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*69000201620100100*LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION
ANNUAL STATEMENTFOR THE YEAR ENDED DECEMBER 31, 2016
OF THE CONDITION AND AFFAIRS OF THE
Northwestern Long Term Care Insurance Company NAIC Group Code 0860 0860 NAIC Company Code 69000 Employer's ID Number 36-2258318
(Current) (Prior)
Organized under the Laws of Wisconsin , State of Domicile or Port of Entry WI
Country of Domicile United States of America
Incorporated/Organized 09/18/1953 Commenced Business 10/07/1953
Statutory Home Office 720 East Wisconsin Avenue , Milwaukee , WI, US 53202
(Street and Number) (City or Town, State, Country and Zip Code)
Main Administrative Office 720 East Wisconsin Avenue
(Street and Number)
Milwaukee , WI, US 53202 , 414-661-2510
(City or Town, State, Country and Zip Code) (Area Code) (Telephone Number)
Mail Address 720 East Wisconsin Avenue , Milwaukee , WI, US 53202
(Street and Number or P.O. Box) (City or Town, State, Country and Zip Code)
Primary Location of Books and Records 720 East Wisconsin Avenue
(Street and Number)
Milwaukee , WI, US 53202 ,
(City or Town, State, Country and Zip Code) (Area Code) (Telephone Number)
Internet Website Address northwesternmutual.com
Statutory Statement Contact Kevin John Abitz , 414-665-5655
(Name) (Area Code) (Telephone Number)
kevinabitz@northwesternmutual.com , 414-625-5655
(E-mail Address) (FAX Number)
OFFICERS
President and CEO Kamilah D Williams-Kemp Vice President and
Controller Todd Matthew Jones
Secretary and General Counsel Raymond Joseph Manista
Vice President and Chief Actuary David Robert Remstad
OTHERJohn Mitchell Grogan, Chairman Lisa A. Cadotte #, Vice President Karen A. Molloy, Vice President and Treasurer
Ronald Paul Joelson, Vice President and CIO Michael Gerard Carter, Vice President and CFO
DIRECTORS OR TRUSTEESRebekah B. Barsch John Mitchell Grogan Ronald Paul Joelson
David Robert Remstad Calvin R. Schmidt Steve Paul Sperka Kamilah D Williams-Kemp
SS:State of Wisconsin
County of Milwaukee
The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement.
Kamilah D. Williams-Kemp Raymond Joseph Manista Todd Matthew Jones
President and CEO Secretary and General Counsel Vice President and Controller
a. Is this an original filing? Yes [ X ] No [ ]
Subscribed and sworn to before me this b. If no,
day of February, 2017 1. State the amendment number
2. Date filed
3. Number of pages attached Leah Lewandoski Notary Public 11/5/2017
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
ASSETSCurrent Year Prior Year
1
Assets
2
Nonadmitted Assets
3Net Admitted Assets
(Cols. 1 - 2)
4Net Admitted
Assets
1. Bonds (Schedule D) 89,439,856 89,439,856 86,313,518
2. Stocks (Schedule D):
2.1 Preferred stocks
2.2 Common stocks
3. Mortgage loans on real estate (Schedule B):
3.1 First liens
3.2 Other than first liens
4. Real estate (Schedule A):
4.1 Properties occupied by the company (less $
encumbrances)
4.2 Properties held for the production of income (less
$ encumbrances)
4.3 Properties held for sale (less $
encumbrances)
5. Cash ($ 5,409,256 , Schedule E - Part 1), cash equivalents
($ , Schedule E - Part 2) and short-term
investments ($ , Schedule DA) 5,409,256 5,409,256 6,759,355
6. Contract loans (including $ premium notes)
7. Derivatives (Schedule DB)
8. Other invested assets (Schedule BA)
9. Receivables for securities 6,694 6,694 2,603
10. Securities lending reinvested collateral assets (Schedule DL)
11. Aggregate write-ins for invested assets
12. Subtotals, cash and invested assets (Lines 1 to 11) 94,855,806 94,855,806 93,075,476
13. Title plants less $ charged off (for Title insurers
only)
14. Investment income due and accrued 335,398 335,398 301,337
15. Premiums and considerations:
15.1 Uncollected premiums and agents' balances in the course of collection 72,254 72,254
15.2 Deferred premiums and agents' balances and installments booked but
deferred and not yet due (including $
earned but unbilled premiums)
15.3 Accrued retrospective premiums ($ ) and
contracts subject to redetermination ($ )
16. Reinsurance:
16.1 Amounts recoverable from reinsurers 4,862,113 4,862,113 4,467,662
16.2 Funds held by or deposited with reinsured companies
16.3 Other amounts receivable under reinsurance contracts 12,994,757 12,994,757 15,464,434
17. Amounts receivable relating to uninsured plans
18.1 Current federal and foreign income tax recoverable and interest thereon
18.2 Net deferred tax asset 11,582,630 8,537,870 3,044,760 2,975,000
19. Guaranty funds receivable or on deposit 5,394,503 5,394,503 4,719,629
20. Electronic data processing equipment and software
21. Furniture and equipment, including health care delivery assets
($ )
22. Net adjustment in assets and liabilities due to foreign exchange rates
23. Receivables from parent, subsidiaries and affiliates 40,405,532 40,405,532 34,684,258
24. Health care ($ ) and other amounts receivable
25. Aggregate write-ins for other than invested assets 10,833,255 10,833,255 10,282,990
26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 181,336,248 8,610,124 172,726,124 165,970,786
27. From Separate Accounts, Segregated Accounts and Protected Cell Accounts
28. Total (Lines 26 and 27) 181,336,248 8,610,124 172,726,124 165,970,786
DETAILS OF WRITE-INS
1101.
1102.
1103.
1198. Summary of remaining write-ins for Line 11 from overflow page
1199. Totals (Lines 1101 thru 1103 plus 1198)(Line 11 above)
2501. Prepaid Modal Reinsurance Premium 10,828,251 10,828,251 10,122,133
2502. Tax Recoveries in Process 5,004 5,004 109,632
2503. Remittances and Items not Allocated 51,225
2598. Summary of remaining write-ins for Line 25 from overflow page
2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 10,833,255 10,833,255 10,282,990
2
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
LIABILITIES, SURPLUS AND OTHER FUNDS1
Current Year2
Prior Year1. Aggregate reserve for life contracts $ 325,756 (Exh. 5, Line 9999999) less $
included in Line 6.3 (including $ Modco Reserve) 325,756 367,778 2. Aggregate reserve for accident and health contracts (including $ Modco Reserve) 3. Liability for deposit-type contracts (Exhibit 7, Line 14, Col. 1) (including $ Modco Reserve) 4,771,475 3,712,019 4. Contract claims:
4.1 Life (Exhibit 8, Part 1, Line 4.4, Col. 1 less sum of Cols. 9, 10 and 11) 4.2 Accident and health (Exhibit 8, Part 1, Line 4.4, sum of Cols. 9, 10 and 11)
5. Policyholders’ dividends $ and coupons $ due and unpaid (Exhibit 4,
Line 10) 6. Provision for policyholders’ dividends and coupons payable in following calendar year - estimated amounts:
6.1 Dividends apportioned for payment (including $ Modco) 6.2 Dividends not yet apportioned (including $ Modco) 6.3 Coupons and similar benefits (including $ Modco)
7. Amount provisionally held for deferred dividend policies not included in Line 6 8. Premiums and annuity considerations for life and accident and health contracts received in advance less
$ discount; including $ 8,153,368 accident and health premiums (Exhibit 1,
Part 1, Col. 1, sum of lines 4 and 14) 8,153,368 7,456,414 9. Contract liabilities not included elsewhere:
9.1 Surrender values on canceled contracts 9.2 Provision for experience rating refunds, including the liability of $ accident and health
experience rating refunds of which $ is for medical loss ratio rebate per the Public Health
Service Act 9.3 Other amounts payable on reinsurance, including $ assumed and $ 52,577,623
ceded 52,577,623 50,907,710 9.4 Interest maintenance reserve (IMR, Line 6) 16,959,619 17,597,291
10. Commissions to agents due or accrued-life and annuity contracts $ accident and health
$ and deposit-type contract funds $ 11. Commissions and expense allowances payable on reinsurance assumed 12. General expenses due or accrued (Exhibit 2, Line 12, Col. 6) 109,200 56,100 13. Transfers to Separate Accounts due or accrued (net) (including $ accrued for expense
allowances recognized in reserves, net of reinsured allowances) 14. Taxes, licenses and fees due or accrued, excluding federal income taxes (Exhibit 3, Line 9, Col. 5) 1,644,695 964,225 15.1 Current federal and foreign income taxes, including $ on realized capital gains (losses) 15.2 Net deferred tax liability 16. Unearned investment income 17. Amounts withheld or retained by company as agent or trustee 18. Amounts held for agents' account, including $ agents' credit balances 19. Remittances and items not allocated 46,409 20. Net adjustment in assets and liabilities due to foreign exchange rates 21. Liability for benefits for employees and agents if not included above 22. Borrowed money $ and interest thereon $ 23. Dividends to stockholders declared and unpaid 24. Miscellaneous liabilities:
24.01 Asset valuation reserve (AVR, Line 16, Col. 7) 24.02 Reinsurance in unauthorized and certified ($ ) companies 24.03 Funds held under reinsurance treaties with unauthorized and certified ($ ) reinsurers 24.04 Payable to parent, subsidiaries and affiliates 11,006 10,779 24.05 Drafts outstanding 24.06 Liability for amounts held under uninsured plans 24.07 Funds held under coinsurance 24.08 Derivatives 24.09 Payable for securities 24.10 Payable for securities lending 24.11 Capital notes $ and interest thereon $
25. Aggregate write-ins for liabilities 5,900,000 5,400,000 26. Total liabilities excluding Separate Accounts business (Lines 1 to 25) 90,499,151 86,472,316 27. From Separate Accounts Statement 28. Total liabilities (Lines 26 and 27) 90,499,151 86,472,316 29. Common capital stock 2,500,000 2,500,000 30. Preferred capital stock 31. Aggregate write-ins for other than special surplus funds 32. Surplus notes 33. Gross paid in and contributed surplus (Page 3, Line 33, Col. 2 plus Page 4, Line 51.1, Col. 1) 115,045,146 115,045,146 34. Aggregate write-ins for special surplus funds 35. Unassigned funds (surplus) (35,318,173) (38,046,676)36. Less treasury stock, at cost:
36.1 shares common (value included in Line 29 $ ) 36.2 shares preferred (value included in Line 30 $ )
37. Surplus (Total Lines 31+32+33+34+35-36) (including $ in Separate Accounts Statement) 79,726,973 76,998,470 38. Totals of Lines 29, 30 and 37 (Page 4, Line 55) 82,226,973 79,498,470 39. Totals of Lines 28 and 38 (Page 2, Line 28, Col. 3) 172,726,124 165,970,786
DETAILS OF WRITE-INS
2501. Reserve for Guaranty Fund 5,900,000 5,400,000 2502.
2503.
2598. Summary of remaining write-ins for Line 25 from overflow page 2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above) 5,900,000 5,400,000 3101.
3102.
3103.
3198. Summary of remaining write-ins for Line 31 from overflow page 3199. Totals (Lines 3101 thru 3103 plus 3198)(Line 31 above) 3401.
3402.
3403.
3498. Summary of remaining write-ins for Line 34 from overflow page 3499. Totals (Lines 3401 thru 3403 plus 3498)(Line 34 above)
3
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SUMMARY OF OPERATIONS1
Current Year2
Prior Year
1. Premiums and annuity considerations for life and accident and health contracts (Exhibit 1, Part 1, Line 20.4, Col. 1, less Col. 11) 160,022 288,910
2. Considerations for supplementary contracts with life contingencies
3. Net investment income (Exhibit of Net Investment Income, Line 17) 2,061,341 1,889,807
4. Amortization of Interest Maintenance Reserve (IMR, Line 5) 637,672 374,896
5. Separate Accounts net gain from operations excluding unrealized gains or losses
6. Commissions and expense allowances on reinsurance ceded (Exhibit 1, Part 2, Line 26.1, Col. 1) 151,201,817 157,510,627
7. Reserve adjustments on reinsurance ceded
8. Miscellaneous Income:
8.1 Income from fees associated with investment management, administration and contract guarantees from Separate Accounts
8.2 Charges and fees for deposit-type contracts
8.3 Aggregate write-ins for miscellaneous income
9. Total (Lines 1 to 8.3) 154,060,852 160,064,240
10. Death benefits
11. Matured endowments (excluding guaranteed annual pure endowments)
12. Annuity benefits (Exhibit 8, Part 2, Line 6.4, Cols. 4 + 8)
13. Disability benefits and benefits under accident and health contracts 8,476 28,185
14. Coupons, guaranteed annual pure endowments and similar benefits
15. Surrender benefits and withdrawals for life contracts
16. Group conversions
17. Interest and adjustments on contract or deposit-type contract funds 235,976 188,500
18. Payments on supplementary contracts with life contingencies 58,332 70,118
19. Increase in aggregate reserves for life and accident and health contracts (42,021) (67,476)
20. Totals (Lines 10 to 19) 260,763 219,327
21. Commissions on premiums, annuity considerations, and deposit-type contract funds (direct business only) (Exhibit 1, Part 2, Line 31, Col. 1) 70,903,757 73,718,154
22. Commissions and expense allowances on reinsurance assumed (Exhibit 1, Part 2, Line 26.2, Col. 1)
23. General insurance expenses (Exhibit 2, Line 10, Cols. 1, 2, 3 and 4) 64,504,185 68,856,133
24. Insurance taxes, licenses and fees, excluding federal income taxes (Exhibit 3, Line 7, Cols. 1 + 2 + 3) 15,803,124 14,806,851
25. Increase in loading on deferred and uncollected premiums
26. Net transfers to or (from) Separate Accounts net of reinsurance
27. Aggregate write-ins for deductions 10,451
28. Totals (Lines 20 to 27) 151,471,829 157,610,916
29. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 28) 2,589,023 2,453,324
30. Dividends to policyholders 123 1,048
31. Net gain from operations after dividends to policyholders and before federal income taxes (Line 29 minus Line 30) 2,588,900 2,452,276
32. Federal and foreign income taxes incurred (excluding tax on capital gains) 337,929
33. Net gain from operations after dividends to policyholders and federal income taxes and before realized capital gains or (losses) (Line 31 minus Line 32) 2,588,900 2,114,347
34. Net realized capital gains (losses) (excluding gains (losses) transferred to the IMR) less capital gains tax of
$ (excluding taxes of $ transferred to the IMR) 402,705
35. Net income (Line 33 plus Line 34) 2,588,900 2,517,052
CAPITAL AND SURPLUS ACCOUNT
36. Capital and surplus, December 31, prior year (Page 3, Line 38, Col. 2) 79,498,470 77,180,472
37. Net income (Line 35) 2,588,900 2,517,052
38. Change in net unrealized capital gains (losses) less capital gains tax of $
39. Change in net unrealized foreign exchange capital gain (loss)
40. Change in net deferred income tax (709,232) (323,697)
41. Change in nonadmitted assets 848,835 (983,777)
42. Change in liability for reinsurance in unauthorized and certified companies
43. Change in reserve on account of change in valuation basis, (increase) or decrease
44. Change in asset valuation reserve
45. Change in treasury stock (Page 3, Lines 36.1 and 36.2, Col. 2 minus Col. 1)
46. Surplus (contributed to) withdrawn from Separate Accounts during period
47. Other changes in surplus in Separate Accounts Statement
48. Change in surplus notes
49. Cumulative effect of changes in accounting principles
50. Capital changes:
50.1 Paid in
50.2 Transferred from surplus (Stock Dividend)
50.3 Transferred to surplus
51. Surplus adjustment:
51.1 Paid in
51.2 Transferred to capital (Stock Dividend)
51.3 Transferred from capital
51.4 Change in surplus as a result of reinsurance
52. Dividends to stockholders
53. Aggregate write-ins for gains and losses in surplus 1,108,420
54. Net change in capital and surplus for the year (Lines 37 through 53) 2,728,503 2,317,998
55. Capital and surplus, December 31, current year (Lines 36 + 54) (Page 3, Line 38) 82,226,973 79,498,470
DETAILS OF WRITE-INS
08.301.
08.302.
08.303.
08.398. Summary of remaining write-ins for Line 8.3 from overflow page
08.399. Totals (Lines 08.301 thru 08.303 plus 08.398)(Line 8.3 above)
2701. Interest maintenance reserve transferred under reinsurance agreement
2702. Fines & Penalties 10,451
2703.
2798. Summary of remaining write-ins for Line 27 from overflow page
2799. Totals (Lines 2701 thru 2703 plus 2798)(Line 27 above) 10,451
5301. Prior period adjustments 1,108,420
5302.
5303.
5398. Summary of remaining write-ins for Line 53 from overflow page
5399. Totals (Lines 5301 thru 5303 plus 5398)(Line 53 above) 1,108,420
4
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
CASH FLOW1
Current Year
2
Prior Year
Cash from Operations
1. Premiums collected net of reinsurance (356,961) 2,787,795
2. Net investment income 1,042,270 1,145,951
3. Miscellaneous income 151,201,817 157,510,627
4. Total (Lines 1 through 3) 151,887,126 161,444,373
5. Benefit and loss related payments 697,236 1,260,235
6. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts
7. Commissions, expenses paid and aggregate write-ins for deductions 151,450,047 161,556,327
8. Dividends paid to policyholders 123 1,048
9. Federal and foreign income taxes paid (recovered) net of $ tax on capital gains (losses) (7,548)
10. Total (Lines 5 through 9) 152,147,406 162,810,062
11. Net cash from operations (Line 4 minus Line 10) (260,280) (1,365,689)
Cash from Investments
12. Proceeds from investments sold, matured or repaid:
12.1 Bonds 3,705,000 9,940,553
12.2 Stocks
12.3 Mortgage loans
12.4 Real estate
12.5 Other invested assets
12.6 Net gains or (losses) on cash, cash equivalents and short-term investments
12.7 Miscellaneous proceeds
12.8 Total investment proceeds (Lines 12.1 to 12.7) 3,705,000 9,940,553
13. Cost of investments acquired (long-term only):
13.1 Bonds 5,846,328 6,039,931
13.2 Stocks
13.3 Mortgage loans
13.4 Real estate
13.5 Other invested assets
13.6 Miscellaneous applications 4,091
13.7 Total investments acquired (Lines 13.1 to 13.6) 5,850,419 6,039,931
14. Net increase (decrease) in contract loans and premium notes
15. Net cash from investments (Line 12.8 minus Line 13.7 minus Line 14) (2,145,419) 3,900,622
Cash from Financing and Miscellaneous Sources
16. Cash provided (applied):
16.1 Surplus notes, capital notes
16.2 Capital and paid in surplus, less treasury stock
16.3 Borrowed funds
16.4 Net deposits on deposit-type contracts and other insurance liabilities 1,059,456 531,701
16.5 Dividends to stockholders
16.6 Other cash provided (applied) (3,856) (661,851)
17. Net cash from financing and miscellaneous sources (Lines 16.1 to 16.4 minus Line 16.5 plus Line 16.6) 1,055,600 (130,150)
RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS
18. Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) (1,350,099) 2,404,783
19. Cash, cash equivalents and short-term investments:
19.1 Beginning of year 6,759,355 4,354,572
19.2 End of year (Line 18 plus Line 19.1) 5,409,256 6,759,355
Note: Supplemental disclosures of cash flow information for non-cash transactions:
5
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
AN
AL
YS
IS O
F O
PE
RA
TIO
NS
BY
LIN
ES
OF
BU
SIN
ES
S1
2O
rdin
ary
6G
rou
pA
ccid
en
t a
nd
He
alth
12
To
tal
Ind
ustr
ial L
ife
3
Life
In
su
ran
ce
4
Ind
ivid
ua
l A
nn
uitie
s
5S
up
ple
me
nta
ry
Co
ntr
acts
Cre
dit L
ife
(G
rou
p
an
d I
nd
ivid
ua
l)
7L
ife
In
su
ran
ce
(a)
8
An
nu
itie
s
9
Gro
up
10
Cre
dit (
Gro
up
an
d
Ind
ivid
ua
l)
11
Oth
er
Ag
gre
ga
te o
f A
ll O
the
r L
ine
s o
f B
usin
ess
1.
Pre
miu
ms a
nd
an
nu
ity c
on
sid
era
tio
ns f
or
life
an
d a
ccid
en
t a
nd
he
alth
co
ntr
acts
160,022
160,022
2.
Co
nsid
era
tio
ns f
or
su
pp
lem
en
tary
co
ntr
acts
with
life
co
ntin
ge
ncie
s
3.
Ne
t in
ve
stm
en
t in
co
me
2,061,
340
5,624
2,055,71
6
4.
Am
ort
iza
tio
n o
f In
tere
st
Ma
inte
na
nce
Re
se
rve
(IM
R)
637,
672
1,
742
635,93
0
5.
Se
pa
rate
Acco
un
ts n
et
ga
in f
rom
op
era
tio
ns e
xclu
din
g u
nre
aliz
ed
ga
ins o
r lo
sse
s
6.
Co
mm
issio
ns a
nd
exp
en
se
allo
wa
nce
s o
n r
ein
su
ran
ce
ce
de
d
151,
201,
817
151,
201,
817
7.
Re
se
rve
ad
justm
en
ts o
n r
ein
su
ran
ce
ce
de
d
8.
Mis
ce
llan
eo
us I
nco
me
:
8.1
Fe
es a
sso
cia
ted
with
in
co
me
fro
m in
ve
stm
en
t m
an
ag
em
en
t,
ad
min
istr
atio
n a
nd
co
ntr
act
gu
ara
nte
es f
rom
Se
pa
rate
Acco
un
ts
8.2
Ch
arg
es a
nd
fe
es f
or
de
po
sit-t
yp
e c
on
tra
cts
8.3
Ag
gre
ga
te w
rite
-in
s f
or
mis
ce
llan
eo
us in
co
me
9.
To
tals
(L
ine
s 1
to
8.3
) 154,
060,851
7,
366
154,
053,
485
10
.D
ea
th b
en
efits
11
.M
atu
red
en
do
wm
en
ts (
exc
lud
ing
gu
ara
nte
ed
an
nu
al p
ure
en
do
wm
en
ts)
12
.A
nn
uity b
en
efits
13
.D
isa
bili
ty b
en
efits
an
d b
en
efits
un
de
r a
ccid
en
t a
nd
he
alth
co
ntr
acts
8,47
6
8,47
6
14
.C
ou
po
ns,
gu
ara
nte
ed
an
nu
al p
ure
en
do
wm
en
ts a
nd
sim
ilar
be
ne
fits
15
.S
urr
en
de
r b
en
efits
an
d w
ith
dra
wa
ls f
or
life
co
ntr
acts
16
.G
rou
p c
on
ve
rsio
ns
17
.In
tere
st
an
d a
dju
stm
en
ts o
n c
on
tra
ct
or
de
po
sit-t
yp
e c
on
tra
ct
fun
ds
235,97
6
235,97
6
18
.P
aym
en
ts o
n s
up
ple
me
nta
ry c
on
tra
cts
with
life
co
ntin
ge
ncie
s
58,3
32
58,3
32
19
.In
cre
ase
in
ag
gre
ga
te r
ese
rve
s f
or
life
an
d a
ccid
en
t a
nd
he
alth
co
ntr
acts
(4
2,021)
(4
2,021)
20
.T
ota
ls (
Lin
es 1
0 t
o 1
9)
260,763
16,3
11
244,
452
21
.C
om
mis
sio
ns o
n p
rem
ium
s,
an
nu
ity c
on
sid
era
tio
ns a
nd
de
po
sit-t
yp
e
co
ntr
act
fun
ds (
dir
ect
bu
sin
ess o
nly
) 70,9
03,7
57
70,9
03,7
57
22
.C
om
mis
sio
ns a
nd
exp
en
se
allo
wa
nce
s o
n r
ein
su
ran
ce
assu
me
d
23
.G
en
era
l in
su
ran
ce
exp
en
se
s
64,504,1
85
64,504,1
85
24
.In
su
ran
ce
ta
xes,
lice
nse
s a
nd
fe
es,
exc
lud
ing
fe
de
ral in
co
me
ta
xes
15,803,1
24
15,803,1
24
25
.In
cre
ase
in
lo
ad
ing
on
de
ferr
ed
an
d u
nco
llecte
d p
rem
ium
s
26
.N
et
tra
nsfe
rs t
o o
r (f
rom
) S
ep
ara
te A
cco
un
ts n
et
of
rein
su
ran
ce
27
.A
gg
reg
ate
wri
te-i
ns f
or
de
du
ctio
ns
28
.T
ota
ls (
Lin
es 2
0 t
o 2
7)
151,
471,
829
16,3
11
151,
455,518
29
.N
et
ga
in f
rom
op
era
tio
ns b
efo
re d
ivid
en
ds t
o p
olic
yh
old
ers
an
d f
ed
era
l in
co
me
ta
xes (
Lin
e 9
min
us L
ine
28
) 2,589,
022
(8,9
45)
2,597,
967
30
.D
ivid
en
ds t
o p
olic
yh
old
ers
123
123
31
.N
et
ga
in f
rom
op
era
tio
ns a
fte
r d
ivid
en
ds t
o p
olic
yh
old
ers
an
d b
efo
re f
ed
era
l in
co
me
ta
xes (
Lin
e 2
9 m
inu
s L
ine
30
) 2,588,899
(8,9
45)
2,597,
844
32
.F
ed
era
l in
co
me
ta
xes in
cu
rre
d (
exc
lud
ing
ta
x o
n c
ap
ita
l g
ain
s)
(5,622)
5,622
33
.N
et
ga
in f
rom
op
era
tio
ns a
fte
r d
ivid
en
ds t
o p
olic
yh
old
ers
an
d f
ed
era
l in
co
me
ta
xes a
nd
be
fore
re
aliz
ed
ca
pita
l g
ain
s o
r (l
osse
s)
(Lin
e 3
1 m
inu
s L
ine
32
) 2,588,899
(3
,323)
2,592,222
DE
TA
ILS
OF
WR
ITE
-IN
S
08
.30
1.
08
.30
2.
08
.30
3.
08
.39
8.
Su
mm
ary
of
rem
ain
ing
wri
te-i
ns f
or
Lin
e 8
.3 f
rom
ove
rflo
w p
ag
e
08
.39
9.
To
tals
(L
ine
s 0
8.3
01
th
ru 0
8.3
03
plu
s 0
8.3
98
) (L
ine
8.3
ab
ove
)
27
01
.
27
02
.
27
03
.
27
98
. S
um
ma
ry o
f re
ma
inin
g w
rite
-in
s f
or
Lin
e 2
7 f
rom
ove
rflo
w p
ag
e
27
99
. T
ota
ls (
Lin
es 2
70
1 t
hru
27
03
plu
s 2
79
8)
(Lin
e 2
7 a
bo
ve
)
(a)
Inclu
de
s t
he
fo
llow
ing
am
ou
nts
fo
r F
EG
LI/
SG
LI:
L
ine
1
,
Lin
e 1
0
,
Lin
e 1
6
,
Lin
e 2
3
,
Lin
e 2
4
6
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
AN
AL
YS
IS O
F I
NC
RE
AS
E I
N R
ES
ER
VE
S D
UR
ING
TH
E Y
EA
R
12
Ord
inary
6G
roup
Tota
lIn
dustr
ial Life
3
Life Insura
nce
4
Indiv
idual A
nnuitie
s
5S
upple
menta
ry
Contr
acts
Cre
dit L
ife (
Gro
up a
nd
Indiv
idual)
7
Life Insura
nce
8
Annuitie
s
Involv
ing L
ife o
r D
isabili
ty C
ontingencie
s (
Reserv
es)
(Net of R
ein
sura
nce C
eded)
1.
Reserv
e D
ecem
ber
31, prior
year
367,778
36
7,778
2.
Tabula
r net pre
miu
ms o
r consid
era
tions
3.
Pre
sent valu
e o
f dis
abili
ty c
laim
s incurr
ed
XX
X
4.
Tabula
r in
tere
st
25,395
25,395
5.
Tabula
r le
ss a
ctu
al re
serv
e r
ele
ased
(9,0
85)
(9
,085
)
6.
Incre
ase in r
eserv
e o
n a
ccount of change in v
alu
ation b
asis
7.
Oth
er
incre
ases (
net)
8.
Tota
ls (
Lin
es 1
to 7
) 38
4,08
8
384,
088
9.
Tabula
r cost
XX
X
10.
Reserv
es r
ele
ased b
y death
XX
XX
XX
XX
X
11.
Reserv
es r
ele
ased b
y oth
er
term
inations (
net)
12.
Annuity,
supple
menta
ry c
ontr
act and d
isabili
ty p
aym
ents
involv
ing life c
ontingencie
s
58,332
58,332
13.
Net tr
ansfe
rs to o
r (f
rom
) S
epara
te A
ccounts
14.
Tota
l D
eductions (
Lin
es 9
to 1
3)
58,332
58,332
15.
Reserv
e D
ecem
ber
31, curr
ent ye
ar
325,
756
32
5,75
6
7
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
EXHIBIT OF NET INVESTMENT INCOME
1 2Collected During Year Earned During Year
1. U.S. Government bonds (a) 2,061,847 2,095,908
1.1 Bonds exempt from U.S. tax (a)
1.2 Other bonds (unaffiliated) (a) 7,132 7,132
1.3 Bonds of affiliates (a)
2.1 Preferred stocks (unaffiliated) (b)
2.11 Preferred stocks of affiliates (b)
2.2 Common stocks (unaffiliated)
2.21 Common stocks of affiliates
3. Mortgage loans (c)
4. Real estate (d)
5 Contract loans
6 Cash, cash equivalents and short-term investments (e) 7 7
7 Derivative instruments (f)
8. Other invested assets
9. Aggregate write-ins for investment income 3,066 3,066
10. Total gross investment income 2,072,052 2,106,113
11. Investment expenses (g) 43,448
12. Investment taxes, licenses and fees, excluding federal income taxes (g) 1,324
13. Interest expense (h)
14. Depreciation on real estate and other invested assets (i)
15. Aggregate write-ins for deductions from investment income
16. Total deductions (Lines 11 through 15) 44,772
17. Net investment income (Line 10 minus Line 16) 2,061,341
DETAILS OF WRITE-INS
0901. Misc. Income 3,066 3,066
0902.
0903.
0998. Summary of remaining write-ins for Line 9 from overflow page
0999. Totals (Lines 0901 thru 0903 plus 0998) (Line 9, above) 3,066 3,066
1501.
1502.
1503.
1598. Summary of remaining write-ins for Line 15 from overflow page
1599. Totals (Lines 1501 thru 1503 plus 1598) (Line 15, above)
(a) Includes $ 999,740 accrual of discount less $ 14,730 amortization of premium and less $ 29,932 paid for accrued interest on purchases.
(b) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued dividends on purchases.
(c) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases.
(d) Includes $ for company’s occupancy of its own buildings; and excludes $ interest on encumbrances.
(e) Includes $ 7 accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases.
(f) Includes $ accrual of discount less $ amortization of premium.
(g) Includes $ investment expenses and $ investment taxes, licenses and fees, excluding federal income taxes, attributable tosegregated and Separate Accounts.
(h) Includes $ interest on surplus notes and $ interest on capital notes.
(i) Includes $ depreciation on real estate and $ depreciation on other invested assets.
EXHIBIT OF CAPITAL GAINS (LOSSES)1
Realized Gain (Loss) On Sales or Maturity
2
Other Realized Adjustments
3
Total RealizedCapital Gain (Loss)
(Columns 1 + 2)
4
Change inUnrealized
Capital Gain (Loss)
5
Change in Unrealized Foreign Exchange Capital Gain (Loss)
1. U.S. Government bonds
1.1 Bonds exempt from U.S. tax
1.2 Other bonds (unaffiliated)
1.3 Bonds of affiliates
2.1 Preferred stocks (unaffiliated)
2.11 Preferred stocks of affiliates
2.2 Common stocks (unaffiliated)
2.21 Common stocks of affiliates
3. Mortgage loans
4. Real estate
5. Contract loans
6. Cash, cash equivalents and short-term investments
7. Derivative instruments
8. Other invested assets
9. Aggregate write-ins for capital gains (losses)
10. Total capital gains (losses)
DETAILS OF WRITE-INS
0901.
0902.
0903.
0998. Summary of remaining write-ins for Line 9 from overflow page
0999. Totals (Lines 0901 thru 0903 plus 0998) (Line 9, above)
NONE
8
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
EX
HIB
IT -
1 P
AR
T 1
- P
RE
MIU
MS
AN
D A
NN
UIT
Y C
ON
SID
ER
AT
ION
S F
OR
LIF
E A
ND
AC
CID
EN
T A
ND
HE
AL
TH
CO
NT
RA
CT
S1
2O
rdin
ary
5G
roup
Accid
ent and H
ealth
11
Tota
lIn
dustr
ial Life
3
Life Insura
nce
4In
div
idual
Annuitie
sC
redit L
ife (
Gro
up
and Indiv
idual)
6
Life Insura
nce
7
Annuitie
s
8
Gro
up
9C
redit (
Gro
up a
nd
Indiv
idual)
10
Oth
er
Aggre
gate
of A
ll O
ther
Lin
es o
f B
usin
ess
FIR
ST
YE
AR
(o
ther
than
sin
gle
)1.
Uncolle
cte
d
2.
Defe
rred a
nd a
ccru
ed
3.
Defe
rred , a
ccru
ed a
nd u
ncolle
cte
d:
3.1
Direct
1,73
7,91
8
1,
737,
918
3.2
Rein
sura
nce a
ssum
ed
3.3
Rein
sura
nce c
eded
1,73
7,91
8
1,
737,
918
3.4
Net (L
ine 1
+ L
ine 2
)
4.
Advance
5.
Lin
e 3
.4 -
Lin
e 4
6.
Colle
cte
d d
uring y
ear:
6.1
Direct
37,599
,681
37,599
,681
6.2
Rein
sura
nce a
ssum
ed
6.3
Rein
sura
nce c
eded
38,1
83,4
51
38,1
83,4
51
6.4
Net
(583,7
70)
(583,7
70)
7.
Lin
e 5
+ L
ine 6
.4
(583,7
70)
(583,7
70)
8.
Prior
year
(uncolle
cte
d +
defe
rred a
nd a
ccru
ed -
advance)
9.
First ye
ar
pre
miu
ms a
nd c
onsid
era
tions:
9.1
Direct
37,3
35,212
37,3
35,212
9.2
Rein
sura
nce a
ssum
ed
9.3
Rein
sura
nce c
eded
37,9
18,9
83
37,9
18,9
83
9.4
Net (L
ine 7
- L
ine 8
) (583,7
71)
(583,7
71)
SIN
GL
E10.
Sin
gle
pre
miu
ms a
nd c
onsid
era
tions:
10.1
Direct
10.2
Rein
sura
nce a
ssum
ed
10.3
Rein
sura
nce c
eded
10.4
Net
RE
NE
WA
L11.
Uncolle
cte
d
10,9
00,505
10,9
00,505
12.
Defe
rred a
nd a
ccru
ed
13.
Defe
rred, accru
ed a
nd u
ncolle
cte
d:
13.1
Direct
4,830,569
4,830,569
13.2
Rein
sura
nce a
ssum
ed
13.3
Rein
sura
nce c
eded
(6,069,9
36)
(6,069,9
36)
13.4
Net (L
ine 1
1 +
Lin
e 1
2)
10,9
00,505
10,9
00,505
14.
Advance
8,153,
368
8,153,
368
15.
Lin
e 1
3.4
- L
ine 1
4
2,74
7,13
7
2,74
7,13
7
16.
Colle
cte
d d
uring y
ear:
16.1
Direct
563,
812,569
563,
812,569
16.2
Rein
sura
nce a
ssum
ed
16.3
Rein
sura
nce c
eded
563,
008,097
563,
008,097
16.4
Net
804,
472
804,
472
17.
Lin
e 1
5 +
Lin
e 1
6.4
3,
551,
609
3,551,
609
18.
Prior
year
(uncolle
cte
d +
defe
rred a
nd a
ccru
ed -
advance)
2,807,
816
2,807,
816
19.
Renew
al pre
miu
ms a
nd c
onsid
era
tions:
19.1
Direct
564,
113,
257
564,
113,
257
19.2
Rein
sura
nce a
ssum
ed
19.3
Rein
sura
nce c
eded
563,
369,
464
563,
369,
464
19.4
Net (L
ine 1
7 -
Lin
e 1
8)
743,
793
743,
793
TO
TA
L20.
Tota
l pre
miu
ms a
nd a
nnuity
consid
era
tions:
20.1
Direct
601,
448,469
601,
448,469
20.2
Rein
sura
nce a
ssum
ed
20.3
Rein
sura
nce c
eded
601,
288,44
7
601,
288,44
7
20.4
Net (L
ines 9
.4 +
10.4
+ 1
9.4
) 160,022
160,022
9
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
EX
HIB
IT -
1 P
AR
T 2
- D
IVID
EN
DS
AN
D C
OU
PO
NS
AP
PL
IED
, R
EIN
SU
RA
NC
E C
OM
MIS
SIO
NS
AN
D E
XP
EN
SE
AL
LO
WA
NC
ES
AN
D C
OM
MIS
SIO
NS
IN
CU
RR
ED
(D
ire
ct
Bu
sin
es
s O
nly
)1
2O
rdin
ary
5G
roup
Accid
ent and H
ealth
11
Tota
lIn
dustr
ial Life
3
Life Insura
nce
4
Indiv
idual
Annuitie
sC
redit L
ife (
Gro
up
and Indiv
idual)
6
Life Insura
nce
7
Annuitie
s
8
Gro
up
9
Cre
dit (
Gro
up a
nd
Indiv
idual)
10
Oth
er
Aggre
gate
of A
ll O
ther
Lin
es o
f B
usin
ess
DIV
IDE
ND
S A
ND
CO
UP
ON
S A
PP
LIE
D
(in
clu
ded
in
Part
1)
21.
To p
ay
renew
al pre
miu
ms
123
123
22.
All
oth
er
RE
INS
UR
AN
CE
CO
MM
ISS
ION
S A
ND
EX
PE
NS
E A
LL
OW
AN
CE
S IN
CU
RR
ED
23.
First ye
ar
(oth
er
than s
ingle
):
23.1
Rein
sura
nce c
eded
38,1
83,4
51
38,1
83,4
51
23.2
Rein
sura
nce a
ssum
ed
23.3
Net ceded less a
ssum
ed
38,1
83,4
51
38,1
83,4
51
24.
Sin
gle
:
24.1
Rein
sura
nce c
eded
24.2
Rein
sura
nce a
ssum
ed
24.3
Net ceded less a
ssum
ed
25.
Renew
al:
25.1
Rein
sura
nce c
eded
113,01
8,36
6
11
3,01
8,36
6
25.2
Rein
sura
nce a
ssum
ed
25.3
Net ceded less a
ssum
ed
113,01
8,36
6
11
3,01
8,36
6
26.
Tota
ls:
26.1
Rein
sura
nce c
eded (
Page 6
, Lin
e 6
) 15
1,20
1,81
7
15
1,20
1,81
7
26.2
Rein
sura
nce a
ssum
ed (
Page 6
, Lin
e 2
2)
26.3
Net ceded less a
ssum
ed
151,
201,
817
151,
201,
817
CO
MM
ISS
ION
S IN
CU
RR
ED
(dir
ect
bu
sin
ess o
nly
)
27.
First ye
ar
(oth
er
than s
ingle
) 27
,503
,941
27
,503
,941
28.
Sin
gle
29.
Renew
al
43,399
,816
43
,399
,816
30.
Deposit-t
ype c
ontr
act fu
nds
31.
Tota
ls (
to a
gre
e w
ith P
age 6
, Lin
e 2
1)
70,9
03,757
70
,903
,757
10
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
EXHIBIT 2 - GENERAL EXPENSESInsurance 5 6
1 Accident and Health 4
Life2
Cost Containment3
All Other
All Other Lines of Business Investment Total
1. Rent 280,000 1,403 281,403
2. Salaries and wages 18,133,988 27,253 18,161,241
3.11 Contributions for benefit plans for employees 3,270,064 9,742 3,279,806
3.12 Contributions for benefit plans for agents 10,072,995 10,072,995
3.21 Payments to employees under non-funded benefit plans
3.22 Payments to agents under non-funded benefit plans
3.31 Other employee welfare 1,093,450 420 1,093,870
3.32 Other agent welfare
4.1 Legal fees and expenses 156,852 156,852
4.2 Medical examination fees 2,826,533 2,826,533
4.3 Inspection report fees 93,636 93,636
4.4 Fees of public accountants and consulting actuaries 109,200 109,200
4.5 Expense of investigation and settlement of policy claims 70,687 655,117 725,804
5.1 Traveling expenses 335,475 651 336,126
5.2 Advertising 2,106,175 2,106,175
5.3 Postage, express, telegraph and telephone 662,338 199 662,537
5.4 Printing and stationery 95,461 65 95,526
5.5 Cost or depreciation of furniture and equipment 169,831 169,831
5.6 Rental of equipment 856,191 2,615 858,806
5.7 Cost or depreciation of EDP equipment and software 2,335,553 2,335,553
6.1 Books and periodicals 18,885 104 18,989
6.2 Bureau and association fees 189,190 72 189,262
6.3 Insurance, except on real estate 143,398 143,398
6.4 Miscellaneous losses 63,582 63,582
6.5 Collection and bank service charges 43,336 43,336
6.6 Sundry general expenses 9,501,285 436 9,501,721
6.7 Group service and administration fees
6.8 Reimbursements by uninsured plans
7.1 Agency expense allowance 10,240,998 10,240,998
7.2 Agents’ balances charged off (less $
recovered)
7.3 Agency conferences other than local meetings 592,318 592,318
9.1 Real estate expenses 387,647 387,647
9.2 Investment expenses not included elsewhere 488 488
9.3 Aggregate write-ins for expenses
10. General expenses incurred 70,687 64,433,498 43,448 (a) 64,547,633
11. General expenses unpaid December 31, prior year 56,100 56,100
12. General expenses unpaid December 31, current year 109,200 109,200
13. Amounts receivable relating to uninsured plans, prior year
14. Amounts receivable relating to uninsured plans, current year
15. General expenses paid during year (Lines 10+11-12-13+14) 70,687 64,380,398 43,448 64,494,533
DETAILS OF WRITE-INS
09.301.
09.302.
09.303.
09.398. Summary of remaining write-ins for Line 9.3 from overflow page
09.399. Totals (Lines 09.301 thru 09.303 plus 09.398) (Line 9.3 above)
(a) Includes management fees of $ 44,284 to affiliates and $ 458,065 to non-affiliates.
EXHIBIT 3 - TAXES, LICENSES AND FEES (EXCLUDING FEDERAL INCOME TAXES)Insurance 4 5
1
Life
2
Accident and Health
3All Other Lines of
Business Investment Total
1. Real estate taxes 288,565 288,565
2. State insurance department licenses and fees 744,562 744,562
3. State taxes on premiums 10,262,498 10,262,498
4. Other state taxes, including $
for employee benefits 37,146 66 37,212
5. U.S. Social Security taxes 3,819,615 1,258 3,820,873
6. All other taxes 650,738 650,738
7. Taxes, licenses and fees incurred 15,803,124 1,324 15,804,448
8. Taxes, licenses and fees unpaid December 31, prior year 964,225 964,225
9. Taxes, licenses and fees unpaid December 31, current year 1,644,695 1,644,695
10. Taxes, licenses and fees paid during year (Lines 7 + 8 - 9) 15,122,654 1,324 15,123,978
EXHIBIT 4 - DIVIDENDS OR REFUNDS1
Life2
Accident and Health
1. Applied to pay renewal premiums 123
2. Applied to shorten the endowment or premium-paying period
3. Applied to provide paid-up additions
4. Applied to provide paid-up annuities
5. Total Lines 1 through 4 123
6. Paid in cash
7. Left on deposit
8. Aggregate write-ins for dividend or refund options
9. Total Lines 5 through 8 123
10. Amount due and unpaid
11. Provision for dividends or refunds payable in the following calendar year
12. Terminal dividends
13. Provision for deferred dividend contracts
14. Amount provisionally held for deferred dividend contracts not included in Line 13
15. Total Lines 10 through 14
16. Total from prior year
17. Total dividends or refunds (Lines 9 + 15 - 16) 123
DETAILS OF WRITE-INS
0801.
0802.
0803.
0898. Summary of remaining write-ins for Line 8 from overflow page
0899. Totals (Lines 0801 thru 0803 plus 0898) (Line 8 above)
11
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS1
Valuation Standard
2
Total
3
Industrial
4
Ordinary
5Credit
(Group and Individual)
6
Group
0199998. Reinsurance ceded
0199999. Life Insurance: Totals (Net)
0299998. Reinsurance ceded XXX XXX
0299999. Annuities: Totals (Net) XXX XXX
0300001. (Gross) - Supplementary Contracts with Life
Contingencies 1971 IAM 7 1/2% (Due) 325,756 325,756 0399997. Totals (Gross) 325,756 325,756 0399998. Reinsurance ceded 0399999. SCWLC: Totals (Net) 325,756 325,756 0499998. Reinsurance ceded 0499999. Accidental Death Benefits: Totals (Net) 0599998. Reinsurance ceded 0599999. Disability-Active Lives: Totals (Net) 0699998. Reinsurance ceded 0699999. Disability-Disabled Lives: Totals (Net) 0799998. Reinsurance ceded 0799999. Miscellaneous Reserves: Totals (Net)
9999999. Totals (Net) - Page 3, Line 1 325,756 325,756
12
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
EXHIBIT 5 - INTERROGATORIES
1.1 Has the reporting entity ever issued both participating and non-participating contracts? Yes [ X ] No [ ]1.2 If not, state which kind is issued.
2.1 Does the reporting entity at present issue both participating and non-participating contracts? Yes [ ] No [ X ]2.2 If not, state which kind is issued.
At present NLTC issues neither participating nor non-participating
life or annuity contracts. 3. Does the reporting entity at present issue or have in force contracts that contain non-guaranteed elements? Yes [ ] No [ X ]
If so, attach a statement that contains the determination procedures, answers to the interrogatories and an actuarial opinion as described in the instructions.
4. Has the reporting entity any assessment or stipulated premium contracts in force? Yes [ ] No [ X ]If so, state:
4.1 Amount of insurance? $ 4.2 Amount of reserve? $ 4.3 Basis of reserve:
4.4 Basis of regular assessments:
4.5 Basis of special assessments:
4.6 Assessments collected during the year $
5. If the contract loan interest rate guaranteed in any one or more of its currently issued contracts is less than 5%, not in advance, state the contract loan rate guarantees on any such contracts.
6. Does the reporting entity hold reserves for any annuity contracts that are less than the reserves that would be held on a standard basis? Yes [ ] No [ X ]
6.1 If so, state the amount of reserve on such contracts on the basis actually held: $ 6.2 That would have been held (on an exact or approximate basis) using the actual ages of the annuitants; the interest rate(s) used in 6.1; and
the same mortality basis used by the reporting entity for the valuation of comparable annuity benefits issued to standard lives. If the reporting entity has no comparable annuity benefits for standard lives to be valued, the mortality basis shall be the table most recently approved by the state of domicile for valuing individual annuity benefits: $
Attach statement of methods employed in their valuation.
7. Does the reporting entity have any Synthetic GIC contracts or agreements in effect as of December 31 of the current year? Yes [ ] No [ X ]7.1 If yes, state the total dollar amount of assets covered by these contracts or agreements $ 7.2 Specify the basis (fair value, amortized cost, etc.) for determining the amount:
7.3 State the amount of reserves established for this business: $ 7.4 Identify where the reserves are reported in the blank:
8. Does the reporting entity have any Contingent Deferred Annuity contracts or agreements in effect as of December 31 of the current year? Yes [ ] No [ X ]
8.1 If yes, state the total dollar amount of account value covered by these contracts or agreements: $ 8.2 State the amount of reserves established for this business: $ 8.3 Identify where the reserves are reported in the blank:
9. Does the reporting entity have any Guaranteed Lifetime Income Benefit contracts, agreements or riders in effect as of December 31 of the
current year? Yes [ ] No [ X ]9.1 If yes, state the total dollar amount of any account value associated with these contracts, agreements or riders: $ 9.2 State the amount of reserves established for this business: $ 9.3 Identify where the reserves are reported in the blank:
EXHIBIT 5A - CHANGES IN BASES OF VALUATION DURING THE YEAR1 Valuation Basis 4
Description of Valuation Class
2
Changed From
3
Changed To
Increase in Actuarial Reserve Due to
Change
9999999 - Total (Column 4, only)
NONE
13
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
EX
HIB
IT 6
- A
GG
RE
GA
TE
RE
SE
RV
ES
FO
R A
CC
IDE
NT
AN
D H
EA
LT
H C
ON
TR
AC
TS
12
34
Oth
er
Indiv
idual C
ontr
acts
Tota
lG
roup A
ccid
ent
and H
ealth
Cre
dit A
ccid
ent
and H
ealth
(Gro
up a
nd Indiv
idual)
Colle
ctively
Renew
able
5
Non-C
ancela
ble
6G
uara
nte
ed
Renew
able
7N
on-R
enew
able
for
Sta
ted R
easons O
nly
8
Oth
er
Accid
ent O
nly
9
All
Oth
er
AC
TIV
E L
IFE
RE
SE
RV
E
1.
Unearn
ed p
rem
ium
reserv
es
122,
478,
445
122,
478,
445
2.
Additio
nal contr
act re
serv
es (
a)
2,80
2,18
0,12
3
2,
802,
180,
123
3.
Additio
nal actu
arial re
serv
es-A
sset/Lia
bili
ty a
naly
sis
4.
Reserv
e for
futu
re c
ontingent benefits
5.
Reserv
e for
rate
cre
dits
6.
Aggre
gate
write
-ins for
reserv
es
7.
Tota
ls (
Gro
ss)
2,92
4,65
8,56
8
2,
924,
658,
568
8.
Rein
sura
nce c
eded
2,92
4,65
8,56
8
2,
924,
658,
568
9.
Tota
ls (
Net)
CLA
IM R
ES
ER
VE
10.
Pre
sent valu
e o
f am
ounts
not ye
t due o
n c
laim
s
333,60
6,52
8
333,60
6,52
8
11.
Additio
nal actu
arial re
serv
es-A
sset/Lia
bili
ty a
naly
sis
12.
Reserv
e for
futu
re c
ontingent benefits
13.
Aggre
gate
write
-ins for
reserv
es
14.
Tota
ls (
Gro
ss)
333,60
6,52
8
333,60
6,52
8
15.
Rein
sura
nce c
eded
333,60
6,52
8
333,60
6,52
8
16.
Tota
ls (
Net)
17.
TO
TA
L (
Net)
18.
TA
BU
LA
R F
UN
D IN
TE
RE
ST
DE
TA
ILS
OF
WR
ITE
-IN
S
0601.
0602.
0603.
0698.
Sum
mary
of re
main
ing w
rite
-ins for
Lin
e 6
fro
m o
verf
low
page
0699.
TO
TA
LS
(Lin
es 0
601 thru
0603 p
lus 0
698)
(Lin
e 6
above)
1301.
1302.
1303.
1398.
Sum
mary
of re
main
ing w
rite
-ins for
Lin
e 1
3 fro
m o
verf
low
page
1399.
TO
TA
LS
(Lin
es 1
301 thru
1303 p
lus 1
398)
(Lin
e 1
3 a
bove)
(a)
Attach s
tate
ment as to v
alu
ation s
tandard
used in c
alc
ula
ting this
reserv
e, specifyi
ng r
eserv
e b
ases, in
tere
st ra
tes a
nd m
eth
ods.
14
Reserve bases, interest rates and methods
ACTIVE LIFE RESERVES
1. Unearned Premium $122,478,445
2. 1983a IAM 4% - 1PT 8/24/98 to 3/24/02 329,289,510
3. 1994 GAM 4.5% - 1PT 3/25/02 to 12/31/05 724,893,485
4. 1994 GAM 4% - 1PT 1/1/06 to 12/31/12 1,576,059,600
5 1994 GAM 3.5% - 1PT 1/1/13 to N.B. 171,937,528
TOTAL $2,924,658,568
Reinsurance 2,924,658,568
TOTAL ACTIVE LIFE RESERVES (NET) $0
CLAIM RESERVES
1. Industry based morbidity table 4.5% claims incurred from 8/24/98 to 12/31/05 3,486,159
2. Industry based morbidity table 4% claims incurred from 1/1/06 to 12/31/12 73,629,235
3. Industry based morbidity table 3.5% claims incurred from 1/1/13 256,491,134
TOTAL $333,606,528
Reinsurance 333,606,528
TOTAL CLAIM RESERVES (NET) $0
TOTAL EXHIBIT 6 $0
NORTHWESTERN LONG TERM CARE INSURANCE COMPANY
FOR 2016
EXHIBIT 6 - ATTACHMENT
AGGREGATE RESERVE FOR ACCIDENT AND HEALTH POLICIES
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
EX
HIB
IT 7
- D
EP
OS
IT T
YP
E C
ON
TR
AC
TS
1
Tota
l
2
Guara
nte
ed
Inte
rest C
ontr
acts
3
Annuitie
s C
ert
ain
4
Supple
menta
l C
ontr
acts
5D
ivid
end
Accum
ula
tions o
r R
efu
nds
6P
rem
ium
and
Oth
er
Deposit F
unds
1.
Bala
nce a
t th
e b
egin
nin
g o
f th
e y
ear
befo
re r
ein
sura
nce
3,71
2,01
9
3,71
2,01
9
2.
Deposits r
eceiv
ed d
uring the y
ear
23,6
95,6
13
23,6
95,6
13
3.
Investm
ent earn
ings c
redited to the a
ccount
233,24
3
23
3,24
3
4.
Oth
er
net change in r
eserv
es
5.
Fees a
nd o
ther
charg
es a
ssessed
6.
Surr
ender
charg
es
7.
Net surr
ender
or
withdra
wal paym
ents
22
,869
,400
22
,869
,400
8.
Oth
er
net tr
ansfe
rs to o
r (f
rom
) S
epara
te A
ccounts
9.
Bala
nce a
t th
e e
nd o
f curr
ent ye
ar
befo
re r
ein
sura
nce (
Lin
es 1
+2+
3+
4-5
-6-7
-8)
4,771,
475
4,771,
475
10.
Rein
sura
nce b
ala
nce a
t th
e b
egin
nin
g o
f th
e y
ear
11.
Net change in r
ein
sura
nce a
ssum
ed
12.
Net change in r
ein
sura
nce c
eded
13.
Rein
sura
nce b
ala
nce a
t th
e e
nd o
f th
e y
ear
(Lin
es 1
0+
11-1
2)
14.
Net bala
nce a
t th
e e
nd o
f curr
ent ye
ar
after
rein
sura
nce (
Lin
es 9
+ 1
3)
4,771,
475
4,771,
475
15
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
EX
HIB
IT 8
- C
LA
IMS
FO
R L
IFE
AN
D A
CC
IDE
NT
AN
D H
EA
LT
H C
ON
TR
AC
TS
PA
RT
1 -
Lia
bil
ity E
nd
of
Cu
rren
t Y
ear
12
Ord
inary
6G
roup
Accid
ent and H
ealth
Tota
lIn
dustr
ial Life
3
Life Insura
nce
4
Indiv
idual A
nnuitie
s
5S
upple
menta
ry
Contr
acts
Cre
dit L
ife (
Gro
up
and Indiv
idual)
7
Life Insura
nce
8
Annuitie
s
9
Gro
up
10
Cre
dit (
Gro
up a
nd
Indiv
idual)
11
Oth
er
1.
Due a
nd u
npaid
:
1.1
Direct
1.2
Rein
sura
nce a
ssum
ed
1.3
Rein
sura
nce c
eded
1.4
Net
2.
In c
ours
e o
f settle
ment:
2.1
Resis
ted
2.1
1 D
irect
2.1
2 R
ein
sura
nce a
ssum
ed
2.1
3 R
ein
sura
nce c
eded
2.1
4 N
et
(b)
(b
)
(b
)
(b)
2.2
Oth
er
2.2
1 D
irect
4,2
07,151
4,2
07,151
2.2
2 R
ein
sura
nce a
ssum
ed
2.2
3 R
ein
sura
nce c
eded
4,2
07,151
4,2
07,151
2.2
4 N
et
(b)
(b
)
(b
)
(b)
(b)
(b
)
(b)
3.
Incurr
ed b
ut unre
port
ed:
3.1
Direct
611,5
75
611,5
75
3.2
Rein
sura
nce a
ssum
ed
3.3
Rein
sura
nce c
eded
611,5
75
611,5
75
3.4
Net
(b)
(b
)
(b
)
(b)
(b)
(b
)
(b)
4.
TO
TA
LS
4.1
Direct
4,8
18,726
4,8
18,726
4.2
Rein
sura
nce a
ssum
ed
4.3
Rein
sura
nce c
eded
4,8
18,726
4,8
18,726
4.4
Net
(a
)
(a)
(a)
(a)
Inclu
din
g m
atu
red e
ndow
ments
(but not guara
nte
ed a
nnual pure
endow
ments
) unpaid
am
ounting to $
in C
olu
mn 2
, $
in C
olu
mn 3
and $
in C
olu
mn 7
.
(b)
Inclu
de o
nly
port
ion o
f dis
abili
ty a
nd a
ccid
ent and h
ealth c
laim
lia
bili
ties a
pplic
able
to a
ssum
ed "
accru
ed"
benefits
. R
eserv
es (
inclu
din
g r
ein
sura
nce a
ssum
ed a
nd n
et of re
insura
nce c
eded)
for
unaccru
ed b
enefits
for
Ord
inary
Life Insura
nce $
Indiv
idual A
nnuitie
s $
, C
redit L
ife (
Gro
up a
nd Indiv
idual) $
, and G
roup L
ife $
, are
inclu
ded in P
age 3
, Lin
e 1
, (S
ee E
xhib
it 5
, S
ection o
n D
isabili
ty D
isable
d L
ives);
and for
Gro
up A
ccid
ent and H
ealth $
Cre
dit (
Gro
up a
nd Indiv
idual) A
ccid
ent and H
ealth $
, and O
ther
Accid
ent and H
ealth $
a
re inclu
ded in P
age 3
, Lin
e 2
(S
ee E
xhib
it 6
, C
laim
Reserv
e).
16
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
EX
HIB
IT 8
- C
LA
IMS
FO
R L
IFE
AN
D A
CC
IDE
NT
AN
D H
EA
LT
H C
ON
TR
AC
TS
PA
RT
2 -
In
cu
rred
Du
rin
g t
he Y
ear
12
Ord
inary
6G
roup
Accid
ent and H
ealth
Tota
lIn
dustr
ial Life
(a)
3Life Insura
nce
(b)
4
Indiv
idual A
nnuitie
s
5S
upple
menta
ry
Contr
acts
Cre
dit L
ife (
Gro
up
and Indiv
idual)
7Life Insura
nce
(c)
8
Annuitie
s
9
Gro
up
10
Cre
dit (
Gro
up
and Indiv
idual)
11
Oth
er
1.
Settle
ments
During the Y
ear:
1.1
Direct
54,9
20,4
80
58
,332
54,8
62,1
48
1.2
Rein
sura
nce a
ssum
ed
1.3
Rein
sura
nce c
eded
54,4
59,2
21
54
,459
,221
1.4
Net
(d)
461,
259
58
,332
402,
927
2.
Lia
bili
ty D
ecem
ber
31, curr
ent
year
from
Part
1:
2.1
Direct
4,81
8,72
6
4,81
8,72
6
2.2
Rein
sura
nce a
ssum
ed
2.3
Rein
sura
nce c
eded
4,81
8,72
6
4,81
8,72
6
2.4
Net
3.
Am
ounts
recovera
ble
fro
m
rein
sure
rs D
ecem
ber
31, curr
ent
year
4,86
2,11
3
4,86
2,11
3
4.
Lia
bili
ty D
ecem
ber
31, prior
year:
4.1
Direct
3,64
2,30
1
3,64
2,30
1
4.2
Rein
sura
nce a
ssum
ed
4.3
Rein
sura
nce c
eded
3,64
2,30
1
3,64
2,30
1
4.4
Net
5.
Am
ounts
recovera
ble
fro
m
rein
sure
rs D
ecem
ber
31, prior
year
4,46
7,66
2
4,46
7,66
2
6.
Incurr
ed B
enefits
6.1
Direct
56,0
96,9
05
58
,332
56,0
38,5
73
6.2
Rein
sura
nce a
ssum
ed
6.3
Rein
sura
nce c
eded
56,0
30,0
97
56
,030
,097
6.4
Net
66,8
08
58
,332
8,47
6
(a)
Inclu
din
g m
atu
red e
ndow
ments
(but not guara
nte
ed a
nnual pure
endow
ments
) am
ounting to $
in L
ine 1
.1, $
in L
ine 1
.4.
$
in L
ine 6
.1, and $
in L
ine 6
.4.
(b)
Inclu
din
g m
atu
red e
ndow
ments
(but not guara
nte
ed a
nnual pure
endow
ments
) am
ounting to $
in L
ine 1
.1, $
in L
ine 1
.4.
$
in L
ine 6
.1, and $
in L
ine 6
.4.
(c)
Inclu
din
g m
atu
red e
ndow
ments
(but not guara
nte
ed a
nnual pure
endow
ments
) am
ounting to $
in L
ine 1
.1, $
in L
ine 1
.4.
$
in L
ine 6
.1, and $
in L
ine 6
.4.
(d)
Inclu
des $
60
,846
p
rem
ium
s w
aiv
ed u
nder
tota
l and p
erm
anent dis
abili
ty b
enefits
.
17
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
EXHIBIT OF NON-ADMITTED ASSETS1
Current Year Total Nonadmitted Assets
2
Prior Year Total Nonadmitted Assets
3Change in Total
Nonadmitted Assets (Col. 2 - Col. 1)
1. Bonds (Schedule D)
2. Stocks (Schedule D):
2.1 Preferred stocks
2.2 Common stocks
3. Mortgage loans on real estate (Schedule B):
3.1 First liens
3.2 Other than first liens
4. Real estate (Schedule A):
4.1 Properties occupied by the company
4.2 Properties held for the production of income
4.3 Properties held for sale
5. Cash (Schedule E - Part 1), cash equivalents (Schedule E - Part 2) and short-term investments (Schedule DA)
6. Contract loans
7. Derivatives (Schedule DB)
8. Other invested assets (Schedule BA)
9. Receivables for securities
10. Securities lending reinvested collateral assets (Schedule DL)
11. Aggregate write-ins for invested assets
12. Subtotals, cash and invested assets (Lines 1 to 11)
13. Title plants (for Title insurers only)
14. Investment income due and accrued
15. Premiums and considerations:
15.1 Uncollected premiums and agents' balances in the course of collection 72,254 142,097 69,843
15.2 Deferred premiums, agents' balances and installments booked but deferred and not yet due
15.3 Accrued retrospective premiums and contracts subject to redetermination
16. Reinsurance:
16.1 Amounts recoverable from reinsurers
16.2 Funds held by or deposited with reinsured companies
16.3 Other amounts receivable under reinsurance contracts
17. Amounts receivable relating to uninsured plans
18.1 Current federal and foreign income tax recoverable and interest thereon
18.2 Net deferred tax asset 8,537,870 9,316,862 778,992
19. Guaranty funds receivable or on deposit
20. Electronic data processing equipment and software
21. Furniture and equipment, including health care delivery assets
22. Net adjustment in assets and liabilities due to foreign exchange rates
23. Receivables from parent, subsidiaries and affiliates
24. Health care and other amounts receivable
25. Aggregate write-ins for other than invested assets
26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 8,610,124 9,458,959 848,835
27. From Separate Accounts, Segregated Accounts and Protected Cell Accounts
28. Total (Lines 26 and 27) 8,610,124 9,458,959 848,835
DETAILS OF WRITE-INS
1101.
1102.
1103.
1198. Summary of remaining write-ins for Line 11 from overflow page
1199. Totals (Lines 1101 thru 1103 plus 1198)(Line 11 above)
2501.
2502.
2503.
2598. Summary of remaining write-ins for Line 25 from overflow page
2599. Totals (Lines 2501 thru 2503 plus 2598)(Line 25 above)
18
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
1. Summary of Significant Accounting Policies
A. Accounting Practices
The accompanying financial statements of The Northwestern Long Term Care Insurance Company (“the Company”) were prepared in accordance with the NAIC “Accounting Practices and Procedures Manual” (“statutory basis of accounting”) as adopted by the Office of the Commissioner of Insurance of the State of Wisconsin ("OCI"), with no exceptions. A reconciliation of the Company’s net income and capital and surplus between NAIC SAP and practices prescribed and permitted by the State of Wisconsin is shown below:
F/S F/S
SSAP # Page Line # 12/31/2016 12/31/2015
NET INCOME
Northwestern Long Term Care Insurance Wisconsin basis 2,588,900$ 2,517,052$
State Prescribed Practices that increase/(decrease) NAIC SAP: N/A N/A N/A- -
State Permitted Practices that increase/(decrease) NAIC SAP: N/A N/A N/A- -
NAIC SAP (1-2-3=4) 2,588,900$ 2,517,052$
SURPLUS
Northwestern Long Term Care Insurance Wisconsin basis 82,226,973$ 79,498,470$
State Prescribed Practices that increase/(decrease) NAIC SAP: N/A N/A N/A- -
State Permitted Practices that increase/(decrease) NAIC SAP: N/A N/A N/A- -
NAIC SAP (5-6-7=8) 82,226,973$ 79,498,470$
B. Use of Estimates in the Preparation of the Financial Statements
The preparation of financial statements in accordance with the statutory basis of accounting requires management to make estimates or assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the periods then ended. Actual future results could differ from these estimates and assumptions.
C. Accounting Policies
1. The Securities Valuation Office (“SVO”) of the NAIC evaluates the credit quality of the Company’s bond investments and issues related credit ratings. Bonds rated "1" (highest quality), "2" (high quality), "3" (medium quality), “4” (low quality) or “5” (lower quality) are reported in the financial statements at amortized cost, less any valuation adjustment. Bonds rated “6” (lowest quality) are reported at the lower of amortized cost or fair value. The interest method is used to amortize any purchase premium or discount, including estimates of future prepayments that are obtained from independent sources. The disclosure of fair value for bonds is primarily based on independent pricing services or internally-developed pricing models utilizing observable market data.
2. The Company has no investments in common stocks.
3. The Company has no investments in preferred stocks.
4. The Company has no investments in mortgage loans.
5. The Company has no investments in subsidiaries, controlled and affiliated companies.
6. The Company has no investments in partnerships.
7. The Company has no investments in derivatives.
8. The Company has determined that no premium deficiency exists.
9. Liabilities for losses for accident and health contracts are estimated by the Company’s valuation actuary using reserves employing mortality/morbidity tables (industry based with provisions for adverse deviation) and discount rates specified by regulatory authorities for long term care business. Liabilities for loss/claim adjustment expenses are estimated by performing periodic product cost studies.
10. The Company has not modified its capitalization policy from the prior period.
11. The Company has no pharmaceutical rebate receivables.
12. Net investment income primarily represents interest and dividends received or accrued on bonds and other investments. Net investment income is reduced by investment management expenses. Accrued investment income more than 90 days past due is a nonadmitted asset and reported as a direct reduction of surplus. Accruals of investment income for securities that have been determined to be other-than-temporarily impaired are generally suspended. Accrued investment income that is ultimately deemed uncollectible is reported as a reduction of net investment income in the period that such determination is made.
13. The Company is required to maintain an interest maintenance reserve (“IMR”). The IMR is used to defer realized capital gains and losses, net of any income tax, on fixed income investments that are attributable to changes in market interest rates, including both changes in risk-free market interest rates and market credit spreads. Net realized capital gains and losses deferred to the IMR are amortized into investment income over the estimated remaining term to maturity of the investment sold.
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.1
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
14. Realized capital gains and losses are recognized based upon specific identification of investment assets sold. Realized capital losses also include valuation adjustments for impairment of bonds and other investments that have experienced a decline in fair value that management considers to be other-than-temporary. There were no realized capital losses related to declines in fair value of investments that were considered to be other-than-temporary for the years ended December 31, 2016 and 2015. Realized capital gains and losses as reported in the summary of operations are net of any capital gains tax (or benefit) and exclude any deferrals to the IMR of interest-rate related capital gains or losses.
15. Changes in unrealized capital gains and losses are reported in the statements of changes in capital and surplus, net of any related changes in deferred taxes.
16. Reserves for policy benefits represent the net present value of future policy benefits, less future policy premiums, calculated using actuarial methods, mortality and morbidity experience tables and valuation interest rates prescribed or permitted by the OCI. These actuarial tables and methods include assumptions regarding future mortality and morbidity experience. Actual future experience could differ from the assumptions used to make these reserve estimates.
Supplementary contract reserves are determined in accordance with the net level premium method at an interest rate of 7.5%.
Active life reserves for long-term care policies consist of mid-terminal reserves and unearned premiums. Mid-terminal reserves are based on the one-year preliminary term method and industry-based morbidity experience. For policies issued prior to March 2002, reserves are based on a 4.00% valuation interest rate and total terminations based on the 1983 Individual Annuitant Mortality table without lapses. For policies issued since March 2002, minimum reserves are based on valuation interest rates ranging from 3.50% to 4.50% and total terminations based on the 1994 Group Annuity Mortality table with lapses. For March 2002 through September 2010 issues, a separate calculation is performed using valuation interest rates ranging from 4.87% to 5.60% and assuming no lapses. Reserves from the separate calculation are compared in the aggregate to the minimum reserves as calculated above and the greater of the two is reported.
For valuations prior to 2012, the Company utilized the 1983 Individual Annuity Mortality table, the 1983 Group Annuity Mortality table, or the 1994 Group Annuity Mortality table for the calculation of minimum reserves for policies. At January 1, 2012, use of the 1983 Group Annuity Mortality table to calculate minimum reserves for policies issued from March 2002 through 2004 was replaced with a calculation using only the 1994 Group Annuity Mortality table and assumptions regarding interest rates and claim costs were adjusted to reflect more recent expectations.
Unpaid claims and claim reserves for long-term care policies are based on the present value of expected benefit payments using industry-based long-term care experience with valuation interest rates ranging from 3.50% to 4.50%.
17. Long-term care premiums and ceded expense allowances are recognized as revenue when due to the Company.
18. Benefit payments to policyholders and beneficiaries include long-term care benefits and payments on supplementary annuity contracts that include life contingencies. Benefit payments are reported net of ceded reinsurance recoveries.
19. Commissions and other operating costs, including costs of acquiring new insurance policies, are generally charged to expense as incurred.
20. Certain assets are designated as nonadmitted on the statutory basis of accounting. Such assets, including deferred tax assets in excess of statutory limits and premiums over 90 days past due, are excluded from assets and surplus. Changes in nonadmitted assets are reported as a direct adjustment to surplus in the statements of changes in capital and surplus.
21. Amounts in these financial statements are reported net of the impact of reinsurance.
2. Accounting Changes and Corrections of Errors
A. Material Accounting Changes and Corrections of Errors None
3. Business Combinations and Goodwill
A. Statutory Purchase Method
None
B. Statutory Merger
None
C. Assumption Reinsurance None
D. Impairment Loss
None
4. Discontinued Operations
None
5. Investments
A. Mortgage Loans, including Mezzanine Real Estate Loans
1. No mortgage loans were originated by the Company during 2016.
2. The Company has no investments in mortgage loans at December 31, 2016.
3. Taxes, assessment and any mortgage amounts advanced and not included in the mortgage loan total: None
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.2
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
4. The Company has no investments in mortgage loans at December 31, 2016. 5. Investment in Impaired Loans With or Without Allowance for Credit Losses: None
6. Investment in Impaired Loans – Average Recorded Investment, Interest Income Recognized, Recorded
Investment on Nonaccrual Status and Amount of Interest Income Recognized Using a Cash-Basis Method of Accounting: None
7. Allowance for Credit Losses:
None
8. Interest Income on Impaired Loans: None
B. Debt Restructuring
None
C. Reverse Mortgages
None
D. Loan-Backed Securities
1. The Company has no investments in loan-backed or structured securities at December 31, 2016.
2. The Company had no loan-backed securities that had other-than-temporary impairment charges taken against them during 2016.
3. The Company held no loan-backed securities for which the present value of cash flows expected to be collected
is less than the amortized cost basis of the security. 4. The Company has no investments in loan-backed or structured securities at December 31, 2016.
5. The Company has no investments in loan-backed or structured securities at December 31, 2016.
E. Repurchase Agreements and/or Securities Lending Transactions
None
F. Real Estate
None
G. Investments in Low Income Housing Tax Credit Properties (LIHTC)
None
H. Restricted Assets
1. Restricted Assets (Including Pledged)
1 2 3 4 5 6 7 8 9 10
Total General
Account (G/A)
G/A Supporting
S/A Activity (a)
Total Separate
Account (S/A)
Restricted
Assets
S/A Assets
Supporting G/A
Activity (b)
Total
(1 plus 3)
Total From
Prior Year
Increase/
(Decrease) (5
minus 6)
Total Current
Year Admitted
Restricted
Gross Restricted
to Total Assets
Admitted
Restricted to
Total Admitted
Assets
a. Subject to contractual obligation for
which liability is not shown -$ -$ -$ -$ -$ -$ -$ -$ 0% 0%
b. Colateral held under security lending
agreements - - - - - - - - 0% 0%
c. Subject to repurchase agreements - - - - - - - - 0% 0%
d. Subject to reverse repurchase
agreements - - - - - - - - 0% 0%
e. Subject to dollar repurchase
agreements - - - - - - - - 0% 0%
f. Subject to dollar reverse repurchase
agreements - - - - - - - - 0% 0%
g. Placed under option contracts - - - - - - - - 0% 0%
h. Letter stock or securities restricted as
to sale - excluding FHLB capital
stock - - - - - - - - 0% 0%
i. FHLB capital stock - - - - - - - - 0% 0%
j. On deposit with states 2,702,008 - - - 2,702,008 2,702,007 1 2,702,007 1.49% 1.56%
k. On deposit with other regulatory
bodies - - - - - - - - 0% 0%
l. Pledged collateral to FHLB
(including assets backing funding
agreements) - - - - - - - - 0% 0%
m. Pledged as collateral not captured in
other categories - - - - - - - - 0% 0%
n. Other restricted assets - - - - - - - - 0% 0%
o. Total Restricted Assets 2,702,008$ -$ -$ -$ 2,702,008$ 2,702,007$ 1$ 2,702,007$ 1.49% 1.56%
(a) Subset of column 1
(b) Subset of column 3
Gross Restricted Percentage
Current Year
Restricted Asset Category
2. Detail of Assets Pledged as Collateral Not Captured in Other Categories (contracts that Share Similar Characteristics, Such as Reinsurance and Derivatives, Are Reported in the Aggregate) None
3. Detail of Other Restricted Assets (Contracts that Share Similar Characteristics, Such as Reinsurance and
Derivatives, Are Reported in the Aggregate) None
4. Collateral Received and Reflected as Assets Within the Reporting Entity’s Financial Statements
None
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.3
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
I. Working Capital Finance Investments
None
J. Offsetting and Netting of Assets and Liabilities
None
K. Structured Notes
None
L. 5* Securities
None
6. Joint Ventures, Partnerships and Limited Liability Companies
A. The Company has no investments in partnerships at December 31, 2016.
B. The Company did not recognize any impairment write downs for its investments in partnerships during the statement period.
7. Investment Income
A-B. The Company had no nonadmitted due and accrued investment income at December 31, 2016 or 2015.
8. Derivative Instruments None
9. Income Taxes
A.
1. The components of the net deferred tax asset/(liability) at December 31, are as follows:
(1) (2) (3) (4) (5) (6) (7) (8) (9)
(Col 1+2) (Col 4+5) (Col 1-4) (Col 2-5) (Col 7+8)
Ordinary Capital Total Ordinary Capital Total Ordinary Capital Total
(a) Gross Deferred Tax Assets 15,904,925 - 15,904,925 16,009,841 - 16,009,841 (104,916) - (104,916)
(b) Statutory Valuation Allowance
Adjustment - - - - - - - - -
(c ) Adjusted Gross Deferred
Tax Assets (1a-1b) 15,904,925 - 15,904,925 16,009,841 - 16,009,841 (104,916) - (104,916)
(d) Deferred Tax Assets Nonadmitted 8,537,870 - 8,537,870 9,316,862 - 9,316,862 (778,992) - (778,992)
(e) Subtotal Net Admitted Deferred
Tax Asset (1c-1d) 7,367,055 - 7,367,055 6,692,979 - 6,692,979 674,076 - 674,076
(f) Deferred Tax Liabilities 3,789,888 532,408 4,322,296 3,542,747 175,232 3,717,979 247,141 357,176 604,317
(g) Net Admitted DTA/(Net DTL) (1e-1f) 3,577,167 (532,408) 3,044,759 3,150,232 (175,232) 2,975,000 426,935 (357,176) 69,759
12/31/2016 12/31/2015 Change
All deferred tax liabilities have been recognized for years ended December 31, 2016 and 2015. The Company exceeded the minimum risk-based capital (“RBC”) level of 300% based on authorized control level RBC computed without net deferred tax assets at December 31, 2016 and 2015 and expects to exceed this minimum during 2017. The Company does not have any known contingent tax liabilities for the years ended December 31, 2016 and 2015.
2. The SSAP 101 deferred tax asset admission calculation components, at December 31, 2016 and 2015, are as follows.
(1) (2) (3) (4) (5) (6) (7) (8) (9)
(Col 1+2) (Col 4+5) (Col 1-4) (Col 2-5) (Col 7+8)
Admission Calculation Components SSAP No. 101 Ordinary Capital Total Ordinary Capital Total Ordinary Capital Total
(a) Federal Income Taxes paid in Prior Years
Recoverable through Loss Carrybacks - - - - - - - - -
(b) Adjusted Gross Deferred Tax Assets
Expected to be Realized (Excluding the
Amount of Deferred Tax Assets From 2(a) 3,044,759 - 3,044,759 2,975,000 - 2,975,000 69,759 - 69,759
above) After Application of the threshold
Limitation. (the lessor of 2(b)1 and 2(b)2 below
1. Adjusted Gross Deferred Tax Assets
Expected to be Realized Following
the Balance Sheet Date 3,044,759 - 3,044,759 2,975,000 - 2,975,000 69,759 - 69,759
2. Adjusted Gross Deferred Tax Assets
Allowed per Limitation Threshold NA NA 11,877,332 NA NA 11,103,524 NA NA 773,808
(c ) Adjusted Gross Deferred Tax Assets
(Excluding the Amount of Deferred Tax 4,322,296 - 4,322,296 3,717,979 - 3,717,979 604,317 - 604,317
Assets From 2(a) and 2(b) above) Offset by
Gross Deferred Tax Liabilities
(d) Deferred Tax Assets Admitted as the result
of application of SSAP No. 101
Total (2(a) + 2(b) + 2(c)) 7,367,055 - 7,367,055 6,692,979 - 6,692,979 674,076 - 674,076
12/31/2016 12/31/2015 Change
3.
2016 2015
(a) Ratio Percentage Used to Detemine
Recovery Period And Threshold Limitation
Amount. 787% 906%
(b) Amount of Adjusted Capital and Surplus
Used to Determine Recovery Period And
Threshold Limitation In 2(b)2 Above. 79,182,213 74,123,493
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.4
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
4.
(1) (2) (3) (4) (5) (6)
(Col 1-3) (Col 2-4)
Ordinary Capital Ordinary Capital Ordinary Capital
Impact of Tax Planning Strategies
(a) Determination of adjusted gross deferred tax assets
and net admitted deferred tax assets, by tax character
as a percentage.
1. Adjusted Gross DTAs amount from Note 9A1(c) 15,904,925 - 16,009,841 - (104,916) -
2. Percentage of adjusted gross DTAs by tax character
attributable to the impact of tax planning strategies 0% 0% 0% 0% 0% 0%
3. Net Admitted Adjusted Gross DTAs amount from
Note 9A1(e) 7,367,055 - 6,692,979 - 674,076 -
4. Percentage of net admitted adjusted gross DTAs by
tax character admitted because of the impact of
tax planning strategies 0% 0% 0% 0% 0% 0%
(b) Does the Company's tax-planning strategies include the use of reinsurance? Yes__________No ____X_____
12/31/2016 12/31/2015 Change
B. There were no unrecognized deferred tax liabilities at December 31, 2016 and 2015. C. Current income tax expenses incurred consist of the following major components:
For the years ended December 31,
2016 2015 Change
1. Current Income Tax
a. Federal -$ 337,929$ (337,929)$
b. Foreign - - -
c. Subtotal - 337,929 (337,929)
d. Federal income tax on net capital gains - (337,929) 337,929
e. Utilization of capital loss carry-forwards - - -
f. Other - - -
g. Federal and foreign income taxes incurred - - -
2. Deferred Tax Assets
a. Ordinary
(1) Discounting of unpaid losses - - -
(2) Unearned premium reserve - - -
(3) Policyholder reserves 7,719,606 8,987,857 (1,268,251)
(4) Investments - - -
(5) Deferred acquisition costs - - -
(6) Policyholder dividends accrual - - -
(7) Fixed assets - 8,751 (8,751)
(8) Compensation and benefits accrual - - -
(9) Pension accrual - - -
(10) Receivables - nonadmitted 25,289 49,734 (24,445)
(11) Net operating loss carry-forward 7,708,530 6,578,499 1,130,031
(12) Tax credit carry-forward - - -
(13) Other 451,500 385,000 66,500
Subtotal 15,904,925 16,009,841 (104,916)
b. Statutory valuation allowance adjustment - - -
c. Nonadmitted 8,537,870 9,316,862 (778,992)
d. Admitted ordinary deferred tax assets 7,367,055 6,692,979 674,076
e. Capital:
(1) Investments - - -
(2) Net capital loss carry-forward - - -
(3) Real estate - - -
(4) Other - - -
Subtotal - - -
f. Statutory valuation allowance adjustment - - -
g. Nonadmitted - - -
h. Admitted capital deferred tax assets - - -
i. Admitted deferred tax assets 7,367,055 6,692,979 674,076
3. Deferred Tax Liabilities
a. Ordinary
(1) Investments - - -
(2) Fixed assets - - -
(3) Deferred and uncollected premium - - -
(4) Policyholder reserves - - -
(5) Other 3,789,888 3,542,747 247,141
Subtotal 3,789,888 3,542,747 247,141
b. Capital:
(1) Investments 532,408 175,232 357,176
(2) Real estate - - -
(3) Other - - -
Subtotal 532,408 175,232 357,176
c. Deferred tax liabilities 4,322,296 3,717,979 604,317
4. Net deferred tax assets/liabilities 3,044,759$ 2,975,000$ 69,759$
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.5
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
Changes in deferred tax assets and liabilities related to unrealized capital gains and losses on investments are included in changes in unrealized capital gains and losses in the statements of changes in capital and surplus. Other net changes in deferred tax assets and liabilities are reported as direct adjustments to surplus in the statements of changes in capital and surplus.
D. Among the more significant book to tax adjustments were the following:
December 31,
2016
Effective Tax
Rate
Provision computed at statutory rate 906,115 35.0%
Amortization of IMR (223,187) -8.6%
Other 26,305 1.0%
Total 709,233 27.4%
Federal and foreign income taxes incurred - 0.0%
Change in net deferred income taxes 709,233 27.4%
Total statutory income taxes 709,233 27.4%
E. 1. The Company has net operating loss carry forwards of $3,229 thousand, $4,612 thousand and $14,184 thousand originating in 2016, 2015 and 2014, respectively. If unused, these will expire in 2036, 2035 and 2034, respectively.
2. There were no federal income taxes incurred in the current and prior years that is available for recoupment in the event of future net losses.
3. The Company had no deposits admitted under Section 6603 of the IRS Code.
F. The Company’s federal income tax return is consolidated with the tax return of its parent, NMLIC which includes the following entities:
Northwestern Mutual Investment Services, LLC Bradford, Inc. and subsidiaries
NML Real Estate Holdings, LLC and subsidiaries Mason Street Advisors, LLC
NML Securities Holdings, LLC and subsidiaries NM GP Holdings, LLC and subsidiaries
Northwestern Mutual MU TLD Registry, LLC NM Pebble Valley, LLC
Northwestern Mutual Wealth Management Company Northwestern Mutual Registry, LLC
NM Investment Holdings, LLC NM Planning, LLC and Subsidiaries
NM Investment Management Company, LLC GRO, LLC and GRO-SUB, LLC
The method of allocation between the companies is subject to written tax-sharing agreements, approved by the management of each entity. Allocation is generally based upon separate return calculations with carry forward credits for net losses available to offset tax due in subsequent years or refund of tax when carryback to prior years is available. Intercompany tax balances are settled quarterly.
G. The Company has no federal or foreign tax loss contingencies.
10. Information Regarding Parent, Subsidiaries and Affiliates
A. The Company is a wholly-owned subsidiary of NMLIC.
B. The Company has no employees. A Product and General Service Agreement is in effect between the Company and NMLIC. Under the terms of this agreement, NMLIC agrees to provide all specified services requested by the Company as necessary for its operations and the Company agrees to reimburse NMLIC for the amount of expenses incurred.
C. The Company has an administrative agreement with NMLIC under which NMLIC provides certain management, administrative and data processing services to the Company. Expenses incurred by the Company for these services totaled $45,820,800 and $51,862,165 for the years ending December 31, 2016 and 2015, respectively. NMLIC did not make any cash contributions of capital during the years ended December 31, 2016 and 2015, respectively.
D. At December 31, the Company reported the following amounts due to and from affiliates:
2016 2015
Due from affiliates:
NMLIC 40,405,532$ 34,684,258$
Total due from affiliates 40,405,532$ 34,684,258$
Due to affiliates:
Northwestern Mutual Investment Management Co. 11,006$ 10,779$
Total 11,006$ 10,779$
December 31,
.
The intercompany balances with NMLIC and Mason Street Advisors, LLC are generally settled in cash within 30 days of the reporting date.
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.6
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
E. The Company has not participated in any guarantees or undertakings for the benefit of affiliates or related parties that have resulted in material contingent exposure of the Company’s or any related party’s assets or liabilities. See note 14A.
F. See A, B and C above. G. All outstanding shares of the Company are owned by NMLIC, an insurance holding company domiciled in the state
of Wisconsin. NMLIC became sole owner on November 23, 1982, by purchasing all of the outstanding shares from the Sundstrand Corporation.
H. The Company does not own any shares of an upstream intermediate entity or ultimate parent.
I. The Company had no investments in subsidiaries, controlled and affiliated companies at December 31, 2016 or 2015.
J. The Company had no investments in impaired subsidiaries, controlled or affiliated companies during 2016 or 2015.
K. The Company has no foreign insurance subsidiaries.
L. The company has no downstream noninsurance holding companies.
M. The Company has no subsidiary, controlled or affiliated investments.
N. The Company has no subsidiary, controlled or affiliated investments.
11. Debt
A. The Company had no debt outstanding at December 31, 2016 or 2015.
B. FHLB (Federal Home Loan Bank) Agreements
None
12. Retirement Plans, Deferred Compensation, Post-Employment Benefits and Compensated Absences and Other
Post-Retirement Benefit Plans
None
13. Capital and Surplus, Shareholders’ Dividend Restrictions and Quasi-Reorganizations
1. The Company has 1,500,000 shares authorized, 1,250,000 shares issued and 1,250,000 shares outstanding. All stock is Class A stock with a $2 par value.
2. The Company has no preferred stock.
3. According to the by-laws of the Company, the Company may pay dividends to stockholders without restriction, in a manner and upon the terms and conditions provided by law and the articles of incorporation. .
4. No stockholder dividends have been paid or accrued during 2016 and 2015.
5. See 3 above.
6. There are no restrictions on unassigned funds.
7. There have been no advances to surplus.
8. The Company held no stock for special purposes.
9. There were no changes in the balances of any special surplus funds during the periods presented.
10. The Company had no portion of unassigned funds (surplus) represented or reduced by cumulative unrealized gains
and (losses).
11. The Company has issued no surplus debentures or similar obligations.
12. The Company has not been involved in any quasi-reorganization.
13. The Company has not been involved in any quasi-reorganization.
14. Liabilities, Contingencies and Assessments
A. Contingent Commitments
1. In the normal course of its investment activities, the Company makes commitments to fund other investments. There were no outstanding commitments at December 31, 2016.
2-3. None
B. Assessments
1) As of December 31, 2016, the Company received the annual notification from the National Organization of Life and Health Insurance Guaranty Association (“NOLHGA”) of the insolvency of various insurance companies. Based on these estimates, it is estimated that these insolvencies may result in retrospective-premium-based guaranty fund assessments against the Company of up to $5,900,000 at December 31, 2016, an amount which is reported as a liability in the financial statements at December 31, 2016. Premium tax offsets related to the potential assessments are expected to be approximately $5,394,503 at December 31, 2016, which is reported as an asset in the financial statements, resulting in an estimated net obligation of $505,497.
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.7
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
2)
a. Assets recognized from paid and accrued premium tax offsets and
policy surcharges prior year-end 4,719,629$
b. Decreases current year
Policy surcharges collected -
Policy surcharges charged off -
Premium tax offset applied (90,568)
c. Increases current year Policy surcharges collected -
Policy surcharges charged off -
Premium tax offset applied 765,442
d. Assets recognized from paid and accrued premium tax offsets and policy surcharges current year-end 5,394,503$
C. Gain Contingencies
None
D. Claims Related to Extra Contractual Obligation and Bad Faith Losses Stemming from Lawsuits
None
E. Joint and Several Liabilities
None
F. All Other Contingencies
The Company is engaged in various legal actions in the course of its investment and insurance operations. The status of these legal actions is actively monitored by management. If management believed, based on available information, that an adverse outcome upon resolution of a given legal action was probable and the amount of that adverse outcome was reasonable to estimate, a loss would be recognized and a related liability recorded.
Legal actions are subject to inherent uncertainties, and future events could change management’s assessment of the probability or estimated amount of potential losses from pending or threatened legal actions. Based on available information, it is the opinion of management that the ultimate resolution of pending or threatened legal actions, both individually and in the aggregate, will not result in losses having a material effect on the Company’s financial position at December 31, 2016.
15. Leases
A. The Company does not have any material lease obligations.
B. Leasing is not a significant part of the Company’s business.
16. Information About Financial Instruments With Off-Balance Sheet Risk and Financial Instruments With Concentrations of Credit Risk
At December 31, 2016, the Company’s bond portfolio includes a significant concentration of investments in U.S. Treasury securities and the vast majority of the Company’s long-term care (“LTC”) in-force business is reinsured by its parent, NMLIC. See Note 21 below for more information regarding the affiliated reinsurance transaction.
17. Sale, Transfer and Servicing of Financial Assets and Extinguishments of Liabilities
A. Transfers of Receivables Reported as Sales
None
B. Transfer and Servicing of Financial Assets
None
C. Wash Sales
None
18. Gain or Loss to the Reporting Entity from Uninsured Plans and the Uninsured Portion of Partially
Insured Plans
None
19. Direct Premium Written/Produced by Managing General Agents/Third Party Administrators
None
20. Fair Value Measurements
A. The Company’s estimation of fair value for financial instruments uses a hierarchy that, where possible, makes use of quoted market prices from active and transparent markets for assets that are identical to those being valued, typically obtained from independent pricing services (“level 1”). In absence of quoted market prices for identical assets, fair value is estimated by these pricing services using relevant and observable market-based inputs for substantially similar securities (“level 2”). Financial instruments for which no quoted market prices or observable inputs are available are generally valued using internally-developed pricing models or indicative (i.e., non-binding) quotes from independent securities brokers (“level 3”).
The Company actively monitors quality control over fair value estimates received from independent pricing services at each financial reporting date, including analysis of valuation changes for individual securities compared to overall market trends and validation on an exception basis with internally-developed pricing models. The Company also performs periodic reviews of the information sources, inputs and methods used by its independent pricing services, including an evaluation of their control processes. Where necessary, the Company will challenge third-party valuations or methods and require more observable inputs or different methodologies.
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.8
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
Bonds
Bonds classified as level 1 financial instruments are generally limited to U.S. Treasury securities. See Note 1 and Note 5 for more information regarding the Company’s investments in bonds.
Cash and Short-term Investments
Cash and short-term investments include cash deposit balances, money market funds, short-term commercial paper and other highly-liquid debt instruments, for which the Company considers amortized cost to approximate fair value.
Assets and Liabilities Reported at Fair Value
1. Fair Value Measurements at Reporting Date - None
2. Fair Value Measurements in (Level 3) of the Fair Value Hierarchy - None
3. The Company may reclassify assets reported at fair value between levels of the SSAP 100 fair value hierarchy if appropriate based on changes in the quality of valuation inputs available during a reporting period. There were no transfers between Level 1 and Level 2 or between Level 2 and Level 3 during the years ended December 31, 2016 or 2015.
4. The Company held no assets or liabilities measured within Level 2 or 3 of the fair value hierarchy at December
31, 2016. 5. The Company held no derivative assets or liabilities at December 31, 2016.
B. Combined Fair Value Measurements
None
C. Financial Instruments
December 31, 2016
Type of Financial Instrument
Aggregate Fair
Value Admitted Assets Level 1 Level 2 Level 3
Assets:
Bonds 92,272,495$ 89,439,856$ 92,272,495$ -$ -$
Cash and short-term securities 5,409,255 5,409,255 5,409,255 - -
December 31, 2015
Type of Financial Instrument
Aggregate Fair
Value Admitted Assets Level 1 Level 2 Level 3
Assets:
Bonds 89,591,651$ 86,313,518$ 89,591,651$ -$ -$
Cash and short-term securities 6,759,355 6,759,355 6,759,355 - -
D. Not Practicable to Estimate Fair Value
None
21. Other Items
A. Extraordinary Items
None
B. Troubled Debt Restructuring-Debtors
None
C. Other Disclosures and Unusual Items
Each year, the Company must perform asset adequacy testing to demonstrate that reserves make adequate provision for the anticipated cash flows required by contractual obligations and related expenses, in light of assets held for the reserves. Asset adequacy testing (“AAT”) is performed in accordance with presently accepted actuarial standards and must include assumptions necessary to determine the adequacy of reserves under moderately adverse conditions. The Company is no longer required to hold any AAT reserves at December 31, 2016 and 2015 as a result of an affiliated reinsurance transaction discussed further in Note 6 of these financial statements. The Company cedes the vast majority of the risk associated with its long-term care business to NMLIC as part of an affiliated reinsurance agreement.
With regard to General Interrogatory 16 (located on page 20.2 of this Annual Statement), NMLIC’s Finance Committee, a subordinate committee of its Board of Trustees, generally delegates the authority to purchase and sell investments on behalf of the Company to its officers (e.g. Chief Investment Officer, Senior Vice President – Securities) or to certain investment managers. These delegations are subject to limitations generally based on the characteristics and amount of the investments which can be purchased or sold on the Company’s behalf.
D. Business Interruption Insurance Recoveries
None
E. State Transferable and Non-transferable Tax Credits None
F. Subprime Mortgage Related Risk Exposure None
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.9
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
G. Retained Assets
None
H. Insurance-linked Securities
None
22. Events Subsequent – Not applicable
23. Reinsurance A. Ceded Reinsurance Report
Section 1- General Interrogatories 1. Are any of the reinsurers listed in Schedule S as non-affiliated owned in excess of 10% or controlled, either
directly or indirectly, by the Company or by any representative, officer, trustee or director of the Company? Yes ( ) No (X)
2. Have any policies issued by the Company been reinsured with a company chartered in a country other than the United States (excluding U.S. branches of such companies) that is owned in excess of 10% or controlled directly or indirectly by an insured, a beneficiary, a creditor, or an insured or any other person not primarily engaged in the insurance business? Yes ( ) No (X)
Section 2- Ceded Reinsurance Report- Part A 1. Does the Company have any reinsurance agreements in effect under which the reinsurer may unilaterally cancel
any reinsurance for reasons other than for nonpayment of premium or other similar credits? Yes ( ) No (X)
2. Does the Company have any reinsurance agreements in effect such that the amount of losses paid or accrued through the statement date may result in a payment to the reinsurer of amounts that, in aggregate and allowing for offset of mutual credits from other reinsurance agreements with the same reinsurer, exceed the total direct premium collected under the reinsured policies? Yes ( ) No (X)
Section 3- Ceded Reinsurance Report- Part B
1. What is the estimated amount of the aggregate reduction in surplus (for agreements other than those under, which the reinsurer may unilaterally cancel for reasons other than nonpayment of premium or other similar credits that are reflected in Section 2 above) of termination of all reinsurance agreements, by either party, as of the date of this statement?
Where necessary, the Company may consider current or anticipated experience of the business reinsured in making this estimate. The surplus impact of a hypothetical termination of all reinsurance agreements would depend on the negotiated terms of the termination. Management believes that the impact would be immaterial based on reasonable assumptions about such terms.
2. Have any new agreements been executed or have any existing agreements been amended since January 1 of the year of this statement to include policies or contracts that were in force or which had existing reserves established by the Company as of the effective date of the agreement?
Yes ( ) No (X)
B. Uncollectible Reinsurance None
C. Commutation of Ceded Reinsurance
None
D. Certified Reinsurance Rating Downgraded or Status Subject to Revocation
1. Not applicable.
2. Not applicable.
E. Reinsurance of Variable Annuity Contracts with an Affiliated Captive Reinsurer None
F. Reinsurance Agreements with Affiliated Captive Reinsurer None
G. Ceding Entities That Utilize Captive Reinsurers to Assume Reserves Subject to the XXX/AXXX Captive
Framework
None
24. Retrospectively Rated Contracts and Contracts Subject to Redetermination
None
25. Change in Incurred Losses and Loss Adjustment Expenses
All reserves have been ceded as of December 31, 2016. All claim reserves and incurred claim detail is provided to the assuming companies.
26. Inter-company Pooling Arrangements
None
27. Structured Settlements
None
28. Health Care Receivables
None
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
19.10
NOTES TO FINANCIAL STATEMENTS _________________________________________________________________________________________________________________
29. Participating Policies At December 31, 2016, 100% of long-term care insurance policies were participating. Annually, the Company’s Board of Directors approves dividends payable on participating policies during the subsequent fiscal year, which are accrued and charged to operations when approved. Participating dividends are only available to reduce future premiums. The Company recognized dividends to policyowners in the summary of operations of $123 and $1,048 during 2016 and 2015, respectively. No additional income was allocated to participating policyowners.
30. Premium Deficiency Reserves
1. Liability carried for premium deficiency reserves $0 2. Date of the most recent evaluation of this liability 2016 3. Was anticipated investment income utilized in the calculation Yes
31. Reserves for Life Contracts and Annuity Contracts
None
32. Analysis of Annuity Actuarial Reserves and Deposit-Type Contract Liabilities by Withdrawal Characteristics
A. – E.
Following is a summary of annuity reserves, including separate accounts, and deposit-fund liabilities by withdrawal characteristic at December 31, 2016:
General Account
Separate
Accounts
with
Guarantees
Separate Accounts
Nonguaranteed Total
% of
Total
A. Subject to discretionary withdrawal:
1. With fair value adjustment -$ -$ -$ -$ 0.0%
2. At book value less current surrender
charge of 5% or more - - - - 0.0%
3. At fair value - - - - 0.0%
4. Total with adjustment or at fair value
(Total of 1 through 3) -$ -$ -$ -$ 0.0%
5. At book value without adjustment
(minimal or no charge or adjustment) 4,771,475 - - 4,771,475 93.6%
B. Not subject to discretionary withdrawal 325,756 - - 325,756 6.4%
C. Total (gross: direct + assumed) 5,097,231$ -$ -$ 5,097,231$ 100.0%
D. Reinsurance ceded - - - -
E. Total (net) C - D 5,097,231$ -$ -$ 5,097,231$
Following is a reconciliation of total annuity actuarial reserves, including separate accounts, and deposit-fund liabilities at December 31, 2016:
F.
Life and Accident and Health Annual Statement:
1. Exhibit 5, Annuities Section, Total (net) -$
2. Exhibit 5, Supplementary Contracts with Life Contingencies Section, Total (net) 325,756
3. Exhibit 7, Deposit-Type Contracts, Line 14, Column 1 4,771,475
4. Subtotal 5,097,231$
Separate Accounts Annual Statement:
5. Exhibit 3, Line 0299999, Column 2 -$
6. Exhibit 3, Line 0399999, Column 2 -
7. Policyholder dividend and coupon accumulations
8. Policyholder premiums
9. Guaranteed interest contracts
10. Other contract deposit funds -
11. Subtotal -$
12. Combined Total 5,097,231$
33. Premium and Annuity Considerations Deferred and Uncollected None
34. Separate Accounts
None
35. Loss/Claim Adjustment Expenses All claim adjustment expenses have been ceded as of December 31, 2016. All liability detail has been provided to the assuming companies.
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
PART 1 - COMMON INTERROGATORIESGENERAL
1.1 Is the reporting entity a member of an Insurance Holding Company System consisting of two or more affiliated persons, one or more of which is an insurer? Yes [ X ] No [ ]
If yes, complete Schedule Y, Parts 1, 1A and 2
1.2 If yes, did the reporting entity register and file with its domiciliary State Insurance Commissioner, Director or Superintendent, or with such regulatory official of the state of domicile of the principal insurer in the Holding Company System, a registration statement providing disclosure substantially similar to the standards adopted by the National Association of Insurance Commissioners (NAIC) in its Model Insurance Holding Company System Regulatory Act and model regulations pertaining thereto, or is the reporting entity subject to standards and disclosure requirements substantially similar to those required by such Act and regulations? Yes [ X ] No [ ] N/A [ ]
1.3 State Regulating? Wisconsin
2.1 Has any change been made during the year of this statement in the charter, by-laws, articles of incorporation, or deed of settlement of the reporting entity? Yes [ ] No [ X ]
2.2 If yes, date of change:
3.1 State as of what date the latest financial examination of the reporting entity was made or is being made. 12/31/2012
3.2 State the as of date that the latest financial examination report became available from either the state of domicile or the reporting entity. This date should be the date of the examined balance sheet and not the date the report was completed or released. 12/31/2012
3.3 State as of what date the latest financial examination report became available to other states or the public from either the state of domicile or the reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheet date). 04/24/2014
3.4 By what department or departments?
Wisconsin
3.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? Yes [ ] No [ ] N/A [ X ]
3.6 Have all of the recommendations within the latest financial examination report been complied with? Yes [ X ] No [ ] N/A [ ]
4.1 During the period covered by this statement, did any agent, broker, sales representative, non-affiliated sales/service organization or any combination thereof under common control (other than salaried employees of the reporting entity), receive credit or commissions for or control a substantial part (more than 20 percent of any major line of business measured on direct premiums) of:
4.11 sales of new business? Yes [ ] No [ X ]
4.12 renewals? Yes [ ] No [ X ]
4.2 During the period covered by this statement, did any sales/service organization owned in whole or in part by the reporting entity or an affiliate, receive credit or commissions for or control a substantial part (more than 20 percent of any major line of business measured on direct premiums) of:
4.21 sales of new business? Yes [ ] No [ X ]
4.22 renewals? Yes [ ] No [ X ]
5.1 Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? Yes [ ] No [ X ]
5.2 If yes, provide the name of the entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that has ceased to exist as a result of the merger or consolidation.
1Name of Entity
2NAIC Company Code
3State of Domicile
6.1 Has the reporting entity had any Certificates of Authority, licenses or registrations (including corporate registration, if applicable) suspended or revoked by any governmental entity during the reporting period? Yes [ ] No [ X ]
6.2 If yes, give full information:
7.1 Does any foreign (non-United States) person or entity directly or indirectly control 10% or more of the reporting entity? Yes [ ] No [ X ]
7.2 If yes,
7.21 State the percentage of foreign control; %
7.22 State the nationality(s) of the foreign person(s) or entity(s) or if the entity is a mutual or reciprocal, the nationality of its manager or attorney-in-fact; and identify the type of entity(s) (e.g., individual, corporation or government, manager or attorney in fact).
1Nationality
2Type of Entity
20
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
8.1 Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? Yes [ ] No [ X ]8.2 If response to 8.1 is yes, please identify the name of the bank holding company.
8.3 Is the company affiliated with one or more banks, thrifts or securities firms? Yes [ X ] No [ ]8.4 If response to 8.3 is yes, please provide below the names and location (city and state of the main office) of any affiliates regulated by a federal
regulatory services agency [i.e. the Federal Reserve Board (FRB), the Office of the Comptroller of the Currency (OCC), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identify the affiliate's primary federal regulator.
1Affiliate Name
2Location (City, State)
3FRB
4OCC
5FDIC
6SEC
Northwestern Mutual Investment Services, LLC Milwaukee, WI NO NO NO YES
Mason Street Advisors, LLC Milwaukee, WI NO NO NO YES
Northwestern Mutual Wealth Management Company Milwaukee, WI NO YES NO NO
LearnVest Planning Services, LLC Scottsdale, AZ NO NO NO YES
9. What is the name and address of the independent certified public accountant or accounting firm retained to conduct the annual audit?
PricewaterhouseCoopers LLP 100 East Wisconsin Ave., Milwaukee, WI 53202
10.1 Has the insurer been granted any exemptions to the prohibited non-audit services provided by the certified independent public accountant requirements as allowed in Section 7H of the Annual Financial Reporting Model Regulation (Model Audit Rule), or substantially similar state law or regulation? Yes [ ] No [ X ]
10.2 If the response to 10.1 is yes, provide information related to this exemption:
10.3 Has the insurer been granted any exemptions related to the other requirements of the Annual Financial Reporting Model Regulation as allowed for in Section 18A of the Model Regulation, or substantially similar state law or regulation? Yes [ ] No [ X ]
10.4 If the response to 10.3 is yes, provide information related to this exemption:
10.5 Has the reporting entity established an Audit Committee in compliance with the domiciliary state insurance laws? Yes [ X ] No [ ] N/A [ ]10.6 If the response to 10.5 is no or n/a, please explain
11. What is the name, address and affiliation (officer/employee of the reporting entity or actuary/consultant associated with an actuarial consulting firm) of the individual providing the statement of actuarial opinion/certification?
Chris G. Trost, VP Actuary, Northwestern Long Term Care Insurance Company, 720 East Wisconsin Avenue, Milwaukee, WI 53202
12.1 Does the reporting entity own any securities of a real estate holding company or otherwise hold real estate indirectly? Yes [ ] No [ X ]
12.11 Name of real estate holding company
12.12 Number of parcels involved
12.13 Total book/adjusted carrying value $
12.2 If, yes provide explanation:
13. FOR UNITED STATES BRANCHES OF ALIEN REPORTING ENTITIES ONLY:
13.1 What changes have been made during the year in the United States manager or the United States trustees of the reporting entity?
13.2 Does this statement contain all business transacted for the reporting entity through its United States Branch on risks wherever located? Yes [ ] No [ ]
13.3 Have there been any changes made to any of the trust indentures during the year? Yes [ ] No [ ]
13.4 If answer to (13.3) is yes, has the domiciliary or entry state approved the changes? Yes [ ] No [ ] N/A [ ]14.1 Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing
similar functions) of the reporting entity subject to a code of ethics, which includes the following standards? Yes [ X ] No [ ](a) Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional
relationships;(b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity;
(c) Compliance with applicable governmental laws, rules and regulations;
(d) The prompt internal reporting of violations to an appropriate person or persons identified in the code; and
(e) Accountability for adherence to the code.
14.11 If the response to 14.1 is No, please explain:
14.2 Has the code of ethics for senior managers been amended? Yes [ ] No [ X ]14.21 If the response to 14.2 is yes, provide information related to amendment(s).
14.3 Have any provisions of the code of ethics been waived for any of the specified officers? Yes [ ] No [ X ]14.31 If the response to 14.3 is yes, provide the nature of any waiver(s).
20.1
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
15.1 Is the reporting entity the beneficiary of a Letter of Credit that is unrelated to reinsurance where the issuing or confirming bank is not on the SVO Bank List? Yes [ ] No [ X ]
15.2 If the response to 15.1 is yes, indicate the American Bankers Association (ABA) Routing Number and the name of the issuing or confirming bank of the Letter of Credit and describe the circumstances in which the Letter of Credit is triggered.
1American Bankers
Association (ABA) Routing
Number
2
Issuing or Confirming Bank Name
3
Circumstances That Can Trigger the Letter of Credit
4
Amount
BOARD OF DIRECTORS16. Is the purchase or sale of all investments of the reporting entity passed upon either by the board of directors or a subordinate committee
thereof? Yes [ X ] No [ ]
17. Does the reporting entity keep a complete permanent record of the proceedings of its board of directors and all subordinate committees thereof? Yes [ X ] No [ ]
18. Has the reporting entity an established procedure for disclosure to its board of directors or trustees of any material interest or affiliation on the part of any of its officers, directors, trustees or responsible employees that is in conflict with the official duties of such person? Yes [ X ] No [ ]
FINANCIAL19. Has this statement been prepared using a basis of accounting other than Statutory Accounting Principles (e.g., Generally Accepted
Accounting Principles)? Yes [ ] No [ X ]
20.1 Total amount loaned during the year (inclusive of Separate Accounts, exclusive of policy loans): 20.11 To directors or other officers $
20.12 To stockholders not officers $
20.13 Trustees, supreme or grand
(Fraternal Only) $
20.2 Total amount of loans outstanding at the end of year (inclusive of Separate Accounts, exclusive of policy loans): 20.21 To directors or other officers $
20.22 To stockholders not officers $
20.23 Trustees, supreme or grand
(Fraternal Only) $
21.1 Were any assets reported in this statement subject to a contractual obligation to transfer to another party without the liability for such obligation being reported in the statement? Yes [ ] No [ X ]
21.2 If yes, state the amount thereof at December 31 of the current year: 21.21 Rented from others $
21.22 Borrowed from others $
21.23 Leased from others $
21.24 Other $
22.1 Does this statement include payments for assessments as described in the Annual Statement Instructions other than guaranty fund or guaranty association assessments? Yes [ X ] No [ ]
22.2 If answer is yes: 22.21 Amount paid as losses or risk adjustment $
22.22 Amount paid as expenses $ 50,070
22.23 Other amounts paid $
23.1 Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page 2 of this statement? Yes [ X ] No [ ]
23.2 If yes, indicate any amounts receivable from parent included in the Page 2 amount: $ 40,405,532
INVESTMENT
24.01 Were all the stocks, bonds and other securities owned December 31 of current year, over which the reporting entity has exclusive control, in the actual possession of the reporting entity on said date? (other than securities lending programs addressed in 24.03) Yes [ ] No [ X ]
24.02 If no, give full and complete information relating thereto
2,695,000 912828G38 US Treasury 2.25% 11/15/2024 on deposit with multiple states.
24.03 For security lending programs, provide a description of the program including value for collateral and amount of loaned securities, and whether collateral is carried on or off-balance sheet. (an alternative is to reference Note 17 where this information is also provided)
24.04 Does the Company's security lending program meet the requirements for a conforming program as outlined in the Risk-Based Capital Instructions? Yes [ ] No [ ] N/A [ X ]
24.05 If answer to 24.04 is yes, report amount of collateral for conforming programs. $
24.06 If answer to 24.04 is no, report amount of collateral for other programs. $
24.07 Does your securities lending program require 102% (domestic securities) and 105% (foreign securities) from the counterparty at the outset of the contract? Yes [ ] No [ ] N/A [ X ]
24.08 Does the reporting entity non-admit when the collateral received from the counterparty falls below 100%? Yes [ ] No [ ] N/A [ X ]
24.09 Does the reporting entity or the reporting entity ’s securities lending agent utilize the Master Securities lending Agreement (MSLA) to conduct securities lending? Yes [ ] No [ ] N/A [ X ]
20.2
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
24.10 For the reporting entity’s security lending program state the amount of the following as December 31 of the current year:
24.101 Total fair value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2. $
24.102 Total book adjusted/carrying value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2 $
24.103 Total payable for securities lending reported on the liability page. $
25.1 Were any of the stocks, bonds or other assets of the reporting entity owned at December 31 of the current year not exclusively under the control of the reporting entity, or has the reporting entity sold or transferred any assets subject to a put option contract that is currently in force? (Exclude securities subject to Interrogatory 21.1 and 24.03). Yes [ X ] No [ ]
25.2 If yes, state the amount thereof at December 31 of the current year: 25.21 Subject to repurchase agreements $
25.22 Subject to reverse repurchase agreements $
25.23 Subject to dollar repurchase agreements $
25.24 Subject to reverse dollar repurchase agreements $
25.25 Placed under option agreements $ 25.26 Letter stock or securities restricted as to sale -
excluding FHLB Capital Stock $
25.27 FHLB Capital Stock $
25.28 On deposit with states $ 2,702,007
25.29 On deposit with other regulatory bodies $ 25.30 Pledged as collateral - excluding collateral pledged to
an FHLB $ 25.31 Pledged as collateral to FHLB - including assets
backing funding agreements $
25.32 Other $
25.3 For category (25.26) provide the following:
1Nature of Restriction
2Description
3Amount
26.1 Does the reporting entity have any hedging transactions reported on Schedule DB? Yes [ ] No [ X ]
26.2 If yes, has a comprehensive description of the hedging program been made available to the domiciliary state? Yes [ ] No [ ] N/A [ X ]If no, attach a description with this statement.
27.1 Were any preferred stocks or bonds owned as of December 31 of the current year mandatorily convertible into equity, or, at the option of the issuer, convertible into equity? Yes [ ] No [ X ]
27.2 If yes, state the amount thereof at December 31 of the current year. $
28. Excluding items in Schedule E - Part 3 - Special Deposits, real estate, mortgage loans and investments held physically in the reporting entity's offices, vaults or safety deposit boxes, were all stocks, bonds and other securities, owned throughout the current year held pursuant to a custodial agreement with a qualified bank or trust company in accordance with Section 1, III - General Examination Considerations, F. Outsourcing of Critical Functions, Custodial or Safekeeping Agreements of the NAIC Financial Condition Examiners Handbook? Yes [ X ] No [ ]
28.01 For agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following:
1Name of Custodian(s)
2Custodian's Address
The Bank of New York Mellon 135 Santilli Highway, Everett, MA 02149
28.02 For all agreements that do not comply with the requirements of the NAIC Financial Condition Examiners Handbook, provide the name, location and a complete explanation:
1Name(s)
2Location(s)
3Complete Explanation(s)
28.03 Have there been any changes, including name changes, in the custodian(s) identified in 28.01 during the current year? Yes [ ] No [ X ]
28.04 If yes, give full and complete information relating thereto:
1Old Custodian
2New Custodian
3Date of Change
4Reason
20.3
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
28.05 Investment management – Identify all investment advisors, investment managers, broker/dealers, including individuals that have the authority to make investment decisions on behalf of the reporting entity. For assets that are managed internally by employees of the reporting entity, note as such. ["…that have access to the investment accounts"; "…handle securities"]
1Name of Firm or Individual
2Affiliation
Northwestern Mutual Investment Management Company, LLC A
28.0597 For those firms/individuals listed in the table for Question 28.05, do any firms/individuals unaffiliated with the reporting entity (i.e. designated with a "U") manage more than 10% of the reporting entity’s assets? Yes [ ] No [ ]
28.0598 For firms/individuals unaffiliated with the reporting entity (i.e. designated with a "U") listed in the table for Question 28.05, does the total assets under management aggregate to more than 50% of the reporting entity’s assets? Yes [ ] No [ ]
28.06 For those firms or individuals listed in the table for 28.05 with an affiliation code of "A" (affiliated) or "U" (unaffiliated), provide the information for the table below.
1
Central Registration Depository Number
2
Name of Firm or Individual
3
Legal Entity Identifier (LEI)
4
Registered With
5Investment
Management Agreement (IMA) Filed
4973327
Northwestern Mutual Investment Management
Company, LLC 549300W5EJUHTUUBZI82 Not a Registered Investment Advisor DS
29.1 Does the reporting entity have any diversified mutual funds reported in Schedule D, Part 2 (diversified according to the Securities and Exchange Commission (SEC) in the Investment Company Act of 1940 [Section 5(b)(1)])? Yes [ ] No [ X ]
29.2 If yes, complete the following schedule:
1
CUSIP #
2
Name of Mutual Fund
3Book/Adjusted Carrying Value
29.2999 - Total
29.3 For each mutual fund listed in the table above, complete the following schedule:
1
Name of Mutual Fund (from above table)
2
Name of Significant Holding of theMutual Fund
3Amount of Mutual
Fund's Book/Adjusted Carrying Value
Attributable to the Holding
4
Date of Valuation
30. Provide the following information for all short-term and long-term bonds and all preferred stocks. Do not substitute amortized value or statement value for fair value.
1
Statement (Admitted) Value
2
Fair Value
3Excess of Statement over Fair Value (-), or
Fair Value over Statement (+)
30.1 Bonds 89,439,856 92,272,495 2,832,639
30.2 Preferred stocks
30.3 Totals 89,439,856 92,272,495 2,832,639
30.4 Describe the sources or methods utilized in determining the fair values:
Prices are provided by independent pricing services.
31.1 Was the rate used to calculate fair value determined by a broker or custodian for any of the securities in Schedule D? Yes [ ] No [ X ]
31.2 If the answer to 31.1 is yes, does the reporting entity have a copy of the broker’s or custodian’s pricing policy (hard copy or electronic copy) for all brokers or custodians used as a pricing source? Yes [ ] No [ ]
31.3 If the answer to 31.2 is no, describe the reporting entity’s process for determining a reliable pricing source for purposes of disclosure of fair value for Schedule D:
32.1 Have all the filing requirements of the Purposes and Procedures Manual of the NAIC Investment Analysis Office been followed? Yes [ X ] No [ ]
32.2 If no, list exceptions:
20.4
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
OTHER
33.1 Amount of payments to trade associations, service organizations and statistical or rating bureaus, if any? $ 10,287
33.2 List the name of the organization and the amount paid if any such payment represented 25% or more of the total payments to trade associations, service organizations and statistical or rating bureaus during the period covered by this statement.
1Name
2Amount Paid
American Council of Life 5,220
34.1 Amount of payments for legal expenses, if any? $
34.2 List the name of the firm and the amount paid if any such payment represented 25% or more of the total payments for legal expenses during the period covered by this statement.
1Name
2Amount Paid
35.1 Amount of payments for expenditures in connection with matters before legislative bodies, officers or departments of government, if any? $ 3,330
35.2 List the name of the firm and the amount paid if any such payment represented 25% or more of the total payment expenditures in connection with matters before legislative bodies, officers or departments of government during the period covered by this statement.
1Name
2Amount Paid
American Council of Life 3,330
20.5
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
PART 2 - LIFE INTERROGATORIES
1.1 Does the reporting entity have any direct Medicare Supplement Insurance in force? Yes [ ] No [ X ]
1.2 If yes, indicate premium earned on U.S. business only $
1.3 What portion of Item (1.2) is not reported on the Medicare Supplement Insurance Experience Exhibit? $
1.31 Reason for excluding:
1.4 Indicate amount of earned premium attributable to Canadian and/or Other Alien not included in Item (1.2) above. $
1.5 Indicate total incurred claims on all Medicare Supplement insurance. $
1.6 Individual policies: Most current three years:
1.61 Total premium earned $
1.62 Total incurred claims $
1.63 Number of covered lives
All years prior to most current three years
1.64 Total premium earned $
1.65 Total incurred claims $
1.66 Number of covered lives
1.7 Group policies: Most current three years:
1.71 Total premium earned $
1.72 Total incurred claims $
1.73 Number of covered lives
All years prior to most current three years
1.74 Total premium earned $
1.75 Total incurred claims $
1.76 Number of covered lives
2. Health Test:
1Current Year
2Prior Year
2.1 Premium Numerator
2.2 Premium Denominator 160,022 288,910
2.3 Premium Ratio (2.1/2.2) 0.000 0.000
2.4 Reserve Numerator 122,478,445 115,309,890
2.5 Reserve Denominator 325,756 367,778
2.6 Reserve Ratio (2.4/2.5) 375.982 313.531
3.1 Does this reporting entity have Separate Accounts? Yes [ ] No [ X ]
3.2 If yes, has a Separate Accounts Statement been filed with this Department? Yes [ ] No [ ] N/A [ ]
3.3 What portion of capital and surplus funds of the reporting entity covered by assets in the Separate Accounts statement, is not currently distributable from the Separate Accounts to the general account for use by the general account? $
3.4 State the authority under which Separate Accounts are maintained:
3.5 Was any of the reporting entity’s Separate Accounts business reinsured as of December 31? Yes [ ] No [ X ]
3.6 Has the reporting entity assumed by reinsurance any Separate Accounts business as of December 31? Yes [ ] No [ X ]
3.7 If the reporting entity has assumed Separate Accounts business, how much, if any, reinsurance assumed receivable for reinsurance of Separate Accounts reserve expense allowances is included as a negative amount in the liability for “Transfers to Separate Accounts due or accrued (net)"?
4.1 Are personnel or facilities of this reporting entity used by another entity or entities or are personnel or facilities of another entity or entities used by this reporting entity (except for activities such as administration of jointly underwritten group contracts and joint mortality or morbidity studies)? Yes [ X ] No [ ]
4.2 Net reimbursement of such expenses between reporting entities:
4.21 Paid $ 47,592,478
4.22 Received $
5.1 Does the reporting entity write any guaranteed interest contracts? Yes [ ] No [ X ]
5.2 If yes, what amount pertaining to these lines is included in:
5.21 Page 3, Line 1 $
5.22 Page 4, Line 1 $
6. FOR STOCK REPORTING ENTITIES ONLY:
6.1 Total amount paid in by stockholders as surplus funds since organization of the reporting entity: $ 115,045,146
7. Total dividends paid stockholders since organization of the reporting entity:
7.11 Cash $
7.12 Stock $
21
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
8.1 Does the company reinsure any Workers’ Compensation Carve-Out business defined as: Yes [ ] No [ X ]
Reinsurance (including retrocessional reinsurance) assumed by life and health insurers of medical, wage loss and death benefits of the occupational illness and accident exposures, but not the employers liability exposures, of business originally written as workers’ compensation insurance.
8.2 If yes, has the reporting entity completed the Workers’ Compensation Carve-Out Supplement to the Annual Statement? Yes [ ] No [ ]
8.3 If 8.1 is yes, the amounts of earned premiums and claims incurred in this statement are:
1Reinsurance
Assumed
2Reinsurance
Ceded
3Net
Retained
8.31 Earned premium
8.32 Paid claims
8.33 Claim liability and reserve (beginning of year)
8.34 Claim liability and reserve (end of year)
8.35 Incurred claims
8.4 If reinsurance assumed included amounts with attachment points below $1,000,000, the distribution of the amounts reported in Lines 8.31 and 8.34 for Column (1) are:
AttachmentPoint
1Earned
Premium
2Claim Liabilityand Reserve
8.41 <$25,000
8.42 $25,000 - 99,999
8.43 $100,000 - 249,999
8.44 $250,000 - 999,999
8.45 $1,000,000 or more
8.5 What portion of earned premium reported in 8.31, Column 1 was assumed from pools? $
9.1 Does the company have variable annuities with guaranteed benefits? Yes [ ] No [ X ]
9.2 If 9.1 is yes, complete the following table for each type of guaranteed benefit.
Type 3 4 5 6 7 8 91
GuaranteedDeath Benefit
2Guaranteed
Living Benefit
WaitingPeriod
RemainingAccount Value
Related to Col. 3Total Related
Account ValuesGross Amount
of ReserveLocation of
ReservePortion
ReinsuredReinsurance
Reserve Credit
10. For reporting entities having sold annuities to another insurer where the insurer purchasing the annuities has obtained a release of liability from the claimant (payee) as the result of the purchase of an annuity from the reporting entity only:
10.1 Amount of loss reserves established by these annuities during the current year: $
10.2 List the name and location of the insurance company purchasing the annuities and the statement value on the purchase date of the annuities.
1
P&C Insurance Company And Location
2Statement Value
on Purchase Dateof Annuities
(i.e., Present Value)
11.1 Do you act as a custodian for health savings accounts? Yes [ ] No [ X ]
11.2 If yes, please provide the amount of custodial funds held as of the reporting date. $
11.3 Do you act as an administrator for health savings accounts? Yes [ ] No [ X ]
11.4 If yes, please provide the balance of funds administered as of the reporting date. $
21.1
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
GENERAL INTERROGATORIES
12.1 Are any of the captive affiliates reported on Schedule S, Part 3, authorized reinsurers? Yes [ ] No [ ] N/A [ X ]
12.2 If the answer to 12.1 is yes, please provide the following:
1 2 3 4 Assets Supporting Reserve Credit
Company Name
NAICCompany
CodeDomiciliary Jurisdiction
ReserveCredit
5Letters of
Credit
6Trust
Agreements
7
Other
13. Provide the following for individual ordinary life insurance* policies (U.S. business only) for the current year (prior to reinsurance assumed or ceded):
13.1 Direct Premium Written $
13.2 Total Incurred Claims $
13.3 Number of Covered Lives
*Ordinary Life Insurance Includes
Term (whether full underwriting,limited underwriting,jet issue,"short form app")
Whole Life (whether full underwriting,limited underwriting,jet issue,"short form app")
Variable Life (with or without secondary gurarantee)
Universal Life (with or without secondary gurarantee)
Variable Universal Life (with or without secondary gurarantee)
21.2
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
FIVE-YEAR HISTORICAL DATAShow amounts in whole dollars only, no cents; show percentages to one decimal place, i.e. 17.6.
Show amounts of life insurance in this exhibit in thousands (OMIT $000)1
20162
20153
20144
20135
2012
Life Insurance in Force
(Exhibit of Life Insurance)
1. Ordinary - whole life and endowment (Line 34, Col. 4)
2. Ordinary - term (Line 21, Col. 4, less Line 34, Col. 4)
3. Credit life (Line 21, Col. 6)
4. Group, excluding FEGLI/SGLI (Line 21, Col. 9 less Lines 43 & 44, Col. 4)
5. Industrial (Line 21, Col. 2)
6. FEGLI/SGLI (Lines 43 & 44, Col. 4)
7. Total (Line 21, Col. 10)
New Business Issued
(Exhibit of Life Insurance)
8. Ordinary - whole life and endowment (Line 34, Col. 2)
9. Ordinary - term (Line 2, Col. 4, less Line 34, Col. 2)
10. Credit life (Line 2, Col. 6)
11. Group (Line 2, Col. 9)
12. Industrial (Line 2, Col. 2)
13. Total (Line 2, Col. 10)
Premium Income - Lines of Business
(Exhibit 1 - Part 1)
14. Industrial life (Line 20.4, Col. 2)
15.1 Ordinary-life insurance (Line 20.4, Col. 3)
15.2 Ordinary-individual annuities (Line 20.4, Col. 4)
16 Credit life (group and individual) (Line 20.4, Col. 5)
17.1 Group life insurance (Line 20.4, Col. 6)
17.2 Group annuities (Line 20.4, Col. 7)
18.1 A & H-group (Line 20.4, Col. 8)
18.2 A & H-credit (group and individual) (Line 20.4, Col. 9)
18.3 A & H-other (Line 20.4, Col. 10) 160,022 288,910 (1,548,340,646) 457,315,030 387,116,275
19. Aggregate of all other lines of business (Line 20.4,Col. 11)
20. Total 160,022 288,910 (1,548,340,646) 457,315,030 387,116,275
Balance Sheet (Pages 2 & 3)
21. Total admitted assets excluding Separate Accounts business (Page 2, Line 26, Col. 3) 172,726,124 165,970,786 161,441,477 2,220,146,334 1,861,552,902
22. Total liabilities excluding Separate Accounts business (Page 3, Line 26) 90,499,151 86,472,316 84,261,005 2,006,396,186 1,586,835,624
23. Aggregate life reserves (Page 3, Line 1) 325,756 367,778 435,253 462,366 541,884
24. Aggregate A & H reserves (Page 3, Line 2) 1,855,256,395 1,392,221,999
25. Deposit-type contract funds (Page 3, Line 3) 4,771,475 3,712,019 3,180,318 2,723,120 2,311,766
26. Asset valuation reserve (Page 3, Line 24.01) 50,273,262 36,167,521
27. Capital (Page 3, Lines 29 and 30) 2,500,000 2,500,000 2,500,000 2,500,000 2,500,000
28. Surplus (Page 3, Line 37) 79,726,973 76,998,470 74,680,472 211,250,148 272,217,278
Cash Flow (Page 5)
29. Net Cash from Operations (Line 11) (260,280) (1,365,689) 294,979,888 336,548,277 237,851,010
Risk-Based Capital Analysis
30. Total adjusted capital 82,226,973 79,498,470 77,180,472 264,023,410 314,064,799
31. Authorized control level risk - based capital 10,066,031 8,441,818 7,006,975 30,740,994 29,262,442
Percentage Distribution of Cash, Cash Equivalents and Invested Assets
(Page 2, Col. 3) (Line No. /Page 2, Line 12, Col. 3) x 100.0
32. Bonds (Line 1) 94.3 92.7 95.3 76.2 73.1
33. Stocks (Lines 2.1 and 2.2) 7.8 8.6
34. Mortgage loans on real estate(Lines 3.1 and 3.2 ) 12.2 13.3
35. Real estate (Lines 4.1, 4.2 and 4.3)
36. Cash, cash equivalents and short-term investments (Line 5) 5.7 7.3 4.7 2.4 4.5
37. Contract loans (Line 6)
38. Derivatives (Page 2, Line 7) 0.0
39. Other invested assets (Line 8) 0.0 1.3 0.6
40. Receivables for securities (Line 9) 0.0 0.0 0.0 0.0 0.0
41. Securities lending reinvested collateral assets (Line 10)
42. Aggregate write-ins for invested assets (Line 11) 0.0
43. Cash, cash equivalents and invested assets (Line 12) 100.0 100.0 100.0 100.0 100.0
22
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
FIVE-YEAR HISTORICAL DATA(Continued)
12016
22015
32014
42013
52012
Investments in Parent, Subsidiaries and Affiliates
44. Affiliated bonds (Schedule D Summary, Line 12, Col. 1)
45. Affiliated preferred stocks (Schedule D Summary, Line 18, Col. 1)
46. Affiliated common stocks (Schedule D Summary Line 24, Col. 1),
47. Affiliated short-term investments (subtotal included in Schedule DA Verification, Col. 5, Line 10)
48. Affiliated mortgage loans on real estate
49. All other affiliated
50. Total of above Lines 44 to 49
51. Total Investment in Parent included in Lines 44 to 49 above
Total Nonadmitted and Admitted Assets
52. Total nonadmitted assets (Page 2, Line 28, Col. 2) 8,610,124 9,458,959 8,475,182 117,193,068 78,431,486
53. Total admitted assets (Page 2, Line 28, Col. 3) 172,726,124 165,970,786 161,441,477 2,220,146,334 1,861,552,902
Investment Data
54. Net investment income (Exhibit of Net Investment Income) 2,061,341 1,889,807 77,652,390 79,242,573 54,266,560
55. Realized capital gains (losses) (Page 4, Line 34, Column 1 ) 402,705 31,486,004 18,105,708 1,774,411
56. Unrealized capital gains (losses) (Page 4, Line 38, Column 1) (20,855,397) 11,920,624 8,754,120
57. Total of above Lines 54, 55 and 56 2,061,341 2,292,512 88,282,997 109,268,905 64,795,091
Benefits and Reserve Increases (Page 6)
58. Total contract benefits - life (Lines 10, 11, 12, 13, 14 and 15 Col. 1, minus Lines 10, 11,12, 13, 14 and 15 Cols. 9, 10 and 11)
59. Total contract benefits - A & H (Lines 13 & 14, Cols. 9, 10 & 11) 8,476 28,185 19,073,373 24,513,467 20,257,199
60. Increase in life reserves - other than group and annuities (Line 19, Cols. 2 and 3 )
61. Increase in A & H reserves (Line 19, Cols. 9, 10 & 11) (1,858,575,142) 465,423,865 454,038,183
62. Dividends to policyholders (Line 30, Col. 1) 123 1,048 10,713 42,825 6,479,198
Operating Percentages
63. Insurance expense percent (Page 6, Col. 1, Lines 21, 22 & 23, less Line 6)/(Page 6, Col. 1, Line 1 plus Exhibit 7, Col. 2, Line 2) x 100.0 (9,869.8) (5,169.9) (6.6) 29.7 39.6
64. Lapse percent (ordinary only) [(Exhibit of Life Insurance, Col. 4, Lines 14 & 15) / 1/2 (Exhibit of Life Insurance, Col. 4, Lines 1 & 21)] x 100.0
65. A & H loss percent (Schedule H, Part 1, Lines 5 and 6, Col. 2) 49.5 35.0 119.3 108.4 141.2
66. A & H cost containment percent (Schedule H, Pt. 1, Line 4, Col. 2) 44.2 25.2 (0.4) 1.4 1.5
67. A & H expense percent excluding cost containment expenses (Schedule H, Pt. 1, Line 10, Col. 2) (38.4) (70.1) (7.6) 33.3 43.4
A & H Claim Reserve Adequacy
68. Incurred losses on prior years’ claims - group health (Schedule H, Part 3, Line 3.1 Col. 2)
69. Prior years’ claim liability and reserve - group health (Schedule H, Part 3, Line 3.2 Col. 2)
70. Incurred losses on prior years’ claims-health other than group (Schedule H, Part 3, Line 3.1 Col. 1 less Col. 2) 20,186,930 129,056,040 102,702,266
71. Prior years’ claim liability and reserve-health other than group (Schedule H, Part 3, Line 3.2 Col. 1 less Col. 2) 156,554,960 135,969,542 96,183,318
Net Gains From Operations After Federal Income Taxes by Lines of Business (Page 6, Line 33)
72. Industrial life (Col. 2)
73. Ordinary - life (Col. 3)
74. Ordinary - individual annuities (Col. 4)
75. Ordinary-supplementary contracts (Col. 5) (3,323) 5,009 466,337 21,133 (33,750)
76. Credit life (Col. 6)
77. Group life (Col. 7)
78. Group annuities (Col. 8)
79. A & H-group (Col. 9)
80. A & H-credit (Col. 10)
81. A & H-other (Col. 11) 2,592,222 2,109,337 371,661,848 (102,320,670) (194,593,735)
82. Aggregate of all other lines of business (Col. 12)
83. Total (Col. 1) 2,588,899 2,114,346 372,128,185 (102,299,537) (194,627,485)
NOTE: If a party to a merger, have the two most recent years of this exhibit been restated due to a merger in compliance with the disclosure requirements of SSAP No. 3, Accounting Changes and Correction of Errors? Yes [ ] No [ ]
If no, please explain:
23
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Exhibit of Life Insurance
N O N E
Exhibit of Life Insurance - Part 2
N O N E
Exhibit of Life Insurance - Part 3
N O N E
Exhibit of Life Insurance - Part 4
N O N E
Exhibit of Life Insurance - Part 5
N O N E
Exhibit of Life Insurance - Part 6
N O N E
Exhibit of Life Insurance - Part 7
N O N E
Exhibit of Life Insurance - Policies with Disability Provisions
N O N E
25, 26
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
EXHIBIT OF NUMBER OF POLICIES, CONTRACTS, CERTIFICATES, INCOME PAYABLE AND ACCOUNT VALUES IN FORCE FOR SUPPLEMENTARY
CONTRACTS, ANNUITIES, ACCIDENT & HEALTH AND OTHER POLICIESSUPPLEMENTARY CONTRACTS
Ordinary Group
1Involving Life Contingencies
2Not Involving Life
Contingencies
3Involving Life Contingencies
4Not Involving Life
Contingencies
1. In force end of prior year 10
2. Issued during year
3. Reinsurance assumed
4. Increased during year (net)
5. Total (Lines 1 to 4) 10
Deductions during year:
6. Decreased (net) 1
7. Reinsurance ceded
8. Totals (Lines 6 and 7) 1
9. In force end of year 9
10. Amount on deposit (a) (a)
11. Income now payable
12. Amount of income payable (a) 57,334 (a) (a) (a)
ANNUITIESOrdinary Group
1Immediate
2Deferred
3Contracts
4Certificates
1. In force end of prior year
2. Issued during year
3. Reinsurance assumed
4. Increased during year (net)
5. Totals (Lines 1 to 4)
Deductions during year:
6. Decreased (net)
7. Reinsurance ceded
8. Totals (Lines 6 and 7)
9. In force end of year
Income now payable:
10. Amount of income payable (a) XXX XXX (a)
Deferred fully paid:
11. Account balance XXX (a) XXX (a)
Deferred not fully paid:
12. Account balance XXX (a) XXX (a)
ACCIDENT AND HEALTH INSURANCEGroup Credit Other
1Certificates
2Premiums in Force
3Policies
4Premiums in Force
5Policies
6Premiums in Force
1. In force end of prior year 231,207 574,772,344
2. Issued during year 18,285 44,467,608
3. Reinsurance assumed
4. Increased during year (net) XXX XXX XXX
5. Totals (Lines 1 to 4) XXX XXX 249,492 XXX
Deductions during year:
6. Conversions XXX XXX XXX XXX XXX
7. Decreased (net) XXX XXX 5,586 XXX
8. Reinsurance ceded XXX XXX XXX
9. Totals (Lines 6 to 8) XXX XXX 5,586 XXX
10. In force end of year (a) (a) 243,906 (a) 619,239,952
DEPOSIT FUNDS AND DIVIDEND ACCUMULATIONS1
Deposit Funds
2Dividend
AccumulationsContracts Contracts
1. In force end of prior year 1,999
2. Issued during year 6,703
3. Reinsurance assumed
4. Increased during year (net)
5. Totals (Lines 1 to 4) 8,702
Deductions During Year:
6. Decreased (net) 6,272
7. Reinsurance ceded
8. Totals (Lines 6 and 7) 6,272
9. In force end of year 2,430
10. Amount of account balance (a) 4,771,475 (a)
(a) See Paragraph 9 of the Annual Audited Financial Reports in the General section of the annual statement instructions.
NONE
27
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
FORM FOR CALCULATING THE INTEREST MAINTENANCE RESERVEINTEREST MAINTENANCE RESERVE
1Amount
1. Reserve as of December 31, Prior Year 17,597,291
2. Current year’s realized pre-tax capital gains/(losses) of $ transferred into the reserve net of taxes of $
3. Adjustment for current year’s liability gains/(losses) released from the reserve
4. Balance before reduction for amount transferred to Summary of Operations (Line 1 + Line 2 + Line 3) 17,597,291
5. Current year’s amortization released to Summary of Operations (Amortization, Line 1, Column 4) 637,672
6. Reserve as of December 31, current year (Line 4 minus Line 5) 16,959,619
AMORTIZATION
Year of Amortization
1
Reserve as of December 31,
Prior Year
2
Current Year’s Realized Capital Gains/(Losses)
Transferred into the Reserve Net of Taxes
3
Adjustment for Current Year’s Liability Gains/(Losses) Released From
the Reserve
4
Balance Before Reduction for Current Year’s Amortization
(Cols. 1 + 2 + 3)
1. 2016 637,672 637,672
2. 2017 660,908 660,908
3. 2018 689,690 689,690
4. 2019 712,227 712,227
5. 2020 723,520 723,520
6. 2021 749,469 749,469
7. 2022 759,372 759,372
8. 2023 776,266 776,266
9. 2024 786,654 786,654
10. 2025 819,343 819,343
11. 2026 840,993 840,993
12. 2027 856,478 856,478
13. 2028 908,244 908,244
14. 2029 912,912 912,912
15. 2030 899,239 899,239
16. 2031 794,714 794,714
17. 2032 698,107 698,107
18. 2033 594,773 594,773
19. 2034 481,861 481,861
20. 2035 426,790 426,790
21. 2036 427,179 427,179
22. 2037 425,816 425,816
23. 2038 439,365 439,365
24. 2039 436,742 436,742
25. 2040 397,455 397,455
26. 2041 314,578 314,578
27. 2042 232,188 232,188
28. 2043 149,797 149,797
29. 2044 44,939 44,939
30. 2045
31. 2046 and Later
32. Total (Lines 1 to 31) 17,597,291 17,597,291
28
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ents
or
reserv
es
7.
Basic
contr
ibution
8.
Accum
ula
ted b
ala
nces (
Lin
es 1
thro
ugh 5
- 6
+ 7
)
9.
Maxi
mum
reserv
e
10.
Reserv
e o
bje
ctive
11.
20%
of (L
ine 1
0 -
Lin
e 8
)
12.
Bala
nce b
efo
re tra
nsfe
rs (
Lin
es 8
+ 1
1)
13.
Tra
nsfe
rs
14.
Volu
nta
ry c
ontr
ibution
15.
Adju
stm
ent dow
n to m
axi
mum
/up to z
ero
16.
Reserv
e a
s o
f D
ecem
ber
31, curr
ent ye
ar
(Lin
es 1
2 +
13 +
14 +
15)
NO
NE
29
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
AS
SE
T V
AL
UA
TIO
N R
ES
ER
VE
BA
SIC
CO
NT
RIB
UT
ION
, R
ES
ER
VE
OB
JE
CT
IVE
AN
D M
AX
IMU
M R
ES
ER
VE
CA
LC
UL
AT
ION
S
DE
FA
UL
T C
OM
PO
NE
NT
12
34
Basic
Contr
ibution
Reserv
e O
bje
ctive
Maxi
mum
Reserv
e
Lin
eN
um
-ber
NA
ICD
esig
-nation
Description
Book/A
dju
ste
d
Carr
ying V
alu
e
Recla
ssify
Rela
ted P
art
y E
ncum
bra
nces
Add T
hird P
art
y E
ncum
bra
nces
Bala
nce for
AV
R R
eserv
eC
alc
ula
tions
(Cols
. 1 +
2 +
3)
5
Facto
r
6
Am
ount
(Cols
.4 x
5)
7
Facto
r
8
Am
ount
(Cols
. 4 x
7)
9
Facto
r
10
Am
ount
(Cols
. 4 x
9)
LO
NG
-TE
RM
BO
ND
S
1.
Exe
mpt O
blig
ations
89,4
39,8
56
XX
XX
XX
89,4
39,8
56
0.00
00
0.
0000
0.00
00
2.
1H
ighest Q
ualit
y
XX
XX
XX
0.
0004
0.00
23
0.
0030
3.
2H
igh Q
ualit
y
XX
XX
XX
0.
0019
0.00
58
0.
0090
4.
3M
ediu
m Q
ualit
y
XX
XX
XX
0.
0093
0.02
30
0.
0340
5.
4Low
Qualit
y
XX
XX
XX
0.
0213
0.05
30
0.
0750
6.
5Low
er
Qualit
y
XX
XX
XX
0.
0432
0.11
00
0.
1700
7.
6In
or
Near
Defa
ult
X
XX
XX
X
0.00
00
0.
2000
0.20
00
8.
Tota
l U
nra
ted M
ulti-cla
ss S
ecurities A
cquired b
y C
onvers
ion
X
XX
XX
X
XX
X
XX
X
XX
X
9.
Tota
l Long-T
erm
Bonds (
Sum
of Lin
es 1
thro
ugh 8
)89
,439
,856
X
XX
XX
X89
,439
,856
X
XX
X
XX
X
XX
PR
EF
ER
RE
D S
TO
CK
10.
1H
ighest Q
ualit
y
XX
XX
XX
0.
0004
0.00
23
0.
0030
11.
2H
igh Q
ualit
y
XX
XX
XX
0.
0019
0.00
58
0.
0090
12.
3M
ediu
m Q
ualit
y
XX
XX
XX
0.
0093
0.02
30
0.
0340
13.
4Low
Qualit
y
XX
XX
XX
0.
0213
0.05
30
0.
0750
14.
5Low
er
Qualit
y
XX
XX
XX
0.
0432
0.11
00
0.
1700
15.
6In
or
Near
Defa
ult
X
XX
XX
X
0.00
00
0.
2000
0.20
00
16.
Affili
ate
d L
ife w
ith A
VR
XX
XX
XX
0.
0000
0.00
00
0.
0000
17.
Tota
l P
refe
rred S
tocks (
Sum
of Lin
es 1
0 thro
ugh 1
6)
X
XX
XX
X
XX
X
XX
X
XX
X
SH
OR
T -
TE
RM
BO
ND
S
18.
Exe
mpt O
blig
ations
X
XX
XX
X
0.00
00
0.
0000
0.00
00
19.
1H
ighest Q
ualit
y
XX
XX
XX
0.
0004
0.00
23
0.
0030
20.
2H
igh Q
ualit
y
XX
XX
XX
0.
0019
0.00
58
0.
0090
21.
3M
ediu
m Q
ualit
y
XX
XX
XX
0.
0093
0.02
30
0.
0340
22.
4Low
Qualit
y
XX
XX
XX
0.
0213
0.05
30
0.
0750
23.
5Low
er
Qualit
y
XX
XX
XX
0.
0432
0.11
00
0.
1700
24.
6In
or
Near
Defa
ult
X
XX
XX
X
0.00
00
0.
2000
0.20
00
25.
Tota
l S
hort
- T
erm
Bonds (
Sum
of Lin
es 1
8 thro
ugh 2
4)
X
XX
XX
X
XX
X
XX
X
XX
X
DE
RIV
AT
IVE
IN
ST
RU
ME
NT
S
26.
Exc
hange T
raded
X
XX
XX
X
0.00
04
0.
0023
0.00
30
27.
1H
ighest Q
ualit
y
XX
XX
XX
0.
0004
0.00
23
0.
0030
28.
2H
igh Q
ualit
y
XX
XX
XX
0.
0019
0.00
58
0.
0090
29.
3M
ediu
m Q
ualit
y
XX
XX
XX
0.
0093
0.02
30
0.
0340
30.
4Low
Qualit
y
XX
XX
XX
0.
0213
0.05
30
0.
0750
31.
5Low
er
Qualit
y
XX
XX
XX
0.
0432
0.11
00
0.
1700
32.
6In
or
Near
Defa
ult
X
XX
XX
X
0.00
00
0.
2000
0.20
00
33.
Tota
l D
erivative Instr
um
ents
XX
XX
XX
X
XX
X
XX
X
XX
34.
Tota
l (L
ines 9
+ 1
7 +
25 +
33)
89,4
39,8
56
XX
XX
XX
89,4
39,8
56
XX
X
XX
X
XX
X
30
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
AS
SE
T V
AL
UA
TIO
N R
ES
ER
VE
(C
on
tin
ue
d)
BA
SIC
CO
NT
RIB
UT
ION
, R
ES
ER
VE
OB
JE
CT
IVE
AN
D M
AX
IMU
M R
ES
ER
VE
CA
LC
UL
AT
ION
S
DE
FA
UL
T C
OM
PO
NE
NT
12
34
Basic
Contr
ibution
Reserv
e O
bje
ctive
Maxi
mum
Reserv
e
Lin
eN
um
-ber
NA
ICD
esig
-nation
Description
Book/A
dju
ste
d
Carr
ying V
alu
e
Recla
ssify
Rela
ted P
art
y E
ncum
bra
nces
Add T
hird P
art
y E
ncum
bra
nces
Bala
nce for
AV
R R
eserv
eC
alc
ula
tions
(Cols
. 1 +
2 +
3)
5
Facto
r
6
Am
ount
(Cols
.4 x
5)
7
Facto
r
8
Am
ount
(Cols
. 4 x
7)
9
Facto
r
10
Am
ount
(Cols
. 4 x
9)
MO
RT
GA
GE
LO
AN
S
In G
ood S
tandin
g:
35.
Farm
Mort
gages -
CM
1 -
Hig
hest Q
ualit
y
X
XX
0.0010
0.0050
0.0065
36.
Farm
Mort
gages -
CM
2 -
Hig
h Q
ualit
y
X
XX
0.0035
0.0100
0.0130
37.
Farm
Mort
gages -
CM
3 -
Mediu
m Q
ualit
y
X
XX
0.0060
0.0175
0.0225
38.
Farm
Mort
gages -
CM
4 -
Low
Mediu
m Q
ualit
y
X
XX
0.0105
0.0300
0.0375
39.
Farm
Mort
gages -
CM
5 -
Low
Qualit
y
X
XX
0.0160
0.0425
0.0550
40.
Resid
ential M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0003
0.0006
0.0010
41.
Resid
ential M
ort
gages -
All
Oth
er
XX
X
0.0013
0.0030
0.0040
42.
Com
merc
ial M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0003
0.0006
0.0010
43.
Com
merc
ial M
ort
gages -
All
Oth
er
- C
M1 -
Hig
hest Q
ualit
y
X
XX
0.0010
0.0050
0.0065
44.
Com
merc
ial M
ort
gages -
All
Oth
er
- C
M2 -
Hig
h Q
ualit
y
X
XX
0.0035
0.0100
0.0130
45.
Com
merc
ial M
ort
gages -
All
Oth
er
- C
M3 -
Mediu
m Q
ualit
y
X
XX
0.0060
0.0175
0.0225
46.
Com
merc
ial M
ort
gages -
All
Oth
er
- C
M4 -
Low
Mediu
m
Qualit
y
X
XX
0.0105
0.0300
0.0375
47.
Com
merc
ial M
ort
gages -
All
Oth
er
- C
M5 -
Low
Qualit
y
X
XX
0.0160
0.0425
0.0550
Overd
ue, N
ot in
Pro
cess:
48.
Farm
Mort
gages
XX
X
0.0420
0.0760
0.1200
49.
Resid
ential M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0005
0.0012
0.0020
50.
Resid
ential M
ort
gages -
All
Oth
er
XX
X
0.0025
0.0058
0.0090
51.
Com
merc
ial M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0005
0.0012
0.0020
52.
Com
merc
ial M
ort
gages -
All
Oth
er
XX
X
0.0420
0.0760
0.1200
In P
rocess o
f F
ore
clo
sure
:
53.
Farm
Mort
gages
XX
X
0.0000
0.1700
0.1700
54.
Resid
ential M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0000
0.0040
0.0040
55.
Resid
ential M
ort
gages -
All
Oth
er
XX
X
0.0000
0.0130
0.0130
56.
Com
merc
ial M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0000
0.0040
0.0040
57.
Com
merc
ial M
ort
gages -
All
Oth
er
XX
X
0.0000
0.1700
0.1700
58.
Tota
l S
chedule
B M
ort
gages (
Sum
of Lin
es 3
5 thro
ugh 5
7)
XX
X
XX
X
XX
X
XX
X
59.
Schedule
DA
Mort
gages
XX
X
0.0030
0.0100
0.0130
60.
Tota
l M
ort
gage L
oans o
n R
eal E
sta
te (
Lin
es 5
8 +
59)
XX
X
XX
X
XX
X
XX
X
31
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
AS
SE
T V
AL
UA
TIO
N R
ES
ER
VE
B
AS
IC C
ON
TR
IBU
TIO
N,
RE
SE
RV
E O
BJ
EC
TIV
E A
ND
MA
XIM
UM
RE
SE
RV
E C
AL
CU
LA
TIO
NS
EQ
UIT
Y A
ND
OT
HE
R I
NV
ES
TE
D A
SS
ET
CO
MP
ON
EN
T1
23
4B
asic
Contr
ibution
Reserv
e O
bje
ctive
Maxi
mum
Reserv
e
Lin
eN
um
-ber
NA
ICD
esig
-nation
Description
Book/A
dju
ste
d
Carr
ying V
alu
e
Recla
ssify
Rela
ted P
art
y E
ncum
bra
nces
Add T
hird P
art
y E
ncum
bra
nces
Bala
nce for
AV
R R
eserv
e
Calc
ula
tions
(Cols
. 1 +
2 +
3)
5
Facto
r
6
Am
ount
(Cols
.4 x
5)
7
Facto
r
8
Am
ount
(Cols
. 4 x
7)
9
Facto
r
10
Am
ount
(Cols
. 4 x
9)
CO
MM
ON
ST
OC
K
1.
Unaffili
ate
d -
Public
XX
XX
XX
0.0000
0.0000
(a)
0.0000
(a)
2.
Unaffili
ate
d -
Private
XX
XX
XX
0.0000
0.1600
0.1600
3.
Federa
l H
om
e L
oan B
ank
X
XX
XX
X
0.0000
0.0050
0.0080
4.
Affili
ate
d -
Life w
ith A
VR
XX
XX
XX
0.0000
0.0000
0.0000
Affili
ate
d -
Investm
ent S
ubsid
iary
:
5.
Fix
ed Incom
e -
Exe
mpt O
blig
ations
XX
X
XX
X
XX
X
6.
Fix
ed Incom
e -
Hig
hest Q
ualit
y
X
XX
X
XX
X
XX
7.
Fix
ed Incom
e -
Hig
h Q
ualit
y
X
XX
X
XX
X
XX
8.
Fix
ed Incom
e -
Mediu
m Q
ualit
y
X
XX
X
XX
X
XX
9.
Fix
ed Incom
e -
Low
Qualit
y
X
XX
X
XX
X
XX
10.
Fix
ed Incom
e -
Low
er
Qualit
y
X
XX
X
XX
X
XX
11.
Fix
ed Incom
e -
In/N
ear
Defa
ult
XX
X
XX
X
XX
X
12.
Unaffili
ate
d C
om
mon S
tock -
Public
0.0000
0.0000
(a)
0.0000
(a)
13.
Unaffili
ate
d C
om
mon S
tock -
Private
0.0000
0.1600
0.1600
14.
Real E
sta
te
(b
)
(b
)
(b
)
15.
Affili
ate
d -
Cert
ain
Oth
er
(See S
VO
Purp
oses a
nd P
rocedure
s
Manual)
X
XX
XX
X
0.0000
0.1300
0.1300
16.
Affili
ate
d -
All
Oth
er
X
XX
XX
X
0.0000
0.1600
0.1600
17.
Tota
l C
om
mon S
tock (
Sum
of Lin
es 1
thro
ugh 1
6)
XX
X
XX
X
XX
X
RE
AL E
ST
AT
E
18.
Hom
e O
ffic
e P
ropert
y (G
enera
l A
ccount only
)
0.0000
0.0750
0.0750
19.
Investm
ent P
ropert
ies
0.0000
0.0750
0.0750
20.
Pro
pert
ies A
cquired in S
atisfa
ction o
f D
ebt
0.0000
0.1100
0.1100
21.
Tota
l R
eal E
sta
te (
Sum
of Lin
es 1
8 thro
ugh 2
0)
XX
X
XX
X
XX
X
OT
HE
R IN
VE
ST
ED
AS
SE
TS
INV
ES
TM
EN
TS
WIT
H T
HE
UN
DE
RLY
ING
C
HA
RA
CT
ER
IST
ICS
OF
BO
ND
S
22.
Exe
mpt O
blig
ations
X
XX
XX
X
0.0000
0.0000
0.0000
23.
1H
ighest Q
ualit
y
XX
XX
XX
0.0004
0.0023
0.0030
24.
2H
igh Q
ualit
y
XX
XX
XX
0.0019
0.0058
0.0090
25.
3M
ediu
m Q
ualit
y
XX
XX
XX
0.0093
0.0230
0.0340
26.
4Low
Qualit
y
XX
XX
XX
0.0213
0.0530
0.0750
27.
5Low
er
Qualit
y
XX
XX
XX
0.0432
0.1100
0.1700
28.
6In
or
Near
Defa
ult
X
XX
XX
X
0.0000
0.2000
0.2000
29.
Tota
l w
ith B
ond C
hara
cte
ristics (
Sum
of Lin
es 2
2 thro
ugh 2
8)
X
XX
XX
X
XX
X
XX
X
XX
X
32
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
AS
SE
T V
AL
UA
TIO
N R
ES
ER
VE
(C
on
tin
ue
d)
BA
SIC
CO
NT
RIB
UT
ION
, R
ES
ER
VE
OB
JE
CT
IVE
AN
D M
AX
IMU
M R
ES
ER
VE
CA
LC
UL
AT
ION
S
EQ
UIT
Y A
ND
OT
HE
R I
NV
ES
TE
D A
SS
ET
CO
MP
ON
EN
T1
23
4B
asic
Contr
ibution
Reserv
e O
bje
ctive
Maxi
mum
Reserv
e
Lin
e
Num
-ber
NA
ICD
esig
-nation
Description
Book/A
dju
ste
d
Carr
ying V
alu
e
Recla
ssify
Rela
ted P
art
y E
ncum
bra
nces
Add T
hird P
art
y E
ncum
bra
nces
Bala
nce for
AV
R R
eserv
e
Calc
ula
tions
(Cols
. 1 +
2 +
3)
5
Facto
r
6
Am
ount
(Cols
.4 x
5)
7
Facto
r
8
Am
ount
(Cols
. 4 x
7)
9
Facto
r
10
Am
ount
(Cols
. 4 x
9)
INV
ES
TM
EN
TS
WIT
H T
HE
UN
DE
RL
YIN
G C
HA
RA
CT
ER
IST
ICS
OF
P
RE
FE
RR
ED
ST
OC
KS
30.
1H
ighest Q
ualit
y
XX
XX
XX
0.0004
0.0023
0.0030
31.
2H
igh Q
ualit
y
XX
XX
XX
0.0019
0.0058
0.0090
32.
3M
ediu
m Q
ualit
y
XX
XX
XX
0.0093
0.0230
0.0340
33.
4Low
Qualit
y
XX
XX
XX
0.0213
0.0530
0.0750
34.
5Low
er
Qualit
y
XX
XX
XX
0.0432
0.1100
0.1700
35.
6In
or
Near
Defa
ult
X
XX
XX
X
0.0000
0.2000
0.2000
36.
Affili
ate
d L
ife w
ith A
VR
XX
XX
XX
0.0000
0.0000
0.0000
37.
Tota
l w
ith P
refe
rred S
tock C
hara
cte
ristics (
Sum
of Lin
es 3
0
thro
ugh 3
6)
X
XX
XX
X
XX
X
XX
X
XX
X
INV
ES
TM
EN
TS
WIT
H T
HE
UN
DE
RL
YIN
G C
HA
RA
CT
ER
IST
ICS
OF
M
OR
TG
AG
E L
OA
NS
In G
ood S
tandin
g A
ffili
ate
d:
38.
Mort
gages -
CM
1 -
Hig
hest Q
ualit
y
X
XX
0.0010
0.0050
0.0065
39.
Mort
gages -
CM
2 -
Hig
h Q
ualit
y
X
XX
0.0035
0.0100
0.0130
40.
Mort
gages -
CM
3 -
Mediu
m Q
ualit
y
X
XX
0.0060
0.0175
0.0225
41.
Mort
gages -
CM
4 -
Low
Mediu
m Q
ualit
y
X
XX
0.0105
0.0300
0.0375
42.
Mort
gages -
CM
5 -
Low
Qualit
y
X
XX
0.0160
0.0425
0.0550
43.
Resid
ential M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0003
0.0006
0.0010
44.
Resid
ential M
ort
gages -
All
Oth
er
X
XX
XX
X
0.0013
0.0030
0.0040
45.
Com
merc
ial M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0003
0.0006
0.0010
Overd
ue, N
ot in
Pro
cess A
ffili
ate
d:
46.
Farm
Mort
gages
XX
X
0.0420
0.0760
0.1200
47.
Resid
ential M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0005
0.0012
0.0020
48.
Resid
ential M
ort
gages -
All
Oth
er
XX
X
0.0025
0.0058
0.0090
49.
Com
merc
ial M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0005
0.0012
0.0020
50.
Com
merc
ial M
ort
gages -
All
Oth
er
XX
X
0.0420
0.0760
0.1200
In P
rocess o
f F
ore
clo
sure
Affili
ate
d:
51.
Farm
Mort
gages
XX
X
0.0000
0.1700
0.1700
52.
Resid
ential M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0000
0.0040
0.0040
53.
Resid
ential M
ort
gages -
All
Oth
er
XX
X
0.0000
0.0130
0.0130
54.
Com
merc
ial M
ort
gages -
Insure
d o
r G
uara
nte
ed
XX
X
0.0000
0.0040
0.0040
55.
Com
merc
ial M
ort
gages -
All
Oth
er
XX
X
0.0000
0.1700
0.1700
56.
Tota
l A
ffili
ate
d (
Sum
of Lin
es 3
8 thro
ugh 5
5)
XX
X
XX
X
XX
X
XX
X
57.
Unaffili
ate
d -
In G
ood S
tandin
g W
ith C
ovenants
X
XX
(c)
(c)
(c)
58.
Unaffili
ate
d -
In G
ood S
tandin
g D
efe
ased W
ith G
overn
ment
Securities
XX
X
0.0010
0.0050
0.0065
59.
Unaffili
ate
d -
In G
ood S
tandin
g P
rim
arily
Senio
r
X
XX
0.0035
0.0010
0.0130
60.
Unaffili
ate
d -
In G
ood S
tandin
g A
ll O
ther
XX
X
0.0060
0.0175
0.0225
61.
Unaffili
ate
d -
Overd
ue, N
ot in
Pro
cess
XX
X
0.0420
0.0760
0.1200
62.
Unaffili
ate
d -
In P
rocess o
f F
ore
clo
sure
X
XX
0.0000
0.1700
0.1700
63.
Tota
l U
naffili
ate
d (
Sum
of Lin
es 5
7 thro
ugh 6
2)
XX
X
XX
X
XX
X
XX
X
64.
Tota
l w
ith M
ort
gage L
oan C
hara
cte
ristics (
Lin
es 5
6 +
63)
XX
X
XX
X
XX
X
XX
X
33
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
AS
SE
T V
AL
UA
TIO
N R
ES
ER
VE
(C
on
tin
ue
d)
BA
SIC
CO
NT
RIB
UT
ION
, R
ES
ER
VE
OB
JE
CT
IVE
AN
D M
AX
IMU
M R
ES
ER
VE
CA
LC
UL
AT
ION
S
EQ
UIT
Y A
ND
OT
HE
R I
NV
ES
TE
D A
SS
ET
CO
MP
ON
EN
T1
23
4B
asic
Contr
ibution
Reserv
e O
bje
ctive
Maxi
mum
Reserv
e
Lin
e
Num
-ber
NA
ICD
esig
-nation
Description
Book/A
dju
ste
d
Carr
ying V
alu
e
Recla
ssify
Rela
ted P
art
y E
ncum
bra
nces
Add T
hird P
art
y E
ncum
bra
nces
Bala
nce for
AV
R R
eserv
e
Calc
ula
tions
(Cols
. 1 +
2 +
3)
5
Facto
r
6
Am
ount
(Cols
.4 x
5)
7
Facto
r
8
Am
ount
(Cols
. 4 x
7)
9
Facto
r
10
Am
ount
(Cols
. 4 x
9)
INV
ES
TM
EN
TS
WIT
H T
HE
UN
DE
RL
YIN
G C
HA
RA
CT
ER
IST
ICS
OF
C
OM
MO
N S
TO
CK
65.
Unaffili
ate
d P
ublic
XX
XX
XX
0.0000
0.1300
(a)
0.1300
(a)
66.
Unaffili
ate
d P
rivate
XX
XX
XX
0.0000
0.1600
0.1600
67.
Affili
ate
d L
ife w
ith A
VR
XX
XX
XX
0.0000
0.0000
0.0000
68.
Affili
ate
d C
ert
ain
Oth
er
(See S
VO
Purp
oses &
Pro
cedure
s
Manual)
X
XX
XX
X
0.0000
0.1300
0.1300
69.
Affili
ate
d O
ther
- A
ll O
ther
X
XX
XX
X
0.0000
0.1600
0.1600
70.
Tota
l w
ith C
om
mon S
tock C
hara
cte
ristics (
Sum
of Lin
es 6
5
thro
ugh 6
9)
X
XX
XX
X
XX
X
XX
X
XX
X
INV
ES
TM
EN
TS
WIT
H T
HE
UN
DE
RL
YIN
G C
HA
RA
CT
ER
IST
ICS
OF
RE
AL
ES
TA
TE
71.
Hom
e O
ffic
e P
ropert
y (G
enera
l A
ccount only
)
0.0000
0.0750
0.0750
72.
Investm
ent P
ropert
ies
0.0000
0.0750
0.0750
73
Pro
pert
ies A
cquired in S
atisfa
ction o
f D
ebt
0.0000
0.1100
0.1100
74.
Tota
l w
ith R
eal E
sta
te C
hara
cte
ristics (
Sum
of Lin
es 7
1 thro
ugh
73)
XX
X
XX
X
XX
X
LO
W IN
CO
ME
HO
US
ING
TA
X C
RE
DIT
IN
VE
ST
ME
NT
S
75.
Guara
nte
ed F
edera
l Low
Incom
e H
ousin
g T
ax
Cre
dit
0.0003
0.0006
0.0010
76.
Non-g
uara
nte
ed F
edera
l Low
Incom
e H
ousin
g T
ax
Cre
dit
0.0063
0.0120
0.0190
77.
Guara
nte
ed S
tate
Low
Incom
e H
ousin
g T
ax
Cre
dit
0.0003
0.0006
0.0010
78.
Non-g
uara
nte
ed S
tate
Low
Incom
e H
ousin
g T
ax
Cre
dit
0.0063
0.0120
0.0190
79.
All
Oth
er
Low
Incom
e H
ousin
g T
ax
Cre
dit
0.0273
0.0600
0.0975
80.
Tota
l LIH
TC
(S
um
of Lin
es 7
5 thro
ugh 7
9)
XX
X
XX
X
XX
X
AL
L O
TH
ER
IN
VE
ST
ME
NT
S
81.
NA
IC 1
Work
ing C
apital F
inance Investm
ents
XX
X
0.0000
0.0037
0.0037
82.
NA
IC 2
Work
ing C
apital F
inance Investm
ents
XX
X
0.0000
0.0120
0.0120
83.
Oth
er
Investe
d A
ssets
- S
chedule
BA
XX
X
0.0000
0.1300
0.1300
84.
Oth
er
Short
-Term
Investe
d A
ssets
- S
chedule
DA
XX
X
0.0000
0.1300
0.1300
85.
Tota
l A
ll O
ther
(Sum
of Lin
es 8
1, 82, 83 a
nd 8
4)
X
XX
XX
X
XX
X
XX
X
86.
Tota
l O
ther
Investe
d A
ssets
- S
chedule
s B
A &
DA
(S
um
of Lin
es
29, 37, 64, 70, 74, 80 a
nd 8
5)
XX
X
XX
X
XX
X
(a)
Tim
es the c
om
pany’
s w
eig
hte
d a
vera
ge p
ort
folio
beta
(M
inim
um
.10, M
axi
mum
.20).
(b)
Dete
rmin
ed u
sin
g the s
am
e facto
rs a
nd b
reakdow
ns u
sed for
directly
ow
ned r
eal esta
te.
(c)
This
will
be the facto
r associa
ted w
ith the r
isk c
ate
gory
dete
rmin
ed in the c
om
pany
genera
ted w
ork
sheet.
34
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Asset Valuation Reserve Replications (Synthetic) Assets
N O N E
Schedule F - Claims
N O N E
35, 36
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
H -
AC
CID
EN
T A
ND
HE
AL
TH
EX
HIB
ITC
redit
Oth
er
Indiv
idual C
ontr
acts
Tota
lG
roup A
ccid
ent
and H
ealth
Accid
ent and H
ealth
(Gro
up a
nd Indiv
idual)
Colle
ctively
Renew
able
Non-C
ancela
ble
Guara
nte
ed R
enew
able
Non-R
enew
able
for
Sta
ted
Reasons O
nly
Oth
er
Accid
ent O
nly
All
Oth
er
1A
mount
2 %3
Am
ount
4 %5
Am
ount
6 %7
Am
ount
8 %9
Am
ount
10 %
11
Am
ount
12 %
13
Am
ount
14 %
15
Am
ount
16 %
17
Am
ount
18 %
PA
RT
1.
- A
NA
LY
SIS
OF
UN
DE
RW
RIT
ING
OP
ER
AT
ION
S
1.
Pre
miu
ms w
ritten
856
,975
X
XX
X
XX
X
XX
X
XX
X
XX
856
,975
X
XX
X
XX
X
XX
X
XX
2.
Pre
miu
ms e
arn
ed
160,
021
XX
X
XX
X
XX
X
XX
X
XX
X160,
021
XX
X
XX
X
XX
X
XX
X
3.
Incurr
ed c
laim
s
8,4
77
5.3
8,4
77
5.3
4.
Cost conta
inm
ent exp
enses
70,6
87
44.2
70
,687
44.2
5.
Incurr
ed c
laim
s a
nd c
ost
conta
inm
ent exp
enses (
Lin
es 3
and 4
) 79,164
49.5
79,164
49.5
6.
Incre
ase in c
ontr
act re
serv
es
7.
Com
mis
sio
ns (
a)
(80,
298,0
60)
(50,
179.7)
(80,
298,0
60)
(50,
179.7
)
8.
Oth
er
genera
l in
sura
nce e
xpenses
64,4
33,4
98
40,2
65.7
64
,433
,498
40
,265
.7
9.
Taxe
s, lic
enses a
nd fees
15,8
03,124
9,875
.7
15,8
03,124
9,875
.7
10.
Tota
l oth
er
exp
enses incurr
ed
(61,43
8)
(38.4
)
(6
1,43
8)
(38.4
)
11.
Aggre
gate
write
-ins for
deductions
12.
Gain
fro
m u
nderw
riting b
efo
re
div
idends o
r re
funds
142,
295
88.9
142,
295
88.9
13.
Div
idends o
r re
funds
123
0.1
123
0.1
14.
Gain
fro
m u
nderw
riting a
fter
div
idends o
r re
funds
142,
172
88.8
142,
172
88.8
DE
TA
ILS
OF
WR
ITE
-IN
S
1101.
1102.
1103.
1198.
Sum
mary
of re
main
ing w
rite
-ins for
Lin
e 1
1 fro
m o
verf
low
page
1199.
Tota
ls (
Lin
es 1
101 thru
1103 p
lus
1198)(
Lin
e 1
1 a
bove)
(a)
Inclu
des $
r
eport
ed a
s "
Contr
act, m
em
bers
hip
and o
ther
fees r
eta
ined b
y agents
.”
37
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
H -
AC
CID
EN
T A
ND
HE
AL
TH
EX
HIB
IT (
Co
nti
nu
ed
)1
23
4O
ther
Indiv
idual C
ontr
acts
Tota
lG
roup A
ccid
ent
and H
ealth
Cre
dit
Accid
ent and H
ealth
(Gro
up a
nd
Indiv
idual)
Colle
ctively
R
enew
able
5
Non-C
ancela
ble
6
Guara
nte
ed
Renew
able
7N
on-R
enew
able
for
Sta
ted
Reasons O
nly
8
Oth
er
Accid
ent
Only
9
All
Oth
er
PA
RT
2.
- R
ES
ER
VE
S A
ND
LIA
BIL
ITIE
SA
. P
rem
ium
Reserv
es:
1.
Unearn
ed p
rem
ium
s
2.
Advance p
rem
ium
s
8,15
3,36
8
8,
153,36
8
3.
Reserv
e for
rate
cre
dits
4.
Tota
l pre
miu
m r
eserv
es, curr
ent ye
ar
8,15
3,36
8
8,
153,36
8
5.
Tota
l pre
miu
m r
eserv
es, prior
year
7,45
6,41
4
7,45
6,41
4
6.
Incre
ase in tota
l pre
miu
m r
eserv
es
696,
954
696,
954
B. C
ontr
act R
eserv
es:
1.
Additio
nal re
serv
es (
a)
2.
Reserv
e for
futu
re c
ontingent benefits
3.
Tota
l contr
act re
serv
es, curr
ent ye
ar
4.
Tota
l contr
act re
serv
es, prior
year.
5.
Incre
ase in c
ontr
act re
serv
es
C. C
laim
Reserv
es a
nd L
iabili
ties:
1.
Tota
l curr
ent ye
ar
2.
Tota
l prior
year
3.
Incre
ase
PA
RT
3.
- T
ES
T O
F P
RIO
R Y
EA
R'S
CL
AIM
RE
SE
RV
ES
AN
D L
IAB
ILIT
IES
1.
Cla
ims p
aid
during the y
ear:
1.1
On c
laim
s incurr
ed p
rior
to c
urr
ent ye
ar
1.2
On c
laim
s incurr
ed d
uring c
urr
ent ye
ar
8,47
7
8,
477
2.
Cla
im r
eserv
es a
nd lia
bili
ties, D
ecem
ber
31, curr
ent ye
ar:
2.1
On c
laim
s incurr
ed p
rior
to c
urr
ent ye
ar
2.2
On c
laim
s incurr
ed d
uring c
urr
ent ye
ar
3.
Test:
3.1
Lin
es 1
.1 a
nd 2
.1
3.2
Cla
im r
eserv
es a
nd lia
bili
ties, D
ecem
ber
31, prior
year
3.3
Lin
e 3
.1 m
inus L
ine 3
.2
PA
RT
4.
- R
EIN
SU
RA
NC
EA
. R
ein
sura
nce A
ssum
ed:
1.
Pre
miu
ms w
ritten
2.
Pre
miu
ms e
arn
ed
3.
Incurr
ed c
laim
s
4.
Com
mis
sio
ns
B. R
ein
sura
nce C
eded:
1.
Pre
miu
ms w
ritten
601,
288,
448
601,
288,
448
2.
Pre
miu
ms e
arn
ed
594,
119,
892
594,
119,
892
3.
Incurr
ed c
laim
s
135,
365,
098
135,
365,
098
4.
Com
mis
sio
ns
151,
201,
817
151,
201,
817
(a)
Inclu
des $
pre
miu
m d
eficie
ncy
reserv
e.
38
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE H - PART 5 - HEALTH CLAIMS1
Medical2
Dental3
Other4
Total
A. Direct:
1. Incurred Claims 135,373,576 135,373,576
2. Beginning Claim Reserves and Liabilities 257,913,827 257,913,827
3. Ending Claim Reserves and Liabilities 338,425,254 338,425,254
4. Claims Paid 54,862,149 54,862,149
B. Assumed Reinsurance:
5. Incurred Claims
6. Beginning Claim Reserves and Liabilities
7. Ending Claim Reserves and Liabilities
8. Claims Paid
C. Ceded Reinsurance:
9. Incurred Claims 135,365,099 135,365,099
10. Beginning Claim Reserves and Liabilities 262,381,489 262,381,489
11. Ending Claim Reserves and Liabilities 343,287,367 343,287,367
12. Claims Paid 54,459,221 54,459,221
D. Net:
13. Incurred Claims 8,477 8,477
14. Beginning Claim Reserves and Liabilities (4,467,662) (4,467,662)
15. Ending Claim Reserves and Liabilities (4,862,113) (4,862,113)
16. Claims Paid 402,928 402,928
E. Net Incurred Claims and Cost Containment Expenses:
17. Incurred Claims and Cost Containment Expenses 79,163 79,163
18. Beginning Reserves and Liabilities (4,467,662) (4,467,662)
19. Ending Reserves and Liabilities (4,862,113) (4,862,113)
20. Paid Claims and Cost Containment Expenses 473,614 473,614
39
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Schedule S - Part 1 - Section 1
N O N E
Schedule S - Part 1 - Section 2
N O N E
40, 41
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE S - PART 2Reinsurance Recoverable on Paid and Unpaid Losses Listed by Reinsuring Company as of December 31, Current Year
1NAIC
CompanyCode
2
IDNumber
3
EffectiveDate
4
Name of Company
5
Domiciliary Jurisdiction
6
Paid Losses
7
Unpaid Losses0399999. Total Life and Annuity - U.S. Affiliates
0699999. Total Life and Annuity - Non-U.S. Affiliates
0799999. Total Life and Annuity - Affiliates
1099999. Total Life and Annuity - Non-Affiliates
1199999. Total Life and Annuity
67091 39-0509570 10/01/2014 The Northwestern Mutual Life Ins Co WI 4,115,586 3,685,776
1399999. Accident and Health - U.S. Affiliates - Other 4,115,586 3,685,776
1499999. Total Accident and Health - U.S. Affiliates 4,115,586 3,685,776
1799999. Total Accident and Health - Non-U.S. Affiliates
1899999. Total Accident and Health - Affiliates 4,115,586 3,685,776
66346 58-0828824 02/01/1998 Munich American Reassurance Co. GA 746,527 521,375
1999999. Accident and Health - U.S. Non-Affiliates 746,527 521,375
2199999. Total Accident and Health - Non-Affiliates 746,527 521,375
2299999. Total Accident and Health 4,862,113 4,207,151
2399999. Total U.S. (Sum of 0399999, 0899999, 1499999 and 1999999) 4,862,113 4,207,151
2499999. Total Non-U.S. (Sum of 0699999, 0999999, 1799999 and 2099999)
9999999 Totals - Life, Annuity and Accident and Health 4,862,113 4,207,151
42
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
S -
PA
RT
3 -
SE
CT
ION
1R
ein
sura
nce C
eded L
ife I
nsura
nce,
Annuitie
s,
Deposit F
unds a
nd O
ther
Lia
bili
ties W
ithout
Life o
r D
isabili
ty C
ontingencie
s,
and R
ela
ted B
enefits
Lis
ted b
y R
ein
suring C
om
pany
as o
f D
ecem
ber
31,
Curr
ent
Year
12
34
56
78
Reserv
e C
redit T
aken
11
Outs
tandin
g S
urp
lus R
elie
f14
15
NA
ICC
om
pany
Code
IDN
um
ber
Effective
Date
Nam
e o
f C
om
pany
Dom
i-cili
ary
Juris-
dic
tion
Typ
e o
f R
ein
sura
nce
Ceded
Typ
e o
f B
usin
ess
Ceded
Am
ount in
Forc
eat E
nd o
f Y
ear
9
Curr
ent Y
ear
10
Prior
Year
Pre
miu
ms
12
Curr
ent Y
ear
13
Prior
Year
Modifie
d
Coin
sura
nce
Reserv
e
Funds W
ithheld
U
nder
Coin
sura
nce
9999999 -
Tota
ls
NO
NE
43
AN
NU
AL
ST
AT
EM
EN
T F
OR
TH
E Y
EA
R 2
016
OF
TH
E N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
S -
PA
RT
3 -
SE
CT
ION
2R
eins
uran
ce C
eded
Acc
iden
t and
Hea
lth In
sura
nce
List
ed b
y R
eins
urin
g C
ompa
ny a
s of
Dec
embe
r 31
, Cur
rent
Yea
r1
23
45
67
89
10O
utst
andi
ng S
urpl
us R
elie
f13
14
NA
ICC
ompa
nyC
ode
IDN
umbe
rE
ffect
ive
Dat
eN
ame
of C
ompa
ny
Dom
i-ci
liary
Ju
ris-
dict
ion
Typ
e of
R
eins
uran
ce
Ced
ed
Typ
e of
B
usin
ess
Ced
edP
rem
ium
s
Une
arne
dP
rem
ium
s(E
stim
ated
)
Res
erve
Cre
dit
Tak
en O
ther
than
for
Une
arne
d P
rem
ium
s
11
Cur
rent
Yea
r
12
Prio
r Y
ear
Mod
ified
Coi
nsur
ance
Res
erve
Fun
ds W
ithhe
ldU
nder
Coi
nsur
ance
67091
39-0509570
10/01/
2014
Th
e No
rthw
este
rn Mut
ual
Life
Ins Co
USCO/I
LTC
589,
499,
051
119,
024,
798
2,97
2,644,
034
0299
999.
Gen
eral
Acc
ount
- A
utho
rized
U.S
. Affi
liate
s -
Oth
er589,
499,
051
119,
024,
798
2,97
2,644,
034
0399
999.
Tot
al G
ener
al A
ccou
nt -
Aut
horiz
ed U
.S. A
ffilia
tes
589,
499,
051
119,
024,
798
2,97
2,644,
034
0699
999.
Tot
al G
ener
al A
ccou
nt -
Aut
horiz
ed N
on-U
.S. A
ffilia
tes
0799
999.
Tot
al G
ener
al A
ccou
nt -
Aut
horiz
ed A
ffilia
tes
589,
499,
051
119,
024,
798
2,97
2,644,
034
6634
6 58-0828824
02/01/
1998
Munich
Ame
rica
n Re
assu
rance
Co.
USCO/I
LTC
11,7
89,3
98
3,453,
647
163,
142,616
0899
999.
Gen
eral
Acc
ount
- A
utho
rized
U.S
. Non
-Affi
liate
s11
,789,3
98
3,453,
647
163,
142,616
1099
999.
Tot
al G
ener
al A
ccou
nt -
Aut
horiz
ed N
on-A
ffilia
tes
11,7
89,3
98
3,453,
647
163,
142,616
1199
999.
Tot
al G
ener
al A
ccou
nt A
utho
rized
601,
288,44
9 122,47
8,44
5 3,
135,786,650
1499
999.
Tot
al G
ener
al A
ccou
nt -
Una
utho
rized
U.S
. Affi
liate
s
1799
999.
Tot
al G
ener
al A
ccou
nt -
Una
utho
rized
Non
-U.S
. Affi
liate
s
1899
999.
Tot
al G
ener
al A
ccou
nt -
Una
utho
rized
Affi
liate
s
2199
999.
Tot
al G
ener
al A
ccou
nt -
Una
utho
rized
Non
-Affi
liate
s
2299
999.
Tot
al G
ener
al A
ccou
nt U
naut
horiz
ed
2599
999.
Tot
al G
ener
al A
ccou
nt -
Cer
tifie
d U
.S. A
ffilia
tes
2899
999.
Tot
al G
ener
al A
ccou
nt -
Cer
tifie
d N
on-U
.S. A
ffilia
tes
2999
999.
Tot
al G
ener
al A
ccou
nt -
Cer
tifie
d A
ffilia
tes
3299
999.
Tot
al G
ener
al A
ccou
nt -
Cer
tifie
d N
on-A
ffilia
tes
3399
999.
Tot
al G
ener
al A
ccou
nt C
ertif
ied
3499
999.
Tot
al G
ener
al A
ccou
nt A
utho
rized
, Una
utho
rized
and
Cer
tifie
d601,
288,44
9 122,47
8,44
5 3,
135,786,650
3799
999.
Tot
al S
epar
ate
Acc
ount
s -
Aut
horiz
ed U
.S. A
ffilia
tes
4099
999.
Tot
al S
epar
ate
Acc
ount
s -
Aut
horiz
ed N
on-U
.S. A
ffilia
tes
4199
999.
Tot
al S
epar
ate
Acc
ount
s -
Aut
horiz
ed A
ffilia
tes
4499
999.
Tot
al S
epar
ate
Acc
ount
s -
Aut
horiz
ed N
on-A
ffilia
tes
4599
999.
Tot
al S
epar
ate
Acc
ount
s A
utho
rized
4899
999.
Tot
al S
epar
ate
Acc
ount
s -
Una
utho
rized
U.S
. Affi
liate
s
5199
999.
Tot
al S
epar
ate
Acc
ount
s -
Una
utho
rized
Non
-U.S
. Affi
liate
s
5299
999.
Tot
al S
epar
ate
Acc
ount
s -
Una
utho
rized
Affi
liate
s
5599
999.
Tot
al S
epar
ate
Acc
ount
s -
Una
utho
rized
Non
-Affi
liate
s
5699
999.
Tot
al S
epar
ate
Acc
ount
s U
naut
horiz
ed
5999
999.
Tot
al S
epar
ate
Acc
ount
s -
Cer
tifie
d U
.S. A
ffilia
tes
6299
999.
Tot
al S
epar
ate
Acc
ount
s -
Cer
tifie
d N
on-U
.S. A
ffilia
tes
6399
999.
Tot
al S
epar
ate
Acc
ount
s -
Cer
tifie
d A
ffilia
tes
6699
999.
Tot
al S
epar
ate
Acc
ount
s -
Cer
tifie
d N
on-A
ffilia
tes
6799
999.
Tot
al S
epar
ate
Acc
ount
s C
ertif
ied
6899
999.
Tot
al S
epar
ate
Acc
ount
s A
utho
rized
, Una
utho
rized
and
Cer
tifie
d
6999
999.
Tot
al U
.S. (
Sum
of 0
3999
99, 0
8999
99, 1
4999
99, 1
9999
99, 2
5999
99, 3
0999
99, 3
7999
99, 4
2999
99, 4
8999
99, 5
3999
99, 5
9999
99 a
nd
6499
999)
601,
288,44
9 122,47
8,44
5 3,
135,786,650
7099
999.
Tot
al N
on-U
.S. (
Sum
of 0
6999
99, 0
9999
99, 1
7999
99, 2
0999
99, 2
8999
99, 3
1999
99, 4
0999
99, 4
3999
99, 5
1999
99, 5
4999
99, 6
2999
99
and
6599
999)
9999
999
- T
otal
s601,
288,44
9 122,47
8,44
5 3,
135,786,650
44
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Schedule S - Part 4
N O N E
Schedule S - Part 4 - Bank Footnote
N O N E
Schedule S - Part 5
N O N E
Schedule S - Part 5 - Bank Footnote
N O N E
45, 46
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE S - PART 6Five Year Exhibit of Reinsurance Ceded Business
(000 OMITTED)1
20162
20153
20144
20135
2012
A. OPERATIONS ITEMS
1. Premiums and annuity considerations for life and accident and health contracts 601,288 559,910 2,058,965 11,252 10,956
2. Commissions and reinsurance expense allowances 151,202 157,511 42,932 2,954 2,872
3. Contract claims 56,030 44,862 16,676 4,905 4,269
4. Surrender benefits and withdrawals for life contracts
5. Dividends to policyholders 1 (39) 37 747
6. Reserve adjustments on reinsurance ceded
7. Increase in aggregate reserve for life and accident and health contracts 583,207 500,977 2,043,713 11,021 12,972
B. BALANCE SHEET ITEMS
8. Premiums and annuity considerations for life and accident and health contracts deferred and uncollected (4,332) (4,429) 6,901 995 954
9. Aggregate reserves for life and accident and health contracts 3,258,265 2,675,058 2,174,081 133,354 122,333
10. Liability for deposit-type contracts
11. Contract claims unpaid 4,819 3,642 3,062 371 330
12. Amounts recoverable on reinsurance 4,862 4,468 3,494 440 364
13. Experience rating refunds due or unpaid
14. Policyholders’ dividends (not included in Line 10) 68 879
15. Commissions and reinsurance expense allowances due 12,995 15,464 11,400 278 277
16. Unauthorized reinsurance offset
17. Offset for reinsurance with Certified Reinsurers
C. UNAUTHORIZED REINSURANCE (DEPOSITS BY AND FUNDS WITHHELD FROM)
18. Funds deposited by and withheld from (F)
19. Letters of credit (L)
20. Trust agreements (T)
21. Other (O)
D. REINSURANCE WITH CERTIFIED REINSURERS (DEPOSITS BY AND FUNDS WITHHELD FROM)
22. Multiple Beneficiary Trust
23. Funds deposited by and withheld from (F)
24. Letters of credit (L)
25. Trust agreements (T)
26. Other (O)
47
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE S - PART 7Restatement of Balance Sheet to Identify Net Credit for Ceded Reinsurance
1As Reported
(net of ceded)
2Restatement Adjustments
3Restated
(gross of ceded)
ASSETS (Page 2, Col. 3)
1. Cash and invested assets (Line 12) 94,855,806 94,855,806
2. Reinsurance (Line 16) 17,856,870 (17,856,870)
3. Premiums and considerations (Line 15) (4,332,018) (4,332,018)
4. Net credit for ceded reinsurance XXX 3,285,272,710 3,285,272,710
5. All other admitted assets (balance) 60,013,448 60,013,448
6. Total assets excluding Separate Accounts (Line 26) 172,726,124 3,263,083,822 3,435,809,946
7. Separate Account assets (Line 27)
8. Total assets (Line 28) 172,726,124 3,263,083,822 3,435,809,946
LIABILITIES, CAPITAL AND SURPLUS (Page 3)
9. Contract reserves (Lines 1 and 2) 325,756 3,258,265,096 3,258,590,852
10. Liability for deposit-type contracts (Line 3) 4,771,475 4,771,475
11. Claim reserves (Line 4) 4,818,726 4,818,726
12. Policyholder dividends/reserves (Lines 5 through 7)
13. Premium & annuity considerations received in advance (Line 8) 8,153,368 8,153,368
14. Other contract liabilities (Line 9) 69,537,242 69,537,242
15. Reinsurance in unauthorized companies (Line 24.02 minus inset amount)
16. Funds held under reinsurance treaties with unauthorized reinsurers (Line 24.03 minus inset amount)
17. Reinsurance with Certified Reinsurers (Line 24.02 inset amount)
18. Funds held under reinsurance treaties with Certified Reinsurers (Line 24.03 inset amount)
19. All other liabilities (balance) 7,711,310 7,711,310
20. Total liabilities excluding Separate Accounts (Line 26) 90,499,151 3,263,083,822 3,353,582,973
21. Separate Account liabilities (Line 27)
22. Total liabilities (Line 28) 90,499,151 3,263,083,822 3,353,582,973
23. Capital & surplus (Line 38) 82,226,973 XXX 82,226,973
24. Total liabilities, capital & surplus (Line 39) 172,726,124 3,263,083,822 3,435,809,946
NET CREDIT FOR CEDED REINSURANCE
25. Contract reserves 3,258,265,096
26. Claim reserves 4,818,726
27. Policyholder dividends/reserves
28. Premium & annuity considerations received in advance
29. Liability for deposit-type contracts
30. Other contract liabilities
31. Reinsurance ceded assets 17,856,870
32. Other ceded reinsurance recoverables
33. Total ceded reinsurance recoverables 3,280,940,692
34. Premiums and considerations (4,332,018)
35. Reinsurance in unauthorized companies
36. Funds held under reinsurance treaties with unauthorized reinsurers
37. Reinsurance with Certified Reinsurers
38. Funds held under reinsurance treaties with Certified Reinsurers
39. Other ceded reinsurance payables/offsets
40. Total ceded reinsurance payable/offsets (4,332,018)
41. Total net credit for ceded reinsurance 3,285,272,710
48
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE T - PREMIUMS AND ANNUITY CONSIDERATIONSAllocated by States and Territories
Direct Business Only
1 Life Contracts 4 5 6 7
States, Etc. Active Status
2
Life InsurancePremiums
3
AnnuityConsiderations
Accident and Health Insurance
Premiums, Including Policy,
Membershipand Other Fees
OtherConsiderations
TotalColumns
2 through 5Deposit-Type
Contracts
1. Alabama AL L 5,963,548 5,963,548 2. Alaska AK L 316,138 316,138 3. Arizona AZ L 6,575,024 6,575,024 4. Arkansas AR L 3,751,385 3,751,385 5. California CA L 35,632,040 35,632,040 6. Colorado CO L 14,785,400 14,785,400 7. Connecticut CT L 14,176,528 14,176,528 8. Delaware DE L 459,501 459,501 9. District of Columbia DC L 1,074,673 1,074,673
10. Florida FL L 34,951,088 34,951,088 11. Georgia GA L 18,775,746 18,775,746 12. Hawaii HI L 2,597,123 2,597,123 13. Idaho ID L 4,026,506 4,026,506 14. Illinois IL L 46,562,252 46,562,252 15. Indiana IN L 12,896,729 12,896,729 16. Iowa IA L 14,383,160 14,383,160 17. Kansas KS L 6,082,979 6,082,979 18. Kentucky KY L 8,784,524 8,784,524 19. Louisiana LA L 9,011,317 9,011,317 20. Maine ME L 1,554,162 1,554,162 21. Maryland MD L 8,435,982 8,435,982 22. Massachusetts MA L 13,306,377 13,306,377 23. Michigan MI L 17,153,679 17,153,679 24. Minnesota MN L 23,347,478 23,347,478 25. Mississippi MS L 4,189,448 4,189,448 26. Missouri MO L 13,881,138 13,881,138 27. Montana MT L 2,232,280 2,232,280 28. Nebraska NE L 6,661,927 6,661,927 29. Nevada NV L 1,562,436 1,562,436 30. New Hampshire NH L 2,932,324 2,932,324 31. New Jersey NJ L 16,356,176 16,356,176 32. New Mexico NM L 2,243,896 2,243,896 33. New York NY L 35,963,355 35,963,355 34. North Carolina NC L 22,388,300 22,388,300 35. North Dakota ND L 2,147,105 2,147,105 36. Ohio OH L 21,488,671 21,488,671 37. Oklahoma OK L 3,510,589 3,510,589 38. Oregon OR L 7,514,947 7,514,947 39. Pennsylvania PA L 15,902,896 15,902,896 40. Rhode Island RI L 2,018,406 2,018,406 41. South Carolina SC L 8,161,438 8,161,438 42. South Dakota SD L 3,690,463 3,690,463 43. Tennessee TN L 13,154,306 13,154,306 44. Texas TX L 28,008,509 28,008,509 45. Utah UT L 3,089,604 3,089,604 46. Vermont VT L 1,118,659 1,118,659 47. Virginia VA L 17,288,728 17,288,728 48. Washington WA L 12,131,699 12,131,699 49. West Virginia WV L 4,246,028 4,246,028 50. Wisconsin WI L 36,566,917 36,566,917 51. Wyoming WY L 828,015 828,015 52. American Samoa AS N 53. Guam GU N 54. Puerto Rico PR N 55. U.S. Virgin Islands VI N 56. Northern Mariana Islands MP N 57. Canada CAN N 51,585 51,585 58. Aggregate Other Alien OT XXX 83,892 83,892 59. Subtotal (a) 51 594,017,076 594,017,076 90. Reporting entity contributions for employee benefits
plans XXX 91. Dividends or refunds applied to purchase paid-up
additions and annuities XXX 92. Dividends or refunds applied to shorten endowment
or premium paying period XXX 93. Premium or annuity considerations waived under
disability or other contract provisions XXX 7,395,175 7,395,175 94. Aggregate or other amounts not allocable by State XXX 95. Totals (Direct Business) XXX 601,412,251 601,412,251 96. Plus reinsurance assumed XXX 97 Totals (All Business) XXX 601,412,251 601,412,251 98. Less reinsurance ceded XXX 601,191,548 601,191,548 99. Totals (All Business) less Reinsurance Ceded XXX (b) 220,703 220,703
DETAILS OF WRITE-INS58001. Other Alien XXX 83,892 83,892 58002. XXX58003. XXX58998. Summary of remaining write-ins for Line 58 from
overflow page XXX 58999. Totals (Lines 58001 through 58003 plus
58998)(Line 58 above) XXX 83,892 83,892
9401. XXX9402. XXX9403. XXX9498. Summary of remaining write-ins for Line 94 from
overflow page XXX 9499. Totals (Lines 9401 through 9403 plus 9498)(Line
94 above) XXX
(L) Licensed or Chartered - Licensed Insurance Carrier or Domiciled RRG; (R) Registered - Non-domiciled RRGs; (Q) Qualified - Qualified or Accredited Reinsurer; (E) Eligible - Reporting
Entities eligible or approved to write Surplus Lines in the state; (N) None of the above - Not allowed to write business in the state.
Explanation of basis of allocation by states, etc., of premiums and annuity considerationsPremiums are listed on the basis of legal residence of the insured. (a) Insert the number of L responses except for Canada and Other Alien.(b) Column 4 should balance with Exhibit 1, Lines 6.4, 10.4, and 16.4, Cols. 8, 9, 10, or with Schedule H, Part 1, Line 1, indicate which: Exhibit 1, Lines 6.4, 10.4 and 16.4, Cols. 8, 9, 10
49
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE T - PART 2INTERSTATE COMPACT - EXHIBIT OF PREMIUMS WRITTEN
Allocated by States and TerritoriesDirect Business Only
States, Etc.
1
Life(Group and Individual)
2
Annuities(Group and Individual)
3Disability Income
(Group and Individual)
4Long-Term
Care(Group and Individual)
5
Deposit-Type Contracts
6
Totals
1. Alabama AL 5,963,548 5,963,548
2. Alaska AK 316,138 316,138
3. Arizona AZ 6,575,024 6,575,024
4. Arkansas AR 3,751,385 3,751,385
5. California CA 35,632,040 35,632,040
6. Colorado CO 14,785,400 14,785,400
7. Connecticut CT 14,176,528 14,176,528
8. Delaware DE 459,501 459,501
9. District of Columbia DC 1,074,673 1,074,673
10. Florida FL 34,951,088 34,951,088
11. Georgia GA 18,775,746 18,775,746
12. Hawaii HI 2,597,123 2,597,123
13. Idaho ID 4,026,506 4,026,506
14. Illinois IL 46,562,252 46,562,252
15. Indiana IN 12,896,729 12,896,729
16. Iowa IA 14,383,160 14,383,160
17. Kansas KS 6,082,979 6,082,979
18. Kentucky KY 8,784,524 8,784,524
19. Louisiana LA 9,011,317 9,011,317
20. Maine ME 1,554,162 1,554,162
21. Maryland MD 8,435,982 8,435,982
22. Massachusetts MA 13,306,377 13,306,377
23. Michigan MI 17,153,679 17,153,679
24. Minnesota MN 23,347,478 23,347,478
25. Mississippi MS 4,189,448 4,189,448
26. Missouri MO 13,881,138 13,881,138
27. Montana MT 2,232,280 2,232,280
28. Nebraska NE 6,661,927 6,661,927
29. Nevada NV 1,562,436 1,562,436
30. New Hampshire NH 2,932,324 2,932,324
31. New Jersey NJ 16,356,176 16,356,176
32. New Mexico NM 2,243,896 2,243,896
33. New York NY 35,963,355 35,963,355
34. North Carolina NC 22,388,300 22,388,300
35. North Dakota ND 2,147,105 2,147,105
36. Ohio OH 21,488,671 21,488,671
37. Oklahoma OK 3,510,589 3,510,589
38. Oregon OR 7,514,947 7,514,947
39. Pennsylvania PA 15,902,896 15,902,896
40. Rhode Island RI 2,018,406 2,018,406
41. South Carolina SC 8,161,438 8,161,438
42. South Dakota SD 3,690,463 3,690,463
43. Tennessee TN 13,154,306 13,154,306
44. Texas TX 28,008,509 28,008,509
45. Utah UT 3,089,604 3,089,604
46. Vermont VT 1,118,659 1,118,659
47. Virginia VA 17,288,728 17,288,728
48. Washington WA 12,131,699 12,131,699
49. West Virginia WV 4,246,028 4,246,028
50. Wisconsin WI 36,566,917 36,566,917
51. Wyoming WY 828,015 828,015
52. American Samoa AS
53. Guam GU
54. Puerto Rico PR
55. U.S. Virgin Islands VI
56. Northern Mariana Islands MP
57. Canada CAN 51,585 51,585
58. Aggregate Other Alien OT 83,892 83,892
59. Total 594,017,076 594,017,076
50
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No
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47
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Th
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26
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hw
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26
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Nort
hw
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26
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39
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26-2
32573
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76.1
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38.0
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entities a
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46
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hw
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hw
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90-0
9002
26
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hw
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dvis
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46-4
3173
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NM
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47-2
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Learn
Vest In
c
80
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DE
Lea
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45-4
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59
7879
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30-0
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hw
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rn M
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Ca
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35-2
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777 N
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81-3
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777 N
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81-3
990
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777 N
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C
81-3
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741
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777 N
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81-3
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Th
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hw
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NA
IC C
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67
09
1
39
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95
70
WI
NM
Edg
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t
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83-0
35
4415
PA
36 P
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LLC
45-3
548
186
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CW
S L
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mon R
eso
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LP
27
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88375
DE
Corp
ora
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am
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LC
33-1
03623
6
DE
Wells
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LL
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27-5
0962
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DE
Vie
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52-1
94720
7
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LC
16-1
73234
8
DE
Re
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20-1
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962
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MC
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LLC
27-4
646
730
DE
99
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95
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5%
90%
50%
75%
85%
85
%
82
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Crite
rion
at
Bedfo
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LC
65
-13
20024
DE
99
%
50
%
Regen
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M J
oh
ns C
ree
k
LLC
27-3
72
2685
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Devon C
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46-1
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20-3
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45-3
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-Skye L
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FO
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Nam
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if P
ublic
ly T
raded
(U.S
. or
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rnational)
8
Nam
es o
fP
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nt, S
ubsid
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Or
Affili
ate
s
9
Dom
i-cili
ary
Loca-
tion
10
Rela
tion-
ship
to
Report
ing
Entity
11
Directly
Contr
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d b
y(N
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f E
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/Pers
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12
Typ
eof C
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(Ow
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,M
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in-F
act,
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13 If
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tage
14
Ultim
ate
Contr
olli
ng
Entity
(ies)/
Pers
on(s
)
15
Is a
nS
CA
F
iling
Re-
quired?
(Y/N
)
16 *
0860
67091
39-0509570
The Northwestern Mutual Life Insurance
Comp
any
WIUDP
N
23-7167456
NML Clubs Associated Inc
WINIA
The Northwestern Mutual Life Insurance
Comp
any
Board of Directors
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1728908
Northwestern Mutual Life Foundation Inc
WINIA
The Northwestern Mutual Life Insurance
Comp
any
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1907562
Bradford Inc
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
Y
39-2035564
Mason Street Advisors LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-2325733
NM GP Holdings LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-4011781
NM Investment Holdings LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-0216148
NM Pebble Valley LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
52-2113746
NML Real Estate Holdings LLC
WINIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
52-2144720
NML Securities Holdings LLC
WINIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
0860
69000
36-2258318
Northwestern Long Term Care Insurance Comp
any
WIRE
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
Y
Northwestern Mutual Capi
tal Limited
GBR
NIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
Y
52-2114207
Northwestern Mutual Investment Services LLC
WINIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-2034777
Northwestern Mutual Investment Management
Comp
any LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-2018056
3017081
Northwestern Mutual Wealth Management Comp
any
WINIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
Y
26-0539797
Juleen LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-1131524
Northwestern Mutual MU TLD Registry LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-1125255
Northwestern Mutual Registry LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
47-2018056
NM Planning LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
80-0226518
LearnVest Inc
DENIA
NM Planning LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-4824536
LearnVest Planning Services LLC
DENIA
LearnVest Inc
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-4317386
Northwest Passage Capi
tal Advisors LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Other
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
86-1095029
Amber LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
86-1095030
Bayridge LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
86-1095031
Burgundy LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-3009856
C-Land Fund LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-3304712
Cortona Holdings LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
52
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
YP
AR
T 1
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DE
TA
IL O
F I
NS
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CE
HO
LD
ING
CO
MP
AN
Y S
YS
TE
M1
Gro
up
Code
2
Gro
up N
am
e
3
NA
ICC
om
pany
Code
4 IDN
um
ber
5
Federa
l R
SS
D
6
CIK
7
Nam
e o
f S
ecurities
Exc
hange
if P
ublic
ly T
raded
(U.S
. or
Inte
rnational)
8
Nam
es o
fP
are
nt, S
ubsid
iaries
Or
Affili
ate
s
9
Dom
i-cili
ary
Loca-
tion
10
Rela
tion-
ship
to
Report
ing
Entity
11
Directly
Contr
olle
d b
y(N
am
e o
f E
ntity
/Pers
on)
12
Typ
eof C
ontr
ol
(Ow
ners
hip
,B
oard
,M
anagem
ent,
Attorn
ey-
in-F
act,
Influence,
Oth
er)
13 If
Contr
ol
isO
wner-
ship
Pro
vid
eP
erc
en-
tage
14
Ultim
ate
Contr
olli
ng
Entity
(ies)/
Pers
on(s
)
15
Is a
nS
CA
F
iling
Re-
quired?
(Y/N
)
16 *
39-1733172
Logan Inc
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-2967207
NM BSA LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-3772668
NM Imp
erial LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-5424412
NM Lion LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-3259112
NM Majestic Holdings LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-2032137
NM RE Funds LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-0385989
NMRM Holdings LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1907566
Olive Inc
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1566278
RE Corp
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1842903
Russet Inc
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1312641
Solar Resources Inc
WINIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-3229323
Walden OC LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1733173
Baraboo Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
51-0490402
Chateau LLC
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1842900
Coral Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1842901
Hazel Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1733174
Higgins Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1733169
Hobby Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-4419951
Hollenberg 1 Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1907491
Klode Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1842902
Maroon Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1813811
Mason & Marshall Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-2317269
Model Portfolios LLC
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
51-0554956
NM Regal LLC
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1565075
NML Developm
ent Corp
oration
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1918716
Nicolet Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1813810
North Van Buren Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
52.1
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
YP
AR
T 1
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DE
TA
IL O
F I
NS
UR
AN
CE
HO
LD
ING
CO
MP
AN
Y S
YS
TE
M1
Gro
up
Code
2
Gro
up N
am
e
3
NA
ICC
om
pany
Code
4 IDN
um
ber
5
Federa
l R
SS
D
6
CIK
7
Nam
e o
f S
ecurities
Exc
hange
if P
ublic
ly T
raded
(U.S
. or
Inte
rnational)
8
Nam
es o
fP
are
nt, S
ubsid
iaries
Or
Affili
ate
s
9
Dom
i-cili
ary
Loca-
tion
10
Rela
tion-
ship
to
Report
ing
Entity
11
Directly
Contr
olle
d b
y(N
am
e o
f E
ntity
/Pers
on)
12
Typ
eof C
ontr
ol
(Ow
ners
hip
,B
oard
,M
anagem
ent,
Attorn
ey-
in-F
act,
Influence,
Oth
er)
13 If
Contr
ol
isO
wner-
ship
Pro
vid
eP
erc
en-
tage
14
Ultim
ate
Contr
olli
ng
Entity
(ies)/
Pers
on(s
)
15
Is a
nS
CA
F
iling
Re-
quired?
(Y/N
)
16 *
76-0195862
Stadium and Arena Management Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1918385
Tupelo Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1813808
White Oaks Inc
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
47-4109936
Dortmund LLC
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-5486209
NM Neptune LLC
DENIA
NM Regal LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
86-4860705
Northwestern Ellis Compa
ny
CAN
NIA
Coral Inc
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-1941228
Scotty LLC
DENIA
Hobby Inc
Ownership
5.660
The Northwestern Mutual Life Insurance
Comp
any
N
20-1941228
Scotty LLC
DENIA
Maroon Inc
Ownership
62.260
The Northwestern Mutual Life Insurance
Comp
any
N
20-1941228
Scotty LLC
DENIA
North Van Buren Inc
Ownership
4.610
The Northwestern Mutual Life Insurance
Comp
any
N
20-1941228
Scotty LLC
DENIA
Stadium and Arena Management Inc
Ownership
27.470
The Northwestern Mutual Life Insurance
Comp
any
N
26-0539949
31 Ogden LLC
DENIA
Juleen LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
66-0526780
Kristiana International Sales Inc
VIR
NIA
Hobby Inc
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
66-0538199
Regina International Sales Inc
VIR
NIA
Hobby Inc
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-0734171
NM Harrisburg Inc
PANIA
Bradford Inc
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-2464411
Northwestern Mutual Capi
tal GP LLC
DENIA
NM GP Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-4236932
Northwestern Mutual Capi
tal GP II LLC
DENIA
NM GP Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-0912644
Northwestern Mutual Capi
tal GP III LLC
DENIA
NM GP Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
16-1732348
AMLI at Perimeter Gardens LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
83-0354415
NM Edgewater Joint Venture
PANIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
99.900
The Northwestern Mutual Life Insurance
Comp
any
N
65-1320024
Criterion at Bedford LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
99.000
The Northwestern Mutual Life Insurance
Comp
any
N
94-6273951
Warren Corporate Center LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
99.000
The Northwestern Mutual Life Insurance
Comp
any
N
94-6273951
Warren Corporate Center LLC
DENIA
Olive Inc
Ownership
1.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-5607948
NM Twin Creeks GP LLC
DENIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-5096295
Wells Street Flats LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
95.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-4646730
MCC IV - Phase 1 LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
95.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1888937
EP Commons LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
50.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-1688783
East Pointe Commons Limited Partnership
WINIA
EP Commons LLC
Ownership
20.000
The Northwestern Mutual Life Insurance
Comp
any
N
52.2
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
YP
AR
T 1
A -
DE
TA
IL O
F I
NS
UR
AN
CE
HO
LD
ING
CO
MP
AN
Y S
YS
TE
M1
Gro
up
Code
2
Gro
up N
am
e
3
NA
ICC
om
pany
Code
4 IDN
um
ber
5
Federa
l R
SS
D
6
CIK
7
Nam
e o
f S
ecurities
Exc
hange
if P
ublic
ly T
raded
(U.S
. or
Inte
rnational)
8
Nam
es o
fP
are
nt, S
ubsid
iaries
Or
Affili
ate
s
9
Dom
i-cili
ary
Loca-
tion
10
Rela
tion-
ship
to
Report
ing
Entity
11
Directly
Contr
olle
d b
y(N
am
e o
f E
ntity
/Pers
on)
12
Typ
eof C
ontr
ol
(Ow
ners
hip
,B
oard
,M
anagem
ent,
Attorn
ey-
in-F
act,
Influence,
Oth
er)
13 If
Contr
ol
isO
wner-
ship
Pro
vid
eP
erc
en-
tage
14
Ultim
ate
Contr
olli
ng
Entity
(ies)/
Pers
on(s
)
15
Is a
nS
CA
F
iling
Re-
quired?
(Y/N
)
16 *
39-1688783
East Pointe Commons Limited Partnership
WINIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
80.000
The Northwestern Mutual Life Insurance
Comp
any
N
52-1947207
Vienna Metro Joint Venture LLC
MDNIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
85.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-3722685
Regency NM Johns Creek LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
90.000
The Northwestern Mutual Life Insurance
Comp
any
N
52-2106692
Lakelands Associates LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
85.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-1112092
Devon Court LLC
DENIA
Lakeland Associates LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-3973400
JLB Citypl
ace LP
TXNIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
84.990
The Northwestern Mutual Life Insurance
Comp
any
N
27-3973400
JLB Citypl
ace LP
TXNIA
NM Twin Creeks GP LLC
Ownership
0.010
The Northwestern Mutual Life Insurance
Comp
any
N
27-4288375
CWS Lemmon Resources LP
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-1208962
Realen Valley Forge Greenes Associates
PANIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
90.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-3548186
36 Park LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
75.000
The Northwestern Mutual Life Insurance
Comp
any
N
35-2246294
American Storage Properties LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
50.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-1158305
Travis Avenue Self Storage LLC
DENIA
American Storage Properties LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
52-2052411
Westpa
rk Corporate Center LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
44.500
The Northwestern Mutual Life Insurance
Comp
any
N
52-2052411
Westpa
rk Corporate Center LLC
DENIA
NM GP Holdings LLC
Ownership
44.500
The Northwestern Mutual Life Insurance
Comp
any
N
80-0371477
NM Cancer Center GP LLC
DENIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
99-0274628
Bishop Square LLC
DENIA
NM BSA LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-2854638
Two Con Holdings LLC
DENIA
Bishop Square LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-2854730
Two Con LLC
DENIA
Two Con Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-1102533
Two Con SPE LLC
DENIA
NML Real Estate Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
59-3265492
Ospr
ey Links LLC
DENIA
NM Imp
erial LLC
Ownership
99.000
The Northwestern Mutual Life Insurance
Comp
any
N
59-3265492
Ospr
ey Links LLC
DENIA
RE Corp
Ownership
1.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-2158280
Ospr
ey Links Golf Course LLC
DENIA
Ospr
ey Links LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
36-3586900
West Huron Joint Venture
WANIA
NM Imp
erial LLC
Ownership
99.000
The Northwestern Mutual Life Insurance
Comp
any
N
36-3586900
West Huron Joint Venture
WANIA
Burgundy LLC
Ownership
1.000
The Northwestern Mutual Life Insurance
Comp
any
N
33-1036236
Corp
orate Camp
us LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
82.400
The Northwestern Mutual Life Insurance
Comp
any
N
20-4874421
Millbrook Ap
artments Associates LLC
VANIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-1517240
Plantation Oaks MHC-NM LLC
DENIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
52.3
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
YP
AR
T 1
A -
DE
TA
IL O
F I
NS
UR
AN
CE
HO
LD
ING
CO
MP
AN
Y S
YS
TE
M1
Gro
up
Code
2
Gro
up N
am
e
3
NA
ICC
om
pany
Code
4 IDN
um
ber
5
Federa
l R
SS
D
6
CIK
7
Nam
e o
f S
ecurities
Exc
hange
if P
ublic
ly T
raded
(U.S
. or
Inte
rnational)
8
Nam
es o
fP
are
nt, S
ubsid
iaries
Or
Affili
ate
s
9
Dom
i-cili
ary
Loca-
tion
10
Rela
tion-
ship
to
Report
ing
Entity
11
Directly
Contr
olle
d b
y(N
am
e o
f E
ntity
/Pers
on)
12
Typ
eof C
ontr
ol
(Ow
ners
hip
,B
oard
,M
anagem
ent,
Attorn
ey-
in-F
act,
Influence,
Oth
er)
13 If
Contr
ol
isO
wner-
ship
Pro
vid
eP
erc
en-
tage
14
Ultim
ate
Contr
olli
ng
Entity
(ies)/
Pers
on(s
)
15
Is a
nS
CA
F
iling
Re-
quired?
(Y/N
)
16 *
46-4530596
Ventura Lakes MHC-NM LLC
DENIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-2961690
3412 Exchange LLC
DENIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
39-0509570
AFE Brentwood Park LLC
DENIA
Cortona Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-1694971
Crosland Greens LLC
NCNIA
C-Land Fund LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
27-1023998
Fairfield West Deer Park LLC
DENIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-5713666
Perimeter Place Master Condominium
Association Inc
GANIA
Millbrook Ap
artments Associates LLC
Board of Directors
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-1746210
Capi
tol View Joint Venture
TNNIA
C-Land Fund LLC
Ownership
85.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-4095708
Bradford Master Association Inc
NCNIA
C-Land Fund LLC
Board of Directors
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-2555945
Piedmont Center 1-4 LLC
DENIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-2555724
Piedmont Center 15 LLC
DENIA
NM Imp
erial LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-8291674
NM DFW Lewisville LLC
DENIA
NM Majestic Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-4242738
Crown Farm Partners LLC
MDNIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
90.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-4242676
Ellington Residential LLC
MDNIA
Crown Farm Partners, LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-2467415
Northwestern Mutual Capi
tal Mezzanine Fund I
LP
DENIA
Northwestern Mutual Capi
tal GP LLC
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-2467415
Northwestern Mutual Capi
tal Mezzanine Fund I
LP
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
76.150
The Northwestern Mutual Life Insurance
Comp
any
N
26-4237214
Northwestern Mutual Capi
tal Mezzanine Fund II
LP
DENIA
Northwestern Mutual Capi
tal GP II LLC
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
90-0900226
Northwestern Mutual Capi
tal Mezzanine Fund
III LP
DENIA
Northwestern Mutual Capi
tal GP III LLC
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-2467616
Northwestern Mutual Capi
tal Strategic Equity
Fund I LP
DENIA
Northwestern Mutual Capi
tal GP LLC
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
26-2467616
Northwestern Mutual Capi
tal Strategic Equity
Fund I LP
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
38.080
The Northwestern Mutual Life Insurance
Comp
any
N
26-4237290
Northwestern Mutual Capi
tal Strategic Equity
Fund II LP
DENIA
Northwestern Mutual Capi
tal GP II LLC
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
90-0899634
Northwestern Mutual Capi
tal Strategic Equity
Fund III LP
DENIA
Northwestern Mutual Capi
tal GP III LLC
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
06-1735155
NR2004 - I LLC
DENIA
NML Securities Holdings LLC
Ownership
95.240
The Northwestern Mutual Life Insurance
Comp
any
N
90-0776267
NWM ZOM GP LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-3857740
Hamp
tons PBG LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-8287969
Northwoods Phase I LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
47-4633131
NM-Hemlock LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
46-1802061
The Village at Valley Forge Association Inc
PANIA
Realen Valley Forge Greenes Associates
Board of Directors
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
52.4
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
YP
AR
T 1
A -
DE
TA
IL O
F I
NS
UR
AN
CE
HO
LD
ING
CO
MP
AN
Y S
YS
TE
M1
Gro
up
Code
2
Gro
up N
am
e
3
NA
ICC
om
pany
Code
4 IDN
um
ber
5
Federa
l R
SS
D
6
CIK
7
Nam
e o
f S
ecurities
Exc
hange
if P
ublic
ly T
raded
(U.S
. or
Inte
rnational)
8
Nam
es o
fP
are
nt, S
ubsid
iaries
Or
Affili
ate
s
9
Dom
i-cili
ary
Loca-
tion
10
Rela
tion-
ship
to
Report
ing
Entity
11
Directly
Contr
olle
d b
y(N
am
e o
f E
ntity
/Pers
on)
12
Typ
eof C
ontr
ol
(Ow
ners
hip
,B
oard
,M
anagem
ent,
Attorn
ey-
in-F
act,
Influence,
Oth
er)
13 If
Contr
ol
isO
wner-
ship
Pro
vid
eP
erc
en-
tage
14
Ultim
ate
Contr
olli
ng
Entity
(ies)/
Pers
on(s
)
15
Is a
nS
CA
F
iling
Re-
quired?
(Y/N
)
16 *
47-4596993
GRO LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
47-4607543
GRO-SUB LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
81-0814291
Tapestry Condominium Owners Association Inc
TNNIA
The Northwestern Mutual Life Insurance
Comp
any
Board of Directors
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
45-3239101
Artisan Garden Apa
rtments LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
83-0512057
Trade Street Associates I LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
Promenade at Clifton LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-5661867
Chelsea Ventures LLC
MDNIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
20-3896114
FB #2 LLC
MDNIA
Chelsea Ventures, LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
47-5597879
Northwestern Mutual Capi
tal GP IV LLC
DENIA
NM GP Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
35-2546047
Northwestern Mutual Capi
tal Mezzanine Fund IV
LP
DENIA
Northwestern Mutual Capi
tal GP IV, LLC
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
30-0888687
Northwestern Mutual Capi
tal Strategic Equity
Fund IV LP
DENIA
Northwestern Mutual Capi
tal GP IV, LLC
Management
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
81-2329275
NM Gen LLC
DENIA
NML Securities Holdings LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
81-3969754
777 North Van Buren Parking LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
81-3990682
777 North Van Buren Ap
artments LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
81-3961741
777 North Van Buren Retail LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
81-3998079
777 North Van Buren Condominium Association
Inc
WINIA
The Northwestern Mutual Life Insurance
Comp
any
Board of Directors
0.000
The Northwestern Mutual Life Insurance
Comp
any
N
1838938 Alberta Ltd
CAN
NIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
90-0861069
Bradford II SPE, LLC
DENIA
C-Land Fund LLC
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
Grant Park Venture Partners LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
90.000
The Northwestern Mutual Life Insurance
Comp
any
N
NM-Pulse LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
NM-Skye LLC
DENIA
The Northwestern Mutual Life Insurance
Comp
any
Ownership
100.000
The Northwestern Mutual Life Insurance
Comp
any
N
Aste
risk
Exp
lanation
NO
NE
52.5
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
YP
AR
T 2
- S
UM
MA
RY
OF
IN
SU
RE
R’S
TR
AN
SA
CT
ION
S W
ITH
AN
Y A
FF
ILIA
TE
S1
NA
ICC
om
pany
Code
2 IDN
um
ber
3
Nam
es o
f In
sure
rs a
nd P
are
nt,
Subsid
iaries o
r A
ffili
ate
s
4
Share
hold
er
Div
idends
5
Capital
Contr
ibutions
6
Purc
hases, S
ale
sor
Exc
hanges o
fLoans, S
ecurities,
Real E
sta
te,
Mort
gage L
oans o
r O
ther
Investm
ents
7In
com
e/
(Dis
burs
em
ents
)In
curr
ed in
Connection w
ith
Guara
nte
es o
rU
ndert
akin
gs for
the B
enefit of any
Affili
ate
(s)
8
Managem
ent
Agre
em
ents
and
Serv
ice C
ontr
acts
9
Incom
e/
(Dis
burs
em
ents
)In
curr
ed U
nder
Rein
sura
nce
Agre
em
ents
10 *
11
Any
Oth
er
Mate
rial
Activity
Not in
the
Ord
inary
Cours
e o
fth
e Insure
r’s
Busin
ess
12
Tota
ls
13
Rein
sura
nce
Recovera
ble
/(P
aya
ble
) on
Losses a
nd/o
rR
eserv
e C
redit
Taken/(
Lia
bili
ty)
6709
1 39
-050
9570
NO
RTHW
ESTERN
MUT
UAL LIFE INS
URAN
CE C
O 95
5,24
5,24
5 (4
85,8
99,799
)
469,
345,
446
(3,0
99,4
70,1
94)
26
-232
5733
NM GP
HOLD
INGS
, LLC
5,
200,
000
5,
200,
000
46
-401
1781
NM
INV
ESTM
ENT HO
LDIN
GS, LLC
(200
,000
,000
)
(2
00,0
00,0
00)
27
-021
6148
NM
PEB
BLE VALLEY, LLC
(26,
510,
813)
(26,
510,
813)
52
-211
3746
NM
L REAL EST
ATE HO
LDIN
GS, LLC
(80,
496,
487)
(80,
496,
487)
52
-214
4720
NM
L SE
CURITIES
HOL
DING
S, LLC
(4
67,6
69,1
43)
149,
542,
321
(318
,126
,822
)
39
-17331
71
MITC
HELL, IN
C (2
,467
,564
)2,
467,56
4
39
-203
5564
MA
SON
STREET ADV
ISOR
S, LLC
(2
2,30
0,00
0)
(2
2,30
0,00
0)
47
-460
7543
GRO-
SUB,
LLC
1,60
4,30
6
1,60
4,30
6
45
-203
4777
NORTHW
ESTERN
MUT
UAL IN
VEST
MENT
MAN
AGEM
ENT
COMP
ANY, LLC
(2
1,90
0,00
0)
(2
1,90
0,00
0)
52
-228
9921
NM
PLANN
ING, LLC
51,0
10,4
39
51
,010
,439
6900
0 36
-225
8318
NO
RTHW
ESTERN
LON
G TERM
CARE IN
SURANC
E CO
.
3,09
9,47
0,19
4
52
-211
4207
NO
RTHW
ESTERN
MUT
UAL IN
VEST
MENT
SERVICE
S,
LLC
(70,
000,
000)
(70,
000,
000)
39
-201
8056
NO
RTHW
ESTERN
MUT
UAL WEALTH
MAN
AGEM
ENT CO
(1
8,00
0,00
0)
(1
8,00
0,00
0)
52
-194
7207
VIEN
NA M
ETRO
JOI
NT VEN
TURE LLC
(4
84,396
)
(4
84,396
)
39
-168
8783
EAST
POI
NTE CO
MMON
S LIMI
TED
PARTNE
RSHI
P (1
,134
,786
)
(1
,134
,786
)
20
-120
8962
REALEN
VALLEY FO
RGE GREENE
S AS
SOCI
ATES
(2
0,44
4,21
1)1,
880,
010
(1
8,56
4,20
1)
52
-210
6692
LAKELAND
S AS
SOCI
ATES
LLC
(2
70,318
)
(2
70,318
)
33-1
0362
36
CORP
ORATE CA
MPUS
LLC
(4
,922
,071
)
(4
,922
,071
)
35
-224
6294
AM
ERIC
AN S
TORAGE P
ROPE
RTIES
LLC
(113
,491
)
(1
13,4
91)
52
-205
2411
WEST
PARK C
ORPO
RATE C
ENTER LLC
(2,1
72,0
26)
(2,1
72,0
26)
27
-372
2685
REGENC
Y NM
JOH
NS C
REEK LLC
(5
70,5
85)
(570
,585
)
94
-627
3951
WARREN
COR
PORATE C
ENTER LLC
(4,0
94,399
)
(4
,094
,399
)
27
-464
6730
MC
C IV - P
HASE
1 LLC
(9
23,1
53)
(923
,153
)
45
-424
2738
CR
OWN
FARM
PARTN
ERS
LLC
(3,0
19,8
15)
(3,0
19,8
15)
GRAN
T PA
RK VEN
TURE P
ARTN
ERS
LLC
9,
426,
372
9,
426,
372
26
-246
7616
NO
RTHW
ESTERN
MUT
UAL CA
PITAL ST
RATEGIC
EQUI
TY FUN
D I LP
(6
,688
,970
)13
8,87
6
(6,5
50,0
94)
26
-246
7415
NO
RTHW
ESTERN
MUT
UAL CA
PITAL ME
ZZAN
INE FU
ND
I LP
(9
32,9
62)
52,365
(880
,597
)
20
-828
7969
NO
RTHW
OODS
PHA
SE I LLC
168,
882
16
8,88
2
16
-17323
48
AMLI AT PE
RIME
TER GARD
ENS
LLC
18
5,20
2
185,
202
47
-463
3131
NM
-HEM
LOCK
LLC
2,39
1,04
4
2,39
1,04
4
20
-566
1867
CH
ELSE
A VENT
URES
LLC
67,9
54,9
79
67
,954
,979
45
-323
9101
ARTISA
N GARD
EN APA
RTME
NTS,
LLC
261,
859
26
1,85
9
83
-051
2057
TRAD
E ST
REET ASS
OCIATES
I, LLC
67,8
40
67
,840
27
-428
8375
CW
S LEMM
ON RES
OURC
ES, LP
306,
798
30
6,79
8
45
-385
7740
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53.1
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIESThe following supplemental reports are required to be filed as part of your statement filing unless specifically waived by the domiciliary state. However, in the event that your domiciliary state waives the filing requirement, your response of WAIVED to the specific interrogatory will be accepted in lieu of filing a “NONE” report and a bar code will be printed below. If the supplement is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatory questions.
Responses
MARCH FILING
1. Will the Supplemental Compensation Exhibit be filed with the state of domicile by March 1? YES
2. Will the confidential Risk-based Capital Report be filed with the NAIC by March 1? YES
3. Will the confidential Risk-based Capital Report be filed with the state of domicile, if required, by March 1? WAIVED
4. Will an actuarial opinion be filed by March 1? YES
APRIL FILING
5. Will Management’s Discussion and Analysis be filed by April 1? YES
6. Will the Life, Health & Annuity Guaranty Association Model Act Assessment Base Reconciliation Exhibit be filed with the state of domicile and the NAIC by April 1? YES
7. Will the Adjustment Form (if required) be filed with the state of domicile and the NAIC by April 1? YES
8. Will the Supplemental Investment Risks Interrogatories be filed by April 1? YES
JUNE FILING
9. Will an audited financial report be filed by June 1? YES
10. Will Accountant's Letter of Qualifications be filed with the state of domicile and electronically with the NAIC by June 1? YES
AUGUST FILING
11. Will the regulator-only (non-public) Communication of Internal Control Related Matters Noted in Audit be filed with the state of domicile and electronically with the NAIC (as a regulator-only non-public document) by August 1? YES
The following supplemental reports are required to be filed as part of your annual statement filing. However, in the event that your company does not transact the type of business for which the special report must be filed, your response of NO to the specific interrogatory will be accepted in lieu of filing a “NONE” report and a bar code will be printed below. If the supplement is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatory questions.
MARCH FILING
12. Will Schedule SIS (Stockholder Information Supplement) be filed with the state of domicile by March 1? NO
13. Will the Medicare Supplement Insurance Experience Exhibit be filed with the state of domicile and the NAIC by March 1? NO
14. Will the Trusteed Surplus Statement be filed with the state of domicile and the NAIC by March 1? NO
15. Will the actuarial opinion on participating and non-participating policies as required in Interrogatories 1 and 2 to Exhibit 5 be filed with the state of domicile and electronically with the NAIC by March 1? NO
16. Will the actuarial opinion on non-guaranteed elements as required in interrogatory #3 to Exhibit 5 be filed with the state of domicile and electronically with the NAIC by March 1? NO
17. Will the actuarial opinion on X-Factors be filed with the state of domicile and electronically with the NAIC by March 1? NO
18. Will the actuarial opinion on Separate Accounts Funding Guaranteed Minimum Benefit be filed with the state of domicile and electronically with the NAIC by March 1? NO
19. Will the actuarial opinion on Synthetic Guaranteed Investment Contracts be filed with the state of domicile and electronically with the NAIC by March 1? NO
20. Will the Reasonableness of Assumptions Certification required by Actuarial Guideline XXXV be filed with the state of domicile and electronically with the NAIC by March 1? NO
21. Will the Reasonableness and Consistency of Assumptions Certification required by Actuarial Guideline XXXV be filed with the state of domicile and electronically with the NAIC by March 1? NO
22. Will the Reasonableness of Assumptions Certification for Implied Guaranteed Rate Method required by Actuarial Guideline XXXVI be filed with the state of domicile and electronically with the NAIC by March 1? NO
23. Will the Reasonableness and Consistency of Assumptions Certification required by Actuarial Guideline XXXVI (Updated Average Market Value) be filed with the state of domicile and electronically with the NAIC by March 1? NO
24. Will the Reasonableness and Consistency of Assumptions Certification required by Actuarial Guideline XXXVI (Updated Market Value) be filed with the state of domicile and electronically with the NAIC by March 1? NO
25. Will the C-3 RBC Certifications required under C-3 Phase I be filed with the state of domicile and electronically with the NAIC by March 1? NO
26. Will the C-3 RBC Certifications required under C-3 Phase II be filed with the state of domicile and electronically with the NAIC by March 1? NO
54
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES27. Will the Actuarial Certifications Related to Annuity Nonforfeiture Ongoing Compliance for Equity Indexed Annuities be filed with the state of domicile
and electronically with the NAIC by March 1? NO
28. Will the actuarial opinion required by the Modified Guaranteed Annuity Model Regulation be filed with the state of domicile and electronically with the NAIC by March 1? NO
29. Will the Actuarial Certifications Related to Hedging required by Actuarial Guideline XLIII be filed with the state of domicile and electronically with the NAIC by March 1? NO
30. Will the Financial Officer Certification Related to Clearly Defined Hedging Strategy required by Actuarial Guideline XLIII be filed with the state of domicile and electronically with the NAIC by March 1? NO
31. Will the Management Certification That the Valuation Reflects Management’s Intent required by Actuarial Guideline XLIII be filed with the state of domicile and electronically with the NAIC by March 1? NO
32. Will the Actuarial Certification Related to the Reserves required by Actuarial Guideline XLIII be filed with the state of domicile and electronically with the NAIC by March 1? NO
33. Will the Actuarial Certification regarding the use of 2001 Preferred Class Tables required by the Model Regulation Permitting the Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities be filed with the state of domicile and electronically with the NAIC by March 1? NO
34. Will the Worker's Compensation Carve-Out Supplement be filed by March 1? NO
35. Will Supplemental Schedule O be filed with the state of domicile and the NAIC by March 1? YES
36. Will the Medicare Part D Coverage Supplement be filed with the state of domicile and the NAIC by March 1? NO
37. Will an approval from the reporting entity’s state of domicile for relief related to the five-year rotation requirement for lead audit partner be filed electronically with the NAIC by March 1? NO
38. Will an approval from the reporting entity’s state of domicile for relief related to the one-year cooling off period for independent CPA be filed electronically with the NAIC by March 1? NO
39. Will an approval from the reporting entity’s state of domicile for relief related to the Requirements for Audit Committees be filed electronically with the NAIC by March 1? NO
40. Will the confidential Regulatory Asset Adequacy Issues Summary (RAAIS) required by Actuarial Opinion and Memorandum Regulation (Model 822), Section 7A(5) be filed with the state of domicile by March 15? YES
APRIL FILING
41. Will the Long-Term Care Experience Reporting Forms be filed with the state of domicile and the NAIC by April 1? YES
42. Will the Interest-Sensitive Life Insurance Products Report Forms be filed with the state of domicile and the NAIC by April 1? NO
43. Will the Credit Insurance Experience Exhibit be filed with the state of domicile and the NAIC by April 1? NO
44. Will the Accident and Health Policy Experience Exhibit be filed by April 1? YES
45. Will the Analysis of Annuity Operations by Lines of Business be filed with the state of domicile and the NAIC by April 1? NO
46. Will the Analysis of Increase in Annuity Reserves During the Year be filed with the state of domicile and the NAIC by April 1? NO
47. Will the Supplemental Health Care Exhibit (Parts 1, 2 and 3) be filed with the state of domicile and the NAIC by April 1? NO
48. Will the regulator only (non-public) Supplemental Health Care Exhibit’s Expense Allocation Report be filed with the state of domicile and the NAIC by April 1? NO
49. Will the confidential Actuarial Memorandum required by Actuarial Guideline XXXVIII 8D be filed with the state of domicile by April 30? NO
50. Will the Supplemental XXX/AXXX Reinsurance Exhibit be filed with the state of domicile and the NAIC by April 1? NO
AUGUST FILING
51. Will Management’s Report of Internal Control Over Financial Reporting be filed with the state of domicile by August 1? YES
Explanations:12. The Company is wholly owned by Northwestern Mutual Life Insurance Company. 13. The Company does no Medicare Supplement business. 14. The Company is not a U.S. branch of an alien insurer. 15. The Company has no participating life or annuity products. 16. The Company has no life or annuity products with non-guaranteed elements. 17. The opinion is not applicable to the Company. 18. The opinion is not applicable to the Company. 19. The opinion is not applicable to the Company. 20. The Company has no products that fall under Actuarial Guidelines XXXV. 21. The Company has no products that fall under Actuarial Guidelines XXXV. 22. The Company has no products that fall under Actuarial Guidelines XXXVI. 23. The Company has no products that fall under Actuarial Guidelines XXXVI. 24. The Company has no products that fall under Actuarial Guidelines XXXVI. 25. C-3 Phase I does not apply to the Company. 26. C-3 Phase II does not apply to the Company. 27. The Company has no equity indexed annuities. 28. This opinion is not applicable to the Company. 29. These Certifications are not applicable to the Company. 30. This Certification is not applicable to the Company. 31. This Certification is not applicable to the Company. 32. The Company has no products that fall under Actuarial Guideline XLIII. 33. This Certification is not applicable to the Company. 34. The Company does no Workers' Compensation business. 36. The Company does no Medicare Part D business. 37. This approval is not applicable to the Company. 38. This approval is not applicable to the Company. 39. This approval is not applicable to the Company. 42. The Company has no interest-sensitive life insurance products. 43. The Company does no credit insurance business. 45. The Company has no annuity products. 46. The Company has no annuity products. 47. The Company does no health care business. 48. The Company does no health care business. 49. The Company has no products that fall under Actuarial Guidelines XXXVIII 8D. 50. The Supplemental XXX/AXXX Reinsurance Exhibit is not applicable to the Company.
Bar Codes:3. Risk-based Capital Report [Document Identifier 390]
*69000201639000000*12. SIS Stockholder Information Supplement [Document Identifier 420]
*69000201642000000*13. Medicare Supplement Insurance Experience Exhibit [Document Identifier 360]
*69000201636000000*14. Trusteed Surplus Statement [Document Identifier 490]
*69000201649000000*15. Participating Opinion for Exhibit 5 [Document Identifier 371]
*69000201637100000*16. Non-Guaranteed Opinion for Exhibit 5 [Document Identifier 370]
*69000201637000000*
54.1
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES17. Actuarial Opinion on X-Factors [Document Identifier 442]
*69000201644200000*18. Actuarial Opinion on Separate Accounts Funding Guaranteed Minimum Benefit
[Document Identifier 443] *69000201644300000*19. Actuarial Opinion on Synthetic Guaranteed Investment Contracts
[Document Identifier 444] *69000201644400000*20. Reasonableness of Assumptions Certification required by Actuarial Guideline
XXXV [Document Identifier 445] *69000201644500000*21. Reasonableness and Consistency of Assumptions Certification required by
Actuarial Guideline XXXV [Document Identifier 446] *69000201644600000*22. Reasonableness of Assumptions Certification for Implied Guaranteed Rate
Method required by Actuarial Guideline XXXVI [Document Identifier 447] *69000201644700000*23. Reasonableness and Consistency of Assumptions Certification required by
Actuarial Guideline XXXVI [Document Identifier 448] *69000201644800000*24. Reasonableness and Consistency of Assumptions Certification required by
Actuarial Guideline XXXVI (Updated Market Value) [Document Identifier 449] *69000201644900000*25. C-3 RBC Certifications Required Under C-3 Phase I [Document Identifier 450]
*69000201645000000*26. C-3 RBC Certifications Required Under C-3 Phase II [Document Identifier 451]
*69000201645100000*27. Actuarial Certifications Related to Annuity Nonforfeiture Ongoing Compliance
for Equity Indexed Annuities [Document Identifier 452] *69000201645200000*28. Modified Guaranteed Annuity Model Regulation [Document Identifier 453]
*69000201645300000*29. Actuarial Certifications Related to Hedging required by Actuarial Guideline XLIII
[Document Identifier 436] *69000201643600000*30. Financial Officer Certification Related to Clearly Defined Hedging Strategy
required by Actuarial Guideline XLIII [Document Identifier 437] *69000201643700000*31. Management Certification That the Valuation Reflects Management’s Intent
required by Actuarial Guideline XLIII [Document Identifier 438] *69000201643800000*32. Actuarial Certification Related to the Reserves required by Actuarial Guideline
XLIII [Document Identifier 439] *69000201643900000*33. Actuarial Certification regarding the use of 2001 Preferred Class Tables
required by the Model Regulation Permitting the Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities [Document Identifier 454]
*69000201645400000*34. Workers' Compensation Carve-Out Supplement [Document Identifier 495]
*69000201649500000*36. Medicare Part D Coverage Supplement [Document Identifier 365]
*69000201636500000*37. Relief from the five-year rotation requirement for lead audit partner
[Document Identifier 224] *69000201622400000*38. Relief from the one-year cooling off period for independent CPA
[Document Identifier 225] *69000201622500000*39. Relief from the Requirements for Audit Committees [Document Identifier 226]
*69000201622600000*42. Interest-Sensitive Life Insurance Products Report Forms
[Document Identifier 280] *69000201628000000*43. Credit Insurance Experience Exhibit [Document Identifier 230]
*69000201623000000*45. Analysis of Annuity Operations by Lines of Business [Document Identifier 510]
*69000201651000000*46. Analysis of Increase in Annuity Reserves During the Year
[Document Identifier 515] *69000201651500000*47. Supplemental Health Care Exhibit (Parts 1, 2 and 3) [Document Identifier 216]
*69000201621600000*48. Supplemental Health Care Exhibit's Expense Allocation Report
[Document Identifier 217] *69000201621700000*49. Actuarial Memorandum Required by Actuarial Guideline XXXVIII 8D
[Document Identifier 435] *69000201643500000*50. Supplemental XXX/AXXX Reinsurance Exhibit [Document Identifier 345]
*69000201634500000*
54.2
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
OVERFLOW PAGE FOR WRITE-INS
NONE
55
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SUMMARY INVESTMENT SCHEDULEGross Investment Holdings
Admitted Assets as Reportedin the Annual Statement
Investment Categories
1
Amount
2
Percentage
3
Amount
4Securities Lending
Reinvested CollateralAmount
5
Total(Col. 3 + 4)
Amount
6
Percentage
1. Bonds:
1.1 U.S. treasury securities 89,439,856 94.290 89,439,856 89,439,856 94.290
1.2 U.S. government agency obligations (excluding mortgage-backed securities):
1.21 Issued by U.S. government agencies 0.000 0.000
1.22 Issued by U.S. government sponsored agencies 0.000 0.000
1.3 Non-U.S. government (including Canada, excluding mortgaged-backed securities) 0.000 0.000
1.4 Securities issued by states, territories, and possessions and political subdivisions in the U.S. :
1.41 States, territories and possessions general obligations 0.000 0.000
1.42 Political subdivisions of states, territories and possessions and political subdivisions general obligations 0.000 0.000
1.43 Revenue and assessment obligations 0.000 0.000
1.44 Industrial development and similar obligations 0.000 0.000
1.5 Mortgage-backed securities (includes residential and commercial MBS):
1.51 Pass-through securities:
1.511 Issued or guaranteed by GNMA 0.000 0.000
1.512 Issued or guaranteed by FNMA and FHLMC 0.000 0.000
1.513 All other 0.000 0.000
1.52 CMOs and REMICs:
1.521 Issued or guaranteed by GNMA, FNMA, FHLMC or VA 0.000 0.000
1.522 Issued by non-U.S. Government issuers and collateralized by mortgage-backed securities issued or guaranteed by agencies shown in Line 1.521 0.000 0.000
1.523 All other 0.000 0.000
2. Other debt and other fixed income securities (excluding short-term):
2.1 Unaffiliated domestic securities (includes credit tenant loans and hybrid securities) 0.000 0.000
2.2 Unaffiliated non-U.S. securities (including Canada) 0.000 0.000
2.3 Affiliated securities 0.000 0.000
3. Equity interests:
3.1 Investments in mutual funds 0.000 0.000
3.2 Preferred stocks:
3.21 Affiliated 0.000 0.000
3.22 Unaffiliated 0.000 0.000
3.3 Publicly traded equity securities (excluding preferred stocks):
3.31 Affiliated 0.000 0.000
3.32 Unaffiliated 0.000 0.000
3.4 Other equity securities:
3.41 Affiliated 0.000 0.000
3.42 Unaffiliated 0.000 0.000
3.5 Other equity interests including tangible personal property under lease:
3.51 Affiliated 0.000 0.000
3.52 Unaffiliated 0.000 0.000
4. Mortgage loans:
4.1 Construction and land development 0.000 0.000
4.2 Agricultural 0.000 0.000
4.3 Single family residential properties 0.000 0.000
4.4 Multifamily residential properties 0.000 0.000
4.5 Commercial loans 0.000 0.000
4.6 Mezzanine real estate loans 0.000 0.000
5. Real estate investments:
5.1 Property occupied by company 0.000 0.000
5.2 Property held for production of income (including
$ of property acquired in satisfaction of
debt) 0.000 0.000
5.3 Property held for sale (including $
property acquired in satisfaction of debt) 0.000 0.000
6. Contract loans 0.000 0.000
7. Derivatives 0.000 0.000
8. Receivables for securities 6,694 0.007 6,694 6,694 0.007
9. Securities Lending (Line 10, Asset Page reinvested collateral) 0.000 XXX XXX XXX
10. Cash, cash equivalents and short-term investments 5,409,255 5.703 5,409,256 5,409,256 5.703
11. Other invested assets 0.000 0.000
12. Total invested assets 94,855,805 100.000 94,855,806 94,855,806 100.000
SI01
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Schedule A - Verification - Real Estate
N O N E
Schedule B - Verification - Mortgage Loans
N O N E
SI02
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE BA - VERIFICATION BETWEEN YEARSOther Long-Term Invested Assets
1. Book/adjusted carrying value, December 31 of prior year
2. Cost of acquired:
2.1 Actual cost at time of acquisition (Part 2, Column 8)
2.2 Additional investment made after acquisition (Part 2, Column 9)
3. Capitalized deferred interest and other:
3.1 Totals, Part 1, Column 16
3.2 Totals, Part 3, Column 12
4. Accrual of discount
5. Unrealized valuation increase (decrease):
5.1 Totals, Part 1, Column 13
5.2 Totals, Part 3, Column 9
6. Total gain (loss) on disposals, Part 3, Column 19
7. Deduct amounts received on disposals, Part 3, Column 16
8. Deduct amortization of premium and depreciation
9. Total foreign exchange change in book/adjusted carrying value:
9.1 Totals, Part 1, Column 17
9.2 Totals, Part 3, Column 14
10. Deduct current year’s other than temporary impairment recognized:
10.1 Totals, Part 1, Column 15
10.2 Totals, Part 3, Column 11
11. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5+6-7-8+9-10)
12. Deduct total nonadmitted amounts
13. Statement value at end of current period (Line 11 minus Line 12)
SCHEDULE D - VERIFICATION BETWEEN YEARSBonds and Stocks
1. Book/adjusted carrying value, December 31 of prior year 86,313,518
2. Cost of bonds and stocks acquired, Part 3, Column 7 5,846,328
3. Accrual of discount 999,740
4. Unrealized valuation increase (decrease):
4.1. Part 1, Column 12
4.2. Part 2, Section 1, Column 15
4.3. Part 2, Section 2, Column 13
4.4. Part 4, Column 11
5. Total gain (loss) on disposals, Part 4, Column 19
6. Deduction consideration for bonds and stocks disposed of, Part 4, Column 7 3,705,000
7. Deduct amortization of premium 14,730
8. Total foreign exchange change in book/adjusted carrying value:
8.1. Part 1, Column 15
8.2. Part 2, Section 1, Column 19
8.3. Part 2, Section 2, Column 16
8.4. Part 4, Column 15
9. Deduct current year’s other than temporary impairment recognized:
9.1. Part 1, Column 14
9.2. Part 2, Section 1, Column 17
9.3. Part 2, Section 2, Column 14
9.4. Part 4, Column 13
10. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5-6-7+8-9) 89,439,856
11. Deduct total nonadmitted amounts
12. Statement value at end of current period (Line 10 minus Line 11) 89,439,856
NONE
SI03
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE D - SUMMARY BY COUNTRYLong-Term Bonds and Stocks OWNED December 31 of Current Year
Description
1Book/Adjusted Carrying Value
2
Fair Value
3
Actual Cost
4
Par Value of Bonds
BONDS
Governments
(Including all obligations guaranteed by governments)
1. United States 89,439,856 92,272,495 87,367,595 128,770,000
2. Canada
3. Other Countries
4. Totals 89,439,856 92,272,495 87,367,595 128,770,000
U.S. States, Territories and Possessions
(Direct and guaranteed) 5. Totals
U.S. Political Subdivisions of States, Territories and Possessions (Direct and guaranteed)
6. Totals
U.S. Special Revenue and Special Assessment Obligations and all Non-Guaranteed Obligations of Agencies and Authorities of Governments and their Political Subdivisions 7. Totals
Industrial and Miscellaneous, SVO Identified Funds and Hybrid Securities (unaffiliated)
8. United States
9. Canada
10. Other Countries
11. Totals
Parent, Subsidiaries and Affiliates 12. Totals
13. Total Bonds 89,439,856 92,272,495 87,367,595 128,770,000
PREFERRED STOCKS
Industrial and Miscellaneous (unaffiliated)
14. United States
15. Canada
16. Other Countries
17. Totals
Parent, Subsidiaries and Affiliates 18. Totals
19. Total Preferred Stocks
COMMON STOCKS
Industrial and Miscellaneous (unaffiliated)
20. United States
21. Canada
22. Other Countries
23. Totals
Parent, Subsidiaries and Affiliates 24. Totals
25. Total Common Stocks
26. Total Stocks
27. Total Bonds and Stocks 89,439,856 92,272,495 87,367,595
SI04
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,518
10
0.0
89,4
39,8
56
2. A
ll O
ther
Govern
ments
2.1
NA
IC 1
XX
X
2.2
NA
IC 2
XX
X
2.3
NA
IC 3
XX
X
2.4
NA
IC 4
XX
X
2.5
NA
IC 5
XX
X
2.6
NA
IC 6
XX
X
2.7
Tota
ls
XX
X
3. U
.S. S
tate
s, T
err
itories a
nd P
ossessio
ns e
tc.,
Guara
nte
ed
3.1
NA
IC 1
XX
X
3.2
NA
IC 2
XX
X
3.3
NA
IC 3
XX
X
3.4
NA
IC 4
XX
X
3.5
NA
IC 5
XX
X
3.6
NA
IC 6
XX
X
3.7
Tota
ls
XX
X
4. U
.S. P
olit
ical S
ubdiv
isio
ns o
f S
tate
s, T
err
itories a
nd
Possessio
ns , G
uara
nte
ed
4.1
NA
IC 1
XX
X
4.2
NA
IC 2
XX
X
4.3
NA
IC 3
XX
X
4.4
NA
IC 4
XX
X
4.5
NA
IC 5
XX
X
4.6
NA
IC 6
XX
X
4.7
Tota
ls
XX
X
5. U
.S. S
pecia
l R
evenue &
Specia
l A
ssessm
ent
Oblig
ations, etc
., N
on-G
uara
nte
ed
5.1
NA
IC 1
XX
X
5.2
NA
IC 2
XX
X
5.3
NA
IC 3
XX
X
5.4
NA
IC 4
XX
X
5.5
NA
IC 5
XX
X
5.6
NA
IC 6
XX
X
5.7
Tota
ls
XX
X
SI05
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
D -
PA
RT
1A
- S
EC
TIO
N 1
(C
on
tin
ue
d)
Qualit
y and M
atu
rity
Dis
trib
ution o
f A
ll B
onds O
wned D
ecem
ber
31,
at
Book/A
dju
ste
d C
arr
ying V
alu
es b
y M
ajo
r T
ypes o
f Is
sues a
nd N
AIC
Desig
nations
NA
IC D
esig
nation
1
1 Y
ear
or
Less
2O
ver
1 Y
ear
Thro
ugh 5
Years
3O
ver
5 Y
ears
T
hro
ugh 1
0 Y
ears
4O
ver
10 Y
ears
T
hro
ugh 2
0 Y
ears
5
Over
20 Y
ears
6N
o M
atu
rity
Date
7
Tota
l C
urr
ent Y
ear
8C
ol. 7
as a
% o
fLin
e 1
0.7
9T
ota
l fr
om
Col. 6
P
rior
Year
10
% F
rom
Col. 7
Prior
Year
11
Tota
l P
ublic
lyT
raded
12
Tota
l P
rivate
lyP
laced (
a)
6. In
dustr
ial &
Mis
cella
neous (
Unaffili
ate
d)
6.1
NA
IC 1
XX
X
6.2
NA
IC 2
XX
X
6.3
NA
IC 3
XX
X
6.4
NA
IC 4
XX
X
6.5
NA
IC 5
XX
X
6.6
NA
IC 6
XX
X
6.7
Tota
ls
XX
X
7. H
ybrid S
ecurities
7.1
NA
IC 1
XX
X
7.2
NA
IC 2
XX
X
7.3
NA
IC 3
XX
X
7.4
NA
IC 4
XX
X
7.5
NA
IC 5
XX
X
7.6
NA
IC 6
XX
X
7.7
Tota
ls
XX
X
8. P
are
nt, S
ubsid
iaries a
nd A
ffili
ate
s
8.1
NA
IC 1
XX
X
8.2
NA
IC 2
XX
X
8.3
NA
IC 3
XX
X
8.4
NA
IC 4
XX
X
8.5
NA
IC 5
XX
X
8.6
NA
IC 6
XX
X
8.7
Tota
ls
XX
X
9. S
VO
Identified F
unds
9.1
NA
IC 1
X
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
9.2
NA
IC 2
X
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
9.3
NA
IC 3
X
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
9.4
NA
IC 4
X
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
9.5
NA
IC 5
X
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
9.6
NA
IC 6
X
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
9.7
Tota
lsX
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
SI06
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
D -
PA
RT
1A
- S
EC
TIO
N 1
(C
on
tin
ue
d)
Qualit
y and M
atu
rity
Dis
trib
ution o
f A
ll B
onds O
wned D
ecem
ber
31,
at
Book/A
dju
ste
d C
arr
ying V
alu
es b
y M
ajo
r T
ypes o
f Is
sues a
nd N
AIC
Desig
nations
NA
IC D
esig
nation
1
1 Y
ear
or
Less
2O
ver
1 Y
ear
Thro
ugh 5
Years
3O
ver
5 Y
ears
T
hro
ugh 1
0 Y
ears
4O
ver
10 Y
ears
T
hro
ugh 2
0 Y
ears
5
Over
20 Y
ears
6N
o M
atu
rity
Date
7
Tota
l C
urr
ent Y
ear
8C
ol. 7
as a
% o
fLin
e 1
0.7
9T
ota
l fr
om
Col. 6
P
rior
Year
10
% F
rom
Col. 7
Prior
Year
11
Tota
l P
ublic
lyT
raded
12
Tota
l P
rivate
lyP
laced (
a)
10. T
ota
l B
onds C
urr
ent Y
ear
10.1
NA
IC 1
(d
)
43
,415
,575
6,
232,
297
39,791
,984
89,4
39,8
56
100.
0 X
XX
XX
X89
,439
,856
10.2
NA
IC 2
(d
)
X
XX
XX
X
10.3
NA
IC 3
(d
)
X
XX
XX
X
10.4
NA
IC 4
(d
)
X
XX
XX
X
10.5
NA
IC 5
(d
)
(c
)
X
XX
XX
X
10.6
NA
IC 6
(d
)
(c
)
X
XX
XX
X
10.7
Tota
ls
43,4
15,5
75
6,23
2,29
7 39
,791
,984
(b)
89,4
39,8
56
100.
0 X
XX
XX
X89
,439
,856
10.8
Lin
e 1
0.7
as a
% o
f C
ol. 7
48.5
7.0
44.5
100.
0 X
XX
XX
XX
XX
100.
0
11. T
ota
l B
onds P
rior
Year
11.1
NA
IC 1
3,71
4,64
4
43,391
,421
6,
077,92
3 33,1
29,5
30
XX
XX
XX
XX
X86
,313
,518
10
0.0
86,313
,518
11.2
NA
IC 2
XX
XX
XX
XX
X
11.3
NA
IC 3
XX
XX
XX
XX
X
11.4
NA
IC 4
XX
XX
XX
XX
X
11.5
NA
IC 5
XX
XX
XX
XX
X(c
)
11.6
NA
IC 6
XX
XX
XX
XX
X(c
)
11.7
Tota
ls
3,71
4,64
4
43,391
,421
6,
077,92
3 33,1
29,5
30
XX
XX
XX
XX
X(b
)86
,313
,518
10
0.0
86,313
,518
11.8
Lin
e 1
1.7
as a
% o
f C
ol. 9
4.3
50
.3
7.0
38.4
X
XX
XX
XX
XX
100.
0 X
XX
100.
0
12. T
ota
l P
ublic
ly T
raded B
onds
12.1
NA
IC 1
43
,415
,575
6,
232,
297
39,791
,984
89,4
39,8
56
100.
0 86
,313
,518
10
0.0
89,4
39,8
56
XX
X
12.2
NA
IC 2
XX
X
12.3
NA
IC 3
XX
X
12.4
NA
IC 4
XX
X
12.5
NA
IC 5
XX
X
12.6
NA
IC 6
XX
X
12.7
Tota
ls
43,4
15,5
75
6,23
2,29
7 39
,791
,984
89,4
39,8
56
100.
0 86
,313
,518
10
0.0
89,4
39,8
56
XX
X
12.8
Lin
e 1
2.7
as a
% o
f C
ol. 7
48
.5
7.0
44.5
100.
0 X
XX
XX
XX
XX
100.
0 X
XX
12.9
Lin
e 1
2.7
as a
% o
f Lin
e 1
0.7
, C
ol. 7
, S
ection 1
0
48
.5
7.0
44.5
100.
0 X
XX
XX
XX
XX
100.
0 X
XX
13. T
ota
l P
rivate
ly P
laced B
onds
13.1
NA
IC 1
X
XX
13.2
NA
IC 2
X
XX
13.3
NA
IC 3
X
XX
13.4
NA
IC 4
X
XX
13.5
NA
IC 5
X
XX
13.6
NA
IC 6
X
XX
13.7
Tota
ls
XX
X
13.8
Lin
e 1
3.7
as a
% o
f C
ol. 7
XX
XX
XX
XX
XX
XX
13.9
Lin
e 1
3.7
as a
% o
f Lin
e 1
0.7
, C
ol. 7
, S
ection 1
0
XX
XX
XX
XX
XX
XX
(a)
Inclu
des $
fre
ely
tra
dable
under
SE
C R
ule
144 o
r qualif
ied for
resale
under
SE
C R
ule
144A
.
(b)
Inclu
des $
c
urr
ent ye
ar,
$
p
rior
year
of bonds w
ith Z
desig
nations a
nd $
, curr
ent ye
ar
$
prior
year
of bonds w
ith Z
* desig
nations. T
he letter
"Z"
means the N
AIC
desig
nation w
as n
ot
assig
ned b
y th
e S
ecurities V
alu
ation O
ffic
e (
SV
O)
at th
e d
ate
of th
e s
tate
ment. "Z
*" m
eans the S
VO
could
not evalu
ate
the o
blig
ation b
ecause v
alu
ation p
rocedure
s for
the s
ecurity
cla
ss a
re u
nder
regula
tory
revie
w.
(c)
Inclu
des $
c
urr
ent ye
ar,
$
p
rior
year
of bonds w
ith 5
* desig
nations a
nd $
, curr
ent ye
ar
$
prior
year
of bonds w
ith 6
* desig
nations. "
5*"
means the N
AIC
desig
nation w
as a
ssig
ned b
y th
e
(SV
O)
in r
elia
nce o
n the insure
r's c
ert
ific
ation that th
e issuer
is c
urr
ent in
all
princip
al and inte
rest paym
ents
. "
6*"
means the N
AIC
desig
nation w
as a
ssig
ned b
y th
e S
VO
due to inadequate
cert
ific
ation o
f princip
al and inte
rest paym
ents
.
(d)
Inclu
des th
e follo
win
g a
mount of short
-term
and c
ash e
quiv
ale
nt bonds b
y N
AIC
desig
nation: N
AIC
1 $
; N
AIC
2 $
; N
AIC
3 $
; N
AIC
4 $
; N
AIC
5 $
; N
AIC
6 $
SI07
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
D -
PA
RT
1A
- S
EC
TIO
N 2
Matu
rity
Dis
trib
ution o
f A
ll B
onds O
wned D
ecem
ber
31,
at
Book/A
dju
ste
d C
arr
ying V
alu
es b
y M
ajo
r T
ype a
nd S
ubty
pe o
f Is
sues
Dis
trib
ution b
y T
ype
1
1 Y
ear
or
Less
2O
ver
1 Y
ear
Thro
ugh 5
Years
3O
ver
5 Y
ears
Thro
ugh 1
0 Y
ears
4O
ver
10 Y
ears
T
hro
ugh 2
0 Y
ears
5
Over
20 Y
ears
6N
o M
atu
rity
Date
7
Tota
l C
urr
ent Y
ear
8C
ol. 7
as a
% o
fLin
e 1
0.6
9T
ota
l fr
om
Col. 6
P
rior
Year
10
% F
rom
Col. 7
Prior
Year
11
Tota
l P
ublic
lyT
raded
12
Tota
l P
rivate
lyP
laced
1. U
.S. G
overn
ments
1.1
Issuer
Oblig
ations
43,4
15,5
75
6,23
2,297
39,7
91,984
XX
X89,43
9,856
100.
0 86,
313,
518
100.
0 89,43
9,856
1.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
1.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
1.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
1.5
Tota
ls
43
,415,5
75
6,23
2,297
39,7
91,984
XX
X89,43
9,856
100.
0 86,
313,
518
100.
0 89,43
9,856
2. A
ll O
ther
Govern
ments
2.1
Issuer
Oblig
ations
X
XX
2.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
2.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
2.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
2.5
Tota
ls
XX
X
3. U
.S. S
tate
s, T
err
itories a
nd P
ossessio
ns, G
uara
nte
ed
3.1
Issuer
Oblig
ations
X
XX
3.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
3.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
3.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
3.5
Tota
ls
XX
X
4. U
.S. P
olit
ical S
ubdiv
isio
ns o
f S
tate
s, T
err
itories a
nd
Possessio
ns, G
uara
nte
ed
4.1
Issuer
Oblig
ations
X
XX
4.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
4.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
4.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
4.5
Tota
ls
XX
X
5. U
.S. S
pecia
l R
evenue &
Specia
l A
ssessm
ent O
blig
ations
etc
., N
on-G
uara
nte
ed
5.1
Issuer
Oblig
ations
X
XX
5.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
5.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
5.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
5.5
Tota
ls
XX
X
6. In
dustr
ial and M
iscella
neous
6.1
Issuer
Oblig
ations
X
XX
6.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
6.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
6.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
6.5
Tota
ls
XX
X
7. H
ybrid S
ecurities
7.1
Issuer
Oblig
ations
X
XX
7.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
7.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
7.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
7.5
Tota
ls
XX
X
8. P
are
nt, S
ubsid
iaries a
nd A
ffili
ate
s
8.1
Issuer
Oblig
ations
X
XX
8.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
8.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
8.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
8.5
Tota
ls
XX
X
SI08
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
D -
PA
RT
1A
- S
EC
TIO
N 2
(C
on
tin
ue
d)
Matu
rity
Dis
trib
ution o
f A
ll B
onds O
wned D
ecem
ber
31,
at
Book/A
dju
ste
d C
arr
ying V
alu
es b
y M
ajo
r T
ype a
nd S
ubty
pe o
f Is
sues
Dis
trib
ution b
y T
ype
1
1 Y
ear
or
Less
2O
ver
1 Y
ear
Thro
ugh 5
Years
3O
ver
5 Y
ears
Thro
ugh 1
0 Y
ears
4O
ver
10 Y
ears
T
hro
ugh 2
0 Y
ears
5
Over
20 Y
ears
6N
o M
atu
rity
Date
7
Tota
l C
urr
ent Y
ear
8C
ol. 7
as a
% o
fLin
e 1
0.6
9T
ota
l fr
om
Col. 6
P
rior
Year
10
% F
rom
Col. 7
Prior
Year
11
Tota
l P
ublic
lyT
raded
12
Tota
l P
rivate
lyP
laced
9. S
VO
Identified F
unds
9.1
Exc
hange T
raded F
unds Identified b
y th
e S
VO
X
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
9.2
Bond M
utu
al F
unds Identified b
y th
e S
VO
X
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
9.3
Tota
lsX
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
X
10. T
ota
l B
onds C
urr
ent Y
ear
10.1
Issuer
Oblig
ations
43,4
15,5
75
6,23
2,297
39,7
91,984
XX
X89,43
9,856
100.
0 X
XX
XX
X89,43
9,856
10.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
XX
XX
XX
10.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
XX
XX
XX
10.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
XX
XX
XX
10.5
SV
O Identified F
unds
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
XX
10.6
Tota
ls
43,4
15,5
75
6,23
2,297
39,7
91,984
89,43
9,856
100.
0 X
XX
XX
X89,43
9,856
10.7
Lin
e 1
0.6
as a
% o
f C
ol. 7
48.5
7.
0 44
.5
100.
0 X
XX
XX
XX
XX
100.
0
11. T
ota
l B
onds P
rior
Year
11.1
Issuer
Oblig
ations
3,714,
644
43
,391,4
21
6,07
7,923
33,129,5
30
XX
XX
XX
XX
X86,
313,
518
100.
0 86,
313,
518
11.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
XX
XX
XX
11.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
XX
XX
XX
11.4
Oth
er
Loan-B
acked a
nd S
tructu
red S
ecurities
X
XX
XX
XX
XX
11.5
SV
O Identified F
unds
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
11.6
Tota
ls
3,714,
644
43
,391,4
21
6,07
7,923
33,129,5
30
XX
XX
XX
XX
X86,
313,
518
100.
0 86,
313,
518
11.7
Lin
e 1
1.6
as a
% o
f C
ol. 9
4.3
50
.3
7.0
38.4
X
XX
XX
XX
XX
100.
0 X
XX
100.
0
12. T
ota
l P
ublic
ly T
raded B
onds
12.1
Issuer
Oblig
ations
43,4
15,5
75
6,23
2,297
39,7
91,984
XX
X89,43
9,856
100.
0 86,
313,
518
100.
0 89,43
9,856
X
XX
12.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
X
XX
12.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
X
XX
12.4
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
X
XX
12.5
SV
O Identified F
unds
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
XX
X
XX
12.6
Tota
ls
43,4
15,5
75
6,23
2,297
39,7
91,984
89,43
9,856
100.
0 86,
313,
518
100.
0 89,43
9,856
X
XX
12.7
Lin
e 1
2.6
as a
% o
f C
ol. 7
48
.5
7.0
44.5
100.
0 X
XX
XX
XX
XX
100.
0 X
XX
12.8
Lin
e 1
2.6
as a
% o
f Lin
e 1
0.6
, C
ol. 7
, S
ection 1
0
48
.5
7.0
44.5
100.
0 X
XX
XX
XX
XX
100.
0 X
XX
13. T
ota
l P
rivate
ly P
laced B
onds
13.1
Issuer
Oblig
ations
X
XX
XX
X
13.2
Resid
ential M
ort
gage-B
acked S
ecurities
X
XX
XX
X
13.3
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
XX
X
13.4
Com
merc
ial M
ort
gage-B
acked S
ecurities
X
XX
XX
X
13.5
SV
O Identified F
unds
XX
XX
XX
XX
XX
XX
XX
X
XX
XX
XX
XX
X
13.6
Tota
ls
XX
X
13.7
Lin
e 1
3.6
as a
% o
f C
ol. 7
XX
XX
XX
XX
XX
XX
13.8
Lin
e 1
3.6
as a
% o
f Lin
e 1
0.6
, C
ol. 7
, S
ection 1
0
XX
XX
XX
XX
XX
XX
SI09
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
DA
- V
ER
IFIC
AT
ION
BE
TW
EE
N Y
EA
RS
Short
-Term
Inve
stm
ents
1
Tota
l
2
Bonds
3
Mort
gage L
oans
4O
ther
Short
-term
In
vestm
ent A
ssets
(a)
5In
vestm
ents
in P
are
nt,
Subsid
iaries a
nd A
ffili
ate
s
1.
Book/a
dju
ste
d c
arr
ying v
alu
e, D
ecem
ber
31 o
f prior
year
2.
Cost of short
-term
investm
ents
acquired
399,
993
399,
993
3.
Accru
al of dis
count
7 7
4.
Unre
aliz
ed v
alu
ation incre
ase (
decre
ase)
5.
Tota
l gain
(lo
ss)
on d
isposals
6.
Deduct consid
era
tion r
eceiv
ed o
n d
isposals
40
0,00
0 40
0,00
0
7.
Deduct am
ort
ization o
f pre
miu
m
8.
Tota
l fo
reig
n e
xchange c
hange in b
ook/a
dju
ste
d c
arr
ying v
alu
e
9.
Deduct curr
ent ye
ar’s o
ther
than tem
pora
ry im
pairm
ent re
cogniz
ed
10.
Book a
dju
ste
d c
arr
ying v
alu
e a
t end o
f curr
ent period (
Lin
es 1
+2+
3+
4+
5-6
-7+
8-9
)
11.
Deduct to
tal nonadm
itte
d a
mounts
12.
Sta
tem
ent valu
e a
t end o
f curr
ent period (
Lin
e 1
0 m
inus L
ine 1
1)
(a)
Indic
ate
the c
ate
gory
of such a
ssets
, fo
r exa
mple
, jo
int ventu
res, tr
ansport
ation e
quip
ment:
SI10
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Schedule DB - Part A - Verification - Options, Caps, Floors, Collars, Swaps and Forwards
N O N E
Schedule DB - Part B - Verification - Futures Contracts
N O N E
Schedule DB - Part C - Section 1 - Replication (Synthetic Asset) Transactions (RSATs) Open
N O N E
Schedule DB-Part C-Section 2-Reconciliation of Replication (Synthetic Asset) Transactions Open
N O N E
Schedule DB - Verification - Book/Adjusted Carrying Value, Fair Value and Potential Exposure of Derivatives
N O N E
Schedule E - Verification - Cash Equivalents
N O N E
Schedule A - Part 1 - Real Estate Owned
N O N E
Schedule A - Part 2 - Real Estate Acquired and Additions Made
N O N E
Schedule A - Part 3 - Real Estate Disposed
N O N E
Schedule B - Part 1 - Mortgage Loans Owned
N O N E
Schedule B - Part 2 - Mortgage Loans Acquired and Additions Made
N O N E
Schedule B - Part 3 - Mortgage Loans Disposed, Transferred or Repaid
N O N E
Schedule BA - Part 1 - Other Long-Term Invested Assets Owned
N O N E
Schedule BA - Part 2 - Other Long-Term Invested Assets Acquired and Additions Made
N O N E
SI11, SI12, SI13, SI14, SI15, E01, E02, E03, E04, E05, E06, E07, E08
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Schedule BA - Part 3 - Other Long-Term Invested Assets Disposed, Transferred or Repaid
N O N E
E09
AN
NU
AL
ST
AT
EM
EN
T F
OR
TH
E Y
EA
R 2
016
OF
TH
E N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
D -
PA
RT
1S
how
ing
All
Long
-Ter
m B
ON
DS
Ow
ned
Dec
embe
r 31
of C
urre
nt Y
ear
12
Cod
es6
7F
air
Val
ue10
11C
hang
e in
Boo
k/A
djus
ted
Car
ryin
g V
alue
Inte
rest
Dat
es3
45
89
1213
1415
1617
1819
2021
22
CU
SIP
Id
entif
icat
ion
Des
crip
tion
C o d e
F o r e i g nB
ond
Cha
rN
AIC
Des
.A
ctua
lC
ost
Rat
e U
sed
to
Obt
ain
Fai
r V
alue
Fai
rV
alue
Par
Val
ue
Boo
k/A
djus
ted
Car
ryin
gV
alue
Unr
ealiz
edV
alua
tion
Incr
ease
/(D
ecre
ase)
Cur
rent
Yea
r's(A
mor
-tiz
atio
n)A
ccre
tion
Cur
rent
Yea
r'sO
ther
-T
han-
Tem
pora
ryIm
pairm
ent
Rec
ogni
zed
Tot
alF
orei
gnE
xcha
nge
Cha
nge
inB
ook/
Adj
uste
dC
arry
ing
Val
ueR
ate
of
Effe
ctiv
eR
ate
ofW
hen
Pai
d
Adm
itted
Am
ount
Due
and
Acc
rued
Am
ount
R
ecei
ved
Dur
ing
Yea
rA
cqui
red
Sta
ted
Con
trac
tual
Mat
urity
Dat
e912810-RN-0
US TREASURY NB BONDS
1
2,023,516
96.2310
1,924,620
2,000,000
2,023,047
(468)
2.875
2.816 FA
21,719
57,500
01/15/2016
08/15/2045
912810-RU-4
US TREASURY NB BONDS
1
3,822,813
96.5470
3,861,880
4,000,000
3,823,120
307
2.875
3.103
MN
14,931
12/01/2016
11/15/2046
912828-D5-6
US TREASURY NOTE
1
28,010,500
100.4650
28,451,688
28,320,000
28,075,670
28,749
2.375
2.500 FA
254,053
672,600
09/23/2014
08/15/2024
912828-G3-8
US TREASURY
SD
115,349,008
99.3870
15,206,211
15,300,000
15,339,905
(4,597)
2.250
2.214
MN
44,695
344,250
12/18/2014
11/15/2024
912833-XS-4
US TREASURY STRIPS
@
16,039,930
70.9500
6,030,750
8,500,000
6,232,297
154,375
0.000
2.524
N/A
09/30/2015
05/15/2029
912833-Z6-0
US TREASURY STRIPS
@
132,121,828
52.0840
36,797,346
70,650,000
33,945,817
816,288
0.000
5.115
N/A
09/25/2014
02/15/2038
0199
999.
Sub
tota
l - B
onds
- U
.S. G
over
nmen
ts -
Issu
er O
blig
atio
ns87,367,595
XX
X92,272,495
128,770,000
89,439,856
994,654
XX
XX
XX
XX
X335,398
1,074,350
XX
XX
XX
0599
999.
Tot
al -
U.S
. Gov
ernm
ent B
onds
87,367,595
XX
X92,272,495
128,770,000
89,439,856
994,654
XX
XX
XX
XX
X335,398
1,074,350
XX
XX
XX
1099
999.
Tot
al -
All
Oth
er G
over
nmen
t Bon
ds
XX
X
XX
XX
XX
XX
X
X
XX
XX
X17
9999
9. T
otal
- U
.S. S
tate
s, T
errit
orie
s an
d P
osse
ssio
ns B
onds
X
XX
X
XX
XX
XX
XX
XX
XX
XX
2499
999.
Tot
al -
U.S
. Pol
itica
l Sub
divi
sion
s B
onds
X
XX
X
XX
XX
XX
XX
XX
XX
XX
3199
999.
Tot
al -
U.S
. Spe
cial
Rev
enue
s B
onds
X
XX
X
XX
XX
XX
XX
XX
XX
XX
3899
999.
Tot
al -
Indu
stria
l and
Mis
cella
neou
s (U
naffi
liate
d) B
onds
X
XX
X
XX
XX
XX
XX
XX
XX
XX
4899
999.
Tot
al -
Hyb
rid S
ecur
ities
X
XX
X
XX
XX
XX
XX
XX
XX
XX
5599
999.
Tot
al -
Par
ent,
Sub
sidi
arie
s an
d A
ffilia
tes
Bon
ds
XX
X
XX
XX
XX
XX
X
X
XX
XX
X60
9999
9. S
ubto
tal -
SV
O Id
entif
ied
Fun
ds
XX
X
XX
XX
XX
XX
X
X
XX
XX
X77
9999
9. T
otal
- Is
suer
Obl
igat
ions
87,367,595
XX
X92,272,495
128,770,000
89,439,856
994,654
XX
XX
XX
XX
X335,398
1,074,350
XX
XX
XX
7899
999.
Tot
al -
Res
iden
tial M
ortg
age-
Bac
ked
Sec
uriti
es
XX
X
XX
XX
XX
XX
X
X
XX
XX
X79
9999
9. T
otal
- C
omm
erci
al M
ortg
age-
Bac
ked
Sec
uriti
es
XX
X
XX
XX
XX
XX
X
X
XX
XX
X80
9999
9. T
otal
- O
ther
Loa
n-B
acke
d an
d S
truc
ture
d S
ecur
ities
X
XX
X
XX
XX
XX
XX
XX
XX
XX
8199
999.
Tot
al -
SV
O Id
entif
ied
Fun
ds
XX
X
XX
XX
XX
XX
X
X
XX
XX
X83
9999
9 -
Tot
al B
onds
87,367,595
XX
X92,272,495
128,770,000
89,439,856
994,654
XX
XX
XX
XX
X335,398
1,074,350
XX
XX
XX
E10
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Schedule D - Part 2 - Section 1 - Preferred Stocks Owned
N O N E
Schedule D - Part 2 - Section 2 - Common Stocks Owned
N O N E
E11, E12
AN
NU
AL
ST
AT
EM
EN
T F
OR
TH
E Y
EA
R 2
016
OF
TH
E N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
D -
PA
RT
3S
how
ing
All
Long
-Ter
m B
onds
and
Sto
cks
AC
QU
IRE
D D
urin
g C
urre
nt Y
ear
1
CU
SIP
Id
entif
icat
ion
2
Des
crip
tion
3
For
eign
4
Dat
eA
cqui
red
5
Nam
e of
Ven
dor
6
Num
ber
of S
hare
sof
Sto
ck
7
Act
ual C
ost
8
Par
Val
ue
9P
aid
for
Acc
rued
Inte
rest
and
Div
iden
ds912810-RN-0
US T
REASURY
NB B
ONDS
2.87
5% 0
8/15/45
01/1
5/2016
Well
s Fargo Securi
ties
, Ll
c
2,023,516
2,00
0,00
0 24,531
912810
-RU-4
US T
REASURY
NB B
ONDS
2.87
5% 1
1/15/46
12/0
1/2016
Goldman Sachs
Co
3,822,81
2 4,00
0,00
0 5,401
0599
999.
Sub
tota
l - B
onds
- U
.S. G
over
nmen
ts5,846,
328
6,00
0,00
0 29,932
8399
997.
Tot
al -
Bon
ds -
Par
t 35,846,
328
6,00
0,00
0 29,932
8399
998.
Tot
al -
Bon
ds -
Par
t 5
8399
999.
Tot
al -
Bon
ds5,846,
328
6,00
0,00
0 29,932
8999
997.
Tot
al -
Pre
ferr
ed S
tock
s -
Par
t 3
XX
X
8999
998.
Tot
al -
Pre
ferr
ed S
tock
s -
Par
t 5
XX
X
8999
999.
Tot
al -
Pre
ferr
ed S
tock
s
XX
X
9799
997.
Tot
al -
Com
mon
Sto
cks
- P
art 3
X
XX
9799
998.
Tot
al -
Com
mon
Sto
cks
- P
art 5
X
XX
9799
999.
Tot
al -
Com
mon
Sto
cks
X
XX
9899
999.
Tot
al -
Pre
ferr
ed a
nd C
omm
on S
tock
s
XX
X
9999
999
- T
otal
s5,846,
328
XX
X29,932
E13
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
D -
PA
RT
4S
how
ing A
ll Long-T
erm
Bonds a
nd S
tocks S
OLD
, R
ED
EE
ME
D o
r O
therw
ise D
ISP
OS
ED
OF
During C
urr
ent
Year
12
34
56
78
910
Change In B
ook/A
dju
ste
d C
arr
ying V
alu
e16
17
18
19
20
21
CU
SIP
Identi-
fication
Description
For-
eig
nD
isposal
Date
Nam
eof P
urc
haser
Num
ber
of
Share
s o
fS
tock
Con-
sid
era
tion
Par
Valu
eA
ctu
al C
ost
Prior
Year
Book/
Adju
ste
d
Carr
ying
Valu
e
11
Unre
aliz
ed
Valu
ation
Incre
ase/
Decre
ase
12
Curr
ent
Year's
(Am
or-
tiza
tion)/
Accre
tion
13
Curr
ent
Year's
Oth
er-
Than-
Tem
pora
ry
Impairm
ent
Recogniz
ed
14
Tota
lC
hange in
Book/
Adju
ste
d
Carr
ying
Valu
e(1
1+
12-1
3)
15
Tota
lF
ore
ign
Exc
hange
Change in
Book/
Adju
ste
d
Carr
ying
Valu
e
Book/
Adju
ste
d
Carr
ying
Valu
e a
t D
isposal
Date
Fore
ign
Exc
hange
Gain
(Loss)
on
Dis
posal
Realiz
ed
Gain
(Loss)
on D
isposal
Tota
l G
ain
(L
oss)
on
Dis
posal
Bond
Inte
rest/
Sto
ck
Div
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E14
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
Schedule D - Part 5 - Long Term Bonds and Stocks Acquired and Fully Disposed Of
N O N E
Schedule D-Part 6-Section 1-Valuation of Shares of Subsidiary, Controlled or Affiliated Companies
N O N E
Schedule D - Part 6 - Section 2
N O N E
Schedule DA - Part 1 - Short-Term Investments Owned
N O N E
Schedule DB - Part A - Section 1 - Options, Caps, Floors, Collars, Swaps and Forwards Open
N O N E
Schedule DB - Part A - Section 2 - Options, Caps, Floors, Collars, Swaps and Forwards Terminated
N O N E
Schedule DB - Part B - Section 1 - Futures Contracts Open
N O N E
Schedule DB - Part B - Section 1B - Brokers with whom cash deposits have been made
N O N E
Schedule DB - Part B - Section 2 - Futures Contracts Terminated
N O N E
Schedule DB - Part D - Section 1 - Counterparty Exposure for Derivative Instruments Open
N O N E
Schedule DB - Part D-Section 2 - Collateral for Derivative Instruments Open - Pledged By
N O N E
Schedule DB - Part D-Section 2 - Collateral for Derivative Instruments Open - Pledged To
N O N E
Schedule DL - Part 1 - Reinvested Collateral Assets Owned
N O N E
Schedule DL - Part 2 - Reinvested Collateral Assets Owned
N O N E
E15, E16, E17, E18, E19, E20, E21, E22, E23, E24, E25
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE E - PART 1 - CASH1
Depository
2
Code
3
Rate ofInterest
4Amount of Interest Received During
Year
5Amount of Interest
Accrued December 31 of Current Year
6
Balance
7
*U.S. Bank Milwaukee, Wisconsin 1,475,703 XXXJPMorgan Chase Springfield, Illinois 3,437,858 XXXMellon Bank New York, New York 495,695 XXX0199998 Deposits in ... depositories which do not exceed the allowable limit in any one depository (See instructions) - open depositories XXX XXX XXX0199999. Totals - Open Depositories XXX XXX 5,409,256 XXX0299998 Deposits in ... depositories which do not exceed the allowable limit in any one depository (See instructions) - suspended depositories XXX XXX XXX0299999. Totals - Suspended Depositories XXX XXX XXX0399999. Total Cash on Deposit XXX XXX 5,409,256 XXX0499999. Cash in Company's Office XXX XXX XXX XXX XXX
0599999 Total - Cash XXX XXX 5,409,256 XXX
TOTALS OF DEPOSITORY BALANCES ON THE LAST DAY OF EACH MONTH DURING THE CURRENT YEAR1. January 4,734,579 4. April 3,715,605 7. July 3,587,498 10. October 4,920,960
2. February 2,937,842 5. May 2,792,625 8. August 3,710,041 11. November 8,515,440
3. March 3,056,316 6. June 3,265,129 9. September 4,291,878 12. December 5,409,256
E26
AN
NU
AL S
TA
TE
ME
NT
FO
R T
HE
YE
AR
2016 O
F T
HE
N
OR
TH
WE
ST
ER
N L
ON
G T
ER
M C
AR
E IN
S C
O
SC
HE
DU
LE
E -
PA
RT
2 -
CA
SH
EQ
UIV
AL
EN
TS
Show
Inve
stm
ents
Ow
ned D
ecem
ber
31 o
f C
urr
ent
Year
1
Description
2
Code
3
Date
Acquired
4
Rate
of In
tere
st
5
Matu
rity
Date
6B
ook/A
dju
ste
dC
arr
ying V
alu
e
7A
mount of In
tere
st
Due a
nd A
ccru
ed
8A
mount R
eceiv
ed
During Y
ear
8699999 -
Tota
l C
ash E
quiv
ale
nts
NO
NE
E27
ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NORTHWESTERN LONG TERM CARE INS CO
SCHEDULE E - PART 3 - SPECIAL DEPOSITS
1 2Deposits For the
Benefit of All Policyholders All Other Special Deposits
States, Etc.Type of Deposit Purpose of Deposit
3Book/Adjusted Carrying Value
4
Fair Value
5Book/Adjusted Carrying Value
6
Fair Value
1. Alabama AL
2. Alaska AK
3. Arizona AZ
4. Arkansas AR B Security of AR policyholders 140,364 139,142
5. California CA
6. Colorado CO
7. Connecticut CT
8. Delaware DE
9. District of Columbia DC
10. Florida FL
11. Georgia GA B Security of GA policyholders 50,130 49,694
12. Hawaii HI
13. Idaho ID
14. Illinois IL
15. Indiana IN
16. Iowa IA
17. Kansas KS
18. Kentucky KY
19. Louisiana LA
20. Maine ME
21. Maryland MD
22. Massachusetts MA B Security of MA policyholders 100,260 99,387
23. Michigan MI
24. Minnesota MN
25. Mississippi MS
26. Missouri MO
27. Montana MT
28. Nebraska NE
29. Nevada NV
30. New Hampshire NH
31. New Jersey NJ
32. New Mexico NM B Security of NM policyholders 110,286 109,326
33. New York NY
34. North Carolina NC B Security of NC policyholders 546,417 541,659
35. North Dakota ND
36. Ohio OH
37. Oklahoma OK
38. Oregon OR
39. Pennsylvania PA
40. Rhode Island RI
41. South Carolina SC
42. South Dakota SD
43. Tennessee TN
44. Texas TX
45. Utah UT
46. Vermont VT
47. Virginia VA B Security of VA policyholders 250,650 248,468
48. Washington WA
49. West Virginia WV
50. Wisconsin WI B Security of WI policyholders 1,503,900 1,490,804
51. Wyoming WY
52. American Samoa AS
53. Guam GU
54. Puerto Rico PR
55. U.S. Virgin Islands VI
56. Northern Mariana Islands MP
57. Canada CAN
58. Aggregate Alien and Other OT XXX XXX
59. Subtotal XXX XXX 2,702,007 2,678,480
DETAILS OF WRITE-INS
5801.
5802.
5803.
5898. Summary of remaining write-ins for Line 58 from overflow page XXX XXX
5899. Totals (Lines 5801 thru 5803 plus 5898)(Line 58 above) XXX XXX
E28
ALPHABETICAL INDEXANNUAL STATEMENT BLANK
Analysis of Increase in Reserves During The Year 7
Analysis of Operations By Lines of Business 6
Asset Valuation Reserve Default Component 30
Asset Valuation Reserve Equity 32
Asset Valuation Reserve Replications (Synthetic) Assets 35
Asset Valuation Reserve 29
Assets 2
Cash Flow 5
Exhibit 1 - Part 1 - Premiums and Annuity Considerations for Life and Accident and Health Contracts 9
Exhibit 1 - Part 2 - Dividends and Coupons Applied, Reinsurance Commissions and Expense 10
Exhibit 2 - General Expenses 11
Exhibit 3 - Taxes, Licenses and Fees (Excluding Federal Income Taxes) 11
Exhibit 4 - Dividends or Refunds 11
Exhibit 5 - Aggregate Reserve for Life Contracts 12
Exhibit 5 - Interrogatories 13
Exhibit 5A - Changes in Bases of Valuation During The Year 13
Exhibit 6 - Aggregate Reserves for Accident and Health Contracts 14
Exhibit 7 - Deposit-Type Contracts 15
Exhibit 8 - Claims for Life and Accident and Health Contracts - Part 1 16
Exhibit 8 - Claims for Life and Accident and Health Contracts - Part 2 17
Exhibit of Capital Gains (Losses) 8
Exhibit of Life Insurance 25
Exhibit of Net Investment Income 8
Exhibit of Nonadmitted Assets 18
Exhibit of Number of Policies, Contracts, Certificates, Income Payable and Account Values 27
Five-Year Historical Data 22
Form for Calculating the Interest Maintenance Reserve (IMR) 28
General Interrogatories 20
Jurat Page 1
Liabilities, Surplus and Other Funds 3
Life Insurance (State Page) 24
Notes To Financial Statements 19
Overflow Page For Write-ins 55
Schedule A - Part 1 E01
Schedule A - Part 2 E02
Schedule A - Part 3 E03
Schedule A - Verification Between Years SI02
Schedule B - Part 1 E04
Schedule B - Part 2 E05
Schedule B - Part 3 E06
Schedule B - Verification Between Years SI02
Schedule BA - Part 1 E07
Schedule BA - Part 2 E08
Schedule BA - Part 3 E09
Schedule BA - Verification Between Years SI03
Schedule D - Part 1 E10
Schedule D - Part 1A - Section 1 SI05
Schedule D - Part 1A - Section 2 SI08
Schedule D - Part 2 - Section 1 E11
Schedule D - Part 2 - Section 2 E12
Schedule D - Part 3 E13
Schedule D - Part 4 E14
Schedule D - Part 5 E15
Schedule D - Part 6 - Section 1 E16
Schedule D - Part 6 - Section 2 E16
Schedule D - Summary By Country SI04
Schedule D - Verification Between Years SI03
Schedule DA - Part 1 E17
Schedule DA - Verification Between Years SI10
Index 1
ANNUAL STATEMENT BLANK (Continued)
Schedule DB - Part A - Section 1 E18
Schedule DB - Part A - Section 2 E19
Schedule DB - Part A - Verification Between Years SI11
Schedule DB - Part B - Section 1 E20
Schedule DB - Part B - Section 2 E21
Schedule DB - Part B - Verification Between Years SI11
Schedule DB - Part C - Section 1 SI12
Schedule DB - Part C - Section 2 SI13
Schedule DB - Part D - Section 1 E22
Schedule DB - Part D - Section 2 E23
Schedule DB - Verification SI14
Schedule DL - Part 1 E24
Schedule DL - Part 2 E25
Schedule E - Part 1 - Cash E26
Schedule E - Part 2 - Cash Equivalents E27
Schedule E - Part 3 - Special Deposits E28
Schedule E - Verification Between Years SI15
Schedule F 36
Schedule H - Accident and Health Exhibit - Part 1 37
Schedule H - Part 2, Part 3 and Part 4 38
Schedule H - Part 5 - Health Claims 39
Schedule S - Part 1 - Section 1 40
Schedule S - Part 1 - Section 2 41
Schedule S - Part 2 42
Schedule S - Part 3 - Section 1 43
Schedule S - Part 3 - Section 2 44
Schedule S - Part 4 45
Schedule S - Part 5 46
Schedule S - Part 6 47
Schedule S - Part 7 48
Schedule T - Part 2 Interstate Compact 50
Schedule T - Premiums and Annuity Considerations 49
Schedule Y - Information Concerning Activities of Insurer Members of a Holding Company Group 51
Schedule Y - Part 1A - Detail of Insurance Holding Company System 52
Schedule Y - Part 2 - Summary of Insurer’s Transactions With Any Affiliates 53
Summary Investment Schedule SI01
Summary of Operations 4
Supplemental Exhibits and Schedules Interrogatories 54
Index 1.1
Recommended