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  • 2015

    ANNUAL STATEMENT

    OF THE

    MCS Life Insurance Company

    of

    San Juan

    in the state of

    Puerto Rico

    TO THE

    Insurance Department

    OF THE STATE OF

    Puerto Rico

    For the Year EndedDECEMBER 31, 2015

    LIFE AND ACCIDENT AND HEALTH

    2015

  • 60030201520100100 2015 Document Code: 201

    LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION

    ANNUAL STATEMENTFor the Year Ended DECEMBER 31, 2015

    OF THE CONDITION AND AFFAIRS OF THE

    MCS Life Insurance CompanyNAIC Group Code 1301 , 1301 NAIC Company Code 60030 Employer's ID Number 66-0520918

    (Current Period) (Prior Period)

    Organized under the Laws of Puerto Rico , State of Domicile or Port of Entry Puerto Rico

    Country of Domicile Puerto Rico

    Incorporated/Organized 02/02/1995 Commenced Business 01/01/1996

    Statutory Home Office Suite 900 255 Ponce de Leon Avenue , San Juan, PR, 00917(Street and Number) (City or Town, State, Country and Zip Code)

    Main Administrative Office Suite 900 255 Ponce de Leon Ave(Street and Number)

    San Juan, PR, 00917 (787)758-2500-2920(City or Town, State, Country and Zip Code) (Area Code) (Telephone Number)

    Mail Address P O Box 193310 , San Juan, PR, 00919-3310(Street and Number or P.O. Box) (City or Town, State, Country and Zip Code)

    Primary Location of Books and Records Suite 900 255 Ponce de Leon Ave(Street and Number)

    San Juan, PR, 00917 (787)758-2500-2920(City or Town, State, Country and Zip Code) (Area Code) (Telephone Number)

    Internet Website Address www.mcs.com.pr

    Statutory Statement Contact David P Schaffer (787)758-2500-2920(Name) (Area Code)(Telephone Number)(Extension)

    davids@medicalcardsystem.com (787)764-5866(E-Mail Address) (Fax Number)

    OFFICERSName Title

    Jose Duran PresidentYumac Velez CFOMaritza Munich Secretary

    OTHERS

    DIRECTORS OR TRUSTEESDan Agroskin Paul S LevyGerald Landgraf Robert VanHeesJames P O'Drobinak Jose G DuranCyril Meduna David Schaffer

    State of Puerto Rico

    County of US ss

    The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of the said reporting entity, and that on the reporting period stated above, all of the herein described assets

    were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein

    contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and

    deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law

    may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively.

    Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to

    electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement.

    (Signature) (Signature) (Signature)

    Jose Duran Yumac Velez(Printed Name) (Printed Name) (Printed Name)

    1. 2. 3.

    Presidente Chief Financial Officer(Title) (Title) (Title)

    Subscribed and sworn to before me this a. Is this an original filing? Yes[X] No[ ]

    day of , 2016 b. If no, 1. State the amendment number

    2. Date filed

    3. Number of pages attached

    (Notary Public Signature)

  • 2

    ANNUAL STATEMENT FOR THE YEAR OF THE 2015 MCS Life Insurance Company

    ASSETSCurrent Year Prior Year

    1 2 3 4

    Net Admitted

    Nonadmitted Assets Net Admitted

    Assets Assets (Cols.1-2) Assets

    1. Bonds (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,225,821 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,225,821 . . . . . . . . . 12,243,159

    2. Stocks (Schedule D)

    2.1 Preferred stocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285,486 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285,486 . . . . . . . . . . . . . 335,778

    2.2 Common Stocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215,052 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215,052 . . . . . . . . . . . . . 242,774

    3. Mortgage loans on real estate (Schedule B):

    3.1 First liens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    3.2 Other than first liens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    4. Real estate (Schedule A):

    4.1 Properties occupied by the company (less $...............0

    encumbrances) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    4.2 Properties held for the production of income (less $...............0

    encumbrances) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    4.3 Properties held for sale (less $...............0 encumbrances) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    5. Cash ($......43,217,476, Schedule E Part 1), cash equivalents

    ($...............0, Schedule E Part 2) and short-term investments

    ($...............0, Schedule DA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43,217,476 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43,217,476 . . . . . . . . . 27,385,534

    6. Contract loans (including $...............0 premium notes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    7. Derivatives (Schedule DB) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    8. Other invested assets (Schedule BA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    9. Receivables for securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    10. Securities Lending Reinvested Collateral Assets (Schedule DL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    11. Aggregate write-ins for invested assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    12. Subtotals, cash and invested assets (Lines 1 to 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49,943,835 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49,943,835 . . . . . . . . . 40,207,245

    13. Title plants less $...............0 charged off (for Title insurers only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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