risk based capital report - washington state office of the ...€¦ · risk based capital report .....
TRANSCRIPT
Risk Based Capital Report
.. :-:-·~· · · ·--===-----==c-=== = ==--
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COMPANY INFORIViATION PAGE (JURAT) Property Risk-Based Capital
For the Year Ending December 31,2013 (A) CompenyNamo Conlrac:lors Bending and Insurance Caapany
(8) NAJC Grwp CGclo 0783 (C) NAJC Ccmpany CGcla 37206
(E) Olganlzed Under llle L.aws ot Ill& State of WA
Conllct p....,,. for PtOperly & Cesulllty RJsk-BaMd Ceplllt
(F) Fits1 Na!M Todd (G) ~iddle 111ame
(I) Mail Addreu ot Conl.ld Person 9025 N. UndblllJh Dmro
(J) Cily • PeOIIa (I<) S~te
(M) Phone Number of RSC Contact p.,_ 3~92·1~
(N) Dale Prepa.-d
(0) Prvparer (~ dill.,..nllllan Ccnlad) Justin
F"ntName
(P) lo llrio filing "" OrigiN~. Amended ot ~g? (O.A.Al Orfslnal (P I I ltAIMnded. AmondedN-
(Q) W.ete arry Items lllat come dileclly from !he annual llellmenlonteted rnonuolly to prvpon INs ftlb1g? (YIN) Yes
Officar Tl1fo: VP. CFO. Assistant Truau,.,
IL
(0) Empl.f&ID Number 91·1082952
(H) Lat Na!M
(l) llp 61815
Jean Mario Slepl!!noon
AVP. Corporate Secroterv
Each sayslllat IIIey at~~ !lie abo-.. dewllltd olllc:.rs olllle said insurer, and thai tills rlst~ased capitllls • ttua and fair repruenlaUon olllla oompany'e affairs and ha& bHn oompllllld In a""""'ance wflll tile NAIC lnsttuctions oooortling to lhe best ollhelr ln!otmation, know1edgo and belief, respecllvely. · · ·
, ;o 0 0 N
PRI!C
Contractors Bonding and Insurance Company
DETAILS FOR AFFILIATED BONOS AND STOCKS PR002
NAIC Company Code Affiliate's RI!C
or Alien fO Alter Name of Affiliate Alfil Type Number Covariance•
Total u
l!ooi</Adjustod Carrying vatue
(s~tement value) of Affiliate's
Common Stock
6
Valuation Basis of Column (5) F.Fair Value A-AIIOiher
Total Value of AHillate·s
Outs~nding Common Stock
XXX
Statulory Surplus of Affiliate
SubJect to RBC (Adjusted for '4
Owned)
XX
Company Code J72116
10
Booi</Adjusted Carrying Value
(statement value) of Affiliate's
Percent Owned Preferred Stock
X X
""0 ;u 0 0 N
-==== ==:-: .... --
PRBC
Contractors Bonding and Insurance Company
DETAILS FOR AFFILIATED BONDS AND STOCKS continued) PR002
Namt of Affiliate Affii T\fpe_
NAIC Company Code
MAiien 10
I I
Total Value of Affiliate's
Outstanding
12
Preferred Stock Petcent Owned
Total XXX XXX ·enter cany,ng value of unde~ytng tnsurers for Hof<Mg c ompany (Affiliate Code 1 O) in Column (4). • •Enter Book/Adjusted Carrying Value in exe<~•s of the carrying value lor Holding Company (Affiliate Code t O) in Column (5).
13
Book/Adj~ted Carrying Value
(statement value) of Affiliate's
Bonds
0
. --.... - . .. . -~===-=-==-=-==:.-.--
14
Total Value of Affitiate•s
Outstanding 8onds
XXX -
15
Percen1 Owned
Company Cooe 37206
16
RBC [email protected]_uired
17 Fair Value
Excess CompOnent
Affiliate Common Stoet< R8C Reauired
0
--;
PRBC
Contractors Bonding and Insurance Company
SUBSIDIARY, CONTROLLED AND AFFILIATED INVESTMENTS PR003
(I) (2)
Affil Number or RBC Required tor Affiliated
Affiliate Tvoes Code RBC Basis Comoanies ComStock
(01) Directly Owned P$C ln•urance Affiliates. Sub's RBC Afte< Covariance ..... 0 ...... 0
(02) DlrecUy Owned Life Insurance Affiliates ..................... Sub·s RBC Mer Covariance ......... 0 ........ 0
(03) Directly OWned Health Insurance Affiliates ......................... Sub's RBC After Covariance .................... 0 .......... ............... 0
(04) Indirectly Owned P&C Insurance Affiliates. Sub's RBC Afte< Covariance ..... 0 .... 0
(OS) Indirectly Owned Life Insurance A!fd1ates .. Sub·s RBC After Covariance .... ..... 0 ... 0
(06) lndirectty Own~ Health Insurance Affiliates .. 6 Sub's RBC After Covariance ....... 0 .... 0
(07) rnvestment Subsidiary ..... , .......... .............. ••••••• ••• u •••••"'' " '''" ' Sub's RBC After Covariance ..... 0 ..................... 0
(08) Directly Owned Alien ln~urance Affiliates .............. 0.5 ......... ..... 0 .. ..................... 0
" (09) Indirectly Owned Alien Insurance Affiliates .... 9 o.s ..... 0 ............. ........ 0 ::0 0
HOJding Coinpany in Excess or Indirect Subs 0 (10) 10 0.225 ... 0 ............ 0 w ... (11) rnvestml!nt in Parent ................................ ·~·· ····· .. ···· .............. 11 0,225 ..... 0 .......... 0
(12) 01her Affiliate· P&C Ins Not Sub) to RBC. 12 0.225 .... 0 .... 0
(13). Other Affiliate • l~e ln.s Not Subj to RBC 13 0.225 ..... 0 .............. 0
(14) Other Alfiliato. Hoallh ln•urance Not Subj to RBC. 14 0.225 ............. 0 .. 0
(15) Other Affiliate- NOA-insurer 15 0.225 0
_116) Total 0
(3) RBC Required for Aftilialed Prerd Stock
.0
Company Code 37206
(4) (5) RBC Required
for Affiliated Bonds Total RBC Reauire<J
................... 0 .................. 0
...... 0 ................................. 0 ...... 0
........ ....... ........... 0 ......... 0 ........................ 0
...... ......... 0 .... .... 0 ............. 0 ·
............ 0 ............... 0 ... 0
.... ....... . ........ 0 ....... 0 .. ...... .. .... .... 0
............................ 0 ........... Jl .. .............. 0
. ................ 0 .............. 0 ........... 0
........ · .................... 0 .. . .... 0 .................................. 0
..... 0 ............ 0 ............. 0
........ 0 ..................... 0 . ....... 0
......... 0 . ...... 0 ......... 0
.. ......................... . 0 .. ........ 0 ...... 0
.......... 0 ... 0 ........ 0
0
0
"U :::0 0 0 ~
------ --- --..
PRBC Company Coae 37206
Contractors Bonding and Insurance Company
SUMMARY FOR SUBSIDIARY, CONTROLLED AND AFFILIATED INVESTMENTS FOR CROSS--CHECKING STATEMENT VALUES PR004
Affiliated Preferred Stock
(1)
(2)
(3)
(4)
Schodulo D Pari 6 section 1 C8
Parent
U.S. P&C Insurer .... ..
u.s. Life Insurer ............................................. ............................................................................................................................................. .
U.S. Heallh Insurer.
(5) Alien Insurer ....
(6) Non-fnsurer \1\hltch Controls Insurer ........... .. .. .
(7)
.(8)
(9)
Investment Sub•idiary ............. ............. . ....... .
Other Affiliates ............. ..
Subtotal
Affiliated Common Stock
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
Parenl .... U.S. P&C lnSU'l!l..
U.S. Lire Insurer.
Schedule D Part 8 Section 1 C8
U.s. Hea.lth l.nsurer ........ ~······ ·· ···· · ····· · ···· · ·· · ·· ·· ··· · ··· ··· Alien ln.surer ..................................................................... . Noo-4ns.urM Wl!ch Controls Insure~ ....... .......................... .
Investment Subsidiary..... . ....................... .
Othe< Affiliates .... ................................. ..... .
Subtotal
Affiliate<! Bonds (Ch~~<:k to SChedule 0 Part1A Section 1 C6. LS.7)
Annual Stateffi4tnt line
Number
0199999
0299999
0399999
0499999
0599999
0699999
0799999
0899999
0999999
Annual Statement line
Number
1099999
1199999
1299999
1399999
1499999
1599999
1699999
1799999
1899999
(1) Annual Statement
Total Prelerred Stoek
(2) Total From RBC
ReJ>Orl
(3)
Difference
.................. 0 ....... 0 '"' .0 ................................. 0 .... 0 .0 .. ................................ 0 ................................... 0 .................................. 0 .................................. 0 .................................. 0 .......................... .... 0
"""' . ... 0 " .... 0 ... 0
....... 0 ................................ 0
(1) Annual Statement
Total Common Stoek
...... D ....................... 0
....... 0 ................ 0
...... 0
. ....... 0
.. .......... 0 . ....... 0
0 0
............... 0 ....... 0
... .. .. .... .!) 0
(2) Total From RBC
Reaort
........... 0
........ 0 .................................. 0
............................. ..... 0
.............. 0 "" .............. . ........ 0
................................. 0
'""''"""'"" ' "'"' .. 0
(3)
,0
. ....... 0 .......... 0
....... 0
Difference
............... 0
............... 0 .............. 0
.......... .. 0
.................. 0
.................. 0 .. ... 0
....... 0 0 0
"U AI 0 0 <11
PRBC
Contractors Bonding and Insurance Company
UNAFFILIATED BONDS PROOS
(1)
(2)
(3)
(4)
($)
(6)
(7)
(8)
(9)
(10) (1 1)
(12)
(13)
(14)
(1$)
(16)
(17)
(18)
(19) _
(20)
(21)
(22)
(23)
(24)
(25)
Annval Statemtnl Source Sch0Pt .1A Sn1
NAIC 01 -u.s. Government-Direct and Guaranteed. . ............................................ C6L1. 1
NAIC 01- U.S. Govemmeri1Agency NOT BACKED BY FUll fAITH AND CREDIT OF THE U.S. GOVERNMENT ................. 7· .... : ................................ .......................................................................................... lnd in C6 l9.1 - LB. 1
Total NAIC 01·B.onds. ......................................................................................................................................... C8L9.1 -L7.1
_.,!filiated NAJC 01 Bonds ................................................................................................................................. C6 l8.1
Total Other_NA!C 01 Unaffifoated Bonds............................... ... L(3) ·l(4) • L(1) • L(2)
Total NAIC 02 801\dS ...................... ................................ . .. .................................. C6l9.2 • ,L7.2
Affiliated NAIC 02 Bonds ... :..................... ....................... ....................... .. .......... C6 L8.2
Total NAJC 02 Unaffiliated bOnds .................................. ................................................................................... L(6) - L(7)
Total NAIC 03 Bonds ........................................................................................................................................ CO l9.3 • L7.3
Affil'oaltd NAIC 03 Bonds................ .................................................................... ... C6 L8.3
Total NAIC 03 Unaffiliated ~nds.............. ...... .... .. ... L(9) • L(10)
Total NAIC 04 Bonds .. _ .... , ............................................................................................................................. C6 L9.4- L7.4
Affiliated NAtC 04 8ond5 .................................................................................................................................... C6 l8.4
Total NAJC 04 Unaffiliated bonds ...................................................................................................................... L(12) • L(13)
Total NAIC 05 Bonds .......................................................................................................................................... C6 L9.$ • L7.5 Affiliated NAIC 0$ Bonds.... .. .......... C6 l6.5
Total NAIC OS Unaffiliated bonds ...................................................................................................................... l(1 $) - L(16)
Total NAIC 06 Bo,;os ................................................................................................................... , ...................... C6 L9.6- L7.6
Affilialed NAIC 06 Bond$ .................................................................................................................................... CS L8.6
Total NAIC 06 Unaffiliated bonds.................................... ............................. .. .......................... L(18). l(19)
Subt~J . Bonds Suoject to Bond Sin FacJor ............. .. .. ............................... ... L(5)+l(8)+L(11)+l(14)•L(17)•L(20)
Number of tssuers, .... - .....• - --······· .. ·············· ·· ·· ~ .. ·····-·······-·· .. ·······•··· ............................................................ . Bond Size Faclor .. : ............................................. - ............................................................................................. .
Bond Size F~clor RBC •l(21) x l (23) ............................................................................ .......................... .
TOial Unaffilialed Bond• RBC • L(l) + L(2) + l(21) + L(24)
(1) Book/Adjusted CarryinQ Value
........ 12.861.091
.............. ..169.807 .723 .. : .. ............................. 0 ..... ......... ..156.946 .632
......... 9.344.542 .................... 0
................... 9.344 ,542 ..... ............................. 0 ..................... : ............. 0
............. 0
.............. 0 ................................... 0 .................................... 0 .................................. 0
.............. 0
.......................... 0 .................................. 0 .................................... 0
.................... 0 ....... .166 .291.174
............ 89
179.152 .265
Faelor
0.000
0.003
0.003
0.010
0.020
0.045
0.100
0.300
Company Cod6 37206
(2)
RBC ReQulrem.nt
....... 0
........... 0
........................ 470 ,84()
......... ..... 93.445
..................... 0
.............. 0
.......................... 0
........... .... 0
... 564 .285
. .................... 0.974 549.614
1.113.899
-o :::t1 0 0 (J)
PR8C
Contractors Bonding and Insurance Company
UNAFFILIATED PREFERRED, COMMON STOCK AND HYBRID SECURITIES PR006
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
( 12)
( 13)
( 14)
( 15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
Unaffiliated Preferred Stook
NAIC 01 Prefetrltd Stock..
NAIC 02 Prel..,ed Stock, ..
NAIC 03 Preferred Sloek
NAIC 04 Prel"""d Stock
NAIC 05 Prele<rod Stack.
NAIC 06 Preferred StOCk
SUBTOTAL- UNAFFILIATED PREFERRED STOCK
(should equal P2 L2.1 C3 1ess Sch 0-Sum Cl LIB)
Hybrid Securities
Annual Statement Source
... .. $r.hOPI2Sn1
................ SCIIDPt2Sn 1
.......................... Sell D Pt 2 Sn 1
... Sc:IIDPt2Sn1
... Sc:IIDP12Sn1
................................ .. SCI\ D Pt 2 Sn 1
Sum of L&{l ) through {6)
NAIC 01 Hybrtd Securtties ..... .. ........................ .......... - .................................................. SCI\. D PI lA Sn I C(6) l (7.1)
NAIC 02 Hybrid Securities.. ................ .. ................................... .................................................... Sch. D PI l A Sn I C(6) l (7.2)
NAIC 03 Hybrid Securities.. .................. ................................ - ......................................................................... Sch. D PI lA Sn I C(6) l (7.3)
NAIC 04 Hybrid Securities ..................... · ................................................................... ....................................... Sch. D PI l A Sn 1 C(O) L (7.4)
NAIC OS Hybrid Securities ................................................................................................... , .... _ .................... Sch. D PI l A Sn I C(O) l (7.5)
NAIC 06 Hybrid Securities .................................................................................................................. .............. Sch. 0 PI l A Sn 1 C(&) L (7.&)
SUBTOTAL- HYBRID SECURIT1ES
Total Uoaffiliated Preferred Stock and Hybrid Securities ...................... ..
Unaffiliated Common StOCk
Non-government Money Marlcet Funds: ....
Total Common StOCk ...... ..
Affiliated Common Stock. .... , ........
Non-admitted Unaffitiat•d Common Stock. .. ·-·····
Other Admitted Unaffiliated Common Stock. ..
Fair Value Exc;ess Affiliated Common Stock..
Total Admitted Unaffiliated Common Stock
Sum of Ls(8) t/lrough (13)
Line (7) + Une (14)
... Sch D Pt 2 Sn2 C(6) L(9399999)
................. Sch 0 • summary C I L25
....... Sch D • summary C I L24
.. ...... P2 C2 L2.2 in part
..................... l(11) ·l(t 6) -L(t8) . L(19)
. I;'R002 C(17) l(9999999)
U 161 + lf20\ + ll21\
{1) Booi</Adjuotod carrvina Value
................................. ·,0
........ 0
.. ............... D
.............. 0
.............. 0
....... 0
... 0
............... 0
............... 0
.. 0
.... 0
..0
........................ ..... 0
Facto,
0.003
0.010
0.020
0.045
0.100
0.300
0.003
0.010
0.020
0.04~
0.100
0.300
0.003
0.150
Company Cooe 37206
(2)
RBC Reauirement
.0
.... 0
..... 0
.0
.... .................... 0
0
.............................. .... 0
.0
.. 0
......... 0
........ 0
........... 0
.......... 0
. ........ ........... .......... 0
............ 0
.............. ............... 0
....... 0
.. 0
0
"'0 ::0 0 0 .......
PRBC
Contractors Bonding and Insurance Company
OTHER LONG-TERM ASSETS PR007
(1)
(2)
(3)
·(4)
Annual Statement Source
Company ~ped Real ESiate .............. : .................................................................................................... P2 L4.1 C3
EncLJn'tbfanee$ ············'" '' '''"''"·············- ··············"''"''""'"''' '"''"·················· .. ., ..... ........ ,. ..... - -····-················ ...... P2 L4.1, ~n5ide ilem
Property Held For tht PTC<tuetion 0! Income ................. - ......... _ .................................................................. P2 L4.2 C3
Property Held For Sale ...................................... .. ....... P2 L4.3 C3
(5) Encumbrances (Property Held For the Production ol Income) ...................... P2 L4.2. inside ~em
{6)
(7)
(&)
(9)
Encvmbra~ (Property Held For Sale) .............................. --........................... - ................... .................... P2 L4.3, inside Item
Total Real Eatate ... ·-···············-······- ·····-····-·-······- ··-················-······-········· ···········-···········- ····· l {1) + L{2) + L(3) + L(4) + L(S) + L(6)
P2 L3.1 C3 Mongage Loan• - Flrsllien5 .............................................................. .
Mortgage loans . Olher Than Firat liens ..... _,,. ..... _ ................................... P2 L3.2 C3
.(10) Tota1Moit!J891! loans ........................................ . .. ...................... .. ...... ................. ..................... L(8) + L(9)
(11) Schedule BAA•sels • Total ............................................................................................................................. P.2 L8 C3
(12) Leu: Collateral Loans ..... : ......... : ..... .................................. PR008l(14)
Federal Guaranteed low Income Housing Tax Credits ................................................................................. Sche<lule BA Part t. C12 l3199999 •
(1) Booi</Adjusled Carrying Value
.............. · ...... 0
............................. 0
............ 0
............................. 0
.................. 0
........................... ...... D
........ 0
............................ ..... 0
.......................... 0
.............. 0
.................................. D
. ............... 0
(13) . . . l3299999 • ' .......... ......................... 0
(14)
(t5)
(16)
(11}
(18)
(t9)
(20)
(2t)
Federal Non-Guaranteed low Income Housing Tax Cred~s ................................................. ................... _. Schedule BA Part 1, 'Ci2 L3399999 • l3499999 ................. ................. 0
State Guaranteed Low Income Housing Tax Credits ..................................................................... .. ....... Schedule BA Part t, Ct 2 L3599999 + L3699999 . ...... 0
Slate Non-Gua<anteed l ow tn<Ome Housing Tax Credi,. ............................................. . ................ ~;::~ BA Part t. C 12 L3 799999 + ................ D
All Other Lowln<Ome Hoosing Tax Cre<'ts ..................................... ....... . ............................ .. ......... Schedule BA Port t . C 12 L3999i99 +
Wor1tin9 Capital Finance ln•Htmmb ......... ..
Schedule BA Assets Excluding Cobteral Loans. U HTC & WCFI...
l4099999 ................................. 0
.......... l (20). l (2t) ................. 0
.............. ....... .. ........... l{1 1) · l{12) -L(13) - l{14) - L(15)l(l6) -l(l?)- L{IS) ... 0
NAIC 01 Wooong Capital Finance lnve51irn!nt& ........................ - .................................................. - .......... company Records
NAIC 02 Wooong Capital Finance lnveslrm!nts .............. . ............. .. Company_ Records
{22) Total Other long-Term Assets l(7) + L( I O) + L(13) + L(14) • L(I S) + lll6l • L{17l • i.oill_• L{20)_+ L(21 0
Foetor
0.100
0.100
0.100
0.100
0.1 00
0.100
0.050
0.050
0.0014
0.0260
0.0014
0.0260
0.1 500
0.2000
0.0038
0.0 125
Company COde 37206
(2)
RBCReauirement
...................... 0
............ 0
.................................. 0
.................................. 0
.... 0
....... 0
.. 0
......... - ................... 0
............ 0
....................... .......... 0
.......... 0
....... 0
........ 0
............................. 0
............................ 0
.................................. 0
............... 0
0
""0 ::0 0 0 00
PRBC
MISCELLANEOUS ASSETS PROOS
(1) Receivable IO< Securities ..... .
(2) Aggregate Wll lor Invest Assets .......
(3) Ca$11..
(4) Cash Equivalents.
(5) Less: Cash Equivalent, Bonds included in SChedule o. Part lA.
(6)
(7)
Net Cash Equivalents ........................ ..
Short-Term Investments . ................ ............. .
(8) len Snort-Term Bonds" ....
Contractors Bonding and Insurance Company
Annual SIJIIement Source
P2 C3 L9
............. P2 C3 L 11
.. ..... P2 LS. inside amt 1
.......... P2 LS. inside amt 2
• Sell E Pt 2 C6 L8399999 in pM
. ... L(4)·L(S)
............ ............ ... .... ..... P2 L5. inside amt J
..... ................ Sen DA P11 C8 L8399999
(9) Less Exempt Money Marl<ol Mutual Funds· .... - ............ . ....... .......... - ................. - .......... - ......... .... Sen DA Pi t C8 L8899999
(10) leu Cia&& One Money Market Mutua1 Funds·. ...... Sch OA PI 1 CS L8999999
Total Ott\er Shor1-Term Investments ............... ............ . . . .. l(7) ·l(8) · l(9) ·l(10)
Collateral Loeni ..... ........................ . . ... Sch BA Pit C12L2599999+2699999
(11)
(12)
(13)
(14)
Less: Non-Admitted Conateral Loans .................................................................................. ............................. P2 l 8 C2 in part
Net Admined COllateral Loans ........ ..... .. ••. l(12) • L(13)
(15) Derivatives ........ . • ... ,~2 C3L7
(16) Total Miscellaneous AMets tg~~ +Lm ;I L(3) + L(6) + l{11) +
• These bonds appear in Schedule 0 Part 1A Section 1 and are already recognized in the Bonds portion of the rormula.
(1) Booi<!Adjusted Carrvino Value
..... 0
. .......... 0
...... 1.578.499
. •... . . ••.. ..... 0
... 0
................... .... 0
. ............................... 0
. ..... 0
...................... ... 0
.. 0
... ....... .... ... . . 0
... 0
. ....... 0
1,578.499
Factor
0.050
0.050
0.003
0.003
0.003
0.050
0.050
Company Cooc 37208
(2)
RBC ReQuirement
.................................. 0
......... 0
... 4.735
. ................... 0
. ................................. 0
............. 0
. ... 0
U3S
"'0 ::0 0 0 <0
PRBC Company Code 37206
Contractors Bonding and Insurance Company
REPLICATION SYNTHETIC ASSET) TRANSACTIONS AND MANDATORY CONVERTIBLE SECURITIES PR009 (1}
RSAT Number
9999999
(2}
Tvoe
XXX
(3}
CUSIP
XXX • Total
(4}
Oesctiotion of Assets
XXX
(5) NAIC Designation or
Other ~scrioUon or Assol
(6}
Value of Asset
(7) RBC
ReQuirement
., ;c 0 _. p
. .. -··-·---- ... .. . ··------
PRBC
Contractors Bonding and Insurance Company
ASSET CONCENTRATION PR010
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(.13).
(14)
.. (15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(1)
ISSUER# VERIZON COMMUNICATIONS
NAIC 02 Unaffiliated 800<1• ·- ········ ....................................................................... .
NAIC 03 Unalflliated 800<1• ............................................................................ ........ .
NAIC 04 Unaffiliated 800<1• .................................... - ........................................................................ ........................... ............................... .
NAIC OS Unaffilialed 800<1s .................................................................................................................... .
Collaloral Loan•
Mortgage Loans ......
(2) Booi!/Adiusted CMVinQ Value
................... 3. 112.303
SUBTOTAL · FIXED INCOME .................................................................................................................................. .................................................. 3.112.303
NAIC 02 Pnolerred Sloe< ............................................................................................................ - ..... .................................. ..................... .................. ............................................. ..
NAIC 03 Prelerred Stock ........................................................................................................................ ............................................................................ .................................... ..
NAIC 04 Prelerred Stoc<
NAIC 05 Prelerred Stock ........................................................................................................... - .... - ................................... - ........................................ ...................................... .
NAJC 02 Hybrid Seeuriliu ..
. NAJC 03 Hybrid Securities .... ..
NAIC 04 Hybrid Securities ......... ..
NAIC OS Hybrid SeeuriUes .... ................................. .
NAIC 02 Wofl<lng Capital FlnaoeelnvestmeoiS .......
Property Held For Produetlonol lncome Exd\Jdlng Home Olfoee .......
Property Held For Prod~lon ollncome Encumbrance ExCluding Home Oft'oee
Sc!>e"';'le BA AsseiS ..................... ......................................................................... .
Receivabte for Securities ...... ................................. "' ...................... --···········-··-················
Aggf'0981o Wri!Hnslor lllVMied Asi81S ............... .................................................................. ...................................... .
Oerivatfvu ········-····-························-· ..................................................................................................... 4 ........ -.. 4··· .... ·--· .. ··· ................ - ........... --........... ............... .
Unalf~ialed Common Stock
SUBTOTAL - EQUITY ... ...... 0
(25) TOTAL -ISSUER • (L7 + L24l 3 , 112,303
Factor
0.0100
0.0200
0.0450
0 .1000
0.0500
0.0500
0.0100
0.0200
0.0450
0.1000
0.0100
0.0200
o.o4so 0.1Cl00
0.0125
0.1000
0.1000
0.10oo
0.0500
0.0500
0.0500
0.1500
Company coeo .. J7206
(3)
Add~iooaiRBC
.......................... 3 1. 123
......................... ......... 0
................................ 0
........................ ......... 0
..... .. 0
................ 0
...... 3 1.123
.. 0
..... 0
... 0
............................... ... 0
............... 0
....... ... 0
.... 0
.... 0
.............. 0
. .............. 0
............... 0
............. 0
. ............ 0
........... 0
........................ 0
............ ............ 0
........................... 0
31 , 123
':'0 ::0 0 _.. 9 N
PRBC
Contractors Bonding and Insurance Company
ASSET CONCENTRATION PR01 0
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
ISSUER#
NAIC 02 Unaffiliated B<mds , ........................... ..
(1)
WESTERN UNION CO
NAIC ~~~ Unalfllialecl BOfld$ .... - ... - .............. _,,,_ .... , ..... - ........... ........................................................................... .
NAIC 04 Unaffiliate<l Bonds 00000000 .... 00 ..... .. 00 .. 00000000000000 . ...
NAIC OS Unaffrtiate<l Bonds 00000000 00 0000
CoDaleral Loans ....... .............. 00
Mortijage Loans ......... oo .. ..
SUBTOTAL- FIX EO INCOME ....................... .
NAIC 02 Ptelened Stock
NAIC 03 Ptelerred Stock
NAJC 04 Prelerred Stock .. 00
NAIC 05 Prelerred Slack ...
NAIC 02 Hybrid Se<urities
NAIC 03 Hybttd Securities
NAIC 04 Hybrid Se<urities 000 00
NAIC OS Hybrid Se<urtties
NAIC 02 Wor1<ing cap;tal Finance lnvestme<tiS. oooo ........................... .
Property Held For PfOdudon of Income ExeiUdino Home Office 0000
Property Held For Prod~tion of Income En<;umbronoe Excluding Horne Offoce ........... oo ..................................................... . 00 ........... . .... .
Schedule BA A.,,&l$ .
Receivable tor SecurUies .....
Aggregate Wite·lns for Invested Assets
Oerivative.s
Unaffiliated Common S~ock - ········:···
SUBTOTAL- EQUITY oo ooooo ... .. . ... - ...... - ....... 00 ..
(25) TOTAL - ISSUER# IL7 • L24)
· (2). Booi<!Adjusted Cartyingilai<Je
........... 2.166 ,169
.. 2.166.169
00000000 00 0 000000000
2.166.169
Factor
0.0100
0.0200
0.0450
0.1000
0.0500
0.0500
0.0100
0.0200
0.0450
o.iooo' 0.0100
0.0200
0.0450
0.1000
0.0125
0,1000
0.1000
0.1 000
0.0500
0,0500
0,0500
0.1500
. (3)
Additional RBC
.... 21.662
..0
.0
.. ... 0
............. ... - .......... ... 0
........... ..... ....... ..... 0
............ 21.662
... ........... 0
........ 0
... 0
............. 0
.. ...... ..................... 0
......................... ........ 0
................... 0
0000 0000000000 000000000 00 00 0000 0000
. .......... . ... 00.0
... ..... 000 ..... 0
........... 0
... ..................... .. 0
..... 0
................................. 0
.................................. 0
................................ 0
. ................................. 0
21 .662
'"0 ::0 0 ..... ~ (,.)
-------------· ----~----· ~ - . . .... .. -
PRBC
Contractors Bonding and Insurance Company
ASSET CONCENTRATION PR010 (1)
ISSUER • NETAPP INC
(1) NAIC 02 Unaffiliated Boods ....................... ..
(2) NAIC 03 Unaffiliated Boods ............................. .. .
(3) NAIC 04 Unaffi~aled Boods ............... .................................... .......................... .
(4) NAIC 05 UnaffiUaled Boods .......... ..... ............. .
(5) Collateral Loans ......................................................................................................... .
(6) . Mort9age Loans ......... ........... ..................................................................................................................................................................... .......................... .
·(7) SUBTOTAL· FIXED INCOME .......... .
(2) Book/Adjusted Carrvina Value
................... 2.006.974
............ .2.006 ,974
(8) NAIC 02 Preferred Stock ....................... ................................................................................ .............................................................. ....................................................................... .
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
NAIC 03 Preferred·Sieek ........................................ - ............................................................................................................................................................ .................................... ..
NAIC 04 Preferred Sleek ....................................................................................................................................................................................................... ..................................... .
NAIC OS Preferred Sleek ......................................................................................................................................................................................................................... ................... .
NAIC 02 Hybrid Sewrilies ............................................. .............................................................................................................. .............. ,. ................. .................................... ..
NAIC 03 Hybrid Sewrilies ............................................. ............................................................................................................................ ............................ .
NAIC 04 Hybrid S«urilies
NAIC OS Hybrid Sewrilies
NAIC 02 WMing Capita.! Finance lnvestm.enl$ ..... --····-····- ·· ... ......................................................... ................................... ,_., ___ ,,, .............................. ...... .
Pfoperty Held for Procluetion ollneome. Excluding Home Ofl'iee ........................................... .
Property Held for Produdion ollncome Eneumbfanc:e Exduding Home Off".ce
Sdu!dule BA ASsel$ ...
Receivable for Set:urities: ............................. .
A99regate ~t .. lns: fof' lnvesled Asset& ... .. ........... .............. .................. - ............ .......... .
Oerivalives ...
Unaffiliated Common Stock ......
SUBTOTAL - EQUITY ... 0
(25) TOTAL -ISSUER# tL7 • l24l 2,006,974
Factor
0.0100
0.0200
0.0450
0.1000
0.0500
0.0500
0.0100
0.0200
0.0450
0.1000
0.0100
0.0200
0,0450
0,1000
0.0125
0.1000
0.1000
0.1000
0.0500
0.0500
0.0500
0.1500
Company Cood 37206
(3)
Additional RBC
.............. 20 ,070
...................... 0
............ 0
.......... 0
.......... ... .... 0
.. ....... ......... 0
.. 20 .070
.. .. 0
............................. 0
....................... 0
...... .... .... 0
.. ......................... 0
.. ............... 0
........ 0
........ 0
.......................... 0
.. .... 0
............... 0
........ 0
... 0
.... 0
............... 0
................. 0
20,070
, ::0 0 ..... 0 ~
PRBC
ASSET CONCENTRATION PR010
ISSUER#
Contractors Bonding and Insurance Company
(1)
ALTRIA GROUP INC (2}
Book/Adjusted carryin~: Value
(1) NAIC 02 Unartiilo~ Bonds .... ......... . .. ..................... 1.066.847
(2) NAIC 03 Unaffiliated Bonds ........ ................................. ..
(3) NAIC 04 Unaffilial ed Bonds ....... .
(4) NAIC OS Unaffiliated 8oods ............................................. ..
(5) Collaleral Loans ........... .
(6) M«tgage Loans ................................................. ..
(7} SUBTOTAL- FIXED INCOME ............. .. ................... 1.056.847
(8) NAIC 02 Preferred Slod< ..................................................................................................................................................... ..
(9) NAIC 03 Preferred Stod< ......................................................................................................................................................................... .
(10) NAIC 04 Preferred Stod< ...... .
(11) NAIC 05 Preferrod Slocl< ................ ..
(12) NAIC 02 Hybrid securities .............. ....... _
(13} NAIC 03 Hybrid s;,curilios ...
(14} NAIC 04 Hybrid securities ............................................................................ .................................. - . ............................................ .
(16) NAIC OS Hyl>rid Securilleo ................................................................................................................................................................................................... .
(16) NAIC 02 Wortcing Capital Finance lnvntments ........... ..
(17} Property Held For Production of Income Excluding Home Office
(18} Property Held For Production or Income Eneumbranu Exoi\Jding Home Office ............. .
<~,9} : (20)
Seh.edule BA Assets ............................................................................................................................. .................................. ..
R.eeervable lor Secul!lles . ..................................................................................................................................................................... ........... .................... ..
(21) 1\ggr~gate Wrilo-fn• for lnvestod Assets .......................................................................................... ...................................................................................................................... ..
(22) Derivatives ............. _. .... - ........................... ....... .
(23) Unaffdialed Commoo Stock .......... ..
(24) SUBT,OTAL- EQUITY .................................... . ...... 0
(25) TOTAL -ISSUER# IL7 • L24l 1.066.847
Factor
0.0100
0.0200
0.0450
0.1000
0.0500
0.0500
0.0100
0.0200
0.~50
0.1000
0.0100
0,0200
0.0450
0.1000
0.0125
0.1000
0.1000
0.1000
0.0500
0.0500
0.0500
0.1500
Company Cooe 37206
(3)
Additional RSC
..... .10.668
............... 0
.................................. 0
....................... 0
. ..... ._ . . 0
................. 0
........... ......... 10.668
. ..... 0
.......... 0
......... 0
...... 0
.. 0
.. ....... 0
....... 0
.. ..................... ........... 0
.0
.................. 0
.................... 0
....... 0
.. ..... 0
.................................. 0
... 0
... 0
...... 0
. 10.668
'"C ;;o 0 .... 0 (1'1
PRBC
Contractors Bonding and Insurance Company
ASSET CONCENTRATION PR010
{1)
(2)
(3)
(~)
(5)
(6)
(7)
(8)
(9)
(10)'
(11)
(12)
(13)
(14)
{15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
ISSUER#
NAIC 02 Unaffiliated Bonds
NAIC 03 Unaffiliated Bonds
NAIC ~ Unaffiliated Bonds
NAIC OS Unaffiliated Bonds
Collateral loans . ...............
Mo~gage loans .........
SUBTOTAl • FIXED INCOME
NAIC 02 Preferred Stock
NAIC OJ Prefem!d Stock .................. ......... .
NAIC ~ PrererTed Stock
NAIC 05 Preferred Stock ...
NAIC 02 Hybrid Securities
NAIC 03 Hybrid Securities
NAtC 04 Hybrid Securities ........................... ..
NA.IC 05 Hybrid SK.Urities
NAIC 02 WOr1ting Capital Finance lnvestmenll ....
(1)
HEVI.\.ETI .PACKARD CO
Prope~ Held For ProdUCtion or Income Exeluding Home Office ................................ .
Prope~ Held For ProdUCtion of rnoome Encumbrance Excluding Home Office .......... .
Sclledute BA ASsets ................................................. .
Receivable for Securiti<ls ... .................. ........ ...... .
Aggregate Wllte-lns tor Invested Asset$ ... .
Oer1vallves . ............... .
Unaffilaled Common Stock ............................ .
SUBTOTAl- EQUITY .................... .. ............. ..................... ........................................ ........................... .
(25) TOTAl - ISSUER# (l7 • L24l
I (2)
BoolVAdjusted C.Orrylng: Value
...... .-992.229
........... .......................... 992 .229
.......................... 0
992 .229
Factor
0.0 100
0.0200
0.0450
0.1000
0.0500
0.0500
0.0100
0.0200
0.0450
0.1000
0.0100
0.0200
0.0450
0.1000
0.0125
0.1000
0.1000
0.1000
0.0500
0.0500
0.0500
0.1500
Company Coov 37206
(3)
Addrtional RBC
..... 9.922
...... 0
...... 0
..................... 0
................... 0
............... 0
.................. 2 .922
.... 0
......... 0
..... ......... . .......... 0
.......... 0
•...... . .. . ....... . 0
................. 0
................. 0
.. .......... 0
.. 0
... .... 0
.. .......... 0
....... 0
............. 0
.............. 0
.......•...... 0
..........•.. 0
.......... 0
9.922
""0 ::0 0 ..... 0 0>
PRBC
Contractors Bonding and Insurance Company
ASSET CONCENTRATION PR010
(1)
(i )
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(tO)
(It)
(12)
(13)
(14)
(IS)·
.(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
ISSUER I
NAIC 02 Unalfii ated Bor>ds ...................................... .
NAIC 03 unalfii ated Bor>ds .......... ............................ .
NAIC 04 Unalfiiated Bor>ds ....
NAIC OS Unalfiiated Bon<Ss ...................................... ..
Collateral loans ..................... ..
Mort~age lo.JOS . ...... ......... ..... ..
SUBTOTAL · FIXED INCOME .............. .. . .... .
NAIC 02 Preferred Slock .............. ........................... .... ..
NAIC 03 Pteferred Stock .. .
NAIC 04 Preferred Stock ..... ..
NAIC 05 Ptefelred Stock ................ ..
NAIC 02 Hyboid Securities ........... _ ........................... .
NAIC 03 Hybtld Securities
NAIC 04 Hybtld Securilies
NAJC 05 Hybrid Securtties ....... ............. ......................... - .................. .
NAfC 02 working capital Finance Investments
Pro~rty Held For ProduCtion of Income Excluding Home Office .... ...... .
(1)
Pro~rty Held For Production of lnoome Encumb<ance Excluding Home Office
Schedt.H BA Assets ......... ... ..
Receivable tor Securities .•.... - ............... --···· ................................. - ...................... _ ....... -...... .
Aggregate write-Ins for lnvuted Assets ............................... .
Derivatives .. ........................... .
Unaffi~ated Common Stock
SUBTOTAL- EQUITY .... _ .......................... .
(25) TOTAL-ISSUER I (L7 + L24)
(2) Booi<IAdjuOied CarrvinQ Value
.. .......... 0
..... 0
0
Factor
0.0100
0.0200
0.0450
0.1000
0.0500
0.0500
0.0100
0.0200
0.0450
0.1000
0.0100
0,0200
0.0450
0 .1000
0.0125
0. 1000
0.1000
0.1000
0.0500
0.0500
0.0500
0.1500
ComP<OnY Code 37208
(3)
AddUional RBC
................................. 0
............... .................. 0
.......................... 0
........... 0
.. 0
..... 0
.. 0
.. ......... 0
......... ................. 0
........ . ... 0
.... .......... 0
.. ..................... . 0
.. 0
... 0
....................... ......... 0
...... 0
.. ................ 0
....... 0
..... 0
....... 0
.0
.0
.0
.. ...... 0
""0 :::0 0 ...... ~ .....,
PRBC
Contractors Bonding and Insurance Company
ASSET CONCENTRATION PR010
(1)
(2)
(3)
(4)
(S)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
ISSUER I
NAIC 02 Unaffiliale<l Bonds ...
NAIC 03 Unaffiliale<l Bonds .
NAIC 04 Unaffiliale<l Bonds
(1)
NAIC 05 Unaffibted Bonds .. ......... _ ................................................... ............... ....................... .............. ................................. .................................. .
CoUatetal Loans ..
Morlgage Loans ...
SUBTOTAL - FIXEO INCOME
NAIC 02 Pre!e<red Stock . ........ ..
NAIC 03 Pre!e<red Sloe~< ................................................................................................................... ..
NAIC 04 Pre!ened SIOCI< ..
NAIC 05 Preferred Stock ..
NAIC 02 Hybrid Securities .... .. .
NAIC 03 Hybrid Securities .... .
NAIC 04 Hybrid Securities
NAIC 05 Hybrid ~li<l•
NAIC 02 Worldng Capital Finance lnveslments .......... _ .. ................. ........................... - .......... -·--·-· .. ··--........... - .......................................... ..
Property Held For PrO<Iuclion OllnCOme Excluding Home Office
Property Held For PrO<Iuction OllnCOme Encumbrance Exekrding Home Onice .......
Schedule BA Assets
~eceivabfe for Securities ..
Aggregate 'Mite-Ins lor Invested A .. ets .................. .......................................................................................................................................................... .
Oerive~tives .................................................................................................................................................................................................................................. .
Unaft'oliale<l Commoo Stock . ...................... ..
SUBTOTAL- EQUITY .... ..... - ................. - ... - ............ --............ .......... - .................. - ....... - ....... ,_ ...... - .......... .......... ......... ..
(25) TOTAL -ISSUER I IL7 + l24l
(2) Book/Adjusted Carrvina Value
............ 0
...... 0
0
Factor
0.0100
0.0200
0,0450
0.1000
0.0500
0.0500
0.0100
0.0200
0.0450
0.1000
0.0100
0.0200
0.0450
0.1000
0.0125
0.1000
0.1000
0.1000
0.0500
0.0500
0.0500
0.1500
Company Coo~: 37206
(3)
Additional RBC
............. 0
....................... 0
........... 0
........... 0
.................................. 0
.................................. 0
.......... 0
.......................... .. .... 0
.. 0
.... 0
... 0
................... ....... 0
.... 0
..... 0
.. 0
................ 0
........ ....... 0
.. 0
.... 0
.... 0
...................... 0
.. ........... 0
....... 0
.............. 0
0
" ::0 0 .... 0 Oo
PRBC
Contractors Bonding and Insurance Company
ASSET CONCENTRATION PR010
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
.(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(1)
ISSUER#
NAIC 02 UnalfiNaled Bonds ...
NAIC 03 unanmated Bonds ....................................................................... .
NAIC 04 \JnaiiiNated Bonds ................ .
NAIC os unaffiliated Bonds ........ .
C~te,.,l loans
Mortgag• I n.an* ·····················-SUBTOTAl- FIXED INCOME ............................................................ .... ...................................................................... ......... .
NAIC 02 Preferred Stool< ....................... .
NAIC 03 Preferred Stool< ............•..........
. (2) Booi</Adjusted CarrvinQ Value
··············· .................................. 0
NAIC 04 Profenrod Stool< ·············- ·························· .. ··•···•·••·•• .. •·•·•·•••••·••••···•••·•••••··•·······• .. ···················· ····-·····················-··········-········· ...................................................... .
NAiC OS Prefe~d Stock ................................................................................................................................... - ................. ........................... ............. ..................................... .
NAIC 02 Hybrid Secur~ies ...
NAIC 03 Hybrid Se<urki .. ............................. .
NAIC 04 Hybrid Securities ........... ......... .
NAIC OS Hybrid Securities ···········--·····-····-··- ·····-······- ···- ······- ············- ·-···-·····
NAIC 02 Wor1<ing Cap;tal Finance lnvestmenls_ . ............. ...................... - ....... ............ ............. .. ................................................................................... .................... ................. .
Property Held For Prodvetion of lnoorne Excluding Home Office .............................................................................................................. .
Property Held For Prodvetion of Income Encumbrance Excluding Home Otroee ..................... .......... ...................... ............. .
SclleduM! 8A As~IS ............................ . .
Recei>lable lot Securilles ........................ .
Aggtegale Writo:lns for Invested "ssols
Derivatives ....
Un.tff~ialed Common Stool< ............................................ .
SUBTOTAL- EQUITY ................................................ ........... - ................................................... . .............. 0
(251_ TOTAl~ ISSUER I (L7 + L24)
Factor
0.0100
0.0200
0.0450
0.1000
0.0500
0.0500
0.0100
0.0200
0.0450
0.1000
0.0100
0.0200
0.0450
0.1000
0.0125
0.1000
0.1000
0.1000
0.0500
0.0500
0.0500
0.1500
Company Code 37 206
(3)
Additional RBC
......... 0
..................... ............. 0
................................. Jl
................ 0
........... 0
....... 0
........ 0
..... 0
. ........ ..... ............. 0
.......................... 0
.... ............. ................. 0
··········-···········' ·········!) ............. 0
..... 0
............... 0
. ................................. 0
..............•.•.•..•.•.......... 0
.... 0
.................................. 0
................................... 0
........................... ........ 0
.................................. 0
.................................. 0
............. 0
IJ ::u 0 ...... 0 (o
.. '""--===:-:: -·~·. ·:=:='-----··---··--- ---- ----·------·
PRBC
ASSET CONCENTRATION PR01 0
ISSUER I
(1) NAIC 02 Unaffilialed BO<>Os ..
(2) NAIC 03 Unallilialed BO<>Os ..
(3) NAIC 04 Unalfilialed BO<>Os .. ..
(4) NAIC OS Unalfilialed Bonds .. .
(5) Collale<al lo.ans ........... .
(6) Mortgage Loans ..... . ................ ..
(7) SUBTOTAL • FIXED INCOME
Contractors Bonding and Insurance Company
(I)
(2) Booi</Adjusted CanyingValue
...... 0
(8) NAIC 02 Prefer"'d Stool< .................................................................................................................................... ................................................. ..................................... .
(9)
(10)
(II)
(12)
(13)
(14)
(15)
(16)
(17)
(IS)
(19)
(20)
(21)
(22)
(23)
(24)
NAIC 03 Prefer""' Slod< ..........
NAIC 04 Preferred Stock ···- ····
NAIC OS Preferred Stod<
NAIC 02 Hybrid Securities
NAIC 03 Hytirid Securities .... .
NAIC 04 Hybrid Securities ........... ..
NAIC OS Hybrid SecuriWes .............................. .
NAIC 02 Worl<i"!J Capital Finance Investments ......
Properly Held For Praductilln o/ Income Excluding Home Office .
Property Held For Production ol Income Encumbrance Exduding Home OffiCe
Schedule BA Assets _ ........
Receivable for Securities
Aggregate Write.fns lOt Invested Assets
Oerjyetives .
Vnalfili;oted Common Stock ...
SUBTOTAL- EQUITY
(25) TOTAL-ISSUER M (l7 +l24)
................. 0
Faetor
0.0100
0.0200
0.0450
0.1000
0.0500
0.0500
0.0100
0.0200
0.0450
0.1000
0.0100
0.0200
0.0450
0.1000
0.0125
0.1000
0.1000
0.1000
0.0500
0.0500
0.0500
0.1500
Company Coae 37206
(3)
A<lditional RBC
.. ................... 0
.. ..................... 0
..................... 0
...... ........ 0
.... 0
.......... 0
...... 0
....... ........ 0
........................... ... 0
............................. 0
.... 0
.. .................. .... 0
................. 0
.... 0
................. 0
..... 0
..... ....... .. ........... 0
............... 0
................... 0
................ 0
.. 0
....... 0
.0
................. 0
""0 ::u 0 ...... !=' ...... 0
PRBC
Contractors Bo nding and Insurance Company
ASSET CONCENTRATION PR010
(1)
(2)
(Sl
(4)
(5)
(ft)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(18)
(17)
(18)
. (19)
(20)
(21)
(22)
(23)
(24)
ISSUER I
.NAIC 02 Unaffoli8ted Bon6s ........... ............. . . "
NAIC 03 UnaffiiO.Ied BonGS
NAIC 04 Unaffiliated Bon6s
NAIC OS Unalfoliated BonGs
Collote~lloans ........... :., .......... .
~ortg~ge Loans . - ···· ···
(1)
(2) BookiM)usted Carl\linQ Value
SUBT~TAL· fiXEO INCOME ........... , ........... ................... ...................................................................... - ........................................................................................................ P
NAIC 02 Preferred Stock ...................................... ..
NAIC 03 Preferred Stocl<
NAIC 04 Preferrtid Stocl<
NAIC 05 Preferred Stock
NAIC 02 Hybrid Securities ............... .
NAIC 03 HYbrid Seeunties .... - ......................... - .................................................... - .......... - ...... - .. .
NAIC 04 Hybrid Securities ..................................... - ......... - ....... - .......... - ................... ............................... - ...... _ ..
NAIC 05 Hybrid Seet~rities ... - .......... - .... - ............................................................................................ ......................................... ..
NAIC 02 Wor1dn9 Capital Finance fn-.wnents ....... .......... ..
Property Held For Production of Income ExCluding Home Office ..................................................... ........ ............................ - ....... ................... ................................................ ..
. Pr~rty Held For Production of Income Encumbtane. E•cludil1g Home Olf'oce ......................................................................................................... ..................................... .
SChedule BA Assets .....
Receivable lOr Securitft& .
Aggregate v.Ait~m; lor lnv .. t.C Auots .................................... .
Derivatives ·····-················
Unolf~iated Common Stocl< .................... .
SUBTOTAL- EQUITY ................................................................................................................................. . ............. 0
(25) TOTAl-ISSUER I ll7 + l24l 0
Faclot·
0.0100
0,0200
0.0450
0.1000
0.0500
o.osnn
0,0100
0.0200
o.o4so 0.1000
0.0100
0,0200
0.0450
0.1000
0.0125
0.1000
0.1000
0.1000
0.0500
0.0500
0.0500
0.1500
Company Code 372~
(3)
Additional RBC
.................................. 0
.................................. 0
................ 0
.................................. 0
......... 0
........... 0
................................. 0
........................... ..... . 0
.............. ........... ......... 0
.................................. D
.................................. 0
. .... 0 ...0
. ......... 0
................................ 0
... : .............................. D
.................................. 0
....... ............. .............. 0
.............. .............. 0
.......................... ...... 0
.. ........................... 0
............................. 0
.................................... 0
...... o·
.. 0
""0 :::0 0 ...... 0 (;) -l
PRBC
Contractors Bonding and Insurance Company
ASSET CONCENTRATION PR010
(1)
(2)
(3)
(4)
(S)
(6)
(7)
(8)
(9)
(10)
(1 1)
(12)
(1 3)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
ISSUER GT
NAIC 02 Unaffiliated Bonds ...... .
NAIC 03 Unaffiliated Bonds ............ .
NAIC 04 Unaffiliated Bonds ....... .
NAIC OS Unaffiliated Bonds
c onateral loans ...
M0<1gage Loans .••
SUBTOTAL • FIXED INCOME .............. .
(1)
Combined Totals • All issuers (2)
Booi<IA<Ijuated carrvloo Value
......... 9.344 .542
........... 0
............ 0
............ 0
......... 0
............ 0
......... 9 ,3« .542
NAIC 02 Preferred Stock ......................................................................................... - ............................. ........................................................... ................... .................................. 0
NAIC 03 Preferred Stock ·····--··- - · ···· ··- ···········-······ ··············· ·································· .. ••••···••·••••·•••···•·••···••••···••··••··••·•····•••···•••••··•••····••···•···•••··•••·•·•·· ........................................... 0 NAIC 04 Preferred Stock ........................... - ............ .... .
NAIC 05 Prefe«ed Stock ............ .
NAIC 02 Hybrid Securities
NAIC 03 Hybrid Securities .
NAIC 04 Hybrid Securities
NAIC 05 Hybrid Securities ........ · - ···- .......... - .......... .
NAIC 02 Working Capital Finance lnvestmepts ··········-····
Property Held For Production of Income Excluding Home Office ·········- ··
Property Hek:l For Production of Income Encumbrance Exc.luding Home Office ......................... .
Schedute BA Assets ........................ .
Receivable for SewriUe-s ..
Aggregate WriteAns ror Invested Msets
Derivatives .. .................................. ............................................... ........... - ........................ ...................... .. ..
unaffiliated Common Stock .......... ·-·-····-··-· .................. - ... - ................... ......... - ................................... - .................. .
SUBTOTAL- EQUITY .. ........ ........................ ..... .
............... 0
..................... 0
........... 0
............... 0
............. 0
.. 0
........................ 0
........... 0
...................................... 0
..... 0
..... 0
0 . 0
......... ... . ................... ....... 0
........ 0
(25) GRANO TOTAL- ALL ISSUERS: Sum ollines_{L7 + L24 9.344 .542
Factor
0.0100
0.0200
0.0450
0.1000
o.osoo
o.osoo
O.Q100
0.0200
0.0450
0.1000
0.0100
0.0200
0.0450
0.1000
0.0125
0.1000
O.tooo
O.tOOO
0.0500
0.0500
0.0500
0.1500
Company Coae 31206
(3)
AddiUonal RBC
..................... .93 .445
..... 0
................. 0
... 0
................... 0
............... 0
......... .93.445
.. ............ 0
....... 0
. ............ 0
........... 0
.... 0
.............. 0
.............. 0
........... 0
.............. 0
....... 0
....... ....... 0
.......... 0
............... 0
. ..... .......... 0
....................... 0
.... - ............... 0
........................ 0
93 .445
\l ::0 0 ...... ......
PRBC
Contractors Bonding and Insurance Company
CREDIT RISK FOR RECEIVABLES PR011
Reinsurance Reeoverables Annual Statement Soorce
(1) AuthOriZed Alien Affiliate$ ......... . .. ...... Sen F Pt 3. C1S.L0799999
(2) AuthOrized U.S. Unaffiliated Insurers ....... Sen F Pt 3, C1S.L0999999
(3) Authorized VolUntary Pools ....... Sen F Pt 3, C 1S,l1199999
(4) ' AuthOrized Alien Unalli.r~ates ..... .......... Sch F Pt 3, Ct5. l t 299999
Unoull10rized Alien Affiliates ..... Sch f Pt 3, C tS. L2099999
(0} Unavthorit•d U.S. Unefritleted li\'$Uter~ .... Sc:h F PI 3 , C 15. L22000013
(7) Unau11lonzed Voluntary Pools .................... Sch F Pt 3, C15. l2499999
(8) Unou\llonzed ArlEn Unalflliate• ................. Sch f Pt 3. CIS. L2S99999
(9) Cerlified Alien AftiHates .............................. Sen F Pt3, C 15. l 3399999
(10) Cer1ified u.s. Unaffiliated Insurers ..... Sen F Pt 3, C 15, l3S99999
(1 1) CeMified Voluntary Pools .................. .......... Sen F Pt 3, C 15. L3799999
(12)
(13)
CMified Alien Unaffiliates .......... .. ......... Sch F Pt 3, CI S. l3899999
Total Reinsurance Recoverables .......... : ....
(14) Guaranty Funds Receivable or on Deposit PZ C3LI9
(15) Investment Income Oue & A<oNed ..... : ...... P2 C3 L 14
(16) Recov from Parent Subs. Allil$ .................. P2 C3 L23
(17) Amts Receive relating to Uninsurso A&H PIDns ........................ P2 C3L I 7
(18) Aggregate W/1 forOH>er Than Invest AsSetS ..... ...................... .... ........ P2 C3 L25
(19) Tot•l Cred« RBC • C3 l(13)•Sum ol C1 l(1~ thrO_Ullh _l0_8l
• Schedule F daiJI sllould be brought to full dol!Jir amount by muniplying 1 000.
(1) (2) (3) Amount Subj to
Statement Value. Aoolicablo Penoltv t ci1~~~12l .......... 0
.... .... .7.304 .000
............. 0
......... 89 .000
. .................................. 0
.......... 0
.......... 0
...... 324 ,000
..... 9
..... 0
....... 0
.................................. 0
7.717 .0()1)
. ................................. .0
... 1.715.782
....... 124.012
.................. 0
96.480
9.653 .274
............. 0
................. ..7.304.000
........... 0
................. 89 .000
.................... 0
............ 0
....................... 0
......... 324.000
..... 0
............... - ........... ..... 0
............. 0
........... 0
7.717 .000
t Column 2Line 13: Apl)licable Penalty IO< Total Reinsurance Recoverables should equal AST page 3 Line 16 k!ss PR0381ine 1 through tine 4.
Factor
0.100
0.100
0.100
0.100
0.100
0 .100
0.100
0.100
0.100
0.1 00
0.100
0.100
0.050
0.0 10
0.050
0,050
0.050
Company Code 37206
(4)
RBC Reauirement
....................... 0
.............. 730 ,400
........... 0
. ............ 8.900
............................. 0
.... 0
........... 32 .400
...................... 0
.. ... ... ....... . 0
..................... 0
.................................. 0
771.700
.................................. 0
......... 17. 158
....... 6.201
.......................... 0
U24
799.833
"'0 ::u 0 .... N
PRBC
HEALTH CREDIT RISK PR012
Contractors Bonding and Insurance Company
PRBC Data Source (t)
Amount
(1) Total Capnauons Pai<l Directly to ProYiOers ...................... ........................ ................................................... .-.• PR020 UO!Ierwrmng R:lsk Manageo .................................. () care Credit Col (2) line (5)
(2) less Socured Capila~ons to Providers ..................... .......... ....................................... . Company Records
(3) Net Capitations to Providers Subjee1 to Credit Risk CMrge .............................. . .. ...... l(t ) -L(2)
(4) Total Capitations to tnter~ties ........... .......................................................................................... ~ ..... : PR020 Colu""' (2) lkres (6) • (7)
(5) less Secured Capitations 10 lntermediaties .. .................... Company Recor<ls
(6) Net Capitations to lnte<mediaties Subject to Credit Risk Charge ................................................................. L(4) - L(5)
(7) Capitation Credit Risk RBC . ...................... . ................................................. - ................ _ L(3) + L(6)
Healtll A SD/ASC Credit Risk
(8) ASC Claims Reported as Incurred ClaimS-
(9) Othe< Medical Coots Paid through ASC Arrangements ............. .
(tO) Fee-tor Service Reeeived from Healh Insurer.
(11) Total Health ASOIASC Credil Risk.
(12) Total Healtll Credit Risk
• Enter amounts of secured capitation in RBC Page PRCPT on filing softWare
....................................... ......... Company Records
......... Company Records
......... Company Records
.. ................. _L(8) + L(9) + L(IO)
l(7) + L(11)
............................ 0
.. ... ..... ...... ........ 0
.................................. 0
.......................... ....... 0
................................... 0
Company C<. •• J7206
(2) Factor RBC Reauirement
0.020 ...................... 0
0.040 ..... 0
.. .. 0
0.010 ................................. 0
0 .010 .................................. 0
0.010 .................................. 0
0
"'0 ::0 0 ...... (J.)
PRSC
Contractors Bonding and Insurance Company
OFF-BALANCE SHEET ITEMS AND OTHER ITEMS PR013
Annual Statement Source
Non-controlled Assets
(1) Lo•ned topther~~onforming SeouriMs Lending Programs . ... General Interrogatories P;ut 1 L24.0S
(2) loaned to Others -Secvrities lending Pnograms ·Other ............. Genera1 1nterrogatories Pa~ 1 l24.06
(3) Subject1o Repvrchase Agreements ................................. . General Interrogatories Pa~ 1 L25.21
(4) Svb~ctto Reverse Repurchase Agreements. .. Gonerallnterroga1ories Pa~ t L25.22
(5) Svb~et to Dollar Repurchase Agreements ..................................... Generat lnterrogalories Pa~ 1 l2S.23
(6) Subject to R•versa Dollar RepurchaM Agreements ...... . General Interrogatories Part 1 L25.24
(7) Pledged as Collateral ....................... .. .... Company Records
(8) AsHIS Placed Under Option Agreements ... .................... . ... Generat lnterrogatories Pan 1 L25.26
. (9) lel\er Stock or other Seevrities ReslriC1ed .............. .. ..... Generallnterrogatorias Part 1 L25.27
(10) On Deposit with State or Other Regulatory Body. ............. Ganeral lnterrogatories Pa~ t L25.28
(II) other .................. ................................................. . ···············--······ General Interrogatories Part 1 l25.29
(12) Total Non-oontrotled AS$et~ ........................ .. ......... Sum of L(1l through l(11)
· (13) Gvoranlees for Affiliates ................................. . . ............................. Notes lo Financial Statements item 14A(03C1)
. (14) Contingent Liaba~les ................. . ...................... ........ .. Notes to Financial Statemenls Item 14a1 • Item 27s Amovnt 2 Unreooroed loss Contingencies
( t 5) . Is lhe entity responsible for filing the U.S. Federal income tax "Yes', ' No' or "NIA' in Column (4) retum for the reporting insurer a regulated insv,anoo company?,
(t6) SSAP No. 101 Paragraph 1 lA Deferred Tax Assets· ... .............. Noles to Financial Statements item 9A2(a)
(17) SSAP No. 101 Paragraph 118 Deferred Tax AsseiL ..
(t3) To!al Miseellaneovs Off Balance Sheet and Other Items • L(12)+ L(13l+L(14)+L(16l+l<17l
. ... Notes to Financial Sfatemonls Item 9A2(b)
(1) sutement Value
..... 0
........... 0
..... .... 0
................ 0
..................... 0
...... 0
. ............ 0
..... ..... 0
.. ................ 5.0?2,376
... ....... .............. 0
................ 5.022.376
.. .... ............ 0
.. ................... 0
...... 2.782 .493
.... .... 174 .006
7 .978,875
(2) Factor
0.002
0.010
0.010
0.010
0.010
0.010
0.010
0,010
0.010
0.010
0.010
0.010
0.010
(3) RBC Requirement
........... 0
............................... 0
.. ........... . .............. 0
...... ........ ............. 0
................... 0
...... 0
............................. 0
... 0
. .............. 0
.............. 50.224
..... 0
.............. 50.224
.................... 0
........... 0
0.005 ......................... t3.9t 2
0.010 .............. 1.74()
65 .876
• II Line (15) Column (4) is 'Yes', thOflthelactor is 0.005. 11 Line (1 5) Colvmn (4) " 'No·. then the ractor is O.Ot 0. "line (15) Colvmn (4) is 'NIA·. then the !actor is 0.000.
Company Code 37206
(4) Yes/No Response
......... YE.
-u ::0 0 _.. ~
------------- --PRBC
Contractors Bonding and Insurance Company
OFF-BALANCE SHEET COLLATERAL AND SCHEDULE DL, PART 1 ASSETS PR014
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(It)
(12)
(13)
(H)
(IS)
(16)
(17)
(18)
(19)
(20)
(21)
Asset Category
Fixed Income Assets
Bonds
NAIC Ot -U.S. Government - Direct and Guaranteed .................... ·- ········-······-······ Ot~er NAIC 0 I Bonds
Total NAIC 01 Bonds .......••.....
Annual Statement Source
...... !company R•co•ds
...... !company Records
....... (1) + l(2)
Total NAIC 02 Bonds ...
Total NAIC 03 Bonds ..
Total NAIC 04 Bonds • .
Total NAIC OS Bonds ..
T otat NAIC 06 Bonds ..
Total Bonds .. .
·· · · · ········· · ········ ·- ·· ·· lcompa~ ReooJds
Equity Assets
. ................................ . !company Records
.... ..................... ... ompany Records
....................... ................. ompany Records
············-· ···"'·· Company R&e:Otds .......................... . ............ l(3)+~(4)+l($)+l(6)+l(7)+l(8)
Preferred Stocl<. Vnaffiflated
NAIC 01 Unaffiliated P~fen-ed Stoclt .................... .... Company Records
NAJC 02 Unaffillated PrefefTed Stoclt...... .. Company Records
NAJC 03 Unaffiliated Preferred SIOCit .... .
NAIC 04 Unaffiliated Preferred Stoelt ... ..
...... Company Records
...... Company Records
(I) Off-8alanee S~eet
Colaleral Boci</Adjusted Carl'ling.Vatue
_________ o
(2)
Sc~edule Dl. Part I Boci</Adjvsted C8ll'li ng Value
(3)
Subtotal
... 0 ...... .......... .................. ......... JJ
........ 0 ............... 0 ... 0
..... 0 ... 0
.. 0 ...................................... ......................................................................... 0
........ 0 .............. 0 ................ 0
........ 0
..... 0 ... 0
..... D NAtC 05 Unaffiliated Preferred Stoelt ............... - ..... Company Records ....................... ........................ .. ......................... 0
NAIC 06 Unaffiliated Preferred S10Cit .......................... Company Records ... 0 Total Unaffiliated Preferred Stod<........ . .......... L(IO)+ L(ll)+ L(t2)+ L(t3)+ L(14)+ l(IS) ................................. 0 .................................. 0 ; .................. .............. 0 Common Stock.. ompany Records .. 0 Real Estate and Sc~te BA - Ot~r Invested Asset> .... ........................... . jcompany Records ................ 0 Ot~r Invested Assets, ................... ............................... Company Records ... 0 Mortgage loans on Real Estate_. . ...... Company Recotdt ...................................... ....................................... ...... .......................... 0 Cash. ca~ Equi\lalents. non-government money mar'kel f\Jnd and SOOri-Term lnvestme11ts .................... Company Records ...................... ... .............. ........... 0 (Not reported as Bonds above)
(22) Total L(9)+L(16)+l( I 7}+L( 18)•L(19)+L(20) ·i.r2tl 0
Factor
0.000
0.003
0.010
0.020
0.045
0.100
0.300
0.003
0.010
0.020
0.045
0.100
0.300
0.150
0.200
0.200
0.050
0.003
Company Co... J7206
(4)
RBC Reauiremer>t
........ 0
................................... 0
..... ..... .. ............... 0 ........ 0
.................................. 0
.......... 0 ........... 0
.................................. 0 .. ........ 0
...................... 0
...... 0 ........ 0 ...... 0
......................... .......... 0
....................... 0
................................... 0 ... 0
...... JJ .. 0
............................... .... 0
.... 0
0
-o ::0 0 ..... (11
PRBC
Contractors Bending and Insurance Company
EXCESSIVE PREMIUM GROWTH PR015 (1)
Company Grou V«inen Premium$•
(1) 2013 .... ...................... ...................... 55. 423,228
(2) 2012. .................. ............. ., ................. 54 .916.~
(3) 2011 ....... .. : ............ \., ....... . : ..... ,., ....... 54.723.357
(4 ) 2010 60.573,373
(2)
Company Adiustrnenls
(3)
Group Gross \Nrilten Premiums•
... 843, 195.292
...... .784.799.175
(4)
Group Adiust,....nts
(5) Setec:tod Adjusted
GroaeWrintn Premium
............................ 843, 195.292
................ ............... 784.799 .175
...................... 720 .684,471 .................... - .............. ............... 720,684 ,471
6!16,889 , 192 6!16 889. 192
(6) (7)
Statemttnt Value Factor
XXX
XXX
XXX
(5) '013 ,..,.._, Rat• • (I (I) .I ('ll/1 ('l ------ .............. ........................ - ................................................... .......................................................................... - ............................ - .... 0.074
(6) 2012G<owln Rate • (l(2) · l(3))1.(3) .. --·--· .. --........... .. - . ............................... _ .............. _ .. ___________________ ,___________________ ..................... _ 0 .089
(7) 2011 o,_, Roll • (l(3) • L(4))1.(4) .................. - ...... - ........ - ... - ........ - .... - ...... --·-·-·--·-·-· -------·-.. ··•·• ----------.. ·--·---··- .. ··-........... ____ ..0.034
(8) Th~ Year Av.,. G<owln Rott •• _________ , _ _ .. _ .............. ---------------·-----------------·--.. ·•· ....... - ................ 0.066
(8) Two YNr Allft1lgt Growth Rote. __ ,, ______ ... , .............. _ ... _ .... _________ ___ ____________ ,_ .. ________ ,, __ .... _ . ..... - ........ - . ................ .. ............... _ .. » .082
(10) One Year 1\vet'agt Growtl1 Rate- .................. ___ , ___________________ ______ ____________ ..... - ....... ......... ............................... _...... .. ...................... .0.074
(11) Ser.cttd Average G<owln lble _________ , ................................... ___ _ ... _ _________ ................................ .......... .. ..................................................... ____ ........................ .0.066
Co~Yl>ony Code 3720&
(8)
R8C Requirement
XXX
XXX
XXX
(12) RBC AYtra!ll Gr"'f''h RAio •l(11) . !0%, capped to lal between 0% and 30% ..... _ .......... ................................................................................... ,....~~~~=""'--l----....!0"".000=+------~
(13) Exoenlve Gtowth Charge Applied to Loss/E>q>ense ResetVe rrom Sclled~ P Summary C24 L12 •1000 (in w!>olo dollars) ............................................. 45 .925.000 ................ .0.000 0
(U) Exc.eui~~e G<owlh Ch~ro. ADOIItd to Net Written Premiums fro,.; U&l E•hibit PI 1 B C8L35 50.040.709 0.000 'En~er Company eM Group Gfoss Wrinen Premiums in PR037.
Name Ot Involuntary Residual Mlrkol AdiUStmenl (For Servicing Caniet Onty) Amount
8999999 Total 0
'1J ::0 0 _. 0>
==~====-- ···===
PRBC Co"1pany CO<>c 37206
Contractors Bonding and Insurance Company
UNDERWRITING RISK - RESERVES PR016 (I)
SCH P LtNE OF BUSINESS Hlf (1) INDUSTRY AVERAGE DEVELOPMENT............... . ............................ .0.960 (2) COMPANY DEVELOPMENT ............................................................ ................... 0. 960 (3) (2)/ (I) ......................................................... .. ..... 1.000 (4) INDUSTRY LOSS & EXPENSE RBC %..................... .. .............. 0. 201 (5) COMPANY RBC% (4)'(3)".5 + (4)' .5............... ........................ .. ...... .0. 201 (6). LOSS & LOSS ADJUS'IMENT EXPENSE UNPAID
SCH. P PART 1 (In 0005) ........................................... ..... .. (7) OTHER DISCOUNT AMOUNT NOT INCLUDED IN
LOSS & LOSS ADJUS'IMENT EXPENSE UNPAID IN
............ 0
(2)
PPA
::::::U: ............. 1.000
............... 0. 192 ................. 0.192
. .................... .D
SCH. P PART 1 (In OOOs).... .. ............ .... ....... . ...... ... 0 .......................... .0 (8) ADJUSTMENT FOR INVESThiENT INCOME .......... . .. ..... 0.938 ................... 0.928 (9) BASE LOSS & LOSS ADJUS'IMENT EXPENSE
RESERVE RISK-BASED CAPITAL (OOO's) MAX (0.(((5)+1)"(8)-1)'[(6)+(7)1) zero if Line ((6)+(7)) is negative ........................... 0 .......................... 0
(10) (11) (12) (13)
%DIRECT LOSS SENS... .............................. .. ....... 0.0 . .................... _().0 %ASSUMED LOSS SENS.............. ..0 .0 ................... ... 0 .0 LOSS SENSITIVE DISCOUNT (in OOOs).................. .......... ......... .. ........ 0 ................ ..... D
(14) (15)
LOSS & LOSS ADJUSTMENT EXPENSE RBC AFTER OSCT (inOOOs) L(09) • L.(l2) .. ........... ..... ............... . ..... .. 0 LOSS CONCEN FACTOR. .......... ......................... ........ . ~~~~.~NET RESERVE RBC XIOOO (converted to Whole
(9) (10)
FIDELITY/ SCH P LINE OF BUSINESS OL SURETY
(1) INDUSTRY AVERAGE DEVELOPMENT.............. ....................... .. ......... 0.919 ..... ............. 1.126 (2) COMPANY DEVELOPMENT............. .. ..................... 0 .919 ................... 0.430 (3) LtNE (2)/ LtNE (1) ............................................................................... ................... 1.000 ................... 0. 382 (4) INDUSTRY LOSS & EXPENSE RBC %... . ..................... .. ... 0.511 ... .............. 0.325 (5) COMPANY RBC% (4) x (3) x .5 • (4) x .5............ .. ......... 0.511 ..... 0 .225 (6)· LOSS & LOSS ADJUSTMENT EXPENSE UNPAID
SCH. P PART 1 (in OOOs) ......................................... . (7) OTHER DISCOUNT AMOUNT NOT INCLUDED IN
LOSS & LOSS ADJUSTMENT EXPENSE UNPAID IN SCH. P PART 1 (in OOOs) .............. ..
(8) ADJUSTMENT FOR INVES'IMENt iNCOME. ..... (9) BASE LOSS & LOSS ADJUS'IMENT EXPENSE
RESERVE RISK-BASED CAPITAL (aGO's)
............................... . 214 ................... 4.722
................. 0 .................. 0 ............. 0.852 ....... 0.940
w ~ ~ ~ m MPL MPL CLMS
CA WC CMP OCCURRENCE MADE
· : .~: .... :: ::: :::: ~:: :: t~~~ :::::: ~:~ : : ::::: ::~ : : ::::: g ::~: ......... 0.814 ..... 1.000 ................... 0.864 ................ 1.000 ............ 1.000
... 0 .230 ........... 0.324 .................. 0 .465 .... .............. 0.431 .. 0 .306 ... 0.209 .......... 0.324 .... . . 0.433 ............. 0.431 ... 0 .306
.. 1.020 ...... 0 ...... 39 .757 .............. . .... 0 .... 0
(8)
SL . .. ...... ........ 0.954 ................... 0.954
........... 1.000 ..... 0.257 ... 0.257
................ 0
.. ............... .0 ...................... 0 .. ................ 0 ............ 0 ..................... 0 ....................... 0 ..... 0.911
...... .103 ......... 0.0
..................... 0.0 ......... 0
103
(11)
SPECIAL PROPERTY
................. 1.035 ................... 1.035 ................... 1.000 ................... 0.191
............. 0.191
.............. ..1
................... 0 ....... 0.986
........... 0.830
........ 0
.... 0 .0 ............... 0.0
.... 0
(12) AUTO
PHYSICAL DAMAGE
................. 1.054 ................... 0. 700 .............. ... 0.664 .................... 0.112
................. 0.093
.... 85
............. 0.876 ................ 0.865 ............. 0 .883 ................... 0.1190
....... 10 ,150 .......... .0.0
............ 0.0 ................ 0
10.150
(13) OTHER
(INCLUDE CREDIT.A&H
........ ........... 1.113 .................... 1.113 ................... 1.000
............ 0 .172 ........... 0. 172
.. 0
....... 0
... 0 .0 ................. 0.0
.......... 0
(14) FINANCIAV MORTGAGE GUARANTY
................... 1.2:56
................... 1.255 .. ................ 1.000 .. ................. 0 . .200 ................... 0.200
......... D ...... .0 .0
... 0.0 ....... 0
(15)
INTL ............. 0.813
.................. 0 .813
................... 1.000 ......... 0 .327 ........... 0 .327
........ 0 ..... ....... 0
................... 0 ........ 0.0 ...... 0.0 ...... . 0
(16) PROPERTY &
FINANCIAL LINES
................... 0.934
................... 0.934
................... 1.000 ................... 0.286
... 0.286
. .... . 0
.......... 0 .......................... 0 .. ........................ 0 .......................... 0 ................ 0 .0.~16 ................... 0 .967 ...... 0.926 ...... ....... 0.874 ................... 0.901
~AX (0.[((5)+1)"(8)-1)"[(6)+(7))) . zero If Une [(6)+(7)) is negative .................... ..... . ............. ........... ........... 61 ........... .715 ........ 0 ............ 6 .......................... 0 .... 0
............ 0 .0 ... 0.0
.. .... 0 .......................... 0 (10) % DIRECT LOSS SENS (11) %ASSUMED LOSS SENS .................................... . (12) LOSS.SENSITIVE DISCOUNT (in OOOs) ...... . (13} LOSS & LOSS ADJUS'IMENT EXPENSE RBC AFTER
OSCT (in OOOs) L(09)- L(12) ............................................................... ..
.. ........................... 0.0 ........... 0.0 ............... 0.0 .... ...................... 0.0 ....................... 0.0 ...................... 0.0
. ........ 0 ................ 0 ............... 0
61 715
...... 0.0 .0.0 ... 0.0 ........ 0.0 ........ 0.0 ........... 0.0 ... 0.0 ........ 0.0
.............. 0 .................. ........ 0 .. .. ......... ...... 0 .. ... 0 .......... 0
6
1 1:~: Lg;;LcNo~c:;s~~~~0R~c~ioiioi~~;~;i~d·i~-;:;h~i~ ;j;li~~-J-------------------------------~------------1
"'0 ::u 0 ..... ~
PR8C
Contractors Bonding and Insurance Company
UNDERWRITING RISK - RESERVES (PR016) (Continued)
(1) (2) (3).
(4) (5) (6)
(7)
(8) (9)
(10) (11) (12) (13)
(14) (1 5)
(17) REIN.
SCH P LINE OF BUSINESS LIABILITY INDUSTRY·AVERAGE DEVElOPMENT.. .............. ....................................... 1.009 COMPAN'!' DEVElOPMENT ... 1................................. .. ........... .1.009 liNE (2)1 LINE (1) ........... : ................................................................................. 1.000 I~DUSTRY lOSS f. EXPENSE RBC % ............................................ ............. 0.769 COMPANY RBC 'I• (4):(3)".5 • (4)".5: ................. .. .......................................... 0.769 ~OSS & lOSS ADJUSTMENT EXPENSE UNPAID
(18)
Pl ................... 0.981
......... 0 .981 ............. 1.000
....... ....... 0.643 ......... 0.643
(19) (20)
WARRANTY TOTAl
:::::::::::::~:::: : :~~ ::::::::: :::~~L::::~~. ................... 1.000 ............ XXX ... .. ................... 0.325 ............ XXX .......... ..
.. 0.325 ............ XXI ........ .
SCH. P PART 1 (in QOO$) •••• - ...... : .. , ............. - ... ·---........... .. ...... 0 ........ 126 ······--················0 ......... 45.925 OTHER DISCOUNT AMOUNT NOT INCLUDED IN ~OSS & lOSS ADJUSTMENT EXPENSE UNPAID IN SCH. P PART 1 (in 0001)....... ................................ . . .......................................... 0 .......... .............. 0 ADJUSTMENT FOR INVESTMENT INCOME--------··- .................... 0.838 ................... 0.841
........... 0 ........................ 0 .. 0.940 ........... UL
IIASE lOSS & l OSS ADJUSTMENT EXPENSE RESERVE RISK-eASED CAPITAl (OOO's) MAll (O,((l))• 1)"(8)·1J"I(6)'(7)D .• toro ~ lO!e ((&)• (7)) Is negative_ ............................................................................... 0 ........................ 43
: ~~~uC,:E~~~isE~itis.::::::~::.:::::.~::::.-::::~--· .. ~:::::~:::::~: :.· ... :::~~ ::::::::~ :~ ':::::~~:::::::::::~~:~ ......... _ .. _, ..... 0 ........ . .. 11 .083 .................. .0.000 ............ ux .... -~ .. .. .. ......... o.ooo ...... ux.. .... _
lOSS Sj;NSI11VE DISCOUNT (In OOOs)__ .... ___ ........................ - ................. _ 0 ......................... 0 ~OSS & lOSS ADJUSTMENT EXPENSE RBC AFTER
......................... 0 .............. - 0
OSCT ('on OOOs) ~cog> - L(t2) ... --·-----------.. -·-'·- . __ .............. +---....2.o_.._ _ __ _:4&=4----!!..o i---!411,4.083:~ ~OSS CONCEN FACTOR -.-......... _ _____ ..... _ ............ - ....... f----------+----4----..:!..:. 0 .• 960=~ !~~~NET RESERVE RBC xtOOO (converle<IIO whOle IO.Sl9 ,680
Compaoy Code 372()e
·--- .-----·----------
PRBC Company co... J7206
Contractors Bonding and Insurance Company
UNDERWRITING RISK · NET WRITTEN PREMIUMS PR017 (1) (2) (3)
SCH P LINE OF BUSINESS H/F PPA CA INDUSTRY AVERAGE LOSS & LOSS ADJUSTMENT EXPENSE RATIO ............................................. .................................. ................... 0.725 ................... 0.784 .................. 0 .668 COMPANY AVERAGE LOSS & LOSS ADJUSTMENT EXPENSE RATIO .... .. (2)/(1) ....... ...................................................................... . INDUSTRY LOSSES & LOSS ADJUSTMENT EXPENSE RATIO ............................... ...................................................... ..
OMPANY RBC LOSSES & LOSS ADJUSTMENT EXPENSE RATIO
...... 0 .125 ................... 0 .184 .................. 0 .526 ....... 1.000 ... .............. 1.000 .. 0.787
............. 0.937 .... 0.969 "" .. 0.988
(4)
we
(5)
CMP
(6) MPL
OCCURRENCE
(7) MPLCLMS
MADE
(8)
SL
........... 0.750 .................... 0.653 ................... 0.874 ................... 0.695 ................... 0.649
......... D.750 ........... 1.000
...... 1.033
.. 0.425 ......... 0.651
... 0.814
... 1.000 ....... 0.695
............ 1.000 ... 0.649
.. ..... 1.000
.... 0.921 "" ............. 1.322 ................... 1.092 .................. 0.904
(3)"(4)' 0.5+(4)'0.5 ....... ""' ........................................... " ..... 0 .937 . ............... 0 .969 ................ 0 .883 ....... 1.033 ... 0 .160 ............. 1.822 """" 1.092 "" ........ 0 .904 COMPANY UNDERWRITING EXPENSE RATIO........................ .. ...... 0.572 ................. 0.572 .................. 0.572 ....... 0.572 .... 0.572 ............. 0.572 .... 0.572 ................... 0.572 ADJUSTMENT FOR INVESTMENT INCOME ............................ ................... 0 .954 ................. 0 .925 .. 0 .890 ...... 0 .839 .... 0 .896 ........... .. 0 .767 ........ 0 .827 ................ 0 .898 C/Y NET WRITTEN PREMIUM Qn OOOs) ......................... ...... .. ...... 0 ...... 0 .... 1. 195 .......................... 0 ......... 29 .992 ................ 0 .............. 0 ..... 0 BASE WRITTEN PREMIUM RISK-BASED CAPITAL (in OOOs) MAX {0, (8) x {(S) x (7) + (6} -1)) zero if line (8) is negative... .. ............ 0 ....................... 0 ...... 428 .............. 0 ................. ] .587 ....... 0 ................ 0 ............ . ........... 0 %DIRECT LOSS SENS WP ................ .'.. .. ......... 0.0 ...................... .0 .0 ..... .0.0 ........... 0.0 ..... .0.0 ... .0 .0 ....... .0 .0 ..................... 0.0 %ASSUMED LOSS SENS WP .......... , ....... ...... ..... ....... ...... .... . ............ 0 .0 . ...................... 0 .0 .................... 0.0 ... ..... . ......... 0 .0 ................... 0.0 ................... 0 .0 .................. 0.0 ...................... 0 .0 LOSS SENSITIVE DSCT • WP (in OOOs) . ............................................................... 0 ...................... .0 ........................ 0 .......................... 0 ........................... 0 .......................... 0 .......................... 0 ....................... .. 0 NWP RBC AFTER DSCT (in 000$)...... .. .................... ..... I----.....::.O.J.... ___ ......::O....L. ___ _;4::;:28::...L. ____ ,::0_._ __ .....:,.7,:.:=.58:::7...L. ____ ::,O .J.... ___ ......::O....L..------'0"-j PREMIUM CONCENTRATION FACTOR .................... .... .. ~!~~ITTEN PREMIUM RBC x 1000 (convened to whole
SCH P LINE OF BUSINESS INDUSTRY AVERAGE LOSSES & LOSS AOJUSTMENT
~~~~~~ ~~~~Ge.i:osses &'i:oss.AoiuiiMiilir EXPENSE RATIO ................................................................ .. LINE (2)/ LINE {1) ................................................. .. INDUSTRY LOSSES & LOSS ADJUSTMENT EXPENSE RATIO .............................................................................. .. OMPANY RBC LOSSES & LOSS AOJUSTMENT EXPENSE
RATIO
(9} (10)
FIDELITY/ OL SURETY
.......... 0.620 ... D.4S6
............ 0.620 ......... 0.096
.. .......... 1.000 ......... .0.194
............ 1.042 ........ 0.883
(11) (12}
AUTO SPECIAL PHYSICAL
PROPERTY DAMAGE
.............. .0 .574 " . .. 0.681
............. 0 .574 ....... 0.633 ... ............... 1.000 ...... 0.930
................... 0.941 ....... 0.843
(13) (14) (15) (18) REIN.
OTHER FINANCIAU PROPERTY & (INCLUDE MORTGAGE FINANCIAL
CREDIT. A&Hl GUARANTY INTL LINES
.. 0.118 ........ 1.211 ...... 1.093 .... ........... ,0.766
............. 0.118 ......... 1. 271 .. 1.093 ................. ,0.766 .. 1.000 ........... 1.000 .... 1.000 .......... 1.000
... 0.893 ............. 1. 482 ..... 1.169 ······· 1.349
(3)'(4}"0.5+(4)"0.5................... .................................. .. .......... 1.042 ................... 0.527 ................... 0 .941 .................... 0 .813 ............. ...... 0.893 ................... 1.482 ................... 1.169 .................. .1. 349 COMPANY UNOERWRmNG EXPENSE RATIO ........................... ................. 0 .572 ................... 0.512 ................... 0 .572 ................... 0 .572 .................... 0 .572 .................. !J .572 ................... 0. 572 .................... 0. 572 AOJUSTMENT FOR INVESTMENT INCOME. ......... _ ........... .. ............ 0 .816 ....... 0.904 .................. 0 .949 ........ 0 .971 ................... 0. 947 ..... .... ...... 0 .884 ................ 0 .905 ....... 0. 893 CIY NET WRITTEN PREMIUM On ooos).......................... .. .................... 321 ......... 17 ,884 ........... 6 .............. 378 ............. 0 ..... . ...... 0 .......... 0 ................. 0 BASE WRITTEN PREMIUM RISK BASED-CAPITAL (in OOO's) MAX (0, (8) X ((5) X (7) + (6) · 1)} ...................................................... ........................ 136 ..................... .866 .......................... 3 ........... 137 .......... 0 ................ 0 ..... 0 .................. 0 %DIRECT LOSS SENS WP..... .. ................. 0.0 .... .0 .0 .......... .0.0 ... D.O .............. 0.0 ..... D.O ....... 0.0 ..... 0.0 %ASSUMED LOSS SENS WP.................... .. .. ............... 0.0 .... 0.0 0.0 ...................... 0.0 .......... 0.0 ... 0 .0 ........ ..... 0.0 ............. 0. 0 LOSS SENSIT~ OSCT • WP (in 000$)...... .. ..... 0 ........ 0 ............ 0 ...... 0 .......... 0 ..... 0 .......... 0 ............... 0 NWP RBC AFTER DSCT (in OOOs)............ l----..::136:::...~ ___ ....,::&i::;:6'-'-----.::.3..._ ___ _::13e:.7....L.. ___ ___:0::....~.. ____ .::,0......_ ___ ___:0'-'-----'10 PREMIUM CONCENTRA TlON FACTOR. ..... NET WRITTEN PREMIUM RBC x 1000 (convMed to whole dollars)
, ;o 0 ...... ;-.J
PRBC Contractors Bonding and Insurance Company
UNDERWRITING RISK- NET WRITTEN PREMIUMS (PR017 (Continued)
(I)
(2)
(3) . (4)
(5)
(6) (7) (8) (9)
(10) ( II) (12) (13) (t•) (1 5)
SCH P LINE OF BUSII'IESS INDUSTRY AVERAGE LOSS & LOSS ADJUSTMENT E~PENSE RATIO ...................... : ....... : ............................ : ..... .
(17) REIN.
LIABILITY
.. ................. 0.782 COMPANY AVERAGE LOSS & LOSS ADJUSTMENT EXPENSE RATIO ........ --·--·--......... ": ... :............................... .. ... ... . .. .... 0.782 LINE (2)/LINE (1) .............. ,, ................. : ............................................ ........ ........... ! .000 INDUSTRY LOSSES & LOSS ADJUSTMENT EXPENSE
(18) (19) (20)
PL WARRANTY TOTAL
........ 0.683 ...... 0 .864 ............ XXX .......... .
... :.0.683 .................... 0.864 ............ XxX... ....... .. ... 1 .ooo .................... • .ooo ............ m .......... ..
RATI!;L ........... · .................................................................................................... .l.fiJ7 ... .... ......... 1.214 ................... 0.883 •••. - ... JU. .......... . COMPANY RBC LOSSES & LOSS ADJUSTMENT EXPENSE RATIO ' · (3)"(4)'0.5+(4)'0.5 ......... , ....................................................................................... ! .507 .................... ! .214 .... - ............ 0.883 ............ XXX. .......... . COMPANY UNOERWfliTING EXPENSE RATIO ......... - ..... ........ ................... 0.572 0.572 .................... 0.572 ...... _ JU . ......... . ADJUS1MENT FOR INVESTMENT INCoME. .... _ ..................... . ................... O.m .................. 0.174 ............. 0.~ XXX. ......... .. ctY NET WRiTTIEN PREMIUM (in 0001).. .. _, __ .. ___ , _____ .......................... 0 .................. _.265 ... _ ................... 0 ............... ..50 .041 BASE WRITIEN PREMIUM 111$1< SA$~1>-CAPITAL (In 0011'&) MAX (0. (8) X ((5) X (7) • (8) • IJ>.---- - ......... - - .... - - -- -.. ·------.. ..0 ..................... .136 -----... - ...... 0 ... - ............. 9,293 %DIRECT LOSS SENS WP ................. - ........................ --- - --· .................. 0 .0 .... ..... ......... 0 .0 ... - .............. ..0 .0 f-·--XXX •• - •• %ASSUMED LOSS $ENS WP ..... : ................ - ............ - ........ --·-·-.......... 0.0 ............ - ...... D.O ...... - ........... 0.0 ........ XX.L .... -LOsS SENSITIVE DSCT • WP (111 OOOs).. ________ .......... --f---·-·-----.. --0 ..... - ................... 0 .... ________ .. 0 .................. _,0 NWP RBC AFTER OSCT (in 0001)- ... --... ·-----.................. _ 0 136 0 9 .293 PREMIUM CONCENTRATION FACTOR ............... ..... -...... O.M<I NET WRITTEN PREMIUM RBC • 1000 (oonvel1ed to whole dollars) a. 177 .840
Company COde 37206
IJ ::0 0 --"
""" )>
- .. ... _ ... - . ,., _____ , .... ,. _____ _ PRBC Company Cc. ••• 7206
Contractors Bonding and Insurance Company
UNDERWRITING RISK· NET WRITTEN PREMIUMS PR017A (For Informational Purposes OnlY)
(I)
(2)
(3) (4)
(S)
(6) (7) (8) (9)
(10) (II ) · (12) (13) (14) (IS)
{I )
(2)
(3) (4)
(Sl
(6) (7) (8) (9)
(10) (1 1) (12) (13l {14) {IS)
{I ) w rn ~ w w (7) MPL CLMS
MADE
(8)
SL lscH P LINE OF BUSINESS HIF PPA CA MPL
we CMP OCCURRENCE INDUSTRY AVERAGE LOSS & lOSS ADJUSTMENT EXPENSE RATIO................... .. ............... ....................... .................... 0 .693 ...... 0.784 .......... 0.668 ............ .0 .750 ...... 0.631 ............. 0.874 ....... 0.6!15 OMPANY AVERAGE LOSS & LOSS ADJUSTMENT
EXPENSE RATIO .................................................................................................. 0 .693 ................... 0.784 ................... 0.520 .................. 0.750 .................... 0.425 .................... 0.874 .................... 0.695
.... 0.629
... 0.629 ....... 1.000 (2)1 (1).................................................................... .. ........................ .. 1.000 ..... .1 .000 ....... 0.787 J .000 .................... 0.674 ...... 1.000 . ...... .1 .000
NDUSTRY LOSSES & LOSS ADJUSTMENT EXPENSE RATIO................................... . ........ ......................... ........... . . ............... 0.900 ~OMPANY RBC l OSSES & LOSS ADJUSTMENT EXPENSE RATIO
...... 0.969 ................... 0.988 .............. 1 .033
(3)'(4)'0.5•(4)'0.5... .................................... . ........ ...... 0 .900 .................. 0.969 ............... 0 .883 .... ...... ...... 1 .033 COMPANY UNDERWRITING EXPENSE RATIO....... .. 0.572 _ .............. 0.572 . .... 0.572 ....... JJ.572 ADJUSTMENT FOR INVESTMENT INCOME............................ .. ....... 0 .954 ........... 0.925 ..... 0.890 ................ 0.839 CIY NET WRJITEN PREI.IIUM (in OOOs)...._ ..... - ......... --......... .......................... 0 .. .................... 0 ....... 1.195 ... .. .. 0 BASE WRirfEN PREMIUM RISK·BASED CAPITAL (in OOOs)
...... 0.882 .................... 1.822 ............. . .1.092 ........ 0 .852
..... 0.738 ........... 1.822 ...... 1.092 ..................... 0 .862 .... 0.572 .... .. ........ 0.572 ...... 0.572 ........... 0.572 ... 0.896 .. 0.767 ................... 0.827 ................ 0.898
.. 29,992 ..... . .......... 0 .............. 0 ........ 0
MAX (0. (8) x ((5) x (7) • (6). 1() zero if line (8) is negative.... .. ...... 0 ............. 0 ..... A 28 .......................... 0 .... .. ... 6.996 ....... 0 ........... 0 ... 0 %DIRECT LOSS SENS WP .................... ................. ........................ ...................... 0.0 ....................... 0.0 ...................... 0.0 ...................... 0.0 ........................ 0 .0 ... 0.0 ................... .0 .0 ... .. .... 0.0 %ASSUMEDlOSSSENSWP .................. ........ ........... .. ..................... 0.0 ....................... 0.0 ....................... 0.0 .................... 0.0 ............... .0.0 .. 0.0 .................. 0.0 .. .0.0 LOSS SENSITIVE DSCT · WP (on 000$) ......................................... ....................... 0 ................ 0 ...................... 0 , ....... .. ......... 0 .................. 0 ....... 0 ............ 0 .. ..... IJ NWP RBC AFTER DSCT (in 000&).. ............... ....... I----~O_l_ ___ ~0~ ___ _:4!!:2!!.8 -'----....::O..L--~6~. 996=..,~,_ ___ ....::,0 -'----~0-'-------'0"-1 PREMIUM CONCENTRATION FACTOR.......... .. ....... . NET WRITTEN PREMIUM RBC x 1000 ((OtWerted to wi10ie dollars
SCH P LINE OF BUSINESS INDUSTRY AVERAGE LOSSES & LOSS ADJUSTMENT
(9)
OL
EXPENSE RATIO .................................................................................................. 0 .620
(10)
FIDELITY/ SURETY
................. 0 .496
(11) (12)
AUTO SPECIAL PHYSICAL
PROPERTY DAMAGE .
............... 0 .551 ......... 0.676 ~OMPANY AVERAGE LOSSES & LOSS ADJUSTMENT EJ!PENSE RATIO .............................................................................. ................... 0.620 ................... 0.096 ................... 0.551 ................... 0.633 LINE (2)/ LINE (1) .......................... _ .................................... .. .... 1.000 ............. 0.194 ... . ..... 1.000 ....... .0.936 I~OUSTRY LOSSES & lOSS A DJUSTMENT EXPENSE RATIO .. .................. ........... ............ .......... ............ ........ .... ... ................... .1 .042 .................. 0 .883 ~OMPANY RBC LOSSES & lOSS ADJUSTMENT EXPENSE RAno
....... 0.892 ......... 0.828
(13) (14) {IS) (16) REIN.
OTHER FINANCIAU PROPERTY & (INCLUDE MORTGAGE FINANCIAL
CREDIT A&Hl GUARANTY 1NTL LINES
......... o.ns ........ 1.271 ....... : ....... 1.080 ........... 0.699
........... 0.778 ......... 1.271 ................ 1.080 ........ 0.699 .............. 1.000 ......... 1.000 .............. 1.000 . ........... 1.000
............. 0.895 ........ 1 .482 ................... 1.052 ........ 1.194
(3)"(4)'0,5•(4)'0.5........... ........ .. .... ................... 1.042 .................. .0 .527 ................... 0.892 ................... 0.802 ................... 0.895 ................... 1.482 ................... 1.052 ................... 1 .194 COMPANY UNDERWRITING EXPENSE RATIO ..................... _ .. ................... 0.572 ................... 0.572 ................... 0.572 ................... 0.572 ............. 0.572 .......... 0.572 ................... 0.572 .......... 0.572 ADJUSTMENT FOR INVESTMENT INCOME. ............................... .................... 0.816 ................... 0.904 ................... 0.949 ................... 0.971 ............ 0.947 ......... 0 .884 .......... 0.905 ................... 0.893 CN NET WRirfEN PREMIUM (in 000$) ..................... ........ .............. 321 ................. 17 .884 .......................... 6 ............ 378 ...... 0 ........... 0 .. ... ..... 0 ........... .............. 0 BASE WRITTEN PREMIUM RISK BASED-<:APITAl (in OOO's) MAX {0, (8) X ((5) X (7) + {6) • I)). .. ........................................ .. % DIRECT LOSS SENS WP ........ . %ASSUMED LOSS SENS WP ............. . LOSS SENSITIVE DSCT - WP (in OOOs) .. .. . . ........ ...... . NWP RBC AFTER OSCT (in 0005) .................. ... PREMIUM CONCENTRATION FACTOR ............................ ... .. ~~!~IITEN PREMIUM RBC x 1000 (c:onvened 10 wl1ole
.... 136 ......... 0.0 ........... 0.0
......... 0 136
... .......... ,_,,866 .......... 0.0
..... 0.0 ........... 0
865
... . 3 ......... 0 .0 ......... 0.0 ........... 0
3
.. ................. 133 ............ 0.0
............ 0.0 ................. 0
133
"" ........... 0 .0.0
................ 0.0 ..... 0
0
............ 0 ........... 0 .0
....... ........... 0 .0 .......................... 0
0
........................ 0 . ................. . 0.0 .. .................... 0.0
. .. D 0
.......... .. ....... 0
..................... 0 .0 ..... D.O ........ 0
0
""0 :::0 0 ..... -.,J
;t>
PRBC
Contractors Bonding and Insurance Company
UNDERWRITING RISK- NET WRITTEN PREMIUMS (PR017 (Continued) (For Informational Purposes Only)
{1)
{2)
(3) {4)
(5)
(6) (7) (8) (9)
(10) (11) (12) (13)
·(14) (15)
{17) (18) {19) {20) . REIN .
SCH'P LINE OF BUSINESS LIABILITY PL ' WARRANTY TOTAL INDUSTRY AVERAGE LOSS & LOSS ADJUSTMENT EXPENSE RATIO .......................................... : .............. .. COMPANY AVERAGE LOSS & LOSS ADJUSTMENT
. ................ ... 0.782 ................. . 0.683 .......... 0.864 ....... XXX ...
EXPENSE RATIO ..... , .................................................................................... ........ 0.782 .................... 0.683 .......... 0.864 ............ XXL .. LINE (2)/ LINE(!)..................................................... .. ......... .1.000 ................ 1.000 .................. .1.000 ............ XXX INDUSTRY LOSSES & LOSS ADJUSTMENT EXPENSE RATIO ............................. .................. .. ................................ ................. .1 .507 .................. 1.214 ................... 0.883 ............ XXX... COMPANY RSC LOSSES & LOSS ADJUSTMENT EXPENSE RATIO (3)"(4)'0.5•{4)'0.5 .................................................................................................... 1.507 ................... 1.214 ................... 0.883 ........... XXX .. .. COMPANY UNDERWRITING EXPENSE RATIO........................... .. ........ 0.572 .................... 0.572 ................... 0.572 ............ XXX ADJUSTMENT FOR INVESTMEtfl iNCOME......... .. ........ 0.777 ............. 0.774 ............. 0.904 ............ XXX ........... . CfY NET WRITTEN PREMIUM (in OOOs)......... . ............ ..... ..... ..... .. .... 0 . . 265 ....... 0 ................. 50 ,041 BASE WRITTEN PREMIUM RISK BASED-CAPITAL (in OOO's) MAX .(O. (8) X ((5) X (7) • (6) • 1)1................................................. .. ........... 0 ..... .136 .......... 0 .......... 8 ,698 %DIRECT LOSS SENS WP .................................................................................... 0.0 ................... ... 0 .0 .0.0 ............ XXX ....... . %ASSUMED LOSS SENS WP.... ........................ .. .......... 0.0 ...... 0 .0 ...................... 0 .0 ... XXX.. ......... . LOSS SENSITIVE DSCT • WP (in OOOs)..................... . ........ .. 0 .... 0 ................. 0 .......................... 0 NWP RBC AFTER DSCT (in ooos)............................................... t----.....:.0_._ ___ ..:,136::::..J._ ____ O=-t---*'8.7698~ PREMIUM CONCENTRATION FACTOR ....................................... t----------------+---!:.0.:.::880::::..j NET WRITTEN PREMIUM RSC x 1000 (cotwerted to whole dollars> · • 7.654.240
Company Code 37206
"0 :;o 0 _.. (XI
PRBC
Contractors Bonding and Insurance Company
HEALTH PREMIUMS PR018
Annual Statement Source
Medleallnsuranee Premium · Individual Mortlldlly VSYal and Cuslomary MajOr Mecfoc:al and Hol!>ilat .. . ............... Earned Premium (Schedule H Part 1 line 2 in part) Medicare Supplement......... ............. ............................................... ... Earned Premium (Schedule H Part 1 line 2 In part)
(1) (2) (3) Dental & Vor.ion .... - ................................ ....... ............................ . .. Earned Premium (Schedule H Part 1 Line 2 in part)
(3.1) Stand.AJone Medieare Part 0 Coverage. . ... Eanned Premium (Schedule H Part 1 line 2 in part) (3.2) Sue>plemental eener•s within Stand-Alone Part D Coverage. . ......................... Earned Premium (Schedule H Part 1 line 2 in part)
Hospitallndemnily and Specilie<l Olse<m> • ..... ............................. - ......... - .... - ............. Earned Premium (Schedule H Part 1 Line 2 in part) AD&D (Maximum Retained R;,k Per lite ........ ). . ........... Earned Premium (Schedule H Part 1 l ine 2 in part) Other Aec:ident.... . ...................... . ... . . . ............. ............... Earned Premium (Schedule H Part 1 Lifle 2 in pan)
(4) (5) (6)
Medtcallnturance Pt"ernlum. Group and Credit Morbldltx (7) usual and Customary Major Medical. Hospital ......................... . -..... . ........ Earned Premium (Schedule H Part 1 Line 2 in pan) (8) Oenlal & VISion.... ................. ............. . .. Earned Premium (Schedule H Part 1 line 2 in part)
Stop Loss and Minimum PremiUm..... ................................. .. .......................... Earned Pr~mium (Schedule H Part 1 line 2 in part) Medicare Supplement. ........................................................................................................... Earned Premium (Schedule H Part 1 line 2 In part)
(9) (10)
Sland·Aione Medicare Part 0 Coverage (see instructions for limits)......... . ... Earned Premium (Schedule H Part t line 2 in part) Sue>plemental benefits within S!Snd-AIOne Pan o coven~ge ...................... Earn~ Premium (Schedule H Pan 1 Line 2 in part) Hospital l ndomnily and Spocifoed Disease •. . .............. ...................................... ..... Earned Premium (Schedule H Part I line 21n part)
(10.1) (10.2) (II) (12) AO&D (Maximum Retained Risl< Per life .......... )........ . ........... Earned Premium (Schedule H Pan 1 Line 2 In pan) (13) Other Aecident..... . ....................................... ............................................................ Earned Premium (Schedule H Part I line 2 in part) (14) federal Employee Heanh Benerrt Plan. .... _ ............... - ......... - ..... - ...... - ........... - Earned Premium (Sched~ H Part 1 Line 2 in pan)
Diublliity Income Pr•mlum (15) NoncanceUable Oisabllily Income -Individual Mort>idily. .. ............................................ EMned Premium (Sclled~ H Part 1 Line 2 in pan) (16) Other DisabiliiY Income - Individual Mortlldily.. . .. ..... Earned Premium (Schedule H Part 1 Line 2 in pan) (17) ();sabilily Income-CredU Monthly Balance Plans... . ...... earned Premium (Schedule H Part I line 2 in pan) (18) Q;sability Income- GrO<JP long-Te<m.................. ...... ........... . ............................. Eamed Premium (Schedule H Pant Line 21n part) (19) o; .. bility Income- Cred~ Single Premum with Additional Reserve ................ _ .......... Earned Premium (Schedule H Part I line 2 in part) (20) ();$ability Income . Credit Single Premium withOut Additional Reserve.......... .. ...... Earned Premium (Schedule H Part t Line 2 in part) (21) ();$ability Income- Group Sllort-Term... .. .... Earned Premium (Schedule H Part I Line 2 in part)
Lona-Ttrm Care (22) Noncancel able long-Term Care Premium - Rate Risk •• ............... . ... Earned Premium (Schedule H Part 1 Line 2 in part)
.............. Eanned Premium (Schedule H Part I lirle 2 in pan) (23) Ollie< Long. Tonm c.,.. Premium :U. Hoann Premium with Limited U!l!fuwrlllng Risk
(24) ASC Business willl Premium Revenue. ........................ .. .............................. Eanned Premium (Schedule H Part 1 Lirle 2 in part) O!he<Healtn ·
(25) Othe< Heahh....... ........................ . ............. _ .......... Eanned Premium (Schedule H Part 1 Lirle 2 in part) (26) Total Eamed Premiums C(l). l(26) should equal Schedule H Part 1 Column t Line 2 Sum or Unes (I) through (25) (27) Additional Re•erve• IO< Credit Disabilily Plans · Company Records (28) Additional Rosorves for Credit Oisabili_!y _plans,J>_rio<_l'!tar Company Records
(1) Statement Value
.................................. 0
Factor
t t t t
0.350 0.035.
* 0.050
t t
0.250 t t
0.350 0.035.
* 0.050 0.000
* * * * * * * 0.1 00 0.000
0.000
0.1 20
Company C"'-- J7206
(2) RBC ReQuiremef\1
.............. . XXX .............. .. ..•.... XXX. ....... XXX.
.............. . XXX. ....... .. ................. 0 .................................. 0
........................... 0 . 0
•....•.. XXX. .... • XXX
........... ...... ........... 0 ..... XXX .. .
................ XXX ..... . ......................... 0
..................... 0 . .......... 0
............... 0 ........ ... .. . ......... 0
.................................. 0
.................................. 0
...................... ....... 0
.............................. 0 ......... 0
.................................. 0
.................................. 0
.................................. 0 .................. 0
.................. 0
0 ................................. 0
t The premium amounts in lllese lines are transfened to PR019 Underwriting R~ . Premium Risk for Comprehensive Medical, Medicare Supplement. Dental & VISion and SlanG-AlOne Medicare Pan 0 Coverage Lines (t ,l ) and (t .2) for tne ealeulation of risk·~ed capital. The premium amounts are Included he<e to assist in the balancing of total health premium. If mana9ed care arrangements have been enle<ed into. the company may also complete PR020 Underwrieing Risk· Managed Care Credit. In which case. the con\j)any wm also need to complete PROt! Health Cntd~ Risk in lhe formula. If there are amounts in any of lines (1). (2). (3). (7). (8) or (tO) on page PR018 Heakn Premiums. the company will atso lbe directed to complete the Health AdlnlnlstTaUve E•pense ponlon or PR021.
t The two tiered calculaliorl is ilustrated in the ri$k.based cat>tal in•lructions lor PROIS fiealth.Premiums.
U The balance ollhe RBC requirement lor long Term Care-Mortlidily Risk is calcuLated on Page PR022. The premi11111 is shOwn 1o allow totals to check to Schedule H.
·u there ;s premium inctuded on either or both of the-se tines. the RSC value in Column (2) will inck.Jde- 3.5% of such ptemium and $.50,000 (included in the line with the &arger t)femi.um).
•• Th@ factor appfies to an NoocanceUab1e premium. §These amounts are used to adjust the premium base lor single premium credit dlsabilily plans that ea~ry additiOnal tabular reserves.
"'0 :::0 0 ....... «>
PRBC Company Code 37206
Contractors Bonding and Insurance Company
UNDERWRITING RISK· PREMIUM RISK FOR COMPREHENSIVE MEDICAL, MEDICARE SUPPLEMENT AND DENTAL & VISION PR019 Experil!tlee Fluctuation Risk in Life RBC formula\
(1) (2) (3} (4) (5) Stand-Alone
Comprehon$i._ Medicare Medicare Part D line of Business Medical Supplement Dental & Vision Coverage TOTAL
( 1.1} Premium : IndividuaL............................. .. ......... 0 ...................... 0 .... 0 ........................... 0 ......... ......... ............... 0
(1.2) Premium. Group. ..... ................. ..... .. ............... 0 ................ 0 0 .......................... 0 .... ........... 0 (1.3) Premium -'Total• (Une (1.1} •line (1 .2).. ................................................. .... .. ..... 0 ............. 0 ....................... 0 .................................. 0 .................................. 0 (2} Tille XVII! • Medlcaret......................... .......................................................... ..... . ............... XXX ................ .......................................................... ..................................................... 0 (3) Tille.X\X • Medicaldt ........... .. .......................................................... .......................... : ........... ................ XXX................ ....................... ......... .................. .. ... 0
(4} Otl>tr Hulth R•sk Revenuet.... ............... ........... .. ...................... .......................... .......... ; . ................ XXl.......... ..... .............................. .. ... 0
(5} Undorwriting Ris~ Revenue; lines (1.3) • (2) + (3) • (4) ............ ............ ......... ...... ........ ~ ........ 0 ...... 0 .... 0 ... .. .... 0 ... 0 (6) Net Incurred Claims. ................ ................ .............. .............................. .............................. ..0 (1) Fee-tor-Service OIISelf..... .. .............. XXX.. ................. ..... ........ ............... ...0 (8) Underwriting Ris~ Incurred Claims •Line (6) · line (7)........... .. ....... 0 ................ 0 .......... 0 ... .. ............ 0 ............... 0 (9) Underwriling Ri$k Ctaims Ratio= Line (8)/lino (5)..................................... ..... .. ......... 0.000. .. ....................... 0.000 ................. 0.000 .................... 0.000 ................ XXX ............... .
(10.1) Underwrii ing Risk Factor't~r Initial Amounts of Premlumt. .................................................. 0.150 ........................... 0 . 105 ........................... 0 . 120 ........................... 0 .251 ............... )XX .. .. (10.2) Underwriting Risk FactO< for ExCHs oflnitial Amoun'*· ............................ ................ .......... 0 .090 ....... 0.067 ...... 0.076 ........................... 0 . 151 ................ XXX.
(10.3) Composite UndeiWriting.RiSit Facie<................................... .. .... 0.000 ...... 0.000 ............. 0.000 .... 0.000 ................ XXX .. (11) .BaseUnderWrilingRiskRBC=Lino(S)xl•no(9)xline(10.3)...... .. .............. 0 .... 0 ........................ .......... 0 ...... 0 ...................... 0 (12) Managed Care Discount Factor • PR020 Column (3) Line (12) .......... 0 .000 ......... 0 .000 .. 0 .000 ......... 0.000 .............. XXX. (13) BaseR8CAfter ManagedCareDiscount•line(l 1) xLine(12)............. ........ .. .... 0 ..... 0 ............. 0 ...... 0 ..... 0
RBC Adjustment For Individual • ((line (1,.1) x 1.2 • l ine (t.2)}1line (1.3)) xline 13)§ ·; ................................................................................. ..
(14) ........ 0 ...... 0 ... 0 ......... 0 .......... ............ .... 0
(15) Maximum Per-Individual Risk Arter Reinsurancet ......... . • .. XXX. (16) Altemat~ Ri$k Charge• ...................................................................... . .. 0 ... ............................... 0 ................................... 0 ....................... 0 .. ........................... 0 (17) Net Alternate Ri$.~ Charge£ ............................... . .. ..................... .. 0 ........................ 0 .................................. 0 ..... 0 ..... 0 (18i Net Unde;.,.;,.IUng_Risk RBC_(Maximum of Uno_(14l_or line_{17l\ 0 0
t Source is company record$ vntess already inclvded i.n premiums.
~For Comprehensive Medicai .the ln~iat Premium Amount is $25,000.000 or the amount in Line (1.3) if •mailer. For Medicare Supplement and Denl<ll & VISion the Initial Premium Amount is $3.000.000 or tne amount in li.ne (1 .3) if smaller. For StaOO·Aione Medicare Part D the tn~ial Premium Amount Is 525.000.000 or the amount in line (1.3) If smaller.
§Formula applies only to Column (1), for all otl>er <olumns l ine (14) should equal line (13).
LESSER OF· $1 .SOO.OOOor
2 xMaximum Individual Risk
£ Applicable only if Line (16) for a column equals line (16) lor Column (5). otherwise zero.
sso.ooo 0<
2 xMaximum Individual Risk
SSO.OOO or
ZxMaximvm Individual RiSI<
$150.000 or
6 x Maxlmum
Individual Risk
===··'""· .• :-::.:-:.=-·· · .. -=:=-=---:- - - - --------.------------ ------·· · · ···-·· ~ .. - --·-·--·-------
-o ::u 0 N 0
PRBC
Contractors Bonding and Insurance Company
UNDERWRITING RISK - MANAGED CARE CREDIT PR020
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10.1)
(10.2)
(10.3)
(10.4)
(10.5)
(10.6)
(11)
(12)
D .. criptloo
Comprthanslve Medical. Mt!llcare Supplement and Penta! & VIsion Claim fW!!!I!I! CategOfY o-Anangements not lnetude<lln Other Categon ...
Catogory 1 - Peyments Madt According to COntractual ArrangemeniS.
Category 2a • Subject to Wthholcls or Bonuses. Otherwise Category 0 • . ..
Annual Statement Source
.... Company reco<ds
. ... Company records
....... Company records
Ca!egory 2b • Subject to v.lthhojds or Bonuses- Othe<wise Category 1 - ......... ............. Company records
CategO<Y 3a • Capitatod Payments Directly to Provid..-s .. , ................ ,., ............ .................. Company records
Category 3b • Capitaled Payments to Regajated Intermediaries......... .. ............. Company records
Category 3c • capitated Payme<~ts to Non-Regulated Intermediaries .............................. Company records
CategOfY 4 · Medical & Hospital Expense Paid as Sata<y to Pro\Mers .....
SUb· Total Paid Claims.
SSand-b'o"' MtdlurJ Pan p Co't!raqe Cltlm Payments
Category o · No federal ReiJ\Surance or RiSI< Comdor Protection
......... Company records
..... Sum Of lines (1) through (8)
... ... Company records
Category 1 • Federal Reinsurance but no Risk Conidor Protection ............................. ...... Company records
CatogOf'( 2a • No Fe<loral Roinsuraoce bvt Risk Corridor Protection ................................ Company record•
Category 3a ·Federal Reinsurance and Risk Corridor Protection apply .......................... Company records
SUb-Total Paid Claims ......................................................................................... .................. SUm Of lines (10.1)1twough (10,4)
Tocal Paid Claims......................... .................. .. ..................................... ...... Sum Of lines (9) and (10.5)
Weighted Average !.Wiaged Care Ois<:ounl .......... .... Col. 13) • Col (3) Une 19)/Col (2) Lin• (9). Col (4) • Col (4) tine (10.5)/Col (2) Line (10.5)
Weighted Average Managed Care Risk Adjustment Factor ....... .............................. .......... Col 131
• 1_0
• Col (3) Une 1111
•
(2)
Paid Claims
.. ............... 0
factor
0.000
0.1 50
Q.600
0.600
o.eoo 0.750
······-····XXL.... ....• . ............. XXX .....•........ ...... ......... XXX ........... ................... XXX .... ......... ..
................................ 0 ............. 0
0.667
0.767
(3)
We_lghted Claims•
.............................. 0
................................. 0 .............. 0
... 0 .................. 0
....... 0
.............. 0 ..... 0
....... 0
.......... 0.000
Company'-· .7206
(4) PartO
VVeklhted Claims•..,
............... XXX ........... .
............... XXX ..• ..... ........ 0
................................ 0 ............ .................... 0
............ 0.000
Col_{4)_• 1.0 . Cal_{4l_llne 1111 ......................... 0.000 ........................ 0.000
(1 3)
(14)
(15)
(16)
(17)
(18)
(19)
CalwlaHon ol category 2 Mtnaae!l Care Factqr
Wthhold & bonus payments. prior year. ........ , .. Company Records
WithhOld & bonuses available. prior year .................. _ ......... Company Reea<ds
Managed Care Credk Mu~iplier. avenlge withhojd returned ............ ................................. Line ( t 3) I (14)
W~hhOtds & bonuses available, prior year ............................................................................ line (14)
Claims payments subject to withhold, prior year.... ........................................................ _ .. Company Records
Avetagewithhojd rat~. prior year ............ ............. .................................................................. lino (16) /Line (17)
Manaaed Care Credk Discount Foetor. CattQOIV 2 Minimum of 0.25 or Line (15) x (18)
·Category 2 Managed Care FaciOr calculated an Line (19).
•• Category 2 Mtnaged Care Factor calcUlated on lin<> (19) with a mini""'m factor al15 perunl.
(1) Amount
......... ,0.000 ................................ 0
.......... 0.000 0 .000
• This column Is lor a single rnajtfor the COmP<ehensive Medical & HOSPital. Medicare Supplement and Denial maM~.~ed care discount !actor.
•• This eolumn is fOr the Stanli-Akloe Medicare Part 0 man~ ad care discount factor.
PRBC
Contractors Bonding and Insurance Company
UNDERWRITING RISK- OTHER AND TOTAL NET HEALTH PREMIUM RBC PR021
Oata Source
Rate Guarant ees & Federal Emplayees Health Benefits
(1) . Business with Rate Guarantees Between 15.36 Months..... . .. Company Records
. (2) Business with ROle Guoranlees Over 36 Months .......................................................... .... Company Records
(3) Federal Employees Heallh Benefit Program (FEHBP) Claims Incurred . ......................... ComJ)any Records
(4) Tolal. Rate Guarantees & Federal Employees Health Benefib. L(1) • L(2) • l(3)
Admlnl,trative Expen'Sts for Certain ~&H Coverages
. (5) Tolal Accidenl and Heallh Prem·,ums.......... .................. ............. ....... .. ...................... . PROI8 Heallh Premiums Column (I ) Line (26)
(6)
(7)
(8)
(9)
Aceident and Hoallh Premiums from Unclerwriling Risk...... . ... PROI9 Undorwriting Risk Column {S) line (1.3)
Acc<~nt al)4 Healln Premiums Factor ... - .................................. _ .................... - .. ........... L(6)11.(5)
AdminislrOiive Expenses for HeaHh Insurance ......... .. .. ..................................... Company Records
less Administrative Expenses for Adminislr.>tive SeNice Conlr.>cls (ASC) included in Company Records line(&)...... . ............................... ..
(10) LossAdmlnlslralive Expenses for Adminlstrallve SeNioes Only (ASO) Busrness Company Reoords include<t in l ine (8)................ ............................................ .. .............. - . ...... .
(11) Less Administralive Expenses for Commissions and Premium Taxes-................ ............ Company Records
(12) Net Administrative Expenses.. ............................. .. ........ L(8) • L(9) - L(t O) ·l(l l )
(13) Composite HeaiU1 Administrative Expenso RisK Faelor........ .. ..... . ............ (7'4 ol ~(6) up to $25 numon • 4% of exoess)/L(6)
(14) Administralive E•pense Componenl for Health..... .. ....... L(12) x l(7) x l (13)
Health ASOIASC
(15) Administrative Expenses for ASC Business ..
(16) Adminislra1ive Expenses for Aso Business ...
(17) Tolal Hea"l\ ASOIASC ...
( 18) Total Underwriting Risk . Olher . ..
Total Net Health Pr•mlum RBC
.............. ......... Company Records •
... Company Records •
........... L (15) + l(16)
L (4) + l(14) + l (17)
(19) Total Heal)h Premium RBC ................... ................................................................................. L(l 8) + PR018 C(2) l(26) • PROI9 C(S) l (18)
(tO) Premium Conoenuation Faelor. ... ... PROI7 C(20) l(14)
(2 1) ToUII Net Heallh Premium RBC L(l9) x l (20)
• Line (15) should be grealer than or equallo Line (9). line (15) should be grealer than or equal to line (10).
(1) Amount
.................................. 0
..................... 0 ........... 0
......... 0.000
............................... 0 ........ 0.070
...... 0
Factor
0.024
0.064
0.020
0.020
0.020
Company COde 37206
(2) . RBC Reauiremenl
.............. 0 ....................... ........... 0
.. : ......... 0 ............... 0
,. ................................ 0
. .................................. 0 .. ...... 0
.............. 0 .. .......... 0
......... 0 ........................... 0.880
0
'"0 ::0 0 N N
PRBC
Contractors Bonding and Insurance Company
LONG-TERM CARE PR022 Annual SLatement SO<Jr<:e
Long·Tenn C•re Cl TCl ln•UJ•nc• Premium
(1) All TC Promil.m • MO<bidity Risk (to $50 million). ............ .... line (4.1) Column (1) up to 50 million
(2) l TC Premium (over $50 milion) • Morbidity Risk. .. Remainde< of line (4.1) Column (1) over 50 milion
(3) Premium-based RBC Col (21. L(1l • LC2l
Annual Stalement Sour<:e
Hittorietl l oss Ratto Expedtnct
(4. I) Current Year ......... .. ......... Company Records
(4.2) lmme<llate Prio1 Year. ......................... Company Records
(4.3) A""rage Loaa Rooo ........... ...................... . ... H loss ratios are usod. (Cotumn (3). line (4.1) + Line (4.2JV2. otherwise zero
(5) Adjusted LTC Claims lor RBC ............................ ................. .. H ColUmn (3) line (4.3) <> 0. then (Column (1). line (1) + Line (2)} X Column (3), l ine (4.3). else Column (2)Line (4.1)
(5. t) Claims (to S35 million) - Morbidity Risk t ........................... Lower ol Col (2). Line (5) and $35 million
(5.2) Cloims (over $35 million)-Morbidity Risk:. ....................... Excess of Cot (2) , Line (5) o...,. $35 milion
(8) Clalms-Daae<l RBC ........ ........ L(5.1) + L(5.2)
(7) l TC Morbidity Risk Col (2). l(3) • Col(4). l(6)
(1)
Premiums
(1) Amount
....... .......... 0
......... ......................... 0
(2)
lnc:<Jrre<l Claims
................. ...... ........... 0
............................. 0
.................................. 0
Factor
0.100
0.030
(3) Col .. (2)(t)
Loss RatiO§
0.000
0.000
0.000
0.370
0.120
t W Colu1T111 (1), Line (4. 1) is PQ$itive, 11\en a !actor ol 0 .250 is used. Otherwise. a higher factor of 0.370 is used. ! I Column (1). Line (4.1) is positive, then a factor ol 0.080 it u&ad. Otherwise, a higher factor of 0.120 is used. * If Column (1). Line (4.1) or (4.2) are Jess than or equalto zero or i t Colomn (2). Line (4.1) or (4.2) are tess than zeio. the lOss rallos are not used and Column (3).line (4.3) is setto zero.
Company Co... J7206
(2) RBC ReGuirement
............... 0
................................... 0
0
(4)
.RBC ReGuirement
............. 0
........ ..... 0
.... 0
0
PRBC
Contractors Bonding and Insurance Company
HEALTH CLAIM RESERVES PR023
Annual Statement Source
(1) Individual claim reseNe& ....... .
(2) Group & credil claim reseNes ...... . ······ ·········· ···· ···············-·-···· ................................... ..... L(3) -l(l )
(3) Total Health Claims RueNe RBC ......................................................................................... Sch H PI 2. See C. Col i , Line C1
. (4) Lo .. Concentration Faclor .......... . .... PR016 C(20) l(14)
(5) Nel Heatlh c~a·,ms Rese.Ves RBC l(3) X l (4)
(1) Statement Value
..... 0
....... 0
Factor
0.050
0,050
Company Code 37206
(2) RBC Reaulremeoil
.... 0
.................................. ll
...... 0.960
()
PR8C
Contractors Bonding and Insurance Company
PREMIUM STABILIZATION RESERVES PR024 Data Source
Group & Credit Health Premium Stablllza~on Reserves Reported
(1) Stabilization ReSE<Vea aM Experience Rating Refunds ... . .. Company Record$
(2) Provision for E)(perience Rating Retvnds. .... Company Re«>rds
(3) Reserve for Group Rate Credits ....... . .. company Records
(4) Reserve for Cred~ Rate Credits ... ·······- ·: Company Records
(5) Premium Stabilization Reserves .............................. ··--···---·········.-- ··· .. ·············--·········· Company RV'COrds
(6) Total of Preliminary Premium Stabilization Reserve Credit .... Sum' of Lines (1) rt>rough (5)
Group & Credit Health Rtsk.llued Capital
(I) Statement Value
................... 0
(7) Maximum Risk-Based Capital ................................ ............................................................... PR023 Healtl> Claim Reserves Column (2) Line (2) + ................................... 0 PR018 He<l> Premiums COlumn (2) Lines (9), (11), (12), (13}, (17}, (1 8}, (19), (20) and (21) • IPR019 Underwriting Ris.k . Premium Risk Column (5) line
• (18) ·Column (4) Line (18) x Une (1.2)/Line (1 .3))
(8) Final Premium Stabilization Reserve Credit Column (2) line (8), but not more than Column (I) Line 17) .
Ccmpany Co-.. J7206
(2) Fector RBC ReQuirement
0.500 ...... 0
0.500 ................... 0
0.500 .......... 0
0.500 ........ 0
0.500 ............... 0
..... 0
·1.000 0
"'0 ::u ·0 N C1l
PRBC
Contractors Bonding and Insurance Company
CALCULATION OF CATASTROPHE RISK CHARGE R6 AND R7 PR025 For Informational Purooses Ontvl
Earthquake
(1) Worst Year in 50
(2) . Worst Year in tOO
(3) Worst Year in 250
(4) Worst Year in 500
Hurricane
(5) Worst Year In so (6) Wor~t Year in 100
(7) Worst Year in 250
_ru_ WO<st Year in soo
(9) Net Eanhquake Risk R6
(10) Contingent Credit Risk lor Eanhquake Risk
{11) Total Earthquake Catasttophe Risk R6
( 12) Not Hurricane Risk R7
_113]_ Contingent Cred~ Risk lor Hurricane Risk
(14\ Total Hunicane CatastrOPhe Risk R7
Reference
Company Records
Company Re<:ords
Company Rec01ds
Comnanv Records
Reference
Company Re<:Oids
Company Reco<ds
Company Records
Comoanv Records
Referenc:.e
L(2) C(2)
L{2) C(1)- C(2) - C(J)
L(9) + L(10)
L(6)C(2l
1.{6j_C{IJ- C{2) C(Jl
L(12) + t(13)
Modeled Losses (1)"" (2)
Direct and Assumed Net
.. .......... ....... . 0 .......... :o
Company Code 37206
(J)t Ceded Amounts With
zero C1odil Ftisk Charae
............. 0 ................................... 0 .................................. 0 . .................................. 0 ............................ 4.000 ........................... 4.000 .................................. 0
39000
Direct and Assumed
(4) Amount
..... 0 .. 0 ... 0
.......... 0
................. 0
39.000 Ceded Amounts with
zero Credit Risk Net Charge
Factot
1.000
0.100
1.000
0.100
.......... 0 ................ 0
......... 0 ........ ... 0 .... 0 .................. 0
(5) RBC Requirement
.... .... .. 0 . ........ .... .............. 0
0
• Li-les (t)-(8), Mode~ lonn to be ente-r~ on these l.u1es are to be e.ak:ulateel u$4ng one of the approved comme~lly ava1rable catastrophe rnodefs.- AIR, EOECAT, RMS, ARA Mutloss (Hu~e only). or the Florida Publcc Model {H'urrieane onPy); and using the insurance company's own inJUred prop-my ex,posure infonn.aUon as: inpu'l$ ~o the model.. The insu111noe company may elect to use the mOCfeleO resuns from any one of the moclels, Of any com~ation of the utsAJh of two or more of tl'le models. Each iftsuter will not be tequited to utilize any prH(tibed set of moeltJing anum;ptlons. bul wiD be e~pected lo use the same da,a. modeling. and essumptions that tt\e ins1.1rer uses in its O'Ml internal cAtastrophe: fisk rno:maoemenl prou:u. An ~nestenon to this etrcet and an e .. planauon of the compMy's key assumptions may be required. and tho company's c.aiastrophe data and modeling may bo subj ec.t to e;•omination. t Column (3) is modettd catostropM loue&U'Ial would be cMN to tl\e eetegoriu of flinsur~ U'lat ate not subjeCI to 11\t RBC a~ it ris.k ch;.rge (i.e .. U.S. ;sffi~tes a·nd rn;and31ory pool$, ~thtr authorized. una~ed, ot cenifi:M). "'Column {1)-For companies that ere pan of en .,let<empany pooling atrangement tho lonet In this totumn shoukf be con.ajstenl with thos.e reported in Schedule P. i.e .. to5Sts reported in this cotumn ihould be tM oroulosu.s fg, the ~mUltiplied by tt\e oompan)fs. s.hare of tM pool.
INTERROGATORY TO DETERMINE EXEMPTION FROM COMPLETING PR025 (To be completed by companies that are participants in an inter-company pooling arrangement and/or an inter-company quota share reinsurance agreement.)
WI (1) Has the company.entated ir1tO a reinsuraf\Ce agteement coverin.g earthquake or hurricane exposure with a r1on-affil&ate or a non.u.s. affiliate? .
(') If a par1kipant in an inter .. company pool. is the company's pool percent3ge 0%, teaving no net ex.post.Jre for earthquak.e and tlurrleane risks? ....
(3) II a panicrpant In a quota Share reins..-ance agreement. does tne company cOde ·100% or its eanhquake and hurricane exposure. leaving no net exposu~ lor earthquake and hurricane risks?. .. ..................... ................................ - .................. ................................................................. ..
II the answer to queStion 1 is ' N" and the answer to either que'Stion 2 or 3 is ·v·. tile company does not have to compl&te this page.
-u ::0 0 N C1>
-- ··-------- .. ··--··- ---· ---·- - ---- ·- ·---··----
PRBC
Contractors Bonding and Insurance Company
CAPITAL NOTES BEFORE LIMITATION PR026
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(II)
(12)
(13)
(14)
(15)
(16)
(17)
Years lo MaturiiY at the Time or the Stat~tmonl
Capital Notes Maturing 15 Years ar less from the Year of Issue
Greater than 0 and len than or equal to 1 ........
Greater than 1 and tess than or equal to 2 .....
(1) Ortglnat Pnnclpal
Amount
Greater lha.n 2 and less lhao or equal to 3 .............................................................................................................................................. .
Greater than 3 and leu than or equal to 4
Greater than 4 and tess than or equal to S
Greater than 5
Capitol Notu Maturing more than 15 Years from U>e Year of bsue
Greater than 0 and less than or equal to 1 ................................................................................................... ..................................... .
Greater Chan 1 and less than or equal to 2 ................................................................................... .
Greater than 2 and less than or equal to J .......
Greater than 3 and tes$ than or equal to 4 ......
Greater than 4 and less !han or equal to 5 ............................................................................................................................. ..
Greater than 5 and less t11an or equal co 6 ......
Greater than 6 and less t11an or equal to 7 ............... .
Greater than ? and fess than or equal to a .......
Greater than 8 and less Chan or equal to 9 ............................................................................................................................. ..
Greater than 9 and less than or equal to 10 ........................................... .
Greater than 10 .......... ..
181 Credit tor Ca<ntal Notes Before Umilation IS<Jm of lines t l throuoh 11 7ll • Column (4) rs calculated as 1110 lesser ot ColUmn (2) Of Column (3).
Limitation Factor
0.000
0.200
0.400
o.eoo
0.800
1.000
0.000
0.100
0.200
0.300
0.400
0.500
0.600
0.700
0.800
0.900
1.000
(2) Limitation on
Principal Amount
.... 0
...... 0
................................... 0
................ 0
.............................. 0
(3) Current Plfncipal
Amount
Company Co... •7206
(4) Crodit to Total
Ad'usled Capital·
.................................. . 0
........... . ................. 0
......... 0
................................... 0
... ... 0
..... 0 .......................................................... .. 0
................................... 0
........... 0
.......................... 0 ...
..... 0
...... 0
.. ....... 0
.... 0 .............................. ... 0
................................... 0 ...................................... ................................... 0
............. 0 ...
.............. 0
............. 0 ....
................................. . 0
............ 0 ....
............... 0
0
................ 0
................. 0
......................... ..... 0
............................ 0
.. ..... .... 0
.0
0
"'0 :::0 0 N ~
PRBC
Contractors Bonding and Insurance Company
CALCULATION OF TOTAL ADJUSTED CAPITAL PR027
Annual Statement Reference
Capital and SUip\vS .•. ........ P3 Cll37
Non-TabUlar Discount -losses .............. . .. S:ch P PI • Svm C32 L12
(1)
(2)
(3)
(4)
(5)
Non-TabVI;,. DiscOunt· Expense.......................... .... .. ........... Sch P PI ·Sum C33 l 12
Discount on Medical lOSS Rese'rves Reporte<l as Tabular in Sclle<lule P. .. Company Records
Discount on Me<llcal ExpenS<! ReS<!rves RePOrted as TabVIat In Sehedule P. . .... Company Reoords
·. (6) (7) (8)
(9)
P&,C SuDS NOr>-Tabular Dis_COYnl · Losses. .......................................................................... SubS Soh P Pll ·SUm C32 L 12
P&C SuDs No~ TabUlar Discoonl- Expense......... Subs Scli P PII • SUm C33 l 12
P&C Su~• Discount on Medical loss Re .. rve• RePOrte<l as Tabular in Soheduk> P . ... Subs Company Reoords
P&C Subs Discount on Medical Expense Reserves Reported a• Tabular in Schedule Sub• Company ~e<:ordo P................................................ ......................... . ... ........ ................. .
(10) AVR - Life Sub$ .. H········-···:··--····· ....... 3vbs P3 C1 LZ4.0t
(II) Dividend l iability -life Subs.................... .. ........... Subs P3 Cl l6. I • l6.2
(12) Total Adjusted Ci!>ilal Before Capital Noles l(l) • l(2) • l(3) · l (4) · l (S) ·l(6) • l(7) ·l(S) ·l(9) •l(IO) + l(ll)
C~K lor CopKal Notes
(13.1) SIKpluS Noles ............. ..
(I 3.2) limitation on Capital Notn ..
(13.3) Capital Notes Belote Limitation.
(13.4) Credit tor Capital Notes.... ........ .. ..................... .
(f4) Total Adjusted Ci!>ital (Post-Oelern!d Tax)
Sonsltlvlty Test:
(15) Detorrad Tax Assets ..... ..
(15.1) OelerredTax Uabilities .. .
(16) Deferred .Tax Assets'"' Subsidiaf)l ...................... ....................................... .
(16.1) Oet.,red Tax liabilities lor SUbsidiary.
(17) Total Adjusted Capital F<>< Sensnivi~ Test
..... Page 3 Col..-nn I line 33
............. 0.5 x [line(12) ·line (13.1)J·line 13.1, but not less than zero
.... PR026 Column (4) Line (18)
.. ......... Lesser of CokJmn (I) Line (13.2) 0< Line (1 J .3)
Line (12) • Line (13.4)
Page 2. Colurm 3, line 18.2
.............. ~ Page 3, Column 1. l ine 7.2
......... Company Record
Company Re<:<><d
line (14) ·Line (15) • line (15.1) . Line (t6) • Line (16.1)
(I) Statement Value·
...J11,491 .623 .... 0
.......... ;, ........... 0
.. ................................ 1!
.. ............... 55 .745 ,812
............................ 0
.... 2.956,499
.. ........ 0
Ex OTA ACL RBC RaUo Sens"lvlty Toot
(18) Deterred Tax Asset Page 2 Column 3 Line 18.2 ................... 2.956.499
(19) Total A4justed Capital less Deferred Tax Asset
(20) Autho~zed Contrcllevel RBC
(21) Ex DTA ACl RBC Ratio
• Report amounts in thiS column as whole dOllars.
line (1 4) tess line ( t8)
P·ROJ2 CO<npatison of Total Adjusted Capital to Risk·
Base<l CapKal Une (4)
line (19)/line (20)
Factor
1.000
1.000
1.000
1.000
1.000
1.000
1.000
i.ooo 1.000
1.000
0,500
1.000
1.000
1.000
1.000
1.000
Company COde 37206
.............. ..1 11. 49'1.623
............ 0 .. I!
.... 0 .. 0
................... 0
............................. 0 ......... 0
....... 0
..... 0 .... 0
111,491.623
...... 0 111.491.623
.......... 2.956 ,499
............. 0 .. ......... 0
.. ................................ 1! 108,535,124
................... 2 .956,499 108.535 ,124
6.926.412
1.566.975
• -===-=:- --: ·--:-:·
"'0 ::u 0 N 00
PRBC
Contractors Bonding and Insurance Company
Calculation of Total Risk-Based Capital After Covariance PR028 RO-R1
PRBC 0&1 Referent<!
RO ·Assai Risk· Subsidiary Insurance Companies
(1} Affiliated US P&C Insurers - Directly Owned .. ._ PR003 L(1) C(S)
(2) Affiliated US P&C Insurers - Indirectly Owned ................. , .. PR003 L(4) C(S}
{3) Affiliated US life Insurers- Oifedly Owned ------ -- -- ----· ._,.,._. .... ._ ... PR003 l(2) C(S)
(4} Aftibated US Life Insure~- Indirectly Own~ ........................... .. ... PRoo3 L(5) C(5) (5) Affiliated US Health Insurer- Directly Owned ............................................................................................................................. PR003l(3) C(S)
{6} Affiliated US Health Insurer -lndireetly Owned ..... ....................... ... PR003 L(o) C(S)
(7) Affiliated Allen Insurers · OlreGtty Owned ......... .. ............. ._ ..... . ...................................... .... ... ._ . ................ PR003L(8} C(S}
(8} Affiliated Allen Insurers· Indirectly Owned....... ..._ ........ ._ ............... ._ ............................................................. PR003 L(9} C(S)
(9) Mise Oil-Balance Sheet· Non-<:<>ntrolled Assets .. .. ................................................................................................ ..... P,R013 L(12) C(3)
(10) Mise Off· Balance Sheet - GuarantHS tor Affiliates ....... .. ................................ -........ .. .................................. PR013 L(13) C{3)
{II} Mise Off-Balance Sheet- Contingent Uabililios .. ........... ........................... .. ............... PR013 L(1 4) C{3}
{12) Mise O!f·Balance Sheet· SSAP No. 101 Par. 11A OTA...................... ... ............................ . PR013 L(16) C{3)
(13) Mise Off-Balance ShHt - SSAP No. 101 Par. 11B OTA ......... PR013 L(17) C{3)
{14} Total RO ................................... .. .. ............................................. - ................. L(1)+L(2)+L(3}+L(4} +L(S)+l(6)+L(7) +L(8)+L(9}+L(10)+l (11) +L(12} • L(13}
R1 · Asset Risk · Fixed InCome
(15) NAIC Ot U.S. Government Agency Bonds ..... ... PROOS L(2) C(2)
(16) Unaffiliated Bonds Subject to Size Factor .......................... PROOSL(21) C(2}+ PR014 L(9} C(4}
(t7) Bond Size Factor RBC .. .. .................................................................................................................. PROOS L(24) C(2)
(18) Bonds - Affd Invest Sub ............................................................................................................................................................... PR003l(7) C(4}
(19) Bonds- Affd Hold. Co. in excess or Ins. Subs ......................... .. .... PR003 L(10) C(4}
(20) Bonds -lnvHtm@nt In Parent .......... ................................. . ....... PR003 L(11) C(4)
(21} Bonds· Affil US P&C Not Subj to RBC .......... .. .................... PR003 L(12) C(4}
(22) Bonds- Affil US Life Not Subj to RBC .......................... ................................. .............................................................. PROOJ L(13) C(4)
(23) BOnd$· Affil US Heallh ln&urvr Not Subj to RBC ...................................................................................................................... PR003 l(14) C(4)
(24) Bonds - Affit Non-insurer.................................. .. ..................... PR003l(1S) C(4)
(25) Other Long-Term AsseiS - Mortgage Loans. LIHTC & WCFI ........................ .. PR007 ·
(26)
(27)
(28)
(29)
(30)
(31)
(32)
Mise Anets 7 CoRateral loans ........ . Mise Assets- Cash .......
Mise Assets- Cash Equivalent& .............................................. ~ ..................... . Mise ASsers · Other Snort-Term Investments ..
Reptlc.1ti<>n -Synthetic Asset: One Han •...... ._ ... .. ........................... - .... ...... ............. ._.
Auet Concentration RBC • Fixed rncome ..... . Total R1
L(10)+l(13}+l(14)•L(15}• L( 16)+L( 1 7)• L(20}•L(21) C(2}
.. PR008 l(14) C(2}
..... PR008 L(3) C(2)
....... PR008 L(6} C(2} • PR014 l (20) • L(21) C(4)
......... PR008 l(11) C(2}
....... PR009 L(9999999}C(7)
....... PROIO L(7) C(3) Grand Total Page
~~~~~~~~~~:~~~~~:~~~g~~1\
Company Code 37~06
(1} RBCAmovnt
......... 0 ........ 0 ....... 0
.......... 0 ..................................... 0
.. ............... . . ...... 0 ....................... ..... 0
................ 0 ........................................ .50 .224
..... 0 .... 0
......... 13,912 ...... 1.740
.......... -......... .. ... ...... .65 .876
.. ............................... ....... ..... 0 ...... 564 .285
....................................... 549.614 ....................................... ... 0
...... 0 .0
........................ ......................... 0 ....... 0
................................................ . 0 ..... 0 ..... 0
........... ...... 0 4.735
..... 0 .. ...... ........................... 0
. ....... Jl .. ........................... ........... »3.44$
1.212 .079
""0 ~ 0 N
• CD
PRBC
Contractors Bonding and Insurance Company
CALCULATION OF TOTAL RISK-BASED CAPITAL AFTER COVARIANCE PR029 R2-R3
(33)
(34)
.. (3~)
(36)
(37)
(38)
(39)
(40)
(41)
(42)
(43)
(44)
(45)
(ole)
(47)
(48)
(49)
(50)
(SI)
(52)
(53)
(54)
(55)
(58)
(57)
(58)
(59)
(60)
(61)
Description
. Rl ·.Anot Rlak ·Equity
common. Affiliate lnvestminrSubsidiary
PRBC 0&1 Reference
......... PR003 l(7) C(2)
.. PR003 L(IO) C(2) Common. AtliMte Hold. Company In excess or Ins. Subs •.
Common • lnve~lment in Parent ... .......................................................... PR003 L(lt) C(2)
Common. Af/'d US P&C Not Subj to RBC .: ........... . ........................................................... - .................................... PR003l(t2) C(2)
Common . !lffif US Liie Not Subj to RBC ................................... _ ..... . ............................................................................ PR003l(13) C(2)
Common . Atlil US ~ .. nh Insurer Not Subj to RBC .............. ..
Common • Aff'd Non-insurer·-···-- · ··· ········ ·····~·· ·· ·· · ... ··
Preferred - Afl'd Invest Sub ...................................................... .
Ptelerred - Affd Hokf. Co. In excess ot Ina. Subs . .. ..
Preferred • lllvestment In Parent ......... .
Preferred· Af!il US P&C Not Subj to' RBC .................................................................................. ..
P<eferred : Atril ~s lffe Not su·bj to RBC
Pteferred • Atfii .US Hultti Insurer Not Sub) to RBC
PRODJl(14) C(2)
.... PR003l(15) C(2)
.......... PR003 l(7) C(3)
PR003l(10) C(3)
........................................... PR003 L(tt) C(3)
. ............. P R003 L( 12) C(3)
........ PR003l(t3) C(3)
........ ................................. PROD3 L(14) C(3)
Preferred. Aflil Nor>-insunH' ............................. -.... .. .................................. .............................. PR003 L(tS) C(J)
Unaffiliated.Preferred Stock and Hybrid Securftles ... .. ........................ ............ PR006 L(15) C(2)+PROt4l(16)C(4)
Unaffiliated Common Stock .... : ... ...... .'............................ ....................................................... ..... .. ..................... PR008 L(22) C(2)+PRO 14 L(17)C(4)
Other Long-Te;.,As!ets ·Real Estate ........ _ ... , ................................................................................... ............................. PR007 l(7) C(2)
·_other Long-Term Assets . Sche<lule SA Assets .............. .
M!•c _Assea. Receivable for Securities ............... ..
Mise Assets- Aggregate Write-ins for Invested A$Sets ..
.. ................ PR007l(19) C(2)+PR014l(18)+PR014 L(I9)C(4)
.. ........ PR008 L(t) C(2)
.......................... PR008 L(2l C(2)
Mise Assets~ Derivatives .................................................................... ..................................................................................... PROOS L(t5) C{2)
Replicat!on -SynthetiC Asset. One Half :..................... .. ................................. ..
Asset,Concentration RBC- Equity ....... ..
Total R2 .......................................................................................................................................... ..
R3 • Asael RISk· Credit
........... PR009 L(9999999) C(7)
....................... PROtO L(24)C(3) Grand Total Page
.. ........... .. ........... ...... l(33)+l(34)+l(35)•L(36)•l(37) •L(38) •l(39)+ l(40)+l(41)+l(42)+l(43)+l (44)+l(45)•l(46) +L(47)+ L(48)+l(49)+L(SO)+l(St )+L(52)+L(S3)+l(54)+L(SS)
Other C<edit RSC .............. ___ _____ ................................................. .... .. .. ............ - .............................................. PROt I l (19) C(4) ·l(13) C(4)
One half of Rein Recoverables ......................................................................... .
Other half of Rein Recovetables ..................................................................................... ..
..... ........ 0.5 x PR011 l(13) C(4)
.............. If R4 l(63)>{R3 l (57) • R3 l(S8)). 0. othe<Wi.se. R3 L(S8)
Health Credit Risk ......................................... ........... . ................................................................................... : . .................... PR012l( t2) C(2)
TotaiR3 L(57)_+ L(S8) • L(59}_ • 1.{_80)
Company Code 37206
(I)
RBCAmount
...... 0
. ..... 0
.................................................. 0
. ...................... 0 . .................. 0
........................ 0
............................. 0 .......... . ....... 0
..... 0
.................................................. 0 .... 0
............. 0 ................... 0
................................................... 0
.......... 0 ......... 0
........... 0
. .......................... ........... 0
...................... ....... . ..... 0
................................................. 0 .. ..... ............ 0
. ...... 0
..0
.......... 0
................ 28 . 183
....................................... 385.850 .. ......................... 0
........................ ......................... 0 414 .033
'"C ::0 0 w 0
===-==-· ··-- .. =--=---~----..:- ----·--=======:::::-:-==~==~:-=-
PRBC
Contractors Bonding and Insurance Company
CALCULATION OF TOTAL RISK-BASED CAPITAL AFTER COVARIANCE PR030 R4-R7
(62)
(63) (64)
(6$)
(66)
(67) (68)
(69)
(70)
(71) (72) (73)
(74)
(75)
(76)
(77)
(78)
(79)
(80) (81)
{82)
Description PRBC 0&1 Reference
R4- Underwriting Risk· Reserves If R4 l (63)>(R3 l (S7) + R3 l (58)). R3 L(S8).
One haH of Reinsurance RBC .....••.... • ...................... ...................... . otherwise. o
Total Adjusted Unpaid l oss/Expense Reserve RBC ....... ........ .... -..... . . PROI6L(I S) C(20)
Excessive Premium Grow!h- Los$/Expense Reserve....... ...... ..................................... . .. PR01SL(I3) C(8) A&H Claims Reserves Adjusted for LCF ...................................... PR023 l(S) C(2) • PR022 l(6) C(4)
Total R4 .... - .............. _ ...... _ .. ., . ... ............................................................................................................................................... l(62)•l (63)•L(64)+l(65) RS - Underwriting Risk. Not Wrtlten Premium
Total Adjuste<l NWP RBC ........................................................................................................................................................... PR017l(15) C(20) Excessive Premium Growth - Wl1tten Premiums Charge •... Total Net Health Premium RBC .
Health Stabilization Reserves ......... - ....... ...... - .... .
Tolal RS .................................... .
. ................ PROI$l{l4) C(8) . ...........................••• ............................ PR021 l(21)C(2)
............................ . ...... PR024 l{8) C{2) + PR022 l(J) C(2) . ............... l(67)+l(68)+l(69)+l(70)
Total RBC After Covartanc;o oxc;ludlng Cataetroph9 Rltk co RO • 3QRT(R1 .. Z•Rz·z•R3 .. 2•R4"'Z•Rs .. z• ..
· Autl1orlzed Control level RBC excluding Cotaol rophe Risk a .& x L(72)
For Informational Purpoaes On tv R6A - Underwrtllng Risk ·Net Wnnen Premium Toral Adjusl e<l NWP RBC ............................... . . ................................................................................................... PR017A l(1S) C(20) Excessive Premium Grow!h - WTinon Premiums Charge ........................... ............... - ...... - ................. ·-······ ..•..•.•.. . PROI5l(14) C(B)
Total Net Health Premium RBC ................................................................................................................................................... PR021l(21)C(2) Health SlaOIIIzaflon Reserves ...... PR024 l (B) C{2) + PR022 l (J) C{Z) Total R5A .......... . . ............................. l{74)•l{75)•l(7G)• L(77)
R6-Cal .. tropho Risk for Earthquake
Total RS ............. - ............................................. . PR025l(1 1) C(5)
R7-Catastrophe Risk for Hunrtcana Total R7 ....................................................... . . .............. PR02S l(14) C(S) Total RBC After Covarlancolncludlng Catostropho Risk • RO • SQRT(R1•2+R2•2+R3•2+R4•2•RSA•2+R6•2+R7•2) ............... ......................... . Aut11orlzed Control Level RBC lncludlna CalastroJ>he Risk ~ .5 • LIB II .. .
Company COde 3720~
(1) RBC Amount
······ ····················· 385 .850 ....................... 10.639.680
.................................................... 0 ........... . . .. ..... ... 0
... 11.025 .530
................................... 8 , 177 .840 ................. ... 0
...... 0 ........ 0
. .... 8 . 177 .840 .................................. 13,852 .82•
6.926.412
...... .7 .654 .240 ..... 0 .... 0 .... 0
.... .7 .654.240
........ 0
........ 0
.. .......... 13.548.838 . .. 6.774 .419
PRBC
Contractors Bonding and Insurance Company
TREND TEST PR031
Annual Statement Source
Or!alnal RBc•a Before Aoplylno Trend Test
(1) Authorized Contlollevel Risk·Based Caphal. ................................................................................................. PR030. C( l } L(73)
(2) Total Adjusted Cspital... .......................... .. ......... PR027, C(2) L(14)
(3) RBC%.,.................. .. ...................... ,............ ..... .. ........ l(Z)C( l )ll(l )C(l )
Combined Ratto Oata
(4} Premiums Eamed ....................................................................................... ..
(5) Losses Incurred. .................... .
(6) Loss Expenses Incurred
(7)
(8)
(9)
Other Undcrwritin9'Expen3es lnevrted ... :._ ...... - ............ .
Aggregate Wr~e'-<ns tor'lJnderwnling Deductions ......................... ..
Dividends to Pollcyhold~rs ........................... .
(I OJ Net Wrinen Premiums .........
Comblnad Ratio Calculation
.................................... Pg 4, Col i , L I
...................... Pg4. Col l , l2
............................... Pg 4, Coli, l3 ...... Pg 4,Col t , l4
... Pg 4, Coli , L5
.................... Pg 4. Col l. l 17
....................... Pg s. Col G. L 35
(I 1) Loss Rallo ......... : .. .................................. , ............................... (Pg • . Coli. L 2 + Pg 4, Coli. L 3(/ Pg 4. COil. L 1
(12) Dividend Ratio .. ..
( t3)
(14)
(IS)
Expenses Ratio ..
Combined Ratio ..
Trend Test Result t
. ..... ~..: ....... :..-····--···--···:, ..
t The Trend Test applies only if Lt15) • Yos.
Pg 4, Col l . l 17 / Pg 4. Coli, L 1
(Pg4, Coli, L4 + Pg4, Coli, l SJ1Pg8, Col G. L3S
.. .... L(1 1)+l(12) +(LI3)
H L(3) Between 200% & 300%& l(14)>120%, L(I S). YES. Ot~se.NO
: If ~su~"' YES, the company triggers regulatory aHenlion at lhe Company Action Level based o~ the trend teol.
( I)
Amount
......... 6.92jj ,412
.... ..111 ,491 .623
.... 1.609.700
..... 49 . 192.548 ...... 6.315.180
. ..... .4.511.795
..... 20 .630,085
. ................................. 0 .. ...... 0
........ 50 .040.709
............. 22.000 .. ...................... 0.000 ........................ !!7 .214
..... ..79 .214
Note: This page is for information only unti11he modifications made by Cspital Adequacy Task Fo<ee to the Ris~·Based Capital (RBC) tor Insurers Model Act are implemented by slates.
TREND TEST INCLUDING CATASTROPHE RISK
For Informational Puroosos Onlvl
(16)
(17)
(18)
Au.tnorlzed Control Level Risk-Based Cap;tal including Catastrophe Risk .... ....................... - ............. PR030. C(l} L(82)
RBC % ..... .. ............ L(2)C(I}/L(16)C(I }
Trend Tesl Resutt • n l ( l7) Between 200% & 300% & l(14)>120%. YES. Otherwise NO
• If result = YES, the eompany tr;ggers regulatory attention at Uw Compaoy Action tevel based OPI'I the trend test.
..... 6.774,419
.. ... >.645 .800
Company Code 37208
(2)
Result
"U ::u 0 (;.) N
... ===-:-:c::::::====··=~...: ~..;: : · · .. . -:.=-:-:·-
PRBC
Contractors Bonding and Insurance Company
COMPARISON OF TOTAL ADJUSTED CAPITAL TO RISK-BASED CAPITAL PR032
Oescriotioo AbbreviatiOn
Excluding the Trend Teat:
(I) Total Adjusted Capital (Posi-Oelerred Tax: PR027 Line 14)
(2) Company Action level = 200% of AuiMrized ConllC>Ilevel. ........... CAL
(3) Regulatory Acti<>n Level= 150% of Authorized Conllol leveL.-.•• .. : .. •.•..••.•.••••••. - ··-···---····-····-······-· ... •· .••.• .... RAL
(4) Authorized Control level = 100~. of Authorized Control level. . ........ ACL
(5) Mandatory Control Level = 70% of Authorized ControllevoL ..•..... ................•...•............•.•............•.................................. ..MCL
(5) Level of Action. if Any (excluding the trend test).
nctudtng t he Trend Test :
(7) Level or Action. if Any (including the trend test)
THE FOLLOWING NUMBERS MUST BE REPORTED IN THE FIV,E YEAR HISTORY EXHIBIT ON T_tlE INDICATED LINE
Total Adjusted Surplus to Policyholders Five Yr Hi$1 Cl l 28
Authorized Control levot Risk-Based Caoital Five Yr Hist Ct l 29
(I ) Amount exd\Jding Catastroohe Risk
................ 111.49t .623
...................... 13.852.824
.... 10. 389. 6t8
...... 6.926 .4t2
... 4,843,488
Compe ny C'- . _,7206
(2) Amount Including Catastrophe Risk
.... 111.491.623
.. 13.548.838
. ........ 10 '161 .629
............... 6.774 .419
................ 4 .742.093
.•....•. NONE. ................................. .
~E.. . ...................... lONE. ................................. .
l(I)C(I) .......... 111 ,491 .623
U4lCIIl ........................ 6 .926 .412
"'0 ::u 0 w w
PRBC
Contractors Bonding and Insurance Company
UNDERWRITING AND INVESTMENT EXHIBIT - PREMIUMS WRITTEN PR033 (t ) Oid yoor company write Accident and Heafth Insurance In 2012 ? ............ - ................ .
1r answer is yes. please·eomplete coromn 2. 201 2 Net Premiums Vllntten. (2) Old yoor company write Accident and Health ln•urance in 2011 ? .......
If an~wer is ye!.. please compfete Colu'mn 3, 201 1 Ne1 Premiums VVI"itten ..
............. No
.. ............................ No
(3) were the total net Premiums w~uen zero in 20t2? - ....... - .... - .................................. _ ........................................ ......... No (4) Weie the total net Premiums wrillen zero in 2011 ? ...... ···············-·-······ ···········---··-···· ................. No
FOr all companies, enter net aremlums written In aU Columns. Lin• 1 throuah Line 34
Company Code 37206
(1) (2) ( t ) ~3 ~~ -1
Line or Business Net PremiuMs Wrinen Net Premiums Written Net Premiums Writ1en t . Fire .......................................................................................................................................................................................................... ....... .............. . ...... 1 ,811 ................ XXX ................................ XXX .............. .. 2. Allied lin.. ..................... .......................... .. ............ 1.491 ................. XXX ................................ XXC .............. . 3. Farmowners Mu«iple Pera ....................... ................. ........... ..... .. ................. 0 ............... XXX ................ ............... .XXX. ..... ....... .. 4. Homeowners Multiple Peril..... ................... ................ .. .................. 0 ................ XXX ................ .............. .XR ............. .. 5. commercial M"'iple Peril ................................................ ........ ................ .. .... 29.991.684 ................ XXX... ............................. XXX. 6. Mortgage Guaranly ....................... ........................................ . ....................... _..... . ........... _ .............................. ........................... ...... D ................ XXX ............................... XXX ............... . 8. Qeean MMne . .............................. ........ ........................ .............................. .. .................................... ...... ........ ................. 0 ....... XXX.... .. ........... XXX... ... .. .... .. 9. Inland Marine ........................................... ............................................... .. ............... 2 .59t ....... XXX ................................ XXX ..
tO. Financial Guaranly ............................................ ......................... ......................... ........................ .. ........................... 0 ......... XXX. .. ..... XXI. .. .. .. t 1. t Medical Professional Uabirrty . Occurrence ......... ................................... .............. ................ ............................ .. .............. 0 ...... XXX .............. XXX. ..... . t t .2 Medical Prot .. sionalliability. Claims-Made ........... ......... ........................................ . ............................. 0 ................ XXX.... .. ....... XXX ...... . t 2. Eartllquake ................................. -....... .......................... ........................ .. .. .. ... 0 ................ XXX... .. .................. XXX... .... . t 3. GroupAcddent and Health• .. _............................................... ............................ . ........................................................................................ 0 ......... ......................... 0 .................................. 0 14. Credit Accident and Health (group and individual) .. .. ........... -....................................... .. ............ -................ .. ..................... 0 ........... 0 .............. 0 t s·: Other Accident and Health .......... ...... ....... .................. ...... .. .................. 0 ............................... ... 0 ................................. 0 t 6. WOII<ers' eompensalion ............................... ...................................... ..................... ........ .. .................... 0 ..... XXX.. .. ........ ... XXX .... . 17.1 'Other liabilily • Occurrenoo .............................................................................. _ ................................................... .. .......... 320 .996 ............... .XXX.. .. ........... XXX .............. .. t 7.2 Other liabilily. Claims-Made ..... ..................................... .. ........................ . ....................... ........ 0 ................ XXX ................ ................ XXX .............. .. 17.3 Excess Workers' Compensation........ ....................................... .......................... .. ....................... 0 ........... XXX................ .. ........... XXX .......... .. t &. t Products liability. Oocurronce . ......................... ........... ... ..................... .. .. ... 264 ,693 .... XXX....... .. ............ Xn ............. .. 16.2 Produel& Liability · Claims-Made ..................... 0 ................ XXX ................................ XXI:.. .... .. t 9.1,19.2Private Passenger Auto Uabilily ...................... ............................................. ........................................................ .. ............ 0 ................ XXX ................................ XXX ................ . t 9.3.19,4Cdmmereial Au:o Liabilily .................................. .. .... t . 195 ,046 ........ XXX .... XXX. 21. · Auto Physical oamage ..................................... ....................... ..................................... ........................ ... ........ .. ......... 378 .463 ...... XXX. .. ........... XXC ......... . 22. Aircraft (all perils) ......................... .. ................ 0 ................ XXX... .. .............. XXX.. ...... ...... . 23. Fldetily ......... --..... - ....... . ...................... - .............. ...................................................... 410 .436 ....... XXX................ .. ....... XXl 24. Surely........................................... ................................................. ............................ .. ..... - .......................................................... 17 .473,478 ................. XXX ................................ XXX ............... . 26. Burglary and Theft . ......................................... ....... ....................... ......................... .. ..................... 0 ..... XXX. ................ XXX 27. Soller and Maellinery ................................. ........ ...................................... .......................... .. ....................... ...... 0 ......... XXX...... .... .. ........... .XXX... ............ . 28. Credit ..... ....................... . ....... .................................. 0 ....... XXX.......... .. ... XXX .............. .. 29. International.................... ............................ ................................. ........ .................. .. ............. ........ 0 ................ XXX........... . ............ XXX 30. Warran1y .... :................. ......................................... .. ........ 0 ......... XXX. .. ..... XXX .. .
~~. ~::::~~:::-ri~:,;_ ~ ~· -.~.~~~~~~~-.~-.~~···~~~· ~·~ -~ ~~~ ~~~~~~ ~ ~~~~~•••••· ~· ·~· ::: :::::~::: ~·· :: :::::::::~~·· ::::::::::::::::: . :::~:::: :. :::: ~:::::::::: :::::::·.:::.-. ~-.::.: .: ... : :: ::::: : ... ::::::::.:: ::::::::::: ::: ::: j ...... :::: ::: ::~~t ...... ::::::: ::: .:::: :::~:3~L :::.:: :::::: 33. Reinsurance Financial l ines ... .................. ......... ............. .... ...... ...... ..................................... .. .......... ............. 0 ........... XXX. .. ............. XXX ............... .
~~. A~~~~i~ Vllnte-lns lor Other l ines of Business ....... .. ...... -...... .......... .. . .. .. ........... ..... .... .. . .. . ....... .... · sij' 'i);ro'j~ · ... . ...... X~:fiii4 :·4ti · ... .... -~;:932 6zaT
···-------- ----- ---- ------ - - -· ---------
PR8C Company Code ) .... •
Contractors Bonding and Insurance Company
SCH F PT 3 REINSURANCE CREDIT AND MEO TABULAR RESERVE PR036
( I)
(2) (3) (4)
(5) (6) (7) (S) (9) (10) (1 1) (12) (13) (14) (1 5) ( I&) (17) (18) 119) (20) (21) (22) (23) (24) (25) (28)
jzri_
ze
Crf!Oil Risk 10r Receivables Annual Slatement Seutet' Adjustmenl For Reinsurance Penally For Affiliate•
-AcOii..,l>le to Schedule F SchedtAe F Pan 3, LOIU999, L0499999, l 1499999, L 1799999, L2799999 ond
Line
PR0 11
Column Value
L3099999 ,........................................... ............ ..................................... .. .................... ...... . .............. ................. .. SchediAe F Pan 3. L 1 t 9e999. Amounts AMbutablo To Exempt Pools ............... .................. 1.3 ................................... 2 ...................................................... .. Sched!Ae F P8113. L2499999. Amounts Anributable To Exempt Pools ... .. ....... 1.3 ................................. 2 ................................... .. Sdled!Ao F Pan 3, L3799999, Amounts Anrti>Uiable To Exempt Pools ........ .. ........ 13......... .. .......... 2 ...................................................... ..
U..deMr1Cing Risk - Rese<Vel
Annual Stot-t Source: Medical Tabular Reserve OiSCO\Inl
Homeowner/Farmowner ............. - ................................... .. ........ .............. .. Private Pan Auto llob ....................................................................................... ___ , Comm Auto liab ........................................................................................................... .. WOII<ets' Comp ............ ...................... •••• . . ..... .. ........... ........................... .. Comm IIIIAU Peril ,_ ................. ,_ ................................................. - ...................... . Me6cal Proleu lonal Liability- OcGutrence , __ , __ ............................................ ..
=I :~re~ l.labo11tf. c~~~~ :::::::::::::::::::::.~::::::::::::::::::~-.::::::::::. Olhtrliob -~ ....... ____________ .. ___ , ____ ,, _ ___________ __ _
~~&;~Mad_·.~·-.::=::::=::_--::::::::-.::_--:::::::::~.::_=::=:::-:::::-. !~;'k~.;;;;·::::::=~=:::~.::.:::::::.:::::::::::::-~::::::::::::::: .. ::::::~-:.-=-OIIlef (Cnedil. A&H) • -------·-··---------·----·--·--·-·--·------------·-· Fin Guoranty/MIIg Guaranty ........................ _ ...................................................... .. lntemallonal - .... ----------·------·--· ................................. _ .. , .•. - ....... . Med;c.l Tabu!¥ Reser.e Discount- Rtltlsu<anc:e: Property - ----·- - --·-- - · Medal Tlbular Restrve Oisc:ount - Rein&uron_.: liability -----------------Medical Tabular Reoer.e Discount- Rtiii$Urance: Financial lines ................... .. Pro4uct Lie~- Occu(rence __ ,, __ ,, ................................................... ....................... .. Proo!uct l iab • Clalmi Made ......................................................................... . Warranty .................................... ................................................................................. .. Totol Underwriting Rit.k • Prom.,, Annual Slatemenl Source: STMnNCOME (llage 4. col. 1. In 4l Other UndtrwrHinq Expenses Incurred
line 7
7 7 7 7 7 · 7 7 7 7 7 7 7 7 7 7 1 7 7 7 7 1
line 6
PRO II
PR017
Column I 2 )
4 $ 6 7
• 9 t 10 11 12 13 14 15 16 17 16 IS IS 19 20
Column
......... -................ , .... _
................................ ii ..
vat"" 28.630 .085
"'tJ ::0 0 (.,) -..J
PRBC
Contractors Bonding and Insurance Company
GROSS WRITTEN PREMIUMS PR037
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
p•l (15)
_(I~
Oescrlotion Annual Statement Source
2013 Company Gtoss Wr1uen Premium .'otrecl... ... Pg a. PREMWRTN. Coil. L35
2013 Company Gro» Wri!!en Ptemlum. Assumed......................... . ........... .......................... . . ................................. Pg 8, PREMWRTN. Cot 3. L3S
2012 Company Oro» Wri!!en Prtmlum • Oire<:L.............................. .. ............ ............... ............ Pg a. PREMWR'TN, Coil, LJS
. 2012 Company G.toss Writlen Ptemlum · Assumed ................................................................................................................................. Pg 8, PREMWRTN. Col3. L35
2011 Company GlOSS Wri!!en Premium . Olrtcl.. .......................................... . .. .. .. ..
201 1 Company Gtoss Wri!!en Premium. Assumed. ......................................................................... . ...... ~-----..
Pg 8, PREMWRTN. Coil, LJS
Pg 8, PREMWRTN, CotS, LJS
'010 r.nmr~.ny r.,,__, \NrfH~ p,.tnlum . nitN:I ················-·····-····-·········· P' e . PR:IEUW'R.YN. Col1. 1..35
2010 Comp~ny Cross WriUen Premium· Aosumed ....... .. ................................................................................................................ Pg a. PREMWR'TN. CotS, L35
2013 Group Groll WMen Premium · Direct. .......... - ................. - ... - ......... -...................................... Pg a. PREMWRTN. Co11. l35
2013 Group Gross Wrilttft Prt"'""" • AUutned. .................................................................................... _____ , ............ - ... - ............... Pg a. PREMWRTN. Col3. L35
2012 Grovp Groos Written Premium · Oireel-----------... - .... - ---...................... - .......... - .. ··-----···- Pg a. PREMWRTN. Coli. L.35
2012 Group Gross WI\!!~ Premium · Assutned.... ·--.. ·----- -----------------------·------------- Pg a. PREMWRTN. Col3. L35
io1 1 Grovp Gross 'wn_t~on Premium· Direct.. .. ·--·-------·---·----·-·--......................... --............................... - .... Pg 8. PREMWRTN, Coil, LSS
2011 Group Groil Written Pre~· Assumed .................................................................................................................................... Pg 8, PREMWRTN. Col 3. L35
2010 Group Gross Wri~en Premllrm • Dlre<:L ............................................................................................................... - .... - ...... _ .. Pg a. PREMWRTN. Coil. L35
2010 Group Gross Wiiften Premium . Assumed Po a. PREMWRTN. Col3. L3S
Company COde 37206
(1)
Slatement Value
..... 55 .423.228
...................... 0
................. 54 .916 .946
......... D . ............... 54 .723 .357
..................... D ................. 60. S13. 373
.................................. 0
............... 170,141.583 _____ .73.053 .709
............. .709 ,106.574 ................ 15 .ti92 .601
............... 648 ,49-1 ,4-12
·-·-.. -·.72. 190.029 . 647 .197.231
49.091 .911