Asset Adequacy Tested Amounts Reserves and Liabilities | |||||
Statement Item | Formula Reserves (1) | Additional Actuarial Reserves a. (2) | Analysis Method b. | Other Amount (3) | Total Amount (1)+(2)+(3) (4) |
Exhibit 8 A Life Insurance | |||||
B Annuities | |||||
C Supplementary Contracts Involving Life Contingencies | |||||
D Accidental Death Benefit | |||||
E Disability - Active | |||||
F Disability - Disabled | |||||
G Miscellaneous | |||||
Total (Exhibit 8, Item 1, Page 3) | |||||
Exhibit 9 A Active Life Reserve | |||||
B Claim Reserve | |||||
Total (Exhibit 9, Item 2, Page 3) |
Statement Item | Formula Reserves (1) | Additional Actuarial Reserves a. (2) | Analysis Method b. | Other Amount (3) | Total Amount (1)+(2)+(3) (4) |
Exhibit 10 1 Premium and Other Deposit Funds (Column 5, Line 14) | |||||
1.1 Guaranteed Interest Contracts (Column 2, line 14) | |||||
1.2 Other (Column 6, Line 14) | |||||
2 Supplementary Contracts and Annuities Certain (Column 3, Line 14) | |||||
3 Dividend Accumulations or Refunds (Column 4, Line 14) | |||||
Total Exhibit 10 (Column 1, Line 14) |
Statement Item | Formula Reserves (1) | Additional Actuarial Reserves a. (2) | Analysis Method b. | Other Amount (3) | Total Amount (1)+(2)+(3) (4) |
Exhibit 11, Part 1 1 Life (Page 3, Line 4.1) | |||||
2 Health (Page 3, Line 4.2) | |||||
Total Exhibit 11, Part 1 | |||||
Separate Accounts (Page 3 of the Annual Statement of the Separate Accounts, Lines 1, 2, 3.1, 3.2, 3.3) | |||||
TOTAL RESERVES |
IMR (General Account, Page___Line _) | |
(Separate Accounts, Page___Line___) |
AVR (Page Line) | c. |
Net Deferred and Uncollected Premium |
Notes:
"In my opinion the reserves and related actuarial values concerning the statement items identified above:
The reserves and related items, when considered in light of the assets held by the company with respect to such reserves and related actuarial items including, but not limited to, the investment earnings on the assets, and the considerations anticipated to be received and retained under the policies and contracts, make adequate provision, according to presently accepted actuarial standards of practice, for the anticipated cash flows required by the contractual obligations and related expenses of the company.
The actuarial methods, considerations and analyses used in forming my opinion conform to the appropriate Standards of Practice as promulgated by the Actuarial Standards Board, which standards form the basis of this statement of opinion.
This opinion is updated annually as required by statute. To the best of my knowledge, there have been no material changes from the applicable date of the annual statement to the date of the rendering of this opinion which should be considered in reviewing this opinion, or
The following material change(s) which occurred between the date of the statement for which this opinion is applicable and the date of this opinion should be considered in reviewing this opinion: (Describe the change or changes.)
Note: Choose one of the above two paragraphs, whichever is applicable.
The impact of unanticipated events subsequent to the date of this opinion is beyond the scope of this opinion. The analysis of asset adequacy portion of this opinion should be viewed recognizing that the company's future experience may not follow all the assumptions used in the analysis.
_________________________
Signature of Appointed Actuary
_________________________
Address of Appointed Actuary
_________________________________
Telephone Number of Appointed Actuary
___________________
Date
(1) Product Type | (2) Death Benefit or Account Value | (3) Reserves Held | (4) Codification Reserves | (5) Codification Standard |
Mont. Admin. r. 6.6.6508
AUTH: 33-1-313, 33-2-407, MCA
IMP: 33-2-407, 33-2-408, 33-2-409, 33-2-410, 33-2-411, 33-2-412, 33-2-413, 33-2-414, 33-2-415, 33-2-416, 33-2-417, 33-7-118, 33-7-411, MCA