68608

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

Symetra Life Insurance Company

In the state of Iowa

Total Assets 42,241,900,005

Total Liabilities 40,100,281,783

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 5,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 663,960,292

Unassigned Funds 1,472,657,930

Total Capital and Surplus

2,141,618,222

Total Liabilities, Capital

and Surplus 42,241,900,005

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 7,352,099

Total Life and Annuity Direct Losses

Paid 2,863,775

Total Accident and Health Direct

Premiums Written 520,752

Total Accident and Health Direct

Losses Paid 13,454

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

85766

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

United Concordia Insurance

Company

In the state of Arizona

Total Assets 267,264,547

Total Liabilities 104,710,018

Aggregate Write-ins for

Special Surplus Funds 14,298,497

Common Capital Stock 2,500,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 36,747,124

Unassigned Funds 109,008,908

Total Capital and Surplus

162,554,529

Total Liabilities, Capital

and Surplus 267,264,547

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

ACCIDENT & HEALTH

Total Premiums Earned 290,513

Total Amount Incurred 290,513

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

23833

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

AtHome Insurance Company

In the state of New Jersey

Total Assets 10,066,420

Total Liabilities 18,472

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 4,200,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 5,900,000

Unassigned Funds (Surplus)

-52,052

Total Capital and Surplus

10,047,948

Total Liabilities, Capital

and Surplus 10,066,420

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred 0

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

99025

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

West McLean County Farmers

Mutual Insurance Company

In the state of North Dakota

Total Admitted Assets 2,888,645

Total Amount of All Liabilities

668,908

Surplus as Regards Policyholders

2,219,737

Total Income 883,590

Total Disbursements 755,981

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Net Premiums Received 815,636

Net Losses Paid 317,601

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 21, 2020)

71153

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

Talcott Resolution Life and Annuity

Insurance Company

In the state of Connecticut

Total Assets 34,277,678,078

Total Liabilities 33,298,393,744

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 2,500,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 223,338,361

Surplus Notes 0

Gross Paid in and

Contributed Surplus 85,431,561

Unassigned Funds 668,014,412

Total Capital and Surplus

979,284,334

Total Liabilities, Capital

and Surplus 34,277,678,078

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 5,213,828

Total Life and Annuity Direct Losses

Paid 22,984,090

Total Accident and Health Direct

Premiums Written 542

Total Accident and Health Direct

Losses Paid 4,800

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

88072

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

Talcott Resolution Life Insurance

Company

In the state of Connecticut

Total Assets 88,716,224,026

Total Liabilities 85,521,775,195

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 5,690,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 157,981,864

Surplus Notes 0

Gross Paid in and

Contributed Surplus 1,107,535,847

Unassigned Funds 1,923,241,120

Total Capital and Surplus

3,194,448,831

Total Liabilities, Capital

and Surplus 88,716,224,026

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 31,722,112

Total Life and Annuity Direct Losses

Paid 19,876,630

Total Accident and Health Direct

Premiums Written 24,366

Total Accident and Health Direct

Losses Paid 17,573

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

76236

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

The Cincinnati Life Insurance

Company

In the state of Ohio

Total Assets 4,674,763,761

Total Liabilities 4,470,941,574

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 3,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 1,000,000

Unassigned Funds 199,822,187

Total Capital and Surplus

203,822,187

Total Liabilities, Capital

and Surplus 4,674,763,761

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 1,714,047

Total Life and Annuity Direct Losses

Paid 3,368,292

Total Accident and Health Direct

Premiums Written 7,318

Total Accident and Health Direct

Losses Paid 7,419

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

86231

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

Transamerica Life Insurance

Company

In the state of Iowa

Total Assets 130,191,349,520

Total Liabilities 123,630,599,903

Aggregate Write-ins for

Special Surplus Funds 195,433,911

Common Capital Stock 6,761,900

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 2,610,712,954

Unassigned Funds 3,747,840,852

Total Capital and Surplus

6,560,749,617

Total Liabilities, Capital

and Surplus 130,191,349,520

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 18,395,233

Total Life and Annuity Direct Losses

Paid 32,896,176

Total Accident and Health Direct

Premiums Written 10,641,319

Total Accident and Health Direct

Losses Paid 23,380,770

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

66281

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

Transamerica Premier Life

Insurance Company

In the state of Iowa

Total Assets 52,514,951,859

Total Liabilities 50,207,465,060

Aggregate Write-ins for

Special Surplus Funds 1,334,024

Common Capital Stock 10,137,150

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 60,000,000

Gross Paid in and

Contributed Surplus 1,057,861,323

Unassigned Funds 1,178,154,302

Total Capital and Surplus

2,307,486,799

Total Liabilities, Capital

and Surplus 52,514,951,859

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 2,193,631

Total Life and Annuity Direct Losses

Paid 3,568,722

Total Accident and Health Direct

Premiums Written 1,882,350

Total Accident and Health Direct

Losses Paid 1,601,958

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

60227

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

Trinity Life Insurance Company

In the state of Oklahoma

Total Assets 315,194,043

Total Liabilities 302,742,206

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 1,500,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 250,000

Gross Paid in and

Contributed Surplus 14,374,564

Unassigned Funds -3,672,727

Total Capital and Surplus

12,451,837

Total Liabilities, Capital

and Surplus 315,194,043

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 0

Total Life and Annuity Direct Losses

Paid 0

Total Accident and Health Direct

Premiums Written 0

Total Accident and Health Direct

Losses Paid 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

92525

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

TruAssure Insurance Company

In the state of Illinois

Total Assets 14,825,345

Total Liabilities 6,593,134

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 2,835,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 19,417,229

Unassigned Funds -14,020,018

Total Capital and Surplus

8,232,211

Total Liabilities, Capital

and Surplus 14,825,345

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 0

Total Life and Annuity Direct Losses

Paid 0

Total Accident and Health Direct

Premiums Written 0

Total Accident and Health Direct

Losses Paid 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

61425

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

Trustmark Insurance Company

In the state of Illinois

Total Assets 1,654,084,711

Total Liabilities 1,323,209,377

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 0

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 0

Unassigned Funds 0

Total Capital and Surplus

0

Total Liabilities, Capital

and Surplus 1,323,209,377

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 75,872

Total Life and Annuity Direct Losses

Paid 50,580

Total Accident and Health Direct

Premiums Written 28,370

Total Accident and Health Direct

Losses Paid 1,409,011

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

62863

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

Trustmark Life Insurance Company

In the state of Illinois

Total Assets 276,681,818

Total Liabilities 103,893,458

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 0

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 0

Unassigned Funds 0

Total Capital and Surplus

0

Total Liabilities, Capital

and Surplus 103,893,458

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 0

Total Life and Annuity Direct Losses

Paid 0

Total Accident and Health Direct

Premiums Written 0

Total Accident and Health Direct

Losses Paid 19,579

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

84530

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

U.S. Financial Life Insurance

Company

In the state of Ohio

Total Assets 529,305,938

Total Liabilities 438,159,131

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 4,050,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 186,285,723

Unassigned Funds -99,188,916

Total Capital and Surplus

91,146,807

Total Liabilities, Capital

and Surplus 529,305,938

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 638,760

Total Life and Annuity Direct Losses

Paid 2,844,847

Total Accident and Health Direct

Premiums Written 0

Total Accident and Health Direct

Losses Paid 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

67423

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

UBS Life Insurance Company USA

In the state of California

Total Assets 43,638,831

Total Liabilities 1,732,197

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 2,500,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 32,867,359

Unassigned Funds 6,539,275

Total Capital and Surplus

41,906,634

Total Liabilities, Capital

and Surplus 43,638,831

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 0

Total Life and Annuity Direct Losses

Paid 0

Total Accident and Health Direct

Premiums Written 0

Total Accident and Health Direct

Losses Paid 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

80314

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Unicare Life & Health Insurance

Company

In the state of Indiana

Total Assets 894,834,913

Total Liabilities 672,699,023

Aggregate Write-ins for

Special Surplus Funds 205,552

Common Capital Stock 3,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 202,054,487

Unassigned Funds 16,875,851

Total Capital and Surplus

222,135,890

Total Liabilities, Capital

and Surplus 894,834,913

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 0

Total Life and Annuity Direct Losses

Paid 0

Total Accident and Health Direct

Premiums Written 0

Total Accident and Health Direct

Losses Paid 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

11121

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Unified Life Insurance Company

In the state of Texas

Total Assets 222,846,879

Total Liabilities 198,843,137

Aggregate Write-ins for

Special Surplus Funds -1,727,547

Common Capital Stock 1,750,000

Preferred Capital Stock 750,000

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 16,298,618

Unassigned Funds 6,932,671

Total Capital and Surplus

24,003,742

Total Liabilities, Capital

and Surplus 222,846,879

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 19,192

Total Life and Annuity Direct Losses

Paid 82,028

Total Accident and Health Direct

Premiums Written 7,779

Total Accident and Health Direct

Losses Paid 4,267

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

91529

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Unimerica Insurance Company

In the state of Wisconsin

Total Assets 396,027,198

Total Liabilities 191,262,827

Aggregate Write-ins for

Special Surplus Funds 330,880

Common Capital Stock 2,600,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 82,849,470

Unassigned Funds 118,984,021

Total Capital and Surplus

204,764,371

Total Liabilities, Capital

and Surplus 396,027,198

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 0

Total Life and Annuity Direct Losses

Paid 0

Total Accident and Health Direct

Premiums Written 775,206

Total Accident and Health Direct

Losses Paid 183,288

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

62596

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Union Fidelity Life Insurance

Company

In the state of Kansas

Total Assets 20,384,636,556

Total Liabilities 19,641,724,126

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 2,903,775

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 6,108,781,964

Unassigned Funds -5,368,773,309

Total Capital and Surplus

742,912,430

Total Liabilities, Capital

and Surplus 20,384,636,556

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 43,723

Total Life and Annuity Direct Losses

Paid 74,254

Total Accident and Health Direct

Premiums Written 34,408

Total Accident and Health Direct

Losses Paid 3,325

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

69744

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Union Labor Life Insurance

Company

In the state of Maryland

Total Assets 4,284,759,934

Total Liabilities 4,154,892,213

Aggregate Write-ins for

Special Surplus Funds 750,000

Common Capital Stock 3,578,700

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 141,056,800

Unassigned Funds -15,517,779

Total Capital and Surplus

129,867,721

Total Liabilities, Capital

and Surplus 4,284,759,934

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 46,058

Total Life and Annuity Direct Losses

Paid 68,555

Total Accident and Health Direct

Premiums Written 11,412

Total Accident and Health Direct

Losses Paid 19,161

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

69892

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

United Farm Family Life Insurance

Company

In the state of Indiana

Total Assets 2,417,079,448

Total Liabilities 2,069,909,776

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 2,500,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 1,000,000

Unassigned Funds 343,669,672

Total Capital and Surplus

347,169,672

Total Liabilities, Capital

and Surplus 2,417,079,448

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 6,893

Total Life and Annuity Direct Losses

Paid 663

Total Accident and Health Direct

Premiums Written 0

Total Accident and Health Direct

Losses Paid 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

79413

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

UnitedHealthcare Insurance

Company

In the state of Connecticut

Total Assets 20,997,100,708

Total Liabilities 12,461,621,975

Aggregate Write-ins for

Special Surplus Funds 816,668,315

Common Capital Stock 3,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 558,595,764

Unassigned Funds 7,157,214,654

Total Capital and Surplus

8,535,478,733

Total Liabilities, Capital

and Surplus 20,997,100,708

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 79,022

Total Life and Annuity Direct Losses

Paid 25,000

Total Accident and Health Direct

Premiums Written 26,687,782

Total Accident and Health Direct

Losses Paid 20,316,654

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

67601

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Unum Insurance Company

In the state of Maine

Total Assets 67,270,050

Total Liabilities 20,013,151

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 2,500,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 126,415

Surplus Notes 0

Gross Paid in and

Contributed Surplus 48,800,000

Unassigned Funds -4,169,516

Total Capital and Surplus

47,256,899

Total Liabilities, Capital

and Surplus 67,270,050

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 1,179

Total Life and Annuity Direct Losses

Paid 0

Total Accident and Health Direct

Premiums Written 16,202

Total Accident and Health Direct

Losses Paid 50

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

62235

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Unum Life Insurance Company of

America

In the state of Maine

Total Assets 22,429,844,712

Total Liabilities 20,664,069,377

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 5,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 7,449,861

Surplus Notes 0

Gross Paid in and

Contributed Surplus 1,097,211,213

Unassigned Funds 656,114,260

Total Capital and Surplus

1,765,775,334

Total Liabilities, Capital

and Surplus 22,429,844,711

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 11,217,825

Total Life and Annuity Direct Losses

Paid 6,317,562

Total Accident and Health Direct

Premiums Written 13,522,770

Total Accident and Health Direct

Losses Paid 7,030,576

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

70319

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Washington National Insurance

Company

In the state of Indiana

Total Assets 5,604,249,159

Total Liabilities 5,256,672,315

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 25,036,850

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 1,283,375,943

Unassigned Funds -960,835,949

Total Capital and Surplus

347,576,844

Total Liabilities, Capital

and Surplus 5,604,249,159

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 317,064

Total Life and Annuity Direct Losses

Paid 905,339

Total Accident and Health Direct

Premiums Written 23,278,287

Total Accident and Health Direct

Losses Paid 12,112,864

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

10155

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

WellCare Prescription Insurance Inc

In the state of Florida

Total Assets 953,473,846

Total Liabilities 719,910,982

Aggregate Write-ins for

Special Surplus Funds 47,600,000

Common Capital Stock 2,500,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 37,500,000

Unassigned Funds 145,962,864

Total Capital and Surplus

233,562,864

Total Liabilities, Capital

and Surplus 953,473,846

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 0

Total Life and Annuity Direct Losses

Paid 0

Total Accident and Health Direct

Premiums Written 10,058,237

Total Accident and Health Direct

Losses Paid 5,894,815

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

85189

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

Western United Life Assurance

Company

In the state of Washington

Total Assets 1,225,139,160

Total Liabilities 1,144,909,776

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 2,500,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 47,107,002

Unassigned Funds 30,622,382

Total Capital and Surplus

80,229,384

Total Liabilities, Capital

and Surplus 1,225,139,160

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Life and Annuity Premiums

Written 11,468,476

Total Life and Annuity Direct Losses

Paid 18,585,081

Total Accident and Health Direct

Premiums Written 543,522

Total Accident and Health Direct

Losses Paid 261,465

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D. 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thoized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D. 2021. IN

TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL)

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

25232

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

21st Century Advantage Insurance

Company

In the state of Minnesota

Total Assets 21,748,559

Total Liabilities 28,052

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 4,200,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 5,020,832

Unassigned Funds (Surplus)

12,499,675

Total Capital and Surplus

21,720,507

Total Liabilities, Capital

and Surplus 21,748,560

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred 0

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

44245

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

21st Century Assurance Company

In the state of Delaware

Total Assets 72,816,928

Total Liabilities 75,902

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 5,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 13,500,000

Unassigned Funds (Surplus)

54,241,026

Total Capital and Surplus

72,741,026

Total Liabilities, Capital

and Surplus 72,816,928

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred 0

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

36404

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

21st Century Casualty Company

In the state of California

Total Assets 12,808,249

Total Liabilities 10,349

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 3,300,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 79,940,622

Unassigned Funds (Surplus)

-70,442,722

Total Capital and Surplus

12,797,900

Total Liabilities, Capital

and Surplus 12,808,249

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred 0

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

34789

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

21st Century Centennial Insurance

Company

In the state of Pennsylvania

Total Assets 209,559,447

Total Liabilities 238,390

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 4,200,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 139,646,136

Unassigned Funds (Surplus)

65,474,921

Total Capital and Surplus

209,321,057

Total Liabilities, Capital

and Surplus 209,559,447

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred -34

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

43974

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

21st Century Indemnity Insurance

Company

In the state of Pennsylvania

Total Assets 16,989,801

Total Liabilities 0

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 5,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 6,961,560

Unassigned Funds (Surplus)

5,028,241

Total Capital and Surplus

16,989,801

Total Liabilities, Capital

and Surplus 16,989,801

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred 0

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

12963

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

of the

21st Century Insurance Company

In the state of California

Total Assets 1,054,974,289

Total Liabilities 1,505,066

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 3,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 487,322,625

Unassigned Funds (Surplus)

563,146,598

Total Capital and Surplus

1,053,469,223

Total Liabilities, Capital

and Surplus 1,054,974,289

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred 0

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

32220

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

21st Century North America

Insurance Company

In the state of New York

Total Assets 613,570,949

Total Liabilities 14,137,281

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 5,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 133,800,000

Unassigned Funds (Surplus)

460,633,667

Total Capital and Surplus

599,433,667

Total Liabilities, Capital

and Surplus 613,570,949

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred 7,250

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

23795

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

21st Century Pacific Insurance

Company

In the state of Colorado

Total Assets 45,615,265

Total Liabilities 46,854

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 3,000,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 1,204,950

Unassigned Funds (Surplus)

41,363,460

Total Capital and Surplus

45,568,410

Total Liabilities, Capital

and Surplus 45,615,264

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 0

Total Direct Losses

Incurred -8,087

Total Accident and Health Direct

Premiums Earned 0

Total Accident and Health Direct

Losses Incurred 0

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

20796

ABSTRACT OF STATEMENT

FOR THE YEAR ENDING

DECEMBER 31, 2019

21st Century Premier Insurance

Company

In the state of Pennsylvania

Total Assets 99,876,135

Total Liabilities 71,177

Aggregate Write-ins for

Special Surplus Funds 0

Common Capital Stock 4,200,000

Preferred Capital Stock 0

Aggregate Write-ins for Other Than

Special Surplus Funds 0

Surplus Notes 0

Gross Paid in and

Contributed Surplus 65,117,603

Unassigned Funds (Surplus)

30,487,355

Total Capital and Surplus

99,804,958

Total Liabilities, Capital

and Surplus 99,876,135

NORTH DAKOTA BUSINESS

ONLY FOR THE YEAR 2019

Total Direct Premiums

Earned 1,961

Total Direct Losses

Incurred 1,207

Total Accident and Health Direct

Premiums Earned 1,961

Total Accident and Health Direct

Losses Incurred 1,235

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

I, Jon Godfread, Commissioner of

Insurance of the State of North

Dakota, do hereby certify that the

foregoing is a true Abstract of State-

ment, as officially filed by the Com-

pany in this office.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and affixed

the seal of this office at Bismarck,

the first day of May, A.D., 2020

(SEAL).

JON GODFREAD

Commissioner of Insurance

STATE OF NORTH DAKOTA

OFFICE OF THE COMMISSIONER

OF INSURANCE

COMPANY’S CERTIFICATE OF

AUTHORITY

WHEREAS, the above corporation

duly organized under the laws of its

state or country of domicile, has filed

in this office a sworn statement exhi-

biting its condition and business for

the year ending December 31, 2019

conformable to the requirements of

the laws of this State regarding the

business of insurance and

WHEREAS, the said company has

filed in this office a duly certified

copy of its charter with certificate of

organization in compliance with the

requirements of insurance law afore-

said, NOW THEREFORE, I, JON

GODFREAD, Commissioner of In-

surance of the State of North Dako-

ta, pursuant to the provisions of said

laws, do hereby certify that the

above named company is fully em-

powered through its authorized

agents and representatives, to tran-

sact its appropriated business of au-

thorized insurance in the state ac-

cording to the laws thereof, until the

30th day of April, A.D., 2021.

IN TESTIMONY WHEREOF, I have

hereunto set my hand and seal at

Bismarck this first day of May, A.D.,

2020 (SEAL).

JON GODFREAD

Commissioner of Insurance

(May 7-14-21, 2020)

NOTICE OF PETITION FOR NAME

CHANGE

IN DISTRICT COURT, WARD

COUNTY, NORTH DAKOTA

In the Matter of the Petition for

Name Change of Eli Joseph

DancingBull, A Minor Child.

PLEASE TAKE NOTICE that a Peti-

tion in the above-entitled matter will

be filed with the Clerk of District

Court for Ward County, North Dako-

ta, requesting an Order changing the

name of Eli Joseph DancingBull

(current full, legal name of child) to

Eli Joseph DeLorme (requested full,

legal name of child). Pursuant to

N.D.C.C. 32-28-02, thirty days previ-

ous notice of the intended applica-

tion must be given in the official

newspaper printed in this County as

well as in the official newspaper of

the county where the non-custodial

parent resides. You are hereby noti-

fied that thirty days after publication,

petitioner intends to file a petition re-

questing entry of the Court’s Order

changing the name of Eli Joseph

DancingBull to Eli Joseph DeLorme.

Any objection to granting this name

change must be given in writing to

the address listed below within 30

days of the date of this publication.

The written objection must also be

filed with the Court. If no objections

are given, the Court may respond to

the Petition without further hearing.

Dated this 15th day of May, 2020.

/s/Marriah DeLorme

Marriah DeLorme

1500 32nd Ave SW Apt 7

Minot, ND 58701

(May 21, 2020)

NOTICE OF SALE

You are herein notified that Midwest

Capital Group, LLC, d/b/a Souris

River Storage, 4000 11th Ave. S.E.,

Minot, North Dakota, will conduct a

sale of abandoned personal property

at the following units: #510 Victoria

Perez; #626 Steven Eckert; #405

Daniel Tenery; #803 Joseph Minni-

field. The contents of the units will

be sold by PRIVATE SALE at 12:00

Noon on June 1, 2020. Questions

should be directed to Donald Mal-

chose, Souris River Storage, (701)

833-5362.

(May 14-21, 2020)

NOTICE TO CREDITORS

Probate No. 51-2020-PR-00087

IN THE DISTRICT COURT OF

WARD COUNTY, STATE OF

NORTH DAKOTA

In the Matter of the Estate of

George B. Officer, Deceased.

NOTICE IS HEREBY GIVEN that

the undersigned have been appoint-

ed co-personal representatives of

the above estate. All persons having

claims against the said deceased

are required to present their claims

within three months after the date of

the first publication or mailing of this

notice or said claims will be forever

barred. Claims must either be

presented to TRACI FRENCH and

TODD OFFICER, Co-Personal

Representatives of the estate, at

2525 Elk Drive, P.O. Box 1000,

Minot ND 58702-1000, or filed with

the Court.

Dated this 8th day of May, 2020.

/s/Traci French

Traci French

/s/Todd Officer

Todd Officer

Carol K. Larson – #04406

PRINGLE & HERIGSTAD, P.C.

2525 Elk Drive

P.O. Box 1000

(701)852-0381

clarson@pringlend.com

Attorneys for: Co-Personal

Representatives

(May 14-21-28, 2020)

NOTICE TO CREDITORS

Probate No. 51-2020-PR-00093

IN THE DISTRICT COURT OF

WARD COUNTY, STATE OF

NORTH DAKOTA

In the Matter of the Estate of Scott

Herslip, Deceased.

NOTICE IS HEREBY GIVEN that

the undersigned has been appointed

personal representative of the above

estate. All persons having claims

against the said deceased are re-

quired to present their claims within

three months after the date of the

first publication or mailing of this no-

tice or said claims will be forever

barred. Claims must either be

presented to Kari Herslip, personal

representative of the estate at c/o

Law Office of Diane K. Lautt, PLLC,

PO Box 1945, Minot, North Dakota

58702-1945, or filed with the Court.

Dated this 14th day of May, 2020.

/s/Kari Herslip

Kari Herslip

PO Box 27

Minot, ND 58702

Diane K. Lautt (ID 07243)

Law Office of Diane K. Lautt, PLLC

PO Box 1945

Minot, ND 58702-1945

701-852-3060

diane@lauttlaw.com

Attorney for Personal

Representative

(May 20-27; June 3, 2020)

2020 Ward County Board of

Equalization

In accordance with North Dakota

Century Code (N.D.C.C.) Å’57-02-52:

Notice of county board of equaliza-

tion meeting.

Date: June 2, 2020

Time: 1:00 pm

Location: Commissioner’s

Chamber (Suite 218) , Ward Coun-

ty Administration Building

Each taxpayer has the right to ap-

pear before the appropriate board of

equalization and petition their

current year’s assessment. For

those wishing to petition their valua-

tion, contact the Ward County Tax

Equalization office at 701.857.6430

to be placed on the agenda for the

meeting, and submit all appeal do-

cumentation, no later than end of

business May 26, 2020.

(May 9-11-12-13-14-15-

16-18-19-20-21-22-23, 2020)