Campmed Casualty & Indemnity Company, Inc
STATEMENT AS OF
ASSETS
Current Statement Date |
4 |
||||
1 |
2 |
3 |
|
||
Net Admitted Assets |
Prior Year Net |
||||
Assets |
Nonadmitted Assets |
(Cols. 1 - 2) |
Admitted Assets |
||
1. Bonds |
................. 19,180,147 |
.................................0 |
................. |
19,180,147 |
................. 19,820,469 |
2. Stocks:
2.1 |
Preferred stocks |
0 |
0 |
0 |
0 |
2.2 Common stocks |
0 |
0 |
0 |
0 |
|
3. Mortgage loans on real estate: |
|||||
3.1 |
First liens |
0 |
0 |
0 |
0 |
3.2 |
Other than first liens |
0 |
0 |
0 |
0 |
4. Real estate:
4.1 Properties occupied by the company (less $ |
0 |
|||||||
encumbrances) |
0 |
0 |
0 |
0 |
||||
4.2 Properties held for |
the production of income (less |
|||||||
$ |
0 |
encumbrances) |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||
4.3 Properties held for sale (less $ |
0 |
|||||||
encumbrances) |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||||
5. |
Cash ($ |
19,372 |
), cash equivalents |
|||||
($ |
................... 1,110,870 ) and short-term |
|||||||
investments ($ |
0 ) |
................... 1,130,242 |
.................................0 |
................... 1,130,242 |
...................... 295,919 |
|||
6. |
Contract loans (including $ |
0 |
premium notes) |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|
7. |
Derivatives |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|||
8. |
Other invested assets |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|||
9. |
Receivables for securities |
..........................2,803 |
.................................0 |
..........................2,803 |
.................................0 |
|||
10. |
Securities lending reinvested collateral assets |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|||
11. |
Aggregate write-ins for invested assets |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|||
12. |
Subtotals, cash and invested assets (Lines 1 to 11) |
................. 20,313,192 |
.................................0 |
................. 20,313,192 |
................. 20,116,388 |
|||
13. |
Title plants less $ |
0 charged off (for Title insurers |
||||||
only) |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||||
14. |
Investment income due and accrued |
...................... 129,269 |
.................................0 |
...................... 129,269 |
...................... 135,614 |
|||
15. |
Premiums and considerations: |
|||||||
15.1 Uncollected premiums and agents' balances in the course of collection |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||||
15.2 Deferred premiums, agents' balances and installments booked but |
||||||||
deferred and not yet due (including $ |
0 |
|||||||
............................................................earned but unbilled premiums) |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||||
15.3 Accrued retrospective premiums ($ |
0 ) and |
|||||||
contracts subject to redetermination ($ |
0 ) |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|||
16. |
Reinsurance: |
|||||||
....................................................16.1 Amounts recoverable from reinsurers |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||||
16.2 Funds held by or deposited with reinsured companies |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||||
16.3 Other amounts receivable under reinsurance contracts |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||||
17. |
Amounts receivable relating to uninsured plans |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|||
18.1 |
....Current federal and foreign income tax recoverable and interest thereon |
............................. 443 |
.................................0 |
............................. 443 |
.................................0 |
|||
18.2 |
...................................................................................Net deferred tax asset |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|||
19. |
Guaranty funds receivable or on deposit |
.................................0 |
0 |
0 |
0 |
|||
20. |
Electronic data processing equipment and software |
0 |
0 |
0 |
0 |
21. Furniture and equipment, including health care delivery assets
($ |
0 ) |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|
22. |
.........Net adjustment in assets and liabilities due to foreign exchange rates |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|
23. |
.....................................Receivables from parent, subsidiaries and affiliates |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|
24. |
Health care ($ |
0 ) and other amounts receivable |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
25. |
........................................Aggregate write-ins for other than invested assets |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|
26. |
Total assets excluding Separate Accounts, Segregated Accounts and |
|||||
Protected Cell Accounts (Lines 12 to 25) |
................. 20,442,904 |
.................................0 |
................. 20,442,904 |
................. 20,252,002 |
||
27. |
From Separate Accounts, Segregated Accounts and Protected Cell |
|||||
Accounts |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
||
28. |
Total (Lines 26 and 27) |
20,442,904 |
0 |
20,442,904 |
20,252,002 |
|
DETAILS OF WRITE-INS |
||||||
1101. |
...................................................................................................................... |
.................................... |
.................................... |
.................................... |
.................................... |
|
1102. |
...................................................................................................................... |
.................................... |
.................................... |
.................................... |
.................................... |
|
1103. |
...................................................................................................................... |
.................................... |
.................................... |
.................................... |
.................................... |
|
1198. |
...................Summary of remaining write-ins for Line 11 from overflow page |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|
1199. |
Totals (Lines 1101 through 1103 plus 1198)(Line 11 above) |
0 |
0 |
0 |
0 |
|
2501. |
....................................................................................................................... |
.................................... |
.................................... |
.................................... |
.................................... |
|
2502. |
....................................................................................................................... |
.................................... |
.................................... |
.................................... |
.................................... |
|
2503. |
....................................................................................................................... |
.................................... |
.................................... |
.................................... |
.................................... |
|
2598. |
...................Summary of remaining write-ins for Line 25 from overflow page |
.................................0 |
.................................0 |
.................................0 |
.................................0 |
|
2599. |
Totals (Lines 2501 through 2503 plus 2598)(Line 25 above) |
0 |
0 |
0 |
0 |
2
STATEMENT AS OF
LIABILITIES, SURPLUS AND OTHER FUNDS
1 |
2 |
|||||||||
Current |
|
|||||||||
Statement Date |
Prior Year |
|||||||||
1. |
Losses (current accident year $ |
0 ) |
.................................0 |
.................................0 |
||||||
2. |
.......................................................................................Reinsurance payable on paid losses and loss adjustment expenses |
.................................0 |
.................................0 |
|||||||
3. |
Loss adjustment expenses |
.................................0 |
.................................0 |
|||||||
4. |
Commissions payable, contingent commissions and other similar charges |
............................................................................. |
.................................0 |
.................................0 |
||||||
5. |
...............................................................................................................Other expenses (excluding taxes, licenses and fees) |
.................................0 |
.................................0 |
|||||||
6. |
...................................................................................Taxes, licenses and fees (excluding federal and foreign income taxes) |
.................................0 |
.................................0 |
|||||||
7.1 |
Current federal and foreign income taxes (including $ |
0 on realized capital gains (losses)) |
.............. |
.................................0 |
..........................2,812 |
|||||
7.2 |
Net deferred tax liability |
........................ 15,899 |
........................ 15,899 |
|||||||
8. |
Borrowed money $ |
0 and interest thereon $ |
0 |
.................................0 |
.................................0 |
|||||
9. |
Unearned premiums (after deducting unearned premiums for ceded reinsurance of $ |
....................... |
365,746 |
and |
||||||
including warranty reserves of $ .................................0 and accrued accident and health experience rating refunds |
||||||||||
including $ |
0 |
...............................for medical loss ratio rebate per the Public Health Service Act) |
.................................0 |
.................................0 |
||||||
10. |
Advance premium |
.................................0 |
.................................0 |
|||||||
11. |
Dividends declared and unpaid: |
|||||||||
11.1 Stockholders |
.................................0 |
.................................0 |
||||||||
11.2 Policyholders |
.................................0 |
.................................0 |
||||||||
12. |
........................................................................................Ceded reinsurance premiums payable (net of ceding commissions) |
.................................0 |
............................. 246 |
|||||||
13. |
..................................................................................................................Funds held by company under reinsurance treaties |
.................................0 |
.................................0 |
|||||||
14. |
..............................................................................................Amounts withheld or retained by company for account of others |
.................................0 |
.................................0 |
|||||||
15. |
........................................................................................................................................Remittances and items not allocated |
.................................0 |
.................................0 |
|||||||
16. |
Provision for reinsurance (including $ |
.................................0 certified) |
.................................0 |
.................................0 |
||||||
17. |
...................................................................................Net adjustments in assets and liabilities due to foreign exchange rates |
.................................0 |
.................................0 |
|||||||
18. |
Drafts outstanding |
.................................0 |
.................................0 |
|||||||
19. |
............................................................................................................................Payable to parent, subsidiaries and affiliates |
..........................1,298 |
..........................1,995 |
|||||||
20. |
Derivatives |
.................................0 |
.................................0 |
|||||||
21. |
Payable for securities |
.................................0 |
.................................0 |
|||||||
22. |
Payable for securities lending |
.................................................................................................................................................... |
.................................0 |
.................................0 |
||||||
23. |
......................................................................................................................Liability for amounts held under uninsured plans |
.................................0 |
.................................0 |
|||||||
24. |
Capital notes $ |
0 and interest thereon $ |
0 |
.................................0 |
.................................0 |
|||||
25. |
Aggregate write-ins for liabilities |
0 |
0 |
|||||||
26. |
Total liabilities excluding protected cell liabilities (Lines 1 through 25) |
17,197 |
20,952 |
|||||||
27. |
Protected cell liabilities |
.................................0 |
.................................0 |
|||||||
28. |
...............................................................................................................................................Total liabilities (Lines 26 and 27) |
........................ 17,197 |
........................ 20,952 |
|||||||
29. |
............................................................................................................................Aggregate write-ins for special surplus funds |
.................................0 |
.................................0 |
|||||||
30. |
Common capital stock |
................... 3,000,000 |
................... 3,000,000 |
|||||||
31. |
Preferred capital stock |
.................................0 |
.................................0 |
|||||||
32. |
Aggregate write-ins for other than special surplus funds |
.................................0 |
.................................0 |
|||||||
33. |
Surplus notes |
.................................0 |
.................................0 |
|||||||
34. |
.......................................................................................................................................Gross paid in and contributed surplus |
................... 7,000,000 |
................... 7,000,000 |
|||||||
35. |
Unassigned funds (surplus) |
....................................................................................................................................................... |
................. 10,425,707 |
................. 10,231,050 |
||||||
36. |
Less treasury stock, at cost: |
|||||||||
36.1 |
0 |
shares common (value included in Line 30 |
$ |
0 |
) |
.................................0 |
.................................0 |
|||
36.2 |
0 |
shares preferred (value included in Line 31 |
$ |
0 |
) |
0 |
0 |
|||
37. |
Surplus as regards policyholders (Lines 29 to 35, less 36) |
20,425,707 |
20,231,050 |
|||||||
38. |
Totals (Page 2, Line 28, Col. 3) |
20,442,904 |
20,252,002 |
|||||||
DETAILS OF WRITE-INS |
||||||||||
2501 |
.................................... |
|||||||||
2502 |
.................................... |
|||||||||
2503 |
.................................... |
|||||||||
2598. |
..............................................................................................Summary of remaining write-ins for Line 25 from overflow page |
.................................0 |
.................................0 |
|||||||
2599. |
Totals (Lines 2501 through 2503 plus 2598)(Line 25 above) |
0 |
0 |
|||||||
2901 |
.................................... |
|||||||||
2902 |
.................................... |
|||||||||
2903 |
.................................... |
|||||||||
2998. |
..............................................................................................Summary of remaining write-ins for Line 29 from overflow page |
.................................0 |
.................................0 |
|||||||
2999. |
Totals (Lines 2901 through 2903 plus 2998)(Line 29 above) |
0 |
0 |
|||||||
3201 |
.................................... |
|||||||||
3202 |
.................................... |
|||||||||
3203 |
.................................... |
|||||||||
3298. |
..............................................................................................Summary of remaining write-ins for Line 32 from overflow page |
.................................0 |
.................................0 |
|||||||
3299. |
Totals (Lines 3201 through 3203 plus 3298)(Line 32 above) |
0 |
0 |
3
STATEMENT AS OF
STATEMENT OF INCOME
1 |
2 |
3 |
Current |
Prior Year |
Prior Year Ended |
Year to Date |
to Date |
|
UNDERWRITING INCOME
1. Premiums earned:
1.1 Direct (written $ |
....................... |
375,894 |
) |
475,194 |
481,852 |
954,046 |
|
1.2 Assumed (written $ |
................................. |
0 ) |
.................................0 |
.................................0 |
.................................0 |
||
1.3 Ceded (written $ |
....................... |
375,894 |
) |
...................... 475,194 |
...................... 481,852 |
...................... 954,046 |
|
1.4 Net (written $ |
0 ) |
..................................................................................... |
.................................0 |
.................................0 |
.................................0 |
||
DEDUCTIONS: |
|||||||
2. |
.................................Losses incurred (current accident year $ |
0 ): |
|||||
2.1 Direct |
(436,119) |
(124,580) |
.......................(36,259) |
||||
2.2 Assumed |
0 |
0 |
.................................0 |
||||
2.3 Ceded |
.....................(436,119) |
.....................(124,580) |
.......................(36,259) |
||||
2.4 Net |
.................................0 |
.................................0 |
.................................0 |
||||
3. |
....................................................................................................Loss adjustment expenses incurred |
.................................0 |
.................................0 |
.................................0 |
|||
4. |
.................................................................................................Other underwriting expenses incurred |
.................................0 |
.................................0 |
.................................0 |
|||
5. |
Aggregate write-ins for underwriting deductions |
||||||
0 |
0 |
.................................0 |
|||||
6. |
Total underwriting deductions (Lines 2 through 5) |
0 |
0 |
.................................0 |
|||
7. |
.............................................................................................................Net income of protected cells |
0 |
0 |
0 |
|||
8. |
Net underwriting gain (loss) (Line 1 minus Line 6 + Line 7) |
0 |
0 |
.................................0 |
|||
INVESTMENT INCOME |
|||||||
9. |
Net investment income earned |
272,751 |
238,026 |
...................... 502,007 |
|||
10. |
Net realized capital gains (losses) |
less capital gains tax of $ |
(5,534) |
(20,816) |
(276) |
(1,580) |
|
11. |
Net investment gain (loss) (Lines 9 + 10) |
251,935 |
237,750 |
...................... 500,427 |
|||
OTHER INCOME |
|||||||
12. |
Net gain or (loss) from agents' or premium balances charged off (amount recovered |
||||||
$ |
0 amount charged off $ |
0 ) |
.................................0 |
.................................0 |
.................................0 |
||
13. |
Finance and service charges not included in premiums |
0 |
0 |
0 |
|||
14. |
Aggregate write-ins for miscellaneous income |
................................................................................... |
0 |
0 |
0 |
||
15. |
Total other income (Lines 12 through 14) |
0 |
0 |
0 |
16. Net income before dividends to policyholders, after capital gains tax and before all other federal
and foreign income taxes (Lines 8 + 11 + 15) |
251,935 |
237,750 |
500,427 |
||
17. |
Dividends to policyholders |
0 |
0 |
0 |
|
18. |
Net income, after dividends to policyholders, after capital gains tax and before all other federal and |
||||
foreign income taxes (Line 16 minus Line 17) |
251,935 |
237,750 |
500,427 |
||
19. |
Federal and foreign income taxes incurred |
57,278 |
49,985 |
103,083 |
|
20. |
Net income (Line 18 minus Line 19)(to Line 22) |
194,657 |
187,765 |
397,344 |
|
CAPITAL AND SURPLUS ACCOUNT |
|||||
21. |
Surplus as regards policyholders, |
20,231,050 |
20,184,742 |
20,184,742 |
|
22. |
Net income (from Line 20) |
194,657 |
187,765 |
397,344 |
|
23. |
Net transfers (to) from Protected Cell accounts |
.................................0 |
.................................0 |
.................................0 |
|
24. |
.................................Change in net unrealized capital gains (losses) less capital gains tax of $ |
0 |
.................................0 |
.................................0 |
.................................0 |
25. |
Change in net unrealized foreign exchange capital gain (loss) |
.................................0 |
.................................0 |
.................................0 |
|
26. |
Change in net deferred income tax |
.................................0 |
.................................0 |
........................ (1,036) |
|
27. |
Change in nonadmitted assets |
.................................0 |
.................................0 |
.................................0 |
|
28. |
Change in provision for reinsurance |
.................................0 |
.................................0 |
.................................0 |
|
29. |
Change in surplus notes |
.................................0 |
.................................0 |
.................................0 |
|
30. |
Surplus (contributed to) withdrawn from protected cells |
.................................0 |
.................................0 |
.................................0 |
|
31. |
Cumulative effect of changes in accounting principles |
0 |
0 |
0 |
32. Capital changes:
32.1 |
Paid in |
.................................0 |
.................................0 |
.................................0 |
|
32.2 |
Transferred from surplus (Stock Dividend) |
.................................0 |
.................................0 |
.................................0 |
|
32.3 |
Transferred to surplus |
.................................0 |
.................................0 |
.................................0 |
|
33. |
Surplus adjustments: |
||||
33.1 |
Paid in |
.................................0 |
.................................0 |
.................................0 |
|
33.2 |
Transferred to capital (Stock Dividend) |
.................................0 |
|||
.................................0 |
.................................0 |
||||
33.3 |
Transferred from capital |
.................................0 |
.................................0 |
.................................0 |
|
34. |
............................................................................................Net remittances from or (to) Home Office |
.................................0 |
.................................0 |
.................................0 |
|
35. |
Dividends to stockholders |
0 |
0 |
.....................(350,000) |
|
36. |
.....................................................................................................................Change in treasury stock |
.................................0 |
.................................0 |
.................................0 |
|
37. |
...........................................................................Aggregate write-ins for gains and losses in surplus |
0 |
0 |
0 |
|
38. |
Change in surplus as regards policyholders (Lines 22 through 37) |
194,657 |
187,765 |
46,308 |
|
39. |
Surplus as regards policyholders, as of statement date (Lines 21 plus 38) |
20,425,707 |
20,372,507 |
20,231,050 |
|
DETAILS OF WRITE-INS |
|||||
0501 |
.................................... |
.................................... |
.................................... |
||
0502 |
.................................... |
.................................... |
.................................... |
||
0503 |
.................................... |
.................................... |
.................................... |
||
0598. |
Summary of remaining write-ins for Line 5 from overflow page |
0 |
0 |
.................................0 |
|
0599. |
Totals (Lines 0501 through 0503 plus 0598)(Line 5 above) |
0 |
0 |
0 |
|
1401 |
.................................... |
.................................... |
.................................... |
||
1402 |
.................................... |
.................................... |
.................................... |
||
1403 |
.................................... |
.................................... |
.................................... |
||
1498. |
Summary of remaining write-ins for Line 14 from overflow page |
.................................0 |
.................................0 |
.................................0 |
|
1499. |
Totals (Lines 1401 through 1403 plus 1498)(Line 14 above) |
0 |
0 |
0 |
|
3701 |
.................................... |
.................................... |
.................................... |
||
3702 |
.................................... |
.................................... |
.................................... |
||
3703 |
.................................... |
.................................... |
.................................... |
||
3798. |
.........................................................Summary of remaining write-ins for Line 37 from overflow page |
.................................0 |
.................................0 |
.................................0 |
|
3799. |
Totals (Lines 3701 through 3703 plus 3798)(Line 37 above) |
0 |
0 |
0 |
4
STATEMENT AS OF
CASH FLOW
Cash from Operations
1
Current Year
To Date
2
Prior Year
To Date
3
Prior Year Ended
1. |
Premiums collected net of reinsurance |
............................(246) |
.................................0 |
............................. 246 |
|
2. |
Net investment income |
...................... 270,185 |
...................... 227,126 |
...................... 468,223 |
|
3. |
Miscellaneous income |
0 |
0 |
0 |
|
4. |
Total (Lines 1 to 3) |
269,939 |
227,126 |
468,469 |
|
5. |
Benefit and loss related payments |
.................................0 |
.................................0 |
.................................0 |
|
6. |
.................Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts |
.................................0 |
.................................0 |
.................................0 |
|
7. |
...............................................Commissions, expenses paid and aggregate write-ins for deductions |
.................................0 |
.................................0 |
.................................0 |
|
8. |
Dividends paid to policyholders |
.................................0 |
.................................0 |
.................................0 |
|
9. |
Federal and foreign income taxes paid (recovered) net of $ |
(5,534) tax on capital |
|||
gains (losses) |
54,999 |
51,001 |
102,001 |
||
10. |
Total (Lines 5 through 9) |
54,999 |
51,001 |
102,001 |
|
11. |
Net cash from operations (Line 4 minus Line 10) |
214,940 |
176,125 |
366,468 |
|
Cash from Investments
12. Proceeds from investments sold, matured or repaid:
12.1 |
Bonds |
...................2,422,048 |
................... 1,883,010 |
................... 2,337,114 |
12.2 |
Stocks |
.................................0 |
.................................0 |
.................................0 |
12.3 |
Mortgage loans |
.................................0 |
.................................0 |
.................................0 |
12.4 |
Real estate |
.................................0 |
.................................0 |
.................................0 |
12.5 |
Other invested assets |
.................................0 |
.................................0 |
.................................0 |
12.6 |
Net gains or (losses) on cash, cash equivalents and short-term investments |
.................................0 |
.................................0 |
............................... (1) |
12.7 |
Miscellaneous proceeds |
0 |
0 |
285,000 |
12.8 Total investment proceeds (Lines 12.1 to 12.7) |
...................2,422,048 |
................... 1,883,010 |
................... 2,622,113 |
13. Cost of investments acquired (long-term only):
13.1 |
Bonds |
................... 1,799,164 |
...................1,609,146 |
...................2,886,919 |
|
13.2 |
Stocks |
.................................0 |
.................................0 |
.................................0 |
|
13.3 |
Mortgage loans |
.................................0 |
.................................0 |
.................................0 |
|
13.4 |
Real estate |
.................................0 |
.................................0 |
.................................0 |
|
13.5 |
Other invested assets |
.................................0 |
.................................0 |
.................................0 |
|
13.6 |
Miscellaneous applications |
2,803 |
0 |
0 |
|
13.7 |
Total investments acquired (Lines 13.1 to 13.6) |
1,801,967 |
1,609,146 |
2,886,919 |
|
14. |
Net increase (or decrease) in contract loans and premium notes |
0 |
0 |
0 |
|
15. |
Net cash from investments (Line 12.8 minus Line 13.7 and Line 14) |
620,081 |
273,863 |
(264,806) |
|
Cash from Financing and Miscellaneous Sources |
|||||
16. |
Cash provided (applied): |
||||
16.1 |
Surplus notes, capital notes |
||||
.................................0 |
.................................0 |
.................................0 |
|||
16.2 |
Capital and paid in surplus, less treasury stock |
.................................0 |
.................................0 |
.................................0 |
|
16.3 |
Borrowed funds |
.................................0 |
.................................0 |
.................................0 |
|
16.4 |
Net deposits on deposit-type contracts and other insurance liabilities |
.................................0 |
.................................0 |
.................................0 |
|
..........................................................................................................16.5 Dividends to stockholders |
.................................0 |
.................................0 |
...................... 350,000 |
||
....................................................................................................16.6 Other cash provided (applied) |
(698) |
253 |
383 |
||
17. |
Net cash from financing and miscellaneous sources (Line 16.1 through Line 16.4 minus Line 16.5 |
||||
plus Line 16.6) |
(698) |
253 |
(349,617) |
||
RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS |
|||||
18. |
.Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) |
.......................834,322 |
...................... 450,242 |
.....................(247,955) |
|
19. |
Cash, cash equivalents and short-term investments: |
||||
19.1 |
Beginning of year |
...................... 295,919 |
.......................543,874 |
.......................543,874 |
|
19.2 End of period (Line 18 plus Line 19.1) |
1,130,242 |
994,115 |
295,919 |
Note: Supplemental disclosures of cash flow information for non-cash transactions:
5
STATEMENT AS OF
NOTES TO FINANCIAL STATEMENTS
NOTE 1 Summary of Significant Accounting Policies and Going Concern
- Accounting Practices
The financial statements ofCampmed Casualty & Indemnity Company, Inc. ("the Company") are presented on the basis of accounting practices prescribed or permitted by theState of New Hampshire Insurance Department .
The State of New Hampshire Insurance Department recognizes only statutory accounting practices prescribed or permitted by theState of New Hampshire for determining and reporting the financial condition and results of operations of an insurance company, for determining its solvency under the New Hampshire Insurance Law. TheNational Association of Insurance Commissioners ("NAIC") "Accounting Practices and Procedures Manual" ("NAIC SAP") has been adopted as a component of prescribed or permitted practices by theState of New Hampshire . The State has not adopted any prescribed accounting practices that differ from those found in
NAIC SAP.
A reconciliation of the Company's net income and capital and surplus between NAIC SAP and practices prescribed and permitted by theState of New Hampshire is shown below:
F/S |
F/S |
|||||||||||||
SSAP # |
Page |
Line # |
2024 |
2023 |
||||||||||
NET INCOME |
||||||||||||||
(1) |
State basis (Page 4, Line 20, Columns 1 & 3) |
XXX |
XXX |
XXX |
$ |
194,657 |
$ |
397,344 |
||||||
(2) |
State Prescribed Practices that are an increase/ |
|||||||||||||
(decrease) from NAIC SAP: |
$ |
- |
$ |
- |
||||||||||
(3) |
State Permitted Practices that are an increase/(decrease) |
|||||||||||||
from NAIC SAP: |
$ |
- |
$ |
- |
||||||||||
NAIC SAP (1-2-3=4) |
||||||||||||||
(4) |
XXX |
XXX |
XXX |
$ |
194,657 |
$ |
397,344 |
|||||||
SURPLUS |
||||||||||||||
(5) |
State basis (Page 3, Line 37, Columns 1 & 2) |
XXX |
XXX |
XXX |
$ |
20,425,707 |
$ |
20,231,050 |
||||||
(6) |
State Prescribed Practices that are an increase/(decrease) from NAIC SAP: |
$ |
- |
$ |
- |
|||||||||
(7) |
State Permitted Practices that are an increase/(decrease) from NAIC SAP: |
$ |
- |
$ |
- |
|||||||||
(8) |
NAIC SAP (5-6-7=8) |
XXX |
XXX |
XXX |
$ |
20,425,707 |
$ |
20,231,050 |
||||||
- Use of Estimates in the Preparation of the Financial Statements
The preparation of financial statements in conformity with Statutory Accounting Principles requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. It also requires disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the period. Actual results could differ from those estimates. - Accounting Policy
-
- Short-terminvestments are stated at amortized cost.
- Bonds not backed by loans are stated at either amortized cost or fair value, using the scientific interest method, in accordance with the NAIC Purposes and Procedures of the Securities Valuation Office.
- The Company does not own any common stocks.
- The Company does not own any preferred stocks.
- The Company does not own any mortgage loans.
- Loan-backedsecurities are stated at either amortized cost or fair value, in accordance with the NAIC Purposes and Procedures of the Securities Valuation Office.
- The Company does not own any stocks of, or have any interest in, any subsidiaries.
- The Company does not own any other invested assets.
- The Company does not own any derivatives.
- The Company does utilize anticipated investment income as a factor in the premium deficiency calculation.
- Unpaid losses and loss adjustment expenses include an amount determined from individual case estimates and loss reports and an amount, based on past experience, for losses incurred but not reported ("IBNR"). Such liabilities are necessarily based on assumptions and estimates and while management believes the amount is adequate, the ultimate liability may be in excess of or less than the amount provided. The methods for making such estimates and for establishing the resulting liabilities are continually reviewed and any adjustments are reflected in the period determined.
- The Company has not modified its capitalization policy from the prior year.
- The Company does not write major medical insurance with prescription drug coverage.
- Going ConceNot applicable
NOTE 2 Accounting Changes and Corrections of Errors
Not applicable
NOTE 3 Business Combinations and
Not applicable
6
STATEMENT AS OF
NOTES TO FINANCIAL STATEMENTS
NOTE 4 Discontinued Operations
Not applicable
NOTE 5 Investments
- Mortgage Loans, including Mezzanine Real Estate Loans
The Company does not own any mortgage loans. - Debt Restructuring
The Company did not have any restructured debt. - Reverse Mortgages
The Company does not own any reverse mortgages. - Loan-BackedSecurities
-
- Prepayment assumptions for loan-backed and structured securities were obtained from prepayment models that are sensitive to refinancing, turnover, equity take-out and other relevant factors. These assumptions are consistent with the current interest rate and economic environment.
- Not applicable
- The Company had no securities with a recognized other-than-temporary impairment.
- All impaired securities (fair value is less than cost or amortized cost) for which an other-than-temporary impairment has not been recognized in earnings as a realized loss (including securities with a recognized other-than-temporary impairment for non-interest related declines when a non-recognized interest related impairment remains):
a) The aggregate amount of unrealized losses:
1. |
Less than 12 Months |
$ |
11,312 |
2. |
12 Months or Longer |
$ |
125,636 |
b) The aggregate related fair value of securities with unrealized losses:
1. |
Less than 12 Months |
$ |
1,081,411 |
2. |
12 Months or Longer |
$ |
917,214 |
- The Company employs a systematic methodology to determine if a decline in market value below book/adjusted carrying value is other-than-temporary. In determining whether a decline in fair value below book/adjusted carrying value is other-than-temporary, the Company evaluates several factors and circumstances, including the issuer's overall financial condition; the issuer's credit and financial strength ratings; the issuer's financial performance, including earnings trends, dividend payments, and asset quality; any specific events which may influence the operations of the issuer including governmental actions; a weakening of the general market conditions in the industry or geographic region in which the issuer operates; the length of time and degree to which the fair value of an issuer's securities remains below cost; the Company's intent and ability to hold the security until such time to allow for the expected recovery in value; and with respect to fixed maturity investments, any factors that might raise doubt about the issuer's ability to pay all amounts due according to the contractual terms. These factors are applied to all securities.
E., F., G., H., I., J., K.
Not applicable
L. Restricted Assets
1. Restricted Assets (Including Pledged)
Gross (Admitted & Nonadmitted) Restricted |
||||||||||||||
Current Year |
6 |
7 |
||||||||||||
1 |
2 |
3 |
4 |
5 |
||||||||||
G/A |
Protected |
|||||||||||||
Supporting |
Total |
Cell Account |
||||||||||||
Protected |
Protected |
Assets |
||||||||||||
Total General |
Cell Account |
Cell Account |
Supporting |
Total |
Increase/ |
|||||||||
Account |
Activity |
Restricted |
G/A Activity |
Total |
From Prior |
(Decrease) (5 |
||||||||
Restricted Asset Category |
(G/A) |
(a) |
Assets |
(b) |
(1 plus 3) |
Year |
minus 6) |
|||||||
a. Subject to contractual obligation for which |
||||||||||||||
liability is not shown |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
b. Collateral held under security lending |
||||||||||||||
agreements |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
c. Subject to repurchase agreements |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
d. Subject to reverse repurchase agreements |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
e. Subject to dollar repurchase agreements |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
f. Subject to dollar reverse repurchase |
||||||||||||||
agreements |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
g. Placed under option contracts |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
h. Letter stock or securities restricted as to sale |
||||||||||||||
- excluding FHLB capital stock |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
i. FHLB capital stock |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
j. On deposit with states |
$ |
8,356,280 |
$ |
- |
$ |
- |
$ |
- |
$ |
8,356,280 |
$ |
8,145,922 |
$ |
210,358 |
k. On deposit with other regulatory bodies |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
l. Pledged collateral to FHLB (including assets |
||||||||||||||
backing funding agreements) |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
m. Pledged as collateral not captured in other |
||||||||||||||
categories |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
n. Other restricted assets |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
$ |
- |
o. Total Restricted Assets (Sum of a through n) |
$ |
8,356,280 |
$ |
- |
$ |
- |
$ |
- |
$ |
8,356,280 |
$ |
8,145,922 |
$ |
210,358 |
(a) Subset of Column 1 |
||||||||||||||
(b) Subset of Column 3 |
6.1
STATEMENT AS OF
NOTES TO FINANCIAL STATEMENTS
Current Year |
||||||
8 |
9 |
Percentage |
||||
10 |
11 |
|||||
Gross |
||||||
(Admitted & |
||||||
Non- |
Admitted |
|||||
admitted) |
Restricted |
|||||
Total |
Total |
Restricted to |
to Total |
|||
Non- |
Admitted |
Total |
Admitted |
|||
admitted |
Restricted |
Assets |
Assets |
|||
Restricted Asset Category |
Restricted |
(5 minus 8) |
(c) |
(d) |
||
a. Subject to contractual obligation for which |
||||||
liability is not shown |
$ |
- |
$ |
- |
0.000% |
0.000% |
b. Collateral held under security lending |
||||||
agreements |
$ |
- |
$ |
- |
0.000% |
0.000% |
c. Subject to repurchase agreements |
$ |
- |
$ |
- |
0.000% |
0.000% |
d. Subject to reverse repurchase agreements |
$ |
- |
$ |
- |
0.000% |
0.000% |
e. Subject to dollar repurchase agreements |
$ |
- |
$ |
- |
0.000% |
0.000% |
f. Subject to dollar reverse repurchase |
||||||
agreements |
$ |
- |
$ |
- |
0.000% |
0.000% |
g. Placed under option contracts |
$ |
- |
$ |
- |
0.000% |
0.000% |
h. Letter stock or securities restricted as to sale |
||||||
- excluding FHLB capital stock |
$ |
- |
$ |
- |
0.000% |
0.000% |
i. FHLB capital stock |
$ |
- |
$ |
- |
0.000% |
0.000% |
j. On deposit with states |
$ |
- |
$ |
8,356,280 |
40.876% |
40.876% |
k. On deposit with other regulatory bodies |
$ |
- |
$ |
- |
0.000% |
0.000% |
l. Pledged collateral to FHLB (including assets |
||||||
backing funding agreements) |
$ |
- |
$ |
- |
0.000% |
0.000% |
m. Pledged as collateral not captured in other |
||||||
categories |
$ |
- |
$ |
- |
0.000% |
0.000% |
n. Other restricted assets |
$ |
- |
$ |
- |
0.000% |
0.000% |
o. Total Restricted Assets (Sum of a through n) |
$ |
- |
$ |
8,356,280 |
40.876% |
40.876% |
-
- Column 5 divided by Asset Page, Column 1, Line 28
- Column 9 divided by Asset Page, Column 3, Line 28
- Detail of Assets Pledged as Collateral Not Captured in Other Categories (Contracts That Share Similar Characteristics, Such as Reinsurance and Derivatives, Are Reported in the Aggregate)
Not applicable - Detail of Other Restricted Assets (Contracts That Share Similar Characteristics, Such as Reinsurance and Derivatives, Are Reported in the Aggregate)
Not applicable - Collateral Received and Reflected as Assets Within the Reporting Entity's Financial Statements
Not applicable
M., N., O., P. Q., R.
Not applicable
NOTE 6 Joint Ventures, Partnerships and Limited Liability Companies
Not applicable
NOTE 7 Investment Income
A., B.
Not applicable
- The gross, nonadmitted and admitted amounts for interest income due and accrued.
Interest Income Due and Accrued |
Amount |
|||
1. |
Gross |
$ |
129,269 |
|
2. |
Nonadmitted |
$ |
- |
|
3. |
Admitted |
$ |
129,269 |
|
D., E. |
||||
Not applicable |
||||
NOTE 8 |
Derivative Instruments |
|||
Not applicable |
||||
NOTE 9 |
Income Taxes |
No Change
6.2
STATEMENT AS OF
NOTES TO FINANCIAL STATEMENTS
NOTE 10 Information Concerning Parent, Subsidiaries, Affiliates and Other Related Parties
- Nature of Relationships
The Company is a wholly-owned subsidiary ofThe Hanover Insurance Company ("Hanover") which, in turn, is a wholly-owned subsidiary ofOpus Investment Management, Inc. ("Opus'), which, in turn, is a wholly-ownednon-insurance subsidiary ofThe Hanover Insurance Group, Inc. ("THG"), a publicly traded company incorporated inDelaware . - Detail of Transactions Greater than 1/2% of Admitted Assets
Not appllicable - Transactions with related party who are not reported on Schedule Y
Not applicable - Amounts Due to or from Related Parties
At the end of the current reporting period, the Company reported$1,298 as amounts due to an affiliate company. These arrangements require that intercompany balances be settled within 30 days. - Management, Service Contracts, Cost Sharing Arrangements
Companies affiliated with Hanover have entered into an intercompany Consolidated Service Agreement. Under the agreement, legal entities will be charged the cost of the service provided or expenses paid by the entity providing the service or paying the expense. In addition, these entities will be charged a portion of the costs associated with activities that are performed for the good of THG legal entities.
Opus provided investment-related services under an intercompany advisory agreement untilJune 3, 2024 , when the agreement was officially canceled. - Guarantees or Contingencies for Related Parties
Not applicable - Nature of Relationships that Could Affect Operations
All outstanding shares of the Company are owned by Hanover.
H., I.,
Not applicable
NOTE 11 Debt
Not applicable
NOTE 12 Retirement Plans, Deferred Compensation, Postemployment Benefits and Compensated Absences and Other
Postretirement Benefit Plans
The labor for the Company is provided and paid for by Hanover. As such, the Company is included in the benefit plans in force for Hanover. Charges for actual salary and benefit costs for services provided to the Company by Hanover employees are ceded 100% pursuant to the Company's Intercompany Reinsurance Agreement.
A., B., C., D., E., F., G., H., I.
Not applicable
NOTE 13 Capital and Surplus, Dividend Restrictions and Quasi-Reorganizations
- Outstanding Shares
The Company has 3,000 shares of$1,000 par value common stock authorized, issued and outstanding. - Dividend Rate of Preferred Stock
Not applicable
(C-F) Dividend Restrictions
Pursuant to
(G-M)
Not applicable
NOTE 14 Liabilities, Contingencies and Assessments
A., B., C., D., E., F
Not applicable
- All Other Contingencies
The Company routinely engages in various legal proceedings in the normal course of business, including claims for punitive damages. In the opinion of management, none of such contingencies are expected to have a material effect on the Company's financial position, although it is possible that the results of operations in a particular quarter or annual period would be materially affected by an adverse development or unfavorable outcome.
6.3
STATEMENT AS OF
NOTES TO FINANCIAL STATEMENTS
NOTE 15 Leases
- Lessee Operating Lease: Not applicable
NOTE 16 Information About Financial Instruments With Off-Balance Sheet Risk and Financial Instruments With Concentrations of Credit Risk
Not applicable
NOTE 17 Sale, Transfer and Servicing of Financial Assets and Extinguishments of Liabilities
A., B.
Not applicable
- Wash Sales
The Company generally does not sell and reacquire securities within 30 days of the sale date. There were no wash sale transactions with a NAIC designation of 3 or below in the current year.
NOTE 18 Gain or Loss to the Reporting Entity from Uninsured Plans and the Uninsured Portion of Partially Insured Plans
Not applicable
NOTE 19 Direct Premium Written/Produced by Managing General Agents/Third Party Administrators
Not applicable
NOTE 20 Fair Value Measurements
A.
- Fair Value Measurements at Reporting Date
-
- There were no assets carried at fair value at the end of the reporting period.
- There were no liabilities carried at fair value at the end of the reporting period.
- The Company does not have any Level 3 assets or liabilities measured at fair value at the end of the reporting period.
- The reporting entity's policy is to recognize transfers in and transfers out as of the actual date of the event or change in circumstances that caused the transfer.
- For fair value measurements categorized within Level 2 of the fair value hierarchy, fair values of bonds are obtained by a quoted market price if available, otherwise, fair values are estimated using independent pricing sources or internally developed pricing models using discounted cash flow analyses.
The Company utilizes a third party pricing service for the valuation of the majority of its fixed maturity securities and receives one quote per security. When quoted market prices in an active market are available, they are provided by the pricing service as the fair value and such values are classified as Level 1. Since fixed maturities other thanU.S. Treasury securities generally do not trade on a daily basis, the pricing service prepares estimates of fair value for those securities using pricing applications based on a market approach. Inputs into the fair value pricing applications which are common to all asset classes include benchmarkU.S. Treasury security yield curves, reported trades of identical or similar fixed maturity securities, broker/dealer quotes of identical or similar fixed maturity securities and structural characteristics of the security, such as maturity date, coupon, mandatory principal payment dates, frequency of interest and principal payments and optional principal redemption features. Inputs into the fair value applications that are unique by asset class include, but are not limited to:
•U.S. government - determination of direct versus indirect government support and whether any contingencies exist with respect to the timely payment of principal and interest.
• All other governments - estimates of appropriate market spread versus underlying related sovereign treasury curves dependent on liquidity and direct or contingent support.
• Corporate bonds, which are included in Industrial and miscellaneous bonds - overall credit quality, including assessments of the level and variability of: economic sensitivity; liquidity; corporate financial policies; management quality; regulatory environment; competitive position; ownership; restrictive covenants; and security or collateral.
• Municipal bonds, which are included in States, territories and possessions; Political subdivisions of states, territories and possessions; and Special revenue and special assessment obligations - overall credit quality, including assessments of the level and variability of: sources of payment such as income, sales or property taxes, levies or user fees; credit support such as insurance; state or local economic and political base; natural resource availability; and susceptibility to natural or man-made catastrophic events such as hurricanes, earthquakes or acts of terrorism.
• Residential mortgage-backed securities,U.S. agency pass-thrus and collateralized mortgage obligations ("CMOs") which are included inU.S. governments and Special revenue and special assessment obligations - estimates of prepayment speeds based upon: historical prepayment rate trends; underlying collateral interest rates; geographic concentration; vintage year; borrower credit quality characteristics; interest rate and yield curve forecasts; government or monetary authority support programs; tax policies; and delinquency/default trends.
• Residential mortgage-backed securities, non-agency CMOs, which are included in Industrial and miscellaneous - estimates of prepayment speeds based upon: historical prepayment rate trends; underlying collateral interest rates; geographic concentration; vintage year; borrower credit quality characteristics; interest rate and yield curve forecasts; government or monetary authority support programs; tax policies; delinquency/default trends; and severity of loss upon default and length of time to recover proceeds following default.
• Commercial mortgage-backed securities, which are included in Industrial and miscellaneous bonds - overall credit quality, including assessments of the value and supply/demand characteristics of: collateral type such as office, retail, residential, lodging, or other; geographic concentration by region, state, metropolitan statistical area and locale; vintage year; historical collateral performance including defeasance, delinquency, default and special servicer trends; and capital structure support features.
• Asset-backed securities, which are included in Industrial and miscellaneous bonds - overall credit quality, including assessments of the underlying collateral type such as credit card receivables, auto loan receivables and equipment lease receivables; geographic diversification; vintage year; historical collateral performance including delinquency, default and casualty trends; economic conditions influencing use rates and resale values; and contract structural support features.
6.4
Attachments
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