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PROPERTY AND CASUALTY COMPANIES - ASSOCIATION EDITION *13687201420100102* QUARTERLY STATEMENT As of June 30, 2014 of the Condition and Affairs of the Prepared Insurance Company NAIC Group Code..... , NAIC Company Code..... 13687 Employer's ID Number..... 26-4756872 (Current Period) (Prior Period) Organized under the Laws of Florida State of Domicile or Port of Entry Florida Country of Domicile Incorporated/Organized..... April 16, 2009 Commenced Business..... September 18, 2009 Statutory Home Office 1715 N Westshore Blvd Suite 930….. Tampa ..... FL ..... US ..... 33607 (Street and Number) Main Administrative Office (City or Town, State, Country and Zip Code) 1715 N Westshore Blvd Suite 930….. Tampa ..... FL ..... US ..... 33607 (Street and Number) (City or Town, State, Country and Zip Code) 1715 N Westshore Blvd Suite 930….. Tampa ..... FL ..... US ..... 33607 Primary Location of Books and Records 1715 N Westshore Blvd Suite 930….. Tampa ..... FL ..... US ..... 33607 (Street and Number or P. O. Box) Internet Web Site Address Statutory Statement Contact 813-286-3730 (Area Code) (Telephone Number) Mail Address (Street and Number) US (City or Town, State, Country and Zip Code) (City or Town, State, Country and Zip Code) Jeffrey Eugene Myers 813-286-3730 (Area Code) (Telephone Number) 813-286-3732 (Name) (Area Code) (Telephone Number) (Extension) [email protected] 813-286-3737 (E-Mail Address) (Fax Number) OFFICERS Name 1. Eric Lee Gobble Title Chief Executive Officer, Chief Risk Officer and Pr Chief Claim Officer 3. Michael Ernest Rubio Name 2. Jeffrey Eugene Myers 4. Stephanie Elaine Siewert OTHER Title Chief Financial Officer, Secretary, and Treasurer Chief Operating Officer and Chief Marketing Office DIRECTORS OR TRUSTEES Eric Lee Gobble Varnavas Louis Zagaris State of........ County of..... Martin Lloyd Schaffel Oscar Armando Garcia John Howard Sykes Danny Correa Panayiotis Vasiloudes Florida Hillsborough The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement. (Signature) (Signature) (Signature) Eric Lee Gobble 1. (Printed Name) Jeffrey Eugene Myers 2. (Printed Name) Michael Ernest Rubio 3. (Printed Name) Chief Executive Officer, Chief Risk Officer and Pr (Title) Chief Financial Officer, Secretary, and Treasurer (Title) Chief Claim Officer (Title) Subscribed and sworn to before me This day of a. Is this an original filing? b. If no: 1. State the amendment number 2. Date filed 3. Number of pages attached Yes [ X ] No [ ] Statement for June 30, 2014 of the Prepared Insurance Company ASSETS 1 Current Statement Date 2 Assets Nonadmitted Assets 3 Net Admitted Assets (Cols. 1 - 2) 4 December 31 Prior Year Net Admitted Assets 1. Bonds........................................................................................................................................... ...............27,653,319 ................................... ...............27,653,319 ...............27,283,451 2. Stocks: 3. 4. 5. 2.1 Preferred stocks................................................................................................................. ....................979,016 ................................... ....................979,016 ....................911,598 2.2 Common stocks................................................................................................................. ......................52,698 ................................... ......................52,698 ......................28,927 Mortgage loans on real estate: 3.1 First liens............................................................................................................................ ................................... ................................... ...............................0 ................................... 3.2 Other than first liens........................................................................................................... ................................... ................................... ...............................0 ................................... Real estate: 4.1 Properties occupied by the company (less $..........0 encumbrances).................................................................................................................. ................................... ................................... ...............................0 ................................... 4.2 Properties held for the production of income (less $..........0 encumbrances).................................................................................................................. ................................... ................................... ...............................0 ................................... 4.3 Properties held for sale (less $..........0 encumbrances)..................................................... ................................... ................................... ...............................0 ................................... Cash ($.....20,503,241), cash equivalents ($..........0) and short-term investments ($.....374,328).................................................................................. ...............20,877,569 ................................... ...............20,877,569 ...............12,384,281 6. Contract loans (including $..........0 premium notes).................................................................... ................................... ................................... ...............................0 ................................... 7. Derivatives................................................................................................................................... ................................... ................................... ...............................0 ................................... 8. Other invested assets.................................................................................................................. ................................... ................................... ...............................0 ................................... 9. Receivables for securities............................................................................................................ ................................... ................................... ...............................0 ................................... 10. Securities lending reinvested collateral assets............................................................................ ................................... ................................... ...............................0 ................................... 11. Aggregate write-ins for invested assets....................................................................................... ...............................0 ...............................0 ...............................0 ...............................0 12. Subtotals, cash and invested assets (Lines 1 to 11).................................................................... ...............49,562,602 ...............................0 ...............49,562,602 ...............40,608,257 13. Title plants less $..........0 charged off (for Title insurers only)..................................................... ................................... ................................... ...............................0 ................................... 14. Investment income due and accrued........................................................................................... ....................198,546 ................................... ....................198,546 ....................195,754 15. Premiums and considerations: 15.1 Uncollected premiums and agents' balances in the course of collection........................... ....................219,098 ........................2,042 ....................217,056 ....................198,435 15.2 Deferred premiums, agents' balances and installments booked but deferred and not yet due (including $..........0 earned but unbilled premiums)................................. .................2,402,974 ................................... .................2,402,974 .................1,886,220 15.3 Accrued retrospective premiums....................................................................................... ................................... ................................... ...............................0 ................................... 16. Reinsurance: 16.1 Amounts recoverable from reinsurers................................................................................ ................................... ................................... ...............................0 ................................... 16.2 Funds held by or deposited with reinsured companies...................................................... ................................... ................................... ...............................0 ................................... 16.3 Other amounts receivable under reinsurance contracts.................................................... ................................... ................................... ...............................0 ................................... 17. Amounts receivable relating to uninsured plans.......................................................................... ................................... ................................... ...............................0 ................................... 18.1 Current federal and foreign income tax recoverable and interest thereon................................... ....................950,570 ................................... ....................950,570 ................................... 18.2 Net deferred tax asset.................................................................................................................. ....................712,552 ......................26,238 ....................686,314 .................1,038,198 19. Guaranty funds receivable or on deposit..................................................................................... ....................163,232 ................................... ....................163,232 ....................468,904 20. Electronic data processing equipment and software................................................................... ................................... ................................... ...............................0 ................................... 21. Furniture and equipment, including health care delivery assets ($..........0)................................. ................................... ................................... ...............................0 ................................... 22. Net adjustment in assets and liabilities due to foreign exchange rates....................................... ................................... ................................... ...............................0 ................................... 23. Receivables from parent, subsidiaries and affiliates.................................................................... ........................7,926 ................................... ........................7,926 ....................443,498 24. Health care ($..........0) and other amounts receivable................................................................. ................................... ................................... ...............................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 through 25)............................................................................................ ...............54,217,500 ......................28,280 ...............54,189,220 ...............44,839,266 27. From Separate Accounts, Segregated Accounts and Protected Cell Accounts.......................... ................................... ................................... ...............................0 ................................... 28. Total (Lines 26 and 27)................................................................................................................ ...............54,217,500 ......................28,280 ...............54,189,220 ...............44,839,266 DETAILS OF WRITE-INS 1101. ..................................................................................................................................................... ................................... ................................... ...............................0 ................................... 1102. ..................................................................................................................................................... ................................... ................................... ...............................0 ................................... 1103. ..................................................................................................................................................... ................................... ................................... ...............................0 ................................... 1198. Summary of remaining write-ins for Line 11 from overflow page................................................. ...............................0 ...............................0 ...............................0 ...............................0 1199. Totals (Lines 1101 thru 1103 plus 1198) (Line 11 above)........................................................... ...............................0 ...............................0 ...............................0 ...............................0 2501. ..................................................................................................................................................... ................................... ................................... ...............................0 ................................... 2502. ..................................................................................................................................................... ................................... ................................... ...............................0 ................................... 2503. ..................................................................................................................................................... ................................... ................................... ...............................0 ................................... 2598. Summary of remaining write-ins for Line 25 from overflow page................................................. ...............................0 ...............................0 ...............................0 ...............................0 2599. Totals (Lines 2501 thru 2503 plus 2598) (Line 25 above)........................................................... ...............................0 ...............................0 ...............................0 ...............................0 Q02 Statement for June 30, 2014 of the Prepared Insurance Company LIABILITIES, SURPLUS AND OTHER FUNDS 1 Current Statement Date 2 December 31 Prior Year 1. Losses (current accident year $.....3,441,717)......................................................................................................................... ...............................6,287,877 ...............................5,586,153 2. Reinsurance payable on paid losses and loss adjustment expenses...................................................................................... ................................................. ................................................. 3. Loss adjustment expenses....................................................................................................................................................... ...............................1,407,281 ...............................1,372,468 4. Commissions payable, contingent commissions and other similar charges............................................................................ ................................................. ................................................. 5. Other expenses (excluding taxes, licenses and fees).............................................................................................................. ..................................154,228 ..................................177,858 6. Taxes, licenses and fees (excluding federal and foreign income taxes).................................................................................. ..................................127,749 ..................................159,877 7.1 Current federal and foreign income taxes (including $.....(950,570) on realized capital gains (losses)).................................. ................................................. ..................................154,830 7.2 Net deferred tax liability............................................................................................................................................................ ................................................. ................................................. 8. Borrowed money $..........0 and interest thereon $..........0....................................................................................................... ................................................. ................................................. 9. Unearned premiums (after deducting unearned premiums for ceded reinsurance of $.....19,236,501 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................................................................. ...............................7,568,731 .............................13,203,295 10. Advance premium.................................................................................................................................................................... ...............................1,760,720 ..................................904,864 11. Dividends declared and unpaid: 11.1 Stockholders.................................................................................................................................................................... ................................................. ................................................. 11.2 Policyholders................................................................................................................................................................... ................................................. ................................................. 12. Ceded reinsurance premiums payable (net of ceding commissions)....................................................................................... .............................20,985,274 ...............................7,317,403 13. Funds held by company under reinsurance treaties................................................................................................................ ................................................. ................................................. 14. Amounts withheld or retained by company for account of others............................................................................................. ..................................287,813 ..................................182,668 15. Remittances and items not allocated....................................................................................................................................... .................................(109,066) .........................................305 16. Provision for reinsurance (including $..........0 certified)........................................................................................................... ................................................. ................................................. 17. Net adjustments in assets and liabilities due to foreign exchange rates.................................................................................. ................................................. ................................................. 18. Drafts outstanding.................................................................................................................................................................... ................................................. ................................................. 19. Payable to parent, subsidiaries and affiliates........................................................................................................................... ................................................. ................................................. 20. Derivatives................................................................................................................................................................................ ................................................. ................................................. 21. Payable for securities............................................................................................................................................................... ................................................. ................................................. 22. Payable for securities lending.................................................................................................................................................. ................................................. ................................................. 23. Liability for amounts held under uninsured plans..................................................................................................................... ................................................. ................................................. 24. Capital notes $..........0 and interest thereon $..........0............................................................................................................. ................................................. ................................................. 25. Aggregate write-ins for liabilities............................................................................................................................................... .............................................0 .............................................0 26. Total liabilities excluding protected cell liabilities (Lines 1 through 25).................................................................................... .............................38,470,607 .............................29,059,721 27. Protected cell liabilities............................................................................................................................................................. ................................................. ................................................. 28. Total liabilities (Lines 26 and 27).............................................................................................................................................. .............................38,470,607 .............................29,059,721 29. Aggregate write-ins for special surplus funds........................................................................................................................... .............................................0 .............................................0 30. Common capital stock.............................................................................................................................................................. ...............................5,000,000 ...............................5,000,000 31. Preferred capital stock.............................................................................................................................................................. ................................................. ................................................. 32. Aggregate write-ins for other than special surplus funds......................................................................................................... .............................................0 .............................................0 33. Surplus notes........................................................................................................................................................................... ...............................6,100,000 ...............................6,100,000 34. Gross paid in and contributed surplus...................................................................................................................................... ...............................5,514,000 ...............................5,514,000 35. Unassigned funds (surplus)...................................................................................................................................................... .................................(895,387) .................................(834,455) 36. Less treasury stock, at cost: 36.1 ..........0.000 shares common (value included in Line 30 $..........0)............................................................................... ................................................. ................................................. 36.2 ..........0.000 shares preferred (value included in Line 31 $..........0).............................................................................. ................................................. ................................................. 37. Surplus as regards policyholders (Lines 29 to 35, less 36)...................................................................................................... .............................15,718,613 .............................15,779,545 38. Totals (Page 2, Line 28, Col. 3)................................................................................................................................................ .............................54,189,220 .............................44,839,266 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 thru 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 thru 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 thru 3203 plus 3298) (Line 32 above)........................................................................................................ .............................................0 .............................................0 Q03 Statement for June 30, 2014 of the Prepared Insurance Company STATEMENT OF INCOME 1 Current Year to Date 2 Prior Year to Date 3 Prior Year Ended December 31 ................22,881,393 ................................... ................10,116,186 ................12,765,207 ................17,402,092 ................................... ..................7,628,275 ..................9,773,817 ................37,984,857 ................................... ................16,908,669 ................21,076,188 ..................5,351,501 ................................... ................................... ..................5,351,501 ..................1,055,000 ..................6,888,332 ................................0 ................13,294,833 ................................... ....................(529,626) ..................3,106,142 ................................... ................................... ..................3,106,142 ..................1,054,197 ..................5,297,580 ................................0 ..................9,457,919 ................................... .....................315,898 ..................7,461,527 ................................... ................................... ..................7,461,527 ..................2,242,864 ................10,786,181 ................................0 ................20,490,572 ................................... .....................585,616 UNDERWRITING INCOME 1. Premiums earned: 1.1 Direct.............. (written $.....28,115,918)................................................................................................................ 1.2 Assumed........ (written $..........0)........................................................................................................................... 1.3 Ceded............. (written $.....20,985,274)................................................................................................................ 1.4 Net.................. (written $.....7,130,644).................................................................................................................. DEDUCTIONS: 2. Losses incurred (current accident year $.....5,102,459): 2.1 Direct........................................................................................................................................................................ 2.2 Assumed.................................................................................................................................................................. 2.3 Ceded....................................................................................................................................................................... 2.4 Net............................................................................................................................................................................ 3. Loss adjustment expenses incurred............................................................................................................................... 4. Other underwriting expenses incurred........................................................................................................................... 5. Aggregate write-ins for underwriting deductions............................................................................................................ 6. Total underwriting deductions (Lines 2 through 5)......................................................................................................... 7. Net income of protected cells......................................................................................................................................... 8. Net underwriting gain (loss) (Line 1 minus Line 6 + Line 7)........................................................................................... INVESTMENT INCOME 9. Net investment income earned....................................................................................................................................... .....................352,180 .....................246,957 .....................561,335 10. Net realized capital gains (losses) less capital gains tax of $.....7,600.......................................................................... ........................(7,600) ...........................(112) .........................5,606 11. Net investment gain (loss) (Lines 9 + 10)....................................................................................................................... .....................344,580 .....................246,845 .....................566,941 OTHER INCOME 12. Net gain or (loss) from agents' or premium balances charged off (amount recovered $.....(34,159) amount charged off $..........0).................................................................................... 13. Finance and service charges not included in premiums................................................................................................ 14. Aggregate write-ins for miscellaneous income............................................................................................................... 15. Total other income (Lines 12 through 14)...................................................................................................................... 16. Net income before dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Lines 8 + 11 + 15)....................................................................................................................... 17. Dividends to policyholders.............................................................................................................................................. 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)................................................................................................................ 19. Federal and foreign income taxes incurred.................................................................................................................... 20. Net income (Line 18 minus Line 19) (to Line 22)........................................................................................................... ......................(34,159) .......................30,943 .............................(31) ........................(3,247) ........................(6,158) .......................24,604 ...........................(172) .......................18,274 ........................(4,567) .......................59,721 ...........................(313) .......................54,841 ....................(188,293) .....................581,017 ..................1,207,398 ................................... ................................... ................................... ....................(188,293) .....................581,017 ..................1,207,398 ....................(413,000) ................................... .....................639,700 .....................224,707 .....................581,017 .....................567,698 CAPITAL AND SURPLUS ACCOUNT 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 34. 35. 36. 37. 38. 39. Surplus as regards policyholders, December 31 prior year........................................................................................... Net income (from Line 20).............................................................................................................................................. Net transfers (to) from Protected Cell accounts............................................................................................................. Change in net unrealized capital gains or (losses) less capital gains tax of $..........0................................................... Change in net unrealized foreign exchange capital gain (loss)...................................................................................... Change in net deferred income tax................................................................................................................................ Change in nonadmitted assets....................................................................................................................................... Change in provision for reinsurance............................................................................................................................... Change in surplus notes................................................................................................................................................. Surplus (contributed to) withdrawn from protected cells................................................................................................ Cumulative effect of changes in accounting principles................................................................................................... Capital changes: 32.1 Paid in................................................................................................................................................................... 32.2 Transferred from surplus (Stock Dividend)............................................................................................................ 32.3 Transferred to surplus........................................................................................................................................... Surplus adjustments: 33.1 Paid in................................................................................................................................................................... 33.2 Transferred to capital (Stock Dividend)................................................................................................................. 33.3 Transferred from capital........................................................................................................................................ Net remittances from or (to) Home Office...................................................................................................................... Dividends to stockholders.............................................................................................................................................. Change in treasury stock................................................................................................................................................ Aggregate write-ins for gains and losses in surplus....................................................................................................... Change in surplus as regards policyholders (Lines 22 through 37)............................................................................... Surplus as regards policyholders, as of statement date (Lines 21 plus 38)................................................................... 0501. 0502. 0503. 0598. 0599. 1401. 1402. 1403. 1498. 1499. 3701. 3702. 3703. 3798. 3799. DETAILS OF WRITE-INS ....................................................................................................................................................................................... ....................................................................................................................................................................................... ....................................................................................................................................................................................... Summary of remaining write-ins for Line 5 from overflow page..................................................................................... Totals (Lines 0501 thru 0503 plus 0598) (Line 5 above)................................................................................................ FHCF assessment written-off......................................................................................................................................... CPIC assessment written-off.......................................................................................................................................... ....................................................................................................................................................................................... Summary of remaining write-ins for Line 14 from overflow page................................................................................... Totals (Lines 1401 thru 1403 plus 1498) (Line 14 above).............................................................................................. ....................................................................................................................................................................................... ....................................................................................................................................................................................... ....................................................................................................................................................................................... Summary of remaining write-ins for Line 37 from overflow page................................................................................... Totals (Lines 3701 thru 3703 plus 3798) (Line 37 above).............................................................................................. 33. Q04 ................15,779,545 .....................224,707 ................................... .......................68,270 ................................... ....................(345,097) ........................(8,812) ................................... ................................... ................................... ................................... ................12,204,193 .....................581,017 ................................... ......................(20,114) ................................... ....................(197,546) .....................197,545 ................................... ..................2,500,000 ................................... ................................... ................12,204,193 .....................567,698 ................................... ......................(88,657) ................................... .....................269,694 .....................326,617 ................................... ..................2,500,000 ................................... ................................... ................................... ..................4,990,000 ..................4,990,000 ................................... ................................... ................................... ................................... ................................... ................................... ................................... ................................... ................................... ................................... ................................... ................................... ................................0 ......................(60,932) ................15,718,613 .................(4,990,000) ................................... ................................... ................................... ................................... ................................... ................................0 ..................3,060,902 ................15,265,095 .................(4,990,000) ................................... ................................... ................................... ................................... ................................... ................................0 ..................3,575,352 ................15,779,545 ................................... ................................... ................................... ................................0 ................................0 .............................(21) .............................(10) ................................... ................................0 .............................(31) ................................... ................................... ................................... ................................0 ................................0 ................................... ................................... ................................... ................................0 ................................0 .............................(33) ...........................(139) ................................... ................................0 ...........................(172) ................................... ................................... ................................... ................................0 ................................0 ................................... ................................... ................................... ................................0 ................................0 .............................(73) ...........................(240) ................................... ................................0 ...........................(313) ................................... ................................... ................................... ................................0 ................................0 Statement for June 30, 2014 of the Prepared Insurance Company CASH FLOW 1 Current Year to Date 2 Prior Year To Date 3 Prior Year Ended December 31 CASH FROM OPERATIONS 1. Premiums collected net of reinsurance............................................................................................................................... ...............21,116,970 ...............18,540,038 ...............28,700,262 2. Net investment income........................................................................................................................................................ ....................557,960 ....................467,541 ....................968,930 3. Miscellaneous income......................................................................................................................................................... .......................(3,247) ......................18,274 ......................54,841 4. Total (Lines 1 through 3)..................................................................................................................................................... ...............21,671,683 ...............19,025,853 ...............29,724,033 5. Benefit and loss related payments...................................................................................................................................... .................4,649,777 .................3,481,982 .................6,784,888 6. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts................................................ ................................... ................................... ................................... 7. Commissions, expenses paid and aggregate write-ins for deductions.............................................................................. .................7,658,605 .................5,895,857 ...............12,380,234 8. Dividends paid to policyholders........................................................................................................................................... ................................... ................................... ................................... 9. Federal and foreign income taxes paid (recovered) net of $..........0 tax on capital gains (losses)................................... ....................700,000 ....................160,000 ...................(230,218) 10. Total (Lines 5 through 9)..................................................................................................................................................... ...............13,008,382 .................9,537,839 ...............18,934,904 11. Net cash from operations (Line 4 minus Line 10)............................................................................................................... .................8,663,301 .................9,488,014 ...............10,789,129 12. Proceeds from investments sold, matured or repaid: CASH FROM INVESTMENTS 12.1 Bonds........................................................................................................................................................................ .................2,822,340 .................6,030,496 ...............10,084,040 12.2 Stocks........................................................................................................................................................................ ................................... ....................999,403 ....................999,403 12.3 Mortgage loans......................................................................................................................................................... ................................... ................................... ................................... 12.4 Real estate................................................................................................................................................................ ................................... ................................... ................................... 12.5 Other invested assets............................................................................................................................................... ................................... ................................... ................................... 12.6 Net gains or (losses) on cash, cash equivalents and short-term investments......................................................... ................................... ................................... .............................84 12.7 Miscellaneous proceeds........................................................................................................................................... .....................(22,392) ................................... ................................... 12.8 Total investment proceeds (Lines 12.1 to 12.7)....................................................................................................... .................2,799,948 .................7,029,899 ...............11,083,527 13. Cost of investments acquired (long-term only): 13.1 Bonds........................................................................................................................................................................ .................3,377,536 .................6,550,671 ...............14,247,367 13.2 Stocks........................................................................................................................................................................ ......................23,771 .................1,999,413 .................2,027,738 13.3 Mortgage loans......................................................................................................................................................... ................................... ................................... ................................... 13.4 Real estate................................................................................................................................................................ ................................... ................................... ................................... 13.5 Other invested assets............................................................................................................................................... ................................... ................................... ................................... 13.6 Miscellaneous applications....................................................................................................................................... ................................... ................................... ................................... 13.7 Total investments acquired (Lines 13.1 to 13.6)...................................................................................................... .................3,401,307 .................8,550,084 ...............16,275,105 14. Net increase or (decrease) in contract loans and premium notes...................................................................................... ................................... ................................... ................................... 15. Net cash from investments (Line 12.8 minus Line 13.7 and Line 14)................................................................................ ...................(601,359) ................(1,520,185) ................(5,191,578) 16. Cash provided (applied): CASH FROM FINANCING AND MISCELLANEOUS SOURCES 16.1 Surplus notes, capital notes...................................................................................................................................... ................................... .................2,500,000 .................2,500,000 16.2 Capital and paid in surplus, less treasury stock....................................................................................................... ................................... ................................... ................................... 16.3 Borrowed funds......................................................................................................................................................... ................................... ................................... ................................... 16.4 Net deposits on deposit-type contracts and other insurance liabilities.................................................................... ................................... ................................... ................................... 16.5 Dividends to stockholders......................................................................................................................................... ................................... ................................... ................................... 16.6 Other cash provided (applied).................................................................................................................................. ....................431,346 ...................(388,772) ....................926,656 17. Net cash from financing and miscellaneous sources (Lines 16.1 through 16.4 minus Line 16.5 plus Line 16.6)............ ....................431,346 .................2,111,228 .................3,426,656 RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 18. Net change in cash, cash equivalents and short-term investments (Line 11 plus Line 15 plus Line 17).......................... .................8,493,288 ...............10,079,057 .................9,024,207 19. Cash, cash equivalents and short-term investments: 19.1 Beginning of year...................................................................................................................................................... ...............12,384,281 .................3,360,074 .................3,360,074 19.2 End of period (Line 18 plus Line 19.1)..................................................................................................................... ...............20,877,569 ...............13,439,131 ...............12,384,281 Note: Supplemental disclosures of cash flow information for non-cash transactions: 20.0001 ................................................................................................................................................................................... ................................... ................................... ................................... Q05 Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS Note 1 - Summary of Significant Accounting Policies A. Accounting Practices State of Domicile NET INCOME (1) Prepared Insurance Company state basis (Page 4, Line 20, Columns 1 & 3) (2) State Prescribed Practices that increase/decrease NAIC SAP 2014 2013 FL 224,707 567,698 FL 224,707 567,698 FL 15,718,613 15,779,545 FL 15,718,613 15,779,545 (3) State Permitted Practices that increase/decrease NAIC SAP (4) NAIC SAP (1 – 2 – 3 = 4) SURPLUS (5) Prepared Insurance Company state basis (Page 3, line 37, Columns 1 & 2) (6) State Prescribed Practices that increase/decrease NAIC SAP (7) State Permitted Practices that increase/decrease NAIC SAP (8) NAIC SAP (5 – 6 – 7 = 8) The accompanying financial statements of Prepared Insurance Company have been prepared on the statutory basis of accounting as defined and in accordance with the NAIC Accounting Practices and Procedures manual except to the extent state law differs. The Commissioner of the Florida Office of Insurance Regulation has the right to permit specific practices that deviate from prescribed practices. B. 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. C. Accounting Policies Premiums are earned over the terms of the related insurance policies and reinsurance contracts. Unearned premium reserves are established to cover the unexpired portion of premiums written. Such reserves are computed by pro rata methods for direct and ceded business. Expenses incurred in connection with acquiring new insurance business, including such acquisition costs as sales commissions, are charged to operations as incurred. Expenses incurred are reduced for ceding allowances received or receivable. In addition, the company uses the following accounting policies: 1. Short-term investments are stated at amortized cost. Non-investment grade short-term investments are stated at the lower of amortized value or fair value. 2. Investment grade bonds not backed by other loans are stated at amortized value using the interest method. Non-investment grade bonds with NAIC designations of 3 through 6 are stated at the lower of amortized value or fair value. 3. Investments in common stocks are stated at market value. 4. Investments in preferred stocks are stated at market value. 5. The Company holds no mortgage loans. 6. The Company has no investments in loan-backed subsidiaries. 7. The Company has no investments in insurance subsidiaries. 8. The Company has no investments in limited partnerships. 9. The Company holds no derivatives. 10. The Company has no premium deficiency reserves. 11. Unpaid losses and loss adjustment expenses include an amount determined from individual case estimates and loss reports and an amount, based on industry experience, for losses incurred but not reported. 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 liability is continually reviewed and any adjustments are reflected in the period determined. Q06 Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS 12. The Company has not modified its capitalization policy from the prior period. 13. Not applicable as the Company does not write major medical insurance with prescription drug coverage. Note 2 - Accounting Changes and Corrections of Errors No significant change. Note 3 - Business Combinations and Goodwill No significant change. Note 4 - Discontinued Operations No significant change. Note 5 - Investments D. Loan-Backed Securities (1) 1 2 Amortized Cost Basis Before Other-than-Temporary Other-than-Temporary Impairment Recognized in Impairment Loss (2) 3 Fair Value 1–2 OTTI recognized 1st Quarter a. Intent to sell b. Inability or lack of intent to retain the investment in the security for a period of time sufficient to recover the amortized cost basis c. Total 1st Quarter OTTI recognized 2nd Quarter d. Intent to sell e. Inability or lack of intent to retain the investment in the security for a period of time sufficient to recover the amortized cost basis f. Total 2nd Quarter OTTI recognized 3rd Quarter g. h. i. Intent to sell Inability or lack of intent to retain the investment in the security for a period of time sufficient to recover the amortized cost basis Total 4th Quarter OTTI recognized 4th Quarter j. Intent to sell k. Inability or lack of intent to retain the investment in the security for a period of time sufficient to recover the amortized cost basis l. Total 4th Quarter m. Annual aggregate total XXX XXX (3) Recognized OTTI securities CUSIP Book/Adjusted Carrying Value Amortized Cost Before Current Period OTTI Present Value of Projected Cash Flows Recognized Other-Than-Tem porary Impairment Amortized Cost After Other-Than-Te mporary Impairment Fair Value at Time of OTTI Date of Financial Statement Where Reported Total (4) 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): E. a. The aggregate amount of unrealized losses: b. The aggregate related fair value of securities with unrealized losses: 1. 2. 1. 2. Repurchase Agreements and/or Securities Lending Transactions (3) Collateral Received Q06.1 Less than 12 Months 12 Months or Longer Less than12 Months 12 Months or Longer (4,185) (88,564) 1,483,508 3,622,514 Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS The fair value of that collateral and of the portion of that collateral that it has sold or repledged b F. Real Estate Not applicable G. Low Income Housing Tax Credits Not applicable H. Other Disclosures and Unusual Items Not applicable I. Working Capital Finance Investments (2) Aggregate Maturity Distribution on the Underlying Working Capital Finance Programs Book/Adjusted Carrying Value (a) (b) (c) Up to 180 Days 181 to 365 Days Total (3) Note 6 - Joint Ventures, Partnerships and Limited Liability Companies No significant change. Note 7 - Investment Income No significant change. Note 8 - Derivative Instruments No significant change. Note 9 - Income Taxes No significant change. Note 10 - Information Concerning Parent, Subsidiaries, Affiliates and Other Related Parties No significant change. Note 11 - Debt B. FHLB (Federal Home Loan Bank) Agreements (1) (2) a. FHLB Capital Stock – Aggregate Totals 1. Current Year 1 Total 2+3 (a) (b) (c) (d) (e) (f) 2. Membership Stock – Class A Membership Stock – Class B Activity Stock Excess Stock Aggregate Total Actual or estimated borrowing capacity as determined by the insurer 2 General Account 3 Protected Cell Accounts XXX XXX 2 General Account 3 Protected Cell Accounts Prior Year 1 Total 2+3 (a) (b) (c) Membership Stock – Class A Membership Stock – Class B Activity Stock Q06.2 Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS 1 Total 2+3 3 Protected Cell Accounts XXX XXX (d) (e) (f) b. Excess Stock Aggregate Total Actual or estimated borrowing capacity as determined by the insurer Membership Stock (Class A and B) Eligible for Redemption 2 General Account Current Period Total 1. Class A 2. Class B Not Eligible for Redemption Less Than 6 Months 6 Months to Less than 1 Year 1 to Less than 3 Years 3 to 5 Years (3) Collateral Pledged to FHLB a. Amount Pledged as of Reporting Date 1. Current Period Total General and Protected Cell Accounts Fair Value Total Collateral Pledged 2. Carrying Value Aggregate Total Borrowing Fair Value Carrying Value Aggregate Total Borrowing Fair Value Carrying Value Aggregate Total Borrowing Prior Year Total General and Protected Cell Accounts Fair Value Total Collateral Pledged Carrying Value Aggregate Total Borrowing Fair Value Carrying Value Amount of Borrowed at Time of Maximum Collateral Fair Value Carrying Value Amount of Borrowed at Time of Maximum Collateral Fair Value Carrying Value Amount of Borrowed at Time of Maximum Collateral Carrying Value Amount of Borrowed at Time of Maximum Collateral Current Period General Account Total Collateral Pledged 3. Current Period Protected Cell Accounts Total Collateral Pledged 4. b. Maximum Amount Pledged During Reporting Period 1. Current Period Total General and Protected Cell Accounts Total Collateral Pledged 2. Current Period General Account Total Collateral Pledged 3. Current Period Protected Cell Accounts Total Collateral Pledged 4. Prior Year Total General and Protected Cell Accounts Fair Value Total Collateral Pledged (4) Borrowing from FHLB a. Amount as of the Reporting Date 1. Current Year 1 Total 2+3 2 General Account 3 Protected Cell Account 4 Funding Agreements Established 1 Total 2+3 2 General Account 3 Protected Cell Account 4 Funding Agreements Established Maximum Amount During Reporting Period (Current Year) 1 Total 2+3 2 General Account 3 Protected Cell Account (a) (b) (c) (d) 2. Prior Year-end (a) (b) (c) (d) b. Debt Funding Agreements Other Aggregate Total Debt Funding Agreements Other Aggregate Total Q06.3 Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS 1. 2. 3. 4. c. Debt Funding Agreements Other Aggregate Total FHLB Prepayment Obligations Does the company have prepayment obligations under the following arrangements? 1. 2. 3. Debt Funding Agreements Other Note 12 - Retirement Plans, Deferred Compensation, Postemployment Benefits and Compensated Absences and Other Postretirement Benefit Plans A. Defined Benefit Plan (1) (2) (3) (4) Components of net periodic benefit cost Pension Benefits 2014 a. b. c. d. e. f. g. h. 2013 Postretirement Benefits 2014 2013 Postemployment 2014 2013 Service cost Interest cost Expected return on plan assets Transition asset or obligation Gains and losses Prior service cost or credit Gain or loss recognized due to a settlements curtailment Total net periodic benefit cost Note 13 - Capital and Surplus, Dividend Restrictions and Quasi-Reorganizations As of September 30, 2011 Prepared Insurance Company had a subordinate debenture of $ 800,000 payable to Prepared Holdings, LLC with interest at prime plus 2% adjusted quarterly, interest payable annually commencing March 31, 2011, with unpaid principal and interest due on December 31, 2014. Payments of all principal and interest are subject to advance approval by the Florida Office of Insurance Regulation. No accrued interest payable has been reflected against surplus as of September 30,2013. In accordance with SSAP # 72, on June 30, 2011, the Company filed with and received approval from the State of Florida Office of Insurance Regulation (OIR) of its request to approve the infusion of $1,400,000 of surplus notes which were funded on July 15, 2011. This $1,400,000 subordinate debenture is payable to Prepared Holdings, LLC with interest at prime plus 3% adjusted quarterly, interest payable annually commencing September 30 2011, with unpaid principal and interest due on December 31, 2015. No accrued interest payable has been reflected against surplus as of September 30,2013. In accordance with SSAP # 72, on December 18, 2012, the Company filed with and received approval from the State of Florida Office of Insurance Regulation (OIR) of its request to approve the infusion of $1,400,000 of surplus notes which were funded on January 15, 2013. This $1,400,000 subordinate debenture is payable to Prepared Holdings, LLC with interest at prime plus 5% adjusted quarterly, interest payable annually commencing March 31, 2013 with unpaid principal and interest due on December 31, 2018.No accrued interest payable has been reflected against surplus as of September 30,2013. In accordance with SSAP # 72, on May 7, 2013, the Company filed with and received approval from the State of Florida Office of Insurance Regulation (OIR) of its request to approve the infusion of $2,500,000 of surplus notes which were funded on May 24, 2013. This $2,500,000 subordinate debenture is payable to Prepared Holdings, LLC with interest at prime plus 5% adjusted quarterly, interest payable annually commencing July 1, 2013 with unpaid principal and interest due on December 31, 2019. No accrued interest payable has been reflected against surplus as of September 30,2013. Note 14 - Contingencies No significant change. Q06.4 Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS Note 15 - Leases No significant change. Note 16 - Information About Financial Instruments With Off-Balance Sheet Risk and Financial Instruments With Concentrations of Credit Risk No significant change. Note 17 - Sale, Transfer and Servicing of Financial Assets and Extinguishments of Liabilities A. Transfers of Receivables Reported as Sales Not applicable B. Transfer and Servicing of Financial Assets (2) b. (4) a. b. C. Wash Sales (1) In the course of the Company's asset management, securities are sold and reacquired within the 30 days of the sale date to enhance the yield of the investments. (2) The details by NAIC designation 3 or below, or unrated of securities sold during the current period, 2014 and reacquired within 30 days of the sale date are: NAIC Designation Description Number of Transactions Book Value of Securities Sold Cost of Securities Repurchased Gain/(Loss) Note 18 - Gain or Loss to the Reporting Entity from Uninsured Plans and the Uninsured Portion of Partially Insured Plans No significant change. Note 19 - Direct Premium Written/Produced by Managing General Agents/Third Party Administrators No significant change. Note 20 - Fair Value A. (1) Fair Value Measurements at Reporting Date Assets at Fair Value Perpetual Preferred Stocks Total Liabilities at Fair Value Level 1 428,420 428,420 Level 2 Level 3 Total 428,420 428,420 Level 1 Level 2 Level 3 Total Total (2) Fair Value Measurements in (Level 3) of the Fair Value Hierarchy a. Assets Beginning Balance at Period Transfers Into Level 3 Transfers Out of Level 3 Total Gains and (Losses) Included in Net Income Total Gains and (Losses) Included in Surplus Transfers Out of Level 3 Total Gains and (Losses) Included in Net Income Total Gains and (Losses) Included in Surplus Purchases Issuances Sales Settlements Ending Balance at Period Settlements Ending Balance at Period Total b. Liabilities Beginning Balance at Period Transfers Into Level 3 Total (3) (4) Q06.5 Purchases Issuances Sales Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS (5) B. C. Type of Financial Instrument Aggregate Fair Value Admitted Assets (Level 1) (Level 2) (Level 3) Total D. Not Practicable to Estimate Fair Value Type of Class or Financial Instrument Carrying Value Effective Interest Rate 0.000 Maturity Date Explanation Total Note 21 - Other Items The Company is not authorized to write Workers Compensation Insurance in the state of Florida , and the Company does not take credit for any recoveries from the Special Disability Trust Fund. Agent's Balance Certification Amounts A 1. Agent's Balances or Uncollected Premium as reported (page 2, Line 15.1) $ 217,056 2. Amount of Agents' Balances or Uncollected Premiums (from Page 2, Line 15.1) that is due from "controlled” or "controlling" persons Amount Reported in #2 above and secured by a : Trust Fund, Letter of Credit, N/A and Financial Guaranty Bond as required by Section 625.012, Florida Statutes. G. Offsetting and Netting of Assets and Liabilities I. Risk Sharing Provisions of the Affordable Care Act (1) Permanent Risk Adjustment Program Assets a. Premium adjustments receivable Amount $ Liabilities b. Risk adjustment user fees payable c. Premium adjustments payable $ $ Operations (Revenue & Expense) d. Premium for accident and health contracts (written/collected) $ (2) Transitional Reinsurance Program Assets a. Amounts recoverable for claims paid b. Amounts recoverable for claims unpaid c. Amounts receivable relating to uninsured plans $ $ $ Liabilities d. Claims unpaid-ceded e. Contributions payable-not reported as ceded premium f. Ceded reinsurance premiums payable g. Liability for amounts held under uninsured plans $ $ $ $ Operations (Revenue & Expense) h. Ceded reinsurance premiums i. Reinsurance recoveries j. Contributions-not reported as ceded premium $ $ $ (3) Temporary Risk Corridors Program Assets a. Accrued retrospective premium $ Liabilities b. Reserve for rate credits or policy experience rating refunds $ Operations (Revenue & Expense) c. Net premium income (paid/received) d. Change in reserves for rate credits $ $ Q06.6 N/A Not Practicable (Carrying Value) Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS (4) Have there been any material re-estimations and/or impairments for the reporting period Yes/No Note 22 - Events Subsequent No significant change. Note 23 - Reinsurance No significant change. Note 24 - Retrospectively Rated Contracts & Contracts Subject to Redetermination F. Risk Sharing Provisions of the Affordable Care Act (1) Permanent Risk Adjustment Program Assets a. Premium adjustments receivable Amount $ Liabilities b. Risk adjustment user fees payable c. Premium adjustments payable $ $ Operations (Revenue & Expense) d. Premium for accident and health contracts (written/collected) $ (2) Transitional Reinsurance Program Assets a. Amounts recoverable for claims paid b. Amounts recoverable for claims unpaid c. Amounts receivable relating to uninsured plans $ $ $ Liabilities d. Claims unpaid-ceded e. Contributions payable-not reported as ceded premium f. Ceded reinsurance premiums payable g. Liability for amounts held under uninsured plans $ $ $ $ Operations (Revenue & Expense) h. Ceded reinsurance premiums i. Reinsurance recoveries j. Contributions-not reported as ceded premium $ $ $ (3) Temporary Risk Corridors Program Assets a. Accrued retrospective premium $ Liabilities b. Reserve for rate credits or policy experience rating refunds $ Operations (Revenue & Expense) c. Net premium income (paid/received) d. Change in reserves for rate credits $ $ (4) Have there been any material re-estimations and/or impairments for the reporting period Yes/No Note 25 - Change in Incurred Losses and Loss Adjustment Expenses Reserves as of June 30, 2014 were $7,695,158. As of June 30, 2014, $3,643,207 has been paid for incurred losses and loss adjustment expenses attributable to insured events of prior years. Reserves remaining for prior years are now $3,691,471 as a result of re-estimation of unpaid claims and claim adjustment expense principally on homeowners lines of insurance. There has been no significant development of prior-year losses as of June 30, 2014. Note 26 - Intercompany Pooling Arrangements No significant change. Note 27 - Structured Settlements No significant change. Note 28 - Health Care Receivables No significant change. Note 29 - Participating Policies No significant change. Note 30 - Premium Deficiency Reserves Q06.7 Statement for June 30, 2014 of the Prepared Insurance Company NOTES TO FINANCIAL STATEMENTS No significant change. Note 31 - High Deductibles No significant change. Note 32 - Discounting of Liabilities for Unpaid Losses or Unpaid Loss Adjustment Expenses No significant change. Note 33 - Asbestos/Environmental Reserves No significant change. Note 34 - Subscriber Savings Accounts No significant change. Note 35 - Multiple Peril Crop Insurance No significant change. Note 36 - Financial Guaranty Insurance The Company does not write Financial Guaranty Insurance. B. Schedule of Insured Financial Obligations at the End of the Period: A 1. 2. 3. B Number of policies Remaining weighted average contract period (in years) Insured contractual payments outstanding: a. Principal b. Interest c. Total Gross claim liability 4. Less 5. a. Gross potential recoveries b. Discount, net 6. Net claim liability 7. Unearned premium revenue 8. Reinsurance recoverables Q06.8 Surveillance Categories C D Total Statement for June 30, 2014 of the Prepared Insurance Company GENERAL INTERROGATORIES PART 1 - COMMON INTERROGATORIES - GENERAL 1.1 Did the reporting entity experience any material transactions requiring the filing of Disclosure of Material Transactions with the State of Domicile, as required by the Model Act? Yes [ ] No [ X ] 1.2 If yes, has the report been filed with the domiciliary state? Yes [ ] No [ X ] 2.1 Has any change been made during the year of this statement in the charter, by-laws, articles of incorporation, or deed of settlement of the reporting entity? Yes [ ] No [ X ] 2.2 If yes, date of change: 3.1 Is the reporting entity a member of an Insurance Holding Company System consisting of two or more affiliated persons, one or more of which is an insurer? ........................................ Yes [ X ] No [ ] Yes [ ] No [ X ] Yes [ ] No [ X ] If yes, complete Schedule Y, Parts 1 and 1A. 3.2 Have there been any substantial changes in the organizational chart since the prior quarter end? 3.3 If the response to 3.2 is yes, provide a brief description of those changes. 4.1 Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? 4.2 If yes, provide name of entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that has ceased to exist as a result of the merger or consolidation. 1 2 3 NAIC State of Name of Entity Company Code Domicile 5. If the reporting entity is subject to a management agreement, including third-party administrator(s), managing general agent(s), attorney-in-fact, or similar agreement, have there been any significant changes regarding the terms of the agreement or principals involved? If yes, attach an explanation. Yes [ ] No [ X ] N/A [ ] 6.1 State as of what date the latest financial examination of the reporting entity was made or is being made. Florida............................. 6.2 State the as of date that the latest financial examination report became available from either the state of domicile or the reporting entity. This date should be the date of the examined balance sheet and not the date the report was completed or released. ..........12/31/2012............ State as of what date the latest financial examination report became available to other states or the public from either the state of domicile or the reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheet date). ..........6/20/2014.............. 6.3 6.4 By what department or departments? Florida Office of Insurance Regulation 6.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? Yes [ ] No [ ] N/A [ X ] 6.6 Have all of the recommendations within the latest financial examination report been complied with? Yes [ ] No [ ] N/A [ X ] 7.1 Has this reporting entity had any Certificates of Authority, licenses or registrations (including corporate registration, if applicable) suspended or revoked by any governmental entity during the reporting period? 7.2 If yes, give full information: 8.1 Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? 8.2 If response to 8.1 is yes, please identify the name of the bank holding company. 8.3 Is the company affiliated with one or more banks, thrifts or securities firms? 8.4 If the response to 8.3 is yes, please provide below the names and location (city and state of the main office) of any affiliates regulated by a federal Yes [ ] No [ X ] Yes [ ] No [ X ] Yes [ ] No [ X ] Yes [ X ] No [ ] Yes [ ] No [ X ] Yes [ ] No [ X ] regulatory services agency [i.e. the Federal Reserve Board (FRB), the Office of the Comptroller of the Currency (OCC), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identify the affiliate's primary federal regulator]. 9.1 1 2 3 4 5 6 Affiliate Name Location (City, State) FRB OCC FDIC SEC Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions) of the reporting entity subject to a code of ethics, which includes the following standards? (a) Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional relationships; (b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity; (c) Compliance with applicable governmental laws, rules and regulations; (d) The prompt internal reporting of violations to an appropriate person or persons identified in the code; and (e) Accountability for adherence to the code. 9.11 If the response to 9.1 is No, please explain: 9.2 Has the code of ethics for senior managers been amended? 9.21 If the response to 9.2 is Yes, provide information related to amendment(s). 9.3 Have any provisions of the code of ethics been waived for any of the specified officers? Q07 Statement for June 30, 2014 of the Prepared Insurance Company GENERAL INTERROGATORIES PART 1 - COMMON INTERROGATORIES - GENERAL 9.31 If the response to 9.3 is Yes, provide the nature of any waiver(s). PART 1 - FINANCIAL 10.1 Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page 2 of this statement? Yes [ X ] 10.2 If yes, indicate any amounts receivable from parent included in the Page 2 amount: No [ ] $............................................0 PART 1 - INVESTMENT 11.1 Were any of the stocks, bonds, or other assets of the reporting entity loaned, placed under option agreement, or otherwise made available for use by another person? (Exclude securities under securities lending agreements.) Yes [ ] No [ X ] 11.2 If yes, give full and complete information relating thereto: 12. Amount of real estate and mortgages held in other invested assets in Schedule BA: $................................0 13. Amount of real estate and mortgages held in short-term investments: $................................0 14.1 Does the reporting entity have any investments in parent, subsidiaries and affiliates? Yes [ ] 14.2 If yes, please complete the following: 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 Bonds............................................................................................................................................................. Preferred Stock.............................................................................................................................................. Common Stock............................................................................................................................................... Short-Term Investments................................................................................................................................. Mortgage Loans on Real Estate..................................................................................................................... All Other......................................................................................................................................................... Total Investment in Parent, Subsidiaries and Affiliates (Subtotal Lines 14.21 to 14.26)................................ Total Investment in Parent included in Lines 14.21 to 14.26 above............................................................... No [ X ] 1 2 Prior Year-End Current Quarter Book/Adjusted Carrying Value Book/Adjusted Carrying Value $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 $ ..................................0 15.1 Has the reporting entity entered into any hedging transactions reported on Schedule DB? Yes [ ] No [ X ] 15.2 If yes, has a comprehensive description of the hedging program been made available to the domiciliary state? If no, attach a description with this statement. Yes [ ] No [ ] 16. For the reporting entity's security lending program, state the amount of the following as of current statement date: 16.1 Total fair value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2: 16.2 Total book adjusted/carrying value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2: 16.3 Total payable for securities lending reported on the liability page: $................................0 $................................0 $................................0 17. Excluding items in Schedule E-Part 3-Special Deposits, real estate, mortgage loans and investments held physically in the reporting entity's offices, vaults or safety deposit boxes, were all stocks, bonds and other securities, owned throughout the current year held pursuant to a custodial agreement with a qualified bank or trust company in accordance with Section 1, III - General Examination Considerations, F. Outsourcing of Critical Functions, Custodial or Safekeeping Agreements of the NAIC Financial Condition Examiners Handbook? 17.1 For all agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following: 1 2 Name of Custodian(s) Custodian Address MORGAN STANLEY TRUST,N.A. 1 New York Plaza 7th Floor, New York, NY 10004 JHS CAPITAL ADVISORS, LLC 501 E Kennedy Blvd, Tampa FL 33602 17.2 For all agreements that do not comply with the requirements of the NAIC Financial Condition Examiners Handbook, provide the name, location and a complete explanation. 1 2 Name(s) Location(s) 17.3 Have there been any changes, including name changes, in the custodian(s) identified in 17.1 during the current quarter? 17.4 If yes, give full and complete information relating thereto: 1 Old Custodian 17.5 2 New Custodian 3 Date of Change Identify all investment advisors, broker/dealers or individuals acting on behalf of broker/dealers that have access to the investment accounts, handle securities and have authority to make investments on behalf of the reporting entity: 1 2 Central Registration Depository Name(s) Q07.1 Yes [ X ] No [ ] Yes [ ] No [ X ] 3 Complete Explanation(s) 4 Reason 3 Address Statement for June 30, 2014 of the Prepared Insurance Company PART 1 - INVESTMENT 18.1 Have all the filing requirements of the Purposes and Procedures Manual of the NAIC Securities Valuation Office been followed? 18.2 If no, list exceptions: Q07.2 Yes [ X ] No [ ] Statement for June 30, 2014 of the Prepared Insurance Company GENERAL INTERROGATORIES (continued) PART 2 PROPERTY & CASUALTY INTERROGATORIES 1. If the reporting entity is a member of a pooling arrangement, did the agreement or the reporting entity's participation change? Yes [ ] No [ ] N/A [ X ] If yes, attach an explanation. 2. Has the reporting entity reinsured any risk with any other reporting entity and agreed to release such entity from liability, in whole or in part, from any loss that may occur on the risk, or portion thereof, reinsured? Yes [ ] No [ X ] Yes [ ] No [ X ] If yes, attach an explanation. 3.1 Have any of the reporting entity's primary reinsurance contracts been canceled? 3.2 If yes, give full and complete information thereto: 4.1 Are any of the liabilities for unpaid losses and loss adjustment expenses other than certain workers' compensation tabular reserves (see Annual Statement Instructions pertaining to disclosure of discounting for definition of "tabular reserves,") discounted at a rate of interest greater than zero? Yes [ ] No [ X ] 4.2 If yes, complete the following schedule: 1 2 3 Total Discount Discount Taken During Period 4 5 6 7 8 9 10 11 Maximum Disc. Unpaid Unpaid Unpaid Unpaid Line of Business Interest Rate Losses LAE IBNR Total Losses LAE IBNR Total ................... ....................... ....................... ....................... ....................... ....................0 ....................... ....................... ....................... ....................0 Total..................................... ........XXX... ........XXX........ ....................0 ....................0 ....................0 ....................0 ....................0 ....................0 ....................0 ....................0 5. Operating Percentages: 5.1 A&H loss percent 0.0 % 5.2 A&H cost containment percent 0.0 % 5.3 A&H expense percent excluding cost containment expenses 0.0 % 6.1 Do you act as a custodian for health savings accounts? Yes [ ] No [ X ] Yes [ ] No [ X ] 6.2 If yes, please provide the amount of custodial funds held as of the reporting date. 0 6.3 Do you act as an administrator for health savings accounts? 6.4 If yes, please provide the amount of funds administered as of the reporting date. 0 Q08 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE F - CEDED REINSURANCE Showing All New Reinsurers - Current Year to Date 1 2 3 4 5 6 7 NAIC Certified Effective Date Company ID Domiciliary Type of Reinsurer Rating of Certified Code Number Name of Reinsurer Jurisdiction Reinsurer (1 through 6) Reinsurer Rating U.S. Insurers 19453................. 135616275.......... Transatlantic Reinsurance Company.................................................................................... NY............. Authorized........ .......................... ......................... 22039................. 132673100.......... General Reinsurance Corporation........................................................................................ DE............. Authorized........ .......................... ......................... All Other Insurers 00000................. AA3191190.......... Hamilton Re.......................................................................................................................... BMU.......... Unauthorized.... .......................... ......................... 00000................. AA1120158.......... Lloyd's Syndicate No.2014 ACA........................................................................................... GBR.......... Certified............ ..........3............. .......01/01/2011 00000................. CR3190829.......... Markel Bermuda Ltd ............................................................................................................ BMU.......... Certified............ ..........3............. .......07/01/2011 00000................. AA3191264.......... Market RE Ltd 2014-2 Prepared (c/o Horeshoe Management) ........................................... BMU.......... Unauthorized.... .......................... ......................... 00000................. AA3190686.......... Partner Re Ltd. .................................................................................................................... BMU.......... Certified............ ..........3............. .......01/01/2011 00000................. AA5320039.......... Peak Reinsurance Company Ltd (Pioneer Underwriters)..................................................... HKG.......... Unauthorized.... .......................... ......................... Q09 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE T - EXHIBIT OF PREMIUMS WRITTEN Current Year to Date - Allocated by States and Territories 1 States, Etc. Active Status Direct Premiums Written 2 3 Current Year Prior Year to Date to Date Direct Losses Paid (Deducting Salvage) 4 5 Current Year Prior Year to Date to Date Direct Losses Unpaid 6 7 Current Year Prior Year to Date to Date 1. Alabama..................................AL .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 2. Alaska.....................................AK .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 3. Arizona....................................AZ .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 4. Arkansas................................AR .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 5. California................................CA .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 6. Colorado................................CO .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 7. Connecticut.............................CT .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 8. Delaware................................DE .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 9. District of Columbia................DC .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 10. Florida.....................................FL .......L........ ...............28,115,918 ...............23,304,461 .................4,649,778 .................3,481,772 .................3,441,717 .................4,456,840 11. Georgia..................................GA .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 12. Hawaii......................................HI .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 13. Idaho........................................ID .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 14. Illinois.......................................IL .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 15. Indiana.....................................IN .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 16. Iowa.........................................IA .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 17. Kansas....................................KS .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 18. Kentucky.................................KY .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 19. Louisiana.................................LA .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 20. Maine.....................................ME .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 21. Maryland................................MD .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 22. Massachusetts.......................MA .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 23. Michigan..................................MI .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 24. Minnesota..............................MN .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 25. Mississippi..............................MS .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 26. Missouri.................................MO .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 27. Montana.................................MT .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 28. Nebraska................................NE .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 29. Nevada...................................NV .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 30. New Hampshire......................NH .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 31. New Jersey.............................NJ .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 32. New Mexico...........................NM .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 33. New York................................NY .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 34. North Carolina........................NC .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 35. North Dakota..........................ND .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 36. Ohio.......................................OH .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 37. Oklahoma...............................OK .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 38. Oregon...................................OR .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 39. Pennsylvania..........................PA .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 40. Rhode Island............................RI .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 41. South Carolina........................SC .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 42. South Dakota..........................SD .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 43. Tennessee..............................TN .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 44. Texas......................................TX .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 45. Utah........................................UT .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 46. Vermont..................................VT .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 47. Virginia....................................VA .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 48. Washington............................WA .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 49. West Virginia.........................WV .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 50. Wisconsin................................WI .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 51. Wyoming................................WY .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 52. American Samoa....................AS .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 53. Guam.....................................GU .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 54. Puerto Rico.............................PR .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 55. US Virgin Islands.....................VI .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 56. Northern Mariana Islands.......MP .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 57. Canada................................CAN .......N........ ................................... ................................... ................................... ................................... ................................... ................................... 58. Aggregate Other Alien............OT .....XXX..... ...............................0 ...............................0 ...............................0 ...............................0 ...............................0 ...............................0 59. Totals........................................... (a)..........1 ...............28,115,918 ...............23,304,461 .................4,649,778 .................3,481,772 .................3,441,717 .................4,456,840 58001. 58002. 58003. 58998. DETAILS OF WRITE-INS .................................................... .....XXX..... ................................... ................................... ................................... ................................... ................................... ................................... .................................................... .....XXX..... ................................... ................................... ................................... ................................... ................................... ................................... .................................................... .....XXX..... ................................... ................................... ................................... ................................... ................................... ................................... Summary of remaining write-ins for Line 58 from overflow page.... .....XXX..... ...............................0 ...............................0 ...............................0 ...............................0 ...............................0 ...............................0 58999. Totals (Lines 58001 thru 58003+ Line 58998) (Line 58 above)....... .....XXX..... ...............................0 ...............................0 ...............................0 ...............................0 ...............................0 ...............................0 (L) - Licensed or Chartered - Licensed Insurance Carrier or Domicilied RRG; (R) - Registered - Non-domiciled RRGs; (Q) - Qualified - Qualified or Accredited Reinsurer; (E) - Eligible - Reporting Entities eligible or approved to write Surplus Lines in the state; (N) - None of the above - Not allowed to write business in the state. (a) Insert the number of L responses except for Canada and Other Alien. Q10 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE Y – INFORMATION CONCERNING ACTIVITIES OF INSURER MEMBERS OF A HOLDING COMPANY GROUP PART 1 – ORGANIZATIONAL CHART P r e p a r e d H o ld in g s , L L C (P H L L C ) F T IN : 2 7 -1 2 0 3 0 8 5 Q11 P re p a re d In s u ra n c e C o (P IC ) F T IN : 2 6 -4 7 5 6 8 7 2 P re p a re d M a n a g e rs , L L C (P M L L C ) F T IN : 2 6 2 9 3 8 2 0 2 P re p a re d In v e s to rs & B o a r d o f D ir e c to r s P r e p a r e d F in a n c ia l S e r v ic e s , L L C (P F L L C ) F T IN : 4 5 -5 3 3 3 0 1 2 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE Y 1 2 3 4 5 6 7 Name of Securities Exchange if Publicly Traded (U.S. or International) PART 1A - DETAIL OF INSURANCE HOLDING COMPANY SYSTEM 8 9 10 11 12 13 Type of Control (Ownership Board, If Control is Management Ownership Attorney-in-Fact, Provide Influence, Other) Percentage 14 15 NAIC Federal Names of Relationship Group Group Company ID Federal Parent, Subsidiaries Domiciliary to Reporting Directly Controlled by Ultimate Controlling Code Name Code Number RSSD CIK or Affiliates Location Entity (Name of Entity/Person) Entity(ies)/Person(s) * Members .............. ....................................................... ............... 27-1203085 ................... ................... .......................... Prepared Holdings, LLC......................................... DE............ UDP............. Investors............................................................. Board................ ...100.000 Prepared Holdings, LLC..................................... ............. .............. ....................................................... ............... 26-2938202 ................... ................... .......................... Prepared Managers, LLC....................................... FL............. NIA............... Prepared Holdings, LLC..................................... Board................ ...100.000 Prepared Holdings, LLC..................................... ............. .............. ....................................................... 13687...... 26-4756872 ................... ................... .......................... Prepared Insurance Company................................ FL............. IA................. Prepared Holdings, LLC..................................... Board................ ...100.000 Prepared Holdings, LLC..................................... ............. .............. ....................................................... ............... 45-5333012 ................... ................... .......................... Prepared Financial Service, LLC............................ FL............. IA................. Prepared Holdings, LLC..................................... Board................ ...100.000 Prepared Holdings, LLC..................................... ............. Q12 Asterisk Explanation NONE Statement for June 30, 2014 of the Prepared Insurance Company PART 1 - LOSS EXPERIENCE 1. 2. 3. 4. 5. 6. 8. 9. 10. 11.1. 11.2. 12. 13. 14. 15. 16. 17.1 17.2 17.3 18.1 18.2 19.1, 19.3, 21. 22. 23. 24. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. Lines of Business Fire................................................................................................................. Allied lines...................................................................................................... Farmowners multiple peril.............................................................................. Homeowners multiple peril............................................................................. Commercial multiple peril............................................................................... Mortgage guaranty......................................................................................... Ocean marine................................................................................................ Inland marine................................................................................................. Financial guaranty.......................................................................................... Medical professional liability - occurrence..................................................... Medical professional liability - claims-made................................................... Earthquake..................................................................................................... Group accident and health............................................................................. Credit accident and health............................................................................. Other accident and health.............................................................................. Workers' compensation.................................................................................. Other liability-occurrence............................................................................... Other liability-claims made............................................................................. Excess workers' compensation...................................................................... Products liability-occurrence.......................................................................... Products liability-claims made........................................................................ 19.2 Private passenger auto liability............................................................. 19.4 Commercial auto liability....................................................................... Auto physical damage.................................................................................... Aircraft (all perils)........................................................................................... Fidelity............................................................................................................ Surety............................................................................................................. Burglary and theft........................................................................................... Boiler and machinery..................................................................................... Credit............................................................................................................. International................................................................................................... Warranty........................................................................................................ Reinsurance-nonproportional assumed property........................................... Reinsurance-nonproportional assumed liability............................................. Reinsurance-nonproportional assumed financial lines.................................. Aggregate write-ins for other lines of business.............................................. Totals............................................................................................................. 3401. 3402. 3403. 3498. 3499. ....................................................................................................................... ....................................................................................................................... ....................................................................................................................... Sum. of remaining write-ins for Line 34 from overflow page.......................... Totals (Lines 3401 thru 3403 plus 3498) (Line 34)........................................ Current Year to Date 1 2 Direct Premiums Direct Losses Earned Incurred .............................224,716 ...............................40,000 ..........................1,044,675 .............................200,000 ........................................... ........................................... ........................21,612,002 ..........................5,111,501 ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ...................XXX................. ...................XXX................. ...................XXX................. ...................XXX................. ...................XXX................. ...................XXX................. ........................................0 ........................................0 ........................22,881,393 ..........................5,351,501 DETAILS OF WRITE-INS ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................0 ........................................0 ........................................0 ........................................0 3 Direct Loss Percentage ...................................17.8 ...................................19.1 .....................................0.0 ...................................23.7 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 ...................XXX................. ...................XXX................. ...................XXX................. .....................................0.0 ...................................23.4 4 Prior Year to Date Direct Loss Percentage ...................................57.5 ...................................16.6 ........................................... ...................................17.4 ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ........................................... ...................XXX................. ...................XXX................. ...................XXX................. ........................................... ...................................17.8 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 .....................................0.0 ........................................... ........................................... ........................................... ...................XXX................. ........................................... PART 2 - DIRECT PREMIUMS WRITTEN 1. 2. 3. 4. 5. 6. 8. 9. 10. 11.1 11.2 12. 13. 14. 15. 16. 17.1 17.2 17.3 18.1 18.2 19.1 19.3 21. 22. 23. 24. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. Lines of Business Fire................................................................................................................... Allied lines........................................................................................................ Farmowners multiple peril................................................................................ Homeowners multiple peril............................................................................... Commercial multiple peril................................................................................. Mortgage guaranty........................................................................................... Ocean marine................................................................................................... Inland marine.................................................................................................... Financial guaranty............................................................................................ Medical professional liability - occurrence........................................................ Medical professional liability - claims made..................................................... Earthquake....................................................................................................... Group accident and health............................................................................... Credit accident and health................................................................................ Other accident and health................................................................................ Workers' compensation.................................................................................... Other liability-occurrence.................................................................................. Other liability-claims made............................................................................... Excess workers' compensation........................................................................ Products liability-occurrence............................................................................ Products liability-claims made.......................................................................... 19.2 Private passenger auto liability................................................................ 19.4 Commercial auto liability......................................................................... Auto physical damage...................................................................................... Aircraft (all perils)............................................................................................. Fidelity.............................................................................................................. Surety............................................................................................................... Burglary and theft............................................................................................. Boiler and machinery........................................................................................ Credit................................................................................................................ International...................................................................................................... Warranty........................................................................................................... Reinsurance-nonproportional assumed property............................................. Reinsurance-nonproportional assumed liability................................................ Reinsurance-nonproportional assumed financial lines..................................... Aggregate write-ins for other lines of business................................................ Totals................................................................................................................ 3401. 3402. 3403. 3498. 3499. ......................................................................................................................... ......................................................................................................................... ......................................................................................................................... Sum. of remaining write-ins for Line 34 from overflow page............................ Totals (Lines 3401 thru 3403 plus 3498) (Line 34)........................................... 1 Current Quarter ............................................103,693 ............................................531,211 ........................................................... .......................................16,456,831 ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... .........................XXX.......................... .........................XXX.......................... .........................XXX.......................... .......................................................0 .......................................17,091,735 DETAILS OF WRITE-INS ........................................................... ........................................................... ........................................................... .......................................................0 .......................................................0 Q13 2 Current Year to Date ............................................234,365 .........................................1,114,292 ........................................................... .......................................26,767,261 ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... .........................XXX.......................... .........................XXX.......................... .........................XXX.......................... .......................................................0 .......................................28,115,918 3 Prior Year Year to Date ............................................209,235 ............................................954,381 ........................................................... .......................................22,140,845 ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... ........................................................... .........................XXX.......................... .........................XXX.......................... .........................XXX.......................... .......................................................0 .......................................23,304,461 ........................................................... ........................................................... ........................................................... .......................................................0 .......................................................0 ........................................................... ........................................................... ........................................................... .......................................................0 .......................................................0 Prepared Insurance Company Statement for June 30, 2014 of the PART 3 (000 omitted) LOSS AND LOSS ADJUSTMENT EXPENSE RESERVES SCHEDULE Years in Which Losses Occurred 1 2 3 Prior Year-End Known Case Loss and LAE Reserves Prior Year-End IBNR Loss and LAE Reserves Total Prior Year-End Loss and LAE Reserves (Cols. 1 + 2) 4 5 2014 2014 Loss and LAE Loss and LAE Payments on Claims Payments on Claims Reported as of Prior Unreported as of Year-End Prior Year-End 6 Total 2014 Loss and LAE Payments (Cols. 4 + 5) 7 8 Q.S. Date Known Q.S. Date Known Case Loss and Case Loss and LAE LAE Reserves on Reserves on Claims Claims Reported and Reported or Reopened Open as of Prior Subsequent to Year-End Prior Year-End 9 10 Q.S. Date IBNR Loss and LAE Reserves Total Q.S. Loss and LAE Reserves (Cols. 7 + 8 + 9) 11 12 Prior Year-End Known Prior Year-End Case Loss and LAE IBNR Loss and LAE Reserves Developed Reserves Developed (Savings)/Deficiency (Savings)/Deficiency (Cols. 4 + 7 (Cols. 5 + 8 + 9 minus Col. 1) minus Col. 2) 13 Prior Year-End Total Loss and LAE Reserve Developed (Savings)/Deficiency (Cols. 11 + 12) 1. 2011 + Prior........ .......................1,330 ..............................5 .......................1,335 ...........................635 ...............................1 ..........................636 ...........................888 ..................................... ................................. ..........................888 .............................193 ...............................(4) ............................189 2. 2012.................. .......................1,255 ..........................188 .......................1,443 ...........................872 ................................... ..........................872 ...........................760 ..................................... ................................. ..........................760 .............................377 ...........................(188) ............................189 3. Subtotals 2012 + Prior........ .......................2,585 ..........................193 .......................2,778 ........................1,507 ...............................1 .......................1,508 ........................1,648 .................................0 ..............................0 .......................1,648 .............................570 ...........................(192) ............................378 4. 2013.................. .......................2,570 .......................1,608 .......................4,178 ........................2,018 ...........................117 .......................2,135 ........................1,204 ..................................... ..........................839 .......................2,043 .............................652 ...........................(652) ................................0 5. Subtotals 2013 + Prior........ .......................5,155 .......................1,801 .......................6,956 ........................3,525 ...........................118 .......................3,643 ........................2,852 .................................0 ..........................839 .......................3,691 ..........................1,222 ...........................(844) ............................378 Q14 6. 2014................... ...............XXX........... ...............XXX........... ...............XXX........... ...............XXX............ ........................2,027 .......................2,027 ...............XXX............ ..........................2,811 .......................1,192 .......................4,003 ...............XXX.............. ...............XXX............. ...............XXX............. 7. Totals.................. .......................5,155 .......................1,801 .......................6,956 ........................3,525 ........................2,145 .......................5,670 ........................2,852 ..........................2,811 .......................2,031 .......................7,694 ..........................1,222 ...........................(844) ............................378 8. Prior YearEnd's Surplus As Regards Policyholders Col. 11, Line 7 As % of Col. 1, Line 7 Col. 12, Line 7 As % of Col. 2, Line 7 Col. 13, Line 7 As % of Col. 3, Line 7 .....................15,780 1. ....................23.7 % 2. ..................(46.9)% 3. .....................5.4 % Col. 13, Line 7 Line 8 4. .....................2.4 % Statement for June 30, 2014 of the Prepared Insurance Company SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES The following supplemental reports are required to be filed as part of your statement filing. However, in the event that your company does not transact the type of business for which the special report must be filed, your response of NO to the specific interrogatory will be accepted in lieu of filing a "NONE" report and a bar code will be printed below. If the supplement is required of your company but is not being filed for whatever reason, enter SEE EXPLANATION and provide an explanation following the interrogatory questions. Response 1. Will the Trusteed Surplus Statement be filed with the state of domicile and the NAIC with this statement? NO 2. Will Supplement A to Schedule T (Medical Professional Liability Supplement) be filed with this statement? NO 3. Will the Medicare Part D Coverage Supplement be filed with the state of domicile and the NAIC with this statement? NO 4. Will the Director and Officer Supplement be filed with the state of domicile and the NAIC with this statement? NO Explanation: 1. 2. 3. 4. Bar Code: *13687201449000002* *13687201445500002* *13687201436500002* *13687201450500002* Q15 Statement for June 30, 2014 of the Prepared Insurance Company Overflow Page for Write-Ins NONE Q16 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE A - VERIFICATION Real Estate 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 2 Prior Year Ended Year to Date December 31 Book/adjusted carrying value, December 31 of prior year....................................................................................................... ...............................................0 ................................................... Cost of acquired: 2.1 Actual cost at time of acquisition...................................................................................................................................... ................................................... ................................................... 2.2 Additional investment made after acquisition................................................................................................................... ................................................... ................................................... Current year change in encumbrances................................................................................................................................... ................................................... ................................................... Total gain (loss) on disposals.................................................................................................................................................. ................................................... ................................................... Deduct amounts received on disposals................................................................................................................................... ................................................... ................................................... Total foreign exchange change in book/adjusted carrying value............................................................................................. ................................................... ................................................... Deduct current year's other than temporary impairment recognized....................................................................................... ................................................... ................................................... Deduct current year's depreciation.......................................................................................................................................... ................................................... ................................................... Book/adjusted carrying value at end of current period (Lines 1+2+3+4-5+6-7-8)................................................................... ...............................................0 ...............................................0 Deduct total nonadmitted amounts.......................................................................................................................................... ................................................... ................................................... Statement value at end of current period (Line 9 minus Line 10)............................................................................................ ...............................................0 ...............................................0 NONE SCHEDULE B - VERIFICATION Mortgage Loans 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 2 Prior Year Ended Year to Date December 31 Book value/recorded investment excluding accrued interest, December 31 of prior year....................................................... ...............................................0 ................................................... Cost of acquired: 2.1 Actual cost at time of acquisition...................................................................................................................................... ................................................... ................................................... 2.2 Additional investment made after acquisition................................................................................................................... ................................................... ................................................... Capitalized deferred interest and other................................................................................................................................... ................................................... ................................................... Accrual of discount.................................................................................................................................................................. ................................................... ................................................... Unrealized valuation increase (decrease)............................................................................................................................... ................................................... ................................................... Total gain (loss) on disposals.................................................................................................................................................. ................................................... ................................................... Deduct amounts received on disposals................................................................................................................................... ................................................... ................................................... Deduct amortization of premium and mortgage interest points and commitment fees............................................................ ................................................... ................................................... Total foreign exchange change in book value/recorded investment excluding accrued interest............................................. ................................................... ................................................... Deduct current year's other than temporary impairment recognized....................................................................................... ................................................... ................................................... Book value/recorded investment excluding accrued interest at end of current period (Lines 1+2+3+4+5+6-7-8+9-10)......... ...............................................0 ...............................................0 Total valuation allowance........................................................................................................................................................ ................................................... ................................................... Subtotal (Line 11 plus Line 12)................................................................................................................................................ ...............................................0 ...............................................0 Deduct total nonadmitted amounts.......................................................................................................................................... ................................................... ................................................... Statement value at end of current period (Line 13 minus Line 14).......................................................................................... ...............................................0 ...............................................0 NONE SCHEDULE BA - VERIFICATION Other Long-Term Invested Assets 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 2 Prior Year Ended Year to Date December 31 Book/adjusted carrying value, December 31 of prior year....................................................................................................... ...............................................0 ................................................... Cost of acquired: 2.1 Actual cost at time of acquisition...................................................................................................................................... ................................................... ................................................... 2.2 Additional investment made after acquisition................................................................................................................... ................................................... ................................................... Capitalized deferred interest and other................................................................................................................................... ................................................... ................................................... Accrual of discount.................................................................................................................................................................. ................................................... ................................................... Unrealized valuation increase (decrease)............................................................................................................................... ................................................... ................................................... Total gain (loss) on disposals.................................................................................................................................................. ................................................... ................................................... Deduct amounts received on disposals................................................................................................................................... ................................................... ................................................... Deduct amortization of premium and depreciation.................................................................................................................. ................................................... ................................................... Total foreign exchange change in book/adjusted carrying value............................................................................................. ................................................... ................................................... Deduct current year's other than temporary impairment recognized....................................................................................... ................................................... ................................................... Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5+6-7-8+9-10)......................................................... ...............................................0 ...............................................0 Deduct total nonadmitted amounts.......................................................................................................................................... ................................................... ................................................... Statement value at end of current period (Line 11 minus Line 12).......................................................................................... ...............................................0 ...............................................0 NONE SCHEDULE D - VERIFICATION Bonds and Stocks 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Book/adjusted carrying value of bonds and stocks, December 31 of prior year...................................................................... Cost of bonds and stocks acquired......................................................................................................................................... Accrual of discount.................................................................................................................................................................. Unrealized valuation increase (decrease)............................................................................................................................... Total gain (loss) on disposals.................................................................................................................................................. Deduct consideration for bonds and stocks disposed of......................................................................................................... Deduct amortization of premium.............................................................................................................................................. Total foreign exchange change in book/adjusted carrying value............................................................................................. Deduct current year's other than temporary impairment recognized....................................................................................... Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5-6-7+8-9)............................................................... Deduct total nonadmitted amounts.......................................................................................................................................... Statement value at end of current period (Line 10 minus Line 11).......................................................................................... QSI01 1 Year to Date ...............................28,223,978 .................................3,401,305 ........................................7,270 ......................................68,270 ......................................22,392 .................................2,822,340 ....................................215,842 ................................................... ................................................... ...............................28,685,033 ................................................... ...............................28,685,033 2 Prior Year Ended December 31 ...............................23,508,547 ...............................16,275,105 ......................................12,143 .....................................(88,658) ........................................8,410 ...............................11,083,443 ....................................408,126 ................................................... ................................................... ...............................28,223,978 ................................................... ...............................28,223,978 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE D - PART 1B Showing the Acquisitions, Dispositions and Non-Trading Activity During the Current Quarter for all Bonds and Preferred Stock by NAIC Designation NAIC Designation 1 Book/Adjusted Carrying Value Beginning of Current Quarter 2 Acquisitions During Current Quarter 3 Dispositions During Current Quarter 4 Non-Trading Activity During Current Quarter 5 Book/Adjusted Carrying Value End of First Quarter 6 Book/Adjusted Carrying Value End of Second Quarter 7 Book/Adjusted Carrying Value End of Third Quarter 8 Book/Adjusted Carrying Value December 31 Prior Year BONDS QSI02 1. NAIC 1 (a)................................................................................................................ ..........................18,035,271 ............................3,097,533 ............................2,851,098 ................................(63,619) ..........................18,035,271 ..........................18,218,087 ............................................. ..........................18,038,693 2. NAIC 2 (a)................................................................................................................ ............................9,497,430 ............................................. ............................................. ................................(42,001) ............................9,497,430 ............................9,455,429 ............................................. ............................9,477,027 3. NAIC 3 (a)................................................................................................................ ...............................233,205 ............................................. ............................................. ..........................................7 ...............................233,205 ...............................233,212 ............................................. ...............................233,199 4. NAIC 4 (a)................................................................................................................ ...............................120,600 ............................................. ............................................. ......................................319 ...............................120,600 ...............................120,919 ............................................. ...............................120,450 5. NAIC 5 (a)................................................................................................................ ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. 6. NAIC 6 (a)................................................................................................................ ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. 7. Total Bonds.............................................................................................................. ..........................27,886,506 ............................3,097,533 ............................2,851,098 ..............................(105,294) ..........................27,886,506 ..........................28,027,647 ..........................................0 ..........................27,869,369 PREFERRED STOCK 8. NAIC 1..................................................................................................................... ...............................300,000 ............................................. ............................................. ............................................. ...............................300,000 ...............................300,000 ............................................. ...............................300,000 9. NAIC 2..................................................................................................................... ...............................466,197 ............................................. ............................................. .................................14,099 ...............................466,197 ...............................480,296 ............................................. ...............................443,598 10. NAIC 3..................................................................................................................... ...............................186,400 ............................................. ............................................. .................................12,320 ...............................186,400 ...............................198,720 ............................................. ...............................168,000 11. NAIC 4..................................................................................................................... ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. 12. NAIC 5..................................................................................................................... ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. 13. NAIC 6..................................................................................................................... ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. ............................................. 14. Total Preferred Stock............................................................................................... ...............................952,597 ..........................................0 ..........................................0 .................................26,419 ...............................952,597 ...............................979,016 ..........................................0 ...............................911,598 15. Total Bonds and Preferred Stock............................................................................. ..........................28,839,103 ............................3,097,533 ............................2,851,098 ................................(78,875) ..........................28,839,103 ..........................29,006,663 ..........................................0 ..........................28,780,967 (a) Book/Adjusted Carrying Value column for the end of the current reporting period includes the following amount of non-rated short-term and cash equivalent bonds by NAIC designation: NAIC 1 $.....116,233; NAIC 2 $..........0; NAIC 3 $..........0; NAIC 4 $..........0; NAIC 5 $..........0; NAIC 6 $..........0. Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE DA - PART 1 Short-Term Investments 1 Book/Adjusted Carrying Value 2 Par Value 3 Actual Cost 4 Interest Collected Year To Date 5 Paid for Accrued Interest Year To Date 9199999........................................................ .................................374,328 ................XXX....................... ................................377,263 ....................................2,906 .............................................. SCHEDULE DA - VERIFICATION Short-Term Investments 1 Year to Date 2 Prior Year Ended December 31 1. Book/adjusted carrying value, December 31 of prior year....................................................................................................... ....................................585,919 .................................1,390,450 2. Cost of short-term investments acquired................................................................................................................................. .................................2,802,297 ...............................11,522,963 3. Accrual of discount.................................................................................................................................................................. ................................................... ................................................... 4. Unrealized valuation increase (decrease)............................................................................................................................... ................................................... ................................................... 5. Total gain (loss) on disposals.................................................................................................................................................. ................................................... .............................................84 6. Deduct consideration received on disposals........................................................................................................................... .................................3,011,430 ...............................12,325,370 7. Deduct amortization of premium.............................................................................................................................................. ........................................2,458 ........................................2,208 8. Total foreign exchange change in book/adjusted carrying value............................................................................................. ................................................... ................................................... 9. Deduct current year's other than temporary impairment recognized....................................................................................... ................................................... ................................................... 10. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5-6-7+8-9)............................................................... ....................................374,328 ....................................585,919 11. Deduct total nonadmitted amounts.......................................................................................................................................... ................................................... ................................................... 12. Statement value at end of current period (Line 10 minus Line 11).......................................................................................... ....................................374,328 ....................................585,919 QSI03 Statement for June 30, 2014 of the Prepared Insurance Company Sch. DB-Pt A-Verification NONE Sch. DB-Pt B-Verification NONE Sch. DB-Pt C-Sn 1 NONE Sch. DB-Pt C-Sn 2 NONE Sch. DB-Verification NONE Sch. E-Verification NONE Sch. A-Pt 2 NONE Sch. A-Pt 3 NONE Sch. B-Pt 2 NONE Sch. B-Pt 3 NONE Sch. BA-Pt 2 NONE Sch. BA-Pt 3 NONE QSI04, QSI05, QSI06, QSI07, QSI08, QE01, QE02, QE03 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE D - PART 3 Show all Long-Term Bonds and Stock Acquired During the Current Quarter 1 2 3 4 5 6 7 8 CUSIP Identification Description Foreign Date Acquired Name of Vendor Number of Shares of Stock Actual Cost Par Value 9 Paid for Accrued Interest and Dividends 10 NAIC Designation or Market Indicator (a) Bonds - U.S. Special Revenue and Special Assessment 9 FNMA PASS-THRU LNG 30 YEAR.................................................................................................................... ........... ....05/27/2014 Morgan Stanley......................................................................................................................... ............................................... .....................................550,103 .....................................520,000 .........................................1,676 1................................ 3199999. Total Bonds - U.S. Special Revenue and Special Assessment................................................................................................................................... .................................................................................................................................................................................................... .....................................550,103 31418B D2 .....................................520,000 .........................................1,676 ..........XXX................. Bonds - Industrial and Miscellaneous 17310M AG 5 CITIGROUP COML MTG 2006-C5..................................................................................................................... ........... ....06/03/2014 Morgan Stanley......................................................................................................................... ............................................... .....................................168,197 .....................................154,000 ..............................................70 1FE........................... 12591R AX 8 COMM MTG TR 2014-CCRE15.......................................................................................................................... ........... ....06/06/2014 Morgan Stanley......................................................................................................................... ............................................... .....................................139,894 .....................................135,000 ............................................121 1FE........................... 36248E AB 1 GS MTG COML 2010-C2 144A.......................................................................................................................... ........... ....04/08/2014 Morgan Stanley......................................................................................................................... ............................................... .....................................112,699 .....................................100,000 ............................................143 1FE........................... 637417 AF 3 NATIONAL RETAIL PPTYS INC......................................................................................................................... ........... ....06/18/2014 Morgan Stanley......................................................................................................................... ............................................... .....................................212,412 .....................................220,000 .........................................1,371 1FE........................... 10553Y AF 2 BRASKEM FINANCE LIMITED........................................................................................................................... R........ ....04/25/2014 Morgan Stanley......................................................................................................................... ............................................... .....................................207,014 .....................................200,000 .........................................3,118 1FE........................... 93443T AB 2 WARNER CHILCOTT CORP.............................................................................................................................. R........ ....04/22/2014 Morgan Stanley......................................................................................................................... ............................................... .....................................186,463 .....................................175,000 .........................................1,507 1FE........................... 3899999. Total Bonds - Industrial and Miscellaneous.................................................................................................................................................................. .................................................................................................................................................................................................... ..................................1,026,679 .....................................984,000 .........................................6,330 ..........XXX................. 8399997. Total Bonds - Part 3...................................................................................................................................................................................................... .................................................................................................................................................................................................... ..................................1,576,782 ..................................1,504,000 .........................................8,006 ..........XXX................. 8399999. Total Bonds................................................................................................................................................................................................................... .................................................................................................................................................................................................... ..................................1,576,782 ..................................1,504,000 .........................................8,006 ..........XXX................. Common Stocks - Money Market Mutual Funds 74926P 72 0 RBC RESERVE CLASS MMKT.......................................................................................................................... ........... ....06/30/2014 JHS CAPITAL........................................................................................................................... ............................10,166.810 .......................................10,167 .....................XXX....................... ................................................... L................................ 9399999. Total Common Stocks - Money Market Mutual Funds................................................................................................................................................. .................................................................................................................................................................................................... .......................................10,167 .....................XXX....................... ................................................0 ..........XXX................. 9799997. Total Common Stocks - Part 3...................................................................................................................................................................................... .................................................................................................................................................................................................... .......................................10,167 .....................XXX....................... ................................................0 ..........XXX................. 9799999. Total Common Stocks.................................................................................................................................................................................................. .................................................................................................................................................................................................... .......................................10,167 .....................XXX....................... ................................................0 ..........XXX................. QE04 9899999. Total Preferred and Common Stocks........................................................................................................................................................................... .................................................................................................................................................................................................... .......................................10,167 .....................XXX....................... ................................................0 ..........XXX................. 9999999. Total Bonds, Preferred and Common Stocks............................................................................................................................................................... .................................................................................................................................................................................................... ..................................1,586,949 .....................XXX....................... .........................................8,006 ..........XXX................. (a) For all common stock bearing the NAIC market indicator "U" provide: the number of such issues:...............0. Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE D - PART 4 Show All Long-Term Bonds and Stock Sold, Redeemed or Otherwise Disposed of During the Current Quarter 1 2 CUSIP Identification Description 3 F o r e i g n 4 5 6 7 8 9 10 Change in Book/Adjusted Carrying Value 12 13 14 Current Year's Unrealized Current Other Than Total Valuation Year's Temporary Change in Increase/ (Amortization)/ Impairment B./A.C.V. (Decrease) Accretion Recognized (11+12-13) 11 Disposal Date Name of Purchaser Number of Shares of Stock Consideration Par Value Actual Cost Prior Year Book/ Adjusted Carrying Value 16 17 18 19 Book/ Adjusted Carrying Value At Disposal Date Foreign Exchange Gain (Loss) on Disposal Realized Gain (Loss) on Disposal Total Gain (Loss) on Disposal 15 Total Foreign Exchange Change in B./A.C.V. 20 21 22 NAIC Bond DesigInterest/ nation Stock Stated or Dividends Contractual Market Received Maturity Indicator During Year Date (a) Bonds - U.S. Government 36202E ZJ 1 GNMA POOL #004345.............................................. ..... 06/20/2014 PRINCIPAL RECEIPT................ .......................... ................5,738 ................5,738 ................6,226 ................6,212 .................... ............(474) .................... ..............(474) .................. ................5,738 .................. .................. ...............0 36200M SE 4 GNMA POOL #604517.............................................. ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ...................378 ...................378 ...................395 ...................390 .................... ..............(11) .................... ................(11) .................. ...................378 .................. .................. ...............0 ...............7 08/15/2018 1........... ...........154 01/20/2039 1........... 36202S A7 3 GNMA POOL #607630.............................................. ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... .....................99 .....................99 ...................105 ...................105 .................... ................(6) .................... ..................(6) .................. .....................99 .................. .................. ...............0 ...............2 01/15/2033 1........... 36202W Y3 7 GNMA POOL #611930.............................................. ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... .....................36 .....................36 .....................38 .....................37 .................... ................(2) .................... ..................(2) .................. .....................36 .................. .................. ...............0 ...............1 05/15/2033 1........... 36290X PL 8 GNMA POOL #620627.............................................. ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ...................438 ...................438 ...................467 ...................466 .................... ..............(27) .................... ................(27) .................. ...................438 .................. .................. ...............0 0599999. Total Bonds - U.S Government.................................................................................................................................................................... ................6,689 ................6,689 ................7,231 ................7,210 .................0 ............(520) .................0 ..............(520) ...............0 ................6,689 .............11 09/15/2033 1........... ...............0 ...............0 ...............0 ...........175 ......XXX... ..XXX.... Bonds - U.S. States, Territories and Possessions 6 CALIFORNIA ST GO BDS......................................... ..... 04/01/2014 MATURITY................................. .......................... ............275,000 ............275,000 ............288,337 ............278,062 .................... .........(3,062) .................... ...........(3,062) .................. ............275,000 .................. .................. ...............0 ........7,219 04/01/2014 1FE...... 1799999. Total Bonds - U.S. States, Territories and Possessions............................................................................................................................... ............275,000 13063A 5B ............275,000 ............288,337 ............278,062 .................0 .........(3,062) .................0 ...........(3,062) ...............0 ........7,219 ......XXX... ..XXX.... ............275,000 ............274,725 ............274,729 .................... ...............16 .................... .................16 .................. ............274,745 .................. ...........255 ............275,000 ...............0 ...............0 ...............0 Bonds - U.S. Special Revenue and Special Assessment QE05 3133ED AR 3 FEDERAL FARM CR BKS......................................... ..... 05/23/2014 CALLED @ 100.0000000............ .......................... ............275,000 ...........255 ........3,193 02/27/2020 1........... 3128MB DD 6 FHLMC GOLD POOL #G12600................................. ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ...................548 ...................548 ...................589 ...................580 .................... ..............(32) .................... ................(32) .................. ...................548 .................. .................. ...............0 .............13 03/01/2022 1........... 3128PG LG 6 FHLMC GOLD POOL #J04827.................................. ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ...................268 ...................268 ...................285 ...................282 .................... ..............(13) .................... ................(13) .................. ...................268 .................. .................. ...............0 ...............6 05/01/2022 1........... 3137A1 WC 3 FHLMC REMIC SERIES 3728................................... ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ..............11,032 ..............11,032 ..............11,356 ..............11,657 .................... ............(625) .................... ..............(625) .................. ..............11,032 .................. .................. ...............0 ...........130 09/15/2020 1........... 3137A3 RW 1 FHLMC REMIC SERIES 3776................................... ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ..............11,511 ..............11,511 ..............12,202 ..............12,196 .................... ............(685) .................... ..............(685) .................. ..............11,511 .................. .................. ...............0 ...........194 09/15/2028 1........... 3137A4 5Y 9 FHLMC REMIC SERIES 3778................................... ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ..............11,768 ..............11,768 ..............12,282 ..............12,247 .................... ............(478) .................... ..............(478) .................. ..............11,768 .................. .................. ...............0 ...........178 03/15/2025 1........... 3137A8 RM 2 FHLMC REMIC SERIES 3841................................... ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ..............14,116 ..............14,116 ..............14,734 ..............14,733 .................... ............(616) .................... ..............(616) .................. ..............14,116 .................. .................. ...............0 ...........203 11/15/2028 1........... 31411R TJ 7 FNMA PASS-THRU ADJ LIBOR.............................. ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ................6,777 ................6,777 ................7,107 ................7,099 .................... ............(322) .................... ..............(322) .................. ................6,777 .................. .................. ...............0 .............58 03/01/2037 1........... 3138A8 SR 8 FNMA PASS-THRU INT 15 YEAR........................... ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ................8,082 ................8,082 ................8,417 ................8,399 .................... ............(316) .................... ..............(316) .................. ................8,082 .................. .................. ...............0 ...........133 03/01/2026 1........... 31417Y XX 0 FNMA PASS-THRU LNG 30 YEAR......................... ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ................9,916 ................9,916 ..............10,064 ..............10,063 .................... ............(147) .................... ..............(147) .................. ................9,916 .................. .................. ...............0 ...........186 04/01/2041 1........... 31418B D2 9 FNMA PASS-THRU LNG 30 YEAR........................... ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ...................908 ...................908 ...................960 .......................... .................... ..............(53) .................... ................(53) .................. ...................908 .................. .................. ...............0 ...............3 06/01/2044 1........... 31418R P7 0 FNMA PASS-THRU LNG 30 YEAR........................... ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ..............15,060 ..............15,060 ..............16,086 ..............16,076 .................... .........(1,016) .................... ...........(1,016) .................. ..............15,060 .................. .................. ...............0 ...........296 04/01/2040 1........... 31403D PX 1 FNMA POOL #745738............................................... ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ................1,007 ................1,007 ................1,096 ................1,093 .................... ..............(87) .................... ................(87) .................. ................1,007 .................. .................. ...............0 .............29 08/01/2036 1........... 31403D VZ 9 FNMA POOL #745932............................................... ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ...................844 ...................844 ...................919 ...................917 .................... ..............(73) .................... ................(73) .................. ...................844 .................. .................. ...............0 .............23 11/01/2036 1........... 3199999. Total Bonds - U.S. Special Revenue and Special Assessment.................................................................................................................... ............366,837 ............366,838 ............370,822 ............370,071 .................0 .........(4,447) .................0 ...........(4,447) ...............0 ............366,582 ...............0 ...........255 ...........255 ........4,645 ......XXX... ..XXX.... Bonds - Industrial and Miscellaneous 04541G QB 1 ABS CORP HEQ 2005-HE2....................................... ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ..............15,050 ..............15,050 ..............14,974 ..............15,014 .................... ...............36 .................... .................36 .................. ..............15,050 .................. .................. ...............0 .............52 02/25/2035 1FM..... 03064F AT 0 AMERCREDIT AUTO REC 2010............................... ..... 06/08/2014 PRINCIPAL RECEIPT................ .......................... ..............58,067 ..............58,067 ..............58,836 ..............58,451 .................... ............(384) .................... ..............(384) .................. ..............58,067 .................. .................. ...............0 ...........663 05/08/2016 1FE...... 06051G DY 2 BANK AMER CORP SR NT....................................... ..... 05/15/2014 MATURITY................................. .......................... ............300,000 ............305,256 .................... .........(5,256) .................... ...........(5,256) .................. ............300,000 .................. .................. ...............0 ......11,063 05/15/2014 1FE...... 07383F 5K 0 BEAR STEARNS CMBS 2005-TOP18....................... ..... 06/13/2014 PRINCIPAL RECEIPT................ .......................... ...................663 ...................663 ...................725 ...................687 .................... ..............(24) .................... ................(24) .................. ...................663 .................. .................. ...............0 .............14 02/13/2042 1FM..... 07388N AE 6 BEAR STEARNS CMBS 2006-TOP24....................... ..... 06/12/2014 PRINCIPAL RECEIPT................ .......................... ................3,988 ................3,988 ................4,430 ................4,173 .................... ............(185) .................... ..............(185) .................. ................3,988 .................. .................. ...............0 ...........108 10/12/2041 1FM..... 07387E EQ 6 BEAR STEARNS COS INC....................................... ..... 04/10/2014 MATURITY................................. .......................... ..............60,000 ..............60,000 ..............58,731 ..............59,726 .................... .............274 .................... ...............274 .................. ..............60,000 .................. .................. ...............0 ...........564 04/10/2014 1FE...... 59022H MU 3 ML MTG TRUST 2005-CKI1 20371112 FL................ ..... 06/12/2014 PRINCIPAL RECEIPT................ .......................... ................2,394 ................2,394 ................2,564 ................2,531 .................... ............(137) .................... ..............(137) .................. ................2,394 .................. .................. ...............0 .............60 11/12/2037 1FM..... 81744U AA 2 SEQUOIA MTG TR 2012-2 20420425 FLT................ ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ................9,411 ................9,411 ................9,517 ................9,513 .................... ............(103) .................... ..............(103) .................. ................9,411 .................. .................. ...............0 ...........147 04/25/2042 1FM..... 81744U AB 0 SEQUOIA MTG TR 2012-2 20420425 FLT................ ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ................4,429 ................4,429 ................4,484 ................4,479 .................... ..............(50) .................... ................(50) .................. ................4,429 .................. .................. ...............0 .............69 04/25/2042 1FM..... ............300,000 ............341,472 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE D - PART 4 Show All Long-Term Bonds and Stock Sold, Redeemed or Otherwise Disposed of During the Current Quarter 1 2 CUSIP Identification Description 3 F o r e i g n 4 5 6 7 8 9 10 Change in Book/Adjusted Carrying Value 12 13 14 Current Year's Unrealized Current Other Than Total Valuation Year's Temporary Change in Increase/ (Amortization)/ Impairment B./A.C.V. (Decrease) Accretion Recognized (11+12-13) 11 Disposal Date Name of Purchaser Number of Shares of Stock Consideration Par Value Actual Cost Prior Year Book/ Adjusted Carrying Value 16 17 18 19 Book/ Adjusted Carrying Value At Disposal Date Foreign Exchange Gain (Loss) on Disposal Realized Gain (Loss) on Disposal Total Gain (Loss) on Disposal 15 Total Foreign Exchange Change in B./A.C.V. 20 21 22 NAIC Bond DesigInterest/ nation Stock Stated or Dividends Contractual Market Received Maturity Indicator During Year Date (a) 81745F AA 4 SEQUOIA MTG TR 2012-3 20420725 FLT................ ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ................6,685 ................6,685 ................6,702 ................6,702 .................... ..............(16) .................... ................(16) .................. ................6,685 .................. .................. ...............0 .............95 07/25/2042 1FM..... 81744T AB 3 SEQUOIA MTG TRUST 2012-1 20420125................ ..... 06/25/2014 PRINCIPAL RECEIPT................ .......................... ................4,942 ................4,942 ................5,019 ................5,017 .................... ..............(75) .................... ................(75) .................. ................4,942 .................. .................. ...............0 .............76 01/25/2042 1FM..... 92978P AE 9 WACHOVIA CMBS 2006-C29................................... ..... 06/15/2014 PRINCIPAL RECEIPT................ .......................... ...................251 ...................251 ...................269 ...................260 .................... ................(8) .................... ..................(8) .................. ...................251 .................. .................. ...............0 ...............5 11/15/2048 1FM..... 92937E AB 0 WFRBS COML MTG TR 2013-C11........................... ..... 06/06/2014 Morgan Stanley........................... .......................... ............141,739 ............140,000 ............141,559 .......................... .................... ............(111) .................... ..............(111) .................. ............141,447 .................. ...........292 ...........292 ...........789 03/17/2045 1FM..... 10553Y AF 2 BRASKEM FINANCE LIMITED................................. R.. 05/08/2014 Morgan Stanley........................... .......................... ............214,100 ............200,000 ............207,014 .......................... .................... ..............(19) .................... ................(19) .................. ............206,995 .................. ........7,105 ........7,105 ........3,583 02/03/2024 1FE...... 3899999. Total Bonds - Industrial and Miscellaneous.................................................................................................................................................. ............821,719 ............805,879 ............856,296 ............471,809 .................0 .........(6,058) .................0 ...........(6,058) ...............0 ............814,322 ...............0 ........7,397 ........7,397 ......17,288 ......XXX... ..XXX.... 8399997. Total Bonds - Part 4.................................................................................................................................................................................... .........1,470,245 .........1,454,407 .........1,522,686 .........1,127,152 .................0 .......(14,087) .................0 .........(14,087) ...............0 .........1,462,593 ...............0 ........7,652 ........7,652 ......29,327 ......XXX... ..XXX.... 8399999. Total Bonds................................................................................................................................................................................................. .........1,470,245 .........1,454,407 .........1,522,686 .........1,127,152 .................0 .......(14,087) .................0 .........(14,087) ...............0 .........1,462,593 ...............0 ........7,652 ........7,652 ......29,327 ......XXX... ..XXX.... 9999999. Total Bonds, Preferred and Common Stocks............................................................................................................................................... .........1,470,245 ...........XXX........ .........1,522,686 .........1,127,152 .................0 .......(14,087) .................0 .........(14,087) ...............0 .........1,462,593 ...............0 ........7,652 ........7,652 ......29,327 ......XXX... ..XXX.... (a) For all common stock bearing the NAIC market indicator "U" provide: the number of such issues:...............0. QE05.1 Statement for June 30, 2014 of the Prepared Insurance Company Sch. DB-Pt A-Sn 1 NONE Sch. DB-Pt A-Sn 1-Footnote A NONE Sch. DB-Pt A-Sn 1-Footnote B NONE Sch. DB-Pt B-Sn 1 NONE Sch. DB-Pt B-Sn 1-Footnote A NONE Sch. DB-Pt B-Sn 1-Footnote B NONE Sch. DB-Pt B-Sn 1B-Broker List NONE Sch. DB-Pt D-Sn 1 NONE Sch. DB-Pt D-Sn 2 NONE Sch. DL-Pt. 1 NONE Sch. DL-Pt. 2 NONE QE06, QE07, QE08, QE09, QE10, QE11 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE E - PART 1 - CASH Month End Depository Balances 1 Depository 2 3 Code Rate of Interest 4 Amount of Interest Received During Current Quarter 5 Amount of Interest Accrued at Current Statement Date 6 Book Balance at End of Each Month During Current Quarter 7 9 8 First Month Second Month Third Month * ...............300,000 ...............300,000 ...............300,000 XXX.. NORTHSTAR BANK MM................................................. NorthStar Bank........................................ ................... ..................... ......................7,838 ................................ ............9,548,953 ..........12,953,693 ..........14,803,694 XXX.. Open Depositories NORTHSTAR BANK CD................................................. NorthStar Bank........................................ SD.............. ...........0.700 .........................431 ...........................64 NORTHSTAR BANK CHECKING ACCCOUNT.............. NorthStar Bank........................................ ................... ..................... ................................ ................................ ..............(508,867) ..............(337,504) ..............(749,248) XXX.. NORTHSTAR BANK PREMIUM TRUST........................ NorthStar Bank........................................ ................... ..................... ................................ ................................ ...............151,250 .................42,190 ...............354,785 XXX.. MORGAN STANLEY ACCT 558-185019-267................. NorthStar Bank........................................ ................... ..................... ................................ ................................ ...................3,048 ............................. .................12,921 XXX.. JHS CAPITAL ACCT 866-14274..................................... JHS Capital............................................. ................... ..................... ................................ ................................ ............................. ............................. ...................3,438 XXX.. PNC BANK MM ACCT 12-1633-5373............................. Morgan Stanley....................................... ................... ..................... .........................749 ................................ ............1,502,960 ............1,503,207 ............1,503,462 XXX.. BANK UNITED ACCT 9853120862................................. PNC Bank................................................ ................... ..................... ......................4,388 ................................ ............2,003,932 ............2,005,424 ............2,006,681 XXX.. SYNOVUS BANK MM ACCT 1005694250...................... Bank United............................................. ................... ..................... .........................174 ................................ ...............250,567 ...............250,628 ...............250,680 XXX.. SYNOVUS BANK OPERATING ACCT 1005694243...... Synovus Bank......................................... ................... ..................... ................................ ................................ ...................1,000 ...................1,000 ...................1,000 XXX.. SYNOVUS BANK CD ACCT 3880644319...................... Synovus Bank......................................... ................... ..................... .........................889 ................................ ............1,007,325 ............1,007,615 ............1,007,914 XXX.. SYNOVUS BANK CD ACCT 3880739268...................... Synovus Bank......................................... ................... ..................... .........................889 ................................ ............1,007,325 ............1,007,615 ............1,007,914 XXX.. 0199999. Total Open Depositories.................................................................................................... ....XXX........ ......XXX........ ....................15,358 ...........................64 ..........15,267,493 ..........18,733,868 ..........20,503,241 XXX.. 0399999. Total Cash on Deposit......................................................................................................... ....XXX........ ......XXX........ ....................15,358 ...........................64 ..........15,267,493 ..........18,733,868 ..........20,503,241 XXX.. 0599999. Total Cash........................................................................................................................... ....XXX........ ......XXX........ ....................15,358 ...........................64 ..........15,267,493 ..........18,733,868 ..........20,503,241 XXX.. QE12 Statement for June 30, 2014 of the Prepared Insurance Company SCHEDULE E - PART 2 - CASH EQUIVALENTS Show Investments Owned End of Current Quarter 1 2 3 4 5 6 7 8 Description Code Date Acquired Rate of Interest Maturity Date Book/Adjusted Carrying Value Amount of Interest Due & Accrued Amount Received During Year QE13 NONE