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California Regulations Automobile Insurance Claims

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California  Regulations Automobile Insurance Claims Powered By Docstoc
					State of California                                                                                               DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)



Form                                                                                         Due                         Download
 No.                              Description                                                Date                         Format
 152                    Special CA Schedule P ("SCASP")                                                                   EXCEL

                                      As of
                                 December 31, 2009                                      March 1, 2010

                          and Upon Request                                              As Requested
            FOR INSURERS LICENSED TO TRANSACT WORKERS'                                                 SUBMIT
        COMPENSATION INSURANCE IN CALIFORNIA OR AUTHORIZED                                    1 FILE IN EXCEL FORMAT
           TO ASSUME THE CARVE-OUT PORTION OF WORKERS'                                     1 SIGNED FILE IN PDF FORMAT
               COMPENSATION BUSINESS IN CALIFORNIA.                                1 HARD COPY ONLY WITH ORIGINAL SIGNATURE

                                        INSTRUCTIONS FOR INITIAL FILING AND AMENDED FILING
  1    DOWNLOADING the FILE:
        - Download the Excel file onto your computer.
        - Use one (1) disk or CD per company. Disks or CDs that contain multiple companies will NOT be accepted.
        - Prior versions of this form will not be accepted for current year's filing.
  2    SAVE FILE AS:                                *** IMPORTANT ***
        - When submitting the INITIAL FILING, rename your file according to the following example:
           SCASP as of December 31, 2009 due March 1, 2010……….…… COMPANY NAME-SCASP2009.xls
           SCASP as of December 31, 2009 due March 1, 2010……….…… COMPANY NAME-SCASP2009.pdf
        - When submitting an AMENDED FILING, rename your file according to the following example:
           SCASP2009 amended June 1, 2010……….…...                               COMPANY NAME-SCASP2009-Amended6-1-10.xls
           SCASP2009 amended June 1, 2010……….……                                 COMPANY NAME-SCASP2009-Amended6-1-10.pdf
            *** NOTE: FILES THAT ARE NOT NAMED ACCORDING TO THE INSTRUCTIONS ABOVE WILL NOT BE ACCEPTED ***
  3    FILE CONTENTS:
       Worksheet Subject                                                                                   Worksheet Title
        - Instructions (This worksheet)                                                                    Instructions
        - Part I - Compensation Premium Earned (CA business)                                               Page 1
        - Part II - Distribution of Unallocated Compensation Claim Expense (CA business)                   Page 2
        - Part III, Section A - Schedule of Reinsurance Assumed                                            Page 3A (1)
            Part III, Section A Overflow                                                                   Page 3A (2)
        - Part III, Section B - Amount of earned WC premiums on reinsurance assumed                        Page 3B (1)
          broken down by years per company.
            Part III, Section B Overflow                                                                   Page 3B (2)
        - Part IV, Section A - Schedule of Reinsurance Ceded to CA Licensed WC Companies or                Page 4A (1)
          CA Authorized WC Reinsurers.
            Part IV, Section A Overflow                                                                    Page 4A (2)
        - Part IV, Section B - Schedule of Reinsurance Ceded to other than CA Licensed WC                  Page 4B (1)
          Companies or CA Authorized WC Reinsurers.
            Part IV, Section B Overflow                                                                    Page 4B (2)
            Part IV, Section B Overflow                                                                    Page 4B (3)
        - Part IV, Section C - Earned premiums on reinsurance ceded to CA Licensed WC                      Page 4C (1)
          Companies or CA Authorized WC Reinsurers broken down by years per company.
            Part IV, Section C Overflow                                                                    Page 4C (2)
        - Part V - Underwriting Expenses (CA Workers' Compensation business)                               Page 5
        - Part VI - Type and Location of Deposit Requirement                                               Page 6
        - Part VII - Actuarial Certification                                                               Page 7
        - List of Companies Licensed/Authorized to Write Workers' Compensation in CA.                      Page A
        - (Hidden, For CDI Internal Use Only, Do Not Print)                                                (CDI Data Co-info, datap1-7)
  4    DATA ENTRY:
        - Enter the data in the tan colored cells only.
        - If you are pasting information, use the paste value function only. DO NOT PASTE OR USE FORMULAS.
        - On page 1, if your company name does not appear after you enter your NAIC Number, go to "Page A, Part 1"
          and enter the required information to proceed.
        - It is the company's responsibility to make sure the NAIC numbers are correct and current.
       There are "Conditions" throughout the schedule that must be met. If your company does not meet any of the conditions,
       please provide an explanation on a separate page and attach to the end of the schedule.
  5    PRINTING:
        - Print out pages used (in legal size).
  6    FORMAT and LABEL:
        - Save the file on a 3.5" floppy disk or CD as MS EXCEL file.
        - Scan signed hardcopy as PDF file and save file on same 3.5" floppy disk or CD.
        - Label your 3.5" floppy disk or CD as follows:                         Company Name
                                                                                NAIC Number
                                                                                File Name (Please see item 2 for instruction)

  7    FILING:
       - Mail the Company's SCASP and disk/CD together to the below address:
                                                                         California Department of Insurance
                                                                         Financial Analysis Division
                                                                         300 South Spring Street, South Tower, 13th floor
                                                                         Los Angeles, CA 90013
                                                                         Attn: Financial Records Unit

        - For questions regarding filing, please contact the Financial Records Unit at (213) 346-6423.
        - For questions concerning the calculations and/or completing this form, please contact WCDRT at (213) 346-6433.
  8     - Your filing must be received by the Department's Financial Records Unit postmarked no later than the due date
          stated above. Late filings will be assessed a late filing fee prescribed n the CA Insurance Code. Incomplete filing will be
          assessed a late filing fee as prescribed in the CA Insurance Code.
        - It is a criminal offense if you intentionally submit forms electronically (either by email or diskette)
          containing viruses or other materials that would cause harm to the Department.
END




                                                                Instructions
     State of California                                                                                                                                                            DEPARTMENT OF INSURANCE
     FAD 152 (12/09)                                                  SPECIAL CALIFORNIA SCHEDULE P
                                                                       as of           December 31, 2009
                                                    For Unpaid California Workers' Compensation Losses and Loss Adjustment Expenses
                                           (for the determination of the deposit required under Sections 11690-11703 of the California Insurance Code)

       "X" and/or fill in the appropriate cells:                               Initial filing (Due March 1, 2010)
                                                                               Amended filing.
                                                                               Date Amended.

                                                    Enter your NAIC# first. If your company name does not appear here, go to page A.
          NAIC No                                   Company Name

                      of
                           Principal Office Street Address                                                                            City, State & Zip Code
                                                     (Round Up to the Nearest Dollar)
                                                                 PART I
     Compensation Premiums Earned (California Business)
                                                                                AMOUNT OF EARNED            EARNED PREMIUMS ON REINSURANCE CEDED
                                                       DIRECT PREMIUMS           WC PREMIUMS ON             TO REINSURERS LICENSED TO TRANSACT WC                 AMOUNT OF EARNED
                             DIRECT PREMIUM           EARNED CALENDAR              REINSURANCE              INS OR AUTHORIZED TO ASSUME THE CARVE-                  WC PREMIUMS
      YEARS IN WHICH              WRITTEN                  YEAR 2009                 ASSUMED                   OUT PORTION OF WC BUSINESS IN CA.                    (AS ADJUSTED)
      PREMIUMS WERE        (A/S, CA STATE PAGE)      (A/S, CA STATE PAGE)        (FROM PART III B)                      (FROM PART IV C)                            (COL. 2 + 3 - 4)
         EARNED
                                    [1]                         [2]                      [3]                                        [4]                                    [5]
   For Workers' Compensation (Line 16) of CA State Page of the Annual Statement:
 1 Prior to 2005                                                                                                                                                                    -
 2      2005                                                              -                                                     -                                                   -
 3      2006                                                              -                                                     -                                                   -
 4      2007                                                              -                                                     -                                                   -
 5      2008                                                              -                                                     -                                                   -
 6      2009                                                              -                                                     -                                                   -
 7 YRS 2007-2009                 -                    -                   -                                                     -                                                   -
 8     TOTAL                     -                    -                   -                                                     -                                                   -
     For Excess Workers' Compensation (Line 17.3) of CA State Page of the Annual Statement:
 9        2008                                                                                                                                                                      -
10        2009                                                                                                                                                                      -
11       TOTAL                    -                    -                    -                                                   -                                                   -



12 GRAND TOTAL
                                              -                          -                      -                               -                         -                         -

     Compensation Loss Payments (Net as to Reinsurance)
                                                                                                    REINSURANCE RECOVERED DURING 2009 ON
      YEARS IN WHICH         CUMULATIVE TO                                                         LOSSES PAID FROM REINSURERS LICENSED TO
        WC POLICIES         DECEMBER 31, 2009        DIRECT LOSSES PAID         LOSSES PAID DURING TRANSACT WC INS OR AUTHORIZED TO ASSUME                          CUMULATIVE TO
     WERE ISSUED AND        (COL. 10 OF PRIOR        CALENDAR YEAR 2009        2009 ON REINSURANCE THE CARVE-OUT PORTION OF WC BUSINESS IN                        DECEMBER 31, 2009
       LOSSES WERE            YEAR'S SCASP)          (A/S, CA STATE PAGE)            ASSUMED                         CA.                                           (COL. 6 + 7 + 8 - 9)
         INCURRED
                                    [6]                         [7]                      [8]                                        [9]                                   [10]
   For Workers' Compensation (Line 16) of CA State Page of the Annual Statement:
 1 Prior to 2005         XXX                                                                                                                                              XXX
 2      2005                                                                                                                                                                        -
 3      2006                                                                                                                                                                        -
 4      2007                                                                                                                                                                        -
 5      2008                                                                                                                                                                        -
 6      2009             XXX                                                                                                                                                        -
 7 YRS 2007-2009                 -                    -                   -                                                     -                                                   -
 8     TOTAL                     -                    -                   -                                                     -                                                   -
     For Excess Workers' Compensation (Line 17.3) of CA State Page of the Annual Statement:
 9        2008                                                                                                                                                                      -
10        2009             XXX                                                                                                                                                      -
11       TOTAL                    -                    -                    -                                                   -                                                   -



12 GRAND TOTAL
                                              -                          -                      -                               -                         -                         -

      YEARS IN WHICH                                 WC LOSS EXPENSE PAYMENTS (NET AS TO REINSURANCE RECOVERED                            TOTAL WC LOSS AND
        WC POLICIES                                     FROM REINSURERS AUTHORIZED TO TRANSACT WC INS IN CA)                                LOSS EXPENSE
     WERE ISSUED AND        WC LOSS PAYMENTS                                       UNALLOCATED                    TOTAL                       PAYMENTS
       LOSSES WERE               (COL. 10)                  ALLOCATED              (FROM PART II)              (COL. 12 + 13)                (COL. 11 + 14)
         INCURRED
                                   [11]                        [12]                     [13]                        [14]                         [15]
   For Workers' Compensation (Line 16) of CA State Page of the Annual Statement:
 1 Prior to 2005         XXX                                              -                                                     -                XXX
 2      2005                     -                                        -                                                     -                         -
 3      2006                     -                                        -                                                     -                         -
 4      2007                     -                                        -                                                     -                         -
 5      2008                     -                                        -                                                     -                         -
 6      2009                     -                                        -                                                     -                         -
 7 YRS 2007-2009                 -                    -                   -                                                     -                         -
 8     TOTAL             XXX                          -                   -                                                     -                XXX
   For Excess Workers' Compensation (Line 17.3) of CA State Page of the Annual Statement:
 9      2008                    -                                                                                               -                         -
10      2009                    -                                                                                               -                         -
11     TOTAL             XXX                         -                    -                                                     -                XXX



12 GRAND TOTAL
                              XXX                        -                -                  -            XXX
     NOTE: If Col. 15 has a value, you MUST complete the "Compensation Premiums Earned" section above for the corresponding years.

                                                                RESERVE FOR WC LOSSES AND LOSS EXPENSES
                                                             WITHOUT DEDUCTION FOR REINSURANCE RECOVERABLE                                                           REINSURANCE
                                                                                                                                                                   RECOVERABLE ON
                                                                                                                                                                  UNPAID LOSSES AND
                           TOTAL ESTIMATED RESERVE FOR WC LOSSES;                 TOTAL ESTIMATED RESERVE FOR LOSS                                               LOSS EXPENSES FROM
                            CASE-BASIS INCLUDING INCURRED, BUT NOT              EXPENSE PERTAINING TO CASE-BASIS LOSS                                            REINSURERS LICENSED
                                   REPORTED (IBNR) LOSSES                             ESTIMATES INCLUDING (IBNR)                                                  TO TRANSACT WC INS
      YEARS IN WHICH                                                                                                                                               OR AUTHORIZED TO        UNPAID WC LOSSES
        WC POLICIES                               [16]                                               [17]                                        TOTAL            ASSUME THE CARVE-       AND LOSS EXPENSES
     WERE ISSUED AND                                                                                                                        (COL. 16a + 16b       OUT PORTION OF WC          (AS ADJUSTED)
       LOSSES WERE                DIRECT                    ASSUMED                   DIRECT                    ASSUMED                       + 17a + 17b)          BUSINESS IN CA.           (COL. 18 - 19)
         INCURRED
                                   [16a]                       [16b]                    [17a]                      [17b]                         [18]                     [19]                   [20]
   For Workers' Compensation (Line 16) of CA State Page of the Annual Statement:
 1 Prior to 2005                                                                                                                                          -                                             -
 2      2005                                                                                                                                              -                                             -
 3      2006                                                                                                                                              -                                             -
 4   SUBTOTAL                    -                    -                   -                                                     -                         -                         -                   -
 5      2007                                                                                                                                              -                                             -
 6      2008                                                                                                                                              -                                             -
 7      2009                                                                                                                                              -                                             -
 8 YRS 2007-2009                 -                    -                   -                                                     -                         -                         -                   -
 9     TOTAL                     -                    -                   -                                                     -                         -                         -                   -
   For Excess Workers' Compensation (Line 17.3) of CA State Page of the Annual Statement:
10      2008                                                                                                                                              -                                             -
11      2009                                                                                                                                              -                                             -
12     TOTAL                    -                    -                    -                                                     -                         -                         -                   -



13 GRAND TOTAL
                                      -                  -                -                  -                    -                                                                 -                   -
     NOTE: If Col. 20 has a value, you MUST complete the "Compensation Premiums Earned" section above for the corresponding years.

     Computation of Reserve for Unpaid Compensation Losses

                             65% OF EARNED                                                                                            CARRY OUT FOR EACH
      YEARS IN WHICH             PREMIUM                   DEDUCT LOSS                                                                YEAR AMOUNT STATED
        WC POLICIES          STATED IN COL. 5             PAYMENTS AND               REMAINDER           UNPAID WC LOSSES               IN COL. 23 OR 24,
     WERE ISSUED AND           FOR YEARS                    EXPENSES                (COL. 21 - 22)      AND LOSS EXPENSES                WHICHEVER IS
       LOSSES WERE              2007 - 2009              STATED IN COL. 15     IF NEGATIVE, ENTER "0"        (COL. 20)                      GREATER
         INCURRED
                                   [21]                        [22]                     [23]                        [24]                         [25]
     For Workers' Compensation (Line 16) of CA State Page of the Annual Statement:
 1        2007                     -                    -                     0                                                 -                         -
 2        2008                     -                    -                     0                                                 -                         -
 3        2009                     -                    -                     0                                                 -                         -
 4       TOTAL                     -                    -                     0                                                 -                         -
     For Excess Workers' Compensation (Line 17.3) of CA State Page of the Annual Statement:
 5        2008                    -                    -                      0                                                 -                         -
 6        2009                    -                    -                      0                                                 -                         -
 7       TOTAL                    -                    -                    -                                                   -                         -



8    GRAND TOTAL
                                              -                          -                      -                               -                         -

                                                                               [26] UNPAID WC LOSSES AND LOSS EXPENSES (Col. 20, Subtotal)…                                                             -
                                                                               [27] COL. 25, GRAND TOTAL + COL. 26……………………………………….................                                                      -

For Workers' Compensation (Line 16) of CA State Page of the Annual Statement:
       Year              2005                  2006                2007                                            2008                         2009
 Actual Loss Ratio            0.000%                0.000%              0.000%                                             0.000%                       0.000%
For Excess Workers' Compensation (Line 17.3) of CA State Page of the Annual Statement:
       Year              2005                 2006                 2007               2008                                                      2009
 Actual Loss Ratio                                                                         0.000%                                                       0.000%




                                                                                                    Page 1
State of California                                                                                                                DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)


       0                               Enter your NAIC# first. If your company name does not appear here, go to page A.
    NAIC No                            Company Name

                                                                         PART II
                                   Distribution of Unallocated Compensation Claim Expenses (California Business)
                           Net as to reinsurance ceded to reinsurers authorized to transact compensation insurance in California



                                                         UNALLOCATED CLAIM EXPENSES PAID
                                                       PERCENTAGES FOR 2009 CALENDAR YEAR             DISTRIBUTION OF UNALLOCATED CLAIM EXPENSE PAID



                                                     ASSOCIATED
                     NET LOSSES        PERCENTAGE     WITH YEAR        ASSOCIATED      TOTAL        2009 CALENDAR      PRIOR TO 2009
                     PAID IN 2009           (%)     LOSSES WERE         WITH YEAR   PERCENTAGE      YEAR EXPENSES    CALENDAR YEAR          TOTAL TO DATE
                       (PART 1:        DISTRIBUTION       PAID           LOSSES     DISTRIBUTION           X         (PART 1, COL. 13 -   FOR PART 1, COL. 13
    ACCIDENT         COL. 7 + 8 - 9)     OF COL. 1  (1/2 OF COL. 2)    OCCURRED      (COL. 3 + 4)        COL. 5         2008 SCASP)           (COL. 6 + 7)
      YEAR
                           [1]              [2]            [3]             [4]           [5]             [6]                [7]                   [8]
For Workers' Compensation (Line 16) of CA State Page (Page 20) of the Annual Statement:
  Prior to 2005              -       0.000%       0.000%                     0.000%                            -                                         -
      2005                   -       0.000%       0.000%                     0.000%                            -                                         -
      2006                   -       0.000%       0.000%                     0.000%                            -                                         -
      2007                   -       0.000%       0.000%                     0.000%                            -                                         -
      2008                   -       0.000%       0.000%           5.000%    5.000%                            -                                         -
      2009                   -       0.000%       0.000%         45.000%    45.000%                            -           XXX                           -
For Excess Workers' Compensation (Line 17.3) of CA State Page (Page 20) of the Annual Statement:
     2008                  -       0.000%        0.000%              -       0.000%                            -                                         -
     2009                  -       0.000%        0.000%              -       0.000%                            -           XXX                           -


GRAND TOTAL
                                  -      0.00%           0.00%         50.00%         50.00%                                      -                 -
NOTE: For companies which have been issuing policies for one year or less , disregard columns (1) through (5) and assign all unallocated claims expense
paid to the latest accident year.

Conditions:       Does "Column - 3 Total" equal 50%?                  NO. Unless this is due to a rounding error, please correct this before proceeding.
Conditions:       Does "Column - 5 Total" equal 100%?                 NO. Unless this is due to a rounding error, please correct this before proceeding.




                                                                           Page 2
State of California                                                                                                                              DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                                   NEW CHANGES
   0                 Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No              Company Name
                                                                  PART III, Section A
                                                         Schedule of Reinsurance Assumed
 List all of the ceding insurers and the amounts assumed on California compensation unpaid losses and loss expenses from each of the insurers. (If the
company name does not appear after you have entered the NAIC #, please type the information directly onto Columns 2 and 3). No segregation by policy
                                                                    year is required.


                                                                                                                                                           *REINSURANCE
                                                                                                                                                            PAYABLE ON
              NAIC                                                 NAME OF CEDING COMPANY                                                                  UNPAID LOSSES
             GROUP                                                                                                                                STATE      AND LOSS
 NAIC NO.     NO.           (If a company name does not appear after you have entered its NAIC number on Col. 1, please type in the name.)       OF DOM.     EXPENSES

    [1]       [2]                                                                [3]                                                                [4]         [5]




SUBTOTAL FROM PART III, Section A (1)                                                                                                                                 -
SUBTOTAL FROM PART III, Section A (2)                                                                                                                                 -
                                                                                                                                             Grand Total              -

                     RESERVE FOR WC LOSSES AND LOSS EXPENSES - ASSUMED BUSINESS (Part I, Col. 16b + 17b, Line 13)                -
                                          REINSURANCE PAYABLE ON UNPAID LOSSES AND LOSS EXPENSES (Part III, Col. 5)              -
                                                                                   DIFFERENCE (OR UNASSIGNED)                    -
Condition:           Does the above total equal "Part I, Col. 16b + 17b, Line 13?                                 YES, Condition met.

* Column 5 Total Should Equal Part I, Col. 16b + 17b, Line 13




                                                                                Page 3A (1)
State of California                                                                                                                         DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                                   NEW CHANGES
   0                 Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No              Company Name
                                                          PART III, Section A (2 - Overflow)
                                                         Schedule of Reinsurance Assumed
 List all of the ceding insurers and the amounts assumed on California compensation unpaid losses and loss expenses from each of the insurers. (If the
company name does not appear after you have entered the NAIC #, please type the information directly onto Columns 2 and 3). No segregation by policy
                                                                    year is required.


                                                                                                                                                      *REINSURANCE
                                                                                                                                                       PAYABLE ON
             NAIC                                                 NAME OF CEDING COMPANY                                                              UNPAID LOSSES
            GROUP                                                                                                                            STATE      AND LOSS
 NAIC NO.    NO.           (If a company name does not appear after you have entered its NAIC number on Col. 1, please type in the name.)   OF DOM.     EXPENSES

    [1]      [2]                                                                [3]                                                           [4]          [5]




                                                                                                      PART III, Section A (2 - Overflow) Subtotal                -




                                                                               Page 3A (2)
State of California                                                                                                                                       DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                                                       NEW CHANGES
   0                Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No             Company Name
                                                                                          PART III, SECTION B
                                               Amount of earned WC premiums on reinsurance assumed broken down by years per company.
                                                List all of the ceding insurers and the premiums ceded from each of the insurers segregated by year.
                                                                  The totals on this page should automatically transfer to Part 1, Col 3.




             NAIC
            GROUP                                                                        STATE OF
 NAIC NO.    NO.                          NAME OF CEDING COMPANY                           DOM.          2005*           2006**           2007***       2008****       2009*****

    [1]      [2]                                     [3]                                     [4]          [5]              [6]              [7]           [8]             [9]




                            SUBTOTAL FROM PART III, Section B (1)                                                -                -                 -              -               -
                            SUBTOTAL FROM PART III, Section B (2)                                                -                -                 -              -               -
                                                                                     Grand Total                 -                -                 -              -               -

*The total from Col 5 of this page should automatically transfer to Col 3, Line 2 of Page 1.
**The total from Col 6 of this page should automatically transfer to Col 3, Line 3 of Page 1.
***The total from Col 7 of this page should automatically transfer to Col 3, Line 4 of Page 1.
****The total from Col 8 of this page should automatically transfer to Col 3, Line 5 of Page 1.
*****The total from Col 9 of this page should automatically transfer to Col 3, Line 6 of Page 1.




                                                                                      Page 3B (1)
State of California                                                                                                                                      DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                                                     NEW CHANGES
   0                Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No             Company Name
                                                                         PART III, SECTION B (2 - Overflow)
                                     Amount of earned WC premiums on reinsurance assumed broken down by years per company.
                                      List all of the ceding insurers and the premiums ceded from each of the insurers segregated by year.
                                                        The totals on this page should automatically transfer to Part 1, Col 3.




             NAIC
            GROUP                                                                        STATE OF
 NAIC NO.    NO.                         NAME OF CEDING COMPANY                            DOM.         2005*           2006**          2007***        2008****       2009*****

    [1]      [2]                                     [3]                                    [4]          [5]              [6]                [7]         [8]             [9]




                                                   PART III, SECTION B (2 - Overflow) Subtotal                  -                -                 -              -               -




                                                                                     Page 3B (2)
State of California                                                                                                        DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                                      NEW CHANGES
   0                 Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No              Company Name
                                                                    PART IV, SECTION A
                                                              Schedule of Reinsurance Ceded
                                        List only CA Licensed WC Companies or CA Authorized WC Reinsurers.
                                       (DO NOT LIST CA UNAUTHORIZED WC REINSURERS ON THIS PAGE.)
                                                           No segregation by policy year is required.
                                            (For the list of CA Authorized WC Reinsurers, please see Page A.)

                                                                                                *REINSURANCE                        ***AMOUNT OF
                                                                                               RECOVERABLE ON                         RESERVES/
                                                                                                UNPAID LOSSES                          DEPOSITS
                                                                                                   AND LOSS          **RESERVES/    MADE BY YOUR
                                                                                                   EXPENSES            DEPOSITS      COMPANY ON
              NAIC                                                                             (Total Should Equal   MADE BY THE    BEHALF OF THE
             GROUP                                                                      STATE    Part I, Col. 19,      ASSUMING       ASSUMING
 NAIC NO.     NO.                 NAME OF REINSURER (ASSUMING COMPANY)                 OF DOM.       Line 13)          COMPANY         COMPANY

    [1]       [2]                                   [3]                                  [4]            [5]              [6]        [7] = [5] - [6], (>0)
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                             SUBTOTAL FROM PART IV, Section A (1)                                             -                -                     -
                             SUBTOTAL FROM PART IV, Section A (2)                                             -                -                     -
* Column 5 Total should equal Part I, Col. 19, Line 13                             Grand Total                -                -                     -
** Column 6 Amount may be changed as it applies to your company.
*** Column 7 Total will increase your company's deposit requirement under Part VI.

                           REINSURANCE RECOVERABLE ON UNPAID LOSSES AND LOSS EXPENSES (Part I, Col. 19, Line 13)            -
                                                 REINSURANCE RECOVERABLE ON UNPAID LOSSES AND LOSS EXPENSES                 -
                                                                                  DIFFERENCE (OR UNASSIGNED)                -
Condition:           Does the above total equal "Part I, Col. 19, Line 13"?                                  YES, Condition met.




                                                                    Page 4A (1)
State of California                                                                                                      DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                                     NEW CHANGES
   0                Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No             Company Name
                                                            PART IV, SECTION A (2 - Overflow)
                                                             Schedule of Reinsurance Ceded
                                       List only CA Licensed WC Companies or CA Authorized WC Reinsurers.
                                      (DO NOT LIST CA UNAUTHORIZED WC REINSURERS ON THIS PAGE.)
                                                          No segregation by policy year is required.
                                           (For the list of CA Authorized WC Reinsurers, please see Page A.)

                                                                                              *REINSURANCE                        ***AMOUNT OF
                                                                                             RECOVERABLE ON                         RESERVES/
                                                                                              UNPAID LOSSES                          DEPOSITS
                                                                                                 AND LOSS          **RESERVES/    MADE BY YOUR
                                                                                                 EXPENSES            DEPOSITS      COMPANY ON
             NAIC                                                                            (Total Should Equal   MADE BY THE    BEHALF OF THE
            GROUP                                                                     STATE    Part I, Col. 19,      ASSUMING       ASSUMING
 NAIC NO.    NO.                 NAME OF REINSURER (ASSUMING COMPANY)                OF DOM.       Line 13)          COMPANY         COMPANY

    [1]      [2]                                   [3]                                  [4]           [5]              [6]        [7] = [5] - [6], (>0)
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                                                PART IV, SECTION A (2 - Overflow) Subtotal                  -                -                     -



                                                                   Page 4A (2)
State of California                                                                                                            DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)


   0                            Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No                         Company Name
                                                                      PART IV, SECTION B
                                                                 Schedule of Reinsurance Ceded
                                 List all reinsurers that are NOT authorized to assume compensation insurance in California.
                                                              No segregation by policy year is required.

              The data entered in this section is for our information only and CANNOT be taken as Workers' Compensation credit for deposit.

                                                                                                                                      REINSURANCE
NAIC NO.      NAIC GROUP                                                                                   STATE OR COUNTRY OF        RECOVERABLE
    (If             NO.                                                                                           DOMICILE.         ON UNPAID LOSSES
Applicable)   (If Applicable)                     NAME OF REINSURER (ASSUMING COMPANY)                          (If Applicable)    AND LOSS EXPENSES

    [1]             [2]                                            [3]                                              [4]                       [5]




                                                SUBTOTAL FROM PART IV, Section B (1)                                                                -
                                                SUBTOTAL FROM PART IV, Section B (2)                                                                -
                                                SUBTOTAL FROM PART IV, Section B (3)                                                                -
                                                                                                                   Grand Total                      -



                                                                         Page 4B (1)
State of California                                                                                                            DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)


   0                            Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No                         Company Name
                                                               PART IV, SECTION B (2 - Overflow)
                                                                 Schedule of Reinsurance Ceded
                                 List all reinsurers that are NOT authorized to assume compensation insurance in California.
                                                              No segregation by policy year is required.

              The data entered in this section is for our information only and CANNOT be taken as Workers' Compensation credit for deposit.

                                                                                                                                      REINSURANCE
NAIC NO.      NAIC GROUP                                                                                   STATE OR COUNTRY OF        RECOVERABLE
    (If             NO.                                                                                           DOMICILE.         ON UNPAID LOSSES
Applicable)   (If Applicable)                     NAME OF REINSURER (ASSUMING COMPANY)                          (If Applicable)    AND LOSS EXPENSES

    [1]             [2]                                            [3]                                              [4]                       [5]




                                                                                   PART IV, SECTION B (2 - Overflow) Subtotal                       -




                                                                         Page 4B (2)
State of California                                                                                                            DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)


   0                            Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No                         Company Name
                                                               PART IV, SECTION B (3 - Overflow)
                                                                 Schedule of Reinsurance Ceded
                                 List all reinsurers that are NOT authorized to assume compensation insurance in California.
                                                              No segregation by policy year is required.

              The data entered in this section is for our information only and CANNOT be taken as Workers' Compensation credit for deposit.

                                                                                                                                      REINSURANCE
NAIC NO.      NAIC GROUP                                                                                   STATE OR COUNTRY OF        RECOVERABLE
    (If             NO.                                                                                           DOMICILE.         ON UNPAID LOSSES
Applicable)   (If Applicable)                     NAME OF REINSURER (ASSUMING COMPANY)                          (If Applicable)    AND LOSS EXPENSES

    [1]             [2]                                            [3]                                              [4]                       [5]




                                                                                   PART IV, SECTION B (3 - Overflow) Subtotal                       -




                                                                         Page 4B (3)
State of California                                                                                                                         DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                                                  NEW CHANGES
   0              Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No           Company Name
                                                                               PART IV, SECTION C
               Earned premiums on reinsurance ceded to CA Licensed WC Companies or CA Authorized WC Reinsurers broken down by years per company.
                                                    (DO NOT LIST CA UNAUTHORIZED WC REINSURERS ON THIS PAGE.)
                                                                      No segregation by policy year is required.
                                                        (For the list of CA Authorized WC Reinsurers, please see Page A.)
                                                    The totals on this page should automatically transfer to Part 1, Col 4.

             NAIC
            GROUP                                                                       STATE
 NAIC NO.    NO.                        NAME OF CEDING COMPANY                         OF DOM.     2005*       2006**       2007***       2008****       2009*****

    [1]      [2]                                   [3]                                    [4]       [5]         [6]           [7]           [8]             [9]




                           SUBTOTAL FROM PART IV, Section C (1)                                            -            -             -              -               -
                           SUBTOTAL FROM PART IV, Section C (2)                                            -            -             -              -               -
                                                                                 Grand Total               -            -             -              -               -


*The total from Col 5 of this page should automatically transfer to Col 4, Line 2 of Page 1.
**The total from Col 6 of this page should automatically transfer to Col 4, Line 3 of Page 1.
***The total from Col 7 of this page should automatically transfer to Col 4, Line 4 of Page 1.
****The total from Col 8 of this page should automatically transfer to Col 4, Line 5 of Page 1.
*****The total from Col 9 of this page should automatically transfer to Col 4, Line 6 of Page 1.




                                                                                  Page 4C (1)
State of California                                                                                                                   DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                                                  NEW CHANGES
   0              Enter your NAIC# first. If your company name does not appear here, go to page A.
NAIC No           Company Name
                                                                         PART IV, SECTION C (2 - Overflow)
               Earned premiums on reinsurance ceded to CA Licensed WC Companies or CA Authorized WC Reinsurers broken down by years per company.
                                                    (DO NOT LIST CA UNAUTHORIZED WC REINSURERS ON THIS PAGE.)
                                                                      No segregation by policy year is required.
                                                        (For the list of CA Authorized WC Reinsurers, please see Page A.)
                                                    The totals on this page should automatically transfer to Part 1, Col 4.

             NAIC
            GROUP                                                                 STATE
 NAIC NO.    NO.                       NAME OF CEDING COMPANY                    OF DOM.   2005*        2006**        2007***       2008****       2009*****

    [1]      [2]                                 [3]                                [4]     [5]          [6]            [7]           [8]             [9]




                                              PART IV, SECTION C (2 - Overflow) Subtotal           -             -              -              -               -




                                                                             Page 4C (2)
State of California                                                        DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)



     0            Enter your NAIC# first. If your company name does not appear here, go to page A.
  NAIC No         Company Name

                                            Part V
                                     Underwriting Expenses
      For BOTH California Workers' Compensation & Excess Workers' Compensation Business

 1. Commission and Brokerage

     a. Direct (including contingent)

     b. Reinsurance Assumed (including contingent)

     c. Reinsurance Ceded (including contingent)

     d. Policy and membership fees

     e. Net Commission and Brokerage
        (1a + 1b - 1c + 1d)                                                                     -

 2. Total California taxes, licenses and fees

 3. All other underwriting expenses

 4. TOTAL UNDERWRITING EXPENSES                                                                 -




                                                   Page 5
State of California                                                                                                                DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)
                                                              NEW CHANGES
    0                     Enter your NAIC# first. If your company name does not appear here, go to page A.
 NAIC No                  Company Name
                                                                  PART VI
                                         Deposit Requirement and Type and Location of Deposit

A.   1.   Unadjusted Requirement:
          Required deposit as calculated (Part I, line 27)                                                                                                              -
          Adjustments:
              Reserves/ deposits made by your company on behalf of the assuming company (Part IV (A), Col. 7)                                                         -
          Adjusted Requirement or minimum requirement pursuant to CICS 11691                                                                                      100,000


     2.   Deposits:
          The Company's total deposit value is determined by taking the lower of par, amortized par, or market value of each security*. The total deposit value should be
          similar to your company's Form A-110, Col. 9 - Grand Total as of 12/31/09. *For more information on deposit valuation, please refer to the California Code of
          Regulations, Title 10, Ch. 5, Subch.3, Art. 9.5.

          a.  Securities on deposit with State Treasurer's Office (STO or CitiBank):
                       Letter of Credit:
                       Certificate of Deposit:
                       Other:
          b. Securities on deposit with offsite depository:
          Total Deposit:                                                                                                                                                -
     3.   Additional Deposit Required (Line 1 - Line 2) (To be funded no later than March 31):                                       100,000
          Note: The Company's total deposit value is determined by taking the lower of par, amortized par, or market value of each
          security* . The total deposit value should be similar to your company's Form A-110, Col. 9 - Grand Total as of 12/31/09. *For
          more information on deposit valuation, please refer to the California Code of Regulations, Title 10, Ch. 5, Subch.3, Art. 9.5.

     4.   If your company used discounting to determine the present value of the Workers' Compensation deposit:
          a. State the maximum rate of interest used (%)
          b. Contact WCDRT at (213) 346-6433 or (213) 346-6390 for additional instructions, forms, schedules and requirements.
B. If your company's deposit is located with an offsite depository, please provide the following information:
     Contact Person:
                          Mr. or Ms.                 First Name                               Middle                                       Last Name
          Name of Financial Institution:
          Street Address:
          City:
          State:
          Zip Code:
          Phone Number:                                                                                                            Extension:
          Fax Number:
          E-mail:
Special CA Schedule P - Company Contact Person Information for CDI Use - THIS SECTION MUST BE COMPLETED.
     Contact Person:
                          Mr. or Ms.                 First Name                               Middle                                       Last Name
          Street Address:
          City:
          State:
          Zip Code:
          Phone Number:                                                                                                            Extension:
          Fax Number:
          E-mail:
Certification
          State of:                                                                  County of:
          Name of Insurer:               Enter your NAIC# first. If your company name does not appear here, go to page A.
          Name of Officer:                                                                                     Title:

                                                                                                                                         Date:
                                                         Signature
           Under penalty of perjury, the above designated officer declares that the foregoing statement is true and
                             correct for the period specified based upon information and belief.
Special CA Schedule P - Company Contact Person Information to be displayed on the CDI Website
     The contact information you provide above will be made available to the public on the Department's Website.
         Check ( X ) here if you DO NOT wish to have the above contact information made available to the public.
     If you wish to list another contact person for this purpose, please complete the following:
     Contact Person:
                          Mr. or Ms.                 First Name                               Middle                                       Last Name
          Street Address:
          City:
          State:
          Zip Code:
          Phone Number:                                                                                                            Extension:
          Fax Number:
          E-mail:



                                                                                 Page 6
State of California                                                                    DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)



    0                   Enter your NAIC# first. If your company name does not appear here, go to page A.
 NAIC No                Company Name

                                               Part VII
                                        Actuarial Certification
           To be completed if the company's SCASP deposit requirement is $1 million or higher.

In my opinion, the California workers compensation reserves reported on the Company’s Special California
Schedule P make a reasonable provision for all unpaid loss and loss adjustment expense obligations of the
Company for its California workers compensation exposure under the terms of its contracts and agreements.



             Signature in BLUE ink                                                            Date



             Name (Printed)



             Designations



             Name of Consulting Firm




             Subscribed and sworn to (or affirmed) before me this                day of                ,
             2010, by                                    , proved to me on the basis of satisfactory
             evidence to be the person(s) who appeared before me.




                                                                     State of:
             Notary Public

                                                                     County of:


             My Commission Expires:




                                                     Page 7
State of California                                                                                  DEPARTMENT OF INSURANCE
SPECIAL CA SCHEDULE P AS OF 12/31/09
FAD 152 (12/09)


 Part 1 If your company name does not appear on page 1, enter your company info below.
                                                                                                                NAIC
 NAIC                                                                                                           Group     Dom.
  No.                                            Filing Company Name                                             No.      State




                                                                      A
           s:\fad\excel\21a46e7a-ec4a-480f-aa78-fbe7319d7703.xls-Page Page 18 of 29   8:09 PM-21a46e7a-ec4a-480f-aa78-fbe7319d7703.xls
                                                                Principal
                                                                 Office        City,                                      contact
                          Initial                   Amended      Sttreet   State & Zip     contact         contact        middle                      contact        contact                       contact e-   contact                    contact    contact zip
    NAIC   Company Name Filing           Amended      on        Address        Code      last name       first name        name         mr - ms       phone         extension       contact fax      mail       address   contact city      state       code
0                      0               0                      0            0
           Enter your NAIC# first. If your company name does not appear here, go to page0A.          0                0             0             -             0               -                 0           0           0            0             0
Compensation Premiums Earned (California Business)
       as
NAIC No. of            Amended ate Amended
              date filed     D       year                     col-1          col-2          col-3         col-4         col-5
0      ###### 3/1/10 0               Prior to 2005                       0              0             0             0             0
0      ###### 3/1/10 0               2005                                0              0             0             0             0
0      ###### 3/1/10 0               2006                                0              0             0             0             0
0      ###### 3/1/10 0               2007                                0              0             0             0             0
0      ###### 3/1/10 0               2008                                0              0             0             0             0
0      ###### 3/1/10 0               2009                                0              0             0             0             0
0      ###### 3/1/10 0               TOTAL                               0              0             0             0             0
0      ###### 3/1/10 0               2008X                               0              0             0             0             0
0      ###### 3/1/10 0               2009X                               0              0             0             0             0
0      ###### 3/1/10 0               TOTAL X                             0              0             0             0             0


Compensation Loss Payments (Net as to Reinsurance)
       as
NAIC No. of            Amended ate Amended
              date filed     D       year                     col-6          col-7          col-8         col-9       col-10          col-11         col-12       col-13       col-14     col-15       col-16a       col-16b       col-17a       col-17b       col-18       col-19       col-20
0      ###### 3/1/10 0               Prior to 2005            XXX                       0             0             0 XXX             XXX                     0            0            0 XXX                    0             0             0             0            0            0            0
0      ###### 3/1/10 0               2005                                0              0             0             0             0             0             0            0            0          0             0             0             0             0            0            0            0
0      ###### 3/1/10 0               2006                                0              0             0             0             0             0             0            0            0          0             0             0             0             0            0            0            0
0      ###### 3/1/10 0               2007                                0              0             0             0             0             0             0            0            0          0             0             0             0             0            0            0            0
0      ###### 3/1/10 0               2008                                0              0             0             0             0             0             0            0            0          0             0             0             0             0            0            0            0
0      ###### 3/1/10 0               2009                     XXX                       0             0             0             0             0             0            0            0          0             0             0             0             0            0            0            0
0      ###### 3/1/10 0               TOTAL                               0              0             0             0             0 XXX                       0            0            0 XXX                    0             0             0             0            0            0            0
0      ###### 3/1/10 0               2008X                               0              0             0             0             0             0             0            0            0          0             0             0             0             0            0            0            0
0      ###### 3/1/10 0               2009X                    XXX                       0             0             0             0             0             0            0            0          0             0             0             0             0            0            0            0
0      ###### 3/1/10 0               TOTAL X                             0              0             0             0             0 XXX                       0            0            0 XXX                    0             0             0             0            0            0            0


Computation of Reserve for Unpaid Compensation Losses
       as
NAIC No. of             Amended ate Amended
               date filed     D       Year                    col-21         col-22         col-23        col-24        col-25
0      ###### 3/1/10 0                2007                               0              0             0             0             0
0      ###### 3/1/10 0                2008                               0              0             0             0             0
0      ###### 3/1/10 0                2009                               0              0             0             0             0
0      ###### 3/1/10 0                TOTAL                              0              0             0             0             0
0      ###### 3/1/10 0                2008X                              0              0             0             0             0
0      ###### 3/1/10 0                2009X                              0              0             0             0             0
0      ###### 3/1/10 0                TOTAL X                            0              0             0             0             0


Columns 26 and 27, and Actual Loss Ratios
       as
NAIC No. of            Amended ate Amended
              date filed       D       col-26                 col-27         loss ratio y1 loss ratio y2 loss ratio y3 loss ratio y4 loss ratio y5
0      ###### 3/1/10 0                                    0              0        0.000%        0.000%        0.000%        0.000%        0.000%


Excess WC Actual Loss Ratios
       as
NAIC No. of            Amended ate Amended
              date filed     D       loss ratio y1            loss ratio y2 loss ratio y3 loss ratio y4 loss ratio y5
0      ###### 3/1/10 0                               0.000%        0.000%        0.000%        0.000%        0.000%
Distribution of Unallocated Compensation Claim Expenses
        as
NAIC No. of               A      D       year
                 date filed mended ate Amended         col-1     col-2    col-3   col-4  col-5     col-6     col-7       col-8
0        ###### 3/1/10 0                 Prior to 2005         0    0.000% 0.000% 0.000%    0.000%         0         0           0
0        ###### 3/1/10 0                 2005                  0    0.000% 0.000% 0.000%    0.000%         0         0           0
0        ###### 3/1/10 0                 2006                  0    0.000% 0.000% 0.000%    0.000%         0         0           0
0        ###### 3/1/10 0                 2007                  0    0.000% 0.000% 0.000%    0.000%         0         0           0
0        ###### 3/1/10 0                 2008                  0    0.000% 0.000% 5.000%    5.000%         0         0           0
0        ###### 3/1/10 0                 2009                  0    0.000% 0.000% 45.000% 45.000%          0 XXX                 0
0        ###### 3/1/10 0                 2008X                 0    0.000% 0.000% 0.000%    0.000%         0         0           0
0        ###### 3/1/10 0                 2009X                 0    0.000% 0.000% 0.000%    0.000%         0 XXX                 0
0        ###### 3/1/10 0                                       0
                                                        GRAND TOTAL0.000% 0.000% 50.000% 50.000%           0         0           0
Part III Section A
NAIC No. as of           date filed Amended             NAIC
                                              Date Amended No.             No.       State of Domicile
                                                                 NAIC GroupName of Ceding CompanyReinsurance Payable on Unpaid Losses and Loss Expenses
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
0               12/31/09      3/1/10 0                  0                                                0
                                                                                     Grand Total         0
Part III Section B
NAIC No.      as of       date filed Amended             NAIC
                                               Date Amended No.   NAIC Group Name of Ceding Company
                                                                             No.                    2005
                                                                                        State of Domicile       2006   2007   2008   2009 Year
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
0                12/31/09      3/1/10 0                  0                                                  0      0      0      0      0      2009
                                                                                         Grand Total        0      0      0      0      0      2009
Schedule of Reinsurance Ceded - Part IV Section A
NAIC No. as of                                     NAIC
                      date filed Amended Date Amended No.              No.        State of    Reinsurance Recoverable on Unpaid by the Assuming Company
                                                            NAIC Group Name of Reinsurer Domicile       Reserves/Deposits Made Losses and Loss Expenses
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
0            12/31/09      3/1/10 0                0                                                  0          0
                                                                                  Grand Total         0          0
Schedule of Reinsurance Ceded - Part IV Section B
NAIC No.   as of                                    NAIC
                       date filed Amended Date Amended No. If Applicable
                                                               NAIC Group   Name of Reinsurer
                                                                                         State       Reinsurance Recoverable on
                                                                            No. If Applicable or Country of Domicile If Applicable Unpaid Losses and Loss Expenses
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            0                    0
0             12/31/09      3/1/10 0                0          0            0            Grand Total          0
Schedule of Reinsurance Ceded - Part IV Section C
NAIC No.    as of                                   NAIC
                       date filed Amended Date Amended No.              No.
                                                             NAIC Group Name of Ceding Company
                                                                                   State of Domicile
                                                                                               2005        2006   2007   2008   2009 Year
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
0             12/31/09      3/1/10 0                0                                                  0      0      0      0      0      2009
                                                                                    Grand Total        0      0      0      0      0      2009
Underwriting Expenses - Part V
NAIC No.   as of       date filed Amended              col-1a
                                            Date Amended            col-1b       col-1c       col-1d       col-1e       col-2       col-3       col-4
0             12/31/09       3/1/10 0                           0            0            0            0            0           0           0           0
Page 6 - PART VI-A
NAIC No.    as of       date filed Amended              A-1
                                              Date Amended Required Deposit
                                                                   A-1 Reserves/ deposits made by yourA-2a Certificate of Deposit
                                                                              A-1 Adjusted Requirement Credit
                                                                                           A-2a Letter ofcompany A-2a Other A-2b Securities Total Deposit
                                                                                                                                        A-2                     A-4 maximum rate of interest
                                                                                                                                                    A-3 Additional Deposit
0              12/31/09       3/1/10 0                           0          0      100000            0           0           0       0            0 100000           0.00%


Page 6 - PART VI-B
NAIC No.    as of       date filed Amended              sal
                                              Date Amended           last       middle      first                    Address
                                                                                                         Name of Financial Institution:
                                                                                                                                     city      state        zipcode   phone       extension   fax     email
0              12/31/09       3/1/10 0                  0            0          0           0            0           0               0         0            0         0           0           0       0


Page 6 - Part VI-C SCAP Contact Person Information
NAIC No.    as of                                     sal
                         date filed Amended Date Amended             first      middle      last         Address      city          state      zipcode      phone     extension   fax         email
0               12/31/09       3/1/10 0               0              0          0           0            0            0             0          0            0         0           0           0


Page 6 - Certification Contact Person Information
NAIC No.    as of                                      state
                          date filed Amended Date Amended            county     insurer     officer         officer-title date-cert
0                12/31/09       3/1/10 0               0             0                      0               0
                                                                                Enter your NAIC# first. If your company name does not appear here, go to page A.


Page 6 - Public Contact Person Information
NAIC No.    as of        date filed Amended             X=Do not release 1st contact info
                                              Date Amended          sal         first       middle       last         Address       city       state        zipcode   phone       extension   fax     email
0               12/31/09       3/1/10 0                 0           0           0           0            0            0             0          0            0         0           0           0       0
Underwriting Expenses - Part VII
NAIC No. as of         date filed Amended              Actuary
                                            Date Amended         Date           DesignationConsulting firm
                                                                                                       day    month   name      notary    state    county    commission expires
0             12/31/09       3/1/10 0                 0                 1/0/00 0          0           0      0               0 0         0        0         0

				
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Description: California Regulations Automobile Insurance Claims document sample