*15800201820100102* QUARTERLY STATEMENT AS OF JUNE 30, 2018 OF THE CONDITION AND AFFAIRS OF THE AmeriHealth Caritas Iowa, Inc. NAIC Group Code 00936 00936 , (Current Period) Organized under the Laws of Country of Domicile Licensed as business type: 15800 NAIC Company Code Iowa Hospital, Medical & Dental Service or Indemnity [ ] Health Maintenance Organization [ X ] Is HMO Federally Qualified? Yes [ ] No [ X ] 08/19/2015 Des Moines, IA, US 50309 (Street and Number) Main Administrative Office Mail Address Iowa , State of Domicile or Port of Entry United States Life, Accident & Health [ ] Property/Casualty [ ] Dental Service Corporation [ ] Vision Service Corporation [ ] Other [ ] 05/05/2015 Commenced Business Two Ruan Center, 601 Locust Street, Suite 900 , Incorporated/Organized Statutory Home Office 47-3923267 Employer’s ID Number (Prior Period) (City or Town, State, Country and Zip Code) 200 Stevens Drive Philadelphia, PA, US 19113 215-937-8000 (Street and Number) (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Two Ruan Center, 601 Locust Street, Suite 900 Des Moines, IA, US 50309 , (Street and Number or P.O. Box) Primary Location of Books and Records Internet Web Site Address Statutory Statement Contact (City or Town, State, Country and Zip Code) 200 Stevens Drive Philadelphia, PA, US 19113 215-937-8000 (Street and Number) (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) www.amerihealthcaritasia.com Sharon Elaine Duncan 717-671-6552 (Name) (Area Code) (Telephone Number) (Extension) sduncan@amerihealthcaritas.com 215-937-5353 (E-Mail Address) (FAX Number) Name Steven Harvey Bohner Russell Raymond Gianforcaro OFFICERS Title Treasurer President , , Name Robert Edward Tootle, Esquire , , Title Secretary OTHER OFFICERS , DIRECTORS OR TRUSTEES Steven Harvey Bohner State of Pennsylvania County of Philadelphia Eileen Mary Coggins Russell Raymond Gianforcaro ss The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement. Steven Harvey Bohner Treasurer Robert Edward Tootle, Esquire Secretary Russell Raymond Gianforcaro President a. Is this an original filing? Subscribed and sworn to before me this August, 2018 day of b. If no: 1. State the amendment number 2. Date filed 3. Number of pages attached Yes [ X ] No [ ] STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. ASSETS 1 Assets Current Statement Date 2 3 Nonadmitted Assets Net Admitted Assets (Cols. 1 - 2) 4,061,144 1. Bonds 4 December 31 Prior Year Net Admitted Assets 4,061,144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104,679,681 0 0 0 0 0 0 108,740,825 129,967,958 0 0 0 0 0 0 129,967,958 197,495 0 197,495 0 226,666 65,495,631 65,495,631 107,587,968 0 0 0 0 30,603 0 0 0 3,146,067 0 0 85,487 597,366 0 0 0 1,638,500 0 0 206,064 0 0 5,000,000 10,135,641 0 2. Stocks: 2.1 Preferred stocks 2.2 Common stocks 3. Mortgage loans on real estate: 3.1 First liens 3.2 Other than first liens 4. Real estate: 4.1 Properties occupied by the company (less $ encumbrances) 4.2 Properties held for the production of income (less $ encumbrances) 4.3 Properties held for sale (less $ encumbrances) 37,768,052 ), 23,214,490 ) cash equivalents ($ 43,697,139 ) and short-term investments ($ 5. Cash ($ 6. Contract loans (including $ 104,679,681 premium notes) 0 0 7. Derivatives 8. Other invested assets 9. Receivables for securities 10. Securities lending reinvested collateral assets 0 108,740,825 11. Aggregate write-ins for invested assets 12. Subtotals, cash and invested assets (Lines 1 to 11) 13. Title plants less $ 0 0 charged off (for Title insurers only) 14. Investment income due and accrued 15. Premiums and considerations: 15.1 Uncollected premiums and agents’ balances in the course of collection 15.2 Deferred premiums, agents’ balances and installments booked but deferred and not yet due (including $ earned but unbilled premiums) 15.3 Accrued retrospective premiums ($ contracts subject to redetermination ($ ) and ) 16. Reinsurance: 30,603 16.1 Amounts recoverable from reinsurers 16.2 Funds held by or deposited with reinsured companies 16.3 Other amounts receivable under reinsurance contracts 17. Amounts receivable relating to uninsured plans 3,146,067 0 18.1 Current federal and foreign income tax recoverable and interest thereon 18.2 Net deferred tax asset 19. Guaranty funds receivable or on deposit 85,487 20. Electronic data processing equipment and software 21. Furniture and equipment, including health care delivery assets ($ ) 271,982 271,982 164,884 8,985,846 228,504 164,884 4,827,277 228,504 0 0 0 4,158,569 0 187,347,324 5,492,647 181,854,677 255,360,163 187,347,324 5,492,647 0 181,854,677 0 255,360,163 0 0 0 0 0 0 0 0 228,504 228,504 0 0 0 0 0 228,504 0 228,504 0 0 0 0 22. Net adjustment in assets and liabilities due to foreign exchange rates 23. Receivables from parent, subsidiaries and affiliates 24. Health care ($ 4,158,569 ) and other amounts receivable 25. Aggregate write-ins for other-than-invested assets 26. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 27. From Separate Accounts, Segregated Accounts and Protected Cell Accounts 28. Total (Lines 26 and 27) DETAILS OF WRITE-INS 1101. 1102. 1103. 1198. Summary of remaining write-ins for Line 11 from overflow page 1199. Totals (Lines 1101 through 1103 plus 1198) (Line 11 above) 2501. Leasehold Improvement 2502. 2503. 2598. Summary of remaining write-ins for Line 25 from overflow page 2599. Totals (Lines 2501 through 2503 plus 2598) (Line 25 above) 2 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. LIABILITIES, CAPITAL AND SURPLUS Current Period 2 Uncovered 1 Covered 1. Claims unpaid (less $ 14,624,276 reinsurance ceded) 532,628 14,624,276 0 532,628 96,624,590 0 3,169,887 420,860 0 0 0 0 0 420,860 0 0 0 0 0 994,510 0 0 0 0 0 0 0 0 0 0 0 170,396 0 0 0 0 7,449,388 0 0 0 0 0 0 0 0 0 0 0 2. Accrued medical incentive pool and bonus amounts 3. Unpaid claims adjustment expenses Prior Year 4 Total 3 Total 4. Aggregate health policy reserves including the liability of $ for medical loss ratio rebate per the Public Health Service Act 5. Aggregate life policy reserves 6. Property/casualty unearned premium reserve 7. Aggregate health claim reserves 8. Premiums received in advance 9. General expenses due or accrued 10.1 Current federal and foreign income tax payable and interest thereon (including $ on realized gains (losses)) 10.2 Net deferred tax liability 11. Ceded reinsurance premiums payable 12. Amounts withheld or retained for the account of others 13. Remittances and items not allocated 14. Borrowed money (including $ current) and interest thereon $ $ (including current) 170,396 15. Amounts due to parent, subsidiaries and affiliates 16. Derivatives 17. Payable for securities 18. Payable for securities lending 19. Funds held under reinsurance treaties (with $ authorized reinsurers, $ and $ unauthorized reinsurers certified reinsurers) 20. Reinsurance in unauthorized and certified ($ ) companies 21. Net adjustments in assets and liabilities due to foreign exchange rates 22. Liability for amounts held under uninsured plans 23. Aggregate write-ins for other liabilities (including $ 24. Total liabilities (Lines 1 to 23) 252,974 16,001,134 25. Aggregate write-ins for special surplus funds XXX XXX 26. Common capital stock XXX XXX 27. Preferred capital stock XXX XXX 28. Gross paid in and contributed surplus XXX XXX 29. Surplus notes XXX XXX 30. Aggregate write-ins for other-than-special surplus funds XXX XXX 31. Unassigned funds (surplus) XXX XXX XXX XXX current) 0 0 252,974 16,001,134 0 1,000 0 648,000,000 0 0 (482,147,457) 569,261 108,807,636 14,798,963 1,000 0 648,000,000 0 0 (516,247,436) 32. Less treasury stock, at cost: 32.1 $ shares common (value included in Line 26 ) 32.2 $ 0 shares preferred (value included in Line 27 XXX XXX 33. Total capital and surplus (Lines 25 to 31 minus Line 32) ) XXX XXX 34. Total liabilities, capital and surplus (Lines 24 and 33) XXX XXX 165,853,543 181,854,677 0 146,552,527 255,360,163 252,974 569,261 DETAILS OF WRITE-INS 2301. Stale Dated Checks 252,974 2302. 2303. 0 0 0 0 252,974 0 252,974 569,261 2398. Summary of remaining write-ins for Line 23 from overflow page 2399. Totals (Lines 2301 through 2303 plus 2398) (Line 23 above) 2501. Subsequent Year Affordable Care Act Assessment XXX XXX 2502. XXX XXX 2503. XXX XXX 2598. Summary of remaining write-ins for Line 25 from overflow page XXX XXX 0 0 2599. Totals (Lines 2501 through 2503 plus 2598) (Line 25 above) XXX XXX 0 14,798,963 3001. XXX XXX 3002. XXX XXX 3003. XXX XXX 3098. Summary of remaining write-ins for Line 30 from overflow page XXX XXX 0 0 3099. Totals (Lines 3001 through 3003 plus 3098) (Line 30 above) XXX XXX 0 0 3 14,798,963 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. STATEMENT OF REVENUE AND EXPENSES Current Year To Date 1 Uncovered 1. Member Months 2 Total XXX 2. Net premium income (including $ non-health premium income) (2,163,477) XXX Prior Year To Date Prior Year Ended December 31 3 Total 4 Total 1,349,088 2,447,330 972,705,095 1,748,319,046 3. Change in unearned premium reserves and reserve for rate credits XXX 0 0 4. Fee-for-service (net of $ XXX 0 0 5. Risk revenue XXX 0 0 6. Aggregate write-ins for other health care related revenues XXX 0 0 0 7. Aggregate write-ins for other non-health revenues XXX 0 0 0 8. Total revenues (Lines 2 to 7) XXX (2,163,477) 972,705,095 1,748,319,046 9. Hospital/medical benefits (31,858,251) 622,230,934 1,061,447,380 10. Other professional services 14,432,665 276,779,350 542,627,141 medical expenses) Hospital and Medical: 0 0 2,395,207 30,755,926 59,267,875 (1,826,828) 102,861,441 181,619,145 25,437,985 45,368,917 11. Outside referrals 12. Emergency room and out-of-area 13. Prescription drugs 0 14. Aggregate write-ins for other hospital and medical 559,185 15. Incentive pool, withhold adjustments and bonus amounts 16. Subtotal (Lines 9 to 15) 0 0 1,058,065,636 1,890,330,458 0 (16,298,022) 13,632 1,350,873 0 (17,542,282) 1,058,052,004 1,888,979,585 0 0 (240,784) 20,923,539 44,150,698 37,288,537 75,630,466 Less: 1,244,260 17. Net reinsurance recoveries 18. Total hospital and medical (Lines 16 minus 17) 19. Non-health claims (net) 20. Claims adjustment expenses, including $ (240,784) cost containment expenses 6,025,682 21. General administrative expenses 22. Increase in reserves for life and accident and health contracts (including $ (77,199,548) increase in reserves for life only) 0 23. Total underwriting deductions (Lines 18 through 22) 24. Net underwriting gain or (loss) (Lines 8 minus 23) (11,757,384) 9,593,907 XXX 25. Net investment income earned 731,718 26. Net realized capital gains (losses) less capital gains tax of $ (18,997) 27. Net investment gains (losses) (Lines 25 plus 26) 0 712,721 0 0 1,039,064,532 (66,359,437) 1,007,124 14,571 (77,199,548) 1,931,561,201 (183,242,155) 2,424,336 (1,056,757) 1,021,695 1,367,579 0 0 0 0 28. Net gain or (loss) from agents’ or premium balances charged off [(amount recovered $ ) (amount charged off $ )] 29. Aggregate write-ins for other income or expenses 30. Net income or (loss) after capital gains tax and before all other federal income taxes (Lines 24 plus 27 plus 28 plus 29) XXX 10,306,628 31. Federal and foreign income taxes incurred XXX (8,515,310) 32. Net income (loss) (Lines 30 minus 31) XXX 18,821,938 (65,337,742) 0 (65,337,742) (181,874,576) (12,532,501) (169,342,075) DETAILS OF WRITE-INS 0 0 0 0 0 0 0 0 XXX 0 0 0 XXX 0 0 0 1401. Durable Medical Equipment 393,405 7,427,295 13,709,731 1402. Alternative Medical Costs 179,334 2,080,718 4,346,402 1403. Provider Passthrough Expenses (71,613) 15,623,176 26,499,699 0601. XXX 0602. XXX 0603. XXX 0698. Summary of remaining write-ins for Line 6 from overflow page XXX 0699. Totals (Lines 0601 through 0603 plus 0698) (Line 6 above) XXX 0701. XXX 0702. XXX 0703. XXX 0798. Summary of remaining write-ins for Line 7 from overflow page 0799. Totals (Lines 0701 through 0703 plus 0798) (Line 7 above) 1498. Summary of remaining write-ins for Line 14 from overflow page 0 58,059 306,796 813,085 1499. Totals (Lines 1401 through 1403 plus 1498) (Line 14 above) 0 559,185 25,437,985 45,368,917 2998. Summary of remaining write-ins for Line 29 from overflow page 0 0 0 0 2999. Totals (Lines 2901 through 2903 plus 2998) (Line 29 above) 0 0 0 0 2901. 2902. 2903. 4 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. STATEMENT OF REVENUE AND EXPENSES (Continued) 1 2 3 Current Year To Date Prior Year To Date Prior Year Ended December 31 CAPITAL & SURPLUS ACCOUNT 146,552,527 140,060,545 140,060,545 18,821,938 (65,337,742) (169,342,075) 33. Capital and surplus prior reporting year 34. Net income or (loss) from Line 32 35. Change in valuation basis of aggregate policy and claim reserves 36. Change in net unrealized capital gains (losses) less capital gains tax of $ 37. Change in net unrealized foreign exchange capital gain or (loss) 38. Change in net deferred income tax 39. Change in nonadmitted assets 40. Change in unauthorized and certified reinsurance 0 0 0 41. Change in treasury stock 0 0 0 42. Change in surplus notes 0 0 0 43. Cumulative effect of changes in accounting principles 0 0 44. Capital Changes: 44.1 Paid in 0 0 44.2 Transferred from surplus (Stock Dividend) 0 0 44.3 Transferred to surplus 0 0 90,000,000 175,000,000 0 0 45.3 Transferred from capital 0 0 46. Dividends to stockholders 0 0 47. Aggregate write-ins for gains or (losses) in surplus 0 0 0 48. Net change in capital and surplus (Lines 34 to 47) 19,301,016 17,191,804 6,491,982 49. Capital and surplus end of reporting period (Line 33 plus 48) 165,853,543 157,252,349 146,552,527 45. 0 348 0 478,730 (180) 0 (286) 0 0 0 0 (7,470,274) 834,343 Surplus adjustments: 45.1 Paid in 0 45.2 Transferred to capital (Stock Dividend) DETAILS OF WRITE-INS 4701. 4702. 4703. 4798. Summary of remaining write-ins for Line 47 from overflow page 0 0 0 4799. Totals (Lines 4701 through 4703 plus 4798) (Line 47 above) 0 0 0 5 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. CASH FLOW 1 Current Year To Date 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Cash from Operations Premiums collected net of reinsurance Net investment income Miscellaneous income Total (Lines 1 to 3) Benefit and loss related payments Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts Commissions, expenses paid and aggregate write-ins for deductions Dividends paid to policyholders Federal and foreign income taxes paid (recovered) net of $ tax on capital gains (losses) Total (Lines 5 through 9) Net cash from operations (Line 4 minus Line 10) Cash from Investments Proceeds from investments sold, matured or repaid: 12.1 Bonds 12.2 Stocks 12.3 Mortgage loans 12.4 Real estate 12.5 Other invested assets 12.6 Net gains or (losses) on cash, cash equivalents and short-term investments 12.7 Miscellaneous proceeds 12.8 Total investment proceeds (Lines 12.1 to 12.7) Cost of investments acquired (long-term only): 13.1 Bonds 13.2 Stocks 13.3 Mortgage loans 13.4 Real estate 13.5 Other invested assets 13.6 Miscellaneous applications 13.7 Total investments acquired (Lines 13.1 to 13.6) Net increase (or decrease) in contract loans and premium notes Net cash from investments (Line 12.8 minus Line 13.7 and Line 14) Cash from Financing and Miscellaneous Sources Cash provided (applied): 16.1 Surplus notes, capital notes 16.2 Capital and paid in surplus, less treasury stock 16.3 Borrowed funds 16.4 Net deposits on deposit-type contracts and other insurance liabilities 16.5 Dividends to stockholders 16.6 Other cash provided (applied) Net cash from financing and miscellaneous sources (Line 16.1 through Line 16.4 minus Line 16.5 plus Line 16.6) RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) Cash, cash equivalents and short-term investments: 19.1 Beginning of year 19.2 End of period (Line 18 plus Line 19.1) 6 39,928,860 760,439 0 40,689,299 57,709,530 15,880,160 (7,007,743) 66,581,947 (25,892,648) 2 Prior Year To Date 3 Prior Year Ended December 31 930,263,036 1,007,122 0 931,270,158 1,052,253,371 0 57,158,629 0 1,702,238,000 2,197,670 0 1,704,435,670 2,014,625,229 0 118,251,486 0 0 1,109,412,000 (178,141,842) (10,894,001) 2,121,982,714 (417,547,044) 0 0 0 0 0 (18,649) 0 (18,649) 0 0 0 0 0 14,391 0 14,391 0 0 0 0 0 (6,393) 0 (6,393) 4,060,694 0 0 0 0 0 4,060,694 0 (4,079,343) 0 0 0 0 0 0 0 0 14,391 0 0 0 0 0 1,050,650 1,050,650 0 (1,057,043) 0 5,000,000 0 0 280,000,000 0 0 0 (489,393) 0 450,000,000 0 0 0 (768,381) 4,683,714 279,510,607 449,231,619 (25,288,277) 101,383,156 30,627,532 129,967,958 104,679,681 99,340,426 200,723,582 99,340,426 129,967,958 0 (316,286) STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. EXHIBIT OF PREMIUMS, ENROLLMENT AND UTILIZATION Comprehensive (Hospital & Medical) 1 Total 2 3 Individual Group 4 5 6 7 8 9 10 Medicare Supplement Vision Only Dental Only Federal Employees Health Benefits Plan Title XVIII Medicare Title XIX Medicaid Other Total Members at end of: 1. Prior Year 0 0 0 0 0 0 0 0 0 0 2. First Quarter 0 0 0 0 0 0 0 0 0 0 3. Second Quarter 0 0 0 0 0 0 0 0 0 0 4. Third Quarter 0 5. Current Year 0 6. Current Year Member Months 0 0 0 0 0 0 0 0 0 0 Total Member Ambulatory Encounters for Period: 7 7. Physician 0 8. Non-Physician 0 9. Total 0 10. Hospital Patient Days Incurred 0 11. Number of Inpatient Admissions 0 12. Health Premiums Written (a) (2,163,477) 13. Life Premiums Direct 0 14. Property/Casualty Premiums Written 0 15. Health Premiums Earned 16. Property/Casualty Premiums Earned 17. Amount Paid for Provision of Health Care Services 18. Amount Incurred for Provision of Health Care Services (2,163,477) (2,163,477) (2,163,477) 0 65,702,292 65,702,292 (16,298,022) (16,298,022) (a) For health premiums written: amount of Medicare Title XVIII exempt from state taxes or fees $ STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. CLAIMS UNPAID AND INCENTIVE POOL, WITHHOLD AND BONUS (Reported and Unreported) 1 Account Aging Analysis of Unpaid Claims 2 3 1 - 30 Days 31 - 60 Days 4 61 - 90 Days 5 91 - 120 Days 6 Over 120 Days 7 Total Claims unpaid (Reported) 8 0199999 Individually listed claims unpaid 0299999 Aggregate accounts not individually listed-uncovered 0399999 Aggregate accounts not individually listed-covered 0499999 Subtotals 0599999 Unreported claims and other claim reserves 0699999 Total amounts withheld 0799999 Total claims unpaid 0899999 Accrued medical incentive pool and bonus amounts 0 0 0 XXX XXX XXX XXX 0 0 XXX XXX XXX XXX 0 0 XXX XXX XXX XXX 0 0 XXX XXX XXX XXX 0 XXX XXX XXX XXX 0 0 0 0 14,624,276 14,624,276 0 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. UNDERWRITING AND INVESTMENT EXHIBIT ANALYSIS OF CLAIMS UNPAID-PRIOR YEAR-NET OF REINSURANCE Claims Paid Year to Date 1 Line of Business On Claims Incurred Prior to January 1 of Current Year Liability End of Current Quarter 3 4 2 On Claims Unpaid Dec. 31 of Prior Year On Claims Incurred During the Year On Claims Incurred During the Year 5 6 Claims Incurred in Prior Years (Columns 1 + 3) Estimated Claim Reserve and Claim Liability Dec. 31 of Prior Year 1. Comprehensive (hospital and medical) 0 0 2. 0 0 3. Dental only 0 0 4. Vision only 0 0 5. Federal Employees Health Benefits Plan 0 0 6. Title XVIII - Medicare 0 0 88,068,154 96,624,590 0 0 88,068,154 96,624,590 8,985,846 0 11. Other non-health 0 0 12. Medical incentive pools and bonus amounts 0 0 79,082,308 96,624,590 Medicare Supplement 9 73,443,878 7. Title XIX - Medicaid 14,624,276 8. Other health 9. Health subtotal (Lines 1 to 8) 10. Health care receivables (a) 13. Totals (Lines 9-10+11+12) (a) Excludes $ loans or advances to providers not yet expensed. 73,443,878 0 14,624,276 0 8,985,846 64,458,032 0 14,624,276 0 STATEMENT AS OF JUNE 30, 2018 OF THE AMERIHEALTH CARITAS IOWA, INC. NOTES TO FINANCIAL STATEMENTS These items are based on illustrations taken from the NAIC Annual Statement Instructions 1. Summary of Significant Accounting Policies and Going Concern A. Accounting Practices The financial statements of AmeriHealth Caritas Iowa, Inc. (the Company) are presented on the basis of accounting practices prescribed or permitted by the Iowa Insurance Division (IID). The IID recognizes only statutory accounting practices prescribed or permitted by the State of Iowa for determining and reporting the financial condition and results of operations of an insurance company, and for determining its solvency under the Iowa Insurance Law. The National Association of Insurance Commissioners’ (NAIC) Accounting Practices and Procedures Manual (NAIC SAP) has been adopted as a component of prescribed or permitted practices by the State of Iowa. The State has adopted certain prescribed or permitted accounting practices that differ from those found in NAIC SAP. Specifically, the State has imposed limitations on the investments held by the Company pursuant to Iowa Statute 515.35. These limitations do not have any monetary effect on net loss, surplus or risk based capital. A reconciliation of the Company’s net income/(loss) and capital and surplus between NAIC SAP and practices prescribed and permitted by the State of Iowa is shown below: SSAP # F/S Page F/S Line# NET INCOME (1) AmeriHealth Caritas Iowa, Inc. state basis (Page 4, Line 32, Columns 2 & 3) 2018 2017 $ ................18,821,938 $ ........... (169,342,075) (2) State Prescribed Practices that are an increase/(decrease) from NAIC SAP ........................ ....................... ........................ $ (3) State Permitted Practices that are an increase/(decrease) from NAIC SAP ........................ ....................... ........................ $ 0 $ 0 $ 18,821,938 $ (169,342,075) $ 165,853,543 $ 146,552,527 (4) NAIC SAP (1-2-3=4) SURPLUS (5) AmeriHealth Caritas Iowa, Inc. state basis (Page 3, Line 33, Columns 3 & 4) (6) State Prescribed Practices that are an increase/(decrease) from NAIC SAP State imposed investment limitations (7) State Permitted Practices that are an increase/(decrease) from NAIC SAP (8) NAIC SAP 00 N/A N/A 0 $ 0 $ 0 $ 0 ........................ ....................... ........................ $ 0 $ 0 $ 165,853,543 $ 146,552,527 (5-6-7=8) B. Use of Estimates in the Preparation of the Financial Statements – No significant changes since December 31, 2017. C. Accounting Policy The Company uses the following accounting policies: (1) Short-term investments – No significant changes since December 31, 2017. (2) Bonds and other debt instruments are stated at amortized cost or at values prescribed by the District of Columbia DISB. Bonds with an NAIC designation of 3 through 6 are reported at the lower of amortized cost or fair value. The amortized cost of bonds is adjusted for amortization of premiums and accretion of discounts using the scientific-interest method. Realized investment gains and losses on the sale of investments are recognized on the specific identification basis as of the trade date. Realized losses also include losses for fair value declines that are considered to be other than temporary. Interest income is recognized when earned. (3) Common Stocks – None (4) Preferred Stock – None (5) Mortgage Loans – None (6) Loan-backed securities – None (7) Investments in subsidiaries, controlled and affiliated (SCA) entities – None (8) Investments in joint ventures, partnerships and limited liability companies – None (9) Derivatives – None (10) Anticipated investment income as a factor in premium deficiency calculation – None (11) Accrued Medical Expense/Unpaid Claim Adjustment Expense – No significant changes since December 31, 2017. (12) Fixed asset capitalization policy modifications – No significant changes since December 31, 2017. (13) Pharmaceutical Rebates – None D. Going Concern – None 2. Accounting Changes and Corrections of Errors Material changes in accounting principle and/or correction of errors – None 3. Business Combinations and Goodwill A. Statutory Purchase Method – None B. Statutory Merger (1) Name and brief description of the combined entities – None (2) Method of accounting – None (3) Shares of stock issued in the transaction – None (4) Details of results of operations – None (5) Adjustments recorded directly to surplus – None C. Assumption Reinsurance – None D. Impairment Loss recognized on Business Combinations and Goodwill – None 4. Discontinued Operations A. Discontinued Operations Disposed of or Classified as Held for Sale – None B. Change in Plan of Sale of Discontinued Operation – None C. Nature of Any Significant Continuing Involvement with Discontinued Operations After Disposal – None D. Equity Interest Retained in the Discontinued Operation After Disposal – None 5. Investments A. Mortgage Loans, including Mezzanine Real Estate Loans – None B. Debt Restructuring – None C. Reverse Mortgages – None D. Loan-Backed Securities (1) Prepayment assumptions – None (2) Recognized Other-than-Temporary Impairment – None (3) Present Value of Cash Flows – None (4) All impaired securities (fair value is less than cost or amortized cost) for which an other than temporary impairment has not been recognized: (a) The aggregate amount of unrealized losses – None (b) The aggregate related fair value of securities with unrealized losses – None E. Dollar Repurchase Agreements and/or Securities Lending Transactions – None F. Repurchase Agreements Transactions Accounted for as Secured Borrowing – None G. Reverse Repurchase Agreements Transactions Accounted for as Secured Borrowing – None H. Repurchase Agreements Transactions Accounted for as a Sale – None I. Reverse Repurchase Agreements Transactions Accounted for as a Sale – None J. Real Estate – None K. Low-income housing tax credits (LIHTC) – None L. Restricted Assets (1) Restricted Assets (Including Pledged) – None (2) Detail of Assets Pledged as Collateral Not Captured in Other Categories – None (3) Detail of Other Restricted Assets – None (4) Collateral Received and Reflected as Assets Within the Reporting Entity’s Financial Statements – None M. Working Capital Finance Investments – None N. Offsetting and Netting of Assets and Liabilities – None O. Structured Notes – None P. 5* Securities – None Q. Short Sales – None R. Prepayment Penalty and Acceleration Fees – None 6. Joint Ventures, Partnerships and Limited Liability Companies A. Investments in Joint Ventures, Partnerships or Limited Liability Companies that exceed 10% of admitted assets – None B. Impaired investments in Joint Ventures, Partnerships and Limited Liability Companies – None 7. Investment Income A. Due and accrued income is excluded from surplus on the following bases – No significant changes since December 31, 2017. B. Total amount excluded – No significant changes since December 31, 2017. 8. Derivative Instruments A. Market risk, credit risk and cash requirements of the derivative instruments – None B. Objective for using derivative instruments – None C. Accounting policies for recognizing and measuring derivatives instruments used – None D. Component of net gain or loss recognized excluded from hedge effectiveness assessment – None E. Net gain or loss recognized for derivative instruments no longer qualifying for hedge accounting – None F. Derivative instruments accounted for as cash flow hedges – None 9. Income Taxes – No significant changes since December 31, 2017. 10 STATEMENT AS OF JUNE 30, 2018 OF THE AMERIHEALTH CARITAS IOWA, INC. 10. Information Concerning Parent, Subsidiaries, Affiliates and Other Related Parties A.,B., Material related party transactions – On February 26, 2018, $5,000,000 in cash was received by the Company from AMHP Holdings C orp, fulfilling Statement of Statutory Accounting C. Principles (SSAP) No. 72, Surplus and Quasi-Reorganizations requirements. D. Amounts due from or to related parties as of June 30, 2018 – No significant changes since December 31, 2017. E. Parental guarantees – None F. Material management or service arrangements – No significant changes since December 31, 2017. G. Nature of control relationship – No significant changes since December 31, 2017. H. Amounts deducted from the value of an upstream intermediate entity or ultimate parent owned, either directly or indirectly, via a downstream SCA entity – None I. Investments in an SCA entity that exceed 10% of admitted assets – None J. Write-downs for impaired investments in SCA entities – None K. Investment in foreign subsidiary calculation – None L. Investment in a downstream noninsurance holding company – None M. All SCA Investments (1) Balance Sheet Value (Admitted and Nonadmitted) All SCAs – None (2) NAIC filing response information – None N. Investment in Insurance SCAs – None 11. Debt A. B. Capital Notes – None Federal Home Loan Bank (FHLB) Agreements – None 12. Retirement Plans, Deferred Compensation, Postemployment Benefits and Compensated Absences and Other Postretirement Benefit Plans A. Defined Benefit Plan – None B.,C. Postretirement Plan Assets – None D. Basis used to determine the overall expected long-term rate-of-return-on-assets assumption – None E. Defined Contribution Plans – None F. Multiemployer Plans – None G. Consolidated/Holding Company Plans – None H. Postemployment Benefits and Compensated Absences – None I. Impact of Medicare Modernization Act on Postretirement Benefits – None 13. Capital and Surplus, Shareholders' Dividend Restrictions and Quasi-Reorganizations A. Common Capital stock outstanding – No significant changes since December 31, 2017. B. Preferred stock – None C. Dividend restrictions – No significant changes since December 31, 2017. D. Dates and amounts of dividends paid – None E. Stockholder’s portion of ordinary dividend from profits – None F. Restrictions placed on unassigned funds (surplus) – None G. The total amount of advances to surplus not repaid – None H. The amount of stock held by the Company for special purposes – None I. Changes in balances of special surplus funds from the prior year – On January 22, 2018, the Continuing Appropriations Act of 2018 placed a moratorium on the Affordable Care Act (ACA) assessment, suspending collection of the health insurance fee for the 2019 calendar year (2018 data year). Thus, premiums written during 2018 are not subject to this assessment and segregation of special surplus is not required. As of June 30, 2018, the change in balance of special surplus funds from the prior year, due to the Subsequent Year ACA assessment, was $14,798,963. J. The portion of unassigned funds (surplus) represented or reduced by cumulative unrealized gains and losses – No significant changes since December 31, 2017. K. Surplus notes – None L. Impact of any restatement due to quasi-reorganization – None M. Effective dates of all quasi-reorganizations in the prior 10 years is/are – None 14. Liabilities, Contingencies and Assessments A. Contingent Commitments – None B. Assessments – None C. Gain Contingencies – None D. Claims Related Extra Contractual Obligation and Bad Faith Losses Stemming from Lawsuits – None E. Joint and Several Liabilities – None F. All Other Contingencies – None 15. Leases A. B. Lessee Operating Leases (1) General description of lessee’s leasing arrangements – No significant changes since December 31, 2017. (2) Minimum aggregate rental commitments – No significant changes since December 31, 2017. (3) Sales leaseback transactions – None Lessor Leases (1) Operating Leases – None (2) Leveraged Leases – None 16. Information About Financial Instruments With Off-Balance-Sheet Risk And Financial Instruments With Concentrations of Credit Risk A. The face, contract or notional principle amount – None B. The nature and terms of the contract – None C. The amount of accounting loss the entity would incur if any party to the financial instrument failed completely to perform according to the term of the contract and the collateral or other security, if any, for the amount due proved to be of no value to the entity – None D. The Company’s policy of requiring collateral or other security to support financial instruments subject to credit risk – None 17. Sale, Transfer and Servicing of Financial Assets and Extinguishments of Liabilities A. Transfers of Receivables reported as Sales – None B. Transfer and Servicing of Financial Assets – None C. Wash Sales – None 18. Gain or Loss to the Reporting Entity from Uninsured Plans and the Uninsured Portion of Partially Insured Plans A. ASO Plans – None B. ASC Plans – None C. Medicare or Other Similarly Structured Cost Based Reimbursement Contract – None 19. Direct Premium Written/Produced by Managing General Agents/Third Party Administrators – None 20. Fair Value Measurements A.,B. Fair value measurement at reporting date (1) Certain assets and liabilities of the Company are measured and reported: (a) at amortized cost, or (b) at values that approximate fair value due to their liquid or short-term nature. (2) Fair Value Measurements in (Level 3) of the Fair Value Hierarchy – None (3) Transfers in and/or out of Level 3 – None (4) Fair value measurements categorized within Level 2 and 3 – None C. The aggregate fair value of all financial instruments and the level within the fair value hierarchy – None D. Not Practicable to Estimate Fair Value – None 21. Other Items A. Extraordinary Items – No significant changes since December 31, 2017. B. Troubled Debt Restructuring: Debtors – None C. Other Disclosures and Unusual Items – None D. Business Interruption Insurance Recoveries – None E. State Transferable and Non-transferable Tax Credits – None F. Subprime-Mortgage-Related Risk Exposure – None G. Retained Assets – None H. Insurance-Linked Securities (ILS) Contracts – None 22. Events Subsequent Type 1 – Recognized subsequent events – None Type 2 – Nonrecognized subsequent events – No significant changes since December 31, 2017. 23. Reinsurance A. Ceded Reinsurance Report – None B. Uncollectible Reinsurance – None C. Commutation of Ceded Reinsurance – None D. Certified Reinsurer Rating Downgraded or Status Subject to Revocation (1) Reporting Entity Ceding to Certified Reinsurer Whose Rating Was Downgraded or Status Subject to Revocation – None (2) Reporting Entity’s Certified Reinsurer Rating Downgraded or Status Subject to Revocation – None 24. Retrospectively Rated Contracts & Contracts Subject to Redetermination A. Accrued retrospective premium adjustments – None B. Accrued retrospective premium as an adjustment to earned premium – None C. The amount of net premium written that are subject to retrospective rating features – None D. Medical loss ratio rebates required pursuant to the Public Health Service Act – None E. Risk-Sharing Provisions of the ACA – None 25. Change in Incurred Claims and Claim Adjustment Expenses Reserves as of December 31, 2017 were $99,794,477 for incurred claims and claim adjustment expenses. As of June 30, 2018, $67,627,919 has been paid for incurred claims and claim adjustment expenses attributable to insured events of prior years. Reserves remaining for prior years are now $14,624,276 as a result of the re-estimation of unpaid claims and claim adjustment expenses. Therefore, there has been favorable prior year development of $17,542,282 during 2018 for the year ended December 31, 2017. Changes in estimates of incurred claims for prior years are primarily attributable to reserving under moderately adverse conditions as well as changes in utilization and loss development trends. Original estimates are increased or decreased as additional information becomes known regarding individual claims. 10.1 STATEMENT AS OF JUNE 30, 2018 OF THE AMERIHEALTH CARITAS IOWA, INC. 26. Intercompany Pooling Arrangements – None 27. Structured Settlements – None 28. Health Care Receivables A. Pharmaceutical Rebate Receivables – None B. Risk Sharing Receivables – None 29. Participating Policies – None 30. Premium Deficiency Reserves – None 31. Anticipated Salvage and Subrogation – None 10.2 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. GENERAL INTERROGATORIES PART 1 - COMMON INTERROGATORIES GENERAL 1.1 Did the reporting entity experience any material transactions requiring the filing of Disclosure of Material Transactions with the State of Domicile, as required by the Model Act? Yes [ ] No [X] 1.2 If yes, has the report been filed with the domiciliary state? Yes [ ] No [ ] 2.1 Has any change been made during the year of this statement in the charter, by-laws, articles of incorporation, or deed of settlement of the reporting entity? Yes [ ] No [X] 2.2 If yes, date of change: 3.1 Is the reporting entity a member of an Insurance Holding Company System consisting of two or more affiliated persons, one or more of which is an insurer? Yes [X] No [ ] If yes, complete Schedule Y, Parts 1 and 1A. Yes [ ] No [X] 3.2 Have there been any substantial changes in the organizational chart since the prior quarter end? 3.3 If the response to 3.2 is yes, provide a brief description of those changes. 3.4 Is the reporting entity publicly traded or a member of a publicly traded group? 3.5 If the response to 3.4 is yes, provide the CIK (Central Index Key) code issued by the SEC for the entity/group. 4.1 Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? 4.2 If yes, provide the name of entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that has ceased to exist as a result of the merger or consolidation. 1 Name of Entity 5. Yes [ ] No [X] 2 NAIC Company Code Yes [ ] No [X] 3 State of Domicile If the reporting entity is subject to a management agreement, including third-party administrator(s), managing general agent(s), attorney-infact, or similar agreement, have there been any significant changes regarding the terms of the agreement or principals involved? Yes [ ] No [X] NA [ ] If yes, attach an explanation. 6.1 State as of what date the latest financial examination of the reporting entity was made or is being made. 12/31/2016 6.2 State the as of date that the latest financial examination report became available from either the state of domicile or the reporting entity. This date should be the date of the examined balance sheet and not the date the report was completed or released. 12/31/2016 6.3 State as of what date the latest financial examination report became available to other states or the public from either the state of domicile or the reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheet date). 05/19/2018 6.4 By what department or departments? Pennsylvania Insurance Department 6.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? 6.6 Have all of the recommendations within the latest financial examination report been complied with? 7.1 Has this reporting entity had any Certificates of Authority, licenses or registrations (including corporate registration, if applicable) suspended or revoked by any governmental entity during the reporting period? 7.2 If yes, give full information: 8.1 Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? 8.2 If response to 8.1 is yes, please identify the name of the bank holding company. 8.3 Is the company affiliated with one or more banks, thrifts or securities firms? 8.4 If response to 8.3 is yes, please provide below the names and location (city and state of the main office) of any affiliates regulated by a federal regulatory services agency [i.e. the Federal Reserve Board (FRB), the Office of the Comptroller of the Currency (OCC), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identify the affiliate’s primary federal regulator.] 1 Affiliate Name Yes [ ] No [ ] NA [X] Yes [ ] No [ ] NA [X] Yes [ ] No [X] Yes [ ] No [X] Yes [ ] No [X] 2 Location (City, State) 11 3 4 5 6 FRB OCC FDIC SEC STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. GENERAL INTERROGATORIES 9.1 Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions) of the reporting entity subject to a code of ethics, which includes the following standards? Yes [X] No [ ] (a) Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional relationships; (b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity; (c) Compliance with applicable governmental laws, rules and regulations; (d) The prompt internal reporting of violations to an appropriate person or persons identified in the code; and (e) Accountability for adherence to the code. 9.11 If the response to 9.1 is No, please explain: 9.2 Yes [ ] No [X] Has the code of ethics for senior managers been amended? 9.21 If the response to 9.2 is Yes, provide information related to amendment(s). 9.3 Yes [ ] No [X] Have any provisions of the code of ethics been waived for any of the specified officers? 9.31 If the response to 9.3 is Yes, provide the nature of any waiver(s). FINANCIAL Yes [ ] No [X] 10.1 Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page 2 of this statement? 10.2 If yes, indicate any amounts receivable from parent included in the Page 2 amount: $ INVESTMENT 11.1 Were any of the stocks, bonds, or other assets of the reporting entity loaned, placed under option agreement, or otherwise made available for use by another person? (Exclude securities under securities lending agreements.) Yes [ ] No [X] 11.2 If yes, give full and complete information relating thereto: 12. Amount of real estate and mortgages held in other invested assets in Schedule BA: $ 13. Amount of real estate and mortgages held in short-term investments: $ 14.1 Does the reporting entity have any investments in parent, subsidiaries and affiliates? 14.2 If yes, please complete the following: Yes [ ] No [X] 1 Prior Year-End Book/Adjusted Carrying Value 14.21 14.22 14.23 14.24 14.25 14.26 14.27 Bonds Preferred Stock Common Stock Short-Term Investments Mortgage Loans on Real Estate All Other Total Investment in Parent, Subsidiaries and Affiliates (Subtotal Lines 14.21 to 14.26) 14.28 Total Investment in Parent included in Lines 14.21 to 14.26 above 2 Current Quarter Book/Adjusted Carrying Value $ $ $ $ $ $ $ $ $ $ $ $ $ $ 0 $ 0 $ 15.1 Has the reporting entity entered into any hedging transactions reported on Schedule DB? Yes [ ] No [X] 15.2 If yes, has a comprehensive description of the hedging program been made available to the domiciliary state? Yes [ ] No [ ] If no, attach a description with this statement. 11.1 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. GENERAL INTERROGATORIES 16 17. For the reporting entity’s security lending program, state the amount of the following as of the current statement date: 16.1 Total fair value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2 16.2 Total book adjusted/carrying value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2 16.3 Total payable for securities lending reported on the liability page 0 0 0 $ $ $ Excluding items in Schedule E – Part 3 – Special Deposits, real estate, mortgage loans and investments held physically in the reporting entity’s offices, vaults or safety deposit boxes, were all stocks, bonds and other securities, owned throughout the current year held pursuant to a custodial agreement with a qualified bank or trust company in accordance with Section 1, III – General Examination Considerations, F. Outsourcing of Critical Functions, Custodial or Safekeeping Agreements of the NAIC Financial Condition Examiners Handbook? Yes [X] No [ ] 17.1 For all agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following: 1 Name of Custodian(s) 2 Custodian Address Bank of New York Mellon 4400 Computer Drive, Westborough, MA 01581 17.2 For all agreements that do not comply with the requirements of the NAIC Financial Condition Examiners Handbook, provide the name, location and a complete explanation: 1 Name(s) 2 Location(s) 3 Complete Explanation(s) Yes [ ] No [X] 17.3 Have there been any changes, including name changes, in the custodian(s) identified in 17.1 during the current quarter? 17.4 If yes, give full and complete information relating thereto: 1 Old Custodian 2 New Custodian 3 Date of Change 4 Reason 17.5 Investment management – Identify all investment advisors, investment managers, broker/dealers, including individuals that have the authority to make investment decisions on behalf of the reporting entity. For assets that are managed internally by employees of the reporting entity, note as such. [“…that have access to the investment accounts”; “…handle securities”] 1 Name of Firm or Individual 2 Affiliation Michael Burgoyne, who makes recommendations to BOD I Steven Bohner, who makes recommendations to BOD I Western Asset Management Company U 17.5097 For those firms/individuals listed in the table for Question 17.5, do any firms/individuals unaffiliated with the reporting entity (i.e., designated with a “U”) manage more than 10% of the reporting entity’s assets? Yes [ X ] No [ 17.5098 For firms/individuals unaffiliated with the reporting entity (i.e., designated with a “U”) listed in the table for Question 17.5, does the total assets under management aggregate to more than 50% of the reporting entity’s assets? Yes [ ] ] No [ X ] 17.6 For those firms or individuals listed in the table for 17.5 with an affiliation code of “A” (affiliated) or “U” (unaffiliated), provide the information for the table below. 1 Central Registration Depository Number CRD 110441 2 Name of Firm or Individual 3 Legal Entity Identifier (LEI) Western Asset Management Company 4 Registered With SEC 18.1 Have all the filing requirements of the Purposes and Procedures Manual of the NAIC Investment Analysis Office been followed? 18.2 If no, list exceptions: 19. 5 Investment Management Agreement (IMA) Filed NO Yes [X] No [ ] By self-designating 5*GI securities, the reporting entity is certifying the following elements for each self-designated 5*GI security: a. b. c. Documentation necessary to permit a full credit analysis of the security does not exist. Issuer or obligor is current on all contracted interest and principal payments. The insurer has an actual expectation of ultimate payment of all contracted interest and principal. Yes [ ] No [ ] Has the reporting entity self-designated 5*GI securities? 11.2 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. GENERAL INTERROGATORIES PART 2 - HEALTH 1. Operating Percentages: 822.0 % 1.1 A&H loss percent 11.1 % 1.2 A&H cost containment percent (278.5) % 1.3 A&H expense percent excluding cost containment expenses Yes [ ] No [X] 2.1 Do you act as a custodian for health savings accounts? 2.2 If yes, please provide the amount of custodial funds held as of the reporting date. $ Yes [ ] No [X] 2.3 Do you act as an administrator for health savings accounts? 2.4 If yes, please provide the balance of the funds administered as of the reporting date. $ 3. Is the reporting entity licensed or chartered, registered, qualified, eligible or writing business in at least two states? Yes [ ] No [X] 3.1 If no, does the reporting entity assume reinsurance business that covers risks residing in at least one state other than the state of domicile of the reporting entity? Yes [ ] No [X] 12 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE S - CEDED REINSURANCE 1 2 3 4 NAIC Company Code ID Number Effective Date Name of Reinsurer Showing All New Reinsurance Treaties - Current Year to Date 5 Domiciliary Jurisdiction 6 Type of Reinsurance Ceded 7 Type of Reinsurer 8 Certified Reinsurer Rating (1 through 6) 9 Effective Date of Certified Reinsurer Rating 13 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE T - PREMIUMS AND OTHER CONSIDERATIONS 1 States, Etc. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. Alabama AL Alaska AK Arizona AZ Arkansas AR California CA Colorado CO Connecticut CT Delaware DE Dist. Columbia DC Florida FL Georgia GA Hawaii HI Idaho ID Illinois IL Indiana IN Iowa IA Kansas KS Kentucky KY Louisiana LA Maine ME Maryland MD Massachusetts MA Michigan MI Minnesota MN Mississippi MS Missouri MO Montana MT Nebraska NE Nevada NV New Hampshire NH New Jersey NJ New Mexico NM New York NY North Carolina NC North Dakota ND Ohio OH Oklahoma OK Oregon OR Pennsylvania PA Rhode Island RI South Carolina SC South Dakota SD Tennessee TN Texas TX Utah UT Vermont VT Virginia VA Washington WA West Virginia WV Wisconsin WI Wyoming WY American Samoa AS Guam GU Puerto Rico PR U.S. Virgin Islands VI Northern Mariana Islands MP Canada CAN Aggregate other alien OT Subtotal Reporting entity contributions for Employee Benefit Plans 61. Total (Direct Business) Active Status (a) N N N N N N N N N N N N N N N L N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N XXX XXX Current Year to Date - Allocated by States and Territories Direct Business Only 2 3 4 5 6 Federal Employees Health Life & Annuity Accident & Benefits Premiums & Health Medicare Medicaid Program Other Premiums Title XVIII Title XIX Premiums Considerations 7 8 9 Property/ Casualty Premiums Total Columns 2 Through 7 Deposit-Type Contracts 0 0 0 0 0 (2,163,477) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (2,163,477) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (2,163,477) 0 0 (2,163,477) 0 0 0 (2,163,477) XXX 0 0 0 0 0 0 0 0 XXX 0 0 0 0 0 0 0 0 (2,163,477) XXX XXX 0 0 0 0 DETAILS OF WRITE-INS XXX XXX XXX 58001. 58002. 58003. 58998. Summary of remaining write-ins for Line 58 from overflow page 58999. Totals (Lines 58001 through 58003 plus 58998) (Line 58 above) (a) Active Status Counts L – Licensed or Chartered – Licensed insurance carrier or domiciled RRG E – Eligible – Reporting entities eligible or approved to write surplus lines in the state N – None of the above – Not allowed to write business in the state 1 R – Registered – Non-domiciled RRGs 0 Q – Qualified – Qualified or accredited reinsurer 56 14 0 0 STATEMENT AS OF JUNE 30, 2018 of AMERIHEALTH CARITAS IOWA, INC. SCHEDULE Y – INFORMATION CONCERNING ACTIVITIES OF INSURER MEMBERS OF A HOLDING COMPANY GROUP PART 1 – ORGANIZATION CHART Independence Health Group, Inc. PA nonprofit corporation FEIN: 47-1233198 AmeriHealth, Inc. PA business corporation FEIN: 23-2425461 50% Tandigm Health, LLC 1819 LLC DE limited liability company FEIN: 46-5339475 DE limited liability company FEIN: 82-5264307 Independence Blue Cross, LLC AmeriHealth Casualty Holdings, LLC AmeriHealth New Jersey Holdings, LLC PA limited liability company FEIN: 46-3878323 (SEE PAGE 2) PA limited liability company FEIN: 46-3893959 (SEE PAGE 2) PA limited liability company FEIN: 46-3867722 AHI SubCo 1, Inc. PA business corporation FEIN: 82-3756593 25.2% Independence Assurance Company PA business corporation FEIN: 81-3078234 NAIC Code: 16053 InsPro Technologies Corp. DE business corporation FEIN: 98-0438502 The AmeriHealth Agency, Inc. PA business corporation FEIN: 23-2800586 AmeriHealth Services, Inc. PA business corporation FEIN: 23-2795357 93.7% 15 Tandigm MSO LLC PA limited liability company FEIN: 82-4299279 Healthcare Delaware, Inc. DE business corporation FEIN: 51-0296135 NAIC Code: 95794 Region 6 RX Corp. PA business corporation FEIN: 30-0326654 NAIC Code: 12812 Independence Insurance, Inc. DE business corporation FEIN: 23-2865349 NAIC Code: 60254 AmeriHealth Assurance, Ltd. Bermuda captive insurance company FEIN: 98-0426648 50% KMHP Holding Company, Inc. PA business corporation FEIN: 23-2944969 AmeriHealth HMO, Inc. PA business corporation FEIN: 23-2314460 NAIC Code: 95044 AmeriHealth Administrators, Inc. PA business corporation FEIN: 23-2521508 Keystone Health Plan East, Inc. PA business corporation FEIN: 23-2405376 NAIC Code: 95056 Self Funded Benefits, Inc. NJ business corporation FEIN: 13-3155962 Veridign Health Solutions, LLC PA limited liability company FEIN: 81-0681081 KHPE SubCo, Inc. PA business corporation FEIN: 82-3774494 5% International Plan Solutions, LLC DE limited liability company FEIN: 27-0204996 Independence Hospital Indemnity Plan, Inc. PA nonprofit corporation FEIN: 23-0370270 NAIC Code: 54704 Highmark, Inc. 34% NS Assisted Living Communities, Inc. PA business corporation FEIN: 23-2824200 Highway to Health, Inc. DE business corporation FEIN: 23-2903313 Independence Blue Cross Foundation PA Nonprofit 501(c)(3) corporation FEIN: 36-4685801 Equal number of directors selected by Independence Hospital Indemnity Plan, Inc. and Highmark, Inc Insurance Company Health Maintenance Organization (HMO) Professional Health Services Plan Corporation Hospital Plan Corporation Third Party Administrator Risk Assuming Non-Licensed PPO Unaffiliated Third Party Charitable Foundation HTH Re, Ltd. Bermuda captive insurance company FEIN: 98-0408753 95% IBC MH LLC 38.2% Insurance Producer Captive Insurance Company AHI SubCo 2, Inc. PA business corporation FEIN: 82-3770369 6.3% PRHP, Inc. Puerto Rico stock corporation FEIN: 66-0195325 Mercy Health Plan. 50% QCC Insurance Company PA business corporation FEIN: 23-2184623 NAIC Code: 93688 Independence Holdings, Inc. PA business corporation FEIN: 23-2982367 Worldwide Insurance Services, LLC VA limited liability company FEIN: 54-1867679 Inter-County Hospitalization Plan, Inc. PA nonprofit corporation FEIN: 23-0724427 NAIC Code: 54763 Inter-County Health Plan, Inc. PA nonprofit corporation FEIN: 23-2063810 NAIC Code: 53252 DE limited liability company FEIN: 45-3672640 (SEE PAGE 2) STATEMENT AS OF JUNE 30, 2018 of AMERIHEALTH CARITAS IOWA, INC. SCHEDULE Y – INFORMATION CONCERNING ACTIVITIES OF INSURER MEMBERS OF A HOLDING COMPANY GROUP PART 1 – ORGANIZATION CHART Independence Health Group, Inc. PA nonprofit corporation FEIN: 47-1233198 AmeriHealth, Inc. PA business corporation FEIN: 23-2425461 Independence Blue Cross, LLC AmeriHealth Casualty Holdings, LLC AmeriHealth New Jersey Holdings, LLC PA limited liability company FEIN: 46-3867722 PA limited liability company FEIN: 46-3878323 PA limited liability company FEIN: 46-3893959 Cooper Medical Services, Inc. AHI SubCo 1, Inc. PA business corporation FEIN: 82-3756593 (SEE PAGE 1) 92.4% 15.1 CompServices, Inc. AHI SubCo 2, Inc. 7.6% PA business corporation FEIN: 82-3770369 AmeriHealth New Jersey, LLC PA business corporation FEIN: 25-1686685 DE limited liability company FEIN: 61-1741302 95% IBC MH LLC CSI Services, Inc. PA business corporation FEIN: 25-1765486 AmeriHealth TPA of New Jersey, LLC NJ limited liability company FEIN: 61-1741805 AmeriHealth Insurance Company of New Jersey NJ business corporation FEIN: 22-3338404 NAIC Code: 60061 AmeriHealth HMO of New Jersey, Inc. DE limited liability company FEIN: 45-3672640 NJ business corporation FEIN: 35-2511976 38.7% 61.3% Vista Health Plan, Inc. PA business corporation FEIN: 23-2408039 NAIC Code: 96660 Blue Cross and Blue Shield 38.7% of Michigan BMH LLC DE limited liability company FEIN: 30-0703311 SEE PAGE 3 STATEMENT AS OF JUNE 30, 2018 of AMERIHEALTH CARITAS IOWA, INC. SCHEDULE Y – INFORMATION CONCERNING ACTIVITIES OF INSURER MEMBERS OF A HOLDING COMPANY GROUP PART 1 – ORGANIZATION CHART BMH LLC DE limited liability company FEIN: 30-0703311 BMH SUBCO I LLC BMH SUBCO II LLC DE limited liability company FEIN: 38-3946080 DE limited liability company FEIN: 80-0768643 50% 50% 50% AmeriHealth Caritas Health Plan PA general partnership FEIN: 23-2859523 AmeriHealth Caritas Services, LLC DE limited liability company FEIN: 45-5415725 50% Keystone Family Health Plan PA general partnership FEIN: 23-2842344 AMHP Holdings Corp. PA business corporation FEIN: 26-1144363 15.2 AmeriHealth Caritas District of Columbia, Inc. Select Health of South Carolina, Inc. District of Columbia business corporation FEIN: 46-1480213 NAIC Code: 15088 Community Behavioral Healthcare Network of Pennsylvania, Inc. PA business corporation FEIN: 25-1765391 70% IA business corporation FEIN: 47-3923267 NAIC Code: 15800 SC business corporation FEIN: 57-1032456 NAIC Code: 95458 AmeriHealth Caritas Delaware, Inc.* DE business corporation FEIN: 61-1847073 PerformRx IPA of New York, LLC AmeriHealth Caritas Iowa, Inc. AmeriHealth Caritas Louisiana, Inc. AmeriHealth Michigan, Inc. LA business corporation FEIN: 27-3575066 NAIC Code: 14143 MI business corporation FEIN: 46-0906893 NAIC Code: 15104 NY limited liability company FEIN: 26-1809217 PA business corporation FEIN: 26-0885397 NAIC Code: 13630 AmeriHealth Caritas Kansas, Inc. AmeriHealth Caritas New Mexico, Inc. KS business corporation FEIN: 82-3313629 NM business corporation FEIN: 61-1857768 PerformRx, LLC AmeriHealth Caritas New Hampshire, Inc. NH business corporation FEIN: 82-5264307 Blue Cross Complete of Michigan LLC MI limited liability company FEIN: 47-2582248 NAIC Code: 11557 50% TX business corporation FEIN: 82-1141687 AmeriHealth Caritas Indiana, LLC IN limited liability company FEIN: 20-4948091 Florida True Health, Inc. FL business corporation FEIN: 45-4088232 NAIC Code: 14378 51% PerformSpecialty, LLC PA limited liability company FEIN: 61-1729412 *Based on direction from the Delaware Department of Insurance, entity is not classified as an HMO; currently pursuing Medicaid Certification through the Delaware Division of Medicaid & Medical Assistance. NE business corporation FEIN: 45-3790685 NAIC Code: 14261 AmeriHealth Caritas Texas, Inc. PA limited liability company FEIN: 27-0863878 CBHNP Services, Inc. AmeriHealth Nebraska, Inc. 50% Community Care of Florida, LLC FL limited liability company FEIN: 61-1720226 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE Y PART 1A – DETAIL OF INSURANCE HOLDING COMPANY SYSTEM 1 Group Code 2 3 Group Name NAIC Company Code 4 ID Number 5 Federal RSSD 6 CIK 7 Name of Securities Exchange if Publicly Traded (U.S. or International) 8 Names of Parent, Subsidiaries or Affiliates 9 10 Relationship to Domiciliary Reporting Location Entity 11 Directly Controlled by (Name of Entity/Person) 12 13 14 15 Type of Control (Ownership, Board, If Control is Is an SCA Management, Ownership Filing Attorney-in-Fact, Provide Ultimate Controlling Required? Influence, Other) Percentage Entity(ies)/Person(s) (Y/N) 00000 00000 47-1233198 Independence Health Group, Inc. PA UIP 00000 00000 23-2425461 AmeriHealth, Inc. PA UIP Independence Health Group, Inc. Ownership 00000 00000 46-5339475 Tandigm Health, LLC DE NIA AmeriHealth, Inc. Ownership 00000 00000 82-4299279 Tandigm MSO LLC PA NIA Tandigm Health, LLC Ownership 16 00000 00000 82-5264307 1819 LLC DE NIA AmeriHealth, Inc. (50%) / Comcast Connected Health, LLC (50%) Ownership 00000 00000 46-3867722 Independence Blue Cross, LLC PA NIA AmeriHealth, Inc. 00000 00000 98-0438502 InsPro Technologies Corp DE NIA Independence Blue Cross, LLC Ownership 00000 23-2800586 The AmeriHealth Agency, Inc. PA NIA Independence Blue Cross, LLC Ownership 12812 30-0326654 Region 6 Rx Corp. PA IA Independence Blue Cross, LLC Ownership 95794 51-0296135 Healthcare Delaware, Inc. DE IA Independence Blue Cross, LLC Ownership 60254 23-2865349 Independence Insurance, Inc. DE IA Independence Blue Cross, LLC Ownership 00000 00000 98-0426648 AmeriHealth Assurance, Ltd. BMU NIA Independence Blue Cross, LLC Ownership 00000 00000 23-2795357 PA NIA Independence Blue Cross, LLC Ownership 00000 00000 23-2824200 AmeriHealth Services, Inc. NS Assisted Living Communities, Inc. PA NIA AmeriHealth Services, Inc. 00000 00000 23-2982367 Independence Holdings, Inc. PA NIA Independence Blue Cross, LLC Ownership 00000 00000 23-2944969 KMHP Holding Company, Inc. PA NIA 00000 00000 66-0195325 PRHP, Inc. PR NIA Independence Holdings, Inc. Independence Holdings, Inc. (93.7%) / QCC Insurance Company (6.3%) 93688 23-2184623 QCC Insurance Company PA IA Independence Blue Cross, LLC Ownership 00000 00000 81-0681081 PA NIA QCC Insurance Company 00000 00000 27-0204996 Veridign Health Solutions, LLC International Plan Solutions, LLC DE NIA 00000 00000 23-2903313 Highway to Health, Inc. DE NIA QCC Insurance Company Ownership International Plan Solutions, LLC Ownership 00000 00936 00936 00936 00936 Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Ownership Ownership Ownership Ownership Ownership Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence Health Group, Inc. / Comcast Connected Health, 50.0 LLC Independence 100.0 Health Group, Inc. Independence 25.2 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence 100.0 Health Group, Inc. Independence Health Group, Inc. / Mercy Health 50.0 Plan Independence 100.0 Health Group, Independence 100.0 Health Group, Independence 100.0 Health Group, Independence 38.2 Health Group, Independence 13.0 Health Group, N N N N N N N N N N N N N N N N Inc. N Inc. N Inc. N Inc. N Inc. N 16 * STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE Y PART 1A – DETAIL OF INSURANCE HOLDING COMPANY SYSTEM 1 Group Code 2 3 Group Name NAIC Company Code 4 ID Number 00000 00000 98-0408753 00000 00000 54-1867679 00000 00000 00000 00936 00936 00936 Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. 00000 16.1 00936 Independence Health Group, Inc. 00000 5 Federal RSSD 6 CIK 7 Name of Securities Exchange if Publicly Traded (U.S. or International) 8 Names of Parent, Subsidiaries or Affiliates 9 Relationship to Domiciliary Reporting Location Entity Directly Controlled by (Name of Entity/Person) 12 13 14 15 Type of Control (Ownership, Board, If Control is Is an SCA Management, Ownership Filing Attorney-in-Fact, Provide Ultimate Controlling Required? Influence, Other) Percentage Entity(ies)/Person(s) (Y/N) BMU NIA Highway to Health, Inc. Ownership 13.0 VA NIA Highway to Health, Inc. Ownership 13.0 23-2521508 PA NIA 100.0 00000 13-3155962 Self Funded Benefits, Inc. NJ NIA Independence Blue Cross, LLC Ownership AmeriHealth Administrators, Inc. Ownership 16053 81-3078234 Independence Assurance Company PA IA Independence Blue Cross, LLC Ownership 100.0 95044 23-2314460 AmeriHealth HMO, Inc. PA IA Independence Blue Cross, LLC Ownership 100.0 95056 23-2405376 Keystone Health Plan East, Inc. PA IA 100.0 00000 82-3774494 PA NIA 54704 23-0370270 PA IA 100.0 36-4685801 PA OTH Inter-County Hospitalization Plan, Inc. PA IA PA IA Independence Blue Cross, LLC Independence Hospital Indemnity Plan, Inc. Independence Hospital Indemnity Plan, Inc. (50%) / Highmark, Inc. (50%) Independence Hospital Indemnity Plan, Inc. (50%) / Highmark, Inc. (50%) Ownership 00000 KHPE SubCo, Inc. Independence Hospital Indemnity Plan, Inc. Independence Blue Cross Foundation Independence Blue Cross, LLC Ownership Keystone Health Plan East, Inc. Ownership PA NIA Independence Health Group, Inc. 54763 23-0724427 00936 Independence Health Group, Inc. 53252 23-2063810 00000 00000 46-3878323 Inter-County Health Plan, Inc. AmeriHealth Casualty Holdings, LLC 00000 00000 25-1686685 CompServices, Inc. PA 00000 00000 25-1765486 00000 00000 46-3893959 CSI Services, Inc. AmeriHealth New Jersey Holdings, LLC 00000 00000 61-1741302 00000 00000 60061 Independence Health Group, Inc. 11 HTH Re, Ltd. Worldwide Insurance Services, LLC AmeriHealth Administrators, Inc. 00936 00936 10 Board 100.0 100.0 0.0 Ownership 50.0 Ownership 50.0 Ownership 100.0 NIA AmeriHealth, Inc. AmeriHealth Casualty Holdings, LLC Ownership 100.0 PA NIA CompServices, Inc. Ownership 100.0 PA NIA AmeriHealth, Inc. Ownership 100.0 AmeriHealth New Jersey, LLC DE NIA AmeriHealth New Jersey Holdings, LLC Ownership 92.4 61-1741805 AmeriHealth TPA of New Jersey, LLC NJ NIA AmeriHealth New Jersey, LLC Ownership 92.4 22-3338404 AmeriHealth Insurance Company of New Jersey NJ IA AmeriHealth New Jersey, LLC Ownership 92.4 Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. / Highmark Health Independence Health Group, Inc. / Highmark Health Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. / Cooper Medical Services, Inc. Independence Health Group, Inc. / Cooper Medical Services, Inc. Independence Health Group, Inc. / Cooper Medical Services, Inc. N N N N N N N N N N N N N N N N N N N 16 * STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE Y PART 1A – DETAIL OF INSURANCE HOLDING COMPANY SYSTEM 1 Group Code 2 3 Group Name NAIC Company Code 4 ID Number 5 Federal RSSD 6 CIK 7 Name of Securities Exchange if Publicly Traded (U.S. or International) 8 Names of Parent, Subsidiaries or Affiliates 9 10 Relationship to Domiciliary Reporting Location Entity 11 Directly Controlled by (Name of Entity/Person) 12 13 14 15 Type of Control (Ownership, Board, If Control is Is an SCA Management, Ownership Filing Attorney-in-Fact, Provide Ultimate Controlling Required? Influence, Other) Percentage Entity(ies)/Person(s) (Y/N) 00000 00000 35-2511976 AmeriHealth HMO of New Jersey, Inc. NJ NIA AmeriHealth New Jersey, LLC Ownership 92.4 00000 00000 82-3756593 AHI SubCo 1, Inc. PA UIP AmeriHealth, Inc. Ownership 100.0 00000 00000 82-3770369 AHI SubCo 2, Inc. PA UIP Ownership 100.0 00000 45-3672640 IBC MH LLC DE UIP AHI SubCo 1, Inc. AHI SubCo 2, Inc. (95%) / KHPE SubCo, Inc. (5%) Ownership 100.0 96660 23-2408039 Vista Health Plan, Inc. PA IA IBC MH LLC Ownership 100.0 00000 00000 30-0703311 BMH LLC DE UIP IBC MH LLC Ownership 61.3 00000 00000 45-5415725 AmeriHealth Caritas Services, LLC DE NIA BMH LLC Ownership 61.3 00000 00000 38-3946080 BMH SUBCO I LLC DE UIP BMH LLC Ownership 61.3 00000 00000 80-0768643 BMH SUBCO II LLC DE UIP BMH LLC Ownership 61.3 00000 00000 23-2842344 Keystone Family Health Plan PA NIA BMH SUBCO I LLC (50%) / BMH SUBCO II LLC (50%) Ownership 61.3 00000 00000 23-2859523 AmeriHealth Caritas Health Plan PA UIP BMH SUBCO I LLC (50%) / BMH SUBCO II LLC (50%) Ownership 61.3 00000 00936 Independence Health Group, Inc. 16.2 00936 Independence Health Group, Inc. 14143 27-3575066 AmeriHealth Caritas Louisiana, Inc. LA IA AMHP Holdings Corp. Ownership 61.3 00936 Independence Health Group, Inc. 15800 47-3923267 AmeriHealth Caritas Iowa, Inc. IA RE AMHP Holdings Corp. Ownership 61.3 Independence Health Group, Inc. / Cooper Medical Services, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan N N N N N N N N N N N N N 16 * STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE Y PART 1A – DETAIL OF INSURANCE HOLDING COMPANY SYSTEM 1 Group Code 2 3 Group Name NAIC Company Code 4 ID Number 5 Federal RSSD 6 CIK 7 Name of Securities Exchange if Publicly Traded (U.S. or International) 8 Names of Parent, Subsidiaries or Affiliates 9 10 Relationship to Domiciliary Reporting Location Entity 11 Directly Controlled by (Name of Entity/Person) 12 13 14 15 Type of Control (Ownership, Board, If Control is Is an SCA Management, Ownership Filing Attorney-in-Fact, Provide Ultimate Controlling Required? Influence, Other) Percentage Entity(ies)/Person(s) (Y/N) 16.3 00936 Independence Health Group, Inc. 15104 46-0906893 AmeriHealth Michigan, Inc. MI IA AMHP Holdings Corp. Ownership 61.3 00936 Independence Health Group, Inc. 95458 57-1032456 Select Health of South Carolina, Inc. SC IA AMHP Holdings Corp. Ownership 61.3 00936 Independence Health Group, Inc. 15088 46-1480213 AmeriHealth Caritas District of Columbia, Inc. DC IA AMHP Holdings Corp. Ownership 61.3 00000 00000 27-0863878 PerformRx, LLC PA NIA AmeriHealth Caritas Health Plan Ownership 61.3 00000 00000 61-1729412 PerformSpecialty, LLC PA NIA PerformRx, LLC Ownership 61.3 00000 00000 26-1809217 PerformRx IPA of New York, LLC NY NIA AmeriHealth Caritas Health Plan Ownership 61.3 00000 00000 26-1144363 AMHP Holdings Corp. PA UDP AmeriHealth Caritas Health Plan Ownership 61.3 25-1765391 Community Behavioral Healthcare Network of Pennsylvania, Inc. PA NIA AMHP Holdings Corp. Ownership 61.3 Ownership 61.3 Ownership 61.3 00000 00936 00000 00000 Independence Health Group, Inc. 13630 26-0885397 CBHNP Services, Inc. PA IA Community Behavioral Healthcare Network of Pennsylvania, Inc. 00000 20-4948091 AmeriHealth Caritas Indiana, LLC IN NIA AmeriHealth Caritas Health Plan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan N N N N N N N N N N 16 * STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE Y PART 1A – DETAIL OF INSURANCE HOLDING COMPANY SYSTEM 1 Group Code 2 3 Group Name NAIC Company Code 4 ID Number 5 Federal RSSD 6 CIK 7 Name of Securities Exchange if Publicly Traded (U.S. or International) 8 Names of Parent, Subsidiaries or Affiliates 9 10 Relationship to Domiciliary Reporting Location Entity 11 Directly Controlled by (Name of Entity/Person) 12 13 14 15 Type of Control (Ownership, Board, If Control is Is an SCA Management, Ownership Filing Attorney-in-Fact, Provide Ultimate Controlling Required? Influence, Other) Percentage Entity(ies)/Person(s) (Y/N) 16.4 00936 Independence Health Group, Inc. 14261 45-3790685 AmeriHealth Nebraska, Inc. NE IA AmeriHealth Caritas Health Plan Ownership 42.9 00936 Independence Health Group, Inc. 14378 45-4088232 Florida True Health, Inc. FL IA AmeriHealth Caritas Health Plan Ownership 30.6 00000 61-1720226 Community Care of Florida, LLC FL NIA Florida True Health, Inc. Ownership 15.6 11557 47-2582248 Blue Cross Complete of Michigan LLC MI IA AmeriHealth Caritas Health Plan Ownership 30.6 00000 00000 61-1847073 AmeriHealth Caritas Delaware, Inc. DE NIA AMHP Holdings Corp. Ownership 61.3 00000 00000 82-1141687 AmeriHealth Caritas Texas, Inc. TX NIA AMHP Holdings Corp. Ownership 61.3 00000 00000 61-1857768 AmeriHealth Caritas New Mexico, Inc. NM NIA AMHP Holdings Corp. Ownership 61.3 00000 00000 82-3313629 AmeriHealth Caritas Kanas, Inc. KS NIA AMHP Holdings Corp. Ownership 61.3 00000 00000 83-0987716 AmeriHealth Caritas New Hampshire, Inc. NH NIA AMHP Holdings Corp. Ownership 61.3 00000 00572 Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan / Blue Cross Blue Shield of Nebraska Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan / Blue Cross Blue Shield of Florida Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan / Blue Cross Blue Shield of Florida / Prestige Health Choice Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan Independence Health Group, Inc. / Blue Cross Blue Shield of Michigan N N N N N N N N N 16 * STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE Y PART 1A – DETAIL OF INSURANCE HOLDING COMPANY SYSTEM Asterisk 1 Explanation Charity 16.5 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES The following supplemental reports are required to be filed as part of your statement filing. However, in the event that your company does not transact the type of business for which the special report must be filed, your response of NO to the specific interrogatory will be accepted in lieu of filing a “NONE” report and a bar code will be printed below. If the supplement is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatory questions. RESPONSE 1. Will the Medicare Part D Coverage Supplement be filed with the state of domicile and the NAIC with this statement? Explanation: 1. Business not written Bar Code: 1. *15800201836500002* 17 NO STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. OVERFLOW PAGE FOR WRITE-INS MQ004 Additional Aggregate Lines for Page 04 Line 14. *REVEX1 1 Current Year To Date Uncovered 1404. Health Ed. and Pop. Mgmnt. 1405. Consumer Incentives 1406. 1497. Summary of remaining write-ins for Line 14 from Page 04 2 Current Year To Date Total 58,059 0 18 58,059 3 Prior Year To Date Total 17,355 289,441 0 306,796 4 Prior Year Ended December 31 Total 20,829 792,256 0 813,085 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE A – VERIFICATION Real Estate 1 2 Prior Year Ended December 31 Year To Date 1. Book/adjusted carrying value, December 31 of prior year 2. Cost of acquired: 2.1 Actual cost at time of acquisition 2.2 Additional investment made after acquisition 3. Current year change in encumbrances 4. Total gain (loss) on disposals 5. Deduct amounts received on disposals 6. Total foreign exchange change in book/adjusted carrying value 7. Deduct current year’s other-than-temporary impairment recognized 8. Deduct current year’s depreciation 9. Book/adjusted carrying value at the end of current period (Lines 1+2+3+4-5+6-7-8) 10. Deduct total nonadmitted amounts 11. Statement value at end of current period (Line 9 minus Line 10) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE B – VERIFICATION Mortgage Loans 1 2 Prior Year Ended December 31 Year To Date 0 1. Book value/recorded investment excluding accrued interest, December 31 of prior year 2. Cost of acquired: 2.1 Actual cost at time of acquisition 2.2 Additional investment made after acquisition 3. Capitalized deferred interest and other 4. Accrual of discount 5. Unrealized valuation increase (decrease) 6. Total gain (loss) on disposals 7. Deduct amounts received on disposals 8. Deduct amortization of premium and mortgage interest points and commitment fees 9. Total foreign exchange change in book value/recorded investment excluding accrued interest 10. Deduct current year’s other-than-temporary impairment recognized 11. Book value/recorded investment excluding accrued interest at end of current period (Lines 1+2+3+4+5+6-78+9-10) 12. Total valuation allowance 13. Subtotal (Line 11 plus Line 12) 14. Deduct total nonadmitted amounts 15. Statement value at end of current period (Line 13 minus Line 14) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE BA – VERIFICATION Other Long-Term Invested Assets 1 2 Prior Year Ended December 31 Year To Date 1. Book/adjusted carrying value, December 31 of prior year 2. Cost of acquired: 2.1 Actual cost at time of acquisition 2.2 Additional investment made after acquisition 3. Capitalized deferred interest and other 4. Accrual of discount 5. Unrealized valuation increase (decrease) 6. Total gain (loss) on disposals 7. Deduct amounts received on disposals 8. Deduct amortization of premium and depreciation 9. Total foreign exchange change in book/adjusted carrying value 10. Deduct current year’s other-than-temporary impairment recognized 11. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5+6-7-8+9-10) 12. Deduct total nonadmitted amounts 13. Statement value at end of current period (Line 11 minus Line 12) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE D – VERIFICATION Bonds and Stocks 1 Year To Date 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Book/adjusted carrying value of bonds and stocks, December 31 of prior year Cost of bonds and stocks acquired Accrual of discount Unrealized valuation increase (decrease) Total gain (loss) on disposals Deduct consideration for bonds and stocks disposed of Deduct amortization of premium Total foreign exchange change in book/adjusted carrying value Deduct current year’s other-than-temporary impairment recognized Total investment income recognized as a result of prepayment penalties and/or acceleration fees Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5-6-7+8-9+10) Deduct total nonadmitted amounts Statement value at end of current period (Line 11 minus Line 12) SI01 0 4,060,694 450 0 0 0 0 0 0 0 4,061,144 0 4,061,144 2 Prior Year Ended December 31 0 0 0 0 0 0 0 0 0 0 0 0 0 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE D - PART 1B Showing the Acquisitions, Dispositions and Non-Trading Activity During the Current Quarter for all Bonds and Preferred Stock by NAIC Designation 2 3 4 5 Non-Trading Book/Adjusted Acquisitions Dispositions Activity Carrying Value During During During End of Current Quarter Current Quarter Current Quarter First Quarter 1 Book/Adjusted Carrying Value Beginning of Current Quarter NAIC Designation 6 Book/Adjusted Carrying Value End of Second Quarter 7 Book/Adjusted Carrying Value End of Third Quarter 8 Book/Adjusted Carrying Value December 31 Prior Year BONDS 1. NAIC 1 (a) 65,619,363 87,304,768 84,405,929 68,517,825 0 115,192,043 2. NAIC 2 (a) 0 0 2,626,217 0 0 (2,626,217) 0 0 3. NAIC 3 (a) 0 0 0 0 0 0 0 0 4. NAIC 4 (a) 0 0 0 0 0 0 0 0 5. NAIC 5 (a) 0 0 0 6. NAIC 6 (a) 0 0 0 0 0 0 0 0 0 0 0 0 0 65,619,363 87,304,768 87,032,146 65,619,363 65,891,608 0 115,192,043 8. NAIC 1 0 0 0 0 0 0 0 0 9. NAIC 2 0 0 0 0 0 0 0 0 10. NAIC 3 0 11. NAIC 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12. NAIC 5 0 0 0 0 0 0 0 0 13. NAIC 6 0 0 0 0 0 0 0 0 14. Total Preferred Stock 0 0 0 0 0 0 0 0 65,619,363 87,304,768 87,032,146 65,619,363 65,891,608 0 115,192,043 7. Total Bonds (377) (377) 65,619,363 SI02 PREFERRED STOCK 15. Total Bonds & Preferred Stock (377) (a) Book/Adjusted Carrying Value column for the end of the current reporting period includes the following amount of short-term and cash equivalent bonds by NAIC designation: NAIC 1 $ NAIC 3 $ 0 ; NAIC 4 $ 0 ; NAIC 5 $ 0 ; NAIC 6 $ 0 61,830,464 ; NAIC 2 $ 0 ; STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE DA - PART 1 Short-Term Investments 1 2 3 4 Book/Adjusted Carrying Value Par Value Actual Cost Interest Collected Year To Date 43,697,139 9199999 XXX 43,696,921 5 Paid for Accrued Interest Year To Date 123,111 0 SCHEDULE DA - VERIFICATION Short-Term Investments 1 2 Prior Year Ended December 31 Year To Date 1. Book/adjusted carrying value, December 31 of prior year 2. Cost of short-term investments acquired 3. Accrual of discount 112,695,323 4,082,691 49,835,066 2,879,202,651 62 19 0 4. Unrealized valuation increase (decrease) (19,009) 5. Total gain (loss) on disposals 0 (4,419) 118,811,021 2,770,581,821 3,282 3,798 8. Total foreign exchange change in book/adjusted carrying value 0 0 9. Deduct current year’s other-than-temporary impairment recognized 0 0 43,697,139 112,695,323 6. Deduct consideration received on disposals 7. Deduct amortization of premium 10. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5-6-7+8-9) 11. Deduct total nonadmitted amounts 12. Statement value at end of current period (Line 10 minus Line 11) SI03 0 0 43,697,139 112,695,323 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. Schedule DB - Part A - Verification NONE Schedule DB - Part B - Verification NONE Schedule DB - Part C - Section 1 NONE Schedule DB - Part C - Section 2 NONE Schedule DB - Verification NONE SI04, SI05, SI06, SI07 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE E – PART 2 – VERIFICATION (Cash Equivalents) 1 Year To Date 1. Book/adjusted carrying value, December 31 of prior year 2 Prior Year Ended December 31 6,519,157 0 225,028,467 393,320,819 3. Accrual of discount 595 4,863 4. Unrealized valuation increase (decrease) 348 2. Cost of cash equivalents acquired 14 5. Total gain (loss) on disposals 6. Deduct consideration received on disposals 7. Deduct amortization of premium 8. Total foreign exchange change in book/adjusted carrying value 9. Deduct current year’s other than temporary impairment recognized 10. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5-6-7+8-9) 11. Deduct total nonadmitted amounts 12. Statement value at end of current period (Line 10 minus Line 11) SI08 (286) (1,688) 208,334,052 386,804,173 39 378 0 0 0 0 23,214,490 6,519,157 0 0 23,214,490 6,519,157 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. Schedule A - Part 2 NONE Schedule A - Part 3 NONE Schedule B - Part 2 NONE Schedule B - Part 3 NONE Schedule BA - Part 2 NONE Schedule BA - Part 3 NONE E01, E02, E03 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE D - PART 3 1 2 CUSIP Identification Description Bonds - Industrial and Miscellaneous (Unaffiliated) 06417G-W4-6 BANK NOVA SCOTIA HOUSTON TEX CD FL 13606B-XZ-4 CANADIAN IMPERIAL BK COMM N Y 78012U-EF-8 ROYAL BK CDA NY BRH CD FLT 19 86563V-AL-3 SUMITOMO MITSUI TR BK LTD 144A 3899999 - Bonds - Industrial and Miscellaneous (Unaffiliated) 8399997 - Subtotals - Bonds - Part 3 8399999 - Subtotals - Bonds Show All Long-Term Bonds and Stock Acquired During the Current Quarter 5 6 3 4 Foreign Date Acquired C D 06/22/2018 06/25/2018 06/12/2018 05/31/2018 Name of Vendor GOLDMAN SACHS GOLDMAN SACHS RBC DAIN RAUSCHER INC. PERSHING LLC Number of Shares of Stock XXX XXX XXX XXX 7 8 Actual Cost Par Value 1,298,804 998,660 1,250,000 513,230 4,060,694 4,060,694 4,060,694 9 1,300,000 1,000,000 1,250,000 520,000 4,070,000 4,070,000 4,070,000 10 NAIC Designation or Paid for Accrued Market Interest and Dividends Indicator (a) 1FE 1FE 1FE 1FE XXX XXX XXX 2,099 XXX E04 0 71 0 2,028 2,099 2,099 2,099 9999999 Totals (a) For all common stock bearing the NAIC market indicator "U" provide: the number of such issues 4,060,694 0 . XXX STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. Schedule D - Part 4 NONE Schedule DB - Part A - Section 1 NONE Schedule DB - Part B - Section 1 NONE Schedule DB - Part D - Section 1 NONE Schedule DB - Part D - Section 2 NONE Schedule DL - Part 1 NONE Schedule DL - Part 2 NONE E05, E06, E07, E08, E09, E10, E11 STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE E - PART 1 - CASH 1 Depository Month End Depository Balances 2 3 4 Code Rate of Interest Amount of Interest Received During Current Quarter 5 Book Balance at End of Each Month During Current Quarter 6 7 8 Amount of Interest Accrued at Current Statement Date First Month Second Month 9 Third Month * Open Depositories P.O. Box 63020 San Francisco, CA 94163 4400 Computer Drive, Bank of New York Mellon Westborough, MA 01581 0199998 Deposits in 0 depositories that do not exceed the allowable limit in any one depository (See Instructions) - Open Depositories 0199999 Total Open Depositories Wells Fargo 0399999 Total Cash on Deposit 0499999 Cash in Company’s Office 0599999 Total 49,456 22,037,459 34,924,444 37,752,682 XXX 15,370 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 49,456 49,456 XXX 22,037,459 34,924,444 0 22,037,459 34,924,444 0 22,037,459 34,924,444 XXX 49,456 E12 0 XXX 37,768,052 XXX 37,768,052 XXX XXX 37,768,052 XXX STATEMENT AS OF JUNE 30, 2018 OF THE AmeriHealth Caritas Iowa, Inc. SCHEDULE E - PART 2 - CASH EQUIVALENTS 1 2 E13 CUSIP Description Industrial and Miscellaneous (Unaffiliated) - Issuer Obligations XXX CELGENE CORP DISC COML PAPER 4 0% XXX CELGENE CORP DISC COML PAPER 4 0% XXX CITIBANK N A N Y BRH INSTL CTF XXX DNB BK ASA NY BR XXX DUKE ENERGY CORP NEW 0% CP 06/07/2 XXX ENTERPRISE PRODS OPER LLC DISC 0% XXX FORTIVE CORP Disc C/P XXX HARLEY-DAVIDSON FDG CORP Disc C/P XXX HENKEL CORP Disc C/P XXX HYUNDAI CAP AMER INC 0% CP 09/07/2 XXX MONDELEZ INTL INC DISC C/P XXX MONDELEZ INTL INC DISC COML PA 0% XXX MUFG BK LTD N Y BRH DISC COML 0% C XXX NRW BK 0% CP 30/07/2018 XXX NORDEA BK AB PUBL DISC COML PA ?Di XXX SOUTHERN CO 0% CP 09/07/2018 XXX TYSON FOOD INC 0% CP 03/08/2018 XXX VIRGINIA ELEC & PWR CO 0% Disc C/P XXX ABN AMRO FDG USA LLC CP Disc C/P XXX ANHEUSER-BUSCH INBEV WORLDWIDE 0% XXX AUTOZONE INC 0% CP 23/07/2018 3299999 - Industrial and Miscellaneous (Unaffiliated) - Issuer Obligations 3899999 - Industrial and Miscellaneous (Unaffiliated) - Subtotals 7799999 - Total Bonds - Subtotals - Issuer Obligations 8399999 - Total Bonds - Subtotals - Bonds Exempt Money Market Mutual Funds - as Identified by SVO BLACKROCK LIQUIDITY FDS FEDFUNDS 09248U-70-0 8599999 - Exempt Money Market Mutual Funds - as Identified by SVO All Other Money Market Mutual Funds BLACKROCK LIQUIDITY FDS TEMP FUNDS 09248U-61-9 WFB INSTITUTIONAL BANK DEPOSIT 993086-12-3 8699999 - All Other Money Market Mutual Funds 8899999 Total Cash Equivalents Show Investments Owned End of Current Quarter 3 4 5 6 Date Rate of Maturity Code Acquired Interest Date 06/20/2018 06/27/2018 05/09/2018 06/27/2018 06/05/2018 06/28/2018 06/11/2018 06/04/2018 06/04/2018 06/07/2018 06/04/2018 06/27/2018 06/22/2018 05/09/2018 06/11/2018 06/05/2018 06/22/2018 06/05/2018 06/04/2018 06/18/2018 06/27/2018 0.000 0.000 1.860 2.220 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 07/11/2018 07/30/2018 07/02/2018 08/01/2018 07/06/2018 07/30/2018 07/10/2018 07/19/2018 07/26/2018 07/09/2018 07/13/2018 08/09/2018 09/10/2018 07/30/2018 07/24/2018 07/09/2018 08/03/2018 07/30/2018 07/16/2018 07/16/2018 07/23/2018 7 Book/Adjusted Carrying Value 8 Amount of Interest Due & Accrued 9 Amount Received During Year 374,486 424,077 1,809,992 1,625,297 723,627 598,791 748,550 747,938 1,296,151 698,619 498,803 299,158 1,497,241 1,368,431 1,531,296 748,428 723,055 747,422 274,373 598,950 798,640 18,133,325 18,133,325 18,133,325 18,133,325 269 112 15,524 6,213 1,152 113 999 1,236 1,996 1,035 828 78 869 4,239 1,720 1,202 416 1,217 402 487 209 40,316 40,316 40,316 40,316 0 0 388 (39) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 349 349 349 06/08/2018 0.000 XXX 854,248 854,248 0 0 46,595 46,595 06/08/2018 06/29/2018 0.000 0.000 XXX XXX 4,222,567 4,350 4,226,917 23,214,490 0 0 0 40,316 23,290 2,022 25,312 72,256