69000 NORTHWESTERN LONG TERM CARE INS CO PrintBooks...

*69000201620100100*LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION

ANNUAL STATEMENTFOR THE YEAR ENDED DECEMBER 31, 2016

OF THE CONDITION AND AFFAIRS OF THE

Northwestern Long Term Care Insurance Company NAIC Group Code 0860 0860 NAIC Company Code 69000 Employer's ID Number 36-2258318

(Current) (Prior)

Organized under the Laws of Wisconsin , State of Domicile or Port of Entry WI

Country of Domicile United States of America

Incorporated/Organized 09/18/1953 Commenced Business 10/07/1953

Statutory Home Office 720 East Wisconsin Avenue , Milwaukee , WI, US 53202

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

Main Administrative Office 720 East Wisconsin Avenue

(Street and Number)

Milwaukee , WI, US 53202 , 414-661-2510

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

Mail Address 720 East Wisconsin Avenue , Milwaukee , WI, US 53202

(Street and Number or P.O. Box) (City or Town, State, Country and Zip Code)

Primary Location of Books and Records 720 East Wisconsin Avenue

(Street and Number)

Milwaukee , WI, US 53202 ,

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

Internet Website Address northwesternmutual.com

Statutory Statement Contact Kevin John Abitz , 414-665-5655

(Name) (Area Code) (Telephone Number)

[email protected] , 414-625-5655

(E-mail Address) (FAX Number)

OFFICERS

President and CEO Kamilah D Williams-Kemp Vice President and

Controller Todd Matthew Jones

Secretary and General Counsel Raymond Joseph Manista

Vice President and Chief Actuary David Robert Remstad

OTHERJohn Mitchell Grogan, Chairman Lisa A. Cadotte #, Vice President Karen A. Molloy, Vice President and Treasurer

Ronald Paul Joelson, Vice President and CIO Michael Gerard Carter, Vice President and CFO

DIRECTORS OR TRUSTEESRebekah B. Barsch John Mitchell Grogan Ronald Paul Joelson

David Robert Remstad Calvin R. Schmidt Steve Paul Sperka Kamilah D Williams-Kemp

SS:State of Wisconsin

County of Milwaukee

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.

Kamilah D. Williams-Kemp Raymond Joseph Manista Todd Matthew Jones

President and CEO Secretary and General Counsel Vice President and Controller

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

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

day of February, 2017 1. State the amendment number

2. Date filed

3. Number of pages attached Leah Lewandoski Notary Public 11/5/2017

ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO

ASSETSCurrent Year Prior Year

1

Assets

2

Nonadmitted Assets

3Net Admitted Assets

(Cols. 1 - 2)

4Net Admitted

Assets

1. Bonds (Schedule D) 89,439,856 89,439,856 86,313,518

2. Stocks (Schedule D):

2.1 Preferred stocks

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 (less $

encumbrances)

4.2 Properties held for the production of income (less

$ encumbrances)

4.3 Properties held for sale (less $

encumbrances)

5. Cash ($ 5,409,256 , Schedule E - Part 1), cash equivalents

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

investments ($ , Schedule DA) 5,409,256 5,409,256 6,759,355

6. Contract loans (including $ premium notes)

7. Derivatives (Schedule DB)

8. Other invested assets (Schedule BA)

9. Receivables for securities 6,694 6,694 2,603

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) 94,855,806 94,855,806 93,075,476

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

only)

14. Investment income due and accrued 335,398 335,398 301,337

15. Premiums and considerations:

15.1 Uncollected premiums and agents' balances in the course of collection 72,254 72,254

15.2 Deferred premiums and agents' balances and installments booked but

deferred and not yet due (including $

earned but unbilled premiums)

15.3 Accrued retrospective premiums ($ ) and

contracts subject to redetermination ($ )

16. Reinsurance:

16.1 Amounts recoverable from reinsurers 4,862,113 4,862,113 4,467,662

16.2 Funds held by or deposited with reinsured companies

16.3 Other amounts receivable under reinsurance contracts 12,994,757 12,994,757 15,464,434

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 11,582,630 8,537,870 3,044,760 2,975,000

19. Guaranty funds receivable or on deposit 5,394,503 5,394,503 4,719,629

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 40,405,532 40,405,532 34,684,258

24. Health care ($ ) and other amounts receivable

25. Aggregate write-ins for other than invested assets 10,833,255 10,833,255 10,282,990

26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 181,336,248 8,610,124 172,726,124 165,970,786

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

28. Total (Lines 26 and 27) 181,336,248 8,610,124 172,726,124 165,970,786

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. Prepaid Modal Reinsurance Premium 10,828,251 10,828,251 10,122,133

2502. Tax Recoveries in Process 5,004 5,004 109,632

2503. Remittances and Items not Allocated 51,225


2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 10,833,255 10,833,255 10,282,990

2


LIABILITIES, SURPLUS AND OTHER FUNDS1

Current Year2

Prior Year1. Aggregate reserve for life contracts $ 325,756 (Exh. 5, Line 9999999) less $

included in Line 6.3 (including $ Modco Reserve) 325,756 367,778 2. Aggregate reserve for accident and health contracts (including $ Modco Reserve) 3. Liability for deposit-type contracts (Exhibit 7, Line 14, Col. 1) (including $ Modco Reserve) 4,771,475 3,712,019 4. Contract claims:

4.1 Life (Exhibit 8, Part 1, Line 4.4, Col. 1 less sum of Cols. 9, 10 and 11) 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) 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 $ 8,153,368 accident and health premiums (Exhibit 1,

Part 1, Col. 1, sum of lines 4 and 14) 8,153,368 7,456,414 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 $ 52,577,623

ceded 52,577,623 50,907,710 9.4 Interest maintenance reserve (IMR, Line 6) 16,959,619 17,597,291

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

$ and deposit-type contract funds $ 11. Commissions and expense allowances payable on reinsurance assumed 12. General expenses due or accrued (Exhibit 2, Line 12, Col. 6) 109,200 56,100 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) 1,644,695 964,225 15.1 Current federal and foreign income taxes, including $ on realized capital gains (losses) 15.2 Net deferred tax liability 16. Unearned investment income 17. Amounts withheld or retained by company as agent or trustee 18. Amounts held for agents' account, including $ agents' credit balances 19. Remittances and items not allocated 46,409 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) 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 11,006 10,779 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 24.10 Payable for securities lending 24.11 Capital notes $ and interest thereon $

25. Aggregate write-ins for liabilities 5,900,000 5,400,000 26. Total liabilities excluding Separate Accounts business (Lines 1 to 25) 90,499,151 86,472,316 27. From Separate Accounts Statement 28. Total liabilities (Lines 26 and 27) 90,499,151 86,472,316 29. Common capital stock 2,500,000 2,500,000 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) 115,045,146 115,045,146 34. Aggregate write-ins for special surplus funds 35. Unassigned funds (surplus) (35,318,173) (38,046,676)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) 79,726,973 76,998,470 38. Totals of Lines 29, 30 and 37 (Page 4, Line 55) 82,226,973 79,498,470 39. Totals of Lines 28 and 38 (Page 2, Line 28, Col. 3) 172,726,124 165,970,786


2501. Reserve for Guaranty Fund 5,900,000 5,400,000 2502.

2503.

2598. Summary of remaining write-ins for Line 25 from overflow page 2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 5,900,000 5,400,000 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.

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)

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) 160,022 288,910

2. Considerations for supplementary contracts with life contingencies

3. Net investment income (Exhibit of Net Investment Income, Line 17) 2,061,341 1,889,807

4. Amortization of Interest Maintenance Reserve (IMR, Line 5) 637,672 374,896

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) 151,201,817 157,510,627

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) 154,060,852 160,064,240

10. Death benefits

11. Matured endowments (excluding guaranteed annual pure endowments)

12. Annuity benefits (Exhibit 8, Part 2, Line 6.4, Cols. 4 + 8)

13. Disability benefits and benefits under accident and health contracts 8,476 28,185

14. Coupons, guaranteed annual pure endowments and similar benefits

15. Surrender benefits and withdrawals for life contracts

16. Group conversions

17. Interest and adjustments on contract or deposit-type contract funds 235,976 188,500

18. Payments on supplementary contracts with life contingencies 58,332 70,118

19. Increase in aggregate reserves for life and accident and health contracts (42,021) (67,476)

20. Totals (Lines 10 to 19) 260,763 219,327

21. Commissions on premiums, annuity considerations, and deposit-type contract funds (direct business only) (Exhibit 1, Part 2, Line 31, Col. 1) 70,903,757 73,718,154

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) 64,504,185 68,856,133

24. Insurance taxes, licenses and fees, excluding federal income taxes (Exhibit 3, Line 7, Cols. 1 + 2 + 3) 15,803,124 14,806,851

25. Increase in loading on deferred and uncollected premiums

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

27. Aggregate write-ins for deductions 10,451

28. Totals (Lines 20 to 27) 151,471,829 157,610,916

29. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 28) 2,589,023 2,453,324

30. Dividends to policyholders 123 1,048

31. Net gain from operations after dividends to policyholders and before federal income taxes (Line 29 minus Line 30) 2,588,900 2,452,276

32. Federal and foreign income taxes incurred (excluding tax on capital gains) 337,929

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) 2,588,900 2,114,347

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

$ (excluding taxes of $ transferred to the IMR) 402,705

35. Net income (Line 33 plus Line 34) 2,588,900 2,517,052

CAPITAL AND SURPLUS ACCOUNT

36. Capital and surplus, December 31, prior year (Page 3, Line 38, Col. 2) 79,498,470 77,180,472

37. Net income (Line 35) 2,588,900 2,517,052

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

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

40. Change in net deferred income tax (709,232) (323,697)

41. Change in nonadmitted assets 848,835 (983,777)

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

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

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 1,108,420

54. Net change in capital and surplus for the year (Lines 37 through 53) 2,728,503 2,317,998

55. Capital and surplus, December 31, current year (Lines 36 + 54) (Page 3, Line 38) 82,226,973 79,498,470


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. Interest maintenance reserve transferred under reinsurance agreement

2702. Fines & Penalties 10,451

2703.


2799. Totals (Lines 2701 thru 2703 plus 2798)(Line 27 above) 10,451

5301. Prior period adjustments 1,108,420

5302.

5303.


5399. Totals (Lines 5301 thru 5303 plus 5398)(Line 53 above) 1,108,420

4


CASH FLOW1

Current Year

2

Prior Year

Cash from Operations

1. Premiums collected net of reinsurance (356,961) 2,787,795

2. Net investment income 1,042,270 1,145,951

3. Miscellaneous income 151,201,817 157,510,627

4. Total (Lines 1 through 3) 151,887,126 161,444,373

5. Benefit and loss related payments 697,236 1,260,235

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

7. Commissions, expenses paid and aggregate write-ins for deductions 151,450,047 161,556,327

8. Dividends paid to policyholders 123 1,048

9. Federal and foreign income taxes paid (recovered) net of $ tax on capital gains (losses) (7,548)

10. Total (Lines 5 through 9) 152,147,406 162,810,062

11. Net cash from operations (Line 4 minus Line 10) (260,280) (1,365,689)

Cash from Investments

12. Proceeds from investments sold, matured or repaid:

12.1 Bonds 3,705,000 9,940,553

12.2 Stocks

12.3 Mortgage loans

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

12.8 Total investment proceeds (Lines 12.1 to 12.7) 3,705,000 9,940,553

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

13.1 Bonds 5,846,328 6,039,931

13.2 Stocks

13.3 Mortgage loans

13.4 Real estate

13.5 Other invested assets

13.6 Miscellaneous applications 4,091

13.7 Total investments acquired (Lines 13.1 to 13.6) 5,850,419 6,039,931

14. Net increase (decrease) in contract loans and premium notes

15. Net cash from investments (Line 12.8 minus Line 13.7 minus Line 14) (2,145,419) 3,900,622

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 1,059,456 531,701

16.5 Dividends to stockholders

16.6 Other cash provided (applied) (3,856) (661,851)

17. Net cash from financing and miscellaneous sources (Lines 16.1 to 16.4 minus Line 16.5 plus Line 16.6) 1,055,600 (130,150)

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) (1,350,099) 2,404,783

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

19.1 Beginning of year 6,759,355 4,354,572

19.2 End of year (Line 18 plus Line 19.1) 5,409,256 6,759,355

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

5

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23

.G

en

era

l in

su

ran

ce

exp

en

se

s

64,504,1

85

64,504,1

85

24

.In

su

ran

ce

ta

xes,

lice

nse

s a

nd

fe

es,

exc

lud

ing

fe

de

ral in

co

me

ta

xes

15,803,1

24

15,803,1

24

25

.In

cre

ase

in

lo

ad

ing

on

de

ferr

ed

an

d u

nco

llecte

d p

rem

ium

s

26

.N

et

tra

nsfe

rs t

o o

r (f

rom

) S

ep

ara

te A

cco

un

ts n

et

of

rein

su

ran

ce

27

.A

gg

reg

ate

wri

te-i

ns f

or

de

du

ctio

ns

28

.T

ota

ls (

Lin

es 2

0 t

o 2

7)

151,

471,

829

16,3

11

151,

455,518

29

.N

et

ga

in f

rom

op

era

tio

ns b

efo

re d

ivid

en

ds t

o p

olic

yh

old

ers

an

d f

ed

era

l in

co

me

ta

xes (

Lin

e 9

min

us L

ine

28

) 2,589,

022

(8,9

45)

2,597,

967

30

.D

ivid

en

ds t

o p

olic

yh

old

ers

123

123

31

.N

et

ga

in f

rom

op

era

tio

ns a

fte

r d

ivid

en

ds t

o p

olic

yh

old

ers

an

d b

efo

re f

ed

era

l in

co

me

ta

xes (

Lin

e 2

9 m

inu

s L

ine

30

) 2,588,899

(8,9

45)

2,597,

844

32

.F

ed

era

l in

co

me

ta

xes in

cu

rre

d (

exc

lud

ing

ta

x o

n c

ap

ita

l g

ain

s)

(5,622)

5,622

33

.N

et

ga

in f

rom

op

era

tio

ns a

fte

r d

ivid

en

ds t

o p

olic

yh

old

ers

an

d f

ed

era

l in

co

me

ta

xes a

nd

be

fore

re

aliz

ed

ca

pita

l g

ain

s o

r (l

osse

s)

(Lin

e 3

1 m

inu

s L

ine

32

) 2,588,899

(3

,323)

2,592,222

DE

TA

ILS

OF

WR

ITE

-IN

S

08

.30

1.

08

.30

2.

08

.30

3.

08

.39

8.

Su

mm

ary

of

rem

ain

ing

wri

te-i

ns f

or

Lin

e 8

.3 f

rom

ove

rflo

w p

ag

e

08

.39

9.

To

tals

(L

ine

s 0

8.3

01

th

ru 0

8.3

03

plu

s 0

8.3

98

) (L

ine

8.3

ab

ove

)

27

01

.

27

02

.

27

03

.

27

98

. S

um

ma

ry o

f re

ma

inin

g w

rite

-in

s f

or

Lin

e 2

7 f

rom

ove

rflo

w p

ag

e

27

99

. T

ota

ls (

Lin

es 2

70

1 t

hru

27

03

plu

s 2

79

8)

(Lin

e 2

7 a

bo

ve

)

(a)

Inclu

de

s t

he

fo

llow

ing

am

ou

nts

fo

r F

EG

LI/

SG

LI:

L

ine

1

,

Lin

e 1

0

,

Lin

e 1

6

,

Lin

e 2

3

,

Lin

e 2

4

6

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

AN

AL

YS

IS O

F I

NC

RE

AS

E I

N R

ES

ER

VE

S D

UR

ING

TH

E Y

EA

R

12

Ord

inary

6G

roup

Tota

lIn

dustr

ial Life

3

Life Insura

nce

4

Indiv

idual A

nnuitie

s

5S

upple

menta

ry

Contr

acts

Cre

dit L

ife (

Gro

up a

nd

Indiv

idual)

7

Life Insura

nce

8

Annuitie

s

Involv

ing L

ife o

r D

isabili

ty C

ontingencie

s (

Reserv

es)

(Net of R

ein

sura

nce C

eded)

1.

Reserv

e D

ecem

ber

31, prior

year

367,778

36

7,778

2.

Tabula

r net pre

miu

ms o

r consid

era

tions

3.

Pre

sent valu

e o

f dis

abili

ty c

laim

s incurr

ed

XX

X

4.

Tabula

r in

tere

st

25,395

25,395

5.

Tabula

r le

ss a

ctu

al re

serv

e r

ele

ased

(9,0

85)

(9

,085

)

6.

Incre

ase in r

eserv

e o

n a

ccount of change in v

alu

ation b

asis

7.

Oth

er

incre

ases (

net)

8.

Tota

ls (

Lin

es 1

to 7

) 38

4,08

8

384,

088

9.

Tabula

r cost

XX

X

10.

Reserv

es r

ele

ased b

y death

XX

XX

XX

XX

X

11.

Reserv

es r

ele

ased b

y oth

er

term

inations (

net)

12.

Annuity,

supple

menta

ry c

ontr

act and d

isabili

ty p

aym

ents

involv

ing life c

ontingencie

s

58,332

58,332

13.

Net tr

ansfe

rs to o

r (f

rom

) S

epara

te A

ccounts

14.

Tota

l D

eductions (

Lin

es 9

to 1

3)

58,332

58,332

15.

Reserv

e D

ecem

ber

31, curr

ent ye

ar

325,

756

32

5,75

6

7


EXHIBIT OF NET INVESTMENT INCOME

1 2Collected During Year Earned During Year

1. U.S. Government bonds (a) 2,061,847 2,095,908

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

1.2 Other bonds (unaffiliated) (a) 7,132 7,132

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)

4. Real estate (d)

5 Contract loans

6 Cash, cash equivalents and short-term investments (e) 7 7

7 Derivative instruments (f)

8. Other invested assets

9. Aggregate write-ins for investment income 3,066 3,066

10. Total gross investment income 2,072,052 2,106,113

11. Investment expenses (g) 43,448

12. Investment taxes, licenses and fees, excluding federal income taxes (g) 1,324

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) 44,772

17. Net investment income (Line 10 minus Line 16) 2,061,341


0901. Misc. Income 3,066 3,066

0902.

0903.


0999. Totals (Lines 0901 thru 0903 plus 0998) (Line 9, above) 3,066 3,066

1501.

1502.

1503.


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

(a) Includes $ 999,740 accrual of discount less $ 14,730 amortization of premium and less $ 29,932 paid for accrued interest on purchases.

(b) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued dividends on purchases.

(c) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases.

(d) Includes $ for company’s occupancy of its own buildings; and excludes $ interest on encumbrances.

(e) Includes $ 7 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

1.1 Bonds exempt from U.S. tax

1.2 Other bonds (unaffiliated)

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)


0901.

0902.

0903.


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

NONE

8

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

EX

HIB

IT -

1 P

AR

T 1

- P

RE

MIU

MS

AN

D A

NN

UIT

Y C

ON

SID

ER

AT

ION

S F

OR

LIF

E A

ND

AC

CID

EN

T A

ND

HE

AL

TH

CO

NT

RA

CT

S1

2O

rdin

ary

5G

roup

Accid

ent and H

ealth

11

Tota

lIn

dustr

ial Life

3

Life Insura

nce

4In

div

idual

Annuitie

sC

redit L

ife (

Gro

up

and Indiv

idual)

6

Life Insura

nce

7

Annuitie

s

8

Gro

up

9C

redit (

Gro

up a

nd

Indiv

idual)

10

Oth

er

Aggre

gate

of A

ll O

ther

Lin

es o

f B

usin

ess

FIR

ST

YE

AR

(o

ther

than

sin

gle

)1.

Uncolle

cte

d

2.

Defe

rred a

nd a

ccru

ed

3.

Defe

rred , a

ccru

ed a

nd u

ncolle

cte

d:

3.1

Direct

1,73

7,91

8

1,

737,

918

3.2

Rein

sura

nce a

ssum

ed

3.3

Rein

sura

nce c

eded

1,73

7,91

8

1,

737,

918

3.4

Net (L

ine 1

+ L

ine 2

)

4.

Advance

5.

Lin

e 3

.4 -

Lin

e 4

6.

Colle

cte

d d

uring y

ear:

6.1

Direct

37,599

,681

37,599

,681

6.2

Rein

sura

nce a

ssum

ed

6.3

Rein

sura

nce c

eded

38,1

83,4

51

38,1

83,4

51

6.4

Net

(583,7

70)

(583,7

70)

7.

Lin

e 5

+ L

ine 6

.4

(583,7

70)

(583,7

70)

8.

Prior

year

(uncolle

cte

d +

defe

rred a

nd a

ccru

ed -

advance)

9.

First ye

ar

pre

miu

ms a

nd c

onsid

era

tions:

9.1

Direct

37,3

35,212

37,3

35,212

9.2

Rein

sura

nce a

ssum

ed

9.3

Rein

sura

nce c

eded

37,9

18,9

83

37,9

18,9

83

9.4

Net (L

ine 7

- L

ine 8

) (583,7

71)

(583,7

71)

SIN

GL

E10.

Sin

gle

pre

miu

ms a

nd c

onsid

era

tions:

10.1

Direct

10.2

Rein

sura

nce a

ssum

ed

10.3

Rein

sura

nce c

eded

10.4

Net

RE

NE

WA

L11.

Uncolle

cte

d

10,9

00,505

10,9

00,505

12.

Defe

rred a

nd a

ccru

ed

13.

Defe

rred, accru

ed a

nd u

ncolle

cte

d:

13.1

Direct

4,830,569

4,830,569

13.2

Rein

sura

nce a

ssum

ed

13.3

Rein

sura

nce c

eded

(6,069,9

36)

(6,069,9

36)

13.4

Net (L

ine 1

1 +

Lin

e 1

2)

10,9

00,505

10,9

00,505

14.

Advance

8,153,

368

8,153,

368

15.

Lin

e 1

3.4

- L

ine 1

4

2,74

7,13

7

2,74

7,13

7

16.

Colle

cte

d d

uring y

ear:

16.1

Direct

563,

812,569

563,

812,569

16.2

Rein

sura

nce a

ssum

ed

16.3

Rein

sura

nce c

eded

563,

008,097

563,

008,097

16.4

Net

804,

472

804,

472

17.

Lin

e 1

5 +

Lin

e 1

6.4

3,

551,

609

3,551,

609

18.

Prior

year

(uncolle

cte

d +

defe

rred a

nd a

ccru

ed -

advance)

2,807,

816

2,807,

816

19.

Renew

al pre

miu

ms a

nd c

onsid

era

tions:

19.1

Direct

564,

113,

257

564,

113,

257

19.2

Rein

sura

nce a

ssum

ed

19.3

Rein

sura

nce c

eded

563,

369,

464

563,

369,

464

19.4

Net (L

ine 1

7 -

Lin

e 1

8)

743,

793

743,

793

TO

TA

L20.

Tota

l pre

miu

ms a

nd a

nnuity

consid

era

tions:

20.1

Direct

601,

448,469

601,

448,469

20.2

Rein

sura

nce a

ssum

ed

20.3

Rein

sura

nce c

eded

601,

288,44

7

601,

288,44

7

20.4

Net (L

ines 9

.4 +

10.4

+ 1

9.4

) 160,022

160,022

9

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

EX

HIB

IT -

1 P

AR

T 2

- D

IVID

EN

DS

AN

D C

OU

PO

NS

AP

PL

IED

, R

EIN

SU

RA

NC

E C

OM

MIS

SIO

NS

AN

D E

XP

EN

SE

AL

LO

WA

NC

ES

AN

D C

OM

MIS

SIO

NS

IN

CU

RR

ED

(D

ire

ct

Bu

sin

es

s O

nly

)1

2O

rdin

ary

5G

roup

Accid

ent and H

ealth

11

Tota

lIn

dustr

ial Life

3

Life Insura

nce

4

Indiv

idual

Annuitie

sC

redit L

ife (

Gro

up

and Indiv

idual)

6

Life Insura

nce

7

Annuitie

s

8

Gro

up

9

Cre

dit (

Gro

up a

nd

Indiv

idual)

10

Oth

er

Aggre

gate

of A

ll O

ther

Lin

es o

f B

usin

ess

DIV

IDE

ND

S A

ND

CO

UP

ON

S A

PP

LIE

D

(in

clu

ded

in

Part

1)

21.

To p

ay

renew

al pre

miu

ms

123

123

22.

All

oth

er

RE

INS

UR

AN

CE

CO

MM

ISS

ION

S A

ND

EX

PE

NS

E A

LL

OW

AN

CE

S IN

CU

RR

ED

23.

First ye

ar

(oth

er

than s

ingle

):

23.1

Rein

sura

nce c

eded

38,1

83,4

51

38,1

83,4

51

23.2

Rein

sura

nce a

ssum

ed

23.3

Net ceded less a

ssum

ed

38,1

83,4

51

38,1

83,4

51

24.

Sin

gle

:

24.1

Rein

sura

nce c

eded

24.2

Rein

sura

nce a

ssum

ed

24.3

Net ceded less a

ssum

ed

25.

Renew

al:

25.1

Rein

sura

nce c

eded

113,01

8,36

6

11

3,01

8,36

6

25.2

Rein

sura

nce a

ssum

ed

25.3

Net ceded less a

ssum

ed

113,01

8,36

6

11

3,01

8,36

6

26.

Tota

ls:

26.1

Rein

sura

nce c

eded (

Page 6

, Lin

e 6

) 15

1,20

1,81

7

15

1,20

1,81

7

26.2

Rein

sura

nce a

ssum

ed (

Page 6

, Lin

e 2

2)

26.3

Net ceded less a

ssum

ed

151,

201,

817

151,

201,

817

CO

MM

ISS

ION

S IN

CU

RR

ED

(dir

ect

bu

sin

ess o

nly

)

27.

First ye

ar

(oth

er

than s

ingle

) 27

,503

,941

27

,503

,941

28.

Sin

gle

29.

Renew

al

43,399

,816

43

,399

,816

30.

Deposit-t

ype c

ontr

act fu

nds

31.

Tota

ls (

to a

gre

e w

ith P

age 6

, Lin

e 2

1)

70,9

03,757

70

,903

,757

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 280,000 1,403 281,403

2. Salaries and wages 18,133,988 27,253 18,161,241

3.11 Contributions for benefit plans for employees 3,270,064 9,742 3,279,806

3.12 Contributions for benefit plans for agents 10,072,995 10,072,995

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 1,093,450 420 1,093,870

3.32 Other agent welfare

4.1 Legal fees and expenses 156,852 156,852

4.2 Medical examination fees 2,826,533 2,826,533

4.3 Inspection report fees 93,636 93,636

4.4 Fees of public accountants and consulting actuaries 109,200 109,200

4.5 Expense of investigation and settlement of policy claims 70,687 655,117 725,804

5.1 Traveling expenses 335,475 651 336,126

5.2 Advertising 2,106,175 2,106,175

5.3 Postage, express, telegraph and telephone 662,338 199 662,537

5.4 Printing and stationery 95,461 65 95,526

5.5 Cost or depreciation of furniture and equipment 169,831 169,831

5.6 Rental of equipment 856,191 2,615 858,806

5.7 Cost or depreciation of EDP equipment and software 2,335,553 2,335,553

6.1 Books and periodicals 18,885 104 18,989

6.2 Bureau and association fees 189,190 72 189,262

6.3 Insurance, except on real estate 143,398 143,398

6.4 Miscellaneous losses 63,582 63,582

6.5 Collection and bank service charges 43,336 43,336

6.6 Sundry general expenses 9,501,285 436 9,501,721

6.7 Group service and administration fees

6.8 Reimbursements by uninsured plans

7.1 Agency expense allowance 10,240,998 10,240,998

7.2 Agents’ balances charged off (less $

recovered)

7.3 Agency conferences other than local meetings 592,318 592,318

9.1 Real estate expenses 387,647 387,647

9.2 Investment expenses not included elsewhere 488 488

9.3 Aggregate write-ins for expenses

10. General expenses incurred 70,687 64,433,498 43,448 (a) 64,547,633

11. General expenses unpaid December 31, prior year 56,100 56,100

12. General expenses unpaid December 31, current year 109,200 109,200

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) 70,687 64,380,398 43,448 64,494,533


09.301.

09.302.

09.303.

09.398. Summary of remaining write-ins for Line 9.3 from overflow page

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

(a) Includes management fees of $ 44,284 to affiliates and $ 458,065 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 288,565 288,565

2. State insurance department licenses and fees 744,562 744,562

3. State taxes on premiums 10,262,498 10,262,498

4. Other state taxes, including $

for employee benefits 37,146 66 37,212

5. U.S. Social Security taxes 3,819,615 1,258 3,820,873

6. All other taxes 650,738 650,738

7. Taxes, licenses and fees incurred 15,803,124 1,324 15,804,448

8. Taxes, licenses and fees unpaid December 31, prior year 964,225 964,225

9. Taxes, licenses and fees unpaid December 31, current year 1,644,695 1,644,695

10. Taxes, licenses and fees paid during year (Lines 7 + 8 - 9) 15,122,654 1,324 15,123,978

EXHIBIT 4 - DIVIDENDS OR REFUNDS1

Life2

Accident and Health

1. Applied to pay renewal premiums 123

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

3. Applied to provide paid-up additions

4. Applied to provide paid-up annuities

5. Total Lines 1 through 4 123

6. Paid in cash

7. Left on deposit

8. Aggregate write-ins for dividend or refund options

9. Total Lines 5 through 8 123

10. Amount due and unpaid

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

12. Terminal dividends

13. Provision for deferred dividend contracts

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

15. Total Lines 10 through 14

16. Total from prior year

17. Total dividends or refunds (Lines 9 + 15 - 16) 123


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

0199998. Reinsurance ceded

0199999. Life Insurance: Totals (Net)

0299998. Reinsurance ceded XXX XXX

0299999. Annuities: Totals (Net) XXX XXX

0300001. (Gross) - Supplementary Contracts with Life

Contingencies 1971 IAM 7 1/2% (Due) 325,756 325,756 0399997. Totals (Gross) 325,756 325,756 0399998. Reinsurance ceded 0399999. SCWLC: Totals (Net) 325,756 325,756 0499998. Reinsurance ceded 0499999. Accidental Death Benefits: Totals (Net) 0599998. Reinsurance ceded 0599999. Disability-Active Lives: Totals (Net) 0699998. Reinsurance ceded 0699999. Disability-Disabled Lives: Totals (Net) 0799998. Reinsurance ceded 0799999. Miscellaneous Reserves: Totals (Net)

9999999. Totals (Net) - Page 3, Line 1 325,756 325,756

12


EXHIBIT 5 - INTERROGATORIES

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

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.

At present NLTC issues neither participating nor non-participating

life or annuity contracts. 3. Does the reporting entity at present issue or have in force contracts that contain non-guaranteed elements? Yes [ ] No [ X ]

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

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

EX

HIB

IT 6

- A

GG

RE

GA

TE

RE

SE

RV

ES

FO

R A

CC

IDE

NT

AN

D H

EA

LT

H C

ON

TR

AC

TS

12

34

Oth

er

Indiv

idual C

ontr

acts

Tota

lG

roup A

ccid

ent

and H

ealth

Cre

dit A

ccid

ent

and H

ealth

(Gro

up a

nd Indiv

idual)

Colle

ctively

Renew

able

5

Non-C

ancela

ble

6G

uara

nte

ed

Renew

able

7N

on-R

enew

able

for

Sta

ted R

easons O

nly

8

Oth

er

Accid

ent O

nly

9

All

Oth

er

AC

TIV

E L

IFE

RE

SE

RV

E

1.

Unearn

ed p

rem

ium

reserv

es

122,

478,

445

122,

478,

445

2.

Additio

nal contr

act re

serv

es (

a)

2,80

2,18

0,12

3

2,

802,

180,

123

3.

Additio

nal actu

arial re

serv

es-A

sset/Lia

bili

ty a

naly

sis

4.

Reserv

e for

futu

re c

ontingent benefits

5.

Reserv

e for

rate

cre

dits

6.

Aggre

gate

write

-ins for

reserv

es

7.

Tota

ls (

Gro

ss)

2,92

4,65

8,56

8

2,

924,

658,

568

8.

Rein

sura

nce c

eded

2,92

4,65

8,56

8

2,

924,

658,

568

9.

Tota

ls (

Net)

CLA

IM R

ES

ER

VE

10.

Pre

sent valu

e o

f am

ounts

not ye

t due o

n c

laim

s

333,60

6,52

8

333,60

6,52

8

11.

Additio

nal actu

arial re

serv

es-A

sset/Lia

bili

ty a

naly

sis

12.

Reserv

e for

futu

re c

ontingent benefits

13.

Aggre

gate

write

-ins for

reserv

es

14.

Tota

ls (

Gro

ss)

333,60

6,52

8

333,60

6,52

8

15.

Rein

sura

nce c

eded

333,60

6,52

8

333,60

6,52

8

16.

Tota

ls (

Net)

17.

TO

TA

L (

Net)

18.

TA

BU

LA

R F

UN

D IN

TE

RE

ST

DE

TA

ILS

OF

WR

ITE

-IN

S

0601.

0602.

0603.

0698.

Sum

mary

of re

main

ing w

rite

-ins for

Lin

e 6

fro

m o

verf

low

page

0699.

TO

TA

LS

(Lin

es 0

601 thru

0603 p

lus 0

698)

(Lin

e 6

above)

1301.

1302.

1303.

1398.

Sum

mary

of re

main

ing w

rite

-ins for

Lin

e 1

3 fro

m o

verf

low

page

1399.

TO

TA

LS

(Lin

es 1

301 thru

1303 p

lus 1

398)

(Lin

e 1

3 a

bove)

(a)

Attach s

tate

ment as to v

alu

ation s

tandard

used in c

alc

ula

ting this

reserv

e, specifyi

ng r

eserv

e b

ases, in

tere

st ra

tes a

nd m

eth

ods.

14

Reserve bases, interest rates and methods

ACTIVE LIFE RESERVES

1. Unearned Premium $122,478,445

2. 1983a IAM 4% - 1PT 8/24/98 to 3/24/02 329,289,510

3. 1994 GAM 4.5% - 1PT 3/25/02 to 12/31/05 724,893,485

4. 1994 GAM 4% - 1PT 1/1/06 to 12/31/12 1,576,059,600

5 1994 GAM 3.5% - 1PT 1/1/13 to N.B. 171,937,528

TOTAL $2,924,658,568

Reinsurance 2,924,658,568

TOTAL ACTIVE LIFE RESERVES (NET) $0

CLAIM RESERVES

1. Industry based morbidity table 4.5% claims incurred from 8/24/98 to 12/31/05 3,486,159

2. Industry based morbidity table 4% claims incurred from 1/1/06 to 12/31/12 73,629,235

3. Industry based morbidity table 3.5% claims incurred from 1/1/13 256,491,134

TOTAL $333,606,528

Reinsurance 333,606,528

TOTAL CLAIM RESERVES (NET) $0

TOTAL EXHIBIT 6 $0

NORTHWESTERN LONG TERM CARE INSURANCE COMPANY

FOR 2016

EXHIBIT 6 - ATTACHMENT

AGGREGATE RESERVE FOR ACCIDENT AND HEALTH POLICIES

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

EX

HIB

IT 7

- D

EP

OS

IT T

YP

E C

ON

TR

AC

TS

1

Tota

l

2

Guara

nte

ed

Inte

rest C

ontr

acts

3

Annuitie

s C

ert

ain

4

Supple

menta

l C

ontr

acts

5D

ivid

end

Accum

ula

tions o

r R

efu

nds

6P

rem

ium

and

Oth

er

Deposit F

unds

1.

Bala

nce a

t th

e b

egin

nin

g o

f th

e y

ear

befo

re r

ein

sura

nce

3,71

2,01

9

3,71

2,01

9

2.

Deposits r

eceiv

ed d

uring the y

ear

23,6

95,6

13

23,6

95,6

13

3.

Investm

ent earn

ings c

redited to the a

ccount

233,24

3

23

3,24

3

4.

Oth

er

net change in r

eserv

es

5.

Fees a

nd o

ther

charg

es a

ssessed

6.

Surr

ender

charg

es

7.

Net surr

ender

or

withdra

wal paym

ents

22

,869

,400

22

,869

,400

8.

Oth

er

net tr

ansfe

rs to o

r (f

rom

) S

epara

te A

ccounts

9.

Bala

nce a

t th

e e

nd o

f curr

ent ye

ar

befo

re r

ein

sura

nce (

Lin

es 1

+2+

3+

4-5

-6-7

-8)

4,771,

475

4,771,

475

10.

Rein

sura

nce b

ala

nce a

t th

e b

egin

nin

g o

f th

e y

ear

11.

Net change in r

ein

sura

nce a

ssum

ed

12.

Net change in r

ein

sura

nce c

eded

13.

Rein

sura

nce b

ala

nce a

t th

e e

nd o

f th

e y

ear

(Lin

es 1

0+

11-1

2)

14.

Net bala

nce a

t th

e e

nd o

f curr

ent ye

ar

after

rein

sura

nce (

Lin

es 9

+ 1

3)

4,771,

475

4,771,

475

15

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

EX

HIB

IT 8

- C

LA

IMS

FO

R L

IFE

AN

D A

CC

IDE

NT

AN

D H

EA

LT

H C

ON

TR

AC

TS

PA

RT

1 -

Lia

bil

ity E

nd

of

Cu

rren

t Y

ear

12

Ord

inary

6G

roup

Accid

ent and H

ealth

Tota

lIn

dustr

ial Life

3

Life Insura

nce

4

Indiv

idual A

nnuitie

s

5S

upple

menta

ry

Contr

acts

Cre

dit L

ife (

Gro

up

and Indiv

idual)

7

Life Insura

nce

8

Annuitie

s

9

Gro

up

10

Cre

dit (

Gro

up a

nd

Indiv

idual)

11

Oth

er

1.

Due a

nd u

npaid

:

1.1

Direct

1.2

Rein

sura

nce a

ssum

ed

1.3

Rein

sura

nce c

eded

1.4

Net

2.

In c

ours

e o

f settle

ment:

2.1

Resis

ted

2.1

1 D

irect

2.1

2 R

ein

sura

nce a

ssum

ed

2.1

3 R

ein

sura

nce c

eded

2.1

4 N

et

(b)

(b

)

(b

)

(b)

2.2

Oth

er

2.2

1 D

irect

4,2

07,151

4,2

07,151

2.2

2 R

ein

sura

nce a

ssum

ed

2.2

3 R

ein

sura

nce c

eded

4,2

07,151

4,2

07,151

2.2

4 N

et

(b)

(b

)

(b

)

(b)

(b)

(b

)

(b)

3.

Incurr

ed b

ut unre

port

ed:

3.1

Direct

611,5

75

611,5

75

3.2

Rein

sura

nce a

ssum

ed

3.3

Rein

sura

nce c

eded

611,5

75

611,5

75

3.4

Net

(b)

(b

)

(b

)

(b)

(b)

(b

)

(b)

4.

TO

TA

LS

4.1

Direct

4,8

18,726

4,8

18,726

4.2

Rein

sura

nce a

ssum

ed

4.3

Rein

sura

nce c

eded

4,8

18,726

4,8

18,726

4.4

Net

(a

)

(a)

(a)

(a)

Inclu

din

g m

atu

red e

ndow

ments

(but not guara

nte

ed a

nnual pure

endow

ments

) unpaid

am

ounting to $

in C

olu

mn 2

, $

in C

olu

mn 3

and $

in C

olu

mn 7

.

(b)

Inclu

de o

nly

port

ion o

f dis

abili

ty a

nd a

ccid

ent and h

ealth c

laim

lia

bili

ties a

pplic

able

to a

ssum

ed "

accru

ed"

benefits

. R

eserv

es (

inclu

din

g r

ein

sura

nce a

ssum

ed a

nd n

et of re

insura

nce c

eded)

for

unaccru

ed b

enefits

for

Ord

inary

Life Insura

nce $

Indiv

idual A

nnuitie

s $

, C

redit L

ife (

Gro

up a

nd Indiv

idual) $

, and G

roup L

ife $

, are

inclu

ded in P

age 3

, Lin

e 1

, (S

ee E

xhib

it 5

, S

ection o

n D

isabili

ty D

isable

d L

ives);

and for

Gro

up A

ccid

ent and H

ealth $

Cre

dit (

Gro

up a

nd Indiv

idual) A

ccid

ent and H

ealth $

, and O

ther

Accid

ent and H

ealth $

a

re inclu

ded in P

age 3

, Lin

e 2

(S

ee E

xhib

it 6

, C

laim

Reserv

e).

16

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

EX

HIB

IT 8

- C

LA

IMS

FO

R L

IFE

AN

D A

CC

IDE

NT

AN

D H

EA

LT

H C

ON

TR

AC

TS

PA

RT

2 -

In

cu

rred

Du

rin

g t

he Y

ear

12

Ord

inary

6G

roup

Accid

ent and H

ealth

Tota

lIn

dustr

ial Life

(a)

3Life Insura

nce

(b)

4

Indiv

idual A

nnuitie

s

5S

upple

menta

ry

Contr

acts

Cre

dit L

ife (

Gro

up

and Indiv

idual)

7Life Insura

nce

(c)

8

Annuitie

s

9

Gro

up

10

Cre

dit (

Gro

up

and Indiv

idual)

11

Oth

er

1.

Settle

ments

During the Y

ear:

1.1

Direct

54,9

20,4

80

58

,332

54,8

62,1

48

1.2

Rein

sura

nce a

ssum

ed

1.3

Rein

sura

nce c

eded

54,4

59,2

21

54

,459

,221

1.4

Net

(d)

461,

259

58

,332

402,

927

2.

Lia

bili

ty D

ecem

ber

31, curr

ent

year

from

Part

1:

2.1

Direct

4,81

8,72

6

4,81

8,72

6

2.2

Rein

sura

nce a

ssum

ed

2.3

Rein

sura

nce c

eded

4,81

8,72

6

4,81

8,72

6

2.4

Net

3.

Am

ounts

recovera

ble

fro

m

rein

sure

rs D

ecem

ber

31, curr

ent

year

4,86

2,11

3

4,86

2,11

3

4.

Lia

bili

ty D

ecem

ber

31, prior

year:

4.1

Direct

3,64

2,30

1

3,64

2,30

1

4.2

Rein

sura

nce a

ssum

ed

4.3

Rein

sura

nce c

eded

3,64

2,30

1

3,64

2,30

1

4.4

Net

5.

Am

ounts

recovera

ble

fro

m

rein

sure

rs D

ecem

ber

31, prior

year

4,46

7,66

2

4,46

7,66

2

6.

Incurr

ed B

enefits

6.1

Direct

56,0

96,9

05

58

,332

56,0

38,5

73

6.2

Rein

sura

nce a

ssum

ed

6.3

Rein

sura

nce c

eded

56,0

30,0

97

56

,030

,097

6.4

Net

66,8

08

58

,332

8,47

6

(a)

Inclu

din

g m

atu

red e

ndow

ments

(but not guara

nte

ed a

nnual pure

endow

ments

) am

ounting to $

in L

ine 1

.1, $

in L

ine 1

.4.

$

in L

ine 6

.1, and $

in L

ine 6

.4.

(b)

Inclu

din

g m

atu

red e

ndow

ments

(but not guara

nte

ed a

nnual pure

endow

ments

) am

ounting to $

in L

ine 1

.1, $

in L

ine 1

.4.

$

in L

ine 6

.1, and $

in L

ine 6

.4.

(c)

Inclu

din

g m

atu

red e

ndow

ments

(but not guara

nte

ed a

nnual pure

endow

ments

) am

ounting to $

in L

ine 1

.1, $

in L

ine 1

.4.

$

in L

ine 6

.1, and $

in L

ine 6

.4.

(d)

Inclu

des $

60

,846

p

rem

ium

s w

aiv

ed u

nder

tota

l and p

erm

anent dis

abili

ty b

enefits

.

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 72,254 142,097 69,843

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 8,537,870 9,316,862 778,992

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

26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 8,610,124 9,458,959 848,835

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

28. Total (Lines 26 and 27) 8,610,124 9,458,959 848,835


1101.

1102.

1103.



2501.

2502.

2503.



18


19

NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________

1. Summary of Significant Accounting Policies

A. Accounting Practices

The accompanying financial statements of The Northwestern Long Term Care Insurance Company (“the Company”) were prepared in accordance with the NAIC “Accounting Practices and Procedures Manual” (“statutory basis of accounting”) as adopted by the Office of the Commissioner of Insurance of the State of Wisconsin ("OCI"), with no exceptions. A reconciliation of the Company’s net income and capital and surplus between NAIC SAP and practices prescribed and permitted by the State of Wisconsin is shown below:

F/S F/S

SSAP # Page Line # 12/31/2016 12/31/2015

NET INCOME

Northwestern Long Term Care Insurance Wisconsin basis 2,588,900$ 2,517,052$

State Prescribed Practices that increase/(decrease) NAIC SAP: N/A N/A N/A- -

State Permitted Practices that increase/(decrease) NAIC SAP: N/A N/A N/A- -

NAIC SAP (1-2-3=4) 2,588,900$ 2,517,052$

SURPLUS

Northwestern Long Term Care Insurance Wisconsin basis 82,226,973$ 79,498,470$

State Prescribed Practices that increase/(decrease) NAIC SAP: N/A N/A N/A- -

State Permitted Practices that increase/(decrease) NAIC SAP: N/A N/A N/A- -

NAIC SAP (5-6-7=8) 82,226,973$ 79,498,470$

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

The preparation of financial statements in accordance with the statutory basis of accounting requires management to make estimates or assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the periods then ended. Actual future results could differ from these estimates and assumptions.

C. Accounting Policies

1. The Securities Valuation Office (“SVO”) of the NAIC evaluates the credit quality of the Company’s bond investments and issues related credit ratings. Bonds rated "1" (highest quality), "2" (high quality), "3" (medium quality), “4” (low quality) or “5” (lower quality) are reported in the financial statements at amortized cost, less any valuation adjustment. Bonds rated “6” (lowest quality) are reported at the lower of amortized cost or fair value. The interest method is used to amortize any purchase premium or discount, including estimates of future prepayments that are obtained from independent sources. The disclosure of fair value for bonds is primarily based on independent pricing services or internally-developed pricing models utilizing observable market data.

2. The Company has no investments in common stocks.

3. The Company has no investments in preferred stocks.

4. The Company has no investments in mortgage loans.

5. The Company has no investments in subsidiaries, controlled and affiliated companies.

6. The Company has no investments in partnerships.

7. The Company has no investments in derivatives.

8. The Company has determined that no premium deficiency exists.

9. Liabilities for losses for accident and health contracts are estimated by the Company’s valuation actuary using reserves employing mortality/morbidity tables (industry based with provisions for adverse deviation) and discount rates specified by regulatory authorities for long term care business. Liabilities for loss/claim adjustment expenses are estimated by performing periodic product cost studies.

10. The Company has not modified its capitalization policy from the prior period.

11. The Company has no pharmaceutical rebate receivables.

12. Net investment income primarily represents interest and dividends received or accrued on bonds and other investments. Net investment income is reduced by investment management expenses. Accrued investment income more than 90 days past due is a nonadmitted asset and reported as a direct reduction of surplus. Accruals of investment income for securities that have been determined to be other-than-temporarily impaired are generally suspended. Accrued investment income that is ultimately deemed uncollectible is reported as a reduction of net investment income in the period that such determination is made.

13. The Company is required to maintain an interest maintenance reserve (“IMR”). The IMR is used to defer realized capital gains and losses, net of any income tax, on fixed income investments that are attributable to changes in market interest rates, including both changes in risk-free market interest rates and market credit spreads. Net realized capital gains and losses deferred to the IMR are amortized into investment income over the estimated remaining term to maturity of the investment sold.


19.1


14. Realized capital gains and losses are recognized based upon specific identification of investment assets sold. Realized capital losses also include valuation adjustments for impairment of bonds and other investments that have experienced a decline in fair value that management considers to be other-than-temporary. There were no realized capital losses related to declines in fair value of investments that were considered to be other-than-temporary for the years ended December 31, 2016 and 2015. Realized capital gains and losses as reported in the summary of operations are net of any capital gains tax (or benefit) and exclude any deferrals to the IMR of interest-rate related capital gains or losses.

15. Changes in unrealized capital gains and losses are reported in the statements of changes in capital and surplus, net of any related changes in deferred taxes.

16. Reserves for policy benefits represent the net present value of future policy benefits, less future policy premiums, calculated using actuarial methods, mortality and morbidity experience tables and valuation interest rates prescribed or permitted by the OCI. These actuarial tables and methods include assumptions regarding future mortality and morbidity experience. Actual future experience could differ from the assumptions used to make these reserve estimates.

Supplementary contract reserves are determined in accordance with the net level premium method at an interest rate of 7.5%.

Active life reserves for long-term care policies consist of mid-terminal reserves and unearned premiums. Mid-terminal reserves are based on the one-year preliminary term method and industry-based morbidity experience. For policies issued prior to March 2002, reserves are based on a 4.00% valuation interest rate and total terminations based on the 1983 Individual Annuitant Mortality table without lapses. For policies issued since March 2002, minimum reserves are based on valuation interest rates ranging from 3.50% to 4.50% and total terminations based on the 1994 Group Annuity Mortality table with lapses. For March 2002 through September 2010 issues, a separate calculation is performed using valuation interest rates ranging from 4.87% to 5.60% and assuming no lapses. Reserves from the separate calculation are compared in the aggregate to the minimum reserves as calculated above and the greater of the two is reported.

For valuations prior to 2012, the Company utilized the 1983 Individual Annuity Mortality table, the 1983 Group Annuity Mortality table, or the 1994 Group Annuity Mortality table for the calculation of minimum reserves for policies. At January 1, 2012, use of the 1983 Group Annuity Mortality table to calculate minimum reserves for policies issued from March 2002 through 2004 was replaced with a calculation using only the 1994 Group Annuity Mortality table and assumptions regarding interest rates and claim costs were adjusted to reflect more recent expectations.

Unpaid claims and claim reserves for long-term care policies are based on the present value of expected benefit payments using industry-based long-term care experience with valuation interest rates ranging from 3.50% to 4.50%.

17. Long-term care premiums and ceded expense allowances are recognized as revenue when due to the Company.

18. Benefit payments to policyholders and beneficiaries include long-term care benefits and payments on supplementary annuity contracts that include life contingencies. Benefit payments are reported net of ceded reinsurance recoveries.

19. Commissions and other operating costs, including costs of acquiring new insurance policies, are generally charged to expense as incurred.

20. Certain assets are designated as nonadmitted on the statutory basis of accounting. Such assets, including deferred tax assets in excess of statutory limits and premiums over 90 days past due, are excluded from assets and surplus. Changes in nonadmitted assets are reported as a direct adjustment to surplus in the statements of changes in capital and surplus.

21. Amounts in these financial statements are reported net of the impact of reinsurance.

2. Accounting Changes and Corrections of Errors

A. Material Accounting Changes and Corrections of Errors None

3. Business Combinations and Goodwill

A. Statutory Purchase Method

None

B. Statutory Merger

None

C. Assumption Reinsurance None

D. Impairment Loss

None

4. Discontinued Operations

None

5. Investments

A. Mortgage Loans, including Mezzanine Real Estate Loans

1. No mortgage loans were originated by the Company during 2016.

2. The Company has no investments in mortgage loans at December 31, 2016.

3. Taxes, assessment and any mortgage amounts advanced and not included in the mortgage loan total: None


19.2


4. The Company has no investments in mortgage loans at December 31, 2016. 5. Investment in Impaired Loans With or Without Allowance for Credit Losses: None

6. Investment in Impaired Loans – Average Recorded Investment, Interest Income Recognized, Recorded

Investment on Nonaccrual Status and Amount of Interest Income Recognized Using a Cash-Basis Method of Accounting: None

7. Allowance for Credit Losses:

None

8. Interest Income on Impaired Loans: None

B. Debt Restructuring

None

C. Reverse Mortgages

None

D. Loan-Backed Securities

1. The Company has no investments in loan-backed or structured securities at December 31, 2016.

2. The Company had no loan-backed securities that had other-than-temporary impairment charges taken against them during 2016.

3. The Company held no loan-backed securities for which the present value of cash flows expected to be collected

is less than the amortized cost basis of the security. 4. The Company has no investments in loan-backed or structured securities at December 31, 2016.

5. The Company has no investments in loan-backed or structured securities at December 31, 2016.

E. Repurchase Agreements and/or Securities Lending Transactions

None

F. Real Estate

None

G. Investments in Low Income Housing Tax Credit Properties (LIHTC)

None

H. Restricted Assets

1. Restricted Assets (Including Pledged)

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

Assets

S/A Assets

Supporting G/A

Activity (b)

Total

(1 plus 3)

Total From

Prior Year

Increase/

(Decrease) (5

minus 6)

Total Current

Year Admitted

Restricted

Gross Restricted

to Total Assets

Admitted

Restricted to

Total Admitted

Assets

a. Subject to contractual obligation for

which liability is not shown -$ -$ -$ -$ -$ -$ -$ -$ 0% 0%

b. Colateral held under security lending

agreements - - - - - - - - 0% 0%

c. Subject to repurchase agreements - - - - - - - - 0% 0%

d. Subject to reverse repurchase

agreements - - - - - - - - 0% 0%

e. Subject to dollar repurchase

agreements - - - - - - - - 0% 0%

f. Subject to dollar reverse repurchase

agreements - - - - - - - - 0% 0%

g. Placed under option contracts - - - - - - - - 0% 0%

h. Letter stock or securities restricted as

to sale - excluding FHLB capital

stock - - - - - - - - 0% 0%

i. FHLB capital stock - - - - - - - - 0% 0%

j. On deposit with states 2,702,008 - - - 2,702,008 2,702,007 1 2,702,007 1.49% 1.56%

k. On deposit with other regulatory

bodies - - - - - - - - 0% 0%

l. Pledged collateral to FHLB

(including assets backing funding

agreements) - - - - - - - - 0% 0%

m. Pledged as collateral not captured in

other categories - - - - - - - - 0% 0%

n. Other restricted assets - - - - - - - - 0% 0%

o. Total Restricted Assets 2,702,008$ -$ -$ -$ 2,702,008$ 2,702,007$ 1$ 2,702,007$ 1.49% 1.56%

(a) Subset of column 1

(b) Subset of column 3

Gross Restricted Percentage

Current Year

Restricted Asset Category

2. Detail of Assets Pledged as Collateral Not Captured in Other Categories (contracts that Share Similar Characteristics, Such as Reinsurance and Derivatives, Are Reported in the Aggregate) None

3. Detail of Other Restricted Assets (Contracts that Share Similar Characteristics, Such as Reinsurance and

Derivatives, Are Reported in the Aggregate) None

4. Collateral Received and Reflected as Assets Within the Reporting Entity’s Financial Statements

None


19.3


I. Working Capital Finance Investments

None

J. Offsetting and Netting of Assets and Liabilities

None

K. Structured Notes

None

L. 5* Securities

None

6. Joint Ventures, Partnerships and Limited Liability Companies

A. The Company has no investments in partnerships at December 31, 2016.

B. The Company did not recognize any impairment write downs for its investments in partnerships during the statement period.

7. Investment Income

A-B. The Company had no nonadmitted due and accrued investment income at December 31, 2016 or 2015.

8. Derivative Instruments None

9. Income Taxes

A.

1. The components of the net deferred tax asset/(liability) at December 31, are as follows:

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

(Col 1+2) (Col 4+5) (Col 1-4) (Col 2-5) (Col 7+8)

Ordinary Capital Total Ordinary Capital Total Ordinary Capital Total

(a) Gross Deferred Tax Assets 15,904,925 - 15,904,925 16,009,841 - 16,009,841 (104,916) - (104,916)

(b) Statutory Valuation Allowance

Adjustment - - - - - - - - -

(c ) Adjusted Gross Deferred

Tax Assets (1a-1b) 15,904,925 - 15,904,925 16,009,841 - 16,009,841 (104,916) - (104,916)

(d) Deferred Tax Assets Nonadmitted 8,537,870 - 8,537,870 9,316,862 - 9,316,862 (778,992) - (778,992)

(e) Subtotal Net Admitted Deferred

Tax Asset (1c-1d) 7,367,055 - 7,367,055 6,692,979 - 6,692,979 674,076 - 674,076

(f) Deferred Tax Liabilities 3,789,888 532,408 4,322,296 3,542,747 175,232 3,717,979 247,141 357,176 604,317

(g) Net Admitted DTA/(Net DTL) (1e-1f) 3,577,167 (532,408) 3,044,759 3,150,232 (175,232) 2,975,000 426,935 (357,176) 69,759

12/31/2016 12/31/2015 Change

All deferred tax liabilities have been recognized for years ended December 31, 2016 and 2015. The Company exceeded the minimum risk-based capital (“RBC”) level of 300% based on authorized control level RBC computed without net deferred tax assets at December 31, 2016 and 2015 and expects to exceed this minimum during 2017. The Company does not have any known contingent tax liabilities for the years ended December 31, 2016 and 2015.

2. The SSAP 101 deferred tax asset admission calculation components, at December 31, 2016 and 2015, are as follows.

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

(Col 1+2) (Col 4+5) (Col 1-4) (Col 2-5) (Col 7+8)

Admission Calculation Components SSAP No. 101 Ordinary Capital Total Ordinary Capital Total Ordinary Capital Total

(a) Federal Income Taxes paid in Prior Years

Recoverable through Loss Carrybacks - - - - - - - - -

(b) Adjusted Gross Deferred Tax Assets

Expected to be Realized (Excluding the

Amount of Deferred Tax Assets From 2(a) 3,044,759 - 3,044,759 2,975,000 - 2,975,000 69,759 - 69,759

above) After Application of the threshold

Limitation. (the lessor of 2(b)1 and 2(b)2 below

1. Adjusted Gross Deferred Tax Assets

Expected to be Realized Following

the Balance Sheet Date 3,044,759 - 3,044,759 2,975,000 - 2,975,000 69,759 - 69,759

2. Adjusted Gross Deferred Tax Assets

Allowed per Limitation Threshold NA NA 11,877,332 NA NA 11,103,524 NA NA 773,808

(c ) Adjusted Gross Deferred Tax Assets

(Excluding the Amount of Deferred Tax 4,322,296 - 4,322,296 3,717,979 - 3,717,979 604,317 - 604,317

Assets From 2(a) and 2(b) above) Offset by

Gross Deferred Tax Liabilities

(d) Deferred Tax Assets Admitted as the result

of application of SSAP No. 101

Total (2(a) + 2(b) + 2(c)) 7,367,055 - 7,367,055 6,692,979 - 6,692,979 674,076 - 674,076

12/31/2016 12/31/2015 Change

3.

2016 2015

(a) Ratio Percentage Used to Detemine

Recovery Period And Threshold Limitation

Amount. 787% 906%

(b) Amount of Adjusted Capital and Surplus

Used to Determine Recovery Period And

Threshold Limitation In 2(b)2 Above. 79,182,213 74,123,493


19.4


4.

(1) (2) (3) (4) (5) (6)

(Col 1-3) (Col 2-4)

Ordinary Capital Ordinary Capital Ordinary Capital

Impact of Tax Planning Strategies

(a) Determination of adjusted gross deferred tax assets

and net admitted deferred tax assets, by tax character

as a percentage.

1. Adjusted Gross DTAs amount from Note 9A1(c) 15,904,925 - 16,009,841 - (104,916) -

2. Percentage of adjusted gross DTAs by tax character

attributable to the impact of tax planning strategies 0% 0% 0% 0% 0% 0%

3. Net Admitted Adjusted Gross DTAs amount from

Note 9A1(e) 7,367,055 - 6,692,979 - 674,076 -

4. Percentage of net admitted adjusted gross DTAs by

tax character admitted because of the impact of

tax planning strategies 0% 0% 0% 0% 0% 0%

(b) Does the Company's tax-planning strategies include the use of reinsurance? Yes__________No ____X_____

12/31/2016 12/31/2015 Change

B. There were no unrecognized deferred tax liabilities at December 31, 2016 and 2015. C. Current income tax expenses incurred consist of the following major components:

For the years ended December 31,

2016 2015 Change

1. Current Income Tax

a. Federal -$ 337,929$ (337,929)$

b. Foreign - - -

c. Subtotal - 337,929 (337,929)

d. Federal income tax on net capital gains - (337,929) 337,929

e. Utilization of capital loss carry-forwards - - -

f. Other - - -

g. Federal and foreign income taxes incurred - - -

2. Deferred Tax Assets

a. Ordinary

(1) Discounting of unpaid losses - - -

(2) Unearned premium reserve - - -

(3) Policyholder reserves 7,719,606 8,987,857 (1,268,251)

(4) Investments - - -

(5) Deferred acquisition costs - - -

(6) Policyholder dividends accrual - - -

(7) Fixed assets - 8,751 (8,751)

(8) Compensation and benefits accrual - - -

(9) Pension accrual - - -

(10) Receivables - nonadmitted 25,289 49,734 (24,445)

(11) Net operating loss carry-forward 7,708,530 6,578,499 1,130,031

(12) Tax credit carry-forward - - -

(13) Other 451,500 385,000 66,500

Subtotal 15,904,925 16,009,841 (104,916)

b. Statutory valuation allowance adjustment - - -

c. Nonadmitted 8,537,870 9,316,862 (778,992)

d. Admitted ordinary deferred tax assets 7,367,055 6,692,979 674,076

e. Capital:


(2) Net capital loss carry-forward - - -

(3) Real estate - - -

(4) Other - - -

Subtotal - - -

f. Statutory valuation allowance adjustment - - -

g. Nonadmitted - - -

h. Admitted capital deferred tax assets - - -

i. Admitted deferred tax assets 7,367,055 6,692,979 674,076

3. Deferred Tax Liabilities

a. Ordinary


(2) Fixed assets - - -

(3) Deferred and uncollected premium - - -

(4) Policyholder reserves - - -

(5) Other 3,789,888 3,542,747 247,141

Subtotal 3,789,888 3,542,747 247,141

b. Capital:

(1) Investments 532,408 175,232 357,176

(2) Real estate - - -

(3) Other - - -

Subtotal 532,408 175,232 357,176

c. Deferred tax liabilities 4,322,296 3,717,979 604,317

4. Net deferred tax assets/liabilities 3,044,759$ 2,975,000$ 69,759$


19.5


Changes in deferred tax assets and liabilities related to unrealized capital gains and losses on investments are included in changes in unrealized capital gains and losses in the statements of changes in capital and surplus. Other net changes in deferred tax assets and liabilities are reported as direct adjustments to surplus in the statements of changes in capital and surplus.

D. Among the more significant book to tax adjustments were the following:

December 31,

2016

Effective Tax

Rate

Provision computed at statutory rate 906,115 35.0%

Amortization of IMR (223,187) -8.6%

Other 26,305 1.0%

Total 709,233 27.4%

Federal and foreign income taxes incurred - 0.0%

Change in net deferred income taxes 709,233 27.4%

Total statutory income taxes 709,233 27.4%

E. 1. The Company has net operating loss carry forwards of $3,229 thousand, $4,612 thousand and $14,184 thousand originating in 2016, 2015 and 2014, respectively. If unused, these will expire in 2036, 2035 and 2034, respectively.

2. There were no federal income taxes incurred in the current and prior years that is available for recoupment in the event of future net losses.

3. The Company had no deposits admitted under Section 6603 of the IRS Code.

F. The Company’s federal income tax return is consolidated with the tax return of its parent, NMLIC which includes the following entities:

Northwestern Mutual Investment Services, LLC Bradford, Inc. and subsidiaries

NML Real Estate Holdings, LLC and subsidiaries Mason Street Advisors, LLC

NML Securities Holdings, LLC and subsidiaries NM GP Holdings, LLC and subsidiaries

Northwestern Mutual MU TLD Registry, LLC NM Pebble Valley, LLC

Northwestern Mutual Wealth Management Company Northwestern Mutual Registry, LLC

NM Investment Holdings, LLC NM Planning, LLC and Subsidiaries

NM Investment Management Company, LLC GRO, LLC and GRO-SUB, LLC

The method of allocation between the companies is subject to written tax-sharing agreements, approved by the management of each entity. Allocation is generally based upon separate return calculations with carry forward credits for net losses available to offset tax due in subsequent years or refund of tax when carryback to prior years is available. Intercompany tax balances are settled quarterly.

G. The Company has no federal or foreign tax loss contingencies.

10. Information Regarding Parent, Subsidiaries and Affiliates

A. The Company is a wholly-owned subsidiary of NMLIC.

B. The Company has no employees. A Product and General Service Agreement is in effect between the Company and NMLIC. Under the terms of this agreement, NMLIC agrees to provide all specified services requested by the Company as necessary for its operations and the Company agrees to reimburse NMLIC for the amount of expenses incurred.

C. The Company has an administrative agreement with NMLIC under which NMLIC provides certain management, administrative and data processing services to the Company. Expenses incurred by the Company for these services totaled $45,820,800 and $51,862,165 for the years ending December 31, 2016 and 2015, respectively. NMLIC did not make any cash contributions of capital during the years ended December 31, 2016 and 2015, respectively.

D. At December 31, the Company reported the following amounts due to and from affiliates:

2016 2015

Due from affiliates:

NMLIC 40,405,532$ 34,684,258$

Total due from affiliates 40,405,532$ 34,684,258$

Due to affiliates:

Northwestern Mutual Investment Management Co. 11,006$ 10,779$

Total 11,006$ 10,779$

December 31,

.

The intercompany balances with NMLIC and Mason Street Advisors, LLC are generally settled in cash within 30 days of the reporting date.


19.6


E. The Company has not participated in any guarantees or undertakings for the benefit of affiliates or related parties that have resulted in material contingent exposure of the Company’s or any related party’s assets or liabilities. See note 14A.

F. See A, B and C above. G. All outstanding shares of the Company are owned by NMLIC, an insurance holding company domiciled in the state

of Wisconsin. NMLIC became sole owner on November 23, 1982, by purchasing all of the outstanding shares from the Sundstrand Corporation.

H. The Company does not own any shares of an upstream intermediate entity or ultimate parent.

I. The Company had no investments in subsidiaries, controlled and affiliated companies at December 31, 2016 or 2015.

J. The Company had no investments in impaired subsidiaries, controlled or affiliated companies during 2016 or 2015.

K. The Company has no foreign insurance subsidiaries.

L. The company has no downstream noninsurance holding companies.

M. The Company has no subsidiary, controlled or affiliated investments.

N. The Company has no subsidiary, controlled or affiliated investments.

11. Debt

A. The Company had no debt outstanding at December 31, 2016 or 2015.

B. FHLB (Federal Home Loan Bank) Agreements

None

12. Retirement Plans, Deferred Compensation, Post-Employment Benefits and Compensated Absences and Other

Post-Retirement Benefit Plans

None

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

1. The Company has 1,500,000 shares authorized, 1,250,000 shares issued and 1,250,000 shares outstanding. All stock is Class A stock with a $2 par value.

2. The Company has no preferred stock.

3. According to the by-laws of the Company, the Company may pay dividends to stockholders without restriction, in a manner and upon the terms and conditions provided by law and the articles of incorporation. .

4. No stockholder dividends have been paid or accrued during 2016 and 2015.

5. See 3 above.

6. There are no restrictions on unassigned funds.

7. There have been no advances to surplus.

8. The Company held no stock for special purposes.

9. There were no changes in the balances of any special surplus funds during the periods presented.

10. The Company had no portion of unassigned funds (surplus) represented or reduced by cumulative unrealized gains

and (losses).

11. The Company has issued no surplus debentures or similar obligations.

12. The Company has not been involved in any quasi-reorganization.

13. The Company has not been involved in any quasi-reorganization.

14. Liabilities, Contingencies and Assessments

A. Contingent Commitments

1. In the normal course of its investment activities, the Company makes commitments to fund other investments. There were no outstanding commitments at December 31, 2016.

2-3. None

B. Assessments

1) As of December 31, 2016, the Company received the annual notification from the National Organization of Life and Health Insurance Guaranty Association (“NOLHGA”) of the insolvency of various insurance companies. Based on these estimates, it is estimated that these insolvencies may result in retrospective-premium-based guaranty fund assessments against the Company of up to $5,900,000 at December 31, 2016, an amount which is reported as a liability in the financial statements at December 31, 2016. Premium tax offsets related to the potential assessments are expected to be approximately $5,394,503 at December 31, 2016, which is reported as an asset in the financial statements, resulting in an estimated net obligation of $505,497.


19.7


2)

a. Assets recognized from paid and accrued premium tax offsets and

policy surcharges prior year-end 4,719,629$

b. Decreases current year

Policy surcharges collected -

Policy surcharges charged off -

Premium tax offset applied (90,568)

c. Increases current year Policy surcharges collected -

Policy surcharges charged off -

Premium tax offset applied 765,442

d. Assets recognized from paid and accrued premium tax offsets and policy surcharges current year-end 5,394,503$

C. Gain Contingencies

None

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

None

E. Joint and Several Liabilities

None

F. All Other Contingencies

The Company is engaged in various legal actions in the course of its investment and insurance operations. The status of these legal actions is actively monitored by management. If management believed, based on available information, that an adverse outcome upon resolution of a given legal action was probable and the amount of that adverse outcome was reasonable to estimate, a loss would be recognized and a related liability recorded.

Legal actions are subject to inherent uncertainties, and future events could change management’s assessment of the probability or estimated amount of potential losses from pending or threatened legal actions. Based on available information, it is the opinion of management that the ultimate resolution of pending or threatened legal actions, both individually and in the aggregate, will not result in losses having a material effect on the Company’s financial position at December 31, 2016.

15. Leases

A. The Company does not have any material lease obligations.

B. Leasing is not a significant part of the Company’s business.

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

At December 31, 2016, the Company’s bond portfolio includes a significant concentration of investments in U.S. Treasury securities and the vast majority of the Company’s long-term care (“LTC”) in-force business is reinsured by its parent, NMLIC. See Note 21 below for more information regarding the affiliated reinsurance transaction.

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

A. Transfers of Receivables Reported as Sales

None

B. Transfer and Servicing of Financial Assets

None

C. Wash Sales

None

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

Insured Plans

None

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

None

20. Fair Value Measurements

A. The Company’s estimation of fair value for financial instruments uses a hierarchy that, where possible, makes use of quoted market prices from active and transparent markets for assets that are identical to those being valued, typically obtained from independent pricing services (“level 1”). In absence of quoted market prices for identical assets, fair value is estimated by these pricing services using relevant and observable market-based inputs for substantially similar securities (“level 2”). Financial instruments for which no quoted market prices or observable inputs are available are generally valued using internally-developed pricing models or indicative (i.e., non-binding) quotes from independent securities brokers (“level 3”).

The Company actively monitors quality control over fair value estimates received from independent pricing services at each financial reporting date, including analysis of valuation changes for individual securities compared to overall market trends and validation on an exception basis with internally-developed pricing models. The Company also performs periodic reviews of the information sources, inputs and methods used by its independent pricing services, including an evaluation of their control processes. Where necessary, the Company will challenge third-party valuations or methods and require more observable inputs or different methodologies.


19.8


Bonds

Bonds classified as level 1 financial instruments are generally limited to U.S. Treasury securities. See Note 1 and Note 5 for more information regarding the Company’s investments in bonds.

Cash and Short-term Investments

Cash and short-term investments include cash deposit balances, money market funds, short-term commercial paper and other highly-liquid debt instruments, for which the Company considers amortized cost to approximate fair value.

Assets and Liabilities Reported at Fair Value

1. Fair Value Measurements at Reporting Date - None

2. Fair Value Measurements in (Level 3) of the Fair Value Hierarchy - None

3. The Company may reclassify assets reported at fair value between levels of the SSAP 100 fair value hierarchy if appropriate based on changes in the quality of valuation inputs available during a reporting period. There were no transfers between Level 1 and Level 2 or between Level 2 and Level 3 during the years ended December 31, 2016 or 2015.

4. The Company held no assets or liabilities measured within Level 2 or 3 of the fair value hierarchy at December

31, 2016. 5. The Company held no derivative assets or liabilities at December 31, 2016.

B. Combined Fair Value Measurements

None

C. Financial Instruments

December 31, 2016

Type of Financial Instrument

Aggregate Fair

Value Admitted Assets Level 1 Level 2 Level 3

Assets:

Bonds 92,272,495$ 89,439,856$ 92,272,495$ -$ -$

Cash and short-term securities 5,409,255 5,409,255 5,409,255 - -

December 31, 2015

Type of Financial Instrument

Aggregate Fair

Value Admitted Assets Level 1 Level 2 Level 3

Assets:

Bonds 89,591,651$ 86,313,518$ 89,591,651$ -$ -$

Cash and short-term securities 6,759,355 6,759,355 6,759,355 - -

D. Not Practicable to Estimate Fair Value

None

21. Other Items

A. Extraordinary Items

None

B. Troubled Debt Restructuring-Debtors

None

C. Other Disclosures and Unusual Items

Each year, the Company must perform asset adequacy testing to demonstrate that reserves make adequate provision for the anticipated cash flows required by contractual obligations and related expenses, in light of assets held for the reserves. Asset adequacy testing (“AAT”) is performed in accordance with presently accepted actuarial standards and must include assumptions necessary to determine the adequacy of reserves under moderately adverse conditions. The Company is no longer required to hold any AAT reserves at December 31, 2016 and 2015 as a result of an affiliated reinsurance transaction discussed further in Note 6 of these financial statements. The Company cedes the vast majority of the risk associated with its long-term care business to NMLIC as part of an affiliated reinsurance agreement.

With regard to General Interrogatory 16 (located on page 20.2 of this Annual Statement), NMLIC’s Finance Committee, a subordinate committee of its Board of Trustees, generally delegates the authority to purchase and sell investments on behalf of the Company to its officers (e.g. Chief Investment Officer, Senior Vice President – Securities) or to certain investment managers. These delegations are subject to limitations generally based on the characteristics and amount of the investments which can be purchased or sold on the Company’s behalf.

D. Business Interruption Insurance Recoveries

None

E. State Transferable and Non-transferable Tax Credits None

F. Subprime Mortgage Related Risk Exposure None


19.9


G. Retained Assets

None

H. Insurance-linked Securities

None

22. Events Subsequent – Not applicable

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)

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) that is owned in excess of 10% or controlled directly or indirectly by an insured, a beneficiary, a creditor, or an insured or any other person not primarily engaged in the insurance business? Yes ( ) No (X)

Section 2- Ceded Reinsurance Report- Part A 1. Does the Company have any reinsurance agreements in effect under which the reinsurer may unilaterally cancel

any reinsurance for reasons other than for nonpayment of premium or other similar credits? Yes ( ) No (X)

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 that, 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)

Section 3- Ceded Reinsurance Report- Part B

1. What is the estimated amount of the aggregate reduction in surplus (for agreements other than those under, which the reinsurer may unilaterally cancel for reasons other than nonpayment of premium or other similar credits that are 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 current or anticipated experience of the business reinsured in making this estimate. The surplus impact of a hypothetical termination of all reinsurance agreements would depend on the negotiated terms of the termination. Management believes that the impact would be immaterial based on reasonable assumptions about such terms.

2. Have any new agreements been executed or have any existing agreements been amended since January 1 of the year of this statement to include policies or contracts that were in force or which had existing reserves established by the Company as of the effective date of the agreement?

Yes ( ) No (X)

B. Uncollectible Reinsurance None

C. Commutation of Ceded Reinsurance

None

D. Certified Reinsurance Rating Downgraded or Status Subject to Revocation

1. Not applicable.

2. Not applicable.

E. Reinsurance of Variable Annuity Contracts with an Affiliated Captive Reinsurer None

F. Reinsurance Agreements with Affiliated Captive Reinsurer None

G. Ceding Entities That Utilize Captive Reinsurers to Assume Reserves Subject to the XXX/AXXX Captive

Framework

None

24. Retrospectively Rated Contracts and Contracts Subject to Redetermination

None

25. Change in Incurred Losses and Loss Adjustment Expenses

All reserves have been ceded as of December 31, 2016. All claim reserves and incurred claim detail is provided to the assuming companies.

26. Inter-company Pooling Arrangements

None

27. Structured Settlements

None

28. Health Care Receivables

None


19.10


29. Participating Policies At December 31, 2016, 100% of long-term care insurance policies were participating. Annually, the Company’s Board of Directors approves dividends payable on participating policies during the subsequent fiscal year, which are accrued and charged to operations when approved. Participating dividends are only available to reduce future premiums. The Company recognized dividends to policyowners in the summary of operations of $123 and $1,048 during 2016 and 2015, respectively. No additional income was allocated to participating policyowners.

30. Premium Deficiency Reserves

1. Liability carried for premium deficiency reserves $0 2. Date of the most recent evaluation of this liability 2016 3. Was anticipated investment income utilized in the calculation Yes

31. Reserves for Life Contracts and Annuity Contracts

None

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

A. – E.

Following is a summary of annuity reserves, including separate accounts, and deposit-fund liabilities by withdrawal characteristic at December 31, 2016:

General Account

Separate

Accounts

with

Guarantees

Separate Accounts

Nonguaranteed Total

% of

Total

A. Subject to discretionary withdrawal:

1. With fair value adjustment -$ -$ -$ -$ 0.0%

2. At book value less current surrender

charge of 5% or more - - - - 0.0%

3. At fair value - - - - 0.0%

4. Total with adjustment or at fair value

(Total of 1 through 3) -$ -$ -$ -$ 0.0%

5. At book value without adjustment

(minimal or no charge or adjustment) 4,771,475 - - 4,771,475 93.6%

B. Not subject to discretionary withdrawal 325,756 - - 325,756 6.4%

C. Total (gross: direct + assumed) 5,097,231$ -$ -$ 5,097,231$ 100.0%

D. Reinsurance ceded - - - -

E. Total (net) C - D 5,097,231$ -$ -$ 5,097,231$

Following is a reconciliation of total annuity actuarial reserves, including separate accounts, and deposit-fund liabilities at December 31, 2016:

F.

Life and Accident and Health Annual Statement:

1. Exhibit 5, Annuities Section, Total (net) -$

2. Exhibit 5, Supplementary Contracts with Life Contingencies Section, Total (net) 325,756

3. Exhibit 7, Deposit-Type Contracts, Line 14, Column 1 4,771,475

4. Subtotal 5,097,231$

Separate Accounts Annual Statement:

5. Exhibit 3, Line 0299999, Column 2 -$

6. Exhibit 3, Line 0399999, Column 2 -

7. Policyholder dividend and coupon accumulations

8. Policyholder premiums

9. Guaranteed interest contracts

10. Other contract deposit funds -

11. Subtotal -$

12. Combined Total 5,097,231$

33. Premium and Annuity Considerations Deferred and Uncollected None

34. Separate Accounts

None

35. Loss/Claim Adjustment Expenses All claim adjustment expenses have been ceded as of December 31, 2016. All liability detail has been provided to the assuming companies.


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? Wisconsin

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. 12/31/2012

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. 12/31/2012

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). 04/24/2014

3.4 By what department or departments?

Wisconsin

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 ]

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

Northwestern Mutual Investment Services, LLC Milwaukee, WI NO NO NO YES

Mason Street Advisors, LLC Milwaukee, WI NO NO NO YES

Northwestern Mutual Wealth Management Company Milwaukee, WI NO YES NO NO

LearnVest Planning Services, LLC Scottsdale, AZ 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 100 East Wisconsin Ave., Milwaukee, WI 53202

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?

Chris G. Trost, VP Actuary, Northwestern Long Term Care Insurance Company, 720 East Wisconsin Avenue, Milwaukee, WI 53202

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 [ X ] No [ ]

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

22.22 Amount paid as expenses $ 50,070

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 [ X ] No [ ]

23.2 If yes, indicate any amounts receivable from parent included in the Page 2 amount: $ 40,405,532

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 [ ] No [ X ]

24.02 If no, give full and complete information relating thereto

2,695,000 912828G38 US Treasury 2.25% 11/15/2024 on deposit with multiple states.

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)

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 $ 2,702,007

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

The Bank of New York Mellon 135 Santilli Highway, Everett, MA 02149

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

Northwestern Mutual Investment Management Company, 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 [ ]

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 [ ]

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

4973327

Northwestern Mutual Investment Management

Company, LLC 549300W5EJUHTUUBZI82 Not a Registered Investment Advisor DS

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 89,439,856 92,272,495 2,832,639


30.3 Totals 89,439,856 92,272,495 2,832,639

30.4 Describe the sources or methods utilized in determining the fair values:

Prices are provided by independent pricing services.

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 [ ] No [ X ]

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 [ ]

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:

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



OTHER

33.1 Amount of payments to trade associations, service organizations and statistical or rating bureaus, if any? $ 10,287

33.2 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

American Council of Life 5,220

34.1 Amount of payments for legal expenses, if any? $

34.2 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

35.1 Amount of payments for expenditures in connection with matters before legislative bodies, officers or departments of government, if any? $ 3,330

35.2 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

American Council of Life 3,330

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 160,022 288,910

2.3 Premium Ratio (2.1/2.2) 0.000 0.000

2.4 Reserve Numerator 122,478,445 115,309,890

2.5 Reserve Denominator 325,756 367,778

2.6 Reserve Ratio (2.4/2.5) 375.982 313.531

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 [ X ]

3.6 Has the reporting entity assumed by reinsurance any Separate Accounts business as of December 31? Yes [ ] No [ X ]

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 $ 47,592,478

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: $ 115,045,146

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? $

9.1 Does the company have variable annuities with guaranteed benefits? Yes [ ] No [ X ]

9.2 If 9.1 is yes, complete the following table for each type of guaranteed benefit.

Type 3 4 5 6 7 8 91

GuaranteedDeath Benefit

2Guaranteed

Living Benefit

WaitingPeriod

RemainingAccount Value

Related to Col. 3Total Related

Account ValuesGross Amount

of ReserveLocation of

ReservePortion

ReinsuredReinsurance

Reserve Credit

10. 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:

10.1 Amount of loss reserves established by these annuities during the current year: $

10.2 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)

11.1 Do you act as a custodian for health savings accounts? Yes [ ] No [ X ]

11.2 If yes, please provide the amount of custodial funds held as of the reporting date. $

11.3 Do you act as an administrator for health savings accounts? Yes [ ] No [ X ]

11.4 If yes, please provide the balance of funds administered as of the reporting date. $

21.1



12.1 Are any of the captive affiliates reported on Schedule S, Part 3, authorized reinsurers? Yes [ ] No [ ] N/A [ X ]

12.2 If the answer to 12.1 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

13. Provide the following for individual ordinary life insurance* policies (U.S. business only) for the current year (prior to reinsurance assumed or ceded):

13.1 Direct Premium Written $

13.2 Total Incurred Claims $

13.3 Number of Covered Lives

*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)

21.2


FIVE-YEAR HISTORICAL DATAShow amounts in whole dollars only, no cents; show percentages to one decimal place, i.e. 17.6.

Show amounts of life insurance in this exhibit in thousands (OMIT $000)1

20162

20153

20144

20135

2012

Life Insurance in Force

(Exhibit of Life Insurance)

1. Ordinary - whole life and endowment (Line 34, Col. 4)

2. Ordinary - term (Line 21, Col. 4, less Line 34, Col. 4)

3. Credit life (Line 21, Col. 6)

4. Group, excluding FEGLI/SGLI (Line 21, Col. 9 less Lines 43 & 44, Col. 4)

5. Industrial (Line 21, Col. 2)

6. FEGLI/SGLI (Lines 43 & 44, Col. 4)

7. Total (Line 21, Col. 10)

New Business Issued

(Exhibit of Life Insurance)

8. Ordinary - whole life and endowment (Line 34, Col. 2)

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)

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)

15.2 Ordinary-individual annuities (Line 20.4, Col. 4)

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) 160,022 288,910 (1,548,340,646) 457,315,030 387,116,275

19. Aggregate of all other lines of business (Line 20.4,Col. 11)

20. Total 160,022 288,910 (1,548,340,646) 457,315,030 387,116,275

Balance Sheet (Pages 2 & 3)

21. Total admitted assets excluding Separate Accounts business (Page 2, Line 26, Col. 3) 172,726,124 165,970,786 161,441,477 2,220,146,334 1,861,552,902

22. Total liabilities excluding Separate Accounts business (Page 3, Line 26) 90,499,151 86,472,316 84,261,005 2,006,396,186 1,586,835,624

23. Aggregate life reserves (Page 3, Line 1) 325,756 367,778 435,253 462,366 541,884

24. Aggregate A & H reserves (Page 3, Line 2) 1,855,256,395 1,392,221,999

25. Deposit-type contract funds (Page 3, Line 3) 4,771,475 3,712,019 3,180,318 2,723,120 2,311,766

26. Asset valuation reserve (Page 3, Line 24.01) 50,273,262 36,167,521

27. Capital (Page 3, Lines 29 and 30) 2,500,000 2,500,000 2,500,000 2,500,000 2,500,000

28. Surplus (Page 3, Line 37) 79,726,973 76,998,470 74,680,472 211,250,148 272,217,278

Cash Flow (Page 5)

29. Net Cash from Operations (Line 11) (260,280) (1,365,689) 294,979,888 336,548,277 237,851,010

Risk-Based Capital Analysis

30. Total adjusted capital 82,226,973 79,498,470 77,180,472 264,023,410 314,064,799

31. Authorized control level risk - based capital 10,066,031 8,441,818 7,006,975 30,740,994 29,262,442

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) 94.3 92.7 95.3 76.2 73.1

33. Stocks (Lines 2.1 and 2.2) 7.8 8.6

34. Mortgage loans on real estate(Lines 3.1 and 3.2 ) 12.2 13.3

35. Real estate (Lines 4.1, 4.2 and 4.3)

36. Cash, cash equivalents and short-term investments (Line 5) 5.7 7.3 4.7 2.4 4.5

37. Contract loans (Line 6)

38. Derivatives (Page 2, Line 7) 0.0

39. Other invested assets (Line 8) 0.0 1.3 0.6

40. Receivables for securities (Line 9) 0.0 0.0 0.0 0.0 0.0

41. Securities lending reinvested collateral assets (Line 10)

42. Aggregate write-ins for invested assets (Line 11) 0.0

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)

12016

22015

32014

42013

52012

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) 8,610,124 9,458,959 8,475,182 117,193,068 78,431,486

53. Total admitted assets (Page 2, Line 28, Col. 3) 172,726,124 165,970,786 161,441,477 2,220,146,334 1,861,552,902

Investment Data

54. Net investment income (Exhibit of Net Investment Income) 2,061,341 1,889,807 77,652,390 79,242,573 54,266,560

55. Realized capital gains (losses) (Page 4, Line 34, Column 1 ) 402,705 31,486,004 18,105,708 1,774,411

56. Unrealized capital gains (losses) (Page 4, Line 38, Column 1) (20,855,397) 11,920,624 8,754,120

57. Total of above Lines 54, 55 and 56 2,061,341 2,292,512 88,282,997 109,268,905 64,795,091

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)

59. Total contract benefits - A & H (Lines 13 & 14, Cols. 9, 10 & 11) 8,476 28,185 19,073,373 24,513,467 20,257,199

60. Increase in life reserves - other than group and annuities (Line 19, Cols. 2 and 3 )

61. Increase in A & H reserves (Line 19, Cols. 9, 10 & 11) (1,858,575,142) 465,423,865 454,038,183

62. Dividends to policyholders (Line 30, Col. 1) 123 1,048 10,713 42,825 6,479,198

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 (9,869.8) (5,169.9) (6.6) 29.7 39.6

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

65. A & H loss percent (Schedule H, Part 1, Lines 5 and 6, Col. 2) 49.5 35.0 119.3 108.4 141.2

66. A & H cost containment percent (Schedule H, Pt. 1, Line 4, Col. 2) 44.2 25.2 (0.4) 1.4 1.5

67. A & H expense percent excluding cost containment expenses (Schedule H, Pt. 1, Line 10, Col. 2) (38.4) (70.1) (7.6) 33.3 43.4

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) 20,186,930 129,056,040 102,702,266

71. Prior years’ claim liability and reserve-health other than group (Schedule H, Part 3, Line 3.2 Col. 1 less Col. 2) 156,554,960 135,969,542 96,183,318

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)

74. Ordinary - individual annuities (Col. 4)

75. Ordinary-supplementary contracts (Col. 5) (3,323) 5,009 466,337 21,133 (33,750)

76. Credit life (Col. 6)

77. Group life (Col. 7)

78. Group annuities (Col. 8)

79. A & H-group (Col. 9)

80. A & H-credit (Col. 10)

81. A & H-other (Col. 11) 2,592,222 2,109,337 371,661,848 (102,320,670) (194,593,735)

82. Aggregate of all other lines of business (Col. 12)

83. Total (Col. 1) 2,588,899 2,114,346 372,128,185 (102,299,537) (194,627,485)

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

N O N E

Exhibit of Life Insurance - Part 2

N O N E


N O N E


N O N E


N O N E


N O N E


N O N E

Exhibit of Life Insurance - Policies with Disability Provisions

N O N E

25, 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 10

2. Issued during year

3. Reinsurance assumed

4. Increased during year (net)

5. Total (Lines 1 to 4) 10

Deductions during year:

6. Decreased (net) 1


8. Totals (Lines 6 and 7) 1

9. In force end of year 9

10. Amount on deposit (a) (a)

11. Income now payable

12. Amount of income payable (a) 57,334 (a) (a) (a)

ANNUITIESOrdinary Group

1Immediate

2Deferred

3Contracts

4Certificates

1. In force end of prior year

2. Issued during year



5. Totals (Lines 1 to 4)


6. Decreased (net)


8. Totals (Lines 6 and 7)

9. In force end of year

Income now payable:

10. Amount of income payable (a) XXX XXX (a)

Deferred fully paid:

11. Account balance XXX (a) XXX (a)

Deferred not fully paid:

12. Account balance XXX (a) 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 231,207 574,772,344

2. Issued during year 18,285 44,467,608


4. Increased during year (net) XXX XXX XXX

5. Totals (Lines 1 to 4) XXX XXX 249,492 XXX


6. Conversions XXX XXX XXX XXX XXX

7. Decreased (net) XXX XXX 5,586 XXX

8. Reinsurance ceded XXX XXX XXX

9. Totals (Lines 6 to 8) XXX XXX 5,586 XXX

10. In force end of year (a) (a) 243,906 (a) 619,239,952

DEPOSIT FUNDS AND DIVIDEND ACCUMULATIONS1

Deposit Funds

2Dividend

AccumulationsContracts Contracts

1. In force end of prior year 1,999

2. Issued during year 6,703



5. Totals (Lines 1 to 4) 8,702

Deductions During Year:

6. Decreased (net) 6,272


8. Totals (Lines 6 and 7) 6,272

9. In force end of year 2,430

10. Amount of account balance (a) 4,771,475 (a)

(a) See Paragraph 9 of the Annual Audited Financial Reports in the General section of the annual statement instructions.

NONE

27


FORM FOR CALCULATING THE INTEREST MAINTENANCE RESERVEINTEREST MAINTENANCE RESERVE

1Amount

1. Reserve as of December 31, Prior Year 17,597,291

2. Current year’s realized pre-tax capital gains/(losses) of $ transferred into the reserve net of taxes of $

3. Adjustment for current year’s liability gains/(losses) released from the reserve

4. Balance before reduction for amount transferred to Summary of Operations (Line 1 + Line 2 + Line 3) 17,597,291

5. Current year’s amortization released to Summary of Operations (Amortization, Line 1, Column 4) 637,672

6. Reserve as of December 31, current year (Line 4 minus Line 5) 16,959,619

AMORTIZATION

Year of Amortization

1

Reserve as of December 31,

Prior Year

2

Current Year’s Realized Capital Gains/(Losses)

Transferred into the Reserve Net of Taxes

3

Adjustment for Current Year’s Liability Gains/(Losses) Released From

the Reserve

4

Balance Before Reduction for Current Year’s Amortization

(Cols. 1 + 2 + 3)

1. 2016 637,672 637,672

2. 2017 660,908 660,908

3. 2018 689,690 689,690

4. 2019 712,227 712,227

5. 2020 723,520 723,520

6. 2021 749,469 749,469

7. 2022 759,372 759,372

8. 2023 776,266 776,266

9. 2024 786,654 786,654

10. 2025 819,343 819,343

11. 2026 840,993 840,993

12. 2027 856,478 856,478

13. 2028 908,244 908,244

14. 2029 912,912 912,912

15. 2030 899,239 899,239

16. 2031 794,714 794,714

17. 2032 698,107 698,107

18. 2033 594,773 594,773

19. 2034 481,861 481,861

20. 2035 426,790 426,790

21. 2036 427,179 427,179

22. 2037 425,816 425,816

23. 2038 439,365 439,365

24. 2039 436,742 436,742

25. 2040 397,455 397,455

26. 2041 314,578 314,578

27. 2042 232,188 232,188

28. 2043 149,797 149,797

29. 2044 44,939 44,939

30. 2045

31. 2046 and Later

32. Total (Lines 1 to 31) 17,597,291 17,597,291

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0.00

23

0.

0030

11.

2H

igh Q

ualit

y

XX

XX

XX

0.

0019

0.00

58

0.

0090

12.

3M

ediu

m Q

ualit

y

XX

XX

XX

0.

0093

0.02

30

0.

0340

13.

4Low

Qualit

y

XX

XX

XX

0.

0213

0.05

30

0.

0750

14.

5Low

er

Qualit

y

XX

XX

XX

0.

0432

0.11

00

0.

1700

15.

6In

or

Near

Defa

ult

X

XX

XX

X

0.00

00

0.

2000

0.20

00

16.

Affili

ate

d L

ife w

ith A

VR

XX

XX

XX

0.

0000

0.00

00

0.

0000

17.

Tota

l P

refe

rred S

tocks (

Sum

of Lin

es 1

0 thro

ugh 1

6)

X

XX

XX

X

XX

X

XX

X

XX

X

SH

OR

T -

TE

RM

BO

ND

S

18.

Exe

mpt O

blig

ations

X

XX

XX

X

0.00

00

0.

0000

0.00

00

19.

1H

ighest Q

ualit

y

XX

XX

XX

0.

0004

0.00

23

0.

0030

20.

2H

igh Q

ualit

y

XX

XX

XX

0.

0019

0.00

58

0.

0090

21.

3M

ediu

m Q

ualit

y

XX

XX

XX

0.

0093

0.02

30

0.

0340

22.

4Low

Qualit

y

XX

XX

XX

0.

0213

0.05

30

0.

0750

23.

5Low

er

Qualit

y

XX

XX

XX

0.

0432

0.11

00

0.

1700

24.

6In

or

Near

Defa

ult

X

XX

XX

X

0.00

00

0.

2000

0.20

00

25.

Tota

l S

hort

- T

erm

Bonds (

Sum

of Lin

es 1

8 thro

ugh 2

4)

X

XX

XX

X

XX

X

XX

X

XX

X

DE

RIV

AT

IVE

IN

ST

RU

ME

NT

S

26.

Exc

hange T

raded

X

XX

XX

X

0.00

04

0.

0023

0.00

30

27.

1H

ighest Q

ualit

y

XX

XX

XX

0.

0004

0.00

23

0.

0030

28.

2H

igh Q

ualit

y

XX

XX

XX

0.

0019

0.00

58

0.

0090

29.

3M

ediu

m Q

ualit

y

XX

XX

XX

0.

0093

0.02

30

0.

0340

30.

4Low

Qualit

y

XX

XX

XX

0.

0213

0.05

30

0.

0750

31.

5Low

er

Qualit

y

XX

XX

XX

0.

0432

0.11

00

0.

1700

32.

6In

or

Near

Defa

ult

X

XX

XX

X

0.00

00

0.

2000

0.20

00

33.

Tota

l D

erivative Instr

um

ents

XX

XX

XX

X

XX

X

XX

X

XX

34.

Tota

l (L

ines 9

+ 1

7 +

25 +

33)

89,4

39,8

56

XX

XX

XX

89,4

39,8

56

XX

X

XX

X

XX

X

30

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

AS

SE

T V

AL

UA

TIO

N R

ES

ER

VE

(C

on

tin

ue

d)

BA

SIC

CO

NT

RIB

UT

ION

, R

ES

ER

VE

OB

JE

CT

IVE

AN

D M

AX

IMU

M R

ES

ER

VE

CA

LC

UL

AT

ION

S

DE

FA

UL

T C

OM

PO

NE

NT

12

34

Basic

Contr

ibution

Reserv

e O

bje

ctive

Maxi

mum

Reserv

e

Lin

eN

um

-ber

NA

ICD

esig

-nation

Description

Book/A

dju

ste

d

Carr

ying V

alu

e

Recla

ssify

Rela

ted P

art

y E

ncum

bra

nces

Add T

hird P

art

y E

ncum

bra

nces

Bala

nce for

AV

R R

eserv

eC

alc

ula

tions

(Cols

. 1 +

2 +

3)

5

Facto

r

6

Am

ount

(Cols

.4 x

5)

7

Facto

r

8

Am

ount

(Cols

. 4 x

7)

9

Facto

r

10

Am

ount

(Cols

. 4 x

9)

MO

RT

GA

GE

LO

AN

S

In G

ood S

tandin

g:

35.

Farm

Mort

gages -

CM

1 -

Hig

hest Q

ualit

y

X

XX

0.0010

0.0050

0.0065

36.

Farm

Mort

gages -

CM

2 -

Hig

h Q

ualit

y

X

XX

0.0035

0.0100

0.0130

37.

Farm

Mort

gages -

CM

3 -

Mediu

m Q

ualit

y

X

XX

0.0060

0.0175

0.0225

38.

Farm

Mort

gages -

CM

4 -

Low

Mediu

m Q

ualit

y

X

XX

0.0105

0.0300

0.0375

39.

Farm

Mort

gages -

CM

5 -

Low

Qualit

y

X

XX

0.0160

0.0425

0.0550

40.

Resid

ential M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0003

0.0006

0.0010

41.

Resid

ential M

ort

gages -

All

Oth

er

XX

X

0.0013

0.0030

0.0040

42.

Com

merc

ial M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0003

0.0006

0.0010

43.

Com

merc

ial M

ort

gages -

All

Oth

er

- C

M1 -

Hig

hest Q

ualit

y

X

XX

0.0010

0.0050

0.0065

44.

Com

merc

ial M

ort

gages -

All

Oth

er

- C

M2 -

Hig

h Q

ualit

y

X

XX

0.0035

0.0100

0.0130

45.

Com

merc

ial M

ort

gages -

All

Oth

er

- C

M3 -

Mediu

m Q

ualit

y

X

XX

0.0060

0.0175

0.0225

46.

Com

merc

ial M

ort

gages -

All

Oth

er

- C

M4 -

Low

Mediu

m

Qualit

y

X

XX

0.0105

0.0300

0.0375

47.

Com

merc

ial M

ort

gages -

All

Oth

er

- C

M5 -

Low

Qualit

y

X

XX

0.0160

0.0425

0.0550

Overd

ue, N

ot in

Pro

cess:

48.

Farm

Mort

gages

XX

X

0.0420

0.0760

0.1200

49.

Resid

ential M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0005

0.0012

0.0020

50.

Resid

ential M

ort

gages -

All

Oth

er

XX

X

0.0025

0.0058

0.0090

51.

Com

merc

ial M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0005

0.0012

0.0020

52.

Com

merc

ial M

ort

gages -

All

Oth

er

XX

X

0.0420

0.0760

0.1200

In P

rocess o

f F

ore

clo

sure

:

53.

Farm

Mort

gages

XX

X

0.0000

0.1700

0.1700

54.

Resid

ential M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0000

0.0040

0.0040

55.

Resid

ential M

ort

gages -

All

Oth

er

XX

X

0.0000

0.0130

0.0130

56.

Com

merc

ial M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0000

0.0040

0.0040

57.

Com

merc

ial M

ort

gages -

All

Oth

er

XX

X

0.0000

0.1700

0.1700

58.

Tota

l S

chedule

B M

ort

gages (

Sum

of Lin

es 3

5 thro

ugh 5

7)

XX

X

XX

X

XX

X

XX

X

59.

Schedule

DA

Mort

gages

XX

X

0.0030

0.0100

0.0130

60.

Tota

l M

ort

gage L

oans o

n R

eal E

sta

te (

Lin

es 5

8 +

59)

XX

X

XX

X

XX

X

XX

X

31

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

AS

SE

T V

AL

UA

TIO

N R

ES

ER

VE

B

AS

IC C

ON

TR

IBU

TIO

N,

RE

SE

RV

E O

BJ

EC

TIV

E A

ND

MA

XIM

UM

RE

SE

RV

E C

AL

CU

LA

TIO

NS

EQ

UIT

Y A

ND

OT

HE

R I

NV

ES

TE

D A

SS

ET

CO

MP

ON

EN

T1

23

4B

asic

Contr

ibution

Reserv

e O

bje

ctive

Maxi

mum

Reserv

e

Lin

eN

um

-ber

NA

ICD

esig

-nation

Description

Book/A

dju

ste

d

Carr

ying V

alu

e

Recla

ssify

Rela

ted P

art

y E

ncum

bra

nces

Add T

hird P

art

y E

ncum

bra

nces

Bala

nce for

AV

R R

eserv

e

Calc

ula

tions

(Cols

. 1 +

2 +

3)

5

Facto

r

6

Am

ount

(Cols

.4 x

5)

7

Facto

r

8

Am

ount

(Cols

. 4 x

7)

9

Facto

r

10

Am

ount

(Cols

. 4 x

9)

CO

MM

ON

ST

OC

K

1.

Unaffili

ate

d -

Public

XX

XX

XX

0.0000

0.0000

(a)

0.0000

(a)

2.

Unaffili

ate

d -

Private

XX

XX

XX

0.0000

0.1600

0.1600

3.

Federa

l H

om

e L

oan B

ank

X

XX

XX

X

0.0000

0.0050

0.0080

4.

Affili

ate

d -

Life w

ith A

VR

XX

XX

XX

0.0000

0.0000

0.0000

Affili

ate

d -

Investm

ent S

ubsid

iary

:

5.

Fix

ed Incom

e -

Exe

mpt O

blig

ations

XX

X

XX

X

XX

X

6.

Fix

ed Incom

e -

Hig

hest Q

ualit

y

X

XX

X

XX

X

XX

7.

Fix

ed Incom

e -

Hig

h Q

ualit

y

X

XX

X

XX

X

XX

8.

Fix

ed Incom

e -

Mediu

m Q

ualit

y

X

XX

X

XX

X

XX

9.

Fix

ed Incom

e -

Low

Qualit

y

X

XX

X

XX

X

XX

10.

Fix

ed Incom

e -

Low

er

Qualit

y

X

XX

X

XX

X

XX

11.

Fix

ed Incom

e -

In/N

ear

Defa

ult

XX

X

XX

X

XX

X

12.

Unaffili

ate

d C

om

mon S

tock -

Public

0.0000

0.0000

(a)

0.0000

(a)

13.

Unaffili

ate

d C

om

mon S

tock -

Private

0.0000

0.1600

0.1600

14.

Real E

sta

te

(b

)

(b

)

(b

)

15.

Affili

ate

d -

Cert

ain

Oth

er

(See S

VO

Purp

oses a

nd P

rocedure

s

Manual)

X

XX

XX

X

0.0000

0.1300

0.1300

16.

Affili

ate

d -

All

Oth

er

X

XX

XX

X

0.0000

0.1600

0.1600

17.

Tota

l C

om

mon S

tock (

Sum

of Lin

es 1

thro

ugh 1

6)

XX

X

XX

X

XX

X

RE

AL E

ST

AT

E

18.

Hom

e O

ffic

e P

ropert

y (G

enera

l A

ccount only

)

0.0000

0.0750

0.0750

19.

Investm

ent P

ropert

ies

0.0000

0.0750

0.0750

20.

Pro

pert

ies A

cquired in S

atisfa

ction o

f D

ebt

0.0000

0.1100

0.1100

21.

Tota

l R

eal E

sta

te (

Sum

of Lin

es 1

8 thro

ugh 2

0)

XX

X

XX

X

XX

X

OT

HE

R IN

VE

ST

ED

AS

SE

TS

INV

ES

TM

EN

TS

WIT

H T

HE

UN

DE

RLY

ING

C

HA

RA

CT

ER

IST

ICS

OF

BO

ND

S

22.

Exe

mpt O

blig

ations

X

XX

XX

X

0.0000

0.0000

0.0000

23.

1H

ighest Q

ualit

y

XX

XX

XX

0.0004

0.0023

0.0030

24.

2H

igh Q

ualit

y

XX

XX

XX

0.0019

0.0058

0.0090

25.

3M

ediu

m Q

ualit

y

XX

XX

XX

0.0093

0.0230

0.0340

26.

4Low

Qualit

y

XX

XX

XX

0.0213

0.0530

0.0750

27.

5Low

er

Qualit

y

XX

XX

XX

0.0432

0.1100

0.1700

28.

6In

or

Near

Defa

ult

X

XX

XX

X

0.0000

0.2000

0.2000

29.

Tota

l w

ith B

ond C

hara

cte

ristics (

Sum

of Lin

es 2

2 thro

ugh 2

8)

X

XX

XX

X

XX

X

XX

X

XX

X

32

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

AS

SE

T V

AL

UA

TIO

N R

ES

ER

VE

(C

on

tin

ue

d)

BA

SIC

CO

NT

RIB

UT

ION

, R

ES

ER

VE

OB

JE

CT

IVE

AN

D M

AX

IMU

M R

ES

ER

VE

CA

LC

UL

AT

ION

S

EQ

UIT

Y A

ND

OT

HE

R I

NV

ES

TE

D A

SS

ET

CO

MP

ON

EN

T1

23

4B

asic

Contr

ibution

Reserv

e O

bje

ctive

Maxi

mum

Reserv

e

Lin

e

Num

-ber

NA

ICD

esig

-nation

Description

Book/A

dju

ste

d

Carr

ying V

alu

e

Recla

ssify

Rela

ted P

art

y E

ncum

bra

nces

Add T

hird P

art

y E

ncum

bra

nces

Bala

nce for

AV

R R

eserv

e

Calc

ula

tions

(Cols

. 1 +

2 +

3)

5

Facto

r

6

Am

ount

(Cols

.4 x

5)

7

Facto

r

8

Am

ount

(Cols

. 4 x

7)

9

Facto

r

10

Am

ount

(Cols

. 4 x

9)

INV

ES

TM

EN

TS

WIT

H T

HE

UN

DE

RL

YIN

G C

HA

RA

CT

ER

IST

ICS

OF

P

RE

FE

RR

ED

ST

OC

KS

30.

1H

ighest Q

ualit

y

XX

XX

XX

0.0004

0.0023

0.0030

31.

2H

igh Q

ualit

y

XX

XX

XX

0.0019

0.0058

0.0090

32.

3M

ediu

m Q

ualit

y

XX

XX

XX

0.0093

0.0230

0.0340

33.

4Low

Qualit

y

XX

XX

XX

0.0213

0.0530

0.0750

34.

5Low

er

Qualit

y

XX

XX

XX

0.0432

0.1100

0.1700

35.

6In

or

Near

Defa

ult

X

XX

XX

X

0.0000

0.2000

0.2000

36.

Affili

ate

d L

ife w

ith A

VR

XX

XX

XX

0.0000

0.0000

0.0000

37.

Tota

l w

ith P

refe

rred S

tock C

hara

cte

ristics (

Sum

of Lin

es 3

0

thro

ugh 3

6)

X

XX

XX

X

XX

X

XX

X

XX

X

INV

ES

TM

EN

TS

WIT

H T

HE

UN

DE

RL

YIN

G C

HA

RA

CT

ER

IST

ICS

OF

M

OR

TG

AG

E L

OA

NS

In G

ood S

tandin

g A

ffili

ate

d:

38.

Mort

gages -

CM

1 -

Hig

hest Q

ualit

y

X

XX

0.0010

0.0050

0.0065

39.

Mort

gages -

CM

2 -

Hig

h Q

ualit

y

X

XX

0.0035

0.0100

0.0130

40.

Mort

gages -

CM

3 -

Mediu

m Q

ualit

y

X

XX

0.0060

0.0175

0.0225

41.

Mort

gages -

CM

4 -

Low

Mediu

m Q

ualit

y

X

XX

0.0105

0.0300

0.0375

42.

Mort

gages -

CM

5 -

Low

Qualit

y

X

XX

0.0160

0.0425

0.0550

43.

Resid

ential M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0003

0.0006

0.0010

44.

Resid

ential M

ort

gages -

All

Oth

er

X

XX

XX

X

0.0013

0.0030

0.0040

45.

Com

merc

ial M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0003

0.0006

0.0010

Overd

ue, N

ot in

Pro

cess A

ffili

ate

d:

46.

Farm

Mort

gages

XX

X

0.0420

0.0760

0.1200

47.

Resid

ential M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0005

0.0012

0.0020

48.

Resid

ential M

ort

gages -

All

Oth

er

XX

X

0.0025

0.0058

0.0090

49.

Com

merc

ial M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0005

0.0012

0.0020

50.

Com

merc

ial M

ort

gages -

All

Oth

er

XX

X

0.0420

0.0760

0.1200

In P

rocess o

f F

ore

clo

sure

Affili

ate

d:

51.

Farm

Mort

gages

XX

X

0.0000

0.1700

0.1700

52.

Resid

ential M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0000

0.0040

0.0040

53.

Resid

ential M

ort

gages -

All

Oth

er

XX

X

0.0000

0.0130

0.0130

54.

Com

merc

ial M

ort

gages -

Insure

d o

r G

uara

nte

ed

XX

X

0.0000

0.0040

0.0040

55.

Com

merc

ial M

ort

gages -

All

Oth

er

XX

X

0.0000

0.1700

0.1700

56.

Tota

l A

ffili

ate

d (

Sum

of Lin

es 3

8 thro

ugh 5

5)

XX

X

XX

X

XX

X

XX

X

57.

Unaffili

ate

d -

In G

ood S

tandin

g W

ith C

ovenants

X

XX

(c)

(c)

(c)

58.

Unaffili

ate

d -

In G

ood S

tandin

g D

efe

ased W

ith G

overn

ment

Securities

XX

X

0.0010

0.0050

0.0065

59.

Unaffili

ate

d -

In G

ood S

tandin

g P

rim

arily

Senio

r

X

XX

0.0035

0.0010

0.0130

60.

Unaffili

ate

d -

In G

ood S

tandin

g A

ll O

ther

XX

X

0.0060

0.0175

0.0225

61.

Unaffili

ate

d -

Overd

ue, N

ot in

Pro

cess

XX

X

0.0420

0.0760

0.1200

62.

Unaffili

ate

d -

In P

rocess o

f F

ore

clo

sure

X

XX

0.0000

0.1700

0.1700

63.

Tota

l U

naffili

ate

d (

Sum

of Lin

es 5

7 thro

ugh 6

2)

XX

X

XX

X

XX

X

XX

X

64.

Tota

l w

ith M

ort

gage L

oan C

hara

cte

ristics (

Lin

es 5

6 +

63)

XX

X

XX

X

XX

X

XX

X

33

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

AS

SE

T V

AL

UA

TIO

N R

ES

ER

VE

(C

on

tin

ue

d)

BA

SIC

CO

NT

RIB

UT

ION

, R

ES

ER

VE

OB

JE

CT

IVE

AN

D M

AX

IMU

M R

ES

ER

VE

CA

LC

UL

AT

ION

S

EQ

UIT

Y A

ND

OT

HE

R I

NV

ES

TE

D A

SS

ET

CO

MP

ON

EN

T1

23

4B

asic

Contr

ibution

Reserv

e O

bje

ctive

Maxi

mum

Reserv

e

Lin

e

Num

-ber

NA

ICD

esig

-nation

Description

Book/A

dju

ste

d

Carr

ying V

alu

e

Recla

ssify

Rela

ted P

art

y E

ncum

bra

nces

Add T

hird P

art

y E

ncum

bra

nces

Bala

nce for

AV

R R

eserv

e

Calc

ula

tions

(Cols

. 1 +

2 +

3)

5

Facto

r

6

Am

ount

(Cols

.4 x

5)

7

Facto

r

8

Am

ount

(Cols

. 4 x

7)

9

Facto

r

10

Am

ount

(Cols

. 4 x

9)

INV

ES

TM

EN

TS

WIT

H T

HE

UN

DE

RL

YIN

G C

HA

RA

CT

ER

IST

ICS

OF

C

OM

MO

N S

TO

CK

65.

Unaffili

ate

d P

ublic

XX

XX

XX

0.0000

0.1300

(a)

0.1300

(a)

66.

Unaffili

ate

d P

rivate

XX

XX

XX

0.0000

0.1600

0.1600

67.

Affili

ate

d L

ife w

ith A

VR

XX

XX

XX

0.0000

0.0000

0.0000

68.

Affili

ate

d C

ert

ain

Oth

er

(See S

VO

Purp

oses &

Pro

cedure

s

Manual)

X

XX

XX

X

0.0000

0.1300

0.1300

69.

Affili

ate

d O

ther

- A

ll O

ther

X

XX

XX

X

0.0000

0.1600

0.1600

70.

Tota

l w

ith C

om

mon S

tock C

hara

cte

ristics (

Sum

of Lin

es 6

5

thro

ugh 6

9)

X

XX

XX

X

XX

X

XX

X

XX

X

INV

ES

TM

EN

TS

WIT

H T

HE

UN

DE

RL

YIN

G C

HA

RA

CT

ER

IST

ICS

OF

RE

AL

ES

TA

TE

71.

Hom

e O

ffic

e P

ropert

y (G

enera

l A

ccount only

)

0.0000

0.0750

0.0750

72.

Investm

ent P

ropert

ies

0.0000

0.0750

0.0750

73

Pro

pert

ies A

cquired in S

atisfa

ction o

f D

ebt

0.0000

0.1100

0.1100

74.

Tota

l w

ith R

eal E

sta

te C

hara

cte

ristics (

Sum

of Lin

es 7

1 thro

ugh

73)

XX

X

XX

X

XX

X

LO

W IN

CO

ME

HO

US

ING

TA

X C

RE

DIT

IN

VE

ST

ME

NT

S

75.

Guara

nte

ed F

edera

l Low

Incom

e H

ousin

g T

ax

Cre

dit

0.0003

0.0006

0.0010

76.

Non-g

uara

nte

ed F

edera

l Low

Incom

e H

ousin

g T

ax

Cre

dit

0.0063

0.0120

0.0190

77.

Guara

nte

ed S

tate

Low

Incom

e H

ousin

g T

ax

Cre

dit

0.0003

0.0006

0.0010

78.

Non-g

uara

nte

ed S

tate

Low

Incom

e H

ousin

g T

ax

Cre

dit

0.0063

0.0120

0.0190

79.

All

Oth

er

Low

Incom

e H

ousin

g T

ax

Cre

dit

0.0273

0.0600

0.0975

80.

Tota

l LIH

TC

(S

um

of Lin

es 7

5 thro

ugh 7

9)

XX

X

XX

X

XX

X

AL

L O

TH

ER

IN

VE

ST

ME

NT

S

81.

NA

IC 1

Work

ing C

apital F

inance Investm

ents

XX

X

0.0000

0.0037

0.0037

82.

NA

IC 2

Work

ing C

apital F

inance Investm

ents

XX

X

0.0000

0.0120

0.0120

83.

Oth

er

Investe

d A

ssets

- S

chedule

BA

XX

X

0.0000

0.1300

0.1300

84.

Oth

er

Short

-Term

Investe

d A

ssets

- S

chedule

DA

XX

X

0.0000

0.1300

0.1300

85.

Tota

l A

ll O

ther

(Sum

of Lin

es 8

1, 82, 83 a

nd 8

4)

X

XX

XX

X

XX

X

XX

X

86.

Tota

l O

ther

Investe

d A

ssets

- S

chedule

s B

A &

DA

(S

um

of Lin

es

29, 37, 64, 70, 74, 80 a

nd 8

5)

XX

X

XX

X

XX

X

(a)

Tim

es the c

om

pany’

s w

eig

hte

d a

vera

ge p

ort

folio

beta

(M

inim

um

.10, M

axi

mum

.20).

(b)

Dete

rmin

ed u

sin

g the s

am

e facto

rs a

nd b

reakdow

ns u

sed for

directly

ow

ned r

eal esta

te.

(c)

This

will

be the facto

r associa

ted w

ith the r

isk c

ate

gory

dete

rmin

ed in the c

om

pany

genera

ted w

ork

sheet.

34


Asset Valuation Reserve Replications (Synthetic) Assets

N O N E

Schedule F - Claims

N O N E

35, 36

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

H -

AC

CID

EN

T A

ND

HE

AL

TH

EX

HIB

ITC

redit

Oth

er

Indiv

idual C

ontr

acts

Tota

lG

roup A

ccid

ent

and H

ealth

Accid

ent and H

ealth

(Gro

up a

nd Indiv

idual)

Colle

ctively

Renew

able

Non-C

ancela

ble

Guara

nte

ed R

enew

able

Non-R

enew

able

for

Sta

ted

Reasons O

nly

Oth

er

Accid

ent O

nly

All

Oth

er

1A

mount

2 %3

Am

ount

4 %5

Am

ount

6 %7

Am

ount

8 %9

Am

ount

10 %

11

Am

ount

12 %

13

Am

ount

14 %

15

Am

ount

16 %

17

Am

ount

18 %

PA

RT

1.

- A

NA

LY

SIS

OF

UN

DE

RW

RIT

ING

OP

ER

AT

ION

S

1.

Pre

miu

ms w

ritten

856

,975

X

XX

X

XX

X

XX

X

XX

X

XX

856

,975

X

XX

X

XX

X

XX

X

XX

2.

Pre

miu

ms e

arn

ed

160,

021

XX

X

XX

X

XX

X

XX

X

XX

X160,

021

XX

X

XX

X

XX

X

XX

X

3.

Incurr

ed c

laim

s

8,4

77

5.3

8,4

77

5.3

4.

Cost conta

inm

ent exp

enses

70,6

87

44.2

70

,687

44.2

5.

Incurr

ed c

laim

s a

nd c

ost

conta

inm

ent exp

enses (

Lin

es 3

and 4

) 79,164

49.5

79,164

49.5

6.

Incre

ase in c

ontr

act re

serv

es

7.

Com

mis

sio

ns (

a)

(80,

298,0

60)

(50,

179.7)

(80,

298,0

60)

(50,

179.7

)

8.

Oth

er

genera

l in

sura

nce e

xpenses

64,4

33,4

98

40,2

65.7

64

,433

,498

40

,265

.7

9.

Taxe

s, lic

enses a

nd fees

15,8

03,124

9,875

.7

15,8

03,124

9,875

.7

10.

Tota

l oth

er

exp

enses incurr

ed

(61,43

8)

(38.4

)

(6

1,43

8)

(38.4

)

11.

Aggre

gate

write

-ins for

deductions

12.

Gain

fro

m u

nderw

riting b

efo

re

div

idends o

r re

funds

142,

295

88.9

142,

295

88.9

13.

Div

idends o

r re

funds

123

0.1

123

0.1

14.

Gain

fro

m u

nderw

riting a

fter

div

idends o

r re

funds

142,

172

88.8

142,

172

88.8

DE

TA

ILS

OF

WR

ITE

-IN

S

1101.

1102.

1103.

1198.

Sum

mary

of re

main

ing w

rite

-ins for

Lin

e 1

1 fro

m o

verf

low

page

1199.

Tota

ls (

Lin

es 1

101 thru

1103 p

lus

1198)(

Lin

e 1

1 a

bove)

(a)

Inclu

des $

r

eport

ed a

s "

Contr

act, m

em

bers

hip

and o

ther

fees r

eta

ined b

y agents

.”

37

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

H -

AC

CID

EN

T A

ND

HE

AL

TH

EX

HIB

IT (

Co

nti

nu

ed

)1

23

4O

ther

Indiv

idual C

ontr

acts

Tota

lG

roup A

ccid

ent

and H

ealth

Cre

dit

Accid

ent and H

ealth

(Gro

up a

nd

Indiv

idual)

Colle

ctively

R

enew

able

5

Non-C

ancela

ble

6

Guara

nte

ed

Renew

able

7N

on-R

enew

able

for

Sta

ted

Reasons O

nly

8

Oth

er

Accid

ent

Only

9

All

Oth

er

PA

RT

2.

- R

ES

ER

VE

S A

ND

LIA

BIL

ITIE

SA

. P

rem

ium

Reserv

es:

1.

Unearn

ed p

rem

ium

s

2.

Advance p

rem

ium

s

8,15

3,36

8

8,

153,36

8

3.

Reserv

e for

rate

cre

dits

4.

Tota

l pre

miu

m r

eserv

es, curr

ent ye

ar

8,15

3,36

8

8,

153,36

8

5.

Tota

l pre

miu

m r

eserv

es, prior

year

7,45

6,41

4

7,45

6,41

4

6.

Incre

ase in tota

l pre

miu

m r

eserv

es

696,

954

696,

954

B. C

ontr

act R

eserv

es:

1.

Additio

nal re

serv

es (

a)

2.

Reserv

e for

futu

re c

ontingent benefits

3.

Tota

l contr

act re

serv

es, curr

ent ye

ar

4.

Tota

l contr

act re

serv

es, prior

year.

5.

Incre

ase in c

ontr

act re

serv

es

C. C

laim

Reserv

es a

nd L

iabili

ties:

1.

Tota

l curr

ent ye

ar

2.

Tota

l prior

year

3.

Incre

ase

PA

RT

3.

- T

ES

T O

F P

RIO

R Y

EA

R'S

CL

AIM

RE

SE

RV

ES

AN

D L

IAB

ILIT

IES

1.

Cla

ims p

aid

during the y

ear:

1.1

On c

laim

s incurr

ed p

rior

to c

urr

ent ye

ar

1.2

On c

laim

s incurr

ed d

uring c

urr

ent ye

ar

8,47

7

8,

477

2.

Cla

im r

eserv

es a

nd lia

bili

ties, D

ecem

ber

31, curr

ent ye

ar:

2.1

On c

laim

s incurr

ed p

rior

to c

urr

ent ye

ar

2.2

On c

laim

s incurr

ed d

uring c

urr

ent ye

ar

3.

Test:

3.1

Lin

es 1

.1 a

nd 2

.1

3.2

Cla

im r

eserv

es a

nd lia

bili

ties, D

ecem

ber

31, prior

year

3.3

Lin

e 3

.1 m

inus L

ine 3

.2

PA

RT

4.

- R

EIN

SU

RA

NC

EA

. R

ein

sura

nce A

ssum

ed:

1.

Pre

miu

ms w

ritten

2.

Pre

miu

ms e

arn

ed

3.

Incurr

ed c

laim

s

4.

Com

mis

sio

ns

B. R

ein

sura

nce C

eded:

1.

Pre

miu

ms w

ritten

601,

288,

448

601,

288,

448

2.

Pre

miu

ms e

arn

ed

594,

119,

892

594,

119,

892

3.

Incurr

ed c

laim

s

135,

365,

098

135,

365,

098

4.

Com

mis

sio

ns

151,

201,

817

151,

201,

817

(a)

Inclu

des $

pre

miu

m d

eficie

ncy

reserv

e.

38


SCHEDULE H - PART 5 - HEALTH CLAIMS1

Medical2

Dental3

Other4

Total

A. Direct:

1. Incurred Claims 135,373,576 135,373,576

2. Beginning Claim Reserves and Liabilities 257,913,827 257,913,827

3. Ending Claim Reserves and Liabilities 338,425,254 338,425,254

4. Claims Paid 54,862,149 54,862,149

B. Assumed Reinsurance:

5. Incurred Claims

6. Beginning Claim Reserves and Liabilities

7. Ending Claim Reserves and Liabilities

8. Claims Paid

C. Ceded Reinsurance:

9. Incurred Claims 135,365,099 135,365,099

10. Beginning Claim Reserves and Liabilities 262,381,489 262,381,489

11. Ending Claim Reserves and Liabilities 343,287,367 343,287,367

12. Claims Paid 54,459,221 54,459,221

D. Net:

13. Incurred Claims 8,477 8,477

14. Beginning Claim Reserves and Liabilities (4,467,662) (4,467,662)

15. Ending Claim Reserves and Liabilities (4,862,113) (4,862,113)

16. Claims Paid 402,928 402,928

E. Net Incurred Claims and Cost Containment Expenses:

17. Incurred Claims and Cost Containment Expenses 79,163 79,163

18. Beginning Reserves and Liabilities (4,467,662) (4,467,662)

19. Ending Reserves and Liabilities (4,862,113) (4,862,113)

20. Paid Claims and Cost Containment Expenses 473,614 473,614

39


Schedule S - Part 1 - Section 1

N O N E

Schedule S - Part 1 - Section 2

N O N E

40, 41


SCHEDULE S - PART 2Reinsurance Recoverable on Paid and Unpaid Losses Listed by Reinsuring Company as of December 31, Current Year

1NAIC

CompanyCode

2

IDNumber

3

EffectiveDate

4

Name of Company

5

Domiciliary Jurisdiction

6

Paid Losses

7

Unpaid Losses0399999. Total Life and Annuity - U.S. Affiliates

0699999. Total Life and Annuity - Non-U.S. Affiliates

0799999. Total Life and Annuity - Affiliates

1099999. Total Life and Annuity - Non-Affiliates

1199999. Total Life and Annuity

67091 39-0509570 10/01/2014 The Northwestern Mutual Life Ins Co WI 4,115,586 3,685,776

1399999. Accident and Health - U.S. Affiliates - Other 4,115,586 3,685,776

1499999. Total Accident and Health - U.S. Affiliates 4,115,586 3,685,776

1799999. Total Accident and Health - Non-U.S. Affiliates

1899999. Total Accident and Health - Affiliates 4,115,586 3,685,776

66346 58-0828824 02/01/1998 Munich American Reassurance Co. GA 746,527 521,375

1999999. Accident and Health - U.S. Non-Affiliates 746,527 521,375

2199999. Total Accident and Health - Non-Affiliates 746,527 521,375

2299999. Total Accident and Health 4,862,113 4,207,151

2399999. Total U.S. (Sum of 0399999, 0899999, 1499999 and 1999999) 4,862,113 4,207,151

2499999. Total Non-U.S. (Sum of 0699999, 0999999, 1799999 and 2099999)

9999999 Totals - Life, Annuity and Accident and Health 4,862,113 4,207,151

42

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

S -

PA

RT

3 -

SE

CT

ION

1R

ein

sura

nce C

eded L

ife I

nsura

nce,

Annuitie

s,

Deposit F

unds a

nd O

ther

Lia

bili

ties W

ithout

Life o

r D

isabili

ty C

ontingencie

s,

and R

ela

ted B

enefits

Lis

ted b

y R

ein

suring C

om

pany

as o

f D

ecem

ber

31,

Curr

ent

Year

12

34

56

78

Reserv

e C

redit T

aken

11

Outs

tandin

g S

urp

lus R

elie

f14

15

NA

ICC

om

pany

Code

IDN

um

ber

Effective

Date

Nam

e o

f C

om

pany

Dom

i-cili

ary

Juris-

dic

tion

Typ

e o

f R

ein

sura

nce

Ceded

Typ

e o

f B

usin

ess

Ceded

Am

ount in

Forc

eat E

nd o

f Y

ear

9

Curr

ent Y

ear

10

Prior

Year

Pre

miu

ms

12

Curr

ent Y

ear

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44


Schedule S - Part 4

N O N E

Schedule S - Part 4 - Bank Footnote

N O N E

Schedule S - Part 5

N O N E

Schedule S - Part 5 - Bank Footnote

N O N E

45, 46


SCHEDULE S - PART 6Five Year Exhibit of Reinsurance Ceded Business

(000 OMITTED)1

20162

20153

20144

20135

2012

A. OPERATIONS ITEMS

1. Premiums and annuity considerations for life and accident and health contracts 601,288 559,910 2,058,965 11,252 10,956

2. Commissions and reinsurance expense allowances 151,202 157,511 42,932 2,954 2,872

3. Contract claims 56,030 44,862 16,676 4,905 4,269

4. Surrender benefits and withdrawals for life contracts

5. Dividends to policyholders 1 (39) 37 747

6. Reserve adjustments on reinsurance ceded

7. Increase in aggregate reserve for life and accident and health contracts 583,207 500,977 2,043,713 11,021 12,972

B. BALANCE SHEET ITEMS

8. Premiums and annuity considerations for life and accident and health contracts deferred and uncollected (4,332) (4,429) 6,901 995 954

9. Aggregate reserves for life and accident and health contracts 3,258,265 2,675,058 2,174,081 133,354 122,333

10. Liability for deposit-type contracts

11. Contract claims unpaid 4,819 3,642 3,062 371 330

12. Amounts recoverable on reinsurance 4,862 4,468 3,494 440 364

13. Experience rating refunds due or unpaid

14. Policyholders’ dividends (not included in Line 10) 68 879

15. Commissions and reinsurance expense allowances due 12,995 15,464 11,400 278 277

16. Unauthorized reinsurance offset

17. Offset for reinsurance with Certified Reinsurers

C. UNAUTHORIZED REINSURANCE (DEPOSITS BY AND FUNDS WITHHELD FROM)

18. Funds deposited by and withheld from (F)

19. Letters of credit (L)

20. Trust agreements (T)

21. Other (O)

D. REINSURANCE WITH CERTIFIED REINSURERS (DEPOSITS BY AND FUNDS WITHHELD FROM)

22. Multiple Beneficiary Trust

23. Funds deposited by and withheld from (F)

24. Letters of credit (L)

25. Trust agreements (T)

26. Other (O)

47


SCHEDULE S - PART 7Restatement of Balance Sheet to Identify Net Credit for Ceded Reinsurance

1As Reported

(net of ceded)

2Restatement Adjustments

3Restated

(gross of ceded)

ASSETS (Page 2, Col. 3)

1. Cash and invested assets (Line 12) 94,855,806 94,855,806

2. Reinsurance (Line 16) 17,856,870 (17,856,870)

3. Premiums and considerations (Line 15) (4,332,018) (4,332,018)

4. Net credit for ceded reinsurance XXX 3,285,272,710 3,285,272,710

5. All other admitted assets (balance) 60,013,448 60,013,448

6. Total assets excluding Separate Accounts (Line 26) 172,726,124 3,263,083,822 3,435,809,946

7. Separate Account assets (Line 27)

8. Total assets (Line 28) 172,726,124 3,263,083,822 3,435,809,946

LIABILITIES, CAPITAL AND SURPLUS (Page 3)

9. Contract reserves (Lines 1 and 2) 325,756 3,258,265,096 3,258,590,852

10. Liability for deposit-type contracts (Line 3) 4,771,475 4,771,475

11. Claim reserves (Line 4) 4,818,726 4,818,726

12. Policyholder dividends/reserves (Lines 5 through 7)

13. Premium & annuity considerations received in advance (Line 8) 8,153,368 8,153,368

14. Other contract liabilities (Line 9) 69,537,242 69,537,242

15. Reinsurance in unauthorized companies (Line 24.02 minus inset amount)

16. Funds held under reinsurance treaties with unauthorized reinsurers (Line 24.03 minus inset amount)

17. Reinsurance with Certified Reinsurers (Line 24.02 inset amount)

18. Funds held under reinsurance treaties with Certified Reinsurers (Line 24.03 inset amount)

19. All other liabilities (balance) 7,711,310 7,711,310

20. Total liabilities excluding Separate Accounts (Line 26) 90,499,151 3,263,083,822 3,353,582,973

21. Separate Account liabilities (Line 27)

22. Total liabilities (Line 28) 90,499,151 3,263,083,822 3,353,582,973

23. Capital & surplus (Line 38) 82,226,973 XXX 82,226,973

24. Total liabilities, capital & surplus (Line 39) 172,726,124 3,263,083,822 3,435,809,946

NET CREDIT FOR CEDED REINSURANCE

25. Contract reserves 3,258,265,096

26. Claim reserves 4,818,726

27. Policyholder dividends/reserves

28. Premium & annuity considerations received in advance

29. Liability for deposit-type contracts

30. Other contract liabilities

31. Reinsurance ceded assets 17,856,870

32. Other ceded reinsurance recoverables

33. Total ceded reinsurance recoverables 3,280,940,692

34. Premiums and considerations (4,332,018)

35. Reinsurance in unauthorized companies

36. Funds held under reinsurance treaties with unauthorized reinsurers

37. Reinsurance with Certified Reinsurers

38. Funds held under reinsurance treaties with Certified Reinsurers

39. Other ceded reinsurance payables/offsets

40. Total ceded reinsurance payable/offsets (4,332,018)

41. Total net credit for ceded reinsurance 3,285,272,710

48


SCHEDULE T - PREMIUMS AND ANNUITY CONSIDERATIONSAllocated by States and Territories

Direct Business Only

1 Life Contracts 4 5 6 7

States, Etc. Active Status

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 5,963,548 5,963,548 2. Alaska AK L 316,138 316,138 3. Arizona AZ L 6,575,024 6,575,024 4. Arkansas AR L 3,751,385 3,751,385 5. California CA L 35,632,040 35,632,040 6. Colorado CO L 14,785,400 14,785,400 7. Connecticut CT L 14,176,528 14,176,528 8. Delaware DE L 459,501 459,501 9. District of Columbia DC L 1,074,673 1,074,673

10. Florida FL L 34,951,088 34,951,088 11. Georgia GA L 18,775,746 18,775,746 12. Hawaii HI L 2,597,123 2,597,123 13. Idaho ID L 4,026,506 4,026,506 14. Illinois IL L 46,562,252 46,562,252 15. Indiana IN L 12,896,729 12,896,729 16. Iowa IA L 14,383,160 14,383,160 17. Kansas KS L 6,082,979 6,082,979 18. Kentucky KY L 8,784,524 8,784,524 19. Louisiana LA L 9,011,317 9,011,317 20. Maine ME L 1,554,162 1,554,162 21. Maryland MD L 8,435,982 8,435,982 22. Massachusetts MA L 13,306,377 13,306,377 23. Michigan MI L 17,153,679 17,153,679 24. Minnesota MN L 23,347,478 23,347,478 25. Mississippi MS L 4,189,448 4,189,448 26. Missouri MO L 13,881,138 13,881,138 27. Montana MT L 2,232,280 2,232,280 28. Nebraska NE L 6,661,927 6,661,927 29. Nevada NV L 1,562,436 1,562,436 30. New Hampshire NH L 2,932,324 2,932,324 31. New Jersey NJ L 16,356,176 16,356,176 32. New Mexico NM L 2,243,896 2,243,896 33. New York NY L 35,963,355 35,963,355 34. North Carolina NC L 22,388,300 22,388,300 35. North Dakota ND L 2,147,105 2,147,105 36. Ohio OH L 21,488,671 21,488,671 37. Oklahoma OK L 3,510,589 3,510,589 38. Oregon OR L 7,514,947 7,514,947 39. Pennsylvania PA L 15,902,896 15,902,896 40. Rhode Island RI L 2,018,406 2,018,406 41. South Carolina SC L 8,161,438 8,161,438 42. South Dakota SD L 3,690,463 3,690,463 43. Tennessee TN L 13,154,306 13,154,306 44. Texas TX L 28,008,509 28,008,509 45. Utah UT L 3,089,604 3,089,604 46. Vermont VT L 1,118,659 1,118,659 47. Virginia VA L 17,288,728 17,288,728 48. Washington WA L 12,131,699 12,131,699 49. West Virginia WV L 4,246,028 4,246,028 50. Wisconsin WI L 36,566,917 36,566,917 51. Wyoming WY L 828,015 828,015 52. American Samoa AS N 53. Guam GU N 54. Puerto Rico PR N 55. U.S. Virgin Islands VI N 56. Northern Mariana Islands MP N 57. Canada CAN N 51,585 51,585 58. Aggregate Other Alien OT XXX 83,892 83,892 59. Subtotal (a) 51 594,017,076 594,017,076 90. Reporting entity contributions for employee benefits

plans XXX 91. Dividends or refunds applied to purchase paid-up

additions and annuities XXX 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 7,395,175 7,395,175 94. Aggregate or other amounts not allocable by State XXX 95. Totals (Direct Business) XXX 601,412,251 601,412,251 96. Plus reinsurance assumed XXX 97 Totals (All Business) XXX 601,412,251 601,412,251 98. Less reinsurance ceded XXX 601,191,548 601,191,548 99. Totals (All Business) less Reinsurance Ceded XXX (b) 220,703 220,703

DETAILS OF WRITE-INS58001. Other Alien XXX 83,892 83,892 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 83,892 83,892

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

(L) Licensed or Chartered - Licensed Insurance Carrier or Domiciled RRG; (R) Registered - Non-domiciled RRGs; (Q) Qualified - Qualified or Accredited Reinsurer; (E) Eligible - Reporting

Entities eligible or approved to write Surplus Lines in the state; (N) None of the above - Not allowed to write business in the state.

Explanation of basis of allocation by states, etc., of premiums and annuity considerationsPremiums are listed on the basis of legal residence of the insured. (a) Insert the number of L responses except for Canada and Other Alien.(b) 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


SCHEDULE T - PART 2INTERSTATE COMPACT - EXHIBIT OF PREMIUMS WRITTEN

Allocated by States and TerritoriesDirect Business Only

States, Etc.

1

Life(Group and Individual)

2

Annuities(Group and Individual)

3Disability Income

(Group and Individual)

4Long-Term

Care(Group and Individual)

5

Deposit-Type Contracts

6

Totals

1. Alabama AL 5,963,548 5,963,548

2. Alaska AK 316,138 316,138

3. Arizona AZ 6,575,024 6,575,024

4. Arkansas AR 3,751,385 3,751,385

5. California CA 35,632,040 35,632,040

6. Colorado CO 14,785,400 14,785,400

7. Connecticut CT 14,176,528 14,176,528

8. Delaware DE 459,501 459,501

9. District of Columbia DC 1,074,673 1,074,673

10. Florida FL 34,951,088 34,951,088

11. Georgia GA 18,775,746 18,775,746

12. Hawaii HI 2,597,123 2,597,123

13. Idaho ID 4,026,506 4,026,506

14. Illinois IL 46,562,252 46,562,252

15. Indiana IN 12,896,729 12,896,729

16. Iowa IA 14,383,160 14,383,160

17. Kansas KS 6,082,979 6,082,979

18. Kentucky KY 8,784,524 8,784,524

19. Louisiana LA 9,011,317 9,011,317

20. Maine ME 1,554,162 1,554,162

21. Maryland MD 8,435,982 8,435,982

22. Massachusetts MA 13,306,377 13,306,377

23. Michigan MI 17,153,679 17,153,679

24. Minnesota MN 23,347,478 23,347,478

25. Mississippi MS 4,189,448 4,189,448

26. Missouri MO 13,881,138 13,881,138

27. Montana MT 2,232,280 2,232,280

28. Nebraska NE 6,661,927 6,661,927

29. Nevada NV 1,562,436 1,562,436

30. New Hampshire NH 2,932,324 2,932,324

31. New Jersey NJ 16,356,176 16,356,176

32. New Mexico NM 2,243,896 2,243,896

33. New York NY 35,963,355 35,963,355

34. North Carolina NC 22,388,300 22,388,300

35. North Dakota ND 2,147,105 2,147,105

36. Ohio OH 21,488,671 21,488,671

37. Oklahoma OK 3,510,589 3,510,589

38. Oregon OR 7,514,947 7,514,947

39. Pennsylvania PA 15,902,896 15,902,896

40. Rhode Island RI 2,018,406 2,018,406

41. South Carolina SC 8,161,438 8,161,438

42. South Dakota SD 3,690,463 3,690,463

43. Tennessee TN 13,154,306 13,154,306

44. Texas TX 28,008,509 28,008,509

45. Utah UT 3,089,604 3,089,604

46. Vermont VT 1,118,659 1,118,659

47. Virginia VA 17,288,728 17,288,728

48. Washington WA 12,131,699 12,131,699

49. West Virginia WV 4,246,028 4,246,028

50. Wisconsin WI 36,566,917 36,566,917

51. Wyoming WY 828,015 828,015

52. American Samoa AS

53. Guam GU

54. Puerto Rico PR

55. U.S. Virgin Islands VI

56. Northern Mariana Islands MP

57. Canada CAN 51,585 51,585

58. Aggregate Other Alien OT 83,892 83,892

59. Total 594,017,076 594,017,076

50

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Directly

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Typ

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Is a

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16 *

0860

67091

39-0509570

The Northwestern Mutual Life Insurance

Comp

any

WIUDP

N

23-7167456

NML Clubs Associated Inc

WINIA


Comp

any

Board of Directors

0.000


Comp

any

N

39-1728908

Northwestern Mutual Life Foundation Inc

WINIA


Comp

any

Management

0.000


Comp

any

N

39-1907562

Bradford Inc

DENIA


Comp

any

Ownership

100.000


Comp

any

Y

39-2035564

Mason Street Advisors LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

26-2325733

NM GP Holdings LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

46-4011781

NM Investment Holdings LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

27-0216148

NM Pebble Valley LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

52-2113746

NML Real Estate Holdings LLC

WINIA


Comp

any

Ownership

100.000


Comp

any

N

52-2144720

NML Securities Holdings LLC

WINIA


Comp

any

Ownership

100.000


Comp

any

N

0860

69000

36-2258318

Northwestern Long Term Care Insurance Comp

any

WIRE


Comp

any

Ownership

100.000


Comp

any

Y

Northwestern Mutual Capi

tal Limited

GBR

NIA


Comp

any

Ownership

100.000


Comp

any

Y

52-2114207

Northwestern Mutual Investment Services LLC

WINIA


Comp

any

Ownership

100.000


Comp

any

N

45-2034777

Northwestern Mutual Investment Management

Comp

any LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

39-2018056

3017081

Northwestern Mutual Wealth Management Comp

any

WINIA


Comp

any

Ownership

100.000


Comp

any

Y

26-0539797

Juleen LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

46-1131524

Northwestern Mutual MU TLD Registry LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

46-1125255

Northwestern Mutual Registry LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

47-2018056

NM Planning LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

80-0226518

LearnVest Inc

DENIA

NM Planning LLC

Ownership

100.000


Comp

any

N

45-4824536

LearnVest Planning Services LLC

DENIA

LearnVest Inc

Ownership

100.000


Comp

any

N

46-4317386

Northwest Passage Capi

tal Advisors LLC

DENIA


Comp

any

Other

0.000


Comp

any

N

86-1095029

Amber LLC

DENIA


Ownership

100.000


Comp

any

N

86-1095030

Bayridge LLC

DENIA


Ownership

100.000


Comp

any

N

86-1095031

Burgundy LLC

DENIA


Ownership

100.000


Comp

any

N

45-3009856

C-Land Fund LLC

DENIA


Ownership

100.000


Comp

any

N

26-3304712

Cortona Holdings LLC

DENIA


Ownership

100.000


Comp

any

N

52

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

YP

AR

T 1

A -

DE

TA

IL O

F I

NS

UR

AN

CE

HO

LD

ING

CO

MP

AN

Y S

YS

TE

M1

Gro

up

Code

2

Gro

up N

am

e

3

NA

ICC

om

pany

Code

4 IDN

um

ber

5

Federa

l R

SS

D

6

CIK

7

Nam

e o

f S

ecurities

Exc

hange

if P

ublic

ly T

raded

(U.S

. or

Inte

rnational)

8

Nam

es o

fP

are

nt, S

ubsid

iaries

Or

Affili

ate

s

9

Dom

i-cili

ary

Loca-

tion

10

Rela

tion-

ship

to

Report

ing

Entity

11

Directly

Contr

olle

d b

y(N

am

e o

f E

ntity

/Pers

on)

12

Typ

eof C

ontr

ol

(Ow

ners

hip

,B

oard

,M

anagem

ent,

Attorn

ey-

in-F

act,

Influence,

Oth

er)

13 If

Contr

ol

isO

wner-

ship

Pro

vid

eP

erc

en-

tage

14

Ultim

ate

Contr

olli

ng

Entity

(ies)/

Pers

on(s

)

15

Is a

nS

CA

F

iling

Re-

quired?

(Y/N

)

16 *

39-1733172

Logan Inc

DENIA


Ownership

100.000


Comp

any

N

27-2967207

NM BSA LLC

DENIA


Ownership

100.000


Comp

any

N

20-3772668

NM Imp

erial LLC

DENIA


Ownership

100.000


Comp

any

N

20-5424412

NM Lion LLC

DENIA


Ownership

100.000


Comp

any

N

20-3259112

NM Majestic Holdings LLC

DENIA


Ownership

100.000


Comp

any

N

39-2032137

NM RE Funds LLC

DENIA


Ownership

100.000


Comp

any

N

26-0385989

NMRM Holdings LLC

DENIA


Ownership

100.000


Comp

any

N

39-1907566

Olive Inc

DENIA


Ownership

100.000


Comp

any

N

39-1566278

RE Corp

DENIA


Ownership

100.000


Comp

any

N

39-1842903

Russet Inc

DENIA


Ownership

100.000


Comp

any

N

39-1312641

Solar Resources Inc

WINIA


Ownership

100.000


Comp

any

N

20-3229323

Walden OC LLC

DENIA


Ownership

100.000


Comp

any

N

39-1733173

Baraboo Inc

DENIA


Ownership

100.000


Comp

any

N

51-0490402

Chateau LLC

DENIA


Ownership

100.000


Comp

any

N

39-1842900

Coral Inc

DENIA


Ownership

100.000


Comp

any

N

39-1842901

Hazel Inc

DENIA


Ownership

100.000


Comp

any

N

39-1733174

Higgins Inc

DENIA


Ownership

100.000


Comp

any

N

39-1733169

Hobby Inc

DENIA


Ownership

100.000


Comp

any

N

26-4419951

Hollenberg 1 Inc

DENIA


Ownership

100.000


Comp

any

N

39-1907491

Klode Inc

DENIA


Ownership

100.000


Comp

any

N

39-1842902

Maroon Inc

DENIA


Ownership

100.000


Comp

any

N

39-1813811

Mason & Marshall Inc

DENIA


Ownership

100.000


Comp

any

N

20-2317269

Model Portfolios LLC

DENIA


Ownership

100.000


Comp

any

N

51-0554956

NM Regal LLC

DENIA


Ownership

100.000


Comp

any

N

39-1565075

NML Developm

ent Corp

oration

DENIA


Ownership

100.000


Comp

any

N

39-1918716

Nicolet Inc

DENIA


Ownership

100.000


Comp

any

N

39-1813810

North Van Buren Inc

DENIA


Ownership

100.000


Comp

any

N

52.1

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

YP

AR

T 1

A -

DE

TA

IL O

F I

NS

UR

AN

CE

HO

LD

ING

CO

MP

AN

Y S

YS

TE

M1

Gro

up

Code

2

Gro

up N

am

e

3

NA

ICC

om

pany

Code

4 IDN

um

ber

5

Federa

l R

SS

D

6

CIK

7

Nam

e o

f S

ecurities

Exc

hange

if P

ublic

ly T

raded

(U.S

. or

Inte

rnational)

8

Nam

es o

fP

are

nt, S

ubsid

iaries

Or

Affili

ate

s

9

Dom

i-cili

ary

Loca-

tion

10

Rela

tion-

ship

to

Report

ing

Entity

11

Directly

Contr

olle

d b

y(N

am

e o

f E

ntity

/Pers

on)

12

Typ

eof C

ontr

ol

(Ow

ners

hip

,B

oard

,M

anagem

ent,

Attorn

ey-

in-F

act,

Influence,

Oth

er)

13 If

Contr

ol

isO

wner-

ship

Pro

vid

eP

erc

en-

tage

14

Ultim

ate

Contr

olli

ng

Entity

(ies)/

Pers

on(s

)

15

Is a

nS

CA

F

iling

Re-

quired?

(Y/N

)

16 *

76-0195862

Stadium and Arena Management Inc

DENIA


Ownership

100.000


Comp

any

N

39-1918385

Tupelo Inc

DENIA


Ownership

100.000


Comp

any

N

39-1813808

White Oaks Inc

DENIA


Ownership

100.000


Comp

any

N

47-4109936

Dortmund LLC

DENIA


Ownership

100.000


Comp

any

N

46-5486209

NM Neptune LLC

DENIA

NM Regal LLC

Ownership

100.000


Comp

any

N

86-4860705

Northwestern Ellis Compa

ny

CAN

NIA

Coral Inc

Ownership

100.000


Comp

any

N

20-1941228

Scotty LLC

DENIA

Hobby Inc

Ownership

5.660


Comp

any

N

20-1941228

Scotty LLC

DENIA

Maroon Inc

Ownership

62.260


Comp

any

N

20-1941228

Scotty LLC

DENIA

North Van Buren Inc

Ownership

4.610


Comp

any

N

20-1941228

Scotty LLC

DENIA

Stadium and Arena Management Inc

Ownership

27.470


Comp

any

N

26-0539949

31 Ogden LLC

DENIA

Juleen LLC

Ownership

100.000


Comp

any

N

66-0526780

Kristiana International Sales Inc

VIR

NIA

Hobby Inc

Ownership

100.000


Comp

any

N

66-0538199

Regina International Sales Inc

VIR

NIA

Hobby Inc

Ownership

100.000


Comp

any

N

20-0734171

NM Harrisburg Inc

PANIA

Bradford Inc

Ownership

100.000


Comp

any

N

26-2464411


tal GP LLC

DENIA

NM GP Holdings LLC

Ownership

100.000


Comp

any

N

26-4236932


tal GP II LLC

DENIA

NM GP Holdings LLC

Ownership

100.000


Comp

any

N

46-0912644


tal GP III LLC

DENIA

NM GP Holdings LLC

Ownership

100.000


Comp

any

N

16-1732348

AMLI at Perimeter Gardens LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

83-0354415

NM Edgewater Joint Venture

PANIA


Comp

any

Ownership

99.900


Comp

any

N

65-1320024

Criterion at Bedford LLC

DENIA


Comp

any

Ownership

99.000


Comp

any

N

94-6273951

Warren Corporate Center LLC

DENIA


Comp

any

Ownership

99.000


Comp

any

N

94-6273951

Warren Corporate Center LLC

DENIA

Olive Inc

Ownership

1.000


Comp

any

N

20-5607948

NM Twin Creeks GP LLC

DENIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

27-5096295

Wells Street Flats LLC

DENIA


Comp

any

Ownership

95.000


Comp

any

N

27-4646730

MCC IV - Phase 1 LLC

DENIA


Comp

any

Ownership

95.000


Comp

any

N

39-1888937

EP Commons LLC

DENIA


Comp

any

Ownership

50.000


Comp

any

N

39-1688783

East Pointe Commons Limited Partnership

WINIA

EP Commons LLC

Ownership

20.000


Comp

any

N

52.2

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

YP

AR

T 1

A -

DE

TA

IL O

F I

NS

UR

AN

CE

HO

LD

ING

CO

MP

AN

Y S

YS

TE

M1

Gro

up

Code

2

Gro

up N

am

e

3

NA

ICC

om

pany

Code

4 IDN

um

ber

5

Federa

l R

SS

D

6

CIK

7

Nam

e o

f S

ecurities

Exc

hange

if P

ublic

ly T

raded

(U.S

. or

Inte

rnational)

8

Nam

es o

fP

are

nt, S

ubsid

iaries

Or

Affili

ate

s

9

Dom

i-cili

ary

Loca-

tion

10

Rela

tion-

ship

to

Report

ing

Entity

11

Directly

Contr

olle

d b

y(N

am

e o

f E

ntity

/Pers

on)

12

Typ

eof C

ontr

ol

(Ow

ners

hip

,B

oard

,M

anagem

ent,

Attorn

ey-

in-F

act,

Influence,

Oth

er)

13 If

Contr

ol

isO

wner-

ship

Pro

vid

eP

erc

en-

tage

14

Ultim

ate

Contr

olli

ng

Entity

(ies)/

Pers

on(s

)

15

Is a

nS

CA

F

iling

Re-

quired?

(Y/N

)

16 *

39-1688783

East Pointe Commons Limited Partnership

WINIA


Comp

any

Ownership

80.000


Comp

any

N

52-1947207

Vienna Metro Joint Venture LLC

MDNIA


Comp

any

Ownership

85.000


Comp

any

N

27-3722685

Regency NM Johns Creek LLC

DENIA


Comp

any

Ownership

90.000


Comp

any

N

52-2106692

Lakelands Associates LLC

DENIA


Comp

any

Ownership

85.000


Comp

any

N

46-1112092

Devon Court LLC

DENIA

Lakeland Associates LLC

Ownership

100.000


Comp

any

N

27-3973400

JLB Citypl

ace LP

TXNIA


Comp

any

Ownership

84.990


Comp

any

N

27-3973400

JLB Citypl

ace LP

TXNIA

NM Twin Creeks GP LLC

Ownership

0.010


Comp

any

N

27-4288375

CWS Lemmon Resources LP

DENIA


Comp

any

Ownership

100.000


Comp

any

N

20-1208962

Realen Valley Forge Greenes Associates

PANIA


Comp

any

Ownership

90.000


Comp

any

N

45-3548186

36 Park LLC

DENIA


Comp

any

Ownership

75.000


Comp

any

N

35-2246294

American Storage Properties LLC

DENIA


Comp

any

Ownership

50.000


Comp

any

N

46-1158305

Travis Avenue Self Storage LLC

DENIA

American Storage Properties LLC

Ownership

100.000


Comp

any

N

52-2052411

Westpa

rk Corporate Center LLC

DENIA


Comp

any

Ownership

44.500


Comp

any

N

52-2052411

Westpa

rk Corporate Center LLC

DENIA

NM GP Holdings LLC

Ownership

44.500


Comp

any

N

80-0371477

NM Cancer Center GP LLC

DENIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

99-0274628

Bishop Square LLC

DENIA

NM BSA LLC

Ownership

100.000


Comp

any

N

27-2854638

Two Con Holdings LLC

DENIA

Bishop Square LLC

Ownership

100.000


Comp

any

N

27-2854730

Two Con LLC

DENIA

Two Con Holdings LLC

Ownership

100.000


Comp

any

N

46-1102533

Two Con SPE LLC

DENIA


Ownership

100.000


Comp

any

N

59-3265492

Ospr

ey Links LLC

DENIA

NM Imp

erial LLC

Ownership

99.000


Comp

any

N

59-3265492

Ospr

ey Links LLC

DENIA

RE Corp

Ownership

1.000


Comp

any

N

45-2158280

Ospr

ey Links Golf Course LLC

DENIA

Ospr

ey Links LLC

Ownership

100.000


Comp

any

N

36-3586900

West Huron Joint Venture

WANIA

NM Imp

erial LLC

Ownership

99.000


Comp

any

N

36-3586900

West Huron Joint Venture

WANIA

Burgundy LLC

Ownership

1.000


Comp

any

N

33-1036236

Corp

orate Camp

us LLC

DENIA


Comp

any

Ownership

82.400


Comp

any

N

20-4874421

Millbrook Ap

artments Associates LLC

VANIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

46-1517240

Plantation Oaks MHC-NM LLC

DENIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

52.3

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

YP

AR

T 1

A -

DE

TA

IL O

F I

NS

UR

AN

CE

HO

LD

ING

CO

MP

AN

Y S

YS

TE

M1

Gro

up

Code

2

Gro

up N

am

e

3

NA

ICC

om

pany

Code

4 IDN

um

ber

5

Federa

l R

SS

D

6

CIK

7

Nam

e o

f S

ecurities

Exc

hange

if P

ublic

ly T

raded

(U.S

. or

Inte

rnational)

8

Nam

es o

fP

are

nt, S

ubsid

iaries

Or

Affili

ate

s

9

Dom

i-cili

ary

Loca-

tion

10

Rela

tion-

ship

to

Report

ing

Entity

11

Directly

Contr

olle

d b

y(N

am

e o

f E

ntity

/Pers

on)

12

Typ

eof C

ontr

ol

(Ow

ners

hip

,B

oard

,M

anagem

ent,

Attorn

ey-

in-F

act,

Influence,

Oth

er)

13 If

Contr

ol

isO

wner-

ship

Pro

vid

eP

erc

en-

tage

14

Ultim

ate

Contr

olli

ng

Entity

(ies)/

Pers

on(s

)

15

Is a

nS

CA

F

iling

Re-

quired?

(Y/N

)

16 *

46-4530596

Ventura Lakes MHC-NM LLC

DENIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

27-2961690

3412 Exchange LLC

DENIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

39-0509570

AFE Brentwood Park LLC

DENIA

Cortona Holdings LLC

Ownership

100.000


Comp

any

N

26-1694971

Crosland Greens LLC

NCNIA

C-Land Fund LLC

Ownership

100.000


Comp

any

N

27-1023998

Fairfield West Deer Park LLC

DENIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

20-5713666

Perimeter Place Master Condominium

Association Inc

GANIA

Millbrook Ap

artments Associates LLC

Board of Directors

0.000


Comp

any

N

26-1746210

Capi

tol View Joint Venture

TNNIA

C-Land Fund LLC

Ownership

85.000


Comp

any

N

46-4095708

Bradford Master Association Inc

NCNIA

C-Land Fund LLC

Board of Directors

0.000


Comp

any

N

26-2555945

Piedmont Center 1-4 LLC

DENIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

26-2555724

Piedmont Center 15 LLC

DENIA

NM Imp

erial LLC

Ownership

100.000


Comp

any

N

20-8291674

NM DFW Lewisville LLC

DENIA

NM Majestic Holdings LLC

Ownership

100.000


Comp

any

N

45-4242738

Crown Farm Partners LLC

MDNIA


Comp

any

Ownership

90.000


Comp

any

N

45-4242676

Ellington Residential LLC

MDNIA

Crown Farm Partners, LLC

Ownership

100.000


Comp

any

N

26-2467415


tal Mezzanine Fund I

LP

DENIA


tal GP LLC

Management

0.000


Comp

any

N

26-2467415


tal Mezzanine Fund I

LP

DENIA


Comp

any

Ownership

76.150


Comp

any

N

26-4237214


tal Mezzanine Fund II

LP

DENIA


tal GP II LLC

Management

0.000


Comp

any

N

90-0900226


tal Mezzanine Fund

III LP

DENIA


tal GP III LLC

Management

0.000


Comp

any

N

26-2467616


tal Strategic Equity

Fund I LP

DENIA


tal GP LLC

Management

0.000


Comp

any

N

26-2467616



Fund I LP

DENIA


Comp

any

Ownership

38.080


Comp

any

N

26-4237290



Fund II LP

DENIA


tal GP II LLC

Management

0.000


Comp

any

N

90-0899634



Fund III LP

DENIA


tal GP III LLC

Management

0.000


Comp

any

N

06-1735155

NR2004 - I LLC

DENIA


Ownership

95.240


Comp

any

N

90-0776267

NWM ZOM GP LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

45-3857740

Hamp

tons PBG LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

20-8287969

Northwoods Phase I LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

47-4633131

NM-Hemlock LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

46-1802061

The Village at Valley Forge Association Inc

PANIA

Realen Valley Forge Greenes Associates

Board of Directors

0.000


Comp

any

N

52.4

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

YP

AR

T 1

A -

DE

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CE

HO

LD

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up

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(U.S

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8

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15

Is a

nS

CA

F

iling

Re-

quired?

(Y/N

)

16 *

47-4596993

GRO LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

47-4607543

GRO-SUB LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

81-0814291

Tapestry Condominium Owners Association Inc

TNNIA


Comp

any

Board of Directors

0.000


Comp

any

N

45-3239101

Artisan Garden Apa

rtments LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

83-0512057

Trade Street Associates I LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

Promenade at Clifton LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

20-5661867

Chelsea Ventures LLC

MDNIA


Comp

any

Ownership

100.000


Comp

any

N

20-3896114

FB #2 LLC

MDNIA

Chelsea Ventures, LLC

Ownership

100.000


Comp

any

N

47-5597879


tal GP IV LLC

DENIA

NM GP Holdings LLC

Ownership

100.000


Comp

any

N

35-2546047


tal Mezzanine Fund IV

LP

DENIA


tal GP IV, LLC

Management

0.000


Comp

any

N

30-0888687



Fund IV LP

DENIA


tal GP IV, LLC

Management

0.000


Comp

any

N

81-2329275

NM Gen LLC

DENIA


Ownership

100.000


Comp

any

N

81-3969754

777 North Van Buren Parking LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

81-3990682

777 North Van Buren Ap

artments LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

81-3961741

777 North Van Buren Retail LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

81-3998079

777 North Van Buren Condominium Association

Inc

WINIA


Comp

any

Board of Directors

0.000


Comp

any

N

1838938 Alberta Ltd

CAN

NIA


Comp

any

Ownership

100.000


Comp

any

N

90-0861069

Bradford II SPE, LLC

DENIA

C-Land Fund LLC

Ownership

100.000


Comp

any

N

Grant Park Venture Partners LLC

DENIA


Comp

any

Ownership

90.000


Comp

any

N

NM-Pulse LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

NM-Skye LLC

DENIA


Comp

any

Ownership

100.000


Comp

any

N

Aste

risk

Exp

lanation

NO

NE

52.5

AN

NU

AL S

TA

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ME

NT

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pany

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um

ber

3

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es o

f In

sure

rs a

nd P

are

nt,

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r A

ffili

ate

s

4

Share

hold

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idends

5

Capital

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6

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ale

sor

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enefit of any

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em

ents

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9

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e/

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em

ents

10 *

11

Any

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ble

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nd/o

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redit

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6709

1 39

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9570

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MUT

UAL LIFE INS

URAN

CE C

O 95

5,24

5,24

5 (4

85,8

99,799

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469,

345,

446

(3,0

99,4

70,1

94)

26

-232

5733

NM GP

HOLD

INGS

, LLC

5,

200,

000

5,

200,

000

46

-401

1781

NM

INV

ESTM

ENT HO

LDIN

GS, LLC

(200

,000

,000

)

(2

00,0

00,0

00)

27

-021

6148

NM

PEB

BLE VALLEY, LLC

(26,

510,

813)

(26,

510,

813)

52

-211

3746

NM

L REAL EST

ATE HO

LDIN

GS, LLC

(80,

496,

487)

(80,

496,

487)

52

-214

4720

NM

L SE

CURITIES

HOL

DING

S, LLC

(4

67,6

69,1

43)

149,

542,

321

(318

,126

,822

)

39

-17331

71

MITC

HELL, IN

C (2

,467

,564

)2,

467,56

4

39

-203

5564

MA

SON

STREET ADV

ISOR

S, LLC

(2

2,30

0,00

0)

(2

2,30

0,00

0)

47

-460

7543

GRO-

SUB,

LLC

1,60

4,30

6

1,60

4,30

6

45

-203

4777

NORTHW

ESTERN

MUT

UAL IN

VEST

MENT

MAN

AGEM

ENT

COMP

ANY, LLC

(2

1,90

0,00

0)

(2

1,90

0,00

0)

52

-228

9921

NM

PLANN

ING, LLC

51,0

10,4

39

51

,010

,439

6900

0 36

-225

8318

NO

RTHW

ESTERN

LON

G TERM

CARE IN

SURANC

E CO

.

3,09

9,47

0,19

4

52

-211

4207

NO

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ESTERN

MUT

UAL IN

VEST

MENT

SERVICE

S,

LLC

(70,

000,

000)

(70,

000,

000)

39

-201

8056

NO

RTHW

ESTERN

MUT

UAL WEALTH

MAN

AGEM

ENT CO

(1

8,00

0,00

0)

(1

8,00

0,00

0)

52

-194

7207

VIEN

NA M

ETRO

JOI

NT VEN

TURE LLC

(4

84,396

)

(4

84,396

)

39

-168

8783

EAST

POI

NTE CO

MMON

S LIMI

TED

PARTNE

RSHI

P (1

,134

,786

)

(1

,134

,786

)

20

-120

8962

REALEN

VALLEY FO

RGE GREENE

S AS

SOCI

ATES

(2

0,44

4,21

1)1,

880,

010

(1

8,56

4,20

1)

52

-210

6692

LAKELAND

S AS

SOCI

ATES

LLC

(2

70,318

)

(2

70,318

)

33-1

0362

36

CORP

ORATE CA

MPUS

LLC

(4

,922

,071

)

(4

,922

,071

)

35

-224

6294

AM

ERIC

AN S

TORAGE P

ROPE

RTIES

LLC

(113

,491

)

(1

13,4

91)

52

-205

2411

WEST

PARK C

ORPO

RATE C

ENTER LLC

(2,1

72,0

26)

(2,1

72,0

26)

27

-372

2685

REGENC

Y NM

JOH

NS C

REEK LLC

(5

70,5

85)

(570

,585

)

94

-627

3951

WARREN

COR

PORATE C

ENTER LLC

(4,0

94,399

)

(4

,094

,399

)

27

-464

6730

MC

C IV - P

HASE

1 LLC

(9

23,1

53)

(923

,153

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45

-424

2738

CR

OWN

FARM

PARTN

ERS

LLC

(3,0

19,8

15)

(3,0

19,8

15)

GRAN

T PA

RK VEN

TURE P

ARTN

ERS

LLC

9,

426,

372

9,

426,

372

26

-246

7616

NO

RTHW

ESTERN

MUT

UAL CA

PITAL ST

RATEGIC

EQUI

TY FUN

D I LP

(6

,688

,970

)13

8,87

6

(6,5

50,0

94)

26

-246

7415

NO

RTHW

ESTERN

MUT

UAL CA

PITAL ME

ZZAN

INE FU

ND

I LP

(9

32,9

62)

52,365

(880

,597

)

20

-828

7969

NO

RTHW

OODS

PHA

SE I LLC

168,

882

16

8,88

2

16

-17323

48

AMLI AT PE

RIME

TER GARD

ENS

LLC

18

5,20

2

185,

202

47

-463

3131

NM

-HEM

LOCK

LLC

2,39

1,04

4

2,39

1,04

4

20

-566

1867

CH

ELSE

A VENT

URES

LLC

67,9

54,9

79

67

,954

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45

-323

9101

ARTISA

N GARD

EN APA

RTME

NTS,

LLC

261,

859

26

1,85

9

83

-051

2057

TRAD

E ST

REET ASS

OCIATES

I, LLC

67,8

40

67

,840

27

-428

8375

CW

S LEMM

ON RES

OURC

ES, LP

306,

798

30

6,79

8

45

-385

7740

HA

MPTO

NS P

BG, LLC

(130

,055

)

(1

30,0

55)

NM-P

ULSE

LLC

93,8

68,5

05

93

,868

,505

53

AN

NU

AL S

TA

TE

ME

NT

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HE

YE

AR

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LE

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UM

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RY

OF

IN

SU

RE

R’S

TR

AN

SA

CT

ION

S W

ITH

AN

Y A

FF

ILIA

TE

S1

NA

ICC

om

pany

Code

2 IDN

um

ber

3

Nam

es o

f In

sure

rs a

nd P

are

nt,

Subsid

iaries o

r A

ffili

ate

s

4

Share

hold

er

Div

idends

5

Capital

Contr

ibutions

6

Purc

hases, S

ale

sor

Exc

hanges o

fLoans, S

ecurities,

Real E

sta

te,

Mort

gage L

oans o

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ther

Investm

ents

7In

com

e/

(Dis

burs

em

ents

)In

curr

ed in

Connection w

ith

Guara

nte

es o

rU

ndert

akin

gs for

the B

enefit of any

Affili

ate

(s)

8

Managem

ent

Agre

em

ents

and

Serv

ice C

ontr

acts

9

Incom

e/

(Dis

burs

em

ents

)In

curr

ed U

nder

Rein

sura

nce

Agre

em

ents

10 *

11

Any

Oth

er

Mate

rial

Activity

Not in

the

Ord

inary

Cours

e o

fth

e Insure

r’s

Busin

ess

12

Tota

ls

13

Rein

sura

nce

Recovera

ble

/(P

aya

ble

) on

Losses a

nd/o

rR

eserv

e C

redit

Taken/(

Lia

bili

ty)

NM-S

KYE LLC

99

,372

,437

99

,372

,437

9999999 C

ontr

ol T

ota

ls

X

XX

53.1


SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIESThe following supplemental reports are required to be filed as part of your statement filing unless specifically waived by the domiciliary state. However, in the event that your domiciliary state waives the filing requirement, your response of WAIVED to the specific interrogatory will be accepted in lieu of filing a “NONE” report and a bar code will be printed below. If the supplement is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatory questions.

Responses

MARCH FILING

1. Will the Supplemental Compensation Exhibit be filed with the state of domicile by March 1? YES

2. Will the confidential Risk-based Capital Report be filed with the NAIC by March 1? YES

3. Will the confidential Risk-based Capital Report be filed with the state of domicile, if required, by March 1? WAIVED

4. Will an actuarial opinion be filed by March 1? YES

APRIL FILING

5. Will Management’s Discussion and Analysis be filed by April 1? YES

6. Will the Life, Health & Annuity Guaranty Association Model Act Assessment Base Reconciliation Exhibit be filed with the state of domicile and the NAIC by April 1? YES

7. Will the Adjustment Form (if required) be filed with the state of domicile and the NAIC by April 1? YES

8. Will the Supplemental Investment Risks Interrogatories be filed by April 1? YES

JUNE FILING

9. Will an audited financial report be filed by June 1? YES

10. Will Accountant's Letter of Qualifications be filed with the state of domicile and electronically with the NAIC by June 1? YES

AUGUST FILING

11. Will the regulator-only (non-public) Communication of Internal Control Related Matters Noted in Audit be filed with the state of domicile and electronically with the NAIC (as a regulator-only non-public document) by August 1? YES

The following supplemental reports are required to be filed as part of your annual statement filing. However, in the event that your company does not transact the type of business for which the special report must be filed, your response of NO to the specific interrogatory will be accepted in lieu of filing a “NONE” report and a bar code will be printed below. If the supplement is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatory questions.

MARCH FILING

12. Will Schedule SIS (Stockholder Information Supplement) be filed with the state of domicile by March 1? NO

13. Will the Medicare Supplement Insurance Experience Exhibit be filed with the state of domicile and the NAIC by March 1? NO

14. Will the Trusteed Surplus Statement be filed with the state of domicile and the NAIC by March 1? NO

15. Will the actuarial opinion on participating and non-participating policies as required in Interrogatories 1 and 2 to Exhibit 5 be filed with the state of domicile and electronically with the NAIC by March 1? NO

16. Will the actuarial opinion on non-guaranteed elements as required in interrogatory #3 to Exhibit 5 be filed with the state of domicile and electronically with the NAIC by March 1? NO

17. Will the actuarial opinion on X-Factors be filed with the state of domicile and electronically with the NAIC by March 1? NO

18. Will the actuarial opinion on Separate Accounts Funding Guaranteed Minimum Benefit be filed with the state of domicile and electronically with the NAIC by March 1? NO

19. Will the actuarial opinion on Synthetic Guaranteed Investment Contracts be filed with the state of domicile and electronically with the NAIC by March 1? NO

20. Will the Reasonableness of Assumptions Certification required by Actuarial Guideline XXXV be filed with the state of domicile and electronically with the NAIC by March 1? NO

21. Will the Reasonableness and Consistency of Assumptions Certification required by Actuarial Guideline XXXV be filed with the state of domicile and electronically with the NAIC by March 1? NO

22. Will the Reasonableness of Assumptions Certification for Implied Guaranteed Rate Method required by Actuarial Guideline XXXVI be filed with the state of domicile and electronically with the NAIC by March 1? NO

23. Will the Reasonableness and Consistency of Assumptions Certification required by Actuarial Guideline XXXVI (Updated Average Market Value) be filed with the state of domicile and electronically with the NAIC by March 1? NO

24. Will the Reasonableness and Consistency of Assumptions Certification required by Actuarial Guideline XXXVI (Updated Market Value) be filed with the state of domicile and electronically with the NAIC by March 1? NO

25. Will the C-3 RBC Certifications required under C-3 Phase I be filed with the state of domicile and electronically with the NAIC by March 1? NO

26. Will the C-3 RBC Certifications required under C-3 Phase II be filed with the state of domicile and electronically with the NAIC by March 1? NO

54


SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES27. Will the Actuarial Certifications Related to Annuity Nonforfeiture Ongoing Compliance for Equity Indexed Annuities be filed with the state of domicile

and electronically with the NAIC by March 1? NO

28. Will the actuarial opinion required by the Modified Guaranteed Annuity Model Regulation be filed with the state of domicile and electronically with the NAIC by March 1? NO

29. Will the Actuarial Certifications Related to Hedging required by Actuarial Guideline XLIII be filed with the state of domicile and electronically with the NAIC by March 1? NO

30. Will the Financial Officer Certification Related to Clearly Defined Hedging Strategy required by Actuarial Guideline XLIII be filed with the state of domicile and electronically with the NAIC by March 1? NO

31. Will the Management Certification That the Valuation Reflects Management’s Intent required by Actuarial Guideline XLIII be filed with the state of domicile and electronically with the NAIC by March 1? NO

32. Will the Actuarial Certification Related to the Reserves required by Actuarial Guideline XLIII be filed with the state of domicile and electronically with the NAIC by March 1? NO

33. Will the Actuarial Certification regarding the use of 2001 Preferred Class Tables required by the Model Regulation Permitting the Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities be filed with the state of domicile and electronically with the NAIC by March 1? NO

34. Will the Worker's Compensation Carve-Out Supplement be filed by March 1? NO

35. Will Supplemental Schedule O be filed with the state of domicile and the NAIC by March 1? YES

36. Will the Medicare Part D Coverage Supplement be filed with the state of domicile and the NAIC by March 1? NO

37. Will an approval from the reporting entity’s state of domicile for relief related to the five-year rotation requirement for lead audit partner be filed electronically with the NAIC by March 1? NO

38. Will an approval from the reporting entity’s state of domicile for relief related to the one-year cooling off period for independent CPA be filed electronically with the NAIC by March 1? NO

39. Will an approval from the reporting entity’s state of domicile for relief related to the Requirements for Audit Committees be filed electronically with the NAIC by March 1? NO

40. Will the confidential Regulatory Asset Adequacy Issues Summary (RAAIS) required by Actuarial Opinion and Memorandum Regulation (Model 822), Section 7A(5) be filed with the state of domicile by March 15? YES

APRIL FILING

41. Will the Long-Term Care Experience Reporting Forms be filed with the state of domicile and the NAIC by April 1? YES

42. Will the Interest-Sensitive Life Insurance Products Report Forms be filed with the state of domicile and the NAIC by April 1? NO

43. Will the Credit Insurance Experience Exhibit be filed with the state of domicile and the NAIC by April 1? NO

44. Will the Accident and Health Policy Experience Exhibit be filed by April 1? YES

45. Will the Analysis of Annuity Operations by Lines of Business be filed with the state of domicile and the NAIC by April 1? NO

46. Will the Analysis of Increase in Annuity Reserves During the Year be filed with the state of domicile and the NAIC by April 1? NO

47. Will the Supplemental Health Care Exhibit (Parts 1, 2 and 3) be filed with the state of domicile and the NAIC by April 1? NO

48. Will the regulator only (non-public) Supplemental Health Care Exhibit’s Expense Allocation Report be filed with the state of domicile and the NAIC by April 1? NO

49. Will the confidential Actuarial Memorandum required by Actuarial Guideline XXXVIII 8D be filed with the state of domicile by April 30? NO

50. Will the Supplemental XXX/AXXX Reinsurance Exhibit be filed with the state of domicile and the NAIC by April 1? NO

AUGUST FILING

51. Will Management’s Report of Internal Control Over Financial Reporting be filed with the state of domicile by August 1? YES

Explanations:12. The Company is wholly owned by Northwestern Mutual Life Insurance Company. 13. The Company does no Medicare Supplement business. 14. The Company is not a U.S. branch of an alien insurer. 15. The Company has no participating life or annuity products. 16. The Company has no life or annuity products with non-guaranteed elements. 17. The opinion is not applicable to the Company. 18. The opinion is not applicable to the Company. 19. The opinion is not applicable to the Company. 20. The Company has no products that fall under Actuarial Guidelines XXXV. 21. The Company has no products that fall under Actuarial Guidelines XXXV. 22. The Company has no products that fall under Actuarial Guidelines XXXVI. 23. The Company has no products that fall under Actuarial Guidelines XXXVI. 24. The Company has no products that fall under Actuarial Guidelines XXXVI. 25. C-3 Phase I does not apply to the Company. 26. C-3 Phase II does not apply to the Company. 27. The Company has no equity indexed annuities. 28. This opinion is not applicable to the Company. 29. These Certifications are not applicable to the Company. 30. This Certification is not applicable to the Company. 31. This Certification is not applicable to the Company. 32. The Company has no products that fall under Actuarial Guideline XLIII. 33. This Certification is not applicable to the Company. 34. The Company does no Workers' Compensation business. 36. The Company does no Medicare Part D business. 37. This approval is not applicable to the Company. 38. This approval is not applicable to the Company. 39. This approval is not applicable to the Company. 42. The Company has no interest-sensitive life insurance products. 43. The Company does no credit insurance business. 45. The Company has no annuity products. 46. The Company has no annuity products. 47. The Company does no health care business. 48. The Company does no health care business. 49. The Company has no products that fall under Actuarial Guidelines XXXVIII 8D. 50. The Supplemental XXX/AXXX Reinsurance Exhibit is not applicable to the Company.

Bar Codes:3. Risk-based Capital Report [Document Identifier 390]

*69000201639000000*12. SIS Stockholder Information Supplement [Document Identifier 420]

*69000201642000000*13. Medicare Supplement Insurance Experience Exhibit [Document Identifier 360]

*69000201636000000*14. Trusteed Surplus Statement [Document Identifier 490]

*69000201649000000*15. Participating Opinion for Exhibit 5 [Document Identifier 371]

*69000201637100000*16. Non-Guaranteed Opinion for Exhibit 5 [Document Identifier 370]

*69000201637000000*

54.1


SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES17. Actuarial Opinion on X-Factors [Document Identifier 442]

*69000201644200000*18. Actuarial Opinion on Separate Accounts Funding Guaranteed Minimum Benefit

[Document Identifier 443] *69000201644300000*19. Actuarial Opinion on Synthetic Guaranteed Investment Contracts

[Document Identifier 444] *69000201644400000*20. Reasonableness of Assumptions Certification required by Actuarial Guideline

XXXV [Document Identifier 445] *69000201644500000*21. Reasonableness and Consistency of Assumptions Certification required by

Actuarial Guideline XXXV [Document Identifier 446] *69000201644600000*22. Reasonableness of Assumptions Certification for Implied Guaranteed Rate

Method required by Actuarial Guideline XXXVI [Document Identifier 447] *69000201644700000*23. Reasonableness and Consistency of Assumptions Certification required by

Actuarial Guideline XXXVI [Document Identifier 448] *69000201644800000*24. Reasonableness and Consistency of Assumptions Certification required by

Actuarial Guideline XXXVI (Updated Market Value) [Document Identifier 449] *69000201644900000*25. C-3 RBC Certifications Required Under C-3 Phase I [Document Identifier 450]

*69000201645000000*26. C-3 RBC Certifications Required Under C-3 Phase II [Document Identifier 451]

*69000201645100000*27. Actuarial Certifications Related to Annuity Nonforfeiture Ongoing Compliance

for Equity Indexed Annuities [Document Identifier 452] *69000201645200000*28. Modified Guaranteed Annuity Model Regulation [Document Identifier 453]

*69000201645300000*29. Actuarial Certifications Related to Hedging required by Actuarial Guideline XLIII

[Document Identifier 436] *69000201643600000*30. Financial Officer Certification Related to Clearly Defined Hedging Strategy

required by Actuarial Guideline XLIII [Document Identifier 437] *69000201643700000*31. Management Certification That the Valuation Reflects Management’s Intent

required by Actuarial Guideline XLIII [Document Identifier 438] *69000201643800000*32. Actuarial Certification Related to the Reserves required by Actuarial Guideline

XLIII [Document Identifier 439] *69000201643900000*33. Actuarial Certification regarding the use of 2001 Preferred Class Tables

required by the Model Regulation Permitting the Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities [Document Identifier 454]

*69000201645400000*34. Workers' Compensation Carve-Out Supplement [Document Identifier 495]

*69000201649500000*36. Medicare Part D Coverage Supplement [Document Identifier 365]

*69000201636500000*37. Relief from the five-year rotation requirement for lead audit partner

[Document Identifier 224] *69000201622400000*38. Relief from the one-year cooling off period for independent CPA

[Document Identifier 225] *69000201622500000*39. Relief from the Requirements for Audit Committees [Document Identifier 226]

*69000201622600000*42. Interest-Sensitive Life Insurance Products Report Forms

[Document Identifier 280] *69000201628000000*43. Credit Insurance Experience Exhibit [Document Identifier 230]

*69000201623000000*45. Analysis of Annuity Operations by Lines of Business [Document Identifier 510]

*69000201651000000*46. Analysis of Increase in Annuity Reserves During the Year

[Document Identifier 515] *69000201651500000*47. Supplemental Health Care Exhibit (Parts 1, 2 and 3) [Document Identifier 216]

*69000201621600000*48. Supplemental Health Care Exhibit's Expense Allocation Report

[Document Identifier 217] *69000201621700000*49. Actuarial Memorandum Required by Actuarial Guideline XXXVIII 8D

[Document Identifier 435] *69000201643500000*50. Supplemental XXX/AXXX Reinsurance Exhibit [Document Identifier 345]

*69000201634500000*

54.2


OVERFLOW PAGE FOR WRITE-INS

NONE

55


SUMMARY INVESTMENT SCHEDULEGross Investment Holdings

Admitted Assets as Reportedin the Annual Statement

Investment Categories

1

Amount

2

Percentage

3

Amount

4Securities Lending

Reinvested CollateralAmount

5

Total(Col. 3 + 4)

Amount

6

Percentage

1. Bonds:

1.1 U.S. treasury securities 89,439,856 94.290 89,439,856 89,439,856 94.290

1.2 U.S. government agency obligations (excluding mortgage-backed securities):

1.21 Issued by U.S. government agencies 0.000 0.000

1.22 Issued by U.S. government sponsored agencies 0.000 0.000

1.3 Non-U.S. government (including Canada, excluding mortgaged-backed securities) 0.000 0.000

1.4 Securities issued by states, territories, and possessions and political subdivisions in the U.S. :

1.41 States, territories and possessions general obligations 0.000 0.000

1.42 Political subdivisions of states, territories and possessions and political subdivisions general obligations 0.000 0.000

1.43 Revenue and assessment obligations 0.000 0.000

1.44 Industrial development and similar obligations 0.000 0.000

1.5 Mortgage-backed securities (includes residential and commercial MBS):

1.51 Pass-through securities:

1.511 Issued or guaranteed by GNMA 0.000 0.000

1.512 Issued or guaranteed by FNMA and FHLMC 0.000 0.000

1.513 All other 0.000 0.000

1.52 CMOs and REMICs:

1.521 Issued or guaranteed by GNMA, FNMA, FHLMC or VA 0.000 0.000

1.522 Issued by non-U.S. Government issuers and collateralized by mortgage-backed securities issued or guaranteed by agencies shown in Line 1.521 0.000 0.000

1.523 All other 0.000 0.000

2. Other debt and other fixed income securities (excluding short-term):

2.1 Unaffiliated domestic securities (includes credit tenant loans and hybrid securities) 0.000 0.000

2.2 Unaffiliated non-U.S. securities (including Canada) 0.000 0.000

2.3 Affiliated securities 0.000 0.000

3. Equity interests:

3.1 Investments in mutual funds 0.000 0.000

3.2 Preferred stocks:

3.21 Affiliated 0.000 0.000

3.22 Unaffiliated 0.000 0.000

3.3 Publicly traded equity securities (excluding preferred stocks):

3.31 Affiliated 0.000 0.000


3.4 Other equity securities:

3.41 Affiliated 0.000 0.000


3.5 Other equity interests including tangible personal property under lease:

3.51 Affiliated 0.000 0.000


4. Mortgage loans:

4.1 Construction and land development 0.000 0.000

4.2 Agricultural 0.000 0.000

4.3 Single family residential properties 0.000 0.000

4.4 Multifamily residential properties 0.000 0.000

4.5 Commercial loans 0.000 0.000

4.6 Mezzanine real estate loans 0.000 0.000

5. Real estate investments:

5.1 Property occupied by company 0.000 0.000

5.2 Property held for production of income (including

$ of property acquired in satisfaction of

debt) 0.000 0.000

5.3 Property held for sale (including $

property acquired in satisfaction of debt) 0.000 0.000

6. Contract loans 0.000 0.000

7. Derivatives 0.000 0.000

8. Receivables for securities 6,694 0.007 6,694 6,694 0.007

9. Securities Lending (Line 10, Asset Page reinvested collateral) 0.000 XXX XXX XXX

10. Cash, cash equivalents and short-term investments 5,409,255 5.703 5,409,256 5,409,256 5.703

11. Other invested assets 0.000 0.000

12. Total invested assets 94,855,805 100.000 94,855,806 94,855,806 100.000

SI01


Schedule A - Verification - Real Estate

N O N E

Schedule B - Verification - Mortgage Loans

N O N E

SI02


SCHEDULE BA - VERIFICATION BETWEEN YEARSOther Long-Term Invested Assets

1. Book/adjusted carrying value, December 31 of prior year

2. Cost of acquired:

2.1 Actual cost at time of acquisition (Part 2, Column 8)

2.2 Additional investment made after acquisition (Part 2, Column 9)

3. Capitalized deferred interest and other:

3.1 Totals, Part 1, Column 16


4. Accrual of discount

5. Unrealized valuation increase (decrease):



6. Total gain (loss) on disposals, Part 3, Column 19

7. Deduct amounts received on disposals, Part 3, Column 16

8. Deduct amortization of premium and depreciation

9. Total foreign exchange change in book/adjusted carrying value:



10. Deduct current year’s other than temporary impairment recognized:



11. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5+6-7-8+9-10)

12. Deduct total nonadmitted amounts

13. Statement value at end of current period (Line 11 minus Line 12)

SCHEDULE D - VERIFICATION BETWEEN YEARSBonds and Stocks

1. Book/adjusted carrying value, December 31 of prior year 86,313,518

2. Cost of bonds and stocks acquired, Part 3, Column 7 5,846,328

3. Accrual of discount 999,740

4. Unrealized valuation increase (decrease):

4.1. Part 1, Column 12

4.2. Part 2, Section 1, Column 15



5. Total gain (loss) on disposals, Part 4, Column 19

6. Deduction consideration for bonds and stocks disposed of, Part 4, Column 7 3,705,000

7. Deduct amortization of premium 14,730

8. Total foreign exchange change in book/adjusted carrying value:





9. Deduct current year’s other than temporary impairment recognized:





10. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5-6-7+8-9) 89,439,856

11. Deduct total nonadmitted amounts

12. Statement value at end of current period (Line 10 minus Line 11) 89,439,856

NONE

SI03


SCHEDULE D - SUMMARY BY COUNTRYLong-Term Bonds and Stocks OWNED December 31 of Current Year

Description


2

Fair Value

3

Actual Cost

4

Par Value of Bonds

BONDS

Governments

(Including all obligations guaranteed by governments)

1. United States 89,439,856 92,272,495 87,367,595 128,770,000

2. Canada

3. Other Countries

4. Totals 89,439,856 92,272,495 87,367,595 128,770,000

U.S. States, Territories and Possessions

(Direct and guaranteed) 5. Totals

U.S. Political Subdivisions of States, Territories and Possessions (Direct and guaranteed)

6. Totals

U.S. Special Revenue and Special Assessment Obligations and all Non-Guaranteed Obligations of Agencies and Authorities of Governments and their Political Subdivisions 7. Totals

Industrial and Miscellaneous, SVO Identified Funds and Hybrid Securities (unaffiliated)

8. United States

9. Canada

10. Other Countries

11. Totals

Parent, Subsidiaries and Affiliates 12. Totals

13. Total Bonds 89,439,856 92,272,495 87,367,595 128,770,000

PREFERRED STOCKS

Industrial and Miscellaneous (unaffiliated)

14. United States

15. Canada

16. Other Countries

17. Totals


19. Total Preferred Stocks

COMMON STOCKS

Industrial and Miscellaneous (unaffiliated)

20. United States

21. Canada

22. Other Countries

23. Totals


25. Total Common Stocks

26. Total Stocks

27. Total Bonds and Stocks 89,439,856 92,272,495 87,367,595

SI04

AN

NU

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FO

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2016 O

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D -

PA

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EC

TIO

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Qualit

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atu

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Dis

trib

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f A

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wned D

ecem

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31,

at

Book/A

dju

ste

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alu

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ajo

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AIC

Desig

nations

NA

IC D

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1

1 Y

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or

Less

2O

ver

1 Y

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Thro

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Years

3O

ver

5 Y

ears

T

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0 Y

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4O

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T

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5

Over

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6N

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Date

7

Tota

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Prior

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Tota

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1. U

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1.1

NA

IC 1

43

,415

,575

6,

232,

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39,791

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X

XX

89,4

39,8

56

100.

0 86

,313

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10

0.0

89,4

39,8

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1.2

NA

IC 2

XX

X

1.3

NA

IC 3

XX

X

1.4

NA

IC 4

XX

X

1.5

NA

IC 5

XX

X

1.6

NA

IC 6

XX

X

1.7

Tota

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43

,415

,575

6,

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39,791

,984

X

XX

89,4

39,8

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100.

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10

0.0

89,4

39,8

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2. A

ll O

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Govern

ments

2.1

NA

IC 1

XX

X

2.2

NA

IC 2

XX

X

2.3

NA

IC 3

XX

X

2.4

NA

IC 4

XX

X

2.5

NA

IC 5

XX

X

2.6

NA

IC 6

XX

X

2.7

Tota

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XX

X

3. U

.S. S

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3.1

NA

IC 1

XX

X

3.2

NA

IC 2

XX

X

3.3

NA

IC 3

XX

X

3.4

NA

IC 4

XX

X

3.5

NA

IC 5

XX

X

3.6

NA

IC 6

XX

X

3.7

Tota

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XX

X

4. U

.S. P

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tate

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Possessio

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4.1

NA

IC 1

XX

X

4.2

NA

IC 2

XX

X

4.3

NA

IC 3

XX

X

4.4

NA

IC 4

XX

X

4.5

NA

IC 5

XX

X

4.6

NA

IC 6

XX

X

4.7

Tota

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XX

X

5. U

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pecia

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Specia

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Oblig

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., N

on-G

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5.1

NA

IC 1

XX

X

5.2

NA

IC 2

XX

X

5.3

NA

IC 3

XX

X

5.4

NA

IC 4

XX

X

5.5

NA

IC 5

XX

X

5.6

NA

IC 6

XX

X

5.7

Tota

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XX

X

SI05

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IC D

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1

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Thro

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6.1

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IC 1

XX

X

6.2

NA

IC 2

XX

X

6.3

NA

IC 3

XX

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6.4

NA

IC 4

XX

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6.5

NA

IC 5

XX

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6.6

NA

IC 6

XX

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6.7

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7. H

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7.1

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IC 1

XX

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7.2

NA

IC 2

XX

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7.3

NA

IC 3

XX

X

7.4

NA

IC 4

XX

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7.5

NA

IC 5

XX

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7.6

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IC 6

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7.7

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8. P

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8.1

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IC 1

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8.2

NA

IC 2

XX

X

8.3

NA

IC 3

XX

X

8.4

NA

IC 4

XX

X

8.5

NA

IC 5

XX

X

8.6

NA

IC 6

XX

X

8.7

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XX

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9. S

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9.1

NA

IC 1

X

XX

XX

XX

XX

XX

XX

XX

X

XX

XX

X

9.2

NA

IC 2

X

XX

XX

XX

XX

XX

XX

XX

X

XX

XX

X

9.3

NA

IC 3

X

XX

XX

XX

XX

XX

XX

XX

X

XX

XX

X

9.4

NA

IC 4

X

XX

XX

XX

XX

XX

XX

XX

X

XX

XX

X

9.5

NA

IC 5

X

XX

XX

XX

XX

XX

XX

XX

X

XX

XX

X

9.6

NA

IC 6

X

XX

XX

XX

XX

XX

XX

XX

X

XX

XX

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9.7

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XX

XX

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SI06

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IC D

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Thro

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IC 1

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43

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39,791

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89,4

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XX

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10.2

NA

IC 2

(d

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X

XX

XX

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10.3

NA

IC 3

(d

)

X

XX

XX

X

10.4

NA

IC 4

(d

)

X

XX

XX

X

10.5

NA

IC 5

(d

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(c

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X

XX

XX

X

10.6

NA

IC 6

(d

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X

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10.7

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Year

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IC 1

3,71

4,64

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43,391

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29,5

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XX

XX

XX

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86,313

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11.2

NA

IC 2

XX

XX

XX

XX

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11.3

NA

IC 3

XX

XX

XX

XX

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11.4

NA

IC 4

XX

XX

XX

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11.5

NA

IC 5

XX

XX

XX

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X(c

)

11.6

NA

IC 6

XX

XX

XX

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X(c

)

11.7

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3,71

4,64

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43,391

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39,791

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12.2

NA

IC 2

XX

X

12.3

NA

IC 3

XX

X

12.4

NA

IC 4

XX

X

12.5

NA

IC 5

XX

X

12.6

NA

IC 6

XX

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12.7

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XX

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XX

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100.

0 X

XX

13. T

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13.1

NA

IC 1

X

XX

13.2

NA

IC 2

X

XX

13.3

NA

IC 3

X

XX

13.4

NA

IC 4

X

XX

13.5

NA

IC 5

X

XX

13.6

NA

IC 6

X

XX

13.7

Tota

ls

XX

X

13.8

Lin

e 1

3.7

as a

% o

f C

ol. 7

XX

XX

XX

XX

XX

XX

13.9

Lin

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3.7

as a

% o

f Lin

e 1

0.7

, C

ol. 7

, S

ection 1

0

XX

XX

XX

XX

XX

XX

(a)

Inclu

des $

fre

ely

tra

dable

under

SE

C R

ule

144 o

r qualif

ied for

resale

under

SE

C R

ule

144A

.

(b)

Inclu

des $

c

urr

ent ye

ar,

$

p

rior

year

of bonds w

ith Z

desig

nations a

nd $

, curr

ent ye

ar

$

prior

year

of bonds w

ith Z

* desig

nations. T

he letter

"Z"

means the N

AIC

desig

nation w

as n

ot

assig

ned b

y th

e S

ecurities V

alu

ation O

ffic

e (

SV

O)

at th

e d

ate

of th

e s

tate

ment. "Z

*" m

eans the S

VO

could

not evalu

ate

the o

blig

ation b

ecause v

alu

ation p

rocedure

s for

the s

ecurity

cla

ss a

re u

nder

regula

tory

revie

w.

(c)

Inclu

des $

c

urr

ent ye

ar,

$

p

rior

year

of bonds w

ith 5

* desig

nations a

nd $

, curr

ent ye

ar

$

prior

year

of bonds w

ith 6

* desig

nations. "

5*"

means the N

AIC

desig

nation w

as a

ssig

ned b

y th

e

(SV

O)

in r

elia

nce o

n the insure

r's c

ert

ific

ation that th

e issuer

is c

urr

ent in

all

princip

al and inte

rest paym

ents

. "

6*"

means the N

AIC

desig

nation w

as a

ssig

ned b

y th

e S

VO

due to inadequate

cert

ific

ation o

f princip

al and inte

rest paym

ents

.

(d)

Inclu

des th

e follo

win

g a

mount of short

-term

and c

ash e

quiv

ale

nt bonds b

y N

AIC

desig

nation: N

AIC

1 $

; N

AIC

2 $

; N

AIC

3 $

; N

AIC

4 $

; N

AIC

5 $

; N

AIC

6 $

SI07

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

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ER

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ON

G T

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AR

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31,

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Book/A

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d C

arr

ying V

alu

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y M

ajo

r T

ype a

nd S

ubty

pe o

f Is

sues

Dis

trib

ution b

y T

ype

1

1 Y

ear

or

Less

2O

ver

1 Y

ear

Thro

ugh 5

Years

3O

ver

5 Y

ears

Thro

ugh 1

0 Y

ears

4O

ver

10 Y

ears

T

hro

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0 Y

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5

Over

20 Y

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6N

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atu

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7

Tota

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as a

% o

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9T

ota

l fr

om

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10

% F

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Col. 7

Prior

Year

11

Tota

l P

ublic

lyT

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12

Tota

l P

rivate

lyP

laced

1. U

.S. G

overn

ments

1.1

Issuer

Oblig

ations

43,4

15,5

75

6,23

2,297

39,7

91,984

XX

X89,43

9,856

100.

0 86,

313,

518

100.

0 89,43

9,856

1.2

Resid

ential M

ort

gage-B

acked S

ecurities

X

XX

1.3

Com

merc

ial M

ort

gage-B

acked S

ecurities

X

XX

1.4

Oth

er

Loan-B

acked a

nd S

tructu

red S

ecurities

X

XX

1.5

Tota

ls

43

,415,5

75

6,23

2,297

39,7

91,984

XX

X89,43

9,856

100.

0 86,

313,

518

100.

0 89,43

9,856

2. A

ll O

ther

Govern

ments

2.1

Issuer

Oblig

ations

X

XX

2.2

Resid

ential M

ort

gage-B

acked S

ecurities

X

XX

2.3

Com

merc

ial M

ort

gage-B

acked S

ecurities

X

XX

2.4

Oth

er

Loan-B

acked a

nd S

tructu

red S

ecurities

X

XX

2.5

Tota

ls

XX

X

3. U

.S. S

tate

s, T

err

itories a

nd P

ossessio

ns, G

uara

nte

ed

3.1

Issuer

Oblig

ations

X

XX

3.2

Resid

ential M

ort

gage-B

acked S

ecurities

X

XX

3.3

Com

merc

ial M

ort

gage-B

acked S

ecurities

X

XX

3.4

Oth

er

Loan-B

acked a

nd S

tructu

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ecurities

X

XX

3.5

Tota

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XX

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4. U

.S. P

olit

ical S

ubdiv

isio

ns o

f S

tate

s, T

err

itories a

nd

Possessio

ns, G

uara

nte

ed

4.1

Issuer

Oblig

ations

X

XX

4.2

Resid

ential M

ort

gage-B

acked S

ecurities

X

XX

4.3

Com

merc

ial M

ort

gage-B

acked S

ecurities

X

XX

4.4

Oth

er

Loan-B

acked a

nd S

tructu

red S

ecurities

X

XX

4.5

Tota

ls

XX

X

5. U

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pecia

l R

evenue &

Specia

l A

ssessm

ent O

blig

ations

etc

., N

on-G

uara

nte

ed

5.1

Issuer

Oblig

ations

X

XX

5.2

Resid

ential M

ort

gage-B

acked S

ecurities

X

XX

5.3

Com

merc

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ort

gage-B

acked S

ecurities

X

XX

5.4

Oth

er

Loan-B

acked a

nd S

tructu

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ecurities

X

XX

5.5

Tota

ls

XX

X

6. In

dustr

ial and M

iscella

neous

6.1

Issuer

Oblig

ations

X

XX

6.2

Resid

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ort

gage-B

acked S

ecurities

X

XX

6.3

Com

merc

ial M

ort

gage-B

acked S

ecurities

X

XX

6.4

Oth

er

Loan-B

acked a

nd S

tructu

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X

XX

6.5

Tota

ls

XX

X

7. H

ybrid S

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7.1

Issuer

Oblig

ations

X

XX

7.2

Resid

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ort

gage-B

acked S

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X

XX

7.3

Com

merc

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ort

gage-B

acked S

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X

XX

7.4

Oth

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acked a

nd S

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X

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7.5

Tota

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XX

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8. P

are

nt, S

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nd A

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8.1

Issuer

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X

XX

8.2

Resid

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gage-B

acked S

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X

XX

8.3

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merc

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gage-B

acked S

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X

XX

8.4

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acked a

nd S

tructu

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X

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8.5

Tota

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XX

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SI08

AN

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FO

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2016 O

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9. S

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9.1

Exc

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X

XX

XX

XX

XX

XX

XX

XX

X

XX

XX

X

9.2

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e S

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X

XX

XX

XX

XX

XX

XX

XX

X

XX

XX

X

9.3

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XX

XX

XX

XX

XX

XX

XX

X

XX

XX

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10. T

ota

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10.1

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43,4

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2,297

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10.2

Resid

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X

XX

XX

XX

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10.3

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gage-B

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X

XX

XX

XX

XX

10.4

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tructu

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X

XX

XX

XX

XX

10.5

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XX

XX

XX

XX

XX

XX

XX

X

XX

XX

XX

10.6

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43,4

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2,297

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11. T

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X

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XX

XX

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X

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XX

XX

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XX

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XX

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XX

XX

XX

XX

XX

XX

XX

XX

XX

XX

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11.6

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X

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X

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12.4

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X

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XX

XX

XX

XX

XX

XX

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X

XX

XX

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X

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12.6

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SI09

AN

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2016 O

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SI10


Schedule DB - Part A - Verification - Options, Caps, Floors, Collars, Swaps and Forwards

N O N E

Schedule DB - Part B - Verification - Futures Contracts

N O N E

Schedule DB - Part C - Section 1 - Replication (Synthetic Asset) Transactions (RSATs) Open

N O N E

Schedule DB-Part C-Section 2-Reconciliation of Replication (Synthetic Asset) Transactions Open

N O N E

Schedule DB - Verification - Book/Adjusted Carrying Value, Fair Value and Potential Exposure of Derivatives

N O N E

Schedule E - Verification - Cash Equivalents

N O N E

Schedule A - Part 1 - Real Estate Owned

N O N E

Schedule A - Part 2 - Real Estate Acquired and Additions Made

N O N E

Schedule A - Part 3 - Real Estate Disposed

N O N E

Schedule B - Part 1 - Mortgage Loans Owned

N O N E

Schedule B - Part 2 - Mortgage Loans Acquired and Additions Made

N O N E

Schedule B - Part 3 - Mortgage Loans Disposed, Transferred or Repaid

N O N E

Schedule BA - Part 1 - Other Long-Term Invested Assets Owned

N O N E

Schedule BA - Part 2 - Other Long-Term Invested Assets Acquired and Additions Made

N O N E

SI11, SI12, SI13, SI14, SI15, E01, E02, E03, E04, E05, E06, E07, E08


Schedule BA - Part 3 - Other Long-Term Invested Assets Disposed, Transferred or Repaid

N O N E

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Dat

e912810-RN-0

US TREASURY NB BONDS

1

2,023,516

96.2310

1,924,620

2,000,000

2,023,047

(468)

2.875

2.816 FA

21,719

57,500

01/15/2016

08/15/2045

912810-RU-4

US TREASURY NB BONDS

1

3,822,813

96.5470

3,861,880

4,000,000

3,823,120

307

2.875

3.103

MN

14,931

12/01/2016

11/15/2046

912828-D5-6

US TREASURY NOTE

1

28,010,500

100.4650

28,451,688

28,320,000

28,075,670

28,749

2.375

2.500 FA

254,053

672,600

09/23/2014

08/15/2024

912828-G3-8

US TREASURY

SD

115,349,008

99.3870

15,206,211

15,300,000

15,339,905

(4,597)

2.250

2.214

MN

44,695

344,250

12/18/2014

11/15/2024

912833-XS-4

US TREASURY STRIPS

@

16,039,930

70.9500

6,030,750

8,500,000

6,232,297

154,375

0.000

2.524

N/A

09/30/2015

05/15/2029

912833-Z6-0

US TREASURY STRIPS

@

132,121,828

52.0840

36,797,346

70,650,000

33,945,817

816,288

0.000

5.115

N/A

09/25/2014

02/15/2038

0199

999.

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tota

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over

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128,770,000

89,439,856

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XX

XX

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128,770,000

89,439,856

994,654

XX

XX

XX

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XX

XX

XX

1099

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Tot

al -

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X

XX

XX

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X

XX

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XX

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XX

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2499

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XX

X

XX

XX

XX

XX

XX

XX

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3199

999.

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al -

U.S

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s B

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XX

X

XX

XX

XX

XX

XX

XX

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3899

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XX

X

XX

XX

XX

XX

XX

XX

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4899

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XX

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XX

XX

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XX

XX

XX

5599

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XX

XX

XX

XX

X

X

XX

XX

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XX

XX

XX

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X

X

XX

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128,770,000

89,439,856

994,654

XX

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1,074,350

XX

XX

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7899

999.

Tot

al -

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iden

tial M

ortg

age-

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ked

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uriti

es

XX

X

XX

XX

XX

XX

X

X

XX

XX

X79

9999

9. T

otal

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ortg

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ked

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uriti

es

XX

X

XX

XX

XX

XX

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XX

XX

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d an

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XX

X

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XX

XX

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XX

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8199

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87,367,595

XX

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128,770,000

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XX

XX

X335,398

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XX

XX

XX

E10


Schedule D - Part 2 - Section 1 - Preferred Stocks Owned

N O N E

Schedule D - Part 2 - Section 2 - Common Stocks Owned

N O N E

E11, E12

AN

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E14


Schedule D - Part 5 - Long Term Bonds and Stocks Acquired and Fully Disposed Of

N O N E

Schedule D-Part 6-Section 1-Valuation of Shares of Subsidiary, Controlled or Affiliated Companies

N O N E

Schedule D - Part 6 - Section 2

N O N E

Schedule DA - Part 1 - Short-Term Investments Owned

N O N E

Schedule DB - Part A - Section 1 - Options, Caps, Floors, Collars, Swaps and Forwards Open

N O N E

Schedule DB - Part A - Section 2 - Options, Caps, Floors, Collars, Swaps and Forwards Terminated

N O N E

Schedule DB - Part B - Section 1 - Futures Contracts Open

N O N E

Schedule DB - Part B - Section 1B - Brokers with whom cash deposits have been made

N O N E

Schedule DB - Part B - Section 2 - Futures Contracts Terminated

N O N E

Schedule DB - Part D - Section 1 - Counterparty Exposure for Derivative Instruments Open

N O N E

Schedule DB - Part D-Section 2 - Collateral for Derivative Instruments Open - Pledged By

N O N E

Schedule DB - Part D-Section 2 - Collateral for Derivative Instruments Open - Pledged To

N O N E

Schedule DL - Part 1 - Reinvested Collateral Assets Owned

N O N E

Schedule DL - Part 2 - Reinvested Collateral Assets Owned

N O N E

E15, E16, E17, E18, E19, E20, E21, E22, E23, E24, E25


SCHEDULE E - PART 1 - CASH1

Depository

2

Code

3

Rate ofInterest

4Amount of Interest Received During

Year

5Amount of Interest

Accrued December 31 of Current Year

6

Balance

7

*U.S. Bank Milwaukee, Wisconsin 1,475,703 XXXJPMorgan Chase Springfield, Illinois 3,437,858 XXXMellon Bank New York, New York 495,695 XXX0199998 Deposits in ... depositories which do not exceed the allowable limit in any one depository (See instructions) - open depositories XXX XXX XXX0199999. Totals - Open Depositories XXX XXX 5,409,256 XXX0299998 Deposits in ... depositories which do not exceed the allowable limit in any one depository (See instructions) - suspended depositories XXX XXX XXX0299999. Totals - Suspended Depositories XXX XXX XXX0399999. Total Cash on Deposit XXX XXX 5,409,256 XXX0499999. Cash in Company's Office XXX XXX XXX XXX XXX

0599999 Total - Cash XXX XXX 5,409,256 XXX

TOTALS OF DEPOSITORY BALANCES ON THE LAST DAY OF EACH MONTH DURING THE CURRENT YEAR1. January 4,734,579 4. April 3,715,605 7. July 3,587,498 10. October 4,920,960

2. February 2,937,842 5. May 2,792,625 8. August 3,710,041 11. November 8,515,440

3. March 3,056,316 6. June 3,265,129 9. September 4,291,878 12. December 5,409,256

E26

AN

NU

AL S

TA

TE

ME

NT

FO

R T

HE

YE

AR

2016 O

F T

HE

N

OR

TH

WE

ST

ER

N L

ON

G T

ER

M C

AR

E IN

S C

O

SC

HE

DU

LE

E -

PA

RT

2 -

CA

SH

EQ

UIV

AL

EN

TS

Show

Inve

stm

ents

Ow

ned D

ecem

ber

31 o

f C

urr

ent

Year

1

Description

2

Code

3

Date

Acquired

4

Rate

of In

tere

st

5

Matu

rity

Date

6B

ook/A

dju

ste

dC

arr

ying V

alu

e

7A

mount of In

tere

st

Due a

nd A

ccru

ed

8A

mount R

eceiv

ed

During Y

ear

8699999 -

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ash E

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NO

NE

E27


SCHEDULE E - PART 3 - SPECIAL DEPOSITS

1 2Deposits For the

Benefit of All Policyholders All Other Special Deposits

States, Etc.Type of Deposit Purpose of Deposit


4

Fair Value


6

Fair Value

1. Alabama AL

2. Alaska AK

3. Arizona AZ

4. Arkansas AR B Security of AR policyholders 140,364 139,142

5. California CA

6. Colorado CO

7. Connecticut CT

8. Delaware DE

9. District of Columbia DC

10. Florida FL

11. Georgia GA B Security of GA policyholders 50,130 49,694

12. Hawaii HI

13. Idaho ID

14. Illinois IL

15. Indiana IN

16. Iowa IA

17. Kansas KS

18. Kentucky KY

19. Louisiana LA

20. Maine ME

21. Maryland MD

22. Massachusetts MA B Security of MA policyholders 100,260 99,387

23. Michigan MI

24. Minnesota MN

25. Mississippi MS

26. Missouri MO

27. Montana MT

28. Nebraska NE

29. Nevada NV

30. New Hampshire NH

31. New Jersey NJ

32. New Mexico NM B Security of NM policyholders 110,286 109,326

33. New York NY

34. North Carolina NC B Security of NC policyholders 546,417 541,659

35. North Dakota ND

36. Ohio OH

37. Oklahoma OK

38. Oregon OR

39. Pennsylvania PA

40. Rhode Island RI

41. South Carolina SC

42. South Dakota SD

43. Tennessee TN

44. Texas TX

45. Utah UT

46. Vermont VT

47. Virginia VA B Security of VA policyholders 250,650 248,468

48. Washington WA

49. West Virginia WV

50. Wisconsin WI B Security of WI policyholders 1,503,900 1,490,804

51. Wyoming WY

52. American Samoa AS

53. Guam GU

54. Puerto Rico PR

55. U.S. Virgin Islands VI

56. Northern Mariana Islands MP

57. Canada CAN

58. Aggregate Alien and Other OT XXX XXX

59. Subtotal XXX XXX 2,702,007 2,678,480


5801.

5802.

5803.

5898. Summary of remaining write-ins for Line 58 from overflow page XXX XXX

5899. Totals (Lines 5801 thru 5803 plus 5898)(Line 58 above) XXX XXX

E28

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 3 - Special Deposits E28

Schedule E - Verification Between Years SI15

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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