67911 PIONEER MUTUAL LIFE INSURANCE COMPANY Original … · Pioneer Mutual Life Insurance Company NAIC Group Code 0619 0619 NAIC Company Code 67911 Employer's ID Number 45-0220640

*67911201620100100*LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION

ANNUAL STATEMENTFOR THE YEAR ENDED DECEMBER 31, 2016

OF THE CONDITION AND AFFAIRS OF THE

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

(Current) (Prior)

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

Country of Domicile United States of America

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

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

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

Main Administrative Office One American Square

(Street and Number)

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

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

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

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

Primary Location of Books and Records One American Square

(Street and Number)

Indianapolis , IN, US 46282-0001 , 317-285-1877

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

Internet Website Address www.OneAmerica.com

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

(Name) (Area Code) (Telephone Number)

[email protected] , 317-285-5114

(E-mail Address) (FAX Number)

OFFICERS

Chairman, President & CEO James Scott Davison Chief Financial Officer Jeffrey David Holley

Secretary Thomas Michael Zurek Actuary Todd Spencer Kennedy

OTHERJohn Charles Mason, Senior Vice President Andrew John Michie #, Senior Vice President James Charles Crampton, Vice President

George Granville Graessle IV #, Vice President Dennis Cameron Martin, Vice President Nancy Brady Moore, Vice President Jay Brian Williams, Vice President

DIRECTORS OR TRUSTEESJames Scott Davison Patrick Michael Foley Jeffrey David Holley

Kelly Michelle Huntington John Charles Mason Mark Cameron Roller Karin Wyvette Sarratt # William Fess Yoerger Thomas Michael Zurek

SS:State of Indiana

County of Marion

The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement.

J. Scott Davison Thomas M. Zurek Jeffrey D. Holley

Chairman, President & CEO Secretary Chief Financial Officer

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

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

6th day of February, 2017 1. State the amendment number

2. Date filed

3. Number of pages attached Brittney N. Hopwood Notary Public 7/24/2024

ANNUAL STATEMENT FOR THE YEAR 2016 OF THE PIONEER MUTUAL LIFE INSURANCE COMPANY

ASSETSCurrent Year Prior Year

1

Assets

2

Nonadmitted Assets

3Net Admitted Assets

(Cols. 1 - 2)

4Net Admitted

Assets

1. Bonds (Schedule D) 461,672,359 461,672,359 441,716,072

2. Stocks (Schedule D):

2.1 Preferred stocks

2.2 Common stocks

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

3.1 First liens 19,827,760 19,827,760 27,630,170

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 ($ 802,745 , Schedule E - Part 1), cash equivalents

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

investments ($ , Schedule DA) 802,745 802,745 10,961,209

6. Contract loans (including $ premium notes) 23,458,317 23,458,317 24,874,459

7. Derivatives (Schedule DB)

8. Other invested assets (Schedule BA) 178,345

9. Receivables for securities 1,045,000 1,045,000

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) 506,806,181 506,806,181 505,360,255

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

only)

14. Investment income due and accrued 4,395,610 4,395,610 4,360,614

15. Premiums and considerations:

15.1 Uncollected premiums and agents' balances in the course of collection 101,659 101,659 170,759

15.2 Deferred premiums and agents' balances and installments booked but

deferred and not yet due (including $

earned but unbilled premiums) 1,599,183 1,599,183 1,688,432

15.3 Accrued retrospective premiums ($ ) and

contracts subject to redetermination ($ )

16. Reinsurance:

16.1 Amounts recoverable from reinsurers 400,151 60,000 340,151 840,121

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 51,485 51,485 485,857

18.2 Net deferred tax asset 11,938,722 8,359,769 3,578,953 3,778,463

19. Guaranty funds receivable or on deposit 228,387 228,387 241,791

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 153,744 153,744

24. Health care ($ ) and other amounts receivable

25. Aggregate write-ins for other than invested assets 7,250 7,250

26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 525,682,372 8,427,019 517,255,353 516,926,292

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

28. Total (Lines 26 and 27) 525,682,372 8,427,019 517,255,353 516,926,292

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. Miscellaneous assets 5,000 5,000

2502. Prepaid expenses 2,250 2,250

2503.


2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 7,250 7,250

2


LIABILITIES, SURPLUS AND OTHER FUNDS1

Current Year2

Prior Year1. Aggregate reserve for life contracts $ 450,074,966 (Exh. 5, Line 9999999) less $

included in Line 6.3 (including $ Modco Reserve) 450,074,966 445,101,496 2. Aggregate reserve for accident and health contracts (including $ Modco Reserve) 3,464 5,006 3. Liability for deposit-type contracts (Exhibit 7, Line 14, Col. 1) (including $ Modco Reserve) 13,959,413 14,870,206 4. Contract claims:

4.1 Life (Exhibit 8, Part 1, Line 4.4, Col. 1 less sum of Cols. 9, 10 and 11) 2,283,046 2,949,532 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) 401,825 427,167 6.2 Dividends not yet apportioned (including $ Modco) 6.3 Coupons and similar benefits (including $ Modco)

7. Amount provisionally held for deferred dividend policies not included in Line 6 8. Premiums and annuity considerations for life and accident and health contracts received in advance less

$ discount; including $ 105 accident and health premiums (Exhibit 1,

Part 1, Col. 1, sum of lines 4 and 14) 9,066 15,470 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 $ 205,000

ceded 205,000 200,000 9.4 Interest maintenance reserve (IMR, Line 6) 153,283 257,207

10. Commissions to agents due or accrued-life and annuity contracts $ 24,937 accident and health

$ and deposit-type contract funds $ 24,937 16,639 11. Commissions and expense allowances payable on reinsurance assumed 12. General expenses due or accrued (Exhibit 2, Line 12, Col. 6) 13. Transfers to Separate Accounts due or accrued (net) (including $ accrued for expense

allowances recognized in reserves, net of reinsured allowances) 14. Taxes, licenses and fees due or accrued, excluding federal income taxes (Exhibit 3, Line 9, Col. 5) 500,159 533,050 15.1 Current federal and foreign income taxes, including $ on realized capital gains (losses) 15.2 Net deferred tax liability 16. Unearned investment income 34,784 36,753 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 432,006 1,668,414 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) 2,275,438 2,416,160 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 344,923 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 12,701 24,838 24.10 Payable for securities lending 24.11 Capital notes $ and interest thereon $

25. Aggregate write-ins for liabilities 425,968 607,765 26. Total liabilities excluding Separate Accounts business (Lines 1 to 25) 470,796,056 469,474,626 27. From Separate Accounts Statement 28. Total liabilities (Lines 26 and 27) 470,796,056 469,474,626 29. Common capital stock 3,000,000 3,000,000 30. Preferred capital stock 31. Aggregate write-ins for other than special surplus funds 32. Surplus notes 33. Gross paid in and contributed surplus (Page 3, Line 33, Col. 2 plus Page 4, Line 51.1, Col. 1) 7,000,000 7,000,000 34. Aggregate write-ins for special surplus funds 700,000 700,000 35. Unassigned funds (surplus) 35,759,297 36,751,666 36. Less treasury stock, at cost:

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

37. Surplus (Total Lines 31+32+33+34+35-36) (including $ in Separate Accounts Statement) 43,459,297 44,451,666 38. Totals of Lines 29, 30 and 37 (Page 4, Line 55) 46,459,297 47,451,666 39. Totals of Lines 28 and 38 (Page 2, Line 28, Col. 3) 517,255,353 516,926,292


2501. Reserve for unclaimed funds 365,358 359,314 2502. Accounts payable 57,890 245,527 2503. Interest on contract funds 2,720 2,924 2598. Summary of remaining write-ins for Line 25 from overflow page 2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 425,968 607,765 3101.

3102.

3103.

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

3403.

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

3


SUMMARY OF OPERATIONS1

Current Year2

Prior Year

1. Premiums and annuity considerations for life and accident and health contracts (Exhibit 1, Part 1, Line 20.4, Col. 1, less Col. 11) 23,482,697 24,057,810

2. Considerations for supplementary contracts with life contingencies

3. Net investment income (Exhibit of Net Investment Income, Line 17) 24,291,852 25,124,847

4. Amortization of Interest Maintenance Reserve (IMR, Line 5) 208,099 188,211

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) 121,823 171,695

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 121,270 3,885

9. Total (Lines 1 to 8.3) 48,225,741 49,546,448

10. Death benefits 16,727,213 13,617,723

11. Matured endowments (excluding guaranteed annual pure endowments) 296,573 93,811

12. Annuity benefits (Exhibit 8, Part 2, Line 6.4, Cols. 4 + 8) 4,111,456 4,067,431

13. Disability benefits and benefits under accident and health contracts 112,354 108,752

14. Coupons, guaranteed annual pure endowments and similar benefits

15. Surrender benefits and withdrawals for life contracts 14,020,917 15,152,518

16. Group conversions

17. Interest and adjustments on contract or deposit-type contract funds 391,859 459,497

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

19. Increase in aggregate reserves for life and accident and health contracts 5,841,655 (2,145,891)

20. Totals (Lines 10 to 19) 41,508,027 31,359,841

21. Commissions on premiums, annuity considerations, and deposit-type contract funds (direct business only) (Exhibit 1, Part 2, Line 31, Col. 1) 2,532,836 2,547,271

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

23. General insurance expenses (Exhibit 2, Line 10, Cols. 1, 2, 3 and 4) 3,191,675 3,669,615

24. Insurance taxes, licenses and fees, excluding federal income taxes (Exhibit 3, Line 7, Cols. 1 + 2 + 3) 759,313 786,221

25. Increase in loading on deferred and uncollected premiums (31,869) (45,173)

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

27. Aggregate write-ins for deductions

28. Totals (Lines 20 to 27) 47,959,982 38,317,775

29. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 28) 265,759 11,228,673

30. Dividends to policyholders 389,826 402,246

31. Net gain from operations after dividends to policyholders and before federal income taxes (Line 29 minus Line 30) (124,067) 10,826,427

32. Federal and foreign income taxes incurred (excluding tax on capital gains) 1,314,969 986,111

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) (1,439,036) 9,840,316

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

$ (94,728) (excluding taxes of $ 69,691 transferred to the IMR) (301,272) 1,870

35. Net income (Line 33 plus Line 34) (1,740,308) 9,842,186

CAPITAL AND SURPLUS ACCOUNT

36. Capital and surplus, December 31, prior year (Page 3, Line 38, Col. 2) 47,451,666 38,345,150

37. Net income (Line 35) (1,740,308) 9,842,186

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 1,201,581 (2,749,419)

41. Change in nonadmitted assets (1,464,091) 1,996,118

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 140,722 17,632

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 869,727

54. Net change in capital and surplus for the year (Lines 37 through 53) (992,369) 9,106,516

55. Capital and surplus, December 31, current year (Lines 36 + 54) (Page 3, Line 38) 46,459,297 47,451,666


08.301. Legal settlement 121,168

08.302. Miscellaneous income 102 3,885

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) 121,270 3,885

2701.

2702.

2703.



5301. Prior year reserve adjustment 869,727

5302.

5303.


5399. Totals (Lines 5301 thru 5303 plus 5398)(Line 53 above) 869,727

4


CASH FLOW1

Current Year

2

Prior Year

Cash from Operations

1. Premiums collected net of reinsurance 23,666,511 24,157,885

2. Net investment income 23,363,221 24,568,935

3. Miscellaneous income 243,093 175,580

4. Total (Lines 1 through 3) 47,272,825 48,902,400

5. Benefit and loss related payments 35,887,888 32,145,447

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

7. Commissions, expenses paid and aggregate write-ins for deductions 6,495,013 7,092,729

8. Dividends paid to policyholders 415,168 419,350

9. Federal and foreign income taxes paid (recovered) net of $ (25,037) tax on capital gains (losses) 855,560 943,745

10. Total (Lines 5 through 9) 43,653,629 40,601,271

11. Net cash from operations (Line 4 minus Line 10) 3,619,196 8,301,129

Cash from Investments

12. Proceeds from investments sold, matured or repaid:

12.1 Bonds 41,686,407 38,174,247

12.2 Stocks

12.3 Mortgage loans 7,802,903 7,123,568

12.4 Real estate

12.5 Other invested assets 178,345 76,596

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

12.7 Miscellaneous proceeds 511,988

12.8 Total investment proceeds (Lines 12.1 to 12.7) 49,667,655 45,886,399

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

13.1 Bonds 60,973,655 52,208,013

13.2 Stocks

13.3 Mortgage loans 507,435

13.4 Real estate

13.5 Other invested assets

13.6 Miscellaneous applications 1,057,137

13.7 Total investments acquired (Lines 13.1 to 13.6) 62,030,792 52,715,448

14. Net increase (decrease) in contract loans and premium notes (1,416,142) (1,334,340)

15. Net cash from investments (Line 12.8 minus Line 13.7 minus Line 14) (10,946,995) (5,494,709)

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 (910,793) (849,521)

16.5 Dividends to stockholders

16.6 Other cash provided (applied) (1,919,872) (981,037)

17. Net cash from financing and miscellaneous sources (Lines 16.1 to 16.4 minus Line 16.5 plus Line 16.6) (2,830,665) (1,830,558)

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) (10,158,464) 975,862

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

19.1 Beginning of year 10,961,209 9,985,347

19.2 End of year (Line 18 plus Line 19.1) 802,745 10,961,209

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

20.0001. Capitalized interest on bonds 400,687

5


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

Total Industrial Life

3

Life Insurance

4

Individual Annuities

5Supplementary

Contracts

Credit Life (Group and Individual)

7Life Insurance

(a)

8

Annuities

9

Group

10Credit (Group and

Individual)

11

Other

Aggregate of All Other Lines of

Business

1. Premiums and annuity considerations for life and accident and health contracts 23,482,697 21,237,341 2,241,284 4,072

2. Considerations for supplementary contracts with life contingencies

3. Net investment income 24,291,852 18,406,522 5,849,412 30,881 4,731 306

4. Amortization of Interest Maintenance Reserve (IMR) 208,099 157,681 50,109 265 41 3

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

6. Commissions and expense allowances on reinsurance ceded 121,823 121,601 222

7. Reserve adjustments on reinsurance ceded

8. Miscellaneous Income:

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

8.2 Charges and fees for deposit-type contracts

8.3 Aggregate write-ins for miscellaneous income 121,270 105,905 15,365

9. Totals (Lines 1 to 8.3) 48,225,741 40,029,050 8,156,170 31,146 4,772 4,603

10. Death benefits 16,727,213 16,727,213

11. Matured endowments (excluding guaranteed annual pure endowments) 296,573 296,573

12. Annuity benefits 4,111,456 4,093,905 17,551

13. Disability benefits and benefits under accident and health contracts 112,354 109,764 2,590

14. Coupons, guaranteed annual pure endowments and similar benefits

15. Surrender benefits and withdrawals for life contracts 14,020,917 10,104,541 3,916,376

16. Group conversions

17. Interest and adjustments on contract or deposit-type contract funds 391,859 393,705 (17,354) 15,508

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

19. Increase in aggregate reserves for life and accident and health contracts 5,841,655 4,903,305 935,664 9,848 (5,620) (1,542)

20. Totals (Lines 10 to 19) 41,508,027 32,535,101 8,928,591 31,356 11,931 1,048

21. Commissions on premiums, annuity considerations and deposit-type contract funds (direct business only) 2,532,836 2,480,538 50,704 1,594

22. Commissions and expense allowances on reinsurance assumed

23. General insurance expenses 3,191,675 2,803,111 388,564

24. Insurance taxes, licenses and fees, excluding federal income taxes 759,313 730,530 28,670 113

25. Increase in loading on deferred and uncollected premiums (31,869) (31,869)

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

27. Aggregate write-ins for deductions

28. Totals (Lines 20 to 27) 47,959,982 38,517,411 9,396,529 31,356 11,931 2,755

29. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 28) 265,759 1,511,639 (1,240,359) (210) (7,159) 1,848

30. Dividends to policyholders 389,826 389,826

31. Net gain from operations after dividends to policyholders and before federal income taxes (Line 29 minus Line 30) (124,067) 1,121,813 (1,240,359) (210) (7,159) 1,848

32. Federal income taxes incurred (excluding tax on capital gains) 1,314,969 617,178 699,975 (290) (2,539) 645

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) (1,439,036) 504,635 (1,940,334) 80 (4,620) 1,203


08.301. Legal settlement 121,168 105,803 15,365

08.302. Miscellaneous income 102 102

08.303.


08.399. Totals (Lines 08.301 thru 08.303 plus 08.398) (Line 8.3 above) 121,270 105,905 15,365

2701.

2702.

2703.


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

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

6


ANALYSIS OF INCREASE IN RESERVES DURING THE YEAR

1 2 Ordinary 6 Group


3

Life Insurance

4


5Supplementary

ContractsCredit Life (Group and

Individual)

7

Life Insurance

8

Annuities

Involving Life or Disability Contingencies (Reserves)

(Net of Reinsurance Ceded)

1. Reserve December 31, prior year 445,101,496 335,245,586 109,750,959 14,174 90,777

2. Tabular net premiums or considerations 22,006,388 19,765,104 2,241,284

3. Present value of disability claims incurred XXX

4. Tabular interest 18,923,853 14,425,392 4,492,646 894 4,921

5. Tabular less actual reserve released (192,612) 88,195 (287,817) 7,010

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

7. Other increases (net) 4,145,227 2,500,000 1,630,273 14,954

8. Totals (Lines 1 to 7) 489,984,352 372,024,277 117,827,345 30,022 102,708

9. Tabular cost 15,635,152 15,635,152 XXX

10. Reserves released by death 4,672,873 4,672,873 XXX XXX XXX

11. Reserves released by other terminations (net) 15,374,141 11,457,765 3,916,376

12. Annuity, supplementary contract and disability payments involving life contingencies 4,227,220 109,764 4,093,905 6,000 17,551

13. Net transfers to or (from) Separate Accounts

14. Total Deductions (Lines 9 to 13) 39,909,386 31,875,554 8,010,281 6,000 17,551

15. Reserve December 31, current year 450,074,966 340,148,723 109,817,064 24,022 85,157

7


EXHIBIT OF NET INVESTMENT INCOME

1 2Collected During Year Earned During Year

1. U.S. Government bonds (a) 3,254,708 3,274,156

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

1.2 Other bonds (unaffiliated) (a) 18,202,451 18,252,817

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) 1,543,158 1,507,810

4. Real estate (d)

5 Contract loans 1,767,991 1,712,758

6 Cash, cash equivalents and short-term investments (e) 20,715 20,715

7 Derivative instruments (f)

8. Other invested assets 2,340 2,340

9. Aggregate write-ins for investment income 21,340 21,340

10. Total gross investment income 24,812,703 24,791,936

11. Investment expenses (g) 466,751

12. Investment taxes, licenses and fees, excluding federal income taxes (g) 33,333

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) 500,084

17. Net investment income (Line 10 minus Line 16) 24,291,852


0901. Miscellaneous investment income 21,340 21,340

0902.

0903.


0999. Totals (Lines 0901 thru 0903 plus 0998) (Line 9, above) 21,340 21,340

1501.

1502.

1503.


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

(a) Includes $ 867,360 accrual of discount less $ 376,874 amortization of premium and less $ 212,828 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 $ 861 accrual of discount less $ 368 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 $ 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 (112,544) (112,544)

1.1 Bonds exempt from U.S. tax

1.2 Other bonds (unaffiliated) 400,410 (510,000) (109,590)

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) 287,866 (510,000) (222,134)


0901.

0902.

0903.


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

8


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


3

Life Insurance

4IndividualAnnuities


6

Life Insurance

7

Annuities

8

Group

9Credit (Group and

Individual)

10

Other


Business

FIRST YEAR (other than single)1. Uncollected 2. Deferred and accrued 3. Deferred , accrued and uncollected:

3.1 Direct 3.2 Reinsurance assumed 3.3 Reinsurance ceded 3.4 Net (Line 1 + Line 2)

4. Advance 5. Line 3.4 - Line 4 6. Collected during year:

6.1 Direct 5,900,711 5,900,711 6.2 Reinsurance assumed 6.3 Reinsurance ceded 11,475 11,475 6.4 Net 5,889,236 5,889,236

7. Line 5 + Line 6.4 5,889,236 5,889,236 8. Prior year (uncollected + deferred and accrued - advance) 9. First year premiums and considerations:

9.1 Direct 5,900,711 5,900,711 9.2 Reinsurance assumed 9.3 Reinsurance ceded 11,475 11,475 9.4 Net (Line 7 - Line 8) 5,889,236 5,889,236

SINGLE10. Single premiums and considerations:

10.1 Direct 156,528 156,528 10.2 Reinsurance assumed 10.3 Reinsurance ceded 10.4 Net 156,528 156,528

RENEWAL11. Uncollected (82,545) (84,425) 1,880 12. Deferred and accrued 1,204,149 1,203,699 450 13. Deferred, accrued and uncollected:

13.1 Direct 1,326,603 1,324,273 450 1,880 13.2 Reinsurance assumed 13.3 Reinsurance ceded 205,000 205,000 13.4 Net (Line 11 + Line 12) 1,121,603 1,119,273 450 1,880

14. Advance 9,066 8,961 105 15. Line 13.4 - Line 14 1,112,537 1,110,312 450 1,775 16. Collected during year:

16.1 Direct 22,988,789 20,742,450 2,241,284 5,055 16.2 Reinsurance assumed 16.3 Reinsurance ceded 5,363,041 5,361,559 1,482 16.4 Net 17,625,748 15,380,891 2,241,284 3,573

17. Line 15 + Line 16.4 18,738,285 16,491,203 2,241,734 5,348 18. Prior year (uncollected + deferred and accrued - advance) 1,301,352 1,299,627 450 1,275 19. Renewal premiums and considerations:

19.1 Direct 22,804,974 20,558,136 2,241,284 5,554 19.2 Reinsurance assumed 19.3 Reinsurance ceded 5,368,041 5,366,559 1,482 19.4 Net (Line 17 - Line 18) 17,436,933 15,191,577 2,241,284 4,072

TOTAL20. Total premiums and annuity considerations:

20.1 Direct 28,862,213 26,615,375 2,241,284 5,554 20.2 Reinsurance assumed 20.3 Reinsurance ceded 5,379,516 5,378,034 1,482 20.4 Net (Lines 9.4 + 10.4 + 19.4) 23,482,697 21,237,341 2,241,284 4,072

9


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

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


3

Life Insurance

4

IndividualAnnuities


6

Life Insurance

7

Annuities

8

Group

9

Credit (Group and Individual)

10

Other


Business

DIVIDENDS AND COUPONS APPLIED

(included in Part 1)

21. To pay renewal premiums 18,510 18,510

22. All other 156,536 156,536

REINSURANCE COMMISSIONS AND

EXPENSE ALLOWANCES INCURRED

23. First year (other than single):

23.1 Reinsurance ceded

23.2 Reinsurance assumed

23.3 Net ceded less assumed

24. Single:



24.3 Net ceded less assumed

25. Renewal:

25.1 Reinsurance ceded 121,823 121,601 222


25.3 Net ceded less assumed 121,823 121,601 222

26. Totals:

26.1 Reinsurance ceded (Page 6, Line 6) 121,823 121,601 222

26.2 Reinsurance assumed (Page 6, Line 22)

26.3 Net ceded less assumed 121,823 121,601 222

COMMISSIONS INCURRED

(direct business only)

27. First year (other than single) 1,861,032 1,861,032

28. Single

29. Renewal 671,804 619,506 50,704 1,594

30. Deposit-type contract funds

31. Totals (to agree with Page 6, Line 21) 2,532,836 2,480,538 50,704 1,594

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 75,637 10,219 85,856

2. Salaries and wages 1,597,376 314,190 1,911,566

3.11 Contributions for benefit plans for employees 379,240 32,321 411,561

3.12 Contributions for benefit plans for agents

3.21 Payments to employees under non-funded benefit plans

3.22 Payments to agents under non-funded benefit plans

3.31 Other employee welfare 31,155 389 31,544

3.32 Other agent welfare

4.1 Legal fees and expenses 3,106 1,994 5,100

4.2 Medical examination fees 36,415 36,415

4.3 Inspection report fees 12,827 12,827

4.4 Fees of public accountants and consulting actuaries 205,271 205,271

4.5 Expense of investigation and settlement of policy claims 7,712 7,712

5.1 Traveling expenses 24,212 24,212

5.2 Advertising 5,491 143 5,634

5.3 Postage, express, telegraph and telephone 92,708 1,511 94,219

5.4 Printing and stationery 36,992 1,859 38,851

5.5 Cost or depreciation of furniture and equipment 3,827 170 3,997

5.6 Rental of equipment

5.7 Cost or depreciation of EDP equipment and software 125,743 125,743

6.1 Books and periodicals 8,437 15,020 23,457

6.2 Bureau and association fees 23,147 509 23,656

6.3 Insurance, except on real estate 18,654 4,679 23,333

6.4 Miscellaneous losses 14,731 14,731

6.5 Collection and bank service charges 813 813

6.6 Sundry general expenses 465,655 61,350 527,005

6.7 Group service and administration fees 1,750 1,750

6.8 Reimbursements by uninsured plans

7.1 Agency expense allowance

7.2 Agents’ balances charged off (less $

recovered)

7.3 Agency conferences other than local meetings 15,925 15,925

9.1 Real estate expenses

9.2 Investment expenses not included elsewhere 22,397 22,397

9.3 Aggregate write-ins for expenses 4,851 4,851

10. General expenses incurred 3,191,675 466,751 (a) 3,658,426

11. General expenses unpaid December 31, prior year

12. General expenses unpaid December 31, current year

13. Amounts receivable relating to uninsured plans, prior year

14. Amounts receivable relating to uninsured plans, current year

15. General expenses paid during year (Lines 10+11-12-13+14) 3,191,675 466,751 3,658,426


09.301. Other Agency Expense 4,851 4,851

09.302.

09.303.


09.399. Totals (Lines 09.301 thru 09.303 plus 09.398) (Line 9.3 above) 4,851 4,851

(a) Includes management fees of $ 3,360,545 to affiliates and $ to non-affiliates.

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

1

Life

2

Accident and Health

3All Other Lines of

Business Investment Total

1. Real estate taxes

2. State insurance department licenses and fees 209,302 33,384 242,686

3. State taxes on premiums 515,109 106 515,215

4. Other state taxes, including $

for employee benefits 30,041 7 30,048

5. U.S. Social Security taxes (333) (51) (384)

6. All other taxes 5,081 5,081

7. Taxes, licenses and fees incurred 759,200 113 33,333 792,646

8. Taxes, licenses and fees unpaid December 31, prior year 523,261 9,789 533,050

9. Taxes, licenses and fees unpaid December 31, current year 489,939 (32) 10,252 500,159

10. Taxes, licenses and fees paid during year (Lines 7 + 8 - 9) 792,522 145 32,870 825,537

EXHIBIT 4 - DIVIDENDS OR REFUNDS1

Life2

Accident and Health

1. Applied to pay renewal premiums 18,510

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

3. Applied to provide paid-up additions 156,536

4. Applied to provide paid-up annuities

5. Total Lines 1 through 4 175,046

6. Paid in cash 35,316

7. Left on deposit 204,806

8. Aggregate write-ins for dividend or refund options


10. Amount due and unpaid

11. Provision for dividends or refunds payable in the following calendar year 401,825

12. Terminal dividends

13. Provision for deferred dividend contracts

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


16. Total from prior year 427,167

17. Total dividends or refunds (Lines 9 + 15 - 16) 389,826


0801.

0802.

0803.


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

11


EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS1

Valuation Standard

2

Total

3

Industrial

4

Ordinary

5Credit

(Group and Individual)

6

Group

LIFE INSURANCE:

0100001. AE 4% NLP Prior 1935 92,928 92,928 0100002. AE 3% NLP 1935-43 583,055 583,055 0100003. 41 CSO 2.75% 1944-47 543,191 543,191 0100004. 41 CSO 2.5% NLP 1948-64 2,173,099 2,173,099 0100005. 41 CSO 2.5% CRVM 1948-64 2,714,542 2,714,542 0100006. 58 CSO 5.5% NLP ALB CRF (SP INT SENS) 83-84 2,685,333 2,685,333 0100007. 58 CSO 5.5% NLP ALB CNF (SP INT SENS) 83-84 2,713,693 2,713,693 0100008. 58 CSO 4.5% NLP ALB CRF 1980-85 101,420 101,420 0100009. 58 CSO 4.5% CRVM ALB CRF 1982-86 382,231 382,231 0100010. 58 CSO 4.5% CRVM ALB CNF 1983-87 43,195,569 43,195,569 0100011. 58 CSO 4% NLP ALB CRF 1978-84 8,562 8,562 0100012. 58 CSO 4% CRVM ALB CRF 1977-84 149,696 149,696 0100013. 58 CSO 3% NLP ALB CRF 1965-87 538,076 538,076 0100014. 58 CSO 3% 5 CRVM - 20 NLP ALB CRF 1965-87 930,590 930,590 0100015. 58 CSO 3% 10 CRVM - 20 NLP ALB CRF 1965-84 506,413 506,413 0100016. 58 CSO 2.5% NLP ALB CRF 1965-87 2,908,020 2,908,020 0100017. 58 CS0 2.5% 5 CRVM - 20 NLP ALB CRF 1965-84 6,370,551 6,370,551 0100018. 58 CS0 2.5% CRVM ALB CRF 1965-87 97,375 97,375 0100019. 58 CET 4.5% ALB CRF 1983-87 54,860 54,860 0100020. 58 CET 3% ALB CRF 1965-87 13,953 13,953 0100021. 58 CET 2.5% ALB CRF 1965-84 108,030 108,030 0100022. 80 CSO 6% CRVM ALB CRF (Fl Pr UL) 1984-86 9,214,305 9,214,305 0100023. 80 CSO 6% S&U CRVM ALB CRF 1985-93 85,747 85,747 0100024. 80 CSO 5.5% NLP ALB CRF 1987-92 472 472 0100025. 80 CSO 5.5% CRVM ALB CRF (Fl Pr UL) 1987-89 2,689,166 2,689,166 0100026. 80 CSO 5.5% CRVM ALB CRF (Fx Pr UL) 1988-92 2,091,826 2,091,826 0100027. 80 CSO 5% NLP ALB CRF AFTER 1992 153 153 0100028. 80 CSO 5% CRVM ALB CRF (Fixed Prem UL) 1993 456,372 456,372 0100029. 80 CSO 5% S&U CRVM ALB CRF 1993-94 15,071 15,071 0100030. 80 CSO 4% NLP ALB CRF AFTER 1987 1,514 1,514 0100031. 80 CSO 4.5% NLP ALB CRF AFTER 1987 417 417 0100032. 80 CSO 4.5% CRVM ALB CNF (Fl Pr UL) AFTER 94 1,654,357 1,654,357 0100033. 80 CSO 4.5% S&U CRVM ALB CNF AFTER 1994 164,693,883 164,693,883 0100034. 80 CSO 4% S&U CRVM ANB CNF AFTER 1998 1,043 1,043 0100035. 80 CSO 4.5% S&U CRVM ANB CNF AFTER 1998 2,353,201 2,353,201 0100036. 80 CSO 4.0% S&U CRVM ALB CNF AFTER 2005 8,396,289 8,396,289 0100037. 80 CSO 4.0% NLP ANB CNF AFTER 1998 147 147 0100038. 80 CSO 4.0% CRVM ANB CNF(Fl Pr UL) AFTER 98 45,384,651 45,384,651 0100039. 80 CET 4.5% ALB CRF AFTER 1984 1,713 1,713 0100040. 2001 CSO 4.0% CRVM ANB CNF (Fl Pr UL) 50,898,058 50,898,058 0100041. 2001 CSO 3.5% CRVM ANB CNF (FI Pr UL) - NB 6,742,592 6,742,592

0199997. Totals (Gross) 361,552,164 361,552,164

0199998. Reinsurance ceded 33,868,102 33,868,102

0199999. Life Insurance: Totals (Net) 327,684,062 327,684,062

ANNUITIES (excluding supplementary contracts with life contingencies):

0200001. 37 SA(-2) 2.5%; DEF PD 3% 1965-78 1,337 XXX 1,337 XXX 0200002. 37 SA(-2) 3.0%; DEF PD 3% 1969-78 (PTS) 165,540 XXX 165,540 XXX 0200003. 37 SA(-2) 3.0%; DEF PD 4% 78-82 (FPA/SPA) 105,281 XXX 105,281 XXX 0200004. A-1949 PROJ 10 YRS, 3.25% PRIOR 76 (SPIA) 3,110 XXX 3,110 XXX 0200005. 71 IAM 6.00% 1976-81 (SPIA) 18,042 XXX 18,042 XXX 0200006. 71 IAM 7.50% 1982-84 (SPIA) 47,321 XXX 47,321 XXX 0200007. 83A 6.25% 1998 (SPIA) 544,270 XXX 544,270 XXX 0200008. 83A 6.50% 1994 (SPIA) 151,336 XXX 151,336 XXX 0200009. 83A 6.75% 1996-97 (SPIA) 839,938 XXX 839,938 XXX 0200010. 83A 7.00% 1993 (SPIA) 296,702 XXX 296,702 XXX 0200011. 83A 7.25% 1995 (SPIA) 682,327 XXX 682,327 XXX 0200012. 83A 7.75% 1992 (SPIA) 149,326 XXX 149,326 XXX 0200013. 83A 8.00% 1987 (SPIA) 146,740 XXX 146,740 XXX 0200014. 83A 8.25% 1990-91 (SPIA) 315,385 XXX 315,385 XXX 0200015. 83A 8.75% 1988-89 (SPIA) 127,859 XXX 127,859 XXX 0200016. 83A 9.25% 1986 (SPIA) 239,770 XXX 239,770 XXX 0200017. 83A 11.00% 1986 (SPIA) 73,278 XXX 73,278 XXX 0200018. 2000A 6.00% 2003 (SPIA) 192,382 XXX 192,382 XXX 0200019. 2000A 6.25% 1999 (SPIA) 580,463 XXX 580,463 XXX 0200020. 2000A 6.50% 2002 (SPIA) 355,675 XXX 355,675 XXX 0200021. 2000A 6.75% 2001 (SPIA) 525,428 XXX 525,428 XXX 0200022. 2000A 7.00% 2000 (SPIA) 878,715 XXX 878,715 XXX 0200023. 71 GAM 6% - PREV PENS PLAN FOR AGENTS 85,157 XXX XXX 85,157 0200024. 37 SA(-2) 3.0%; DEF PD CI W/ 3% GUAR 30,797,828 XXX 30,797,828 XXX 0200025. 37 SA(-2) 3.0%; DEF PD CI W/ 4.5% GUAR 61,936,738 XXX 61,936,738 XXX 0200026. 1983 (F+1) 3.00% DEF PD. C1 W/4.00% GUAR 7,563,775 XXX 7,563,775 XXX 0200027. 1983 (F+1) 3.00% DEF PD. C1 W/3.00% GUAR 578,391 XXX 578,391 XXX

0299997. Totals (Gross) 107,402,114 XXX 107,316,957 XXX 85,157

0299998. Reinsurance ceded XXX XXX

0299999. Annuities: Totals (Net) 107,402,114 XXX 107,316,957 XXX 85,157

SUPPLEMENTARY CONTRACTS WITH LIFE CONTINGENCIES:

0300001. 83A 8.00%; GUAR PD 8.25% 24,020 24,020

0399997. Totals (Gross) 24,020 24,020

0399998. Reinsurance ceded

0399999. SCWLC: Totals (Net) 24,020 24,020

ACCIDENTAL DEATH BENEFITS:

0400001. 59 ADB W/ 58 CSO 2.50% 1965-87 40,796 40,796 0400002. 59 ADB W/ 80 CSO 4.50% AFTER 1984 11,245 11,245

0499997. Totals (Gross) 52,041 52,041

0499998. Reinsurance ceded 266 266

0499999. Accidental Death Benefits: Totals (Net) 51,775 51,775

DISABILITY-ACTIVE LIVES:

0500001. 150% MOD 26 CLASS (3) W/ 41 CSO 2.50% 48-64 108 108 0500002. 52 DIS PD 2, BEN 5 W/ 58 CSO 2.50% 65-87 48,651 48,651

12


EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS1

Valuation Standard

2

Total

3

Industrial

4

Ordinary

5Credit

(Group and Individual)

6

Group

0500003. 52 DIS PD 2, BEN 5 W/ 80 CSO 4% AFTER 1984 670 670 0500004. 52 DIS PD 2, BEN 5 W/ 80 CSO 4.50% AFTER 84 77,781 77,781 0500005. 52 DIS PD 2, BEN 5 W/ 2001 CSO 4.0% NB 38 38 0599997. Totals (Gross) 127,248 127,248 0599998. Reinsurance ceded 41,699 41,699 0599999. Disability-Active Lives: Totals (Net) 85,549 85,549 DISABILITY-DISABLED LIVES:

0600001. 52 INTERCO DISA (P2.2, BEN 5) 2.50% 843,089 817,709 25,380 0699997. Totals (Gross) 843,089 817,709 25,380 0699998. Reinsurance ceded 152,227 126,847 25,380 0699999. Disability-Disabled Lives: Totals (Net) 690,862 690,862 MISCELLANEOUS RESERVES:

0700001. For excess of valuation net premiums over

corresponding gross premiums on respective

policies, computed according to the standard

of valuation required by this state 3,843,953 3,843,953 0700002. For non-deduction of deferred fractional

premiums or return of premiums at the death of

the insured 61,184 61,184 0700003. For surrender values in excess of reserves

otherwise required and carried in this

schedule 329,591 329,591 0700004. Additional actuarial reserves-Asset/liability

analysis............... 10,000,000 10,000,000 0799997. Totals (Gross) 14,234,728 14,234,728 0799998. Reinsurance ceded 98,144 98,144 0799999. Miscellaneous Reserves: Totals (Net) 14,136,584 14,136,584 9999999. Totals (Net) - Page 3, Line 1 450,074,966 449,989,809 85,157

12.1


EXHIBIT 5 - INTERROGATORIES

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

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

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

If so, attach a statement that contains the determination procedures, answers to the interrogatories and an actuarial opinion as described in the instructions.

4. Has the reporting entity any assessment or stipulated premium contracts in force? Yes [ ] No [ X ]If so, state:

4.1 Amount of insurance? $ 4.2 Amount of reserve? $ 4.3 Basis of reserve:

4.4 Basis of regular assessments:

4.5 Basis of special assessments:

4.6 Assessments collected during the year $

5. If the contract loan interest rate guaranteed in any one or more of its currently issued contracts is less than 5%, not in advance, state the contract loan rate guarantees on any such contracts.

6. Does the reporting entity hold reserves for any annuity contracts that are less than the reserves that would be held on a standard basis? Yes [ ] No [ X ]

6.1 If so, state the amount of reserve on such contracts on the basis actually held: $ 6.2 That would have been held (on an exact or approximate basis) using the actual ages of the annuitants; the interest rate(s) used in 6.1; and

the same mortality basis used by the reporting entity for the valuation of comparable annuity benefits issued to standard lives. If the reporting entity has no comparable annuity benefits for standard lives to be valued, the mortality basis shall be the table most recently approved by the state of domicile for valuing individual annuity benefits: $

Attach statement of methods employed in their valuation.

7. Does the reporting entity have any Synthetic GIC contracts or agreements in effect as of December 31 of the current year? Yes [ ] No [ X ]7.1 If yes, state the total dollar amount of assets covered by these contracts or agreements $ 7.2 Specify the basis (fair value, amortized cost, etc.) for determining the amount:

7.3 State the amount of reserves established for this business: $ 7.4 Identify where the reserves are reported in the blank:

8. Does the reporting entity have any Contingent Deferred Annuity contracts or agreements in effect as of December 31 of the current year? Yes [ ] No [ X ]

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

9. Does the reporting entity have any Guaranteed Lifetime Income Benefit contracts, agreements or riders in effect as of December 31 of the

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

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

Description of Valuation Class

2

Changed From

3

Changed To

Increase in Actuarial Reserve Due to

Change

9999999 - Total (Column 4, only) NONE

13


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

TotalGroup Accident

and Health

Credit Accidentand Health

(Group and Individual)CollectivelyRenewable

5

Non-Cancelable

6Guaranteed Renewable

7Non-Renewable for

Stated Reasons Only

8

Other Accident Only

9

All Other

ACTIVE LIFE RESERVE

1. Unearned premium reserves

2. Additional contract reserves (a)

3. Additional actuarial reserves-Asset/Liability analysis 23,631 716 22,915

4. Reserve for future contingent benefits

5. Reserve for rate credits

6. Aggregate write-ins for reserves

7. Totals (Gross) 23,631 716 22,915

8. Reinsurance ceded 20,167 20,167

9. Totals (Net) 3,464 716 2,748

CLAIM RESERVE

10. Present value of amounts not yet due on claims

11. Additional actuarial reserves-Asset/Liability analysis

12. Reserve for future contingent benefits

13. Aggregate write-ins for reserves

14. Totals (Gross)

15. Reinsurance ceded

16. Totals (Net)

17. TOTAL (Net) 3,464 716 2,748

18. TABULAR FUND INTEREST 127 26 101


0601.

0602.

0603.


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

1301.

1302.

1303.


1399. TOTALS (Lines 1301 thru 1303 plus 1398) (Line 13 above)

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

14

Pioneer Mutual Life Insurance Company

Supplemental Statement Regarding Additional Reserves – Accident and Health

December 31, 2016

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

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

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

individual Policies.

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

Year Preliminary Term.

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

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

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

70 ff.

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

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

Table with 1958 CSO, 3%.

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

anticipated experience combined with 1980 CSO, 4%.

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

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

(ii) Active Life Reserves 1983 GAM at 4.50%


EXHIBIT 7 - DEPOSIT TYPE CONTRACTS1

Total

2

GuaranteedInterest Contracts

3

Annuities Certain

4

Supplemental Contracts

5Dividend

Accumulations or Refunds

6Premium and

OtherDeposit Funds

1. Balance at the beginning of the year before reinsurance 14,870,206 24,433 3,813,046 9,075,636 1,957,091

2. Deposits received during the year 1,891,862 1,649,188 204,806 37,868

3. Investment earnings credited to the account 352,902 201 31,067 263,107 58,527

4. Other net change in reserves (17,475) (17,475)

5. Fees and other charges assessed

6. Surrender charges

7. Net surrender or withdrawal payments 3,138,082 6,394 2,374,109 671,180 86,399

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

9. Balance at the end of current year before reinsurance (Lines 1+2+3+4-5-6-7-8) 13,959,413 765 3,119,192 8,872,369 1,967,087

10. Reinsurance balance at the beginning of the year

11. Net change in reinsurance assumed

12. Net change in reinsurance ceded

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

14. Net balance at the end of current year after reinsurance (Lines 9 + 13) 13,959,413 765 3,119,192 8,872,369 1,967,087

15


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

1 2 Ordinary 6 Group Accident and Health


3

Life Insurance

4


5Supplementary

ContractsCredit Life (Group

and Individual)

7

Life Insurance

8

Annuities

9

Group

10Credit (Group and

Individual)

11

Other

1. Due and unpaid:

1.1 Direct



1.4 Net

2. In course of settlement:

2.1 Resisted 2.11 Direct



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

2.2 Other 2.21 Direct 3,632,123 3,632,123


2.23 Reinsurance ceded 1,785,759 1,785,759

2.24 Net 1,846,364 (b) 1,846,364 (b) (b) (b) (b) (b) (b)

3. Incurred but unreported:

3.1 Direct 827,760 827,760


3.3 Reinsurance ceded 391,078 391,078

3.4 Net 436,682 (b) 436,682 (b) (b) (b) (b) (b) (b)

4. TOTALS 4.1 Direct 4,459,883 4,459,883



4.4 Net 2,283,046 (a) (a) 2,283,046 (a)

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

(b) Include only portion of disability and accident and health claim liabilities applicable to assumed "accrued" benefits. Reserves (including reinsurance assumed and net of reinsurance ceded) for unaccrued benefits for Ordinary Life Insurance $ 690,862

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

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

16


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

1 2 Ordinary 6 Group Accident and Health

TotalIndustrial Life

(a)

3Life Insurance

(b)

4


5Supplementary

ContractsCredit Life (Group

and Individual)

7Life Insurance

(c)

8

Annuities

9

Group

10Credit (Groupand Individual)

11

Other

1. Settlements During the Year:

1.1 Direct 29,113,112 24,993,066 4,093,905 6,000 17,551 2,590



1.4 Net (d) 21,480,113 17,360,067 4,093,905 6,000 17,551 2,590

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

2.1 Direct 4,459,883 4,459,883



2.4 Net 2,283,046 2,283,046

3. Amounts recoverable from reinsurers December 31, current year 400,151 400,151

4. Liability December 31, prior year:

4.1 Direct 4,256,706 4,256,706



4.4 Net 2,949,532 2,949,532

5. Amounts recoverable from reinsurers December 31, prior year 840,121 840,121

6. Incurred Benefits

6.1 Direct 29,316,289 25,196,243 4,093,905 6,000 17,551 2,590



6.4 Net 21,253,597 17,133,551 4,093,905 6,000 17,551 2,590

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

$ in Line 6.1, and $ in Line 6.4.

(b) Including matured endowments (but not guaranteed annual pure endowments) amounting to $ 296,573 in Line 1.1, $ 296,573 in Line 1.4.

$ 296,573 in Line 6.1, and $ 296,573 in Line 6.4.

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

$ in Line 6.1, and $ in Line 6.4.

(d) Includes $ 43,714 premiums waived under total and permanent disability benefits.

17


EXHIBIT OF NON-ADMITTED ASSETS1

Current Year Total Nonadmitted Assets

2

Prior Year Total Nonadmitted Assets

3Change in Total

Nonadmitted Assets (Col. 2 - Col. 1)

1. Bonds (Schedule D)

2. Stocks (Schedule D):

2.1 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

4.2 Properties held for the production of income

4.3 Properties held for sale

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

6. Contract loans

7. Derivatives (Schedule DB)

8. Other invested assets (Schedule BA)

9. Receivables for securities

10. Securities lending reinvested collateral assets (Schedule DL)

11. Aggregate write-ins for invested assets

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

13. Title plants (for Title insurers only)

14. Investment income due and accrued

15. Premiums and considerations:

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

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

15.3 Accrued retrospective premiums and contracts subject to redetermination

16. Reinsurance:

16.1 Amounts recoverable from reinsurers 60,000 (60,000)

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 8,359,769 6,958,678 (1,401,091)

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 7,250 4,250 (3,000)

26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 8,427,019 6,962,928 (1,464,091)

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

28. Total (Lines 26 and 27) 8,427,019 6,962,928 (1,464,091)


1101.

1102.

1103.



2501. Miscellaneous assets 5,000 2,000 (3,000)

2502. Prepaid expenses 2,250 2,250

2503.


2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 7,250 4,250 (3,000)

18


19

NOTES TO FINANCIAL STATEMENTS

Note # Description

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35 Loss/Claim Adjustment Expenses

Participating Policies

Premium Deficiency Reserves

Reserves for Life Contracts and Annuity Contracts

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

Premium and Annuity Considerations Deferred and Uncollected

Separate Accounts

Intercompany Pooling Arrangements

Structured Settlements

Heath Care Receivables

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

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

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

Fair Value Measurement

Other Items

Events Subsequent

Reinsurance

Change in Incurred Losses and Loss Adjustment Expenses

Retrospectively Rated Contracts & Contracts Subject to Redetermination

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

Debt

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

Liabilities, Contingencies and Assessments

Summary of Significant Accounting Policies and Going Concern

Accounting Changes and Corrections of Errors

Business Combinations and Goodwill

Discontinued Operations

Investments

Joint Ventures, Partnerships and Limited Liability Companies

Leases

Investment Income

Derivative Instruments

Income Taxes

Information Concerning Parent, Subsidiaries and Affiliates

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

1. Summary of Significant Accounting Policies and Going Concern

A. Accounting Practices

The accompanying financial statements of Pioneer Mutual Life Insurance Company (the “Company”), have been prepared in conformity with the National Association of Insurance Commissioners (“NAIC”) Annual Statement Instructions and Accounting Practices and Procedures manuals, except to the extent that state laws may differ. The statements are also prepared in conformity with accounting practices prescribed or permitted by the Insurance Department of North Dakota. The Company does not have any permitted practices.

SSAP# F/S Pg F/S Line # 12/31/2016 12/31/2015

(1) State basis (Page 4, line 35, Columns 1 & 2) XXX XXX XXX (1,740,308)$ 9,842,186$

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

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

(4) NAIC SAP XXX XXX XXX (1,740,308)$ 9,842,186$

Surplus

(5) State basis (Page 3, line 38, Columns 1 & 2) XXX XXX XXX 46,459,297$ 47,451,666$

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

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

(8) NAIC SAP XXX XXX XXX 46,459,297$ 47,451,666$

Net Income


19.1


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

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

C. Accounting Policy

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

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

In addition, the Company uses the following accounting policies:

(1) Short-term investments are stated at amortized cost. (2) Bonds not backed by other loans are stated at amortized cost using the scientific method. (3) The Company has no common stock. (4) The Company has no preferred stock. (5) Mortgage loans on real estate are stated at amortized cost. (6) Loan-backed securities are stated at amortized cost using the interest method including anticipated prepayments at the date of

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

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

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

D. Going Concern – not applicable.

2. Accounting Changes and Corrections of Errors

A. Correction of Errors

In the third quarter of 2016, the Company identified and corrected data inconsistencies in payout annuity reserving models. On a net basis, the prior year surplus was understated due to reserve liabilities being overstated by $0.9 million as of December 31, 2015. The error was corrected as a direct increase to surplus. The tax effect impacted federal income taxes incurred by $0.3 million.

B. Cumulative Effect of Changes in Accounting Principles – not applicable.

3. Business Combinations and Goodwill

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

4. Discontinued Operations – not applicable.

5. Investments

A. Mortgage Loans, including Mezzanine Real Estate Loans 1) There were no new mortgage loans made during 2016. 2) There were no new mortgage loans made during 2016.

19.1


19.2

12/31/2016 12/31/2015

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

4) An age analysis of mortgage loans:

Farm Insured All Other Insured All Other Mezzanine Total

a. Current year

1. Recorded Investment

a Current -$ -$ -$ -$ 19,827,760$ -$ 19,827,760$

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

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

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

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

2 Accruing interest 90-179 days past due

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

b Interest accrued - - - - - - -

3 Accruing interest 180+ days past due



4 Interest reduced



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

b Prior year

1. Recorded Investment

a Current -$ -$ -$ -$ 27,630,170$ -$ 27,630,170$

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

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

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

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

2 Accruing interest 90-179 days past due



3 Accruing interest 180+ days past due



4 Interest reduced



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

5) Investment in impaired loans with or without allowance for credit losses:

a. Current year

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

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

b Prior year

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

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

6)

a. Current year

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

2 Interest income recognized - - - - - - -

3 - - - - - - -

4 - - - - - - -

b Prior year

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

2 Interest income recognized - - - - - - -

3 - - - - - - -

4 - - - - - - -

7) Allowance for credit losses: 12/31/2016 12/31/2015

a

)

Balance at beginning of period -$ -$

b

) Additions charged to operations - -

c

)

Direct write-downs charged against the allowance - -

d

)

Recoveries amounts previously charges off - -

e

)

Balance at end of period -$ -$

8) Mortgage Loans Derecognized as a Result of Foreclosure:

12/31/2016 12/31/2015

a

)

Aggregate amount of mortgage loan derecognized -$ -$

b

)

Real estate collateral recognized - -

c

)

Other collateral recognized - -

d

)

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

Recorded investments on

nonaccrual statusAmount of interest income

recognized using a cash-basis

method of accounting

Residential

Invesment in impaired loans - average recorded investment, interest income recognized, recorded investment in nonaccrual status and amount of interest

income recognized using a cash-basis method of accounting:

Commercial

Amount of interest income

recognized using a cash-basis

method of accounting

Recorded investments on

nonaccrual status

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

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

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


19.3

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

(2)

Amortized Cost

Basis Before

Other-Than

Other-than-Temporary Impairment

Recognized in Loss

Temporary

Impairment 2a Interest 2b Non-Interest

Fair Value

1 - (2a + 2b)

OTTI recognized 1st Quarter

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

b. Inability or lack of intent to retain

the investment in the security for

a period of time sufficient to

recover the amortized cost basis

- - - -

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

OTTI recognized 2nd Quarter

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

e. Inability or lack of intent to retain




- - - -

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

OTTI recognized 3rd Quarter

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

h. Inability or lack of intent to retain




- - - -

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

OTTI recognized 4th Quarter

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

k. Inability or lack of intent to retain




- - - -

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

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

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

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

CUSIP

Book/Adjusted

Carrying Value

Amortized

Cost Before

Current Period

OTTI

Present Valu

Documents

67911 PIONEER MUTUAL LIFE INSURANCE COMPANY Original … · Pioneer Mutual Life Insurance Company NAIC Group Code 0619 0619 NAIC Company Code 67911 Employer's ID Number 45-0220640