LIFE, ACCIDENT AND HEALTH INSURERS COMPANY NAME: …

1 _____Page 152017 INSTRUCTIONS FOR REQUIRED FILINGS IN MICHIGANLIFE, ACCIDENT AND HEALTH INSURERSCOMPANY NAME: NAIC COMPANY Code:Contact:Telephone: REQUIRED FILINGS IN THE STATE OF:MICHIGANF ilings Made During the Year 2018(1)Check-list(2)Line#(3)REQUIRED FILINGS FOR THE ABOVE STATE(4)NUMBER OF COPIES*(5)DUE DATE(6)FORM SOURCE**(7)APPLICABLENOTESD omesticForeignState NAIC StateI. NAIC FINANCIAL STATEMENTS1 Annual Statement (8 x14 )1 EO xxx 3/1 NAICA-K, Printed Investment Schedule detail (Pages E01-E27) @1 EO xxx 3/1 NAICA-K, M2 Quarterly Financial Statement (8 x 14 )1 EO xxx 5/15, 8/15, 11/15 NAICA-K, M3 Separate Accounts Annual Statement (8 x14 )1 EO xxx 3/1 NAICA-K, MII. NAIC SUPPLEMENTS11 ACCIDENT & HEALTH Policy Experience Exhibit1 EO xxx 4/1 NAICA-K, M12 Analysis of Annuity Operations by Lines of Business1 EO xxx 4/1 NAICA-K, M13 Analysis of Increase in Annuity Reserves During Year1 EO xxx 4/1 NAICA-K, M14 Credit Insurance Experience Exhibit1 EO xxx 4/1 NAICA-K, M15 Interest Sensitive Life Insurance Products Reportxxx EO xxx 4/1 NAICA-K, M16 Life, HEALTH & Annuity Guaranty Assessment Base Reconciliation Exhibitxxx EO xxx 4/1 NAICA-K, M17 Life, HEALTH & Annuity Guaranty Assessment Base Reconciliation Exhibit Adjustment Formxxx EO xxx 4/1 NAICA-K, M18 Long Term Care Experience Reporting Formsxxx EO xxx 4/1 NAICA-K.

2 M19 Management Discussion & Analysis1 EO xxx 4/1 COMPANY A-K20 Medicare Supplement Insurance Experience Exhibitxxx EO xxx 3/1 NAICA-K, M21 Medicare Part D Coverage Supplement1 EO xxx 3/1, 5/15, 8/15, 11/15 NAICA-K, M22 Risk-Based Capital Report1 EO xxx 3/1 NAICA-K23 Schedule SIS1 N/A N/A 3/1 NAICA-K, M24 Supplemental Compensation Exhibit1 N/A N/A 3/1 NAICA-K, M25 Supplemental HEALTH Care Exhibit (Part 1, 2 and 3) 1 EO xxx 4/1 NAICA-K, M26 Supplemental HEALTH Care Exhibit s Allocation Report 1 EO xxx 4/1 NAICA-K, M27 Supplemental Investment Risk Interrogatories1 EO xxx 4/1 NAICA-K, M28 Supplemental Schedule O1 EO xxx 3/1 NAICA-K, M29 Supplemental Term and Universal Life InsuranceReinsurance Exhibit1 EO xxx 4/1 NAICA-K, M30 Trusteed Surplus Statementxxx EO xxx 3/1, 5/15, 8/15, 11/15 NAICA-K, M31 Variable Annuities Supplement1 EO xxx 4/1 NAICA-K, M32 VM 20 Reserves Supplement1 EO xxx 3/1 NAICA-K, M33 Workers Compensation Carve Out Supplement1 EO xxx 3/1 NAICA-K, MActuarial Related Items34 Actuarial Certification regarding use 2001 Preferred Class Table 1 EO xxx 3/1 COMPANY A-K.

3 M35 Actuarial Certification Related Annuity Nonforfeiture Ongoing Compliance for Equity Indexed Annuities1 EO xxx 3/1 COMPANY A-K, M36 Actuarial Certifications Related to Hedging required by Actuarial Guideline XLIII1 EO xxx 3/1 COMPANY A-K, M37 Actuarial Certification Related to Reserves required by Actuarial Guideline XLIII1 EO xxx 3/1 COMPANY A-K, M38 Actuarial Memorandum Related to Universal Life with Secondary Guarantee Policies required by Actuarial Guideline XXXVIII 8D1 N/A N/A 4/30 COMPANY A-K, M39 Actuarial Opinion1 EO xxx 3/1 COMPANY A-K, M40 Actuarial Opinion on Separate Accounts Funding Guaranteed Minimum Benefit1 EO xxx 3/1 COMPANY A-K, M41 Actuarial Opinion on Synthetic Guaranteed Investment Contracts1 EO xxx 3/1 COMPANY A-K, M42 Actuarial Opinion on X-Factors1 EO xxx 3/1 COMPANY A-K, M43 Actuarial Opinion required by Modified Guaranteed Annuity Model Regulation 1 EO xxx 3/1 COMPANY A-K, M_____2017 INSTRUCTIONS FOR REQUIRED FILINGS IN MICHIGANPage 1644 Financial Officer Certification Related to Clearly Defined Hedging Strategy required by Actuarial Guideline XLIII1 EO xxx 3/1 COMPANY A-K, M45 Life PBR Exemption (formerly Companywide Exemption) 1 EO xxx Commissioner 7/1 NAIC 8/15 COMPANY A-K, M46 Management Certification that the Valuation Reflects Management s Intent required by Actuarial Guideline XLIII1 EO xxx 3/1 COMPANY A-K, M47 Regulatory Asset Adequacy Issues Summary (send to Office of Insurance Evaluation of the Department of Insurance and Financial Services)

4 1 N/A xxx 4/1 COMPANY A-K48 Reasonableness & Consistency of Assumptions Certification required by Actuarial Guideline XXXVxxx EO xxx 3/1, 5/15, 8/15, 11/15 COMPANY A-K, M49 Reasonableness of Assumptions Certification required by Actuarial Guideline XXXVxxx EO xxx 3/1, 5/15, 8/15, 11/15 COMPANY A-K, M50 Reasonableness & Consistency of Assumptions Cert. required by Actuarial Guideline XXXVI (Updated Average Market Value)1 EO xxx 3/1, 5/15, 8/15, 11/15 COMPANY A-K, M51 Reasonableness & Consistency of Assumptions Cert. required by Actuarial Guideline XXXVI (Updated Market Value)1 EO xxx 3/1, 5/15, 8/15, 11/15 COMPANY A-K, M52 Reasonableness of Assumptions Cert. for Implied Guaranteed Rate Method required by Actuarial Guideline XXXVI1 EO xxx 3/1, 5/15, 8/15, 11/15 COMPANY A-K, M53 RBC Certification required under C-3 Phase I1 EO xxx 3/1 COMPANY A-K54 RBC Certification required under C-3 Phase II1 EO xxx 3/1 CompanyA-K55 Statement on non-guaranteed elements - Exhibit 5 Interrogatory #3xxx EO xxx 3/1 COMPANY A-K, M56 Statement on participating/non-participating policies -Exhibit 5 Interrogatory #1 & 2xxx EO xxx 3/1 COMPANY A-K, MIII.

5 ELECTRONIC FILING REQUIREMENTS61 Annual Statement Electronic Filingxxx EO xxx 3/1 NAICA-K, M62 March .PDF Filingxxx EO xxx 3/1 NAICA-K, M63 Risk-Based Capital Electronic Filingxxx EO N/A 3/1 NAICA-K, M64 Risk-Based Capital .PDF Filingxxx EO N/A 3/1 NAICA-K, M65 Separate Accounts Electronic Filingxxx EO xxx 3/1 NAICA-K, M66 Separate Accounts .PDF Filingxxx EO xxx 3/1 NAICA-K, M67 Supplemental Electronic Filingxxx EO xxx 4/1 NAICA-K, M68 Supplemental .PDF Filingxxx EO xxx 4/1 NAICA-K, M69 Quarterly Statement Electronic Filingxxx EO xxx 5/15, 8/15, 11/15 NAIC A-K, M70 Quarterly .PDF Filingxxx EO xxx 5/15, 8/15, 11/15 NAICA-K, M71 June .PDF Filingxxx EO xxx 6/1 NAICA-K, MIV. AUDIT/INTERNAL CONTROL RELATED REPORTS81 Accountants Letter of Qualifications1 EO N/A 6/1 COMPANY A-K, O82 Audited Financial Reports1 EO xxx 6/1 COMPANY A-K, O83 Audited Financial Statements Exemption Affidavit1 N/A N/A 6/1 COMPANY A-K84 Communication of Internal Control Related Matters Noted in Audit 1 EO xxx 8/1 COMPANY A-K, Q85 Independent CPA (change)

6 1 N/A N/A 6/1 COMPANY A-K, O86 Management s Report of Internal Control Over Financial Reporting 1 N/A N/A 8/1 COMPANY A-K87 Notification of Adverse Financial Condition1 N/A1 SEE NOTEC ompany A-K, P88 Request for Exemption to File1 N/A N/A SEE NOTEC ompany A-K, R89 Relief from the five-year rotation requirement for lead audit partner1 EO xxx 3/1 COMPANY A-K90 Relief from the one-year cooling off period for independent CPA1 EO xxx 3/1 COMPANY A-K91 Relief from the Requirements for Audit Committees1 EO xxx 3/1 COMPANY A-KV. STATE REQUIRED FILINGS101 Certificate of Compliancexxx 00 3/1 StateA-K102 Certificate of Depositxxx 00 3/1 StateA-K103 Certificate of Valuation (foreign companies do not need to file Certificate of Valuation with DIFS, but should have it available upon request)xxx 00 7/1 StateA-K104 Corporate Governance Annual Disclosure (Michigan has not adopted the NAIC Corporate Governance Annual Disclosure Model Act) **0 SEE ** BELOWC ompany A-K105 Filings Checklist (with Column 1 completed)xxx 0 StateA-K106 Form B-Holding COMPANY Registration Statement10N/A 5/1 CompanyA-K, S_____Page 172017 INSTRUCTIONS FOR REQUIRED FILINGS IN MICHIGAN107 Form F-Enterprise Risk Report (per Section 1325a of the Michigan Insurance Code) **10N/A 5/1 COMPANY A-K, S108 ORSA (.)

7 ORSA filings will be required in Michigan starting in 2018. This filing is intended to be submitted to the lead state if filed at the insurance group Chapter 17 of the Michigan Insurance Code.) **10N/A SEE **BELOWC ompany A-K109 Premium Tax0 SEE NOTES tateD110 State Filing Fees0 SEE NOTES tateC111 Signed Jurat000 SEE NOTENAICL112 ACCIDENT and Sickness Insurance Advertising Certificate of Compliance per Admin Rule only applies to INSURERS writing disability insurance. Advertisement of Life Insurance and Annuities Certificate of Compliance per Admin Rule Submit via 0EO 3/1 COMPANY A-K113 Qualifying Assets under Section 901(1) of the Michigan Insurance Code10N/A 3/1 State FIS 0081A-K, T114 Complaint and Grievance Summary for HEALTH Carriers (File Via SERFF )EO 0EO 4/15 State-FIS 0318A-K115 Michigan HEALTH Insurance Enrollment, Premiums and Losses (Companies should note that beginning with the 2015 reporting year, the FIS 0322 must be submitted electronically to DIFS.

8 The submission website address, along with an authentication code and more detailed instructions, will be sent to the Statutory Statement Contact on or before March 1) EO 0EO 4/1 State FIS 0322A-K116 Officer and Director Biographical Information10xxx SEE NOTENAICA-K, U*If XXX appears in this column, this state does not require this filing, if hard copy is filed with the state of domicile and if the data is filed electronically with the NAIC. If N/A appears in this column, the filing is required with the domiciliary state. EO (electronic only filing).**If Form Source is NAIC, the form should be obtained from the appropriate vendor.**For those states that have adopted the NAIC Corporate Governance Annual Disclosure Model Act, an annual disclosure is required of all INSURERS or insurance groups by June 1. The Corporate Governance Annual Disclosure is a state filing only and should not be submitted by the COMPANY to the NAIC.

9 Note however that this filing is intended to be submitted to the lead state if filed at the insurance group level. For more information on lead states, see the following NAIC URL: Michigan has not adopted the NAIC Corporate Governance Annual Disclosure Model Act.**For those states that have adopted the NAIC updated Holding COMPANY Model Act, a Form F filing is required annually by holding COMPANY groups. Consistent with the Form B filing requirements, the Form F is a state filing only and should notbe submitted by the COMPANY to the NAIC. Note however that this filing is intended to be submitted to the lead state. For more information on lead states, see the following NAIC URL: **For those states that have adopted the NAIC Risk Management and Own Risk and Solvency Assessment Model Act, a summary report is required annually by INSURERS and insurance groups above a specified premium threshold.

10 The ORSA Summary Report is a state filing only and should not be submitted by the COMPANY to the NAIC. Note however that this filing is intended to be submitted to the lead state. For more information on lead states, see the following NAIC URL: filings will be required in Michigan starting in 2018.@If schedule is included in the annual statement submitted as item #1, an additional copy is not required.