Bohemian Mutual Insurance Association

Joanne Wacha

1309 S. County Road

Toledo IA 52342

Iowa Company Number: 0139

December 31, 2016 - Annual Statement

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0'39 _,

DECEMBER 31,2016

1. Ledger Assets, D ecember 31 of previous year, Total column 1, page 4 ................................. . .

INCOME - INCREASES IN LEDGER ASSETS

PREMIUMS (1 ) (2) (3) (4)

Reinsurance Specific Net Direct Premiums Reinsurance Premiums

Premiums Assumed Premiums Ceded (1+2-3=4l

2. Fire .................... . $ 610,821 $ $ $ 610,821

3. Windstorm .......... 430,046 430,046

4. Crop Hail. .......... ..

Homeowner 5. Assumed .......... .. XXXXXXX 6. Totals ................ .. ~ 1,040,867 $ $ $ 1,040,867

,II ' 'd oss reinsurance pal ................................................ 7. Aggregate excess 394686

8. Total net assessm

9. Net interest receiv,

10. Increase in adju 9.920

11. Dividends receiv,

12. Interest received

13. Interest received

14. Other interest... .

15. Profit on sale of

16. Rents received"

17. Total income fro

18. Borrowed money

19. Premiums collec

20. Checks charged

21. Increase in ledge

22. Underwriting exp

23. Federal income

24. Miscellaneous in

25. Crop Hail Cantin

26.

27. Total {items 18 t

28. Total income {ite

29. Total assets and

ent, premiums and fees {line 6, col. 4 - line 7 = line 8) ..............................

,d on bonds .................................................. __ .............. 79,313

tment of bonds 477 , less lecrease in adjustment of bonds ................................. (9.443)

d .... ... .......... ........... ...... ..................................... ...... ..... 15926

m bank deposits {schedule C-2, column 7) ................

m mortgage loans {schedule D, column 6) .................

............................................. .......................................

vestment. .................................................................... 14,741

............................................... , ............................ , .. , .... 14,520

I investments {items 9 through 16) ............. .. ...... ........................ .....

............................ , .......................................................

ld for other companies {less refunds) ................. ........ 86.460

ft .....................................................................

liabilities ...................................................................... 2,359

'nse reimbursement. ............ ................ ........ ........... .....

x refund .. ...... ....... ...... ............ ............. ............. ........... .

orne .............................................................................

ency Commission ............ ... .......... .... ......... .... ..............

. ................................................... , ................... , ...........

'ough 26) ...................................................................................................

1S 8, 17, and 27) ...................................................................... ..................

1come {item 1 plus item 28) .......... .. ..................................... ....................

'Includes $6,000 for association's occupancy of its own buildings.

2

$ 2606.440

$ 646,181

$ 115,057

$ 88819

$ 850,057

$ ~ 4~~ ~27

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0139

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DECEMBER 31, 2016 1. Amount brought forward from line 29 page

, ..

DISBURSEMENTS - DECREASES IN LEDGER ASSETS

LOSSES (3)

Specific Reinsurance Recovered

7. Received from aggregate excess loss reinsurance .............................................................. .

$

(4) Net Losses Paid

(1+2-3=4l

605,257

294909

I $ 3.456.497

8. Total of all net losses (line 6, column 4 - line 7 = line 8) ... ..... ...... ...... ..................... . .... 1$ 310.348

OPERATING EXPENSE 9. Loss Adjustment Expenses ................................................................................................ . 28065 1 O. Commissions ..................................................................................................................... . 132,023 11. Advertising ......................................................................................................................... . 15.173 12. Boards, bureaus and associations .......................................................................... . 6589 13. Inspection and loss prevention ......................................................................................... . 18,720 14. Salaries of officers .......................................................................................................... .. 36194 15. Expenses of officers .......................................... .. ...... .. ....................................................... . 1876 16. Salaries of office employees .............................................................................................. . 32714 17. Employee welfare .. ..... ... ..... .. ............. .......... ......... .. .... .... .................................................... . ~ 18. Insurance .................................. ................................................................... .. .. .. .. .. .. .......... . .1.Q..i11 19. Directors' compensation ..................................................................................................... . Z&QQ 20. Directors' expenses ...................................... ............................................................... . 647 21. Rent and rent items ............................................................................................................ . 6000 22. Equipment. ......................................................................................................................... . 18,726 23. Printing, stationery and supplies ........................................................................................ . 4.287 24. Postage and telephone .... 8.528 25. Legal and auditing .............................................................................................................. . 8.145

26. State insurance taxes (March 1, 309 ) (June 1, 5,040 ) (August 15, 5,040 ) 10.388 27. Insurance Division licenses and fees .......................................................................... . ....1.a§ 28. Payroll taxes ....................................................................................................................... . §..lli 29. All other taxes (excluding Federal income) ....................................................................... . ....1§1 30. Real estate expenses ........................................................................................................ . 4,204 31. Real estate taxes ........................................................................................ .. .. ................... . 3,156 32. Interest on borrowed money ............................................................................................ ..

33. Miscellaneous ................................................................................................................... . 6,286 a. Annual Meeting ...................................................................................................... . 727 b. Donations/Contributions ......................................................................................... . 698 c. Travel and Travel Items .......................................................................................... . d. Over and Short ........................................... .. ........................................................ ..

34. 35. Total operating expense (items 9 through 34) ................................................................................................... 1$ 373.351

NON-OPERATING EXPENSE 36. Borrowed money repaid ..................................................................................................... .

37. Depreciation on real estate ................ ................................................................................ . 2.019 38. Loss on sale of investments ............................................................................................... . 986 39. Federal income tax Prior year, o Current year, 2,370 2.370 40. Premium collections transmitted to other companies ............................. . 56.802 41. Commission paid agents for other companies ............................................... ... . 15.400 42. Decrease in ledger liabilijies .............................................................................................. .

43. Federal income tax penaltyflnterest... ................................................................................. LI ======~

44. Total non-operating expense (items 36 through 43) .......................................................... . 77.577 45. Total disbursements (items 8, 35, and 44) ........................................................................ . $ 761276 46. Balance -ledger assets, December 31st must agree with Line 22, Column 1, Page 4 ... $ 2.695.222

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0139 ~ I , , ASSETS - DECEMBER 31,2016

(1) (2) (3) (4) (5) Non-ledger including Assets not admitted Current Year Prior Year

including excess of Net Net excess of market book over market Admitted Assets Admitted Assets

Ledger Assets (or amortized) over or amortized values (1+2-3=4) book value

1. -Bonds (schedule A-part 1 ) .......... . ~ 1,970,646 $ $ $ 1,970,646 $ 1,960,674

2. Stocks (schedule A-part 2) .......... . 683,647 554,492 1,238,139 1,127,264

3. Bank Balances

3.1 Subject to check(C-I) .......... .. (4,438) (4,438) (16,650)

3.2 On interest (C-2) .................. .

4. Mortgage loans (schedule D)

4.1 First liens ............................ .

4.2 Other than first.. ................ ..

5. Collateral loans (schedule E) ...... .

6. Real estate (schedule F) ............ .. 45,215 45,215 39,234

7. Cash in office .............................. . 150 150 150

8. Unpaid Premiums

8.1 Due before November 1.. ..... XXXXXX xxx xxx 8.2 Due after November 1 .......... 527 527 398

9. Bills receivable .......................... .. XXXXXX XXXXXX

10. Agent's balances ...................... ..

11 . Reinsurance receivable on paid losses ..................................... .

12. Accrued interest.. ...................... .. XXXXXX 19,982 19,982 20,942

13. Accrued rent due ...................... . XXXXXX

14. Equipment and furniture .......... .. xxx XXX XXXXXX

15. Supplies ..................................... . xxx XXX xxx XXX

16. Automobiles .............................. .. xxx XXX xxx XXX

17. Cash surrender value of life ins.

18. Federal Inc. tax recoverable .....

19. Electronic data processing equipment. ................................ .

20. Service fees & misc receivables ..

21 . Prepaid Reins. & other assets .. ..

22. Totals ...................................... . $ 2,695,220 $ 575,001 $ $ 3,270,221 $ 3,132,012

-Bonds are amortized through 12/31/16.

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0'139" LIABILITIES - DECEMBER 31,2016 . ...-=-_,..,..,.....--,-...."...,---:-:-----.

I Current Year I Prior Year

1. Unpaid claims (reported) .......... ....... .. ....... ......................... .. · ..... .... . 236

2. Unpaid claims (incurred but not reported) ................ .. .......... .. .......... .

3. Total unpaid losses ................... ...................... · .. · .. ·· .. ... · .. ·· .. · .. · .. · .. ·· 26.236

4. Less: reinsurance recoverable on unpaid losses ................ .. ............ . 7.500

5. Net unpaid claims .... .. .. .. .... .... ...... .. ..

6. Unpaid adjusting expenses ............ .. ........... ...... ..... ... ........ · .. ... ·· .. · .. · .. · .. · ...... · .. ....... .

7. Ceded reinsurance balances payable ............... ................................................ ..... .

8. Unpaid salaries and commissions ...

9. Borrowed money ..... ......... ............. ... ........................ ......... · .. · ............. .. .......... .. ... .

10. Interest due on borrowed money ...... ............... .. ... ....................... .......... · .. .......... ..

11. Amounts withheld for the account of others ........ ................ .. .......... ..................... ..

12. Taxes payable: Real estate ......................... ... ................ ....... ..... ............. ......... ... .

Federal Income ............... ........... .. ......... .. ......... .. .. .. ...... .............. ..

Premium ......... ... ... ............ ......... .. ................. ..... .... ......... ... .... ... .. .

Other ........... ...... . ..

13. Other unpaid expenses ................ .

14. Premiums collected for other companies - not remitted ................. ...................... ..

15. Premiums received in advance .... .

16 .. Unearned premium reserve .... .. .. ..

17. Service Fees and Employee Benefits Payable ...................... ........ ... .......... .. ........ .

18. Miscellaneous Liabilities ......... .. ........... .. ... .. .. ........ .. .................. .. ... .. .. ...... .......... .

19. Total liabilities .......... .. .. .. .............. ..

20. Surplus ...................... .......... ......... .

21 . Total liabilities and surplus .......... ..

(line 21 must agree with line 22, column 4, and page 4)

-Method of calculation: 40% method.

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18.7

525 400

31.509 32.534

63 799

3.210 3. 102

329 309

1.102 1.370

3.918 3.607

25.106 19.790

405.000 387,000

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3.132.012

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l (. ,. HISTORICAL INFORMATION

2016 2015 2014 2013 2012

Gross Premium Fire ...... ..... .......... .............................. ......... 610,621 567,349 556,309 561 ,193 555,097 Windstorm ............ ..................................... 430,046 420,603 416,756 421,763 411 ,220 Crop Hail .................................................... 0 0 0 0 o. Total ................ ... ...... ...... ...... ..................... 1,040,667 1,007,952 977,067 962,956 966,317

Net Premium Written Fire .. .. ...................................... ............... ... 610,621 567,349 556,309 561,193 555,097 Windstorm ................................................ . 430,046 420,603 416,758 421,763 411,220 Crop Hail ......... .......................................... . 0 0 0 0 0 Total ... ............................ ......... ................... 1,040,867 1,007,952 977,067 982,956 966,317 Total Net of Agg ......................................... 646,181 619,853 582,318 639,961 705,062

Gross Losses Paid Fire ............................................................ 537,850 362,134 331 ,831 129,827 61 ,151 Windstorm ................................ ................. 67,407 6,169 113,244 292,660 2,437,216 Crop Hail ............ ..... ................................... 0 0 0 0 0 Total ..... ............................................. ..... .... 605,257 366,303 445,075 422,487 2,498,367

Net Losses Paid Fire .. ... ......................................... .............. 537,850 362,134 331,831 129,827 61,151 Windstorm ................................ ... ............. . 67,407 6,169 113,244 292,660 2,437,216 Crop Hail ..................... .......... ... .. ... ............. 0 0 0 0 0 Total ... ........................................................ 605,257 368,303 445,075 422,487 2,498,367 Total Net of Agg ............ ........ .. ..... .. .......... .. 310,348 346,908 419,841 202,361 131,563

Loss Percentag! (Di!:!ctl Fire losseslFire Prem ............................... 88 % 62 % 59 % 23 % 11 % Windstorm losses/Windstorm Prem ....... 16 % 1 % 27 % 69% 593 % Crop Hail Losses/Crop Hail Prem ........ .. .. 0 % 0% 0 % 0 % 0 % Totallosses/Total Prem ............................ 56 % 37 % 46 % 43 % 259 %

Loss Percen1;!ge (Netl Fire Losses/Fire Prem .............................. . 88 % 62 % 59 % 23 % 11 % Windstorm losseslWindstorm Prem ...... 16 % 1 % 27 % 69 % 593 % Crop Hail losses/Crop Hail Prem ............ 0% 0 % 0% 0% 0 % Total LosseslTotal Prem ...... ..... ... .. .... ...... . 58 % 37 % 46 % 43 % 259 % Total Net Agg losseslTotal Net Ag Prem 48 % 56 % 72 % 32 % 19 %

Balanc! Sheet Items Total Admitted Assets ................................ 3,270,221 3,132,011 3,182,987 3,192,692 2,879,164 Uabilrties ............................... ..................... 489,498 468,899 518,943 487,321 540,764 ' Surplus ............................................ ....... .. . 2,780,723 2,663,112 2,664,044 2,705,371 2,338,400 Bonds ... ..................................................... 1,970,646 1,960,674 1,894,567 1,921,073 1,571,546 Stocks ... ....... .... .............................. ............ 1,238,139 1,127,264 1,170,592 1,103,141 1,133,927 Real Estate ...... ............. ............... .......... .... 45,215 39,234 41 ,625 44,961 46,297 Unpaid Premium(line 8.1) .......................... 0 0 0 0 0 Unpaid Premium(line 8.2) .......................... 527 398 16,813 17,621 17,014 Agent's Balances ....................................... 0 0 0 0 0 Unearned Premium ................................... 405,000 367,000 382,000 383,000 375,000 i

Balance Shill P!![centages Bonds/Admitted Assets ............................ 60 % 63 % 60 % 60% 55 % Stocks/Admitted Assets ............................. 38 % 36 % 37 % 35 % 39 % Real Estate/Admitted Assets ..................... 1 % 1 % 1 % 1 % 2% Unpaid Prem (line 8.2)/Admitted Assets. 0 % 0 % 1 % 1 % 1 % Agents' Balances/Admitted Assets ......... 0 % 0 % 0 % 0 % 0 %

Income/Disbursement Items Total Income ... .. ......................................... 650,056 651 ,576 810,544 643,747 899,817 Total Disbursements ..................... .. ......... 761,275 646,653 869,249 645,340 571,771 Operating Expense .................................... 373,350 381,766 355,574 364,284 356,641 Commissions ............... .. .... .. ...................... 132,023 127,727 123,650 124,419 122,127 Investment Income .................................... 115,057 136,803 146,006 126,077 123,339 Salaries (lines 14.17) ................................. 73,666 73,197 72,395 74,416 65,567

Other Gross Risk in Force ..................... 313,852,646 267,769,606 258,596,769 246,472,953 241,102,648 Number of Policies ......................... .......... . 1,042 1,030 1,051 1,046 1,077 Operating Expense/Net Premium .............. 58 % ~- 61 % 57 % 51 %

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