. Bonds at fair value -$ -$ -$ -$ -$

b. Total Assets at fair value -$ -$ -$ -$ -$ c. Liabilities at fair value - - - - -

December 31, 2018

December 31, 2017

There were no transfers between Level 1 and Level 2 of the fair value hierarchy. The Company’s policy is to recognize transfers between levels as of the beginning of the reporting period.

(2) Fair Value Measurements in (Level 3) of the Fair Value Hierarchy:

Ending Total gains Total gains Ending

Balance for Transfer Transfer (losses) (losses) Balance for

Prior into out of included in included in Current

Year End Level 3 Level 3 Net Income Surplus Purchases Issuances Sales Settlements Year End

Total Assets -$ -$ -$ -$ -$ -$ -$ -$ -$ -$

Total Liabilities -$ -$ -$ -$ -$ -$ -$ -$ -$ -$

(3) There were no transfers into or out of Level 3 of the fair value hierarchy.

(4) Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Authoritative guidance establishes a framework for measuring fair value that includes a hierarchy used to classify the inputs used in measuring fair value based on their observability. The hierarchy prioritizes the inputs to valuation techniques used to measure fair value into three levels. The level in the fair value hierarchy within which the fair value measurement falls is determined based on the lowest level input that is significant to the fair value measurement. The levels of the fair value hierarchy are as follows:

• Level 1 – Fair value is based on unadjusted quoted prices in active markets that are accessible to the Company for identical assets. These generally provide the most reliable evidence and are used to measure fair value whenever available. Active markets provide current pricing data on a more frequent basis. Examples include certain U.S. Treasury securities and exchange-traded equity securities.

• Level 2 – Fair value is based on quoted prices for similar assets in active markets, inactive markets, or model-derived valuations in which all significant inputs and significant value drivers are observable in active markets. This level includes financial


19.11

instruments that are valued by independent pricing services using models or other valuation methodologies. These models are primarily industry-standard models that consider various inputs which are observable or derived from observable information in the marketplace. Examples include certain public and private corporate securities.

• Level 3 – Fair value is based on valuations derived from techniques in which one or more significant inputs or significant value drivers are unobservable for assets or liabilities. Examples include certain public corporate securities and other less liquid securities.

In certain instances, the inputs used to measure fair value fall into different levels of the fair value hierarchy. In such cases, the level disclosed is based on the lowest level significant to the fair value measurement. The assessment of the significance of a particular input to the fair value measurement and ultimate classification of each asset and liability requires judgment.

Fair values for equity securities and separate account assets are based on quoted market prices where available. The Company is responsible for the determination of fair value and therefore performs quantitative and qualitative analysis of prices received from third parties.

(5) The Company does not invest in derivatives. B., C. Aggregate fair value of financial instruments:

Aggregate Not Practicable Net Asset Value

Fair Admitted Carrying (NAV) Included in

Financial Instrument Value Asset Level 1 Level 2 Level 3 Value Level 2

Bonds 467,002,453$ 463,702,362$ 14,171,948$ 446,729,713$ 6,100,792$ -$ -$

Mortgage loans 11,026,184 10,597,324 - - 11,026,184 - -

Contract loans - 23,156,516 - - - 23,156,516 -

Other invested assets 1,795,360 1,995,754 - 1,795,360 - - -

Total financial assets 479,823,997$ 499,451,956$ 14,171,948$ 448,525,073$ 17,126,976$ 23,156,516$ -$ -$

Aggregate Not Practicable Net Asset Value

Fair Admitted Carrying (NAV) Included in

Financial Instrument Value Asset Level 1 Level 2 Level 3 Value Level 2

Bonds 496,064,564$ 465,830,315$ 15,629,967$ 474,274,369$ 6,160,228$ -$ -$

Mortgage loans 14,234,753 13,532,793 - - 14,234,753 - -

Contract loans - 23,003,094 - - - 23,003,094 -

Other invested assets 2,028,440 1,995,668 - 2,028,440 - - -

Total financial assets 512,327,757$ 504,361,870$ 15,629,967$ 476,302,809$ 20,394,981$ 23,003,094$ -$

Type of

December 31, 2018

December 31, 2017

Type of

D. Financial instruments which are not practicable to estimate fair value:

Carrying Interest Maturity

Financial Instrument Value Rate Date Explanation

23,156,516 varies variesContract loans It was not practicable to determine the fair value of these

financial instruments as a quoted market price is not

available.

Type of

21. Other Items

A. Extraordinary Items – not applicable.

B. Troubled Debt Restructuring – not applicable.

C. Other Disclosures and Unusual Items

Management fees paid to AUL were allocated to the appropriate expense classification based on the ratio of actual AUL expense allocated to the Company, which were derived through cost studies.

In this statement, items may not add due to rounding amounts. D. Business Interruption Insurance Recoveries – not applicable.

E. State Transferable and Non-transferable Tax Credits – not applicable.

F. Subprime Mortgage Related Risk Exposure

1) Subprime mortgages are defined as any residential mortgage loan that is made to a borrower with a poor credit history, or one that has a low credit score, typically below 630. Alternative A (Alt-A) is another form of subprime that involves low or no documentation loans to non-prime borrowers. Prime loans involve borrowers with good credit histories and credit scores above 720. The Company has not engaged in direct or indirect lending to subprime or Alt-A borrowers. Additionally, the Company has no investments in securitized assets that are supported by subprime or Alt-A loans. The Company has managed its risk to subprime mortgage loans by avoiding them.

2) The Company has no direct exposure to subprime or Alt-A loans.

3) The Company has no direct exposure through other investments.

4) The Company does not underwrite mortgage or financial guaranty insurance coverage.


19.12

G. Retained Assets

(1) Individual settled claims of $25,000 and greater are automatically distributed utilizing a retained asset account, unless prohibited by state law or regulation. Claims of less than $25,000 are distributed utilizing a retained asset account when elected as the mode of settlement by the beneficiary. The beneficiary has immediate access to all the funds in the account by writing a draft for the full amount of the proceeds.

The retained asset account balance is reported as a Supplemental Contract without Life Contingencies within the Company’s liability for Deposit-type Contracts. The interest rate on retained asset balances was 0.5% through July 14, 2018 and changed to 1% on July 15, 2018 for the remainder of the year.

There are no fees for account services. The additional charges would be incurred in the event of a stop-payment order, insufficient funds, or draft copy request.

(2) In Force

Number Balance Number Balance

Up to and including 12 months 5 318,265$ 4 198,830$

13 to 24 months 3 120,765 4 366,130

25 to 36 months 4 265,564 2 19,576

37 to 48 months 1 6,982 6 508,455

49 to 60 months 4 60,069 0 -

Over 60 months 43 1,143,917 46 1,387,931

Total 60 1,915,562$ 62 2,480,922$

(3)

Number Balance Number Balance

December 31, 2017 62 2,480,922$ - -$

Issued/added during the year 8 692,271 - -

Investment earnings credited - 16,441 - -

Fees and other charges - - - -

Transferred to state unclaimed property - - - -

Closed/withdrawn 10 1,274,072 - -

December 31, 2018 60 1,915,562$ - -$

As of 12/31/2017As of 12/31/2018

Individual Group

H. Insurance-Linked Securities (ILS) Contracts – not applicable.

22. Events Subsequent

Type I and Type II – Subsequent events have been considered through the filing date on or before March 1, 2019, and none were noted.

12/31/2018 12/31/2017

A. NO

B. ACA fee assessment payable for the upcoming year -$ -$

C. ACA fee assessment paid - -

D. Premium written subject to ACA 9010 assessment - -

E. Total Adjusted Capital before surplus adjustment 49,065,578 39,769,121

F. Total Adjusted Capital after surplus adjustment 49,065,578 39,769,121

G. Authorized Control Level 6,698,317 5,601,794

H. NO

Did the reporting entity write accident and health insurance premium that is subject to Section

9010 of the federal Affordable Care Act?

Would reporting the ACA assessment as of December 31, 2018, have triggered an RBC action

level?

23. Reinsurance

A. Ceded Reinsurance Report Section 1 - General Interrogatories 1. Are any of the reinsurers, listed in Schedule S as non-affiliated, owned in excess of 10% or controlled, either directly or indirectly, by

the company or by any representative, officer, trustee, or director of the company? Yes [ ] No [X] If yes, give full details.

2. Have any policies issued by the company been reinsured with a company chartered in a country other than the United States (excluding U.S. Branches of such companies) which is owned in excess of 10% or controlled directly or indirectly by an insured, a beneficiary, a creditor of an insured or any other person not primarily engaged in the insurance business? Yes [ ] No [X] If yes, give full details.

Section 2 - Ceded Reinsurance Report - Part A

1. Does the company have any reinsurance agreements in effect under which reinsurer may unilaterally cancel any reinsurance for reasons

other than for nonpayment of premium or other similar credits? Yes [ ] No [X]


19.13

a. If yes, what is the estimated amount of the aggregate reduction in surplus of a unilateral cancellation by the reinsurer as of the date of this statement, for those agreements in which cancellation results in a net obligation of the company to the reinsurer, and for which such obligation is not presently accrued? Where necessary, the company may consider the current or anticipated experience of the business reinsured in making this estimate. $0

b. What is the total amount of reinsurance credits taken, whether as an asset or as a reduction of liability, for these agreements in this

statement? $0

2. Does the company have any reinsurance agreements in effect such that the amount of losses paid or accrued through the statement date may result in a payment to the reinsurer of amounts which, in aggregate and allowing for offset of mutual credits from other reinsurance agreements with the same reinsurer, exceed the total direct premium collected under the reinsured policies? Yes [ ] No [X] If yes, give full details.

Section 3 - Ceded Reinsurance Report - Part B

1. What is the estimated amount of the aggregate reduction in surplus, for agreements not reflected in Section 2 above, of termination of all reinsurance agreements, by either party, as of the date of this statement? Where necessary, the company may consider the current or anticipated experience of the business reinsured in making this estimate. $0

2. Have any new agreements been executed or existing agreements amended, since January 1 of the year of this statement, to include policies or contracts which were in-force or which had existing reserves established by the company as of the effective date of the agreement? Yes [ ] No [X] If yes, what is the amount of reinsurance credits, whether an asset or a reduction of liability, taken for such new agreements or amendments?

B. Uncollectible Reinsurance

The Company has not written off any uncollectible reinsurance during the year. The Company did not nonadmit any amounts recoverable from reinsurers due to aging as of December 2018.

C. Commutation of Ceded Reinsurance

There were no commutations of ceded reinsurance in 2018 or 2017.

D. Certified Reinsurer Rating Downgraded or Status Subject to Revocation – not applicable.

E. Reinsurance of Variable Annuity Contracts/Certificates with an Affiliated Captive Reinsurer – not applicable.

F. Reinsurance Agreement with an Affiliated Captive Reinsurer – not applicable.

G. Ceding Entities That Utilize Captive Reinsurers to Assume Reserves Subject to the XXX/AXXX Captive Framework – not applicable.

24. Retrospectively Rated Contracts & Contracts Subject to Redetermination – not applicable.

25. Change in Incurred Losses and Loss Adjustment Expenses

Reserves on accident and health contracts for incurred losses and associated loss adjustment expenses attributable to insured events of prior years developed as anticipated during 2018. See Schedule H-Part 3 and the Five-Year Historical Data. Original estimates are increased or decreased, as additional information becomes known regarding individual claims. However, no significant trends or unanticipated events were noted in 2018. None of the Company’s accident and health contracts are subject to retrospective rating or experience refunds.

26. Intercompany Pooling Arrangements – not applicable. 27. Structured Settlements – not applicable.

28. Health Care Receivables – not applicable.

29. Participating Policies

For the year ended December 31, 2018, premiums under individual direct life participating policies were 100% of total individual life premiums earned. The Company accounts for its policyholder dividends based upon the three factor method and follows the contribution principle. Dividends of $364,390 were paid to policyholders in 2018. No additional income was allocated to policyholders.

30. Premium Deficiency Reserves

There was no premium deficiency reserve for accident and health contracts for 2018 as a result of the evaluation performed in January 2019.

31. Reserves for Life Contracts and Annuity Contracts

(1) The Company waives deduction of deferred fractional premiums upon death and holds reserves for the Commissioners Reserve Valuation Method and the Net Level Premium method using mortality and interest bases, which are consistent with the basic policies. The Company does not return any portion of the final premium for periods beyond the policy month of death. In certain situations, the surrender value promised is in excess of the reserve. The excess is included in Exhibit 5, Miscellaneous Reserves. Deferred annuity surrender charges are waived upon death of the annuitant, and the Company holds a mortality reserve for the death benefit in excess of the cash surrender value.

(2) Additional premiums are charged for policies issued on substandard lives according to underwriting classifications. The corresponding reserve held on such policies for substandard risks are calculated at 50% of the substandard extra annual premium in force.

(3) As of December 31, 2018, the Company has $311,486,724 of insurance in force for which deficiency reserves total $3,198,896 at year-end and are reported in Exhibit 5, Miscellaneous Reserves.


19.14

(4) Tabular Interest, Tabular Cost, and Tabular Less Actual Reserves Released have been determined using the appropriate formula in the Page 7 instructions for all insurance and annuities, respectively.

(5) Tabular Interest on funds not involving life contingencies (Exhibit 7) has been determined from ledger entries except for Individual Supplementary Contracts Not Involving Life Contingencies and Annuities Certain Not Involving Life Contingencies. For these exceptions, Tabular Interest was calculated using Formula (3).

(6) The amount of "Other Increases" (net) under Page 7 is mainly due to reserve adjustments and additional actuarial reserves as a result of asset/liability analysis.

Item Total

Life

Insurance

Individual

Annuities

Supplementary

Contracts

Life

Insurance Annuities

Additional actuarial reserves - Asset/Liability analysis (5,000,000)$ (3,500,000)$ (1,500,000)$ -$ -$ -$ -$

Other reserve adjustments 3,384$ -$ -$ 3,384$ -$ -$ -$

Total (4,996,616)$ (3,500,000)$ (1,500,000)$ 3,384$ -$ -$ -$

Ordinary

Credit Life

Group and

Individual

Group

32. Analysis of Annuity Actuarial Reserves and Deposit Type Liabilities by Withdrawal Characteristics

General

Account

Separate

Account with

Guarantees

Separate Account

Nonguaranteed Total % of Total

A. Subject to discretionary withdrawal:

(1) With market value adjustment -$ -$ -$ -$ 0.0%

- - - - 0.0%

(3) At fair value - - - - 0.0%

- - - - 0.0%

(5) At book value without adjustment 105,893,073 - - 105,893,073 95.7%

B. Not subject to discretionary withdrawal 4,756,523 - - 4,756,523 4.3%

C. Total (gross: direct + assumed) 110,649,596 - - 110,649,596 100.0%

D. Reinsurance ceded - - - -

E. Total (net) (C) - (D) 110,649,596$ -$ -$ 110,649,596$

F. Life and Accident and Health Annual Statement:

(1) Exhibit 5, Annuities, Total (net) 98,123,311$

(2)

21,966

(3)

12,504,319

(4) Subtotal 110,649,596$

Separate Accounts Annual Statement:

(5) Exhibit 3, Line 0299999, Column 2 -$

(6) Exhibit 3, Line 0399999, Column 2 -

(7)

-

(8) Policyholder premiums -

(9) Guaranteed interest contracts -

(10) Other contract deposit funds -

(11) Subtotal -

(12) Combined total 110,649,596$

(2) At book value less current surrender

charge of 5% or more

Exhibit 5, Supplementary Contracts

with Life Contingencies, total (net)

Exhibit 7, Deposit-Type Contracts,

Line 14, Column 1

Policyholder dividend and coupon

accumulations

(4) total with market value adjustment or at

fair value

33. Premium and Annuity Considerations Deferred and Uncollected

Deferred and uncollected life insurance premiums and annuity considerations as of December 31, 2018 were as follows:

Gross Net of Loading

-$ -$

- -

1,397,303 1,093,121

- -

- -

- -

1,397,303$ 1,093,121$

Type

Total

Industrial

Ordinary New Business

Ordinary Renewal

Credit Life

Group Life

Group Annuity

34. Separate Accounts – the Company is not engaged in Separate Accounts.

35. Loss/Claim Adjustment Expenses – not applicable.


GENERAL INTERROGATORIES

PART 1 - COMMON INTERROGATORIESGENERAL

1.1 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? Yes [ X ] No [ ]If yes, complete Schedule Y, Parts 1, 1A and 2

1.2 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? Yes [ X ] No [ ] N/A [ ]

1.3 State Regulating? North Dakota

1.4 Is the reporting entity publicly traded or a member of a publicly traded group? Yes [ ] No [ X ]

1.5 If the response to 1.4 is yes, provide the CIK (Central Index Key) code issued by the SEC for the entity/group.

2.1 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? Yes [ ] No [ X ]

2.2 If yes, date of change:

3.1 State as of what date the latest financial examination of the reporting entity was made or is being made. 12/31/2014

3.2 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. 12/31/2014

3.3 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). 02/09/2016

3.4 By what department or departments?

North Dakota

3.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? Yes [ ] No [ ] N/A [ X ]

3.6 Have all of the recommendations within the latest financial examination report been complied with? Yes [ X ] No [ ] N/A [ ]

4.1 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 20 percent of any major line of business measured on direct premiums) of:

4.11 sales of new business? Yes [ ] No [ X ]

4.12 renewals? Yes [ ] No [ X ]

4.2 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 20 percent of any major line of business measured on direct premiums) of:

4.21 sales of new business? Yes [ ] No [ X ]

4.22 renewals? Yes [ ] No [ X ]

5.1 Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? Yes [ ] No [ X ]

If yes, complete and file the merger history data file with the NAIC.

5.2 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.

1Name of Entity

2NAIC Company Code

3State of Domicile

6.1 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? Yes [ ] No [ X ]

6.2 If yes, give full information:

7.1 Does any foreign (non-United States) person or entity directly or indirectly control 10% or more of the reporting entity? Yes [ ] No [ X ]

7.2 If yes,

7.21 State the percentage of foreign control; %

7.22 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).

1Nationality

2Type of Entity

20



8.1 Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? Yes [ ] No [ X ]8.2 If response to 8.1 is yes, please identify the name of the bank holding company.

8.3 Is the company affiliated with one or more banks, thrifts or securities firms? Yes [ X ] No [ ]8.4 If response to 8.3 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.

1Affiliate Name

2Location (City, State)

3FRB

4OCC

5FDIC

6SEC

OneAmerica Securities, Inc. Indianapolis, IN NO NO NO YES

OneAmerica Asset Management, LLC Indianapolis, IN NO NO NO YES

OneAmerica Investment Advisory Services, LLC Indianapolis, IN NO NO NO YES

9. What is the name and address of the independent certified public accountant or accounting firm retained to conduct the annual audit?

PricewaterhouseCoopers, LLP, 101 West Washington Street, Suite 1300, Indianapolis, IN 46204

10.1 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? Yes [ ] No [ X ]

10.2 If the response to 10.1 is yes, provide information related to this exemption:

10.3 Has the insurer been granted any exemptions related to the other requirements of the Annual Financial Reporting Model Regulation as allowed for in Section 18A of the Model Regulation, or substantially similar state law or regulation? Yes [ ] No [ X ]

10.4 If the response to 10.3 is yes, provide information related to this exemption:

10.5 Has the reporting entity established an Audit Committee in compliance with the domiciliary state insurance laws? Yes [ X ] No [ ] N/A [ ]10.6 If the response to 10.5 is no or n/a, please explain

11. 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?

Jonathan William Wilkins,

Assistant Vice President and Appointed Actuary,

OneAmerica Financial Partners, Inc.,

One American Square,

Indianapolis, IN 46282

12.1 Does the reporting entity own any securities of a real estate holding company or otherwise hold real estate indirectly? Yes [ ] No [ X ]

12.11 Name of real estate holding company

12.12 Number of parcels involved

12.13 Total book/adjusted carrying value $

12.2 If, yes provide explanation:

13. FOR UNITED STATES BRANCHES OF ALIEN REPORTING ENTITIES ONLY:

13.1 What changes have been made during the year in the United States manager or the United States trustees of the reporting entity?

13.2 Does this statement contain all business transacted for the reporting entity through its United States Branch on risks wherever located? Yes [ ] No [ ]

13.3 Have there been any changes made to any of the trust indentures during the year? Yes [ ] No [ ]

13.4 If answer to (13.3) is yes, has the domiciliary or entry state approved the changes? Yes [ ] No [ ] N/A [ ]14.1 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? Yes [ X ] No [ ](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.

14.11 If the response to 14.1 is No, please explain:

14.2 Has the code of ethics for senior managers been amended? Yes [ ] No [ X ]14.21 If the response to 14.2 is yes, provide information related to amendment(s).

14.3 Have any provisions of the code of ethics been waived for any of the specified officers? Yes [ ] No [ X ]14.31 If the response to 14.3 is yes, provide the nature of any waiver(s).

20.1



15.1 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? Yes [ ] No [ X ]

15.2 If the response to 15.1 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.

1American Bankers

Association (ABA) Routing

Number

2

Issuing or Confirming Bank Name

3

Circumstances That Can Trigger the Letter of Credit

4

Amount

BOARD OF DIRECTORS16. 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? Yes [ X ] No [ ]

17. Does the reporting entity keep a complete permanent record of the proceedings of its board of directors and all subordinate committees thereof? Yes [ X ] No [ ]

18. 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? Yes [ X ] No [ ]

FINANCIAL19. Has this statement been prepared using a basis of accounting other than Statutory Accounting Principles (e.g., Generally Accepted

Accounting Principles)? Yes [ ] No [ X ]

20.1 Total amount loaned during the year (inclusive of Separate Accounts, exclusive of policy loans): 20.11 To directors or other officers $

20.12 To stockholders not officers $

20.13 Trustees, supreme or grand

(Fraternal Only) $

20.2 Total amount of loans outstanding at the end of year (inclusive of Separate Accounts, exclusive of policy loans): 20.21 To directors or other officers $

20.22 To stockholders not officers $

20.23 Trustees, supreme or grand

(Fraternal Only) $

21.1 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? Yes [ ] No [ X ]

21.2 If yes, state the amount thereof at December 31 of the current year: 21.21 Rented from others $

21.22 Borrowed from others $

21.23 Leased from others $

21.24 Other $

22.1 Does this statement include payments for assessments as described in the Annual Statement Instructions other than guaranty fund or guaranty association assessments? Yes [ ] No [ X ]

22.2 If answer is yes: 22.21 Amount paid as losses or risk adjustment $

22.22 Amount paid as expenses $

22.23 Other amounts paid $

23.1 Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page 2 of this statement? Yes [ ] No [ X ]

23.2 If yes, indicate any amounts receivable from parent included in the Page 2 amount: $

INVESTMENT

24.01 Were all the stocks, bonds and other securities owned December 31 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 24.03) Yes [ X ] No [ ]

24.02 If no, give full and complete information relating thereto

24.03 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 17 where this information is also provided)N/A

24.04 Does the Company's security lending program meet the requirements for a conforming program as outlined in the Risk-Based Capital Instructions? Yes [ ] No [ ] N/A [ X ]

24.05 If answer to 24.04 is yes, report amount of collateral for conforming programs. $

24.06 If answer to 24.04 is no, report amount of collateral for other programs. $

24.07 Does your securities lending program require 102% (domestic securities) and 105% (foreign securities) from the counterparty at the outset of the contract? Yes [ ] No [ ] N/A [ X ]

24.08 Does the reporting entity non-admit when the collateral received from the counterparty falls below 100%? Yes [ ] No [ ] N/A [ X ]

24.09 Does the reporting entity or the reporting entity ’s securities lending agent utilize the Master Securities lending Agreement (MSLA) to conduct securities lending? Yes [ ] No [ ] N/A [ X ]

20.2



24.10 For the reporting entity’s security lending program state the amount of the following as December 31 of the current year:

24.101 Total fair value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2. $

24.102 Total book adjusted/carrying value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2 $

24.103 Total payable for securities lending reported on the liability page. $

25.1 Were any of the stocks, bonds or other assets of the reporting entity owned at December 31 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 21.1 and 24.03). Yes [ X ] No [ ]

25.2 If yes, state the amount thereof at December 31 of the current year: 25.21 Subject to repurchase agreements $

25.22 Subject to reverse repurchase agreements $

25.23 Subject to dollar repurchase agreements $

25.24 Subject to reverse dollar repurchase agreements $

25.25 Placed under option agreements $ 25.26 Letter stock or securities restricted as to sale -

excluding FHLB Capital Stock $

25.27 FHLB Capital Stock $

25.28 On deposit with states $ 4,170,619

25.29 On deposit with other regulatory bodies $ 25.30 Pledged as collateral - excluding collateral pledged to

an FHLB $ 25.31 Pledged as collateral to FHLB - including assets

backing funding agreements $

25.32 Other $

25.3 For category (25.26) provide the following:

1Nature of Restriction

2Description

3Amount

26.1 Does the reporting entity have any hedging transactions reported on Schedule DB? Yes [ ] No [ X ]

26.2 If yes, has a comprehensive description of the hedging program been made available to the domiciliary state? Yes [ ] No [ ] N/A [ X ]If no, attach a description with this statement.

27.1 Were any preferred stocks or bonds owned as of December 31 of the current year mandatorily convertible into equity, or, at the option of the issuer, convertible into equity? Yes [ ] No [ X ]

27.2 If yes, state the amount thereof at December 31 of the current year. $

28. Excluding items in Schedule E - Part 3 - 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 1, III - General Examination Considerations, F. Outsourcing of Critical Functions, Custodial or Safekeeping Agreements of the NAIC Financial Condition Examiners Handbook? Yes [ X ] No [ ]

28.01 For agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following:

1Name of Custodian(s)

2Custodian's Address

Bank of New York Mellon 225 Liberty Street, New York, NY 10286

28.02 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:

1Name(s)

2Location(s)

3Complete Explanation(s)

28.03 Have there been any changes, including name changes, in the custodian(s) identified in 28.01 during the current year? Yes [ ] No [ X ]

28.04 If yes, give full and complete information relating thereto:

1Old Custodian

2New Custodian

3Date of Change

4Reason

20.3



28.05 Investment management – Identify all investment advisors, investment managers, broker/dealers, including individuals that have the authority to make investment decisions on behalf of the reporting entity. For assets that are managed internally by employees of the reporting entity, note as such. ["…that have access to the investment accounts"; "…handle securities"]

1Name of Firm or Individual

2Affiliation

OneAmerica Asset Management, LLC A

28.0597 For those firms/individuals listed in the table for Question 28.05, do any firms/individuals unaffiliated with the reporting entity (i.e. designated with a "U") manage more than 10% of the reporting entity’s assets? Yes [ ] No [ X ]

28.0598 For firms/individuals unaffiliated with the reporting entity (i.e. designated with a "U") listed in the table for Question 28.05, does the total assets under management aggregate to more than 50% of the reporting entity’s assets? Yes [ ] No [ X ]

28.06 For those firms or individuals listed in the table for 28.05 with an affiliation code of "A" (affiliated) or "U" (unaffiliated), provide the information for the table below.

1

Central Registration Depository Number

2

Name of Firm or Individual

3

Legal Entity Identifier (LEI)

4

Registered With

5Investment

Management Agreement (IMA) Filed

165929 OneAmerica Asset Management, LLC SEC OS

29.1 Does the reporting entity have any diversified mutual funds reported in Schedule D, Part 2 (diversified according to the Securities and Exchange Commission (SEC) in the Investment Company Act of 1940 [Section 5(b)(1)])? Yes [ ] No [ X ]

29.2 If yes, complete the following schedule:

1

CUSIP #

2

Name of Mutual Fund

3Book/Adjusted Carrying Value

29.2999 - Total

29.3 For each mutual fund listed in the table above, complete the following schedule:

1

Name of Mutual Fund (from above table)

2

Name of Significant Holding of theMutual Fund

3Amount of Mutual

Fund's Book/Adjusted Carrying Value

Attributable to the Holding

4

Date of Valuation

30. Provide the following information for all short-term and long-term bonds and all preferred stocks. Do not substitute amortized value or statement value for fair value.

1

Statement (Admitted) Value

2

Fair Value

3Excess of Statement over Fair Value (-), or

Fair Value over Statement (+)

30.1 Bonds 463,702,362 467,002,453 3,300,091


30.3 Totals 463,702,362 467,002,453 3,300,091

30.4 Describe the sources or methods utilized in determining the fair values:

Securities are valued based on the following price hierarchy, 1) OneAmerica, 2) Bloomberg BVAL, 3) Reuters, 4) BNY, 5) IDC, 6) BlackRock Solutions (BRS) Money market matrix, 7) BRS OAS spread price, 8) Trade price, 9) BRS price (10) IHS Markit. The order of the hierarchy indicates the system logic to assign prices by the highest available source code and does not indicate a preference for the first in the hierarchy to price all investments. OneAmerica prices are typically used for private placements, which are priced using a multi-dimensional spread matrix (sector, quality, and maturity).

31.1 Was the rate used to calculate fair value determined by a broker or custodian for any of the securities in Schedule D? Yes [ X ] No [ ]

31.2 If the answer to 31.1 is yes, does the reporting entity have a copy of the broker’s or custodian’s pricing policy (hard copy or electronic copy) for all brokers or custodians used as a pricing source? Yes [ ] No [ X ]

31.3 If the answer to 31.2 is no, describe the reporting entity’s process for determining a reliable pricing source for purposes of disclosure of fair value for Schedule D:

Approximately 2% of total bonds are priced using broker quotes or other observable market data as a primary source. OneAmerica's Bond Analysts review prices obtained from brokers or estimated using market data to check for reasonableness. This review takes into account a number of factors such as: (i) general interest rate and market conditions; (ii) macroeconomic and/or deal-specific credit fundamentals; (iii) valuations of other financial instruments which are comparable in terms of quality, structure, maturity and/or covenant protection; (iv) size of the transaction; and (v) comparable trades, where observable. The valuation is based upon information derived from sources believed to be reliable.

32.1 Have all the filing requirements of the Purposes and Procedures Manual of the NAIC Investment Analysis Office been followed? Yes [ X ] No [ ]

32.2 If no, list exceptions:

20.4



33. By self-designating 5GI securities, the reporting entity is certifying the following elements of each self-designated 5GI security:

a. Documentation necessary to permit a full credit analysis of the security does not exist or an NAIC CRP credit rating for an FE or PL security is not available.

b. Issuer or obligor is current on all contracted interest and principal payments.

c. The insurer has an actual expectation of ultimate payment of all contracted interest and principal.

Has the reporting entity self-designated 5GI securities? Yes [ ] No [ X ]

34. By self-designating PLGI securities, the reporting entity is certifying the following elements of each self-designated PLGI security:

a. The security was purchased prior to January 1, 2018.

b. The reporting entity is holding capital commensurate with the NAIC Designation reported for the security.

c. The NAIC Designation was derived from the credit rating assigned by an NAIC CRP in its legal capacity as a NRSRO which is shown on a current private letter rating held by the insurer and available for examination by state insurance regulators.

d. The reporting entity is not permitted to share this credit rating of the PL security with the SVO.

Has the reporting entity self-designated PLGI securities? Yes [ ] No [ X ]

OTHER

35.1 Amount of payments to trade associations, service organizations and statistical or rating bureaus, if any? $ 3,681

35.2 List the name of the organization and the amount paid if any such payment represented 25% or more of the total payments to trade associations, service organizations and statistical or rating bureaus during the period covered by this statement.

1Name

2Amount Paid

ACLI 3,681

36.1 Amount of payments for legal expenses, if any? $

36.2 List the name of the firm and the amount paid if any such payment represented 25% or more of the total payments for legal expenses during the period covered by this statement.

1Name

2Amount Paid

37.1 Amount of payments for expenditures in connection with matters before legislative bodies, officers or departments of government, if any? $ 819

37.2 List the name of the firm and the amount paid if any such payment represented 25% or more of the total payment expenditures in connection with matters before legislative bodies, officers or departments of government during the period covered by this statement.

1Name

2Amount Paid

ACLI 819

20.5



PART 2 - LIFE INTERROGATORIES

1.1 Does the reporting entity have any direct Medicare Supplement Insurance in force? Yes [ ] No [ X ]

1.2 If yes, indicate premium earned on U.S. business only $

1.3 What portion of Item (1.2) is not reported on the Medicare Supplement Insurance Experience Exhibit? $

1.31 Reason for excluding:

1.4 Indicate amount of earned premium attributable to Canadian and/or Other Alien not included in Item (1.2) above. $

1.5 Indicate total incurred claims on all Medicare Supplement insurance. $

1.6 Individual policies: Most current three years:

1.61 Total premium earned $

1.62 Total incurred claims $

1.63 Number of covered lives

All years prior to most current three years




1.7 Group policies: Most current three years:




All years prior to most current three years




2. Health Test:

1Current Year

2Prior Year

2.1 Premium Numerator

2.2 Premium Denominator 14,216,958 19,129,925

2.3 Premium Ratio (2.1/2.2) 0.000 0.000

2.4 Reserve Numerator

2.5 Reserve Denominator 425,417,286 436,232,479

2.6 Reserve Ratio (2.4/2.5) 0.000 0.000

3.1 Does this reporting entity have Separate Accounts? Yes [ ] No [ X ]

3.2 If yes, has a Separate Accounts Statement been filed with this Department? Yes [ ] No [ ] N/A [ ]

3.3 What portion of capital and surplus funds of the reporting entity covered by assets in the Separate Accounts statement, is not currently distributable from the Separate Accounts to the general account for use by the general account? $

3.4 State the authority under which Separate Accounts are maintained:

3.5 Was any of the reporting entity’s Separate Accounts business reinsured as of December 31? Yes [ ] No [ ]

3.6 Has the reporting entity assumed by reinsurance any Separate Accounts business as of December 31? Yes [ ] No [ ]

3.7 If the reporting entity has assumed Separate Accounts business, how much, if any, reinsurance assumed receivable for reinsurance of Separate Accounts reserve expense allowances is included as a negative amount in the liability for “Transfers to Separate Accounts due or accrued (net)"? $

4.1 Are personnel or facilities of this reporting entity used by another entity or entities or are personnel or facilities of another entity or entities used by this reporting entity (except for activities such as administration of jointly underwritten group contracts and joint mortality or morbidity studies)? Yes [ X ] No [ ]

4.2 Net reimbursement of such expenses between reporting entities:

4.21 Paid $ 3,410,103

4.22 Received $

5.1 Does the reporting entity write any guaranteed interest contracts? Yes [ ] No [ X ]

5.2 If yes, what amount pertaining to these lines is included in:

5.21 Page 3, Line 1 $

5.22 Page 4, Line 1 $

6. FOR STOCK REPORTING ENTITIES ONLY:

6.1 Total amount paid in by stockholders as surplus funds since organization of the reporting entity: $ 7,000,000

7. Total dividends paid stockholders since organization of the reporting entity:

7.11 Cash $

7.12 Stock $

21



8.1 Does the company reinsure any Workers’ Compensation Carve-Out business defined as: Yes [ ] No [ X ]

Reinsurance (including retrocessional reinsurance) assumed by life and health insurers of medical, wage loss and death benefits of the occupational illness and accident exposures, but not the employers liability exposures, of business originally written as workers’ compensation insurance.

8.2 If yes, has the reporting entity completed the Workers’ Compensation Carve-Out Supplement to the Annual Statement? Yes [ ] No [ ]

8.3 If 8.1 is yes, the amounts of earned premiums and claims incurred in this statement are:

1Reinsurance

Assumed

2Reinsurance

Ceded

3Net

Retained

8.31 Earned premium

8.32 Paid claims

8.33 Claim liability and reserve (beginning of year)

8.34 Claim liability and reserve (end of year)

8.35 Incurred claims

8.4 If reinsurance assumed included amounts with attachment points below $1,000,000, the distribution of the amounts reported in Lines 8.31 and 8.34 for Column (1) are:

AttachmentPoint

1Earned

Premium

2Claim Liabilityand Reserve

8.41 <$25,000

8.42 $25,000 - 99,999

8.43 $100,000 - 249,999

8.44 $250,000 - 999,999

8.45 $1,000,000 or more

8.5 What portion of earned premium reported in 8.31, Column 1 was assumed from pools? $

9. For reporting entities having sold annuities to another insurer where the insurer purchasing the annuities has obtained a release of liability from the claimant (payee) as the result of the purchase of an annuity from the reporting entity only:

9.1 Amount of loss reserves established by these annuities during the current year: $

9.2 List the name and location of the insurance company purchasing the annuities and the statement value on the purchase date of the annuities.

1

P&C Insurance Company And Location

2Statement Value

on Purchase Dateof Annuities

(i.e., Present Value)

10.1 Do you act as a custodian for health savings accounts? Yes [ ] No [ X ]

10.2 If yes, please provide the amount of custodial funds held as of the reporting date. $

10.3 Do you act as an administrator for health savings accounts? Yes [ ] No [ X ]

10.4 If yes, please provide the balance of funds administered as of the reporting date. $

21.1



11.1 Are any of the captive affiliates reported on Schedule S, Part 3, authorized reinsurers? Yes [ ] No [ ] N/A [ X ]

11.2 If the answer to 11.1 is yes, please provide the following:

1 2 3 4 Assets Supporting Reserve Credit

Company Name

NAICCompany

CodeDomiciliary Jurisdiction

ReserveCredit

5Letters of

Credit

6Trust

Agreements

7

Other

12. Provide the following for individual ordinary life insurance* policies (U.S. business only) for the current year (prior to reinsurance assumed or ceded):

12.1 Direct Premium Written $ 18,596,740

12.2 Total Incurred Claims $ 21,481,191

12.3 Number of Covered Lives 24,678

*Ordinary Life Insurance Includes

Term (whether full underwriting,limited underwriting,jet issue,"short form app")

Whole Life (whether full underwriting,limited underwriting,jet issue,"short form app")

Variable Life (with or without secondary gurarantee)

Universal Life (with or without secondary gurarantee)

Variable Universal Life (with or without secondary gurarantee)

13. Is the reporting entity licensed or chartered, registered, qualified, eligible or writing business in at least two states? Yes [ X ] No [ ]

13.1 If no, does the reporting entity assume reinsurance business that covers risks residing in at least one state other than the state of domicile of the reporting entity? Yes [ ] No [ ]

21.2


FIVE-YEAR HISTORICAL DATAShow amounts in whole dollars only, no cents; show percentages to one decimal place, i.e. 17.6.

$000 omitted for amounts of life insurance1

20182

20173

20164

20155

2014

Life Insurance in Force

(Exhibit of Life Insurance)

1. Ordinary - whole life and endowment (Line 34, Col. 4) 1,833,098 1,933,471 2,023,065 2,106,121 2,181,090

2. Ordinary - term (Line 21, Col. 4, less Line 34, Col. 4) 278,541 327,026 363,494 393,808 424,884

3. Credit life (Line 21, Col. 6)

4. Group, excluding FEGLI/SGLI (Line 21, Col. 9 less Lines 43 & 44, Col. 4) 209 209 209 209 209

5. Industrial (Line 21, Col. 2)

6. FEGLI/SGLI (Lines 43 & 44, Col. 4)

7. Total (Line 21, Col. 10) 2,111,848 2,260,706 2,386,768 2,500,138 2,606,183

7.1 Total in force for which VM-20 deterministic/stochastic reserves are calculated XXX XXX XXX

New Business Issued

(Exhibit of Life Insurance)

8. Ordinary - whole life and endowment (Line 34, Col. 2) 50 17,972 32,022 40,973 36,858

9. Ordinary - term (Line 2, Col. 4, less Line 34, Col. 2)

10. Credit life (Line 2, Col. 6)

11. Group (Line 2, Col. 9)

12. Industrial (Line 2, Col. 2)

13. Total (Line 2, Col. 10) 50 17,972 32,022 40,973 36,858

Premium Income - Lines of Business

(Exhibit 1 - Part 1)

14. Industrial life (Line 20.4, Col. 2)

15.1 Ordinary-life insurance (Line 20.4, Col. 3) 13,213,257 17,238,910 21,237,341 22,143,842 24,158,089

15.2 Ordinary-individual annuities (Line 20.4, Col. 4) 1,010,870 1,886,763 2,241,284 1,912,035 2,256,629

16 Credit life (group and individual) (Line 20.4, Col. 5)

17.1 Group life insurance (Line 20.4, Col. 6)

17.2 Group annuities (Line 20.4, Col. 7)

18.1 A & H-group (Line 20.4, Col. 8)

18.2 A & H-credit (group and individual) (Line 20.4, Col. 9)

18.3 A & H-other (Line 20.4, Col. 10) (7,169) 4,252 4,072 1,933 2,281

19. Aggregate of all other lines of business (Line 20.4,Col. 11)

20. Total 14,216,958 19,129,925 23,482,697 24,057,810 26,416,999

Balance Sheet (Pages 2 & 3)

21. Total admitted assets excluding Separate Accounts business (Page 2, Line 26, Col. 3) 509,566,120 517,858,469 517,255,353 516,926,292 511,371,179

22. Total liabilities excluding Separate Accounts business (Page 3, Line 26) 462,668,800 480,370,783 470,796,056 469,474,626 473,026,029

23. Aggregate life reserves (Page 3, Line 1) 443,716,209 458,067,178 450,074,966 445,101,496 447,246,038

23.1 Excess VM-20 deterministic/stochastic reserve over NPR related to Line 7.1 XXX XXX XXX

24. Aggregate A & H reserves (Page 3, Line 2) 1,373 2,303 3,464 5,006 6,356

25. Deposit-type contract funds (Page 3, Line 3) 12,504,319 13,574,270 13,959,413 14,870,206 15,719,727

26. Asset valuation reserve (Page 3, Line 24.01) 1,990,602 2,093,347 2,275,438 2,416,160 2,433,792

27. Capital (Page 3, Lines 29 and 30) 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000

28. Surplus (Page 3, Line 37) 43,897,320 34,487,686 43,459,297 44,451,666 35,345,150

Cash Flow (Page 5)

29. Net Cash from Operations (Line 11) (2,742,223) (3,208,963) 3,619,196 8,301,129 7,616,218

Risk-Based Capital Analysis

30. Total adjusted capital 49,065,578 39,769,121 46,660,210 47,665,250 38,567,286

31. Authorized control level risk - based capital 6,698,317 5,601,794 5,951,250 6,687,258 6,327,967

Percentage Distribution of Cash, Cash Equivalents and Invested Assets

(Page 2, Col. 3) (Line No. /Page 2, Line 12, Col. 3) x 100.0

32. Bonds (Line 1) 92.6 92.2 91.1 87.4 85.7

33. Stocks (Lines 2.1 and 2.2)

34. Mortgage loans on real estate(Lines 3.1 and 3.2 ) 2.1 2.7 3.9 5.5 6.9

35. Real estate (Lines 4.1, 4.2 and 4.3)

36. Cash, cash equivalents and short-term investments (Line 5) 0.3 0.1 0.2 2.2 2.0

37. Contract loans (Line 6) 4.6 4.6 4.6 4.9 5.3

38. Derivatives (Page 2, Line 7)

39. Other invested assets (Line 8) 0.4 0.4 0.0 0.1

40. Receivables for securities (Line 9) 0.2 0.1

41. Securities lending reinvested collateral assets (Line 10)

42. Aggregate write-ins for invested assets (Line 11)

43. Cash, cash equivalents and invested assets (Line 12) 100.0 100.0 100.0 100.0 100.0

22


FIVE-YEAR HISTORICAL DATA(Continued)

12018

22017

32016

42015

52014

Investments in Parent, Subsidiaries and Affiliates

44. Affiliated bonds (Schedule D Summary, Line 12, Col. 1)

45. Affiliated preferred stocks (Schedule D Summary, Line 18, Col. 1)

46. Affiliated common stocks (Schedule D Summary Line 24, Col. 1),

47. Affiliated short-term investments (subtotal included in Schedule DA Verification, Col. 5, Line 10)

48. Affiliated mortgage loans on real estate

49. All other affiliated

50. Total of above Lines 44 to 49

51. Total Investment in Parent included in Lines 44 to 49 above

Total Nonadmitted and Admitted Assets

52. Total nonadmitted assets (Page 2, Line 28, Col. 2) 5,655,093 7,325,449 8,427,019 6,962,928 8,959,046

53. Total admitted assets (Page 2, Line 28, Col. 3) 509,566,120 517,858,469 517,255,353 516,926,292 511,371,179

Investment Data

54. Net investment income (Exhibit of Net Investment Income) 22,895,451 23,871,890 24,291,852 25,124,847 25,719,016

55. Realized capital gains (losses) (Page 4, Line 34, Column 1 ) 2,985 167,589 (301,272) 1,870 13,461

56. Unrealized capital gains (losses) (Page 4, Line 38, Column 1) (92) (4)

57. Total of above Lines 54, 55 and 56 22,898,344 24,039,479 23,990,580 25,126,717 25,732,473

Benefits and Reserve Increases (Page 6)

58. Total contract benefits - life (Lines 10, 11, 12, 13, 14 and 15 Col. 1, minus Lines 10, 11,12, 13, 14 and 15 Cols. 9, 10 and 11) 36,387,339 37,281,044 35,265,923 33,038,035 32,407,146

59. Total contract benefits - A & H (Lines 13 & 14, Cols. 9, 10 & 11) 12,240 12,220 2,590 2,200 8,830

60. Increase in life reserves - other than group and annuities (Line 19, Cols. 2 and 3 ) (7,310,171) 6,515,322 4,903,305 931,385 15,547,810

61. Increase in A & H reserves (Line 19, Cols. 9, 10 & 11) (930) (1,161) (1,542) (1,349) (2,052)

62. Dividends to policyholders (Line 30, Col. 1) 343,527 366,622 389,826 402,246 429,471

Operating Percentages

63. Insurance expense percent (Page 6, Col. 1, Lines 21, 22 & 23, less Line 6)/(Page 6, Col. 1, Line 1 plus Exhibit 7, Col. 2, Line 2) x 100.0 25.0 26.6 23.9 25.1 23.7

64. Lapse percent (ordinary only) [(Exhibit of Life Insurance, Col. 4, Lines 14 & 15) / 1/2 (Exhibit of Life Insurance, Col. 4, Lines 1 & 21)] x 100.0 5.8 4.9 4.9 5.0 5.4

65. A & H loss percent (Schedule H, Part 1, Lines 5 and 6, Col. 2) (152.7) 271.1 24.9 24.0 297.2

66. A & H cost containment percent (Schedule H, Pt. 1, Line 4, Col. 2)

67. A & H expense percent excluding cost containment expenses (Schedule H, Pt. 1, Line 10, Col. 2) 0.8 11.8 36.9 98.4 77.1

A & H Claim Reserve Adequacy

68. Incurred losses on prior years’ claims - group health (Schedule H, Part 3, Line 3.1 Col. 2)

69. Prior years’ claim liability and reserve - group health (Schedule H, Part 3, Line 3.2 Col. 2)

70. Incurred losses on prior years’ claims-health other than group (Schedule H, Part 3, Line 3.1 Col. 1 less Col. 2) 12,240 11,220 2,590 2,200 8,830

71. Prior years’ claim liability and reserve-health other than group (Schedule H, Part 3, Line 3.2 Col. 1 less Col. 2)

Net Gains From Operations After Federal Income Taxes by Lines of Business (Page 6, Line 33)

72. Industrial life (Col. 2)

73. Ordinary - life (Col. 3) 6,897,806 (4,520,453) 504,635 9,002,714 (3,597,361)

74. Ordinary - individual annuities (Col. 4) 2,224,928 (2,305,596) (1,940,334) 836,929 1,123,018

75. Ordinary-supplementary contracts (Col. 5) (12,707) 20,456 80 7,306 10,691

76. Credit life (Col. 6)

77. Group life (Col. 7) (1,812) 3,011

78. Group annuities (Col. 8) (8,583) 2,531 (4,620) (4,877) (687)

79. A & H-group (Col. 9) (3,136)

80. A & H-credit (Col. 10)

81. A & H-other (Col. 11) (14,473) (4,570) 1,203 56 (3,771)

82. Aggregate of all other lines of business (Col. 12)

83. Total (Col. 1) 9,086,971 (6,807,632) (1,439,036) 9,840,316 (2,468,235)

NOTE: If a party to a merger, have the two most recent years of this exhibit been restated due to a merger in compliance with the disclosure requirements of SSAP No. 3, Accounting Changes and Correction of Errors? Yes [ ] No [ ]

If no, please explain:

23


EXHIBIT OF LIFE INSURANCE($000 Omitted for Amounts of Life Insurance)

Industrial Ordinary Credit Life (Group and Individual) Group 10

1 2 3 4 5 6 Number of 9

Number of Policies Amount of Insurance Number of Policies Amount of Insurance

Number of Individual Policies and Group

Certificates Amount of Insurance

7

Policies

8

Certificates Amount of InsuranceTotal

Amount of Insurance

1. In force end of prior year 26,199 2,260,497 2 7 209 2,260,706

2. Issued during year 1 50 50

3. Reinsurance assumed

4. Revived during year 14 1,604 1,604

5. Increased during year (net) 2,959 2,959

6. Subtotals, Lines 2 to 5 15 4,613 4,613

7. Additions by dividends during year XXX XXX 23 XXX XXX XXX 23

8. Aggregate write-ins for increases

9. Totals (Lines 1 and 6 to 8) 26,214 2,265,133 2 7 209 2,265,342

Deductions during year:

10. Death 408 20,058 XXX 20,058

11. Maturity 54 60 XXX 60

12. Disability XXX

13. Expiry 2 486 486

14. Surrender 1,011 118,285 118,285

15. Lapse 55 9,027 9,027

16. Conversion 5 525 XXX XXX XXX 525

17. Decreased (net) 1 5,053 5,053

18. Reinsurance

19. Aggregate write-ins for decreases

20. Totals (Lines 10 to 19) 1,536 153,494 153,494

21. In force end of year (Line 9 minus Line 20) 24,678 2,111,639 2 7 209 2,111,848

22. Reinsurance ceded end of year XXX XXX 668,775 XXX XXX XXX 209 668,984

23. Line 21 minus Line 22 XXX XXX 1,442,864 XXX (a) XXX XXX 1,442,864


0801.

0802.

0803.

0898. Summary of remaining write-ins for Line 8 from overflow page.


1901.

1902.

1903.

1998. Summary of remaining write-ins for Line 19 from overflow page.


(a) Group $ ; Individual $

25


EXHIBIT OF LIFE INSURANCE($000 Omitted for Amounts of Life Insurance) (Continued)

ADDITIONAL INFORMATION ON INSURANCE IN FORCE END OF YEARIndustrial Ordinary

1Number of Policies

2Amount of Insurance

3Number of Policies

4Amount of Insurance

24. Additions by dividends XXX XXX 4,558

25. Other paid-up insurance 3,795 21,721

26. Debit ordinary insurance XXX XXX

ADDITIONAL INFORMATION ON ORDINARY INSURANCEIssued During Year(Included in Line 2)

In Force End of Year(Included in Line 21)

Term Insurance Excluding Extended Term Insurance1

Number of Policies2

Amount of Insurance3

Number of Policies4

Amount of Insurance

27. Term policies - decreasing 5 53

28. Term policies - other 1,040 159,590

29. Other term insurance - decreasing XXX XXX 245

30. Other term insurance XXX XXX 117,307

31. Totals (Lines 27 to 30) 1,045 277,195

Reconciliation to Lines 2 and 21:

32. Term additions XXX XXX

33. Totals, extended term insurance XXX XXX 178 1,345

34. Totals, whole life and endowment 1 50 23,455 1,833,098

35. Totals (Lines 31 to 34) 1 50 24,678 2,111,638

CLASSIFICATION OF AMOUNT OF INSURANCE BY PARTICIPATING STATUSIssued During Year(Included in Line 2)

In Force End of Year(Included in Line 21)

1Non-Participating

2Participating

3Non-Participating

4Participating

36 Industrial

37. Ordinary 50 2,111,638

38. Credit Life (Group and Individual)

39. Group 209

40. Totals (Lines 36 to 39) 50 2,111,847

ADDITIONAL INFORMATION ON CREDIT LIFE AND GROUP INSURANCECredit Life Group

1Number of Individual Policies and Group

Certificates

2

Amount of Insurance

3

Number of Certificates

4

Amount of Insurance

41. Amount of insurance included in Line 2 ceded to other companies XXX XXX

42. Number in force end of year if the number under shared groups is counted on a pro-rata basis XXX XXX

43. Federal Employees’ Group Life Insurance included in Line 21

44. Servicemen’s Group Life Insurance included in Line 21

45. Group Permanent Insurance included in Line 21

ADDITIONAL ACCIDENTAL DEATH BENEFITS46. Amount of additional accidental death benefits in force end of year under ordinary policies 40,390

BASIS OF CALCULATION OF ORDINARY TERM INSURANCE47. State basis of calculation of (47.1) decreasing term insurance contained in Family Income, Mortgage Protection, etc., policies and riders and of (47.2) term insurance on

wife and children under Family, Parent and Children, etc., policies and riders included above.

47.1 100% of actual death benefit

47.2 1000 per family unit (1000 per family member): 1000 per plan child unit (1000 per insured child)

POLICIES WITH DISABILITY PROVISIONSIndustrial Ordinary Credit Group

Disability Provisions

1

Number of Policies

2

Amount of Insurance

3

Number of Policies

4

Amount of Insurance

5

Number of Policies

6

Amount of Insurance

7Number of

Certifi-cates

8

Amount of Insrance

48. Waiver of Premium 3,595 431,747 7 209

49. Disability Income

50. Extended Benefits XXX XXX

51. Other

52. Total (a) 3,595 (a) 431,747 (a) 7 (a) 209

(a) See the Annual Audited Financial Reports section of the annual statement instructions

NONE

26


EXHIBIT OF NUMBER OF POLICIES, CONTRACTS, CERTIFICATES, INCOME PAYABLE AND ACCOUNT VALUES IN FORCE FOR SUPPLEMENTARY

CONTRACTS, ANNUITIES, ACCIDENT & HEALTH AND OTHER POLICIESSUPPLEMENTARY CONTRACTS

Ordinary Group

1Involving Life Contingencies

2Not Involving Life

Contingencies

3Involving Life Contingencies

4Not Involving Life

Contingencies

1. In force end of prior year 1 79

2. Issued during year


4. Increased during year (net)

5. Total (Lines 1 to 4) 1 79


6. Decreased (net) 3


8. Totals (Lines 6 and 7) 3

9. In force end of year 1 76

10. Amount on deposit (a) 2,369,637 (a)

11. Income now payable 1

12. Amount of income payable (a) 6,000 (a) (a) (a)

ANNUITIESOrdinary Group

1Immediate

2Deferred

3Contracts

4Certificates

1. In force end of prior year 273 3,245 1 21



4. Increased during year (net)

5. Totals (Lines 1 to 4) 273 3,245 1 21


6. Decreased (net) 26 235


8. Totals (Lines 6 and 7) 26 235

9. In force end of year 247 3,010 1 21

Income now payable:

10. Amount of income payable (a) 945,354 XXX XXX (a) 21,880

Deferred fully paid:

11. Account balance XXX (a) 40,436,520 XXX (a) 70,839

Deferred not fully paid:

12. Account balance XXX (a) 52,948,491 XXX (a)

ACCIDENT AND HEALTH INSURANCEGroup Credit Other

1Certificates

2Premiums in Force

3Policies

4Premiums in Force

5Policies

6Premiums in Force

1. In force end of prior year 18 4,383



4. Increased during year (net) XXX XXX XXX

5. Totals (Lines 1 to 4) XXX XXX 18 XXX


6. Conversions XXX XXX XXX XXX XXX

7. Decreased (net) XXX XXX 3 XXX

8. Reinsurance ceded XXX XXX XXX

9. Totals (Lines 6 to 8) XXX XXX 3 XXX

10. In force end of year (a) (a) 15 (a) 3,881

DEPOSIT FUNDS AND DIVIDEND ACCUMULATIONS1

Deposit Funds

2Dividend

AccumulationsContracts Contracts

1. In force end of prior year 880 2,991



4. Increased during year (net) (73)

5. Totals (Lines 1 to 4) 807 2,991

Deductions During Year:

6. Decreased (net) 213


8. Totals (Lines 6 and 7) 213

9. In force end of year 807 2,778

10. Amount of account balance (a) 1,617,405 (a) 8,520,016

(a) See the Annual Audited Financial Reports section of the annual statement instructions.

27


SCHEDULE T - PREMIUMS AND ANNUITY CONSIDERATIONS (b)

Allocated by States and TerritoriesDirect Business Only

1 Life Contracts 4 5 6 7

States, Etc.Active Status

(a)

2

Life InsurancePremiums

3

AnnuityConsiderations

Accident and Health Insurance

Premiums, Including Policy,

Membershipand Other Fees

OtherConsiderations

TotalColumns

2 through 5Deposit-Type

Contracts

1. Alabama AL L 65,613 2,000 67,613 2. Alaska AK N 18,509 18,509 3. Arizona AZ L 433,078 8,450 441,528 4. Arkansas AR L 147,672 147,672 5. California CA L 4,212,713 25,967 4,238,680 6. Colorado CO L 315,753 3,005 318,758 7. Connecticut CT L 483,878 17,200 3,276 504,354 8. Delaware DE L 22,642 22,642 9. District of Columbia DC L 1,653 1,653

10. Florida FL L 552,726 2,000 554,726 11. Georgia GA L 54,248 54,248 12. Hawaii HI L 100,098 8,400 108,498 13. Idaho ID L 220,367 220,367 14. Illinois IL L 461,154 461,154 15. Indiana IN L 889,861 100 889,961 16. Iowa IA L 349,633 49,900 399,533 17. Kansas KS L 162,633 2,100 164,733 18. Kentucky KY L 106,387 106,387 19. Louisiana LA L 169,169 169,169 20. Maine ME L 3,796 61 3,857 21. Maryland MD L 34,394 34,394 22. Massachusetts MA L 22,946 22,946 23. Michigan MI L 151,915 180 152,095 24. Minnesota MN L 1,401,892 317,351 1,719,243 25. Mississippi MS L 67,914 67,914 26. Missouri MO L 478,854 18,617 497,471 27. Montana MT L 516,922 21,549 538,471 28. Nebraska NE L 95,319 95,319 29. Nevada NV L 195,851 195,851 30. New Hampshire NH L 7,981 7,981 31. New Jersey NJ L 23,337 23,337 32. New Mexico NM L 304,145 23,000 327,145 33. New York NY N 18,599 18,599 34. North Carolina NC L 134,156 134,156 35. North Dakota ND L 1,827,689 294,007 2,121,696 36. Ohio OH L 329,984 150 330,134 37. Oklahoma OK L 393,921 150 394,071 38. Oregon OR L 599,036 30,101 629,137 39. Pennsylvania PA L 81,198 2,880 84,078 40. Rhode Island RI L 8,484 8,484 41. South Carolina SC L 37,629 1,170 38,799 42. South Dakota SD L 219,059 6,475 225,534 43. Tennessee TN L 119,300 119,300 44. Texas TX L 1,003,579 30,760 1,034,339 45. Utah UT L 441,015 441,015 46. Vermont VT L 506 506 47. Virginia VA L 152,753 152,753 48. Washington WA L 541,729 124,300 (6,279) 659,750 49. West Virginia WV L 11,809 11,809 50. Wisconsin WI L 424,912 100 425,012 51. Wyoming WY L 168,380 21,107 189,487 52. American Samoa AS N 53. Guam GU N 910 910 54. Puerto Rico PR N 55. U.S. Virgin Islands VI N 88 88 56. Northern Mariana Islands MP N 57. Canada CAN N 2,844 2,844 58. Aggregate Other Alien OT XXX 6,107 6,107 59. Subtotal XXX 18,596,740 1,010,869 (2,792) 19,604,817 90. Reporting entity contributions for employee benefits

plans XXX 91. Dividends or refunds applied to purchase paid-up

additions and annuities XXX 137,119 137,119 92. Dividends or refunds applied to shorten endowment

or premium paying period XXX 93. Premium or annuity considerations waived under

disability or other contract provisions XXX 47,149 47,149 94. Aggregate or other amounts not allocable by State XXX 95. Totals (Direct Business) XXX 18,781,008 1,010,869 (2,792) 19,789,085 96. Plus reinsurance assumed XXX 97 Totals (All Business) XXX 18,781,008 1,010,869 (2,792) 19,789,085 98. Less reinsurance ceded XXX 6,310,318 6,310,318 99. Totals (All Business) less Reinsurance Ceded XXX 12,470,690 1,010,869 (c) (2,792) 13,478,767

DETAILS OF WRITE-INS58001. Other Alien XXX 6,107 6,107 58002. XXX58003. XXX58998. Summary of remaining write-ins for Line 58 from

overflow page XXX 58999. Totals (Lines 58001 through 58003 plus

58998)(Line 58 above) XXX 6,107 6,107

9401. XXX9402. XXX9403. XXX9498. Summary of remaining write-ins for Line 94 from

overflow page XXX 9499. Totals (Lines 9401 through 9403 plus 9498)(Line

94 above) XXX

(a) Active Status Counts:L - Licensed or Chartered - Licensed insurance carrier or domiciled RRG 49 R - Registered - Non-domiciled RRGs E - Eligible - Reporting entities eligible or approved to write surplus lines in the state Q - Qualified - Qualified or accredited reinsurer N - None of the above - Not allowed to write business in the state 8

(b) Explanation of basis of allocation by states, etc., of premiums and annuity considerationsAddress of record at time that payment is received. (c) Column 4 should balance with Exhibit 1, Lines 6.4, 10.4, and 16.4, Cols. 8, 9, 10, or with Schedule H, Part 1, Line 1, indicate which: Exhibit 1, Lines 6.4, 10.4, and 16.4, Cols. 8, 9, 10

49


51

American United Mutual

Insurance Holding

Company

Employer ID #35-2126604

OneAmerica Financial

Partners, Inc.


American United Life

Insurance Company

NAIC #60895 IN

Group Code: 0619


AUL Reinsurance

Management Services,

LLC


MRO-A, LLC


OneAmerica Securities,

Inc.


McCready and Keene, Inc.


NewOhio, LLC


OldOhio, LLC


OneAmerica Asset

Management, LLC


OneAmerica Investment

Advisory Services, LLC


OneAmerica Retirement

Services, LLC


Pioneer Mutual Life

Insurance Company

NAIC #67911 ND

Group Code: 0619


The State Life Insurance

Company

NAIC #69116 IN

Group Code: 0619


MRO-S, LLC


SCHEDULE Y – INFORMATION CONCERNING ACTIVITIES OF INSURER MEMBERS OF A HOLDING COMPANY GROUP

PART 1 – ORGANIZATIONAL CHART


OVERFLOW PAGE FOR WRITE-INS

NONE

55

ALPHABETICAL INDEXANNUAL STATEMENT BLANK

Analysis of Increase in Reserves During The Year 7

Analysis of Operations By Lines of Business 6

Asset Valuation Reserve Default Component 30

Asset Valuation Reserve Equity 32

Asset Valuation Reserve Replications (Synthetic) Assets 35

Asset Valuation Reserve 29

Assets 2

Cash Flow 5

Exhibit 1 - Part 1 - Premiums and Annuity Considerations for Life and Accident and Health Contracts 9

Exhibit 1 - Part 2 - Dividends and Coupons Applied, Reinsurance Commissions and Expense 10

Exhibit 2 - General Expenses 11

Exhibit 3 - Taxes, Licenses and Fees (Excluding Federal Income Taxes) 11

Exhibit 4 - Dividends or Refunds 11

Exhibit 5 - Aggregate Reserve for Life Contracts 12

Exhibit 5 - Interrogatories 13

Exhibit 5A - Changes in Bases of Valuation During The Year 13

Exhibit 6 - Aggregate Reserves for Accident and Health Contracts 14

Exhibit 7 - Deposit-Type Contracts 15

Exhibit 8 - Claims for Life and Accident and Health Contracts - Part 1 16

Exhibit 8 - Claims for Life and Accident and Health Contracts - Part 2 17

Exhibit of Capital Gains (Losses) 8

Exhibit of Life Insurance 25

Exhibit of Net Investment Income 8

Exhibit of Nonadmitted Assets 18

Exhibit of Number of Policies, Contracts, Certificates, Income Payable and Account Values 27

Five-Year Historical Data 22

Form for Calculating the Interest Maintenance Reserve (IMR) 28

General Interrogatories 20

Jurat Page 1

Liabilities, Surplus and Other Funds 3

Life Insurance (State Page) 24

Notes To Financial Statements 19

Overflow Page For Write-ins 55

Schedule A - Part 1 E01



Schedule A - Verification Between Years SI02

Schedule B - Part 1 E04



Schedule B - Verification Between Years SI02

Schedule BA - Part 1 E07



Schedule BA - Verification Between Years SI03

Schedule D - Part 1 E10

Schedule D - Part 1A - Section 1 SI05

Schedule D - Part 1A - Section 2 SI08

Schedule D - Part 2 - Section 1 E11







Schedule D - Summary By Country SI04

Schedule D - Verification Between Years SI03

Schedule DA - Part 1 E17

Schedule DA - Verification Between Years SI10

Index 1

ANNUAL STATEMENT BLANK (Continued)

Schedule DB - Part A - Section 1 E18

Schedule DB - Part A - Section 2 E19

Schedule DB - Part A - Verification Between Years SI11

Schedule DB - Part B - Section 1 E20

Schedule DB - Part B - Section 2 E21

Schedule DB - Part B - Verification Between Years SI11

Schedule DB - Part C - Section 1 SI12

Schedule DB - Part C - Section 2 SI13

Schedule DB - Part D - Section 1 E22

Schedule DB - Part D - Section 2 E23

Schedule DB - Verification SI14

Schedule DL - Part 1 E24

Schedule DL - Part 2 E25

Schedule E - Part 1 - Cash E26

Schedule E - Part 2 - Cash Equivalents E27

Schedule E - Part 2 - Verification Between Years SI15

Schedule E - Part 3 - Special Deposits E28

Schedule F 36

Schedule H - Accident and Health Exhibit - Part 1 37

Schedule H - Part 2, Part 3 and Part 4 38

Schedule H - Part 5 - Health Claims 39

Schedule S - Part 1 - Section 1 40


Schedule S - Part 2 42







Schedule T - Part 2 Interstate Compact 50

Schedule T - Premiums and Annuity Considerations 49

Schedule Y - Information Concerning Activities of Insurer Members of a Holding Company Group 51

Schedule Y - Part 1A - Detail of Insurance Holding Company System 52

Schedule Y - Part 2 - Summary of Insurer’s Transactions With Any Affiliates 53

Summary Investment Schedule SI01

Summary of Operations 4

Supplemental Exhibits and Schedules Interrogatories 54

Index 1.1

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