Blanks (E) Working Group

Editorial Revisions to the Blanks and Instructions

(adopted 11/9/2017 through 8/4/2018)

This listing does not include editorial revisions adopted for annual and quarterly statements for the year 2017 and prior

Statement Type:

F = Fraternal; H = Health; L = Life; L/F =Life/Fraternal; P/C = Property/Casualty; SA = Separate Accounts; T = Title


Effective

Table Name

Description

Date Adopted

Statement Type

Filing Type

Annual / Quarterly

2018 Annual

Schedule DB, Part C, Section 1

CHANGE TO BLANK AND INSTRUCTIONS

Part C was missed on proposal 2018-06BWG and should have been included to make 10 digit line numbers.

8/4/2018

F, H, L, P/C, T, SA

Annual

2019 Quarterly

Schedule DB, Part C, Section 1

CHANGE TO BLANK AND INSTRUCTIONS

Part C was missed on proposal 2018-06BWG and should have been included to make 10 digit line numbers.

8/4/2018

H, L/F, P/C, T

Quarterly

2018 Annual

Schedule BA, Part 1

CHANGE TO INSTRUCTIONS

Column 21 – Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R–Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments. If NAV) is used instead of fair value leave blank. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 22 – Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R–Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

For Method Code "e," leave blank.

If net asset value (NAV) is used instead of fair value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

8/4/2018

F, H, L, P/C, T

Annual

2018 Annual

Schedule DL, Part 1

CHANGE TO INSTRUCTIONS

Column 8 – Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R–Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments. If NAV) is used instead of fair value leave blank. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 9 – Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R–Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

For Method Code "e," leave blank.

If net asset value (NAV) is used instead of fair value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

8/4/2018

F, H, L, P/C, T

Annual

2018 Annual

Schedule DL, Part 2

CHANGE TO INSTRUCTIONS

Column 8 – Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R–Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments. If NAV) is used instead of fair value leave blank. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 9 – Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R–Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

For Method Code "e," leave blank.

If net asset value (NAV) is used instead of fair value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

8/4/2018

F, H, L, P/C, T

Annual

2018 Annual

Schedule A, Part 1

CHANGE TO INSTRUCTIONS

Column 18 – Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R–Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 19 – Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R–Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

For Method Code "e," leave blank.

8/4/2018

F, H, L, P/C, T

Annual

2018 Annual

Schedule DB, Part A, Section 1

CHANGE TO INSTRUCTIONS

Column 24 – Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R–Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 25 – Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R–Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

8/4/2018

F, H, L, P/C, T

Annual

2018 Annual

Schedule DB, Part B, Section 1

CHANGE TO INSTRUCTIONS

Column 23 – Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R–Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments.. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 24 – Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R–Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

8/4/2018

F, H, L, P/C, T

Annual

2019 Quarterly

Schedule T

CHANGE TO INSTRUCTIONS

Column 1 – Active Status

Use the following codes to identify the Reporting Entity's status for each state or territory reported in the schedule as of the end of the reporting period. Enter the code that applies to the Reporting Entity's status in the state or territory. Each line must have an entry in order to subtotal to Footnote (a).

L – Licensed or Chartered (Licensed Carrier and Domiciled Risk Retention Groups referred to in some states as admitted.)
R – Registered (Non-domiciled Risk Retention Groups)
E – Eligible (Reporting Entities eligible or approved to write Surplus Lines in the state. In some states referred to as nonadmitted.)
Q – Qualified (Qualified or Accredited Reinsurer)
N – None of the above (Not allowed to write business in the state or none of the above codes apply)

8/4/2018

H, L/F, T

Quarterly

2018 Annual

Schedule T

CHANGE TO INSTRUCTIONS

Column 1 – Active Status

Use the following codes to identify the Reporting Entity's status for each state or territory reported in the schedule as of the end of the reporting period. Enter the code that applies to the Reporting Entity's status in the state or territory. Each line must have an entry in order to subtotal to Footnote (a).

L – Licensed or Chartered (Licensed Carrier and Domiciled Risk Retention Groups referred to in some states as admitted.)
R – Registered (Non-domiciled Risk Retention Groups)
E – Eligible (Reporting Entities eligible or approved to write Surplus Lines in the state. In some states referred to as nonadmitted.)
Q – Qualified (Qualified or Accredited Reinsurer)
N – None of the above (Not allowed to write business in the state or none of the above codes apply)

8/4/2018

F, H, L, T

Annual

2019 Quarterly

Schedule T

CHANGE TO INSTRUCTIONS

Column 1 – Active Status

Use the following codes to identify the Reporting Entity's status for each state or territory reported in the schedule as of the end of the reporting period. Enter the code that applies to the Reporting Entity's status in the state or territory. Each line must have an entry in order to subtotal to Footnote (a).

L – Licensed or Chartered (Licensed Carrier and Domiciled Risk Retention Groups referred to in some states as admitted.)
R – Registered (Non-domiciled Risk Retention Groups)
E – Eligible (Reporting Entities eligible or approved to write Surplus Lines in the state. In some states referred to as nonadmitted.)
Q – Qualified (Qualified or Accredited Reinsurer)
D – DSLI (Domestic Surplus Lines Insurer (DSLI) – Reporting Entities authorized to write Surplus Lines in the state of domicile)
N – None of the above (Not allowed to write business in the state or none of the above codes apply)

8/4/2018

P/C

Quarterly

2018 Annual

Schedule T

CHANGE TO INSTRUCTIONS

Column 1 – Active Status

Use the following codes to identify the Reporting Entity's status for each state or territory reported in the schedule as of the end of the reporting period. Enter the code that applies to the Reporting Entity's status in the state or territory. Each line must have an entry in order to subtotal to Footnote (a).

L – Licensed or Chartered (Licensed Carrier and Domiciled Risk Retention Groups referred to in some states as admitted.)
R – Registered (Non-domiciled Risk Retention Groups)
E – Eligible (Reporting Entities eligible or approved to write Surplus Lines in the state. In some states referred to as nonadmitted.)
Q – Qualified (Qualified or Accredited Reinsurer)
D – DSLI (Domestic Surplus Lines Insurer (DSLI) – Reporting Entities authorized to write Surplus Lines in the state of domicile)
N – None of the above (Not allowed to write business in the state or none of the above codes apply)

8/4/2018

P

Annual

2019 Quarterly

General Interrogatories, Part 2

CHANGE TO BLANK

Add table to the Blank. Was left out of the proposal 2018-18BWG but is part of the blank in the 2018 Fraternal Quarterly Blank.

6.2.. If yes, what is the date(s) of the original lien and the total outstanding balance of liens that remain in surplus?

Date

Outstanding Lien Amount

 

$

 

$

 

$

8/4/2018

L/F

Quarterly

Annual 2018

Supplemental Exhibits and Schedules Interrogatories

CHANGE TO BLANK

Added language, underline and bold to accentuate that the second part of the interrogatories applies only if the reporting entity writes the type of business covered by the supplemental schedule.

The following supplemental reports are required to be filed as part of your statement filing if your company is engaged in the type of business covered by the supplement. 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.

6/12/2018 F, H, L, P, T Annual

Annual 2018

Sep. Acct. Analysis of Increase in Reserves

CHANGE TO BLANK

Line 6.1: Change in excess of VM-20 deterministic/stochastic reserve over net premium reserve added in wrong place. Should be line 5.1 for SEPA

6/12/2018 SA Annual

Annual 2018

Schedule S, Part 3, Section 1

CHANGE TO INSTRUCTIONS

Make the following edit to the paragraph in Column 7.

If the reporting entity uses the codes XXXL (XXX Life) or AXXX (AXXX Life) as the type of business ceded for any reinsurer reported on this schedule, the Supplemental Term and Universal Life Insurance XXX/AXXX Reinsurance Exhibit must be completed.

6/12/2018 F,L Annual

Annual 2018

Supplemental Term and Universal Life Insurance Reinsurance Exhibit,
Part 1

CHANGE TO INSTRUCTIONS

Add the following note to Part 1 before the definition of terms.

NOTE:        Cessions reported on this exhibit should be reported on Schedule S, Part 3, Section 1 using only the codes XXXL (XXX Life) or AXXX (AXXX Life) as the type of business ceded in Column 6 of that schedule.

6/12/2018 F,L Annual

Annual 2018

Notes to Financial Statement

CHANGE TO INSTRUCTIONS

Make the following changes to illustration for Note 31:

The columns on the table for A(1) should be numbered 1 through 5.

Add the following note for Column 1 – Annual Statement Line of Business.

"NOTE:  For Column 1 – Annual Statement Line of Business (ASL), provide both the line number and description in the column. (e.g., 11.1 Medical Professional Liability – Occurrence). The ASL number should be provided before the ASL description."

Add total line for table.

Add the following to the column description for the 5th column as a crosscheck.

"Total High Deductibles and Billed Recoverables (Col 3 + Col 4)"

Modify the line description below as follow:

a.     Total high deductibles and billed recoverables on paid claims
(Should equal total line for Column 5 for A(1) above)

b.     Collateral on balance sheet
Must be equal to or greater than zero}

c.     Collateral off balance sheet
Must be equal to or greater than zero}

d.     Total unsecured deductibles and billed recoverables on paid claims d=a-(b+c)
Must be equal to or greater than zero}

6/12/2018 P Annual

Annual 2018

Schedule D, Part 1

CHANGE TO INSTRUCTIONS

Column 24 –    Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R—Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments. If NAV) is used instead of fair value leave blank. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 25 –    Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R—Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

For Method Code "e," leave blank.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R—Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

6/12/2018 F, H, L, P, T Annual

Annual 2018

Schedule D, Part 2, Section 1

CHANGE TO INSTRUCTIONS

Column 22 –    Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R—Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments. If NAV) is used instead of fair value leave blank. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 23 –    Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R—Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

For Method Code "e," leave blank.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R—Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

6/12/2018 F, H, L, P, T Annual

Annual 2018

Schedule D, Part 2, Section 2

CHANGE TO INSTRUCTIONS

Column 19 –    Fair Value Hierarchy Level and Method Used to Obtain Fair Value Code

***Detail Eliminated to Conserve Space***

The guidance in SSAP No. 100R—Fair Value allows the use of net asset value per share (NAV) instead of fair value for certain investments. If NAV) is used instead of fair value leave blank. The guidance is effective Jan. 1, 2018 with early adoption permitted. For reporting entities electing to early-adopt, the reporting entity shall the code "2c".

Column 20 –    Source Used to Obtain Fair Value

***Detail Eliminated to Conserve Space***

For Method Code "c," identify the specific broker or custodian used.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R—Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

For Method Code "d," leave blank.

For Method Code "e," leave blank.

If net asset value (NAV) is used instead of fair value by early adopting the guidance in SSAP No. 100R—Fair Value, the reporting entity should use "NAV" to indicate net asset value used instead of fair value.

6/12/2018 F, H, L, P, T Annual

Annual 2018

Schedule D, Part 6, Section 1

CHANGE TO BLANK

Modify the description for Column 8 as shown below:

NAIC Valuation Method (See Purposes and Procedures Manual of the NAIC Investment Analysis Office)

3/24/2018

F, H, L, P, T

Annual

Quarterly 2018

Schedule D, Part 3

CHANGE TO INSTRUCTIONS:
Add code to preferred stock designation matrix for P5*GI, P5*AGI, P5*LGI, P5*UGI, P5*VGI, RP5*GI, RP5*AGI, RP5*LGI, RP5*UGI and RP5*VGI for preferred stock in Column 10.

11/09/2017

F, L, H, P, T

Quarterly

Quarterly 2018

Schedule D, Part 4

CHANGE TO INSTRUCTIONS:
Add code to preferred stock designation matrix for P5*GI, P5*AGI, P5*LGI, P5*UGI, P5*VGI, RP5*GI, RP5*AGI, RP5*LGI, RP5*UGI and RP5*VGI for preferred stock in Column 22.

11/09/2017

F, L, H, P, T

Quarterly

Annual 2018

Schedule D, Part 6, Section 1

CHANGE TO INSTRUCTIONS:

Modify the instructions for Columns 6 and 7 to reflect the guidance moving from the Purposes and Procedures Manual of the NAIC Investment Analysis Office to SSAP No. 97–Subsidiary, Controlled, and Affiliated Entities

Column 6 – NAIC Valuation Method

Include the NAIC valuation method as detailed in Part Five, Section 2 of the SSAP No. 97–Subsidiary, Controlled, and Affiliated Entities Purposes and Procedures Manual of the NAIC Investment Analysis Office.

Use the following codes to indicate a specific valuation method:

CODE Valuation Method
8a2ciA1 Market Value
8bi2ciB1 Investment in U.S. Insurance Company SCAs
8bii 2ciB2 Investments in non-insurance SCA Entities Statutory Basis
8biii 2ciB3 Investments in non-insurance SCA Entities GAAP Basis
8biv2ciB4 Investments in Foreign Insurance Company SCA Entities
2ciB5 Investments in Foreign non-insurance SCA Entities
2ciB6 Investments in Preferred Stock of an SCA

Any NAIC Valuation Method which has not been approved by the filing of a SUB 1 or SUB 2 form with the NAIC SCA Group and which is entered by the reporting entity under its own judgment shall have the letter “Z” appended to the method designation.

Column 7 –

Do Insurer’s Assets Include Intangible Assets Connected with Holding of Such Company’s Stock?

State whether the assets shown by the reporting entity in this statement include, through the carrying value of stock of the SCA Company valued under the SSAP No. 97—Subsidiary, Controlled, and Affiliated Entities Purposes and Procedures Manual of the NAIC Investment Analysis Office, intangible assets arising out of the purchase of such stock by the reporting entity or the purchase by the SCA Company of the stock of a lower-tier company controlled by the SCA Company. For purposes of this question, intangible assets at purchase shall be defined as the excess of the purchase price over the tangible net worth (total assets less intangible assets and total liabilities) represented by such shares as recorded, immediately prior to the date of purchase, on the books of the company whose stock was purchased.

11/09/2017

F, H, L, P, T

Annual

Quarterly 2018

Schedule D, Part 3

CHANGE TO INSTRUCTIONS:
Add code to bond designation matrix for 5*GI for bonds in Column 10.

12/15/2016

F, L, H, P, T

Quarterly

Quarterly 2018

Schedule D, Part 4

CHANGE TO INSTRUCTIONS:
Add code to bond designation matrix for 5*GI for bonds in Column 22.

12/15/2016

F, L, H, P, T

Quarterly