BEGINNING WITH FIRST QUARTER, 2019, FRATERNAL
FRATERNAL SOCIETIESCOMPANY NAME:NAIC Company Code:Contact:Telephone:REQUIRED FILINGS IN THE STATE OF:OREGONFilings Made During the Year 2019BEGINNING WITH FIRST QUARTER, 2019, FRATERNAL ENTITIES FILE ON LIFE STATEMENT.(1)(2)(3)ChecklistLine #REQUIRED FILINGS FOR THE ABOVE STATE1Printed Investment Schedule detail (Pages E01-E27)Quarterly Financial Statement (8 ½” x 14”)Separate Accounts Annual Statement (8 ½”x 14”)11121314151617II. NAIC SUPPLEMENTSAccident & Health Policy Experience ExhibitAnalysis of Annuity Operations by Lines of BusinessAnalysis of Increase in Annuity Reserves During YearInterest Sensitive Life Insurance Products ReportLong-Term Care Experience Reporting FormsManagement Discussion & AnalysisMedicare Part D Coverage icStateNAIC(5)DUE DATEForeignState(6)FORMSOURCE**I. NAIC FINANCIAL STATEMENTSAnnual Statement (8 ½”x14”)1.12318192021222324(4)NUMBER OF COPIES*Medicare Supplement Insurance Experience ExhibitRisk-Based Capital ReportSupplemental Compensation ExhibitSupplemental Health Care Exhibit (Parts 1, 2 and 3)Supplemental Health Care Exhibit’s Allocation ReportSupplemental Investment Risk InterrogatoriesSupplemental Term and Universal Life InsuranceReinsurance ExhibitTrusteed Surplus StatementVariable Annuities SupplementVM 20 Reserves SupplementActuarial Related ItemsActuarial Certification regarding use 2001 Preferred ClassTableActuarial Certification Related Annuity NonforfeitureOngoing Compliance for Equity Indexed AnnuitiesActuarial Certification Related to Hedging required byActuarial Guideline XLIIIActuarial Certification Related to Reserves required byActuarial Guideline XLIIIActuarial Memorandum Related to Universal Life withSecondary Guarantee Policies required by ActuarialGuideline XXXVIII 8DActuarial OpinionExecutive Summary of the PBR Actuarial Report (if VMearly adopted)Actuarial Opinion on Separate Accounts FundingGuaranteed Minimum BenefitActuarial Opinion on Synthetic Guaranteed InvestmentContractsActuarial Opinion on X-FactorsActuarial Opinion required by Modified GuaranteedAnnuity Model RegulationFinancial Officer Certification Related to Clearly DefinedHedging Strategy required by Actuarial Guideline XLIIILife PBR ExemptionManagement Certification that the Valuation ReflectsManagement’s Intent required by Actuarial GuidelineXLIII 2018 National Association of Insurance 14/14/13/1 ,5/15, mpanyNAICxxxxxxxxx4/13/1, 5/15, xx3/1Company2EOxxxCompany1E/Oxxx3/1Commissioner 7/1NAIC 8/15KKK, AAKKCompanyK21EOxxx3/1CompanyFraternal
(1)(2)(3)ChecklistLine #REQUIRED FILINGS FOR THE ABOVE 11(4)NUMBER OF COPIES*DomesticStateNAICRAAIS required by Valuation ManualReasonableness & Consistency of AssumptionsCertification required by Actuarial Guideline XXXVReasonableness of Assumptions Certification required byActuarial Guideline XXXVReasonableness & Consistency of AssumptionsCertification required by Actuarial Guideline XXXVI(Updated Average Market Value)Reasonableness & Consistency of AssumptionsCertification required by Actuarial Guideline XXXVI(Updated Market Value)Reasonableness of Assumptions Certification for ImpliedGuaranteed Rate Method required by Actuarial GuidelineXXXVIRBC Certification required under C-3 Phase IRBC Certification required under C-3 Phase IIStatement on non-guaranteed elements – Exhibit 5 Int. #3Statement on participating/non-participating policies –Exhibit 5, Inter. #1&2III. ELECTRONIC FILING REQUIREMENTSAnnual Statement Electronic FilingMarch .PDF FilingRisk-Based Capital Electronic FilingRisk-Based Capital .PDF FilingSeparate Accounts Electronic FilingSeparate Accounts .PDF FilingSupplemental Electronic FilingSupplemental .PDF FilingQuarterly Statement Electronic FilingQuarterly .PDF FilingJune .PDF FilingIV. AUDIT/INTERNAL CONTROLRELATED REPORTSAccountants Letter of QualificationsAudited Financial ReportsAudited Financial Reports Exemption AffidavitCommunication of Internal Control Related MattersNoted in AuditIndependent CPA (change)Management’s Report of Internal Control Over FinancialReportingNotification of Adverse Financial ConditionRelief from the five-year rotation requirement for leadaudit partnerRelief from the one-year cooling off period forindependent CPARelief from the Requirements for Audit CommitteesRequest for Exemption to File Management's Report ofInternal Control Over Financial ReportingV. STATE REQUIRED FILINGSAnnual Actuarial Certification of SEHI ComplianceAnnual Report of Segregated PremiumsCertificate of ComplianceCertificate of DepositCertificate of ValuationCertification report from the exchangeContinuation Fee ( 1,500.00)Corporate Governance Annual Disclosure***Credit Life and Health Experience ReportExpanded Practice Dental HygienistsFilings Checklist (with Column 1 completed) 2018 National Association of Insurance Commissioners2(5)DUE /13/1, 5/15, 8/15,11/153/1, 5/15, 8/15,11/15xxx3/1, 5/15, 8/15,11/15xxx3/1, 5/15, OCompanyJ,K2112EOEOEOEOxxxxxxxxxxxx3/1, 5/15, GRRSSUHHOOFraternal
(1)(2)(3)ChecklistLine #REQUIRED FILINGS FOR THE ABOVE 127128129130(4)NUMBER OF COPIES*DomesticStateNAICForm B-Holding Company Registration StatementForm F-Enterprise Risk Report ****Health Benefit Plan ReportHealth Insurer Segregation of Premium Accounting PlanLife Illustration ReportLong Term Care ReportsMarket Conduct Annual Statement (MCAS)Medical Loss RatioMedicare Select and Supplement ReportsOregon Exhibit of Premiums (State Page)ORSA*****Patient Protection ReportPremium TaxPrompt Pay ReportsQuarterly Health Enrollment ReportRescission ReportState Filing FeesSigned JuratStatement of Compliance for 00(5)DUE 4/304/304/13/13/1, 5/1, 6/304/303/1, 3/31 ,5/313/18/16/303/12/1, 5/1, 8/1, TTIILLNNJJKKK, RQQMMEECCDDCG,H,J,K,LV*If XXX appears in this column, this state does not require this filing, if hard copy is filed with the state of domicile and if the data is filed electronicallywith the NAIC. If N/A appears in this column, the filing is required with the domiciliary state. EO (electronic only filing).**If Form Source is NAIC, the form should be obtained from the appropriate vendor.***For those states that have adopted the NAIC Corporate Governance Annual Disclosure Model Act, an annual disclosure is required of all insurersor insurance groups by June 1. The Corporate Governance Annual Disclosure is a state filing only and should not be submitted by the company tothe NAIC. Note however that this filing is intended to be submitted to the lead state if filed at the insurance group level. For more information onlead states, see the following NAIC URL: http://www.naic.org/public lead state report.htm.****For those states that have adopted the NAIC updated Holding Company Model Act, a Form F filing is required annually by holding companygroups. Consistent with the Form B filing requirements, the Form F is a state filing only and should not be submitted by the company to the NAIC.Note however that this filing is intended to be submitted to the lead state. For more information on lead states, see the following NAIC URL:http://www.naic.org/public lead state report.htm*****For those states that have adopted the NAIC Risk Management and Own Risk and Solvency Assessment Model Act, a summary report isrequired annually by insurers and insurance groups above a specified premium threshold. The ORSA Summary Report is a state filing only andshould not be submitted by the company to the NAIC. Note however that this filing is intended to be submitted to the lead state if filed at the insurancegroup level. For more information on lead states, see the following NAIC URL: http://www.naic.org/public lead state report.htm. 2018 National Association of Insurance Commissioners3Fraternal
ABNOTES AND INSTRUCTIONS (A-K APPLY TO ALL FILINGS)Required Filings Contact Person:General:Sara Warburton 503-947-7227503-947-7982Bar Code:Sara Warburton 503-947-7227Internet Address:sara.m.warburton@oregon.govStreet Address:Department of Consumer & Business ServicesDivision of Financial Regulation350 Winter Street NESalem OR 97301-3883Mailing Address:CMailing Address for Filing Fees:Mailing Address:Department of Consumer & Business ServicesDivision of Financial RegulationP.O. Box 14480Salem OR 97309-0405No filing fees required.DMailing Address for Premium Tax Payments:N/AEDelivery Instructions:FLate Filings:GOriginal Signatures:All filings must be postmarked no later than theindicated due date. If the due date falls on aweekend or holiday, then the deadline is extendedto the next business day.Failure to comply with any of the filingrequirements may result in the assessment of acivil penalty pursuant to ORS 731.988 or theexpiration of your company’s certificate ofauthority pursuant to ORS 731.410.LATE FEE - 500 PER DAYFacsimile signatures are acceptable and have thesame force as original JDomestic insurers: The annual statement andquarterly statements must be signed by thepresident and secretary, or in their absence, twoother principal officers of the company, withsignatures notarized.Amended Filings:Foreign insurers: The Signed Jurat page must besigned by the president and secretary, or in theirabsence, two other principal officers of thecompany, with signatures notarized.Domestic insurers: The annual statement andquarterly statements must be signed by thepresident and secretary, or in their absence, twoother principal officers of the company, withsignatures notarized.Exceptions from normal filings:Foreign insurers: The Signed Jurat page must besigned by the president and secretary, or in theirabsence, two other principal officers of thecompany, with signatures notarized.Domestic insurers: The annual statement andquarterly statements must be signed by thepresident and secretary, or in their absence, twoother principal officers of the company, withsignatures notarized.Foreign insurers: The Signed Jurat page must besigned by the president and secretary, or in theirabsence, two other principal officers of thecompany, with signatures notarized. 2018 National Association of Insurance Commissioners4Fraternal
KBar Codes (State or NAIC):LSigned Jurat:Bar codes are required. Please refer to the NAICAnnual Statement Instructions, Bar CodesAppendix and the attached listing.Note: State page bar code must have “38” in thestate code position and reflect only Oregonbusiness. Grand Total “58” is not acceptable evenif it is “none.”This state waives foreign insurers from filingprinted annual statements and supplements.Foreign insurers will file a completed SignedJurat page as confirmation of NAIC electronicfiling. The signature requirements for the SignedJurat page are the same as the requirements for theannual statement Jurat page. In the event that yourefile or amend any financial data, a newlycompleted Signed Jurat page is required.See NAIC Annual Statement Instructions forSupplemental Interrogatories.MNONE Filings:NFilings new, discontinued or modified materially since last year:N/AOAnnual Statement Instruction for electronic filing:PQuarterly Statements for foreign companies:Domestic and foreign insurers are required to fileannual statements and supplements electronicallywith the NAIC. Foreign insurers: See note L.Only required if requested by Commissioner.QConsolidated Management Discussion & Analysis and Consolidated Audited FinancialReports:ROregon Exhibit of Premiums (State Page):SDesignation of Independent CPA:TNotification of Adverse Financial Condition:UContinuation Fee:VStatement of Compliance for Advertising:Domestic insurers within a consolidated group arerequired to file a copy of the report displaying theappropriate bar code for that document on theupper-right corner of the cover of the report. Thebar code must reflect the filing insurer’s NAICcompany code; not the group’s NAIC group code.Only domestic insurers are to file hard copies ofthe Oregon Exhibit of Premiums in both theoriginal statement and the copy. Note: State pagebar code must have “38” in the state code positionand reflect only Oregon business. Grand Total“58” is not acceptable even if it is “none.”If the CPA is not the CPA who prepared theimmediately preceding filed audited financialreport for the insurer, the insurer shall notify theCommissioner of the engagement no later than the30th day after the effective date of the engagement.An insurer that has received a report of adversefinancial condition shall forward a copy of thereport to the Commissioner no later than the fifthbusiness day after receiving the report and shallprovide the CPA with evidence that the report wasfurnished to the Commissioner.You must pay the 1,500.00 continuation feewith the invoice mailed under separate cover.An insurer that advertises health products must fileper OAR 836-020-0280(2). If an insurer isauthorized for health but does not write oradvertise health products, you do not need to filethis statement.Send to:Department of Consumer & Business ServicesAttn: Rhett StoyerPO Box 14480Salem OR 97309-0405503-947-7208WHolding Company Registration: 2018 National Association of Insurance CommissionersEvery domestic insurer that is a member of aninsurance holding company system shall registeron or before April 30 for the previous calendaryear per ORS 732.551(1)(2).Foreign insurers need not register if the statutesor rules of its domicile are substantially similar tothose of Oregon.5Fraternal
XAnnual Statement Cover and Binding:Annual Statements are to be bound with a sturdyfront and back cover. The minimum acceptableweight for the cover is 65# paper. It is acceptableto use a lesser weight paper and laminate it. Thecovers are to be similar in color to the requiredNAIC Blank. The statements are to be bound alongthe left edge with sufficient margins, so the printedmaterial is not obscured by the binding. The sturdycovers and bound statements are required tomaintain the integrity of the filing because thesestatements are used extensively by Divisionemployees and the public.YQuarterly Statement Binding:Quarterly statements are to be bound along the leftedge with sufficient margins, so the printedmaterial is not obscured by the binding. Thebinding is to maintain the integrity of the filingbecause these statements are used extensively byDivision employees and the public. A sturdy frontand back cover is preferred but not required.ZAudited Financial Report Cover and Binding:This state requests that Audited Financial Reportsinclude a sturdy front and back cover and to bebound along the left edge with sufficient margins,so the binding does not obscure the printedmaterial. The binding is to maintain the integrity ofthe filing because Division employees and thepublic use these statements extensively.AAActuarial Opinion required by Modified Guaranteed Annuity Model RegulationDomestic and Foreign insurers: state filing notrequired as Oregon has not adopted the “ModifiedGuaranteed Annuity Model Regulation.”BBHealth Benefit Plan Report:This report is to be filed electronically on or beforeApril 1 per ORS 743.748.Exemption requests are not currently required andnull or blank reports are not porting ile/Direct all inquiries to:Spencer Peacock(503) 947-7201ins.mrktsurv@oregon.govCCQuarterly Health Enrollment Report:This report is filed electronically on a quarterlybasis per ORS 743.745, 743.818, OAR 836-0100051and OAR 836-053-1180.Exemption requests must be filed electronically byMay 1 each calendar aspxReporting irect all inquiries to:Spencer Peacock(503) 947-7201ins.mrktsurv@oregon.gov 2018 National Association of Insurance Commissioners6Fraternal
DDDue June 30 (both Domestic and Foreign)OAR 836-053-0825(4) (subject to change)Rescission Report:No specific template is provided.Send report to ins.mrktsurv@oregon.govDirect all inquiries to:Spencer Peacock503-947-7201ins.mrktsurv@oregon.govEEPrompt Pay Reports:This report is filed annually.ORS 836-080-0085 (subject to change)Companies who have issued fully insured healthpolicies to Oregon residents or Oregon-basedbusinesses that fit the definition of "Health BenefitPlan" (as defined in ORS 743.730(17) are requiredto report. Reporting is not required on policiesissued to residents or businesses outside ofOregon, when covered persons are living orreceiving medical care from Oregon providers.Reporting is also not required for those individualclaims submitted by providers outside of Oregonon policies issued in Oregon.The reporting form is on our r/Documents/3431.doc Reports sent to:ins.mrktsurv@oregon.govDirect all inquiries to:Spencer PeacockDepartment of Consumer & Business ServicesMarket Surveillance-7PO Box 14480Salem, OR 97309503-947-7201ins.mrktsurv@oregon.govFFRAAIS required by Actuarial Opinion and Memorandum Regulation (Model 872),Section 7A(5)File only upon request.GGAnnual Actuarial Certification of SEHI Compliance:HHCredit Life and Health Experience Report:ORS 743.737 (13) (b); ORS 743.733This report is required as a component of a healthrate filing. If you do not file health rates in Oregon,these reports are not required. There is no explicitdue date since they can be filed multiple times ayear.Direct all inquiries to:Michael SinkProduct RegulationDepartment of Consumer & Business ServicesPO Box 14480Salem OR 97309-0405971-673-2031OAR 836-060-0041 (subject to change)Due 6/1. This report should show a breakdownbetween underwritten and non-underwrittenbusiness.Direct all inquiries to:David BallProduct RegulationDepartment of Consumer & Business ServicesPO Box 14480Salem OR 97309-0405503-947-7849 2018 National Association of Insurance Commissioners7Fraternal
IILife Illustration Report:OAR 836-051-0590 (subject to change)Direct all inquiries to:Maleeia PruittProduct RegulationDepartment of Consumer & Business ServicesPO Box 14480Salem OR 97309-0405971-239-5814JJMedical Loss Ratio:C.F.R. 158.110 (subject to change)This report is required as a component of a healthrate filing. If you do not file health rates in Oregon,these reports are not required. There is no explicitdue date since they can be filed multiple times ayear.Direct al
COMPANY NAME: NAIC Company Code: Contact: Telephone: REQUIRED FILINGS IN THE STATE OF: OREGON Filings Made During the Year 2019 . this state does not require this filing, if hard copy is filed with the state of domicile and if the data is filed electronically with the NAIC. If N/A ap
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RESUME OF EFFORTS TO SAID LEASE SECTION 19: The Northeast Quarter of the Southwest Quarter of the Southeast Quarter; and The Northwest Quarter of the Southeast Quarter of the Southeast Quarter. Checked probate records in Nevada County. Checked old leases, royalty payment records, and peo
STATISTICS SOUTH AFRICA P0441 Gross domestic product, first quarter 2019 2 GDP in the first quarter of 2019 fell by 3,2%1 Real gross domestic product (measured by production) decreased by 3,2% in the first quarter of 2019, following an increase of 1,4% in the fourth quarter of 2018. Figure 1 - Growth in GDP (%)
Personal saving was 4.12 trillion in the first quarter, compared with 2.25 trillion in the fourth quarter. The personal saving rate—personal saving as a percentage of disposable personal income—was 21.0 percent in the first quarter, compared with 13.0 percent in the fourth quarter. Source Data for the Advance Esti
HONOUR BOARD VOLUNTEERS 2019 - CURRENT David Staniforth Boorowa 2019 Bruce Gruber Boorowa 2019 Lindsay Cosgrove Boorowa 2019 Dennis Osborne Boorowa 2019 John Cook Boorowa 2019 Sue Cook Boorowa 2019 Mick Hughes Boorowa 2019 Daryl Heath Boorowa 2019 Lesley Heath Boorowa 2019 Russell Good Boorowa 2019 John Peterson Boorowa 2019 Heather Bottomley Boorowa 2019 James Armstrong Boorowa 2019
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3 % vs. September Quarter 2019 September Quarter Guidance (As of July 14, 2021) September Quarter Outlook Expect September quarter pre-tax margin, adjusted1 in the mid-single digits at the mid-point of guidance ranges Total Revenue, adjusted1 expected to improve another 2 billion versus June quarter 2021 on 10% capacity growth as business and international demand continues to recover
June 6, 2019 Opioid Operational Command Center 2019 First Quarter Report January 1, 2019 – March 31, 2019
