statement as of june 30, 2012 of the unitedhealthcare plan

STATEMENT AS OF JUNE 30, 2012 OF THE UnitedHealthcare Plan of the River Valley, Inc.

SCHEDULEY PART 1A ·DETAIL OF INSURANCE HOLDING COMPANY SYSTEM

Group Code

2

Group Name

... 0707 .. lklitedlleallh Group Incorporated ....

3

NAIC Company

Code ...... 00000 .....

4

FederaiiD Number

... 00000 .... 45-3143218 ..

.... 00000 .... 27-230!1024 .. ...... 00000 ..... ()S-()471309 ... . ...... 00000 ..... 39-1974851 ... . ...... 00000 ..... 91-1263758 ... . ...... 00000 ... .. .... 60321 .... 52-1803283 ..

....... ...... ........................................................ . ..... 00000 ..... 14-1782475 ... .

... 0707 ... lklitedllealth Group Incorporated ............. 96310 ..... 52-1169135 ... .

... 00000 .. .

... 00000 .... 52-2178531 . ... 0707 .. lkliledlleallh Group Incorporated ............ .12756 .... 20-3391186 ... . ... 0707 ... lklitedllealth Group Incorporated ............ .12155 ..... 01-o788576 ... .

...... 00000 ..... 26-4808018 ... .

... 00000 .... 32-0037402 ..

... 0707 .. lkliledllealth Group Incorporated ....... ..... 79480 .... 35-1279304 ..

...... 00000 ..... SH693199 ....

.... 00000 .... 45-3142852 .... ... 0707 .. lklitedllealth Group Incorporated ....... ..... 95251 ... 7lHl196559 .. ... 0707 .. lkliledllealth Group Incorporated .... . ... 95123 .... ~107 ..

...... 00000 ..... 2<>-4755277 ....

... 0707 .. lklitadllealth Group Incorporated ....... ..... 95758 .... 8IHl228572 .. ... 00000 .... 8H245121 .

...... 00000 ... .

... 0707 ... lklitedllealth Group Incorporated ............. 96940 ..... 52-1518174 ... . ...... 00000 ..... 45-3142512 ... . ... 00000 .... 04-3574101 . ... 00000 .... 2G-4581265 ..

...... 00000 ..

5

Federal RSSD

...... 00000 ..... .................... . .................. .

...... 00000 ..... 4H683454 .... . .................. . ... 00000 .... 3(H)58()62() .... 3119994 .

.... 00000 .... 47-o858534 .... 3202702

...... 00000 ..... 27-()5()8164 ....

...... 00000 ..... 41-1591944 ... .

.... 00000 .... 47-o858530 ... .

. ... 00000 ... .

6

CIK

7 8 9 10 11

Relationship

12 Type

13 If

Control is

Owner-

14

Name of Securities Exchange if Publidy Traded

Names of Domi- to Parent, Subsidiaries ciliary Reporting Directly Controlled by

of Control (Ownenship,

Board, Management,

Attorney-in-Fact, Influence,

Other)

ship Provide Percen

tage Ultimata Controlling Entitv(ie& l/Person(s l (U.S. or lntemationall or Affiliates Location Entitv (Name of Entilv/Personl

.................................................... International Psydlologic:al Services PPC Worldwide Ply Ltd__________________ lkliledllealth Group Incorporated ...... . Pty Limited ---------------------------------------- .... JIJ .. . _________ foliA.__________ Ownership . .. . ... . 100.000 .. .

.. Lifeprinl East, Inc. . . .... IE ..... _________ foliA. __________ Colllborative Care Holdings, LLC _ Ownership........ .100.000 ... lklitedllealth Group Incorporated .. . ................................................... Lifeprint Heelth, Inc . ....................... ...... IE ... . _________ foliA. __________ Collaborative Cere Holdings, llC _ Ownership ................. . 100.000 ... lkliledllealth Group Incorporated .. . ................................................... Lidlthousei!D, Inc ...................................... RL. ..... _________ foliA. __________ Optumlnsidlt. Inc ......................... Ownership .................... 100.000 ... lklitedllealth Group Incorporated ...... . . ................................................... Logistics Health, Inc ............................... IlL ..... _________ foliA. __________ ()ptumllealth Holdings, LLC ____________ Ownership ................... 100.000 ... lklitedllealth Group Incorporated ...... . . ................................................... Lynx Medical Systems, Inc ......................... IlL .... _________ foliA. __________ Picis, Inc .................................... Ownership ................... 100.000 ... lkliledllealth Group Incorporated ...... .

.. MAMSI Insurance Resources, llC ---------- .. ... ./.IL . _________ foliA. __________ ~eNat PPO, llC ---------------------------- Ownership ........ .100.000 ... lklitedllealth Group Incorporated .. . ................................................... MAMSI Life and Health Insurance lkliled llealthCare Services, Inc. . lklitedllealth Group Incorporated ..

Co~y ----------------------------------------------- ..... JIL .. _________ JA.___________ Ownership........ . .... 100.000 .. .................................................... Managed Physical Network, Inc .................. NL .... _________ foliA. __________ Optuntfealth Cere Solutions, Inc .. Ownership .................... 100.000 ... lklitedllealth Group Incorporated ...... . . ................................................... liD-Individual Practice Auociation, lklited llealthCare Services, Inc. . lklitedllealth Group Incorporated ...... .

Inc ........................................................... JIL .... __________ u___________ Ownership ................... 100.000 .. . .................................................... Medekit.com Limited ................................. J.K .. __________ foliA. __________ FrontieriEDEX Limited ------------------ Ownership .................. . 100.000 ... lklitedllealth Group Incorporated ..

IEilEX Insurance Services, Inc. . . .... JIL .. _________ foliA. __________ FrontieriEDEX, Inc. .... . ... Ownership........ . .... 100.000 ... lklitedllealth Group Incorporated .. .. Medica Heelth Plans of Florida, Inc. . ..... A... .... . __________ u ___________ lkliled HeelthCere Services, Inc . . Ownership.... . ... . 100.000 ... lkliledllealth Group Incorporated .... .

. ................................................... Medica HeelthCere Plans, Inc .................... A... ...... _________ JA. ___________ lklited HeelthCere Services, Inc .. Ownership .................... 100.000 ... lklitedllealth Group Incorporated ...... .

. ................................................... Medical Preparatory School of Allied We liMed Medical Management, Inc. . lklitedllealth Group Incorporated ...... . Heellh, llC ---------------------------------------- ....... JL .... _________ foliA.__________ Ownership ................... 100.000 .. . Medical Transportation Services, llC lklited HeelthCare Services, Inc. lklitedllealth Group Incorporated .. ----------------------------------------------------------- ....... A... .... . _________ foliA. _________ _ Ownership .... . ... . 100.000 ...

.. Midwest Security Life Insurance lkliledHeelthcare, Inc. lkliledllealth Group Incorporated .. Co~y ----------------------------------------------- ....... Ill. ...... _________ _jA____________ Ownership .................... 100.000 .. .

.................................................... Mohave Valley HoSpital, Inc. .............. Southwest Medical Auociates, Inc. lklitedllealth Group Incorporated ...... . . ...... M.. ...... _________ foliA. __________ ------------------------------------------------------ Ownership ................... 100.000 .. .

.. Monardl Management Services, Inc . ...... ...... IE .... . _________ foliA. __________ Collaborative Care Holdings, llC _ Ownership..... . ... . 100.000 ... lklitedllealth Group Incorporated .... .

.. National Pacific Dental, Inc. . . .... JL ... _________ JA. ___________ Dental Benefit Providers, Inc . .... Ownership........ .100.000 ... lklitedllealth Group Incorporated .. . ................................................... NeidJborhood Heelth Partnership, Inc. lkliledHeelthcare, Inc. . lkliledllealth Group Incorporated ..

----------------------------------------------------------- ....... A... ...... _________ _jA____________ Ownership .................... 100.000 .. . .................................................... Netwerkes, LLC ----------------------------------- Payment Resolution Services, Inc. lklitedllealth Group Incorporated ...... .

. ...... IN. ...... _________ foliA. __________ ------------------------------------------------------ Ownership ................... 100.000 .. . .. Nevada Pacific Dental ------------------------ .. .... NV.. . _________ JA. ___________ Dental Benefit Providers, Inc . .... Ownership ........ .100.000 ... lklitedllealth Group Incorporated ..

. ................................................... Northern Nevada Health Network, Inc . ....... NV.. . _________ foliA. __________ Sierra Health Services, Inc . ........ Ownership ................. . 100.000 ... lklitedllealth Group Incorporated .. ~eNet PPO, llC ---------------------------------- lkliledHeelthcare Insurance lklltedllealth Group Incorporated ..

. ....... t.IL .... _________ foliA. __________ Co~y ----------------------------------------- Ownership .................... 100.000 .. . .................................................... Optimum Choice, Inc ................................. .I.IL .... _________ _jA_ ___________ lklited llealthCare Services, Inc .. Ownership ................... 100.000 ... lklitedllealth Group Incorporated ...... . . ................................................... Opium Cl inic:al Services, Inc .................... IE ...... _________ foliA. __________ Collaborative Cere Holdings, llC _ Ownership ................... 100.000 ... lkliledllealth Group Incorporated ...... . . ................................................... Opium Government Solutions, Inc . ....... ...... IE ... . _________ foliA. __________ OptumlnsidJt, Inc . ........................ Ownership .................. . 100.000 ... lklitedllealth Group Incorporated ..

Opium Pub I ic Sector Solutions, Inc. . . ..... IE ...... _________ foliA. __________ OptumlnsidJI, Inc. . . ..... Ownership........ . .... 100.000 ... lklitedllealth Group Incorporated .. .. Opium Se de Servi os (Bresi I) Llde ___ lngenix lnnovus (Netherlands) B.V. lkliledllealth Group Incorporated .....

. ..... ~ ...... _________ foliA. __________ ------------------------------------------------------ Ownership ..................... 99.000 ... . .................................................... Opium Sa de Servi os (Brasi I) Ltda ___ ...... ~ ...... _________ foliA. __________ ()ptumlnsidJI, Inc ......................... Ownership ..................... 1.000 ..... lklitedllealth Group Incorporated ...... . . ................................................... Opium Services, Inc .................................. IE ...... _________ foliA. __________ Opium, Inc .................................... Ownership ................... 100.000 ... lkliledllealth Group Incorporated ...... .

Opium, Inc. . ..... IE ...... _________ foliA. __________ lklited HeelthCare Services, Inc. Ownership ..... 100.000 ... lklitedllealth Group Incorporated .. .. Optumlleallh Bank, Inc. .. Optumlleallh Financial Services, lklitedllealth Group Incorporated .....

.. .... UL . _________ foliA. __________ Inc. Ownership. ....... ..100.000 .. .................................................... Optuntfealth Capital, Inc. .................. Optuntfealth Financial Services, lklitedllealth Group Incorporated ...... .

. ...... IE ...... _________ foliA. __________ Inc ............................................... Ownership ................... 100.000 .. . .................................................... Opluntfeallh Cere Solutions, Inc .............. .IlL .... _________ foliA. __________ Opluntfeallh Holdings, llC ____________ Ownership ................... .100.000 ... lkliledllealth Group Incorporated ...... .

.. Optuntfealth Financial Services, Inc. . ..... IE ..... _________ foliA. __________ Optuntfealth Holdings, llC ------------ Ownership......... . ... . 100.000 ... lklitedllealth Group Incorporated .... .

..loPtumlleallh Holdings, LLC ------------------ ... ... IE ..... _________ foliA. _________ oPium, Inc . ... ....... ....... ....... ....... Ownership ...... . .. . . 100.000 ... lklitedllealth Group Incorporated ..

15

Group Code

2

Group Name

3

NAIC Company

Code ...... 00000 ..... .... 00000 .. ...... 00000 .....

...... 00000 .... .

...... 00000 .... .

...... 00000 .... . ... 00000 .. .

4

FaderaiiD Number

...... 00000 ........................ .

...... 00000 ..... 04-3383745 ... .

...... 00000 ........................ .

...... 00000 ... .

...... 00000 .... 41-1858498 ... .

...... 00000 ........................ .

...... 00000 ..... ~1200 ... .

...... 00000 ..... 41-1921007 ... . ... 00000 .... 0&-1587795 ..

... 0707 .. lklitedHeallh Group Incorporated ............. 78026 .... 22-2797560 ... .

... 0707 .. lkliledHeallh Group Incorporated ....... ..... 96798 .... 0&-1181201 .

... 0707 ... lklitedllealth Group Incorporated ............. 95506 ..... 22-Z745725 ... .

... 0707 ... lklitedHealth GroUp Incorporated ............. 95479 ..... 06-1181200 ... . ...... 00000 ..... 52-2443751 ... . .... 00000 .... 35-1508167 ... .

.... 00000 .... 20-3375956 .. ... 0707 ... lklitedHealth Group Incorporated ............. 7!JT85 ..... 35-1137395 ... .

... 0707 ... lkliledlleallh Group Incorporated ............. 7!JT85 ..... 35-1137395 ... .

... 0707 .. lklitedHeallh Group Incorporated .... . ... 84506 .... 95-2829463 ..


... 0707 ... lkliledHeallh GroUp Incorporated ............. 95434 ..... 84-1011378 ... .

... 0707 ... lklitedHeallh Group Incorporated ....... ...... 95685 .... 81Hl875231 .

...... 00000 ........................ .

...... 00000 ..... ~1832 ... .

... 00000 .... 62-1451147 .. .... 00000 ..

...... 00000 .....

...... 00000 .....

. ... 00000 .... IKHl506053 ..



5

Federal RSSD

6

CIK

7 8 9 10 11 12 13 14 Type If

of Control Control (Ownenship, is

Board, Owner-Management, ship


Names of Parent, Subsidiaries

or Affiliates

Domiciliary

Location

Relationship to

Reporting Entity

Directly Controlled by (Name of Entilv/Personl

Attorney-in-Fact, Provide Influence, Parcen- Ultimata Controlling

Entitv{ie& l/Person<s l cu.s. or lntemationall Otherl taQe .................................................... ~luntieellh Internal ional B.V .................. !t. ...... _________ NIA. __________ ~tum, Inc. ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Ownership. __________________ . .100.000 ... lkli ledlleallh Group Incorporated ·-·-·-·

.. ~tumlnsiitJt (Canada) Inc. .. . .. ...... CA .... __________ NIL ________ ~tumlnsiitJt, Inc. Ownership . .. . ... . .100.000 ... lklitedlleallh Group Incorporated .... .

.. ~tumlnsiitJI (Deutschland) QMJH -------- lngenix lnnovus (Netherlands) B.V. lklitedHeallh Group Incorporated .. ....... IE. ... __________ NIA. __________ ------------------------------------------------------ Ownership. ................. . .100.000 ..

-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· ~tumlnsiitlt (Singapore) Pte. Ltd. ____ ....... SG ·-·-·- _________ NIL ________ ~tumlnsiitJt, Inc. ·-·-·-·-·-·-·-·-·-·-·-·- Ownership ___________________ . .100.000 ... lklitedlleallh Group Incorporated·-·-·-· -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· ~tumlnsi~t~t (Sweden) N3 ___________________ lngenix lnnovus (Nether lands) B.V. lkli tedHeallh Group Incorporated ·-·-·-·

______ _a: ·-·-·- _________ NIL ________ ------------------------------------------------------ Ownership. __________________ . .100.000 .. . .. ~tumlnsiitJt Holdings, LLC ---------------- .. .... IE. ..... _________ NIL ________ ~tum, Inc. .. Ownership . ....... ..100.000 ... lklitedlleallh Group Incorporated ..

. ................................................... ~tumlnsiitJI Italy S.r.l. ------------------- lngenix lnnovus (Netherlands) B.V. lklitedHeallh Group Incorporated .. . .... .IT .... __________ NIA. __________ ------------------------------------------------------ Ownership......... . .... .100.000 ..

-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· ~tumlnsiitlt Korea LLC _______________________ ...... Re ·-·-·- _________ NIL ________ ~tum, Inc. ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Ownership ___________________ . .100.000 ... lklitedlleallh Group Incorporated·-·-·-· -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· ~tumlnsi~t~t Life Sciences, Inc. ·-·-·-· _______ IE. _______________ NIL ________ ~tumlnsi~t~t. Inc. ·-·-·-·-·-·-·-·-·-·-·-·- Ownership. __________________ . .100.000 ... lklitedHeallh Group Incorporated·-·-·-· -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· ~lumlnsiitJI Poland sp. z.o.o. lngenix lnnovus (Netherlands) B.V. lkliledlleallh Group Incorporated·-·-·-·

. ..... Po .. __________ NIA. __________ ------------------------------------------------------ Ownership._ ................ .. 99.000 .. ~tumlnsiitJI Poland sp. z.o.o. . . .... Po ... __________ NIL ________ ~tumlnsiitJI, Inc. . Ownership......... . ...... 1.000 .. _ lklitedHeallh Group Incorporated ..

.. ~lumlnsiitJI, Inc. .. . . .... IE. .... __________ NIL ________ ~lumlnsiitJI Holdings, LLC ---------- Ownership.. ... . ... . .100.000 ... lkliledlleallh Group Incorporated ..... -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· ~!unfix Holdings, LLC _______________________________ IE. _______________ NIL ________ ~tum, Inc. ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Ownership ___________________ . .100.000 ... lklitedlleallh Group Incorporated·-·-·-· -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· ~!unfix, Inc. ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·- ....... CA ...... _________ NIL ________ ~!unfix Holdings, LLC __________________ Ownership. __________________ . .100.000 ... lklitedHealth Group Incorporated·-·-·-· -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Oval ions, Inc. ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·- ....... IE. ...... _________ NIL ________ lk1 i led HealthCare Services, Inc. . Ownership. __________________ . .100.000 ... lkli ledlleallh Group Incorporated ·-·-·-·

Oxford Benefit Management, Inc. . . ..... .cr .... _________ NIL ________ Oxford Health Plans LLC --------------- Ownership ........ . .... .100.000 ... lkli tedlleallh Group Incorporated .. .. Oxford Health Insurance, Inc. .. . . .... NL .. __________ JA. ___________ Oxford Health Plans (NY). Inc. ·· -· Ownership.. ... . ... . .100.000 ... lklitedHealth Group Incorporated ..... .. Oxford Health Plans (CTJ, Inc. . . .... CT ... ___________ u ___________ Oxford Health Plans LLC --------------- Ownership.. ....... ..100.000 ... lkliledlleallh Group Incorporated ..

-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Oxford Health Plans (NJJ, Inc. ·-·-·-·-·- ....... .N.J ....... _________ JA. ___________ Oxford Health Plans LLC _______________ Ownership ___________________ . .100.000 ... lklitedllealth Group Incorporated·-·-·-· -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Oxford Health Plans (NY). Inc. ·-·-·-·-·- ....... NL .... _________ JA. ___________ Oxford Health Plans LLC _______________ Ownership. __________________ . .100.000 ... lklitedHealth Group Incorporated·-·-·-· -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Oxford Health Plans LLC _____________________ ....... IE. ...... _________ NIL ________ lkli ledHeallh Group Incorporated __ Ownership. __________________ . .100.000 ... lkli ledlleallh Group Incorporated ·-·-·-·

.. Pacif iCare Health Plan Pacif iCare Health Systems, LLC ____ lklitedllealth Group Incorporated ..... Administrators, Inc. .. .... JN. ..... _________ NIL________ Ownership.. ....... ..100.000 ..

.................................................... Pacif iCare Health Systems, LLC ---------- ...... IE. ... __________ NIA. __________ lklitedHealth Group Incorporated __ Ownership. ................. . .100.000 ... lkliledlleallh Group Incorporated .. -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Pacif iCare Life and Health Insurance Pacif iCare Health Plan lklitedllealth Group Incorporated·-·-·-·

Company----------------------------------------------- ....... .IN. _____ __________ JA. ___________ Administrators, Inc. ·-·-·-·-·-·-·-·-·-·-· Ownership. __________________ .. 99.000 ___ _ -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Paci f iCare Life and Health Insurance Paci f iCare Health Systems, LLC ____ lkli ledlleallh Group Incorporated ·-·-·-·

Company ----------------------------------------------- ....... J N. ...... _________ _j "------------ Ownership . -···-·· .. ... 1.000 .. . ···················································· Pacif iCare Life Assurance Company _____ Pacif iCare Health Plan lkli tedHealth Group Incorporated ..

. ..... CO ...... __________ u ___________ Administrators, Inc. . . .. Ownership. ..... .100.000 .. -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Paci f iCare of Arizona, Inc. ·-·-·-·-·-·-·-· Paci f iCare Health Plan lkli tedllealth Group Incorporated ·-·-·-·

....... J1.. ...... _________ JA. ___________ Administrators, Inc. ·-·-·-·-·-·-·-·-·-·-· Ownership. __________________ . .100.000 .. . -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Paci f iCare of Colorado, Inc. Paci f iCare Health Plan lkli ledlleallh Group Incorporated ·-·-·-·

. ...... .CO .. __________ _j,l ___________ Administrators, Inc . ..................... Ownership._ ................ . .100.000 .. PacifiCare of Nevada, Inc . . Pacif iCare Health Plan lklitedHealth Group Incorporated ..

. . .... NV ..... ___________ u ___________ Administrators, Inc. ··· -· Ownership. .... . .100.000 .. . -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Passport Coast-to-coast LLC ______________________ IE. _______________ NIL ________ lkli ted Heal thCare Services, Inc. . Ownership ___________________ . .100.000 ... lkli tedllealth Group Incorporated ·-·-·-· -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Paular ino 111 i rd Party Administrators, For Health, Inc. ·-·-·-·-·-·-·-·-·-·-·-·-·-· lkli tedHealth Group Incorporated ·-·-·-·

Inc. ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·- ....... CA ...... _________ NIL________ Ownership. __________________ . .100.000 .. . Payment Resolution Services, Inc. . . ...... TIL .... _________ NIL ________ ~tumlnsiitJt, Inc. . Ownership ..... .100.000 ... lklitedllealth Group Incorporated ..

.. Personal Performance Consultants ~tumHealth International B.V. . lklitedHealth Group Incorporated ..... India Private Limited ------------------------ .. .... JN. ..... _________ NIL________ Ownership.. ....... ..99.996 ·· -

-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Persona I Performance Consu I !ants lk1 i ted Behav iora I Hea I th ______________ lkli tedllealth Group Incorporated ·-·-·-· India Private Limited ________________________ ....... .IN. _______________ NIL________ Ownership. __________________ ... 0.004 ·-·-·

-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· Personal Performance Consultants U< PPC International, L.L.C. ______________ lkliledlleallh Group Incorporated·-·-·-· Limited ----------------------------------------------- .... .l.K ... _________ NIL________ Ownership .... . .100.000 .. .

. . . . . . . . . . . . . . . . . . . . PI«: Holdings of Florida, Inc. . . .. ... JX. .... __________ NIL _______ PI«: SUbsidiary Holdings, LLC _______ Ownership. .. ... . .. . . .100.000 ... lklitedHealth Group Incorporated ..

15

Group Code

2

Group Name

___ 0707 __ ~itedHeallh Group Incorporated

___ 0707 __ ~iledHealth Group Incorporated ___ _

3 4

NAIC Company FadaraiiD

Code Number ______ 00000 ----- 35--2288416 _____ _13160 ---- ~1407

___ _12977 ---- ~191973 -

___ 0707 ___ ~itedllealth Group Incorporated _____________ 11494 _____ 04-3677255

___ 00000 - -- 52-1162824 -

_____ 00000 - -

______ 00000

--- 00000 ---- 3&---4375169 -___ 00000 - -

______ 00000 --______ 00000 ----- 20--2149493 ______ 00000 ----- 43-1747235 ______ 00000 --------------------

---- 00000 --___ 00000 -

______ 00000

---- 00000 -----00000 - -- 75-2741619 -____ 00000 ----~-

______ 00000 ----- 26-1845018

___ 00000 - -- 26-1845018 -

___ 0707 ___ ~itedllealth Group Incorporated _______ ______ 11176 . __ ~.

______ 00000 ----- 8H253112 ______ 00000 ----- 5---1579905 --- 00000 ---- 26-3168754 ---- 00000 - -- 20--0151096 -

______ 00000 --

______ 00000 ----- --------------------___ 0707 ___ ~itedHealth Group Incorporated ____________ .71420 _____ Q.Hl734860

___ 00000 - -- 81Hl200415 ----- 00000 ---- 8IHl254322 ---00000 - -- 8IHl3B5705 -

______ 00000 ----- 8IHl264562 ______ 00000 ----- 8H201420 ______ 00000 ----- 38--2609888

- ___ 00000 -- - 41-1921983 -



5

Federal RSSD

3886791 -

6

CIK

7 8 9 10 11 12 13 Type If


Board, Owner-Relationship Management, ship

Name of Securities Exchange Names of Domi- to Attorney-in-Fact, Provide if Publidy Traded Parent, Subsidiaries ciliary Reporting Directly Controlled by Influence, Parcen-

cu.s. or International) or Affiliates Location Entitv (Name of Entilv/Personl Otharl taQe .................................................... PK: &Jbsidiary Holdings, llC ____________________ IX_ _____ _ _________ NIA. __________ ~ited HealthCare Services, Inc. _ Ownership. __________________ . .100.000

__ Physicians Health Choice of Arkansas, PK: &Jbsidiary Holdings, llC ______ _ Inc. __ __ ___ AIL _____________ JA. __________ _ Ownership. _______ _ . .100.000 -

---------------------------------------------------- Physicians Health Choice of New PK: &Jbsidiary Holdings, llC ______ _ Mexico, Inc. --------------------------------------- _______ tfL _____________ _jA_ __________ _ Ownership ___________________ . .100.000

---------------------------------------------------- Pliys ic ians Hea I th Choice of Texas, PK: &Jbs id iary Holdings, Ll.C ______ _ llC ----------------------------------------------------- _______ :rx_ ________________ JA. __________ _ Ownership. __________________ . .100.000

__ Physicians Health Plan of Maryland, ~itad HealthCare Services, Inc. _ Inc. ---------------------------------------------------- __ _____ Ill___ _ _________ NIA. _________ _ Ownership. ----------------- . .100.000 _ Picis Reseerch and Development, S.A.U. lngenix lnnovus (Netherlands) B.V. ----------------------------------------------------------- ______ fS _______________ NIA. __________ ------------------------------------------------------ Ownership ___________________ .. 100.000

---------------------------------------------------- Pic is SAS ------------------------------------------- lngenix lnnovus (Netherlands) B.V. ------~ _______________ NIL ________ ------------------------------------------------------ Ownership. __________________ . .100.000

14

Ultimata Controlling Entity{ie& l/Person<s l

~i tedHeallh Group Incorporated ~i tedHeallh Group Incorporated

~i tedHeallh Group Incorporated .

U1i tedHealth Group Incorporated

~i tedHeallh Group Incorporated _

~ltedHeallh Group Incorporated .


---------------------------------------------------- Pic is, Inc. ----------------------------------------- ...... !£ ... __________ NIA. __________ OptumlnsiitJI, Inc. ------------------------ Ownership __ ---------------- . .100.000 ___ ~itedHeallh Group Incorporated _ Pic is, Ltd. _ _ ____ .l.K ____ __________ NIL ________ Pic is, Inc. _ _ ___ Ownership.________ _ ___ . .100.000 ___ U1itedHealth Group Incorporated _

__ P-ositive People Company --------------------- ______ at__ ____________ NIL ________ PPC International, L.L.C. -------------- Ownership.____ _ ___ . .100.000 ~itedHeallh Group Incorporated ---------------------------------------------------- PPC International II, Ll.C _________________________ NO ________________ NIL ________ ~itad Behavioral Health ______________ Ownership ___________________ . .100.000 ~itedlteallh Group Incorporated ---------------------------------------------------- PPC Internal ional, L.L.C. __________________________ NO ______ __________ NIL ________ Optum, Inc. ----------------------------------- Ownership. __________________ . .100.000 U1i tedHealth Group Incorporated ---------------------------------------------------- PPC Worldwide Canada EAP Services PPC International, L.L.C. ______________ ~itedHeallh Group Incorporated

Ltd. _____ _ CA. ______________ NIL________ Ownership ________ _ ___ . .100.000 _ __ PPC Worldwide Management Ply Ltd _________ .. JJJ ___ __________ NIL ________ PPC Worldwide Ply Ltd ------------------ Ownership._ __ _ ___ . .100.000 __ PPC Worldwide Pte. ltd. International Psychologicel

_______ SG _______________ NIL ________ Services Ply Limited ____________________ Ownership ___________________ . .100.000 ---------------------------------------------------- PPC Worldwide Pty Ltd________________________ Personal Performance Consultants

______ JJJ _______________ NIL ________ U< Limited------------------------------------ Ownership. __________________ . .100.000

U1i tedHealth Group Incorporated ~i tedHeallh Group Incorporated .


__ PPC Worldwide ~it Trust ------------------- __ .. JJJ ___ __________ NIL ________ PPC Worldwide Ply Ltd ------------------ Ownership _ __ _ ___ . .100.000 ~itedlteallh Group Incorporated __ ppoOIE, Inc. __ __ ____ !£ _____ _________ NIL ________ ~ited HealthCare Services, Inc. _ Ownership.________ . .100.000 __ _ U1itedHealth Group Incorporated _

---------------------------------------------------- Preferred Care Partners Holding, ~ited HealthCare Services, Inc. . ~itedHeallh Group Incorporated . Corp. -------------------------------------------------- _______ R._ _______________ NIL________ Ownership ___________________ . .100.000

---------------------------------------------------- Preferred Care Partners Medical Preferred Care Partners Holding, U1i tedHealth Group Incorporated Group, Inc. ----------------------------------------- _______ R._ _______________ NIL ________ Corp. --------------------------------------------- Ownership. __________________ . .100.000

__ Preferred Care Partners Medical Preferred Care Partners Holding, ~i tedlteallh Group Incorporated _ Group, Inc. ----------------------------------------- __ ____ R.. ___ __________ NIL ________ Corp. --------------------------------------------- Ownership.----------------- . .100.000 _ Preferred Care Partners, Inc. . Preferred Care Partners Holding, ~ltedHeallh Group Incorporated .

_______ R._ _____ __________ _jA_ ___________ Corp. --------------------------------------------- Ownership ___________________ . .100.000 ---------------------------------------------------- Prime Health, Inc. ------------------------------ _______ NV ________________ NIL ________ Sierra Health Services, Inc. ________ Ownership. __________________ . .100.000 U1itedHealth Group Incorporated ---------------------------------------------------- ProcessWorks, Inc. ------------------------------ _______ Jfl. _____ __________ NIL ________ ~itedHealthcere, Inc. _________________ Ownership. __________________ . .100.000 ~itedHeallh Group Incorporated ---------------------------------------------------- RaH Family Fitness ~I imited Ll.C _________ _____ :rx_ ___ __________ NIL ________ We liMed Medical Management, Inc. _ Ownership __ ---------------- . .100.000 ___ ~itedlteallh Group Incorporated _

Rx Solutions NY IPA, Inc. _ _ ____ _ NL ___________ NIL ________ OptumRx, Inc. _ Ownership.________ _ ___ . .100.000 ___ U1itedHealth Group Incorporated _ __ ScriptSwitch Holdings Limited ----------- _____ 1.1( . __ _________ NIL ________ lngenix U( Holdings Limited --------- Ownership.____ _ ___ . .100.000 ~itedHeallh Group Incorporated

---------------------------------------------------- ScriptSwi tch Limi tad ________________________________ .l.K _______________ NIL ________ Scr iptSwi tch Holdings Limi tad ______ Ownership ___________________ . .100.000 ~i tedlteallh Group Incorporated ---------------------------------------------------- Sierra Health and Life Insurance Sierra Health Services, Inc. U1itedHealth Group Incorporated

Company, Inc. -------------------------------------- _______ CA_ ________________ JA____________ Ownership. __________________ . .100.000 Sierra Health Services, Inc. _ _ ____ _ NV _______________ NIL ________ ~itedHealthcare, Inc. _ Ownership ________ _ ___ . .100.000 ___ ~itedlteallh Group Incorporated _

__ Sierra Health-care Options, Inc. ______ ______ NV ____ ___________ NIL ________ Sierra Health Services, Inc. Ownership.____ _ ___ . .100.000 U1itedHealth Group Incorporated __ Sierra Home Medical Products, Inc. __ ____ ____ NV ___ __________ NIL ________ Sierra Health Services, Inc. __ _____ Ownership.________ . .100.000 __ _ ~itedHeallh Group Incorporated .

---------------------------------------------------- Sierra Nevade Administrators, Inc. _______ NV ______ __________ NIL ________ Sierra Health Services, Inc. ________ Ownership ___________________ . .100.000 ~itedlteallh Group Incorporated ---------------------------------------------------- Southwest Medical Associates, Inc. _______ NV ________________ NIL ________ Sierra Health Services, Inc. ________ Ownership. __________________ . .100.000 U1itedHealth Group Incorporated ---------------------------------------------------- Southwest Michigan Health Network ~itedHealthcere, Inc. _________________ ~itedHeallh Group Incorporated

Inc. ------------------------------------ ---- __________________________________ _ I Specialty Benefits, Ll.C ___ _

_____ MI. ___ ___________ NIL________ Ownership ____ . .100.000 _ _____ !£ _____ _________ NIL _______ ~ited HealthCare Services, Inc. _ Ownership_ _____ _ __ _ . .100.000 ___ U1itedHealth Group Incorporated _

15



Group Code

2

Group Name

3 4

NAIC Company FederaiiD

Code Number ...... 00000 ..... 71-()886811 ----···· 00000 .... 52-1260282 .... ... 00000 ·-·· 56-1970224 ..

...... 00000 ..... 25-1825549 ----______ 00000 ..... 52-1431155 ----______ 00000 ..... 94-3077084 ----

... 00000 .... 41-1913059 .. ..... 00000 .... 95-2931460 ..

...... 00000 ..... 41-1921008 ----______ 00000 ..... 14-1892398 ----··· 00000 .... 75-2788811 . ... 00000 .... 75-2788811 .

...... 00000 .... :B--1995276 .... ... 0707 ___ lklitedltealth Group Incorporated _______ ...... 91529 _____ 52-1996029 ___ _ ... 0707 ___ lklitedllealth Group Incorporated _______ ...... 11596 _____ 01-()637149 ___ _

... 00000 .... 25-1877716 .. .... 00000 .... 20-591n14 ....

... 0707 .. lkliledllealth Group Incorporated-···-·· ..... 11139 .... 62-1839257 ..

... 0707 ___ lklitedllealth GroUp Incorporated _______ ...... 13032 _____ 2jH)651931 ___ _

.... 00000 .... 94-2649097 .... ... 00000 ·-·· 41-1868911 .

5

Federal RSSD

...... 00000 ..... 41-1941615 ---- --------------------______ 00000 ..... 41-1289245 ---- 3410132 ---------...... 00000 ..... 3!Hl318238 ---- --------------------

... 00000 .... 01-()539317 .. ...... 00000 ... . ...... 00000 ..... --------------------

...... 00000 .....

... 00000 .... 41-1321939 .. ...... 00000 ..

...... 00000 .....

...... 00000 ....

... 00000 ·-·· 41-1917398 .. ...... 00000 ..... 26-2574977 ----

-------------------------------------------------------- ...... 00000 ..... --------------------... 0707 .. lkliledltealth GroUp Incorporated ............. 95174 .... 3:Hl115163 ... .

6

CIK

7


cu.s. or lntemationall

8

Names of Panant, Subsidiaries

or Affiliates

9 10 11 12 13 Type If


Board. Owner-Relationship Management, ship

Domi- to Attorney-in-Fact, Provide ciliary Reporting Directly Controlled by Influence, Parcen-

Location Entitv (Name of Entilv/Person) Other) laQe

14

Ultimata Controlling Entity{ie& l/Person<s)

---------------------------------------------------- Spec:tera of New York, IPA, Inc. __ Spec:tera, Inc. __

....... NY ....... _________ NIL ________ Spec:tera, Inc. ------------------------------ Ownership. __________________ . .100.000 ... lklitedlteallh Group Incorporated ______ _

. . ... JIL .. __________ NIA. __________ Specialty Benefits, L1C --------------- Ownership_____ .... . .100.000 ... lklitedlteallh Group Incorporated ..... .. The Lewin Group, Inc. Opium Pub I ic Sector Solutions, lklitedlleallh Group Incorporated ..

. ..... NC .... __________ NIA. __________ Inc. ---------------------------------------------- Ownership. ................. . .100.000 .. ---------------------------------------------------- Three Rivers Holdings, Inc. ______________________ tE _______________ NIA. __________ Amer iCho ice Corporal ion _______________ Ownership ___________________ .. 100.000 ___ lkli tedlteallh Group Incorporated ______ _ ---------------------------------------------------- Travel Express Incorporated _____________________ ./{L ___ __________ NIA. __________ FrontieriEDEX, Inc. ______________________ Ownership. __________________ . .100.000 ___ U1itedlleallh Group Incorporated ______ _ ---------------------------------------------------- U.S. Behavioral Health Plan, lk1 i ted Behav iora I Ilea lth ______________ lkli tedlteallh Group Incorporated ______ _

California ------------------------------------------ .. .... CA. ..... _________ .JA.___________ Ownership _ _______ . .100.000 .. ---------------------------------------------------- LK: Internal ional Services, Inc . ....... ...... 1£ ... __________ NIA. __________ lkli tedieal th Group Incorporated __ Ownership. ................. . .100.000 ... U1i tedlleallh Group Incorporated ..

LK: of California ------------------------------- Pacif iCare Health Plan lklltedlteallh Group Incorporated .. _______ CA. _____ __________ _jA_ ___________ Administrators, Inc. _____________________ Ownership ___________________ .. 100.000 __ _

---------------------------------------------------- lliiC Holdings, Inc. ---------------------------- _______ tE _______________ NIA. __________ lklited llealthCare Services, Inc .. Ownership. __________________ . .100.000 ___ U1itedllealth Group Incorporated ______ _ ---------------------------------------------------- Ultima Rx, L1C ----------------------------------- ....... R.. ...... _________ NIA. __________ lklited HeallhCare Services, Inc .. Ownership. __________________ . .100.000 ... lklitedlteallh Group Incorporated ______ _ ---------------------------------------------------- lMI Care Management, lliP ------------------ ...... 1£ ... __________ NIA. __________ lkli ted Heal thCare Services, Inc. . Ownership __ ................ .. 99.000 .... lkli tedlteallh Group Incorporated ..

lMI Care Management, lliP ------------------ ...... 1£ ...... _________ NIA. __________ lMI, Inc. . . ... Ownership......... . ...... 1.000 .. _ U1i tedllealth Group Incorporated .. .. lMI, Inc. .. . . .... 1£ .... __________ NIL ________ lkliled HealthCare Services, Inc . . Ownership.. ... . ... . .100.000 ... lklitedlteallh Group Incorporated .....

---------------------------------------------------- lklimarica Insurance CollfllllY _______________ ....... Ill.. ..... _________ _jA_ ___________ Optuntiealth Holdings, L1C ____________ Ownership ___________________ .. 100.000 ___ lklitedlteallh Group Incorporated ______ _ ---------------------------------------------------- lklimer ica Life Insurance CollfllllY of lkli tediealthcare Insurance U1i tedllealth Group Incorporated ______ _

New York --------------------------------------------- ....... NY ....... __________ JA_ ___________ Collflllly ----------------------------------------- Ownership. __________________ . .100.000 .. . lklison Administrative Services, L1C __ ...... PL .... _________ NIA. __________ Three Rivers Holdings, Inc. . Ownership ........ . .... .100.000 ... lklitedlteallh Group Incorporated ..

.. lklison Health Plan of Delaware, Inc. . . .... 1£ .... __________ _jA_ ___________ Three Rivers Holdings, Inc. Ownership.____ .... . .100.000 ... U1itedllealth Group Incorporated .....

.. lklison Health Plan of Tennessee, Inc. Three Rivers Holdings, Inc. lklitedlteallh Group Incorporated .. ----------------------------------------------------------- ....... TIL .... _________ _jA____________ Ownership ___________________ .. 100.000 __ _

---------------------------------------------------- lklison Health Plan of the Capital Three Rivers Holdings, Inc. U1itedllealth Group Incorporated ______ _ Aree, Inc. ------------------------------------------ ....... DC ....... __________ JA____________ Ownership. __________________ . .100.000 .. .

.. lklited Behavioral Health ------------------- ..... CA. .... __________ NIL ________ Optuntiealth Holdings, L1C ------------ Ownership . .. . ... . .100.000 ... lklitedlteallh Group Incorporated .....

.. lklited Behavioral Health of New York, lklited Behavioral Health -------------- U1itedllealth Group Incorporated .. I.P.A., Inc. ----------------------------------------- ...... NY .. __________ NIA.__________ Ownership. ................. ..100.000 ..

---------------------------------------------------- lk1 i ted Health Foundation _________________________ ./IL .... _________ NIA. __________ lk1 i tedlleal th Group Incorporated __ Ownership ___________________ .. 100.000 ___ lkli tedlteallh Group Incorporated ______ _ ---------------------------------------------------- lklited llealthCare Services, Inc. _____________ ./IL .... _________ !liP ___________ lklitediealth Group Incorporated __ Ownership. __________________ . .100.000 ___ U1itedllealth Group Incorporated ______ _ ---------------------------------------------------- lklited Resource Networks IPA of New Optuntiealth Care Solutions, Inc. . lklitedlteallh Group Incorporated ______ _

York, Inc. . . .... NY ... __________ NIA.__________ Ownership ________ . .100.000 .. ---------------------------------------------------- lk1 i tedieal th Advisors, LLC ---------------- ...... IE ... __________ NIA. __________ lkli ted Ileal thCare Services, Inc. . Ownership. ................. . .100.000 ... U1i tedllealth Group Incorporated ..

lkliledllealth Capital, L1C ------------------ ...... 1£ ... ___________ NIA. __________ lkliled HealthCare Services, Inc. Ownership. ..... .100.000 ... lklltedlteallh Group Incorporated .. ---------------------------------------------------- lklitedllealth Group Global Healthcare Pacif iCare Health Plan lklitedlteallh Group Incorporated ______ _

Services Limited-------------------------------- ...... .IE _______________ NIA. __________ Administrators, Inc. _____________________ Ownership. __________________ . .100.000 __ _ ---------------------------------------------------- lklitedllealth Group Global Services, lklitedlleallh Group International lklitedlteallh Group Incorporated ______ _

Inc. ---------------------------------------------------- ...... PH .. __________ NIA. __________ B.V. _ --------------------------------------------- Ownership __ ................ . .100.000 .. 0000731766 ... New York Stock Exchange . lkli tedieal th Group Incorporated ________ ..... .IlL ... _________ !liP___________ ---------------------------------------------------- .

.. lkli ledllealth Group Informal ion lk1 i ledllealth Group Internal ional lkli tedlteallh Group Incorporated ..... Services Private Limited ___________________ ....... .IN. _______________ NIA. __________ B.V. ----------------------------------------------- Ownership ___________________ .. 99.370 ___ _

---------------------------------------------------- lkli tedieal th Group Informal ion lkli tediealth Internal ional, Inc. . U1i tedllealth Group Incorporated ______ _ Services Private Limited ___________________ ....... .IN. ...... _________ NIA. _________ _ Ownership. __________________ ... 0.630 ____ _ lklitedllealth Group International B.V. lklitedllealth Group Incorporated __ lkli tedlteallh Group Incorporated .. ----------------------------------------------------------- ____ __ NL ____ __________ NIA.__________ Ownership.___ __ .... . .100.000 .. .

.. lkliledllealth International, Inc . ...... .. .... 1£ ..... _________ NIA_ __________ lkliledllealth Group Incorporated __ Ownership.________ . .100.000 ... lklitedlteallh Group Incorporated .. ---------------------------------------------------- lklitedllealth Mi I itary & Veterans lklited HealthCare Services, Inc. . lklitedltealth Group Incorporated ______ _

Services, LLC ------------------------------------- _______ tE _______________ NIA.__________ Ownership. __________________ . .100.000 __ _ ---------------------------------------------------- lklitedlleallh U< Limited _____________________ ...... .LK _______________ NIA. __________ lngenix U< Holdings Limited _________ Ownership. __________________ . .100.000 ... lklitedlteallh Group Incorporated ______ _

.. lklitedllealthcare Benefits of Texas, Pacif iCare Health Plan lklitedltealth Group Incorporated ..... Inc. . . .. ... JX. .... __________ _jA_ ___________ Administrators, Inc . ... ....... ....... . Ownership_ __ ... . _ . . . .100.000 __

15

. ... J -·-·

. ..... 1 ..... .

2 3 4

NAIC Group Company FederaiiD Code Group Name Code Number

... 0707 ___ lklitedllealth Group Incorporated ____________ _12323 _____ 56-2451429

... 0707 __ lklitedHealth Group Incorporated ___ ____ ___ __ 11141 ___ 91-2008361 _

... 0707 ___ lklitedllealth Group Incorporated _____________ 95467 _____ 3&--3204052

______ 00000 ----- --------------------

... 00000 -

... 0707 ___ lklitedltealth Group Incorporated _____________ 79413 _____ 36-2739571

... 0707 ___ lklitedllealth Group Incorporated _____________ 60318 _____ 36-3800349

... 0707 __ lklitedllealth Group Incorporated ____ ... 60093 _ _ 11-3283886 _

... 0707 __ lkliledltealth Group Incorporated _____ _12231 ____ 20-1902768

______ 00000 ----- --------------------

... 0707 ___ lklitedllealth Group Incorporated _______ ______ 95784 ___ 6:Hl899562 _

... 0707 __ lklitedllealth Group Incorporated _______ ...... 96016 ____ 81Hl507074 ___ 0707 __ lklitedllealth Group Incorporated ___ ____ ___ __ 115446 . __ 63-1036819 . ... 0707 ___ lklitedltealth Group Incorporated _____________ 95090 _____ 84-1004639 ... 0707 ___ lklitedllealth Group Incorporated _____________ 95264 _____ 59-1293865 ... 0707 ___ lklitedllealth Group Incorporated _____________ 95850 _____ 511-1653544 ... 0707 __ lklitedltealth Group Incorporated _____________ 95776 ____ 36-3280214 ... 0707 __ lklitedHealth Group Incorporated ___ ____ ___ __ 96644 ___ 62-1240316 _ ___ 0707 __ lklitedltealth Group Incorporated ____ _ ___ 96644 ____ 62-1240316 . ... 0707 ___ lklitedllealth Group Incorporated _____________ 95833 _____ 72-1074008 ... 0707 ___ lklitedHealth Group Incorporated _____________ 95716 _____ 63-1036817

... 0707 __ lklitedltealth Group Incorporated ___ ____ ___ __ 95149 ___ 15-()413469 _

... 0707 ___ lklitedllealth Group Incorporated _____ _13214 - - 26-2697886 -


... 0707 ___ lklitedltealth Group Incorporated _____________ 95103 _____ 56-1461010

... 0707 ___ lklitedllealth Group Incorporated _______ ______ 95186 ___ 31-1142815 _

... 0707 __ lkliledltealth Group Incorporated _____________ 96903 ____ 3lHl115166


... 0707 ___ lklitedllealth Group Incorporated ______ 95220 - -- 25-1756858 -

___ 0707 __ lklitedllealth Group Incorporated ___ ____ ___ _ _11775 . __ 32-0062883 .





5

Federal RSSD

6

CIK

7


cu.s. or lntemationell

8


or Affiliates

9

Domiciliary

Location

10

Relationship to

Reporting Entity

11

Directly Controlled by (Name of Entilv/Person)

---------------------------------------------------- lk1 i te«Hee I thcare Co11111Jn i ty P 1111 of Three Rivers Holdings, Inc. ________ _ Ohio, Inc. .. . ......... lH .... __________ J.'-.. ........ .

.. lklitediealthcare CoiiiiiJnity Pl111 of Ovations, Inc . TeXIlll, L.L.C. --------------------------------------- ....... JX. ... ___________ u ___________ _

---------------------------------------------------- lk1 i tectfeal thcare Co11111Jn i ty Pl111, Inc. Amer iCho ice Corporal ion ______________ _ ----------------------------------------------------------- ....... 111 ....... _________ JA_ __________ _

---------------------------------------------------- lk1 i te«Hee I thcare lnd ia Private lk1 i te«Hee I th Group Internal iona I lkli tedlteallh Group Incorporated Limited ----------------------------------------------- .. ... IN. ..... _________ NIA. .......... B.V. . ...... . ... Ownership ...... . . 99.995 . --

.................................................... lk1 i tedieal thcare India Private lkli tedieal th Internal ional, Inc . . lkli tedlleallh Group Incorporated . Limited ----------------------------------------------- ...... IN. ...... _________ foliA.__________ Ownership........ . ...... 0.005 .

---------------------------------------------------- lk1 i tectfea I thcere lnsur111ce Comp111y ___ ....... CT ....... _________ JA. ___________ lliiC Holdings, Inc. ______________________ Ownership___________________ .. 100.000 lkli tedlteallh Group Incorporated lkli tedlleallh Group Incorporated ---------------------------------------------------- lk1 i tediea I thcare lnsur111ce Comp111y of lk1 i tediea I thcare lnsur111ce

Illinois --------------------------------------------- ....... IL. ..... __________ JA_ ___________ Comp111y ----------------------------------------- Ownership __________________ .JOO.OOO .................................................... lk1 i tectfea I thcare lnsur111ce Comp111y of lk1 i tectfea I thcare lnsur111ce lkli tedlteallh Group Incorporated .

New York --------------------------------------------- ...... NY ..... _________ JA. ___________ Comp111y ----------------------------------------- Ownership........ . .... .100.000 . .. lklitectfealthcare lnsur111ce Comp111y of lklitectfealthcare Services Comp111y lkli tedlteallh Group Incorporated

the River Valley-------------------------------- ....... IL. ..... _________ JA. ___________ of the River Valley, Inc. _____________ Ownership ___________________ .. 100.000 ---------------------------------------------------- lk1 i tediea I thcare Internal iona I Asia, lk1 i tediea I th Group Incorporated __

LLC ----------------------------------------------------- -------~------ _________ NIA. _________ _ lklitectfealthcare of Alabama, Inc. . . .... AI... ...... _________ JA. ___________ lklitectfealthcare, Inc . .

.. lklitediealthcare of Arizona, Inc. ______ .. .... Jl. .... __________ JA. ___________ lklitediealthcare, Inc.

.. lklitectfealthcare of Ark111sas, Inc . ...... .... AIL ... __________ u ___________ lklitectfealthcare, Inc. ---------------------------------------------------- lk1 i tectfea I thcare of Co lorado, Inc. ____ ....... CO ....... _________ JA. ___________ lk1 i tectfea I thcare, Inc. ---------------------------------------------------- lk1 i tediea I thcare of Florida, Inc. ______ ....... R.. ...... _________ JA. ___________ lk1 i tediea I thcare, Inc. ---------------------------------------------------- lk1 i te«Hee I thcare of Georgia, Inc. ______ ....... .GA. ...... __________ JA_ ___________ lk1 i te«Hee I thcare, Inc.

.. lklitectfealthcare of Illinois, Inc . .... .. .... IL. ... __________ JA. ___________ lklitectfealthcare, Inc.

.. lklitediealthcare of Kentucky, Ltd . ...... .... KY ... __________ JA. ___________ lklited llealthCare Services, Inc .. .................................................... lk1 i tectfea I thcare of Kentucky, Ltd . .......... KY .. __________ JA_ ___________ lk1 i tectfeal thcare, Inc . . ---------------------------------------------------- lk1 i tectfeal thcare of Lou isi111a, Inc. . ...... LA. ...... _________ JA. ___________ lk1 i tectfeal thcare, Inc. ________________ _ ---------------------------------------------------- lk1 i tediea I thcare of Miss iss ipp i , Inc. lk1 i tediea I thcare, Inc. ________________ _

----------------------------------------------------------- ....... MS. ...... __________ jA_ __________ _ .. lklitectfealthcare of New E11gl111d, Inc. lklited HeelthCare Services, Inc ..

----------------------------------------------------------- ....... RI __ __________ JA_ __________ _ lklitectfealthcare of New Mexico, Inc. lklitectfealthcare lnsur111ce

lkli tedlleallh Group Incorporated Ownership __________________ .JOO.OOO Ownership ________ _ ___ .JOO.OOO ... lklitedlteallh Group Incorporated . Ownership. ___ .... . JOO.OOO lkli tedlleallh Group Incorporated Ownership. -···-·· .JOO.OOO ... lkli tedlteallh Group Incorporated . Ownership ___________________ .. 100.000 lkli tedltealth Group Incorporated Ownership __________________ . .100.000 lkli tedlleallh Group Incorporated Ownership __________________ .JOO.OOO lkli tedlteallh Group Incorporated Ownership .. ___ .... . .100.000 lkli tedlteallh Group Incorporated Ownership. -···-·· .. 94.180 . _ lkli tedlleallh Group Incorporated . Ownership ................. .. 5.820 . _ lkli tedlteallh Group Incorporated . Ownership ___________________ .. 100.000 lkli tedltealth Group Incorporated

lkli tedlleallh Group Incorporated Ownership __________________ .JOO.OOO

lkli tedlteallh Group Incorporated . Ownership ................. . .100.000 .

lkllledlteallh Group Incorporated . _______ tfL .... _________ JA. ___________ Comp111y ----------------------------------------- Ownership ___________________ .. 100.000

---------------------------------------------------- lkli tedieal thcare of New York, Inc. ____ ....... NY ....... _________ JA. ___________ Amer iChoice Corporal ion _______________ Ownership. __________________ . .100.000 ---------------------------------------------------- lk1 i te«Hee I thcare of North Caro I ina, lk1 i te«Hee I thcare, Inc. ________________ _

Inc . ........................................................... NC... __________ JA. __________ _ Ownership __ ................ . .100.000 .

lkli tedlleallh Group Incorporated lkli tedlteallh Group Incorporated

lklitediealthcare of Ohio, Inc. . . ..... lH ..... _________ JA. ___________ lklited llealthCare Services, Inc. Ownership ..... .100.000 ... lkli tedlleallh Group Incorporated . .. lklitectfealthcare of Oklahoma, Inc. Pacif iCare Heelth Pl111

_______ a<_ _______________ JA. ___________ Administrators, Inc. _____________________ Ownership ___________________ .. 100.000 ---------------------------------------------------- lk1 i tediea I thcare of Oregon, Inc. _______ Pac if iCare Ilea I th Pl111

....... OR. ...... __________ JA____________ Admin i strators, Inc. _____________________ OwnershiP------------------ .JOO.OOO lklitectfealthcare of Pennsylv111ia, Inc . .. ....... PA. .... - _________ JA. __________ _

Three Rivers Holdings, Inc . .

.. lklitectfealthcare of South Carol ina, Three Rivers Holdings, Inc. Inc. ---------------------------------------------------- ....... SC ....... _________ JA. __________ _

---------------------------------------------------- lk1 i tediea I thcare of Texas, Inc. _________ ....... JX. ...... _________ JA. ___________ lk1 i tediea I thcare, Inc. ---------------------------------------------------- lk1 i te«Hee I thcare of the Mid-At l111t ic, lk1 i te«Hee I thcare, Inc.

Inc . .. .. JIL JL

Ownership. __ _ --- . .100.000

Ownership ___________________ .. 100.000 Ownership. __________________ . .100.000

OwnershiP _ .. . 100.000 --·

lkli tedlteallh Group Incorporated

lkli tedlleallh Group Incorporated

lkli tedlteallh Group Incorporated .

lkli tedlteallh Group Incorporated .

lkli tedlleallh Group Incorporated lkli tedlteallh Group Incorporated

... 2 .....

. ... 2 -·-·

2 3 4

NAIC Group Company FederaiiD Code Group Name Code Number

... 0707 ... lklitedllealth Group Incorporated ............. 95591 ..... 47-o676824 ... .

... 0707 .. lklitedHealth Group Incorporated-······ ..... 96385 .... 43-1361841 .


... 0707 ... lklitedHealth Group Incorporated ............. 48038 ..... 91-1312551 ... .

... 0707 .. lklitedllealth Group Incorporated-······ ..... 95710 .... 39-1555888 ..

... 0707 .. lklitedHealth Group Incorporated .... . ... 95378 .... 36-3379845 ..

...... 00000 ..... 47-oe54646 ....

...... 00000 ..... 36-3355110 ....

... 00000 .... 41-1922511 . ...... 00000 .... 37-0!120164 ....

...... 00000 ..... 74-2797745 ....



5

Federal RSSD

6

CIK

7


cu.s. or lntemationall

8


or Affiliates .................................................... lklite«Heelthc:are of the Midlands,

Inc . .. .. lklitediealthcare of the Midwest, Inc.

9

Domiciliary

Location

10

Relationship to

Reporting Entity

...... JE. .... . ......... JA. .......... .

··························································· ....... MO .... - ......... JA. .......... .

11

Directly Controlled by (Name of Entilv/Personl

lk1 i te«Hee I thc:are, Inc .

lk1 i tediea I thcare, Inc.

12 Type

of Control (Ownenship,

Board, Management,

Attorney-in-Fact, Influence,

Other)

13 If

Control is

Owner-ship

Provide Percen

tage

Ownership .. -·· .... . 100.000 ...

Ownership ................. . 100.000 ..

14

Ultimata Controlling Entitv{ie& l/Person<s l

lkli tedHaallh Group Incorporated ...... .

lkli tedHeallh Group Incorporated ..

.................................................... lklitecHealthcare of Utah, Inc ................. JJL ............. JL ......... lklitecHealthcare, Inc . Ownership .................... 100.000 ... lkli tedHeallh Group Incorporated ...... .

. ................................................... lklitediealthcare of Washington, Inc. . Pacif iCare Health Pl111 lkli tedHealth Group Incorporated ...... . . ...... JIL .............. JL ......... Administrators, Inc ...................... Ownership ................... 100.000 .. .

.. lklitecHealthcare of Wisconsin, Inc . .... .... J/1.. _ ......... JL ......... lklitecHealthcare, Inc. Ownership . ....... .100.000 ... lklitedHeallh Group Incorporated .. . ................................................... lklitediealthcare Pl111 of the River lklitediealthcare Services Con.-ny lklitedHealth Group Incorporated ..

Valley, Inc. . . ..... JL .... ···········-·············of the River Valley, Inc. . . .. Ownership........ . .... 100.000 .. .................................................... lklitecHealthcare Service Ll.C ............. lklitecHealthcare Insurance lklitedHealth Group Incorporated ...... .

. ...... I£ ............... NIL ........ Con.-ny ......................................... Ownership ................... 100.000 .. . .................................................... lklite«Heelthc:are Services Co~y of lklite«Heelthc:are, Inc. ................. lklitedHaallh Group Incorporated ...... .

the River Valley, Inc . ....................... ...... I£ ... _ ......... ID'........... Ownership .................. . 100.000 .. lklitediealthcare, Inc. . . ..... I£ ............. JJIP ........... lklited HealthCare Services, Inc. Ownership........ . .... 100.000 ... lklitedHealth Group Incorporated ..

.. lklitecHealthOne Agency, Inc. .. Golden Rule Financial Corporation lklitedHealth Group Incorporated ..... . ..... ..IN. ............... NIL .............................................................. Ownership .................... 100.000 .. .

.................................................... WeiiMed Medical Mlllagement of WeiiMed Medical Mlllagement, Inc. . lklitedHealth Group Incorporated ...... . Florida, Inc .............................................. R.. ............... NIL........ Ownership ................... 100.000 .. .

15

... 00000 .... 74-2786364 .. WeiiMed Medical Mlllagement, Inc. . . ..... JL ............. NIL ........ Collaborative Care Holdings, Ll.C _ Ownership ........ . ..... 80.000 ... lklitedHeallh Group Incorporated .. . .... 3 .... 00000 .... 36-3437660 .... .. Wellness, Inc. .. . . ... .JL ... _ ......... NIL ........ OptumHealth Care Solutions, Inc . . Ownership. ... . ... . 100.000 ... lklitedHealth Group Incorporated .... . ... 00000 .... 21Hl325334 .. .. XL.Health BIPA, Inc. . . ... .IlL _ ......... NIL ........ XL.Health Corporation .................... Ownership. ....... ..100.000 ... lklitedHealth Group Incorporated ..

...... 00000 ..... 52-2102846 ... . . ................................................... XL.Health Corporation ................................ .I.IL .... ......... NIL ........ lklited HeelthCare Services, Inc .. Ownership .................... 100.000 ... lklitedHealth Group Incorporated ...... .

...... 00000 ........................ . . ................................................... Xl..Health Corporation India Private Xl..Health Corporation.................... lklitedHealth Group Incorporated ...... . Limited ..................................................... ..IN. ...... ......... NIL........ Ownership ................... .100.000 .. .

.... 00000 .... 20-2717264 .... .. XL.Health Tennessee, Ll.C ..................... .. ... .IlL .. _ ......... NIL ........ XL.Health Corporation .................... Ownership. . ... . 100.000 ... lklitedHeallh Group Incorporated .... . ... 00000 .... 52-2111342 .. .. XL.Health Texas, Inc. . . ... .Ill.. _ ......... NIL ........ Xl..Health Corporation .................... Ownership. ....... .100.000 ... lklitedHealth Group Incorporated ..

Asterisk EXPlanation 1 2 3 ·--······

_ The general partnership interest of 1.01 is held by lMI, Inc. and the I imi ted partnership interest of 991 is held by United HealthCare Services, Inc . ..... The general partnership interest of 89.77\ is held by lklited HealthCare Services, Inc. (UHS) and 10.23~ is held by lklitedHealthcare, Inc. (LK:). UHS also holds 1~ of the limited partnership interests. llhen combining general and limited partner interests, IllS owns 94.18\ 111d LK: owns 5.1m

The remaining 201 is owned by M Haalthcare Partners, L.P., a non-alii liated company. ·--······


SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES The following supplemental reports are required to be filed as part af your statement filing. However, in the event that your company does not transact the type af 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 coda 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 eJCPianation following the interrogatory questions.

Response

1. Will the Medicare Part D Coverage Supplement be filed with the stale of domicile and the NAIC with this statement? ------------------------------ NO

Explanation:

1. The Company does not offer the Medicare Part D Supplement Product

BarCode:

1. Medicare Part D Coverage Supplement [Document Identifier 365]

17


OVERFLOW PAGE FOR WRITE-INS

Additional Write-ins for Assets Line 25 Currant Statement Dele

2

Allsete Nonadmitted Assets 2504. State Tax Receivable ------------------------------------------------------------------------------------------ ................................... 0 ................................... 0 2597. Summary of ramaining write-ins for Line 25 from ovarftow page 0 0

18

3 Net Admitted Assets

(Col&. 1- 2) ................................... 0

0

4

Prior Year Net Admitted Assets

.......................... 10,244 10,244


SCHEDULE A- VERIFICATION Real Estate

1. Book/adjusted carrying value, December 31 of prior year

2. Cost of acquired:

2.1 Actual cost at time of acquisition -------------------------------------------------------------------------------------------------------------------------------------------------

Year to Date

2 Prior Year Ended

December 31

3. ~~:~:;~~n;;~:~~u~:~~c:;~uisition_~- ___ --_ _-_ -g-_ _ _ _ _ _--__ N ___ _ _ _ _ -E-_______ --____ --__ ::::::_:::::::_:::::::_:::::::_::::::: ::::::_:::::::_:::::::_:::::::_::::::: 4. Total gain (loss) on disposals _ _ _ _ _ _ _ _ _ _ _ _ ______________________ ______________________ _

5. Deduct amounts racaivad on disposals________________ _______ _ _____ _________________ ____ _______ _ ______ ------------------------------ -------------------------------------- --------------------------------------8. Total foreign exchange change in book/adjusted rrying __ __ ___ _ ____ __ __ ____ ___ _ _ _ _ _ ___ __ _____ ____ __ ___ __ ___ __ ___ __ ___ ___ __ ___ __ ___ __ ___ _ ___ _

7. Deduct currant year's other than temporary impa ant re ized _______________________________________________ -------------------------------------- --------------------------------------Deduct currant year's depreciation ___ _ 8.

9. Book/adjusted carrying value at the and of currant period (Unas 1+2+3-+-4-5+6-7-8) ------------------------------------------------------------------10. Deduct total nonadmitted amounts __ ______ _

11. Statement value at and of currant period (Line 9 minus Line 1 0)

SCHEDULE B ·VERIFICATION Mortgage Loans

1_ Book valuefracorded invastmant excluding accrued interest, Dacambar 31 of prior year __

2_ Cost of acquired: 2.1 Actual cost at time of acquisition __

Year to Date

2 Prior Year Ended

December 31

2.2 Additional investment made after acquisition ----------------------------------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------

3. Capitalized deferred interest and other --------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------4. Accrualofdiscount _____________________________________________ IJ___ _ ___________ -----~-----------~-_________________ E ______________ ----------------------- -----------------------5. Unrealized valuation increase (deaeaae) __ __ _ __ __ __ __ __ __ __ -------------------------------------- --------------------------------------8. Total gain (loss) on disposals _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ____ __ ___ __ ___ __ ___ __ ___ _ __ __ ___ __ ___ __ ___ __ __ _

;: ~=~: :~:~r:~~:e::re:::::~~~~~ i ---l-p ~d --- --i~ --- --- _-::: _ _ ::-_ :-_-:: :-_-:: :-_-:: :-_-:: -:-:::-:-:-:::-:-:-:::-:-:-:::-:-:-::: -:-:::-:-:-:::-:-:-:::-:-:-:::-:-:-:::

II. Total foreign exchange change in book value/ ed in ent accru _____ __ ___ __ ___ __ ___ __ ___ __ ___ __ -------------------------------------- --------------------------------------

10. Deduct current year's other than temporary impainment recognized ---------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------11. Book value/recorded investment excluding accrued interest at end of current period (Unes 1+2+3+4+5+6-7-8+9-10) ---------- -------------------------------------- --------------------------------------

12. Total valuation aHowance -------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------

13. Subtotal (Line 11 plus Line 12) ----------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------14. Deduct total nonadmitted amounts ---------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------15. Statement value at end of current period (Line 13 minus Une 14)

SCHEDULE BA ·VERIFICATION Other Long-Term Invested Assets

2 Prior Year Ended

Year to Date December 31

1. Book/adjusted carrying value, DKembar 31 of prior year--------------------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------2. Cost of acquired:

2. 1 Actual cost at lime of acquisition ___ _

~ §~~J~-~~~-€)-~-l--- ========= ========= 8. Deduct amortization of premium and depreciation--------------------------------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------

9- Total foreign exchange change in book/adjusted carrying value ---------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------1 o_ Deduct currant year's other than temporary impainment recognized ---------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------11_ Book/adjusted carrying value at end of currant period (Unas 1+2+3+4+5+6-7-8+9-10) ___ __ -------------------------------------- --------------------------------------12_ Deduct total nonadmitted amounts ---------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------- --------------------------------------13_ Statement value at end of currant period (Line 11 minus Una 12)

SCHEDULE D -VERIFICATION Bonds and Stocks

2 Prior Year Ended

Year to Date December 31 1. Book/adjusted carrying value of bonds and stockB, December 31 of prior year ---------------------------------------------------------------------------- _________________ 628, 251 , 495 _________________ 5S), 542,524

2. Cost of bonds and stocks acquired __ ------------------------------------------------------------------------------------------------------------------------------------------------- _________________ 127, 763,435 ________________ _233, 006,501 3- Accrual of discount ___ _ _ ________________________ 52, 811 ________________________ 119, 544

4. Unrealized valuation increase (deaeaae) ----------------------------------------------------------------------------------------------------------------------------------------- ________________________ (26,055) -----------------------------------0 5. Total gain (loss) on disposals ------------------------------------------------------------------------------------------------------------------------------------------------------------- ____________________ _, , 260, 417 ____________________ _3, 361 , 395 8_ Deduct consideration for bonds and stocks disposed of------------------------------------------------------------------------------------------------------------------ ___________________ n, 338,009 _________________ 161 , 022,036 7. Deduct amortization of premium __ _ _____________________ 4, 675,606 ____________________ ], 793,643

8. Total foreign exchange change in book/adjusted carrying value ---------------------------------------------------------------------------------------------------- -----------------------------------0 -----------------------------------0 9- Deduct currant year's other than temporary impainment recognized _ _ ___ -----------------------------------0 __________________________ 52, 788

10. Book/adjusted carrying value at end of current period (Unes 1+2+3+4+5-6-7+8-9) --------------------------------------------------------------------- _________________ 675,288,488 _________________ 628,251 ,495 11. Deduct total nonadmitted amounts ---------------------------------------------------------------------------------------------------------------------------------------------------- -----------------------------------0 -----------------------------------0 12_ Statement value at end of currant period (Line 10 minus Una 11) 675,288,488 628,251,495

8101

BONDS

STATEMENT AS OF JUNE 30,2012 OF THE UnitedHealthcare Plan of the River Valley, Inc.

SCHEDULED· PART 18 Showing the Acquisitions, Dispositions and Non-Trading Activity

During the Current Quarter for all Bonds and Preferred Stock by Rating Class 1 2 3 4

Book/Adjusted Carrying Value

Beginning of Current Quarter

Acquisitions During

Current Quarter

Dispositions During

Current Quarter

Non-Trading Activity During

Current Quarter

5 Book/Adjusted Carrying Value

End of First Quarter


End of Second Quarter


End of Third Quarter

8 Book/AdjiiSted Carrying Value December31

Prior Year

1. Class 1 (a) ... ................. 826,226,304 .............. 1,984,343,498 ............. 2,025, 139,Q(JI ................... (3,590,670) ................. 826,226,304 ................. 781,839,225 ................................... 0 ................. 792,382,009

2. Cl811112 (a) .. . ...... 50,679,489 . ........ 2,401,357 ......... .3,815,000 .1121,600) . .. _50,679,489 ........ 49, 144,246 ..... 0 ........ 40,994,963

3. Cl81111 3 (a) ................................................................................................................................................................................................. 0 ................................... 0 ................................... 0 ........................ 807' 029 ................................... 0 ........................ 807' 029 ................................... 0 ................................... 0

4. Class 4 (a) ............................................................................................................................................................. ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0

5. Cl811115 (a) . . ... .. 0 .... .. 0 .... .. 0 .... .. 0 .... .. 0 .... .. 0 .0 .... .. 0

6. Cl811116 (a) ······························································································································································1---------=-o+---------"o~ _____ ..:.o+---------"o~ _____ ..:.o+---------"o~ _____ ..:.o+---------"o~ 7. Total Bonds 876,905,793 1,986,744,855 2,028,954,Q(JI {2,905,241) 876,905,793 831,790,500 0 833,376,972

PREFERRED STOCK

8. Cl81111 1 ................................................................................................................................................................... . ......... 0 .......... 0 .......... 0 .......... 0 .......... 0 .......... 0 .......... 0 .......... 0

9. Cl81111 2 ................................................................................................................................................................... . .................................. 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0

1 o. Class 3 ................................................................................................................................................................... . .................................. 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0

11. Cl81111 4 ................................................................................................................................................................... . ..... 0 ...... 0 ...... 0 ...... 0 ...... 0 ...... 0 ...... 0 ...... 0

12. Cl81111 5 ................................................................................................................................................................... . .................................. 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0 ................................... 0

13. c1ass 6 .................................................................................................................................................................. t----------'o'-+--------'o'-+-______ o'-+-______ o'-+-______ o"-+ ______ o"-+ _____ _;;_o +-------"-to 14. Total Preferred stock ............................................................................................................................................ t----------"o+------o"-+ _____ ...:;o+------o"-+ _____ ...:;o+------o"-+ _____ ...:;o+------o"-~ 15. Total Bonds and Preferred Stock 876,905,793 1,986,744,855 2,028,954,Q(JI (2,905,241) 876,905,793 831,790,500 0 833,376,972

(a) Book/Adjusted Carrying Value column for the end of the current reporting period includes the following amount of norH&ted short-term and cash equivalent bonds by NAIC designation: NAIC 1 $ .................... 50, 332,007 ; NAIC 2 $ ..................... 6,559,482 ; NAIC 3 $ .................................... 0 ;

NAIC 4 $ .0 ; NAIC 5 $ ... . .. 0 ; NAIC 6 $ .................................... 0


SCHEDULE DA- PART 1 Short-Tenn Investments

1 2 3 4

Book/Adjusted Interest Collected Carrying Value Par Value Actual Cost Year-to-Date

9199999 Totals 156,502,012 XXX 157,211,072 603,197

SCHEDULE DA ·VERIFICATION Short-Tenn Investments

Year To Date

5 Paid for

Accnled Interest Year-to-Date

249,530

2

PriorYearEnded December 31

1. Book/adjusted carrying value, December 31 of prior year .. . .................... 194, 539, 154 ................. 417, 762,526

2. Cost of short-term inveetments acquired ....................................................................................................................................................... 3,631 ,087,359 ............. 7 ,035, 728,626

3. Accn.lal of discount.............................................................................................................................................................................. . ........................... 4, 118 ............................ 4, 776

4. Unrealized valuation increase (decrease) ......................................................................................................................................... . .................................. 0 ................................... 0

5. Total gain (1088) on disposals ............................................................................................................................................................................................... 0 ............................... 235

8. Deduct consideration received on disposals .... . ............. 3,6611,349,049 ............ .1 ,258,238,944

7. Deduct amortization of premium ... . ... ........................ 779,570 ........................ 718,0115

8. Total foreign exchange change in book/adjusted carrying value.................................................................................................... . .................................. 0 ................................... 0

9. Daduct current year's other than temporary impairment recognized ................................................................................................................................. 0 ................................... 0

10. Book/adjusted carrying value at end of current period (Unes 1 +2+3+4+5-6-7+8-9) ...................................................................................... 156, 502,012 ................. 194, 539, 154

11. Deduct total nonadmitted amounts . . ................................... 0 ................................... 0

12. Statement value at end of current period (Line 10 minus Une 11) 156,502,012 194,539,154

8103


Schedule DB - Part A - Verification - Options, Caps, Floors, Collars, Swaps and Forwards

NONE

Schedule DB- Part B- Verification- Futures Contracts

NONE

Schedule DB- Part C- Section 1 -Replication (Synthetic Asset) Transactions (RSATs) Open

NONE

Schedule DB-Part C-Section 2-Reconciliation of Replication (Synthetic Asset) Transactions Open

NONE

Schedule DB - Verification - Book/Adjusted Carrying Value, Fair Value and Potential Exposure of Derivatives

NONE

SI04, SI05, SI06, SI07


SCHEDULE E -VERIFICATION (Cash Equivalents)

Year To Date

2

Prior Year Ended December31

1. Book/adjusted cartying value, December 31 of prior year ................................................................................................................................ J0,586,325 .................. J5,053,036

2. Cost of cash equivalents acquired ..................................................................................................................................................................... 163, 761,9112 ............ ..1 ,872,358,0!14

3. Accrual of discount ............................................................................................................................................................................................................. 879 ........................... J,261

4. Unrealized valuation increase (decrease) ......................................................................................................................................... .. ................................. 0 ................................... 0

5. Total gain (loss) on disposals ................................................................................................................................................................................................ 0 ................................ .110

6. Deduct consideration received on disposals .................................................................................................................................................... 'E4,330,000 .............. 1 ,876,812,000

7. Deduct amortization of premium .. . .......................... 18, 9116 .......................... 16, 146

8. Total foreign exchange change in book/adjusted cartying value .................................................................................................... . .................................. 0 ................................... 0

9. Deduct currant year's other than temporary impairment recognized .. ...... .. ................................. 0 ................................... 0

10. Book/adjusted cartying value at end of current period (Unes 1 +2+3+4+5-6-7+8-9) .................................................................... .. ................................. 0 .................. JO, 5116,325

11. Deduct total nonadmitted amounts .................................................................................................................................................... .. ................................. 0 ................................... 0

12. Statement value at and of currant Dariod (Line 10 minus Una 111 0 10,5116,325

8108


Schedule A - Part 2 - Real Estate Acquired and Additions Made

NONE

Schedule A- Part 3- Real Estate Disposed

NONE

Schedule B- Part 2- Mortgage Loans Acquired

NONE

Schedule B- Part 3- Mortgage Loans Disposed, Transferred or Repaid

NONE

Schedule BA- Part 2- Other Long-Term Invested Assets Acquired

NONE

Schedule BA- Part 3- Other Long-Term Invested Assets Disposed, Transferred or Repaid

NONE

E01,E02,E03

m ~


2 3

CUSIP 1 Foreian

~~~= ::! ::::Cal: ~:= =:: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 1:~= ----------~~Treasury:::: ~:= ~~:~-------------------------··------------------------------------------------------1

0599999. Subtotal - Bonds - U.S. G 145216HT-Q IlL S1 00 Non Call 6.00011 06101/19

1799999. Subtotal - Bonds - U.S. Slates, 1emwn..a and 1581852-"111-G .JMe1roaoii1U1 COIIlcl lfj GO Non Cal 5.00011 09/01/1i 2499999. Subtillal -Bonds- U.S. Political i 'of Statss, Territories and

~~~ ::::::::::1~~0~~: :P ~-~ a~~~t'; ea ___ ~~~ ______ s __ ·_OOOII _______ 0610 ______ 1 __ '_1 __ 7 ____________________________________________ 1

3138AI'-IJ'-4J I RU Pool Al9109 IllS 4.00011 05101/42 -----------------------------------------------------------------------3138E9-YH-7 IRiil Pool MS211 res 3.00011 04/01127 -----------------------------------------------------------------------i:k~ I ~NY~·~: ~~~.:US 11av :;,~~~~42 -4:m-iii/Oi/i7 _________________________________________________ _

3199999. Subtillal -Bonds- U.S. Special

I=~ ... .. .. i:~:.H;:';~~!; ~:;:::::~on~~ P;~~ ~~~ 10101113 345397-VT-7 I Ford Credl1 Corp No1t Non Call 5.0001105/15118 ---------------------------------------------------I 369668--AA-i I<£CCJW W Hold Corp No1e Non Call Prv Pic 3.~ 06/18/19 ________________________________________ _

lili448Q-AQ-ll I Mecl< Cal i Really Corp No1e Call 4.5001 04/18122 :-:-:::-:::-:------------------------------------------- 1 58217G-AQ-2 __________ ,Me1Lift Global Corp No1t Non Call Prv Pic 3.8751 04/11/22 _____________________________________________ 1 629481-A/,-jl I NY!II' BJI(JEXT Corp No1e Non Call 4.~ 06128113 ---------------------------------------------------------

1913017-!l'H lllli1ed Tech Coro No1e Non Call 0.7371 1211Tl113 3899999. Subtotal - Bonds - Industrial and • •• tl

ota 3onds - Part 3 01 londa - Part 5 ol londs ol 'refemld Stocks - Part 3 01 'refemld Stocks - Part 5

8999999. Total- Preferred Stocks 9799997. T ota1 - Common stocks - Part 3 9799998. Total- Common Stocks- Part 5 9799999. Total- Common Stocks 9899999. Total- Prefemld and Common Stocks 9999999- Totals (a) For all common stock bearing the NAIC marttet indicator "U" provide: the number of such issues

SCHEDULE D • PART 3 Show All Long-Term Bonds and Stock A,...,,;,..r~ During the Current Quarter

4 5

Dale Acauired Name

112 I DEPFA Fi ra1 Albany

_.1l6/0612012 S' llor11111 a...

6

Number of Shares of

Stock

7

Actual Cost 2~.~

~-~:; 2.002,734 7,5111,687

',li2!i 2,817 ,1i21i ~.389

4.882.38!il

2 oo~:?; 511711,1110 ~ !WI, 138 2.~:~ 2:158:944

·~~~ ······:~~f[[[[[[[[[[[[[[[[[[[[[[[~~ -- -- -- -- -- -- -- -- ·- -- -- -- -- -- -· -- -- -- 1 -- -- -- -- -- -- -- -- -- -- -- -~···· 20,663,042

- ~1~:;?; 11.'14: 100 5!!.'!,~

1,077,861 ,083,839 ,041,418 .500.000

. ;~; •••••• ~~~~;~tctctctctctctctctctctci ~ -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- ~ -- -- -- -- -- -- -- -- -- -- -- -- --.... 7.135,834

42.688.4n XXX

42,688,4n 0

XXX 0 0

XXX 0 0

42,688,4n

8 9 10 NAIC Desig-

nation or Paid for Accrued Market

Interest and Indicator Par Value Cal

2~.~ 0

~·=:~ 0 ,_ __ ______ __ ______ __ _

~:: :--------------------2.000 ,000 2, 7,500,000 10,1155 XXX

1.000 2,500 ,000 0 XXX 9.11511,000 5,882 11'1'

3,860,000 6,882 XXX l.ooo

~·~~ 5 ~~:;; ,_ ___________________

~·~ ,_ __ ,_ .. , ___ __ .. ____ _

~'!7~.~ ::; ,_ ___________________

2.~:~ :R=-----------------,875:000 ~::

18,980,001 22,7i6 XXX

.a;:; ~:; 1f£ ________________

~:~ _1:4~ 3f£ ________________ 5!!4,~ 11'£ _____

1,080,000 0 2f£ __ ________ ______

,086,000 0 1f£ ________________ ,000,000 22,133 11'£ _________

.500.000 0 1FF

6.959,000 37,875 XXX 39,769,001 n.508

XXX XXX 39 ,769 ,001 n,508

XXX 0 XXX XXX XXX 0 XXX XXX 0 XXX XXX XXX XXX XXX 0 XXX XXX 0 XXX XXX n.508 XXX

m 0 CJI


SCHEDULE D • PART 4 Show All Long-Term Bonds and Stock Sold, Redeemed or otherwise Disposed of During the Current Quarter

CUSIP ldent-

iii cation

2

Description

3 4

For- Disposal eign Data

5 8

Number of Nama Shares of

of Purchaser stock Bank of ,l,,.rlca Corp Nolo Non Call RliC

.. fl60!illl-..llt 3.129. 06/15/12 .. .06/1512012 ~- llalur i ly ~~~~~~~~~~~~~~~~~~~~ Bank of """riel Corp Nola Non Call RliC

.. 116051B-Al1-4 0.8531 04/30/12 ........................................ ~~~~~~~~ .04/3012012 ~~ llatur I ty ~~~~~~~~~~~~~~~~~~~~ ---------------------

.. .1731~

.. 31337o4-IIU-6

. . 31337s-61Hl

. 3135IIHIH

.. 313/EA-CC-1

. . 3622111-\V-ll

. 3622111-'N-ll

.. 3622111-'N-ll

Ciligroup Inc Corp Note Non Call RliC 2.125"1. 04/30/12 .. -·· ···· -·· ···· -·· ···· -·· ···· -·· ·· ~~~~~~~~ .0413012012 ~~ llatur i ty ~~~~~~~~~~~~~~~~~~~~ . -·· ···· -·· ···· -·· FIUI Note Call 0.3501 08/10/12 ................ ~~~~~~~~ .0412812012 ~~ Call 100.oaco ........................... . FIUI Note Call 0.23111 03/08/13 ........ ....... ~-~~~~~- _04128/2012 ~- Call 100.oaco . .. . FMM Nota Call 0.7501 12106/13 ... .... -·· . .. . ~~~~~~~~ .0610612012 ~- Call 100.oaco ........ -·· ···· -·· ··· _ FIUI: Note Non Co II 1.7501 06/15/12 ·-·-·-·-· ~~~~~~~~ _06/1512012 ~~ llatur I ty ~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·-IMIA Pool 283327 fillS 9.CXIM 12115/19 .... -· -~~~~~~~ .04/01/2012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ . IMIA Pool 283327 fillS 9.cxm 12115118 . . _06/0112012 ~- Paydown~~~~~~~~~~~~~~~~~~~~~~ .................. . IJfiiA Pool 283327 fillS 9.CXIM 12115/19 -·-·-·-· ~~~~~~~~ _06/01/2012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·Gald .. n Sachs Corp Note Non Call RliC

7

Consid-eration

~~~~~~~1.2!iO.aco

~~~~~~~~~250.aco

~~~~~~J,2!iO,QCO

~~~~~~~~~~.93. 750 -~-~~~~1.500,QCO ~~~~~~-1,500,QCO

~~~~~~~1.500.aco ~~~~~~~~~~~~~~.874

~~~~~~~~~~~~~~.181

~~~~~~~~~~~~~~~~74

8

Par Value

-~ - ·· ·· 1,250,000

........... 250,QCO

.. . .. .. I' 250,000 ·-·-·-·-·-·-93, 750 .... .... 1,500,000 .. . .. .. I ,500, 000 ........ 1 ,500, 000

..... B74 ............... 181 ·-·-·-·-·-·-·-·-·.74

9

Actual Cost

... . ... 1 ,301 ,282

.......... .251 , 109

... . .. . 1 ,280 ,5lM -·-·-·-·-·-·93 ,750 ..... .. . 1 ,500,QCO ... . ... 1 ,500 ,aco -·-·-·-·1 ,529,286

.... B74 .............. J81

-·-·-·-·-·-·-·-·-.74

10

Prior Year Book/

Adjusted Carrying Value

. .. .... I' 264,732

........... 250,252

. .. .... I' 258,854 ·-·-·-·-·-·-93, 750 .. ...... .. ...... .. . 0 . .. .... I ,500, 000 ........ 1 ,508,457

-···-·-B73 ................ .181 ·-·-·-·-·-·-·-·-·.74

Chance In BookiA<fustecl Carrvina Value 11 12 13

Current Year's

Current Other Than Unrealized Year's Temporary Valuation (Am or- Impairment Increase/ lization)l Raoog-Decrease Accretion nized

~~~~~~~~~~~~~~~.0 .. .... 114,732) · ·· -- ·· ·· _0

~~~~~~~~~~~~~~~.0 ............ (252) ............... .0

~~~~~~~~~~~~~~~.0 -·· ·-···-(8,854) · -- ·· ·-·· -- ·· ·· _0 ~~~~~~~~~~~~~~~.0 -·-·-·-·-·-·-·-.0 -·-·-·-·-·-·-·-.0 ~-~~~~~~~-~~~~~.0 ............... .0 ............... .0 ~~~~~~~~~~~~~~~.0 -·· ···· -- ·· ···- ·0 · -- ·· ·· ·· -- ·· ·· _0 ~~~~~~~~~~~~~~~.0 -·-·-·-·-(8,457) -·-·-·-·-·-·-·-.0 ~~~~~~~~~~~~~~~.0 -···-·· -·· ·-·· -1 . .. .. .0 ~~~~~~~~~~~~~~~JJ ................ 0 ............... JJ ~~~~~~~~~~~~~~~.0 -·-·-·-·-·-·-·-.0 -·-·-·-·-·-·-·-_0

14 15 Total Total

Change in Foreign Book/ Exchange

Adjusted Change in Carrying Book Value /Adjusted

(11+12- Carrying 13) Value

~~~~~~.1 14. 732) ........ .0

~~~~~~~~~~~1252) ............... .0

~~~~~~~~J8,864) .. -·· ·-·· . .. .. 0 ~~~~~~~~~~~~~~~.0 ·-·-·-·-·-·-·-·.0 ~~~~-~~~~~~~-~~.0 ............... JJ ~~~~~~~~~~~~~~~JJ ·· -- ·· ·· ·· -- ·· ·-0 ~~~~~~~~~<8.457) ·-·-·-·-·-·-·-·.0 ~~~~~~~~~~~~~~~.1 .... .0 ~~~~~~~~~~~~~~~JJ ............... 0 ~~~~~~~~~~~~~~~.0 ·-·-·-·-·-·-·-·.0

18

Book/ Adjusted Carrying Value at Disposal

Data

.... . .. 1 ,250,QCO

.......... .250,QCO

... . .. 1 ,250,QCO ·-·-·-·-·-·-93, 750 ...... .. 1,500,QCO .... . .. 1 ,500,QCO ....... .1 ,500,QCO

... B74 ............. 181

·-·-·-·-·-·-·-·-·.74

17

Foreign Exchange

Gain (Loss) on Disposal

··· -- ···· .0

............... .0

· -- ·· ·-·· -- ·· ·· -0 -·-·-·-·-·-·-·-_0 . .. ...... .. .... JJ · -- ·· ·· ·· -- ·· ·· -0 -·-·-·-·-·-·-·-.0

.... JJ ............... . 0 -·-·-·-·-·-·-·-.0

18

Realized Gain

(Loss) on Disposal

..•...• .0

............... .0

··· -- ·· ·-·· -- ·· .0 -·-·-·-·-·-·-·-_0 •.•.•.•.•.•.•.• .0 ··· -- ·· ···· -- ·· .0 -·-·-·-·-·-·-·-_0

..• .0 ............. .0

-·-·-·-·-·-·-·-_0

19

Total Gain (Loss) on Disposal

~~~~~~~~~~~~~~~.0

~~~~~~~~~~~~~~~.0

~~~~~~~~~~~~~~~JJ ~~~~~~~~~~~~~~~.0 ~~~~~~-~~~~~~~-.0 ~~~~~~~~~~~~~~~JJ

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.D ~~~~~~~~~~~~~~~JJ

~~~~~~~~~~~~~~~.0

20

Bond lntsrest/ stock

Dividends Received

During Year

.... . .. .... 19,531

................ i99

... . .. .... 13,281 ·-·-·-·-·-·-·-·-·184 ..... ........ .. 575 .... . .. .... . .5,825 ·-·-·-·-·-·-·13, 125

... .. 26 ................ 7

·-·-·-·-·-·-·-·-·-·3

21 22

NAIC Desig-nation

Stated or Con- Market

tractual In-Maturity dicator

Data (a)

Jl&/1512012 .. 1FE. ..

~04/3012012 .. 1FE. ..........

_04/3012012 -· 1FE. .. -·· ·-·· ~08/1012012 -· 1FE. ......... . .0310812013 -· 1. .. . ~ 1210612013 .. L ...... -··· ~06/1512012 .. L .......... . ~ 1211512019 -· L ..... . ~ 1211512018 .. 1. ............ . ~ 1211512019 .. L .......... .

. 38146F--A/HI 3.2501 06/15112 .. . ...... ....... ...... · ···········- _06/1512012 ~- llatur i ty ~~~~~~~-~~~~~~~-~~~~ -~-~~~J,2!iO,IlCO .... .... I, 250,000 ..... ... 1 ,305,275 .. ...... I, 265, lUI ~-~~~~~~~-~~~~~JJ . ...... 115, lUll . .. ........ .... .0 ~~~~-~.1 15,7U1) .... ........ .. .. 0 ...... .. 1 ,250,QCO . .. ........ ..... 0 ..... ........ .. .0 ~~~~~~-~~~~~~~-JJ ... .. ...... 20,313 _06/1512012 .. 1FE. .. . I'll: Funding Corp Note Non Call RliC 0.86111

. . llll361o-,o-6 04/01/12 . . ··················· .91282&-IIHi US Tr111urv Nota 0.8251 06/30/12 _ . 0599999. Subtotal - Bonds - U.S. Govemments

OPEN DEPOSITORY

_04/02/2012 ~- llalur i ly ~~~~~~~~~~~~~~~~~~~~ 0613012012 ~ llatur i tv ~

Ont1rio Province Cnd1 Corp Note Non Call ScotilllciiOd CorpOration .. !183234-81-7 4.4001 04/14120 ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·- A.__~~~~ .041211/2012 ~~ ~~~~~~-~~~~~~~-~~~~~~~-~~~~~~~-~~ -·-·-·-·-·-·-·-·-·-·-1099999. Subtotal - Bonds -All Other Govammanlll

.. 70UI41-IAHi PA Sl W Coni Call Prfd 5.5001 05101/18 ... ~~~~~~~~ .06/01/2012 ~~ Call 100.0ilCO -·-·-·- -·-·-·-·-·-·-·-·-·-·-1799999. Subtotal -Bonds- U.S. States Territories and Possessions

Detroit Ml City Schl Dial W Cont Call Prfd

~~~~~~-1.2!iO,QCO ....... 1,250,000 ~ J!iOOQCO . . . 1500000 11,344,879 11,344,B79

~~~~~~~1 595 589 ........ I 385 000 1 595 589 I 385 000

~~~~~~J.aco.aco ........ 7 '000, 000 7 aco aco 7 000 000

...... 1 ,254,026 ... 1,250,740 ~~~~~~~~~~~~~~~.0 .... (740) . . . 1504224 . I 501 303 JJ . (I 303)

11,520,675 9,893,007 0 (48, 128)

-·-·-·-·1 380 457 ........ I 381 103 ~~~~~-~~~~~~~-~.0 -·-·-·-·-·-·-130 1 380 457 I 381 103 0 130

-·-·-·-·7 ,579,460 ........ 7,11S1,773 ~~~~~~~~~~~~~~~.0 ....... 157 '773) 7 579 460 7 IIS/773 (57 773)

...•.• .0 ~~~~~~~~~~~1140) ...•. JJ ..... 1 ,250,QCO ...... .0 ...• .0 ~~~~~~~~~~~~~~~.0 .. 4,241 _04/0112012 .. 1FE. . · - . .0 (1 303) . - . 0 · - .1500QCO . - . 0 · - . .0 ~ JJ . 4 688 06/3012012 . 1

(48,1211) 0 11,344,879 0 0 0 82,578 XXX XXX

-·-·-·-·-·-·-·-.0 -~~~~~~~-~~~_130 ·-·-·-·-·-·-·-·.0 ........ 1 381 232 -·-·-·-·-·-·-·-.0 ....... 214 357 ~~-~~~~214 357 ·-·-·-·-·-·-33 348 ~04/1412020 -· 1FE. .......... 0 130 0 1 381 232 0 214 357 214 357 33348 XXX XXX

-·-·-·-·-·-·-·-.0 ~~~~~~~~57. 773) ·-·-·-·-·-·-·-·.0 ........ 7,000,000 -·-·-·-·-·-·-·-.0 -·-·-·-·-·-·-·-.0 ~~~~~~~~~~~~~~~.0 ·-·-·-·-·-·192,500 ~0510112018 -· 1FE. .......... 0 (57 773) 0 1 aco aco 0 0 192 500 XXX XXX

.. 25112&-ZS-4 5.5001 05101/17 ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·- ~~~~~~~~ _06/01/2012 ~~ Call 1oo.oaco _______ -·-·-·-·-·-·-·-·-·-·- ~~~~~~~1.750.aco ________ 1,750, ooo ________ 1 ,939,830 ________ I, 788, 129 ~~~~~~~~~~~~~~~.o ....... 118, 129l _______________ .o ~~~~~~~H&.129l ·-·-·-·-·-·-·-·.o ....... .1, 7so,aco _______________ .o _______________ .o ~~~~~~~~~~~~~~~.o ·-·-·-·-·---"'· 125 ~0510112017 __ 1FE. _________ _ Pierce Cnly lA Sch Dis! W Non Call 5.CXIM

7203110-11.-6 06/01112 . 06/0112012 llaturitv ~

2499999. Subtotal - Bonds - U.S. Political Subdivisions of States Territories and Possessions

---~~ .. 3128P0-2X-i . . 3128PC-2H .. 312~ .. 312ft-.4K-I . 312ft-.4K-I .. 312ft-.4K-I -. 3128f'E--.4IYI . 3128fE-.41Yl -. 3128f'E--.4IYI .. 312ft-KP-2 .. 3128PHP-2 .. 312ft-KP-2 -. 3128A{-f11Hi . . 3128A{-f11Hi -. 3128A{-f11Hi -. 31281\. -lfi-7 . 3128PL -lfi-7 -. 31281\. -lfi-7 -. 3128Pfl-2M-.4 . 31281'P-311--4 -. 3128Pfl-2M-.4 .. 312fli'P-fllr4 •. 31281'P--111).4 .. 312fli'P-f!lr4 .. 3128PP-ll.-l

CA Stat11lde Cimtyo Oev Rev Bond Non Call s.cxm 07/01112 ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·- ~~~~~~~~ .06/14/2012 ~~ ~;,., and eo. ·-·-·- -·-·-·-·-·-·-·-·-·-·FilM: Pool J:I18UO fillS 5.5001 04/01121 ·-·-·- ~~~~~~~~ .04/0112012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool J:IIBUO fillS 5.5001 04/01121 .. -·· ~~~~~~~~ .06/01/2012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ . -·· ·-·· -·· ·-·· -·· FIUI: Pool J)IBUO fillS 5.5001 04/01121 ·-·-·- ~~~~~~~~ .06/01/2012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool J)3526 fillS a.cxm 10101121 ·-·-·- ~~~~~~~~ .04/0112012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FilM: Pool J)3526 fillS e.cxm 10101121 .. -·· ~~~~~~~~ .06/01/2012 ~- Paydown ~~~~~~~~~~~~~~~~~~~~~~ . -·· ···· -·· ··· _ FIUI: Pool J)3526 fillS 6.CXIM 10/01121 ·-·-·- ~~~~~~~~ .06/01/2012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool Jl3530 fillS a.cxm 10101121 ·-·-·- ~~~~~~~~ .04/0112012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·-FilM: Pool Jl3530 fillS 8.cxm 10101121 . _06/0112012 ~- Paydown ~~~~~~~~~~~~~~~~~~~~~~ .................. . FIUI: Pool J)3530 fillS 6.CXIM 10/01121 ·-·-·- ~~~~~~~~ .06/01/2012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool Jl3002 fillS 5.5001 07/01121 ·-·-·- ~~~~~~~~ .04/0112012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·-FIUI: Pool Jl3002 fillS 5.5001 07/01121 .... .. ~-~~~~~- _06/01/2012 ~- Paydown ~~-~~~~~~~-~~~~~~~-~~~ . FIUI: Pool Jl3002 fillS 5.5001 07/01121 ·-·-·- ~~~~~~~~ .06/01/2012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool Jl7571 fillS 5.5001 04/01123 ·-·-·- ~~~~~~~~ .04/0112012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool Jl7571 fillS 5.5001 04/01123 .. -·· ~~~~~~~~ .06/01/2012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ . -·· ·-·· -·· ·-·· -·· FIUI: Pool Jl7571 fillS 5.5001 04/01123 ·-·-·- ~~~~~~~~ .06/01/2012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool J:l8532 fillS 5.5001 08/01123 ·-·-·- ~~~~~~~~ .04/0112012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool J:l8532 fillS 5.5001 08/01123 .. -·· ~~~~~~~~ .06/01/2012 ~- Paydown ~~~~~~~~~~~~~~~~~~~~~~ . -·· ···· -·· ··· _ FIUI: Pool J:l8532 fillS 5.5001 08/01123 ·-·-·- ~~~~~~~~ .06/01/2012 ~~ Paydown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool J10780 fillS 4.5001 09/01124 ·-·-·- ~~~~~~~~ .04/0112012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·-FIUI: Pool J10780 fillS 4.5001 09/01124 . _06/0112012 ~- Paydown ~~~~~~~~~~~~~~~~~~~~~~ .................. . FIUI: Pool JI0780 fillS 4.5001 08/01124 ·-·-·- ~~~~~~~~ .06/01/2012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool J10355 fillS 4.5001 07/01124 ·-·-·- ~~~~~~~~ .04/0112012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·-FIUI: Pool JI0355 fillS 4.5001 07/01124 .... .. ~-~~~~~- _06/01/2012 ~- Paydown ~~-~~~~~~~-~~~~~~~-~~~ . FIUI: Pool JI0355 fillS 4.5001 07/01124 ·-·-·- ~~~~~~~~ .06/01/2012 ~~ Paydown~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·FIUI: Pool J10715 fillS 4.5001 09/01124 ·-·-·- ~~~~~~~~ .04/0112012 ~~ PaYdown ~~~~~~~~~~~~~~~~~~~~~~ -·-·-·-·-·-·-·-·-·-·-

~~2 aco aco 3,750,QCO

~~~~~~~1.502,025 ~~~~~~~~~~_13,062 ~~~~~~~~~~~~ 1.812 ~~~~~~~~~~~11.9e0 ~~~~~~~~~~~~2,1180 ~~~~~~~~~~~-9.772 ~~~~~~~~~~~~9.212 ~~~~~~~~~~_12,500 ~~~~~~~~~~-~ 1.8111 ~~~~~~~~~~.25.436 ~~~~~~~~~~~~8,101!

-~-~~~~~~~--3.028 ~~~~~~~~~~~~2.400 ~~~~~~~~~~~~4,197 ~~~~~~~~~~~-3.877 ~~~~~~~~~~.36.451 ~~~~~~~~~~~~] ,222 ~~~~~~~~~~-47. 718 ~~~~~~~~~~~~8.984 ~~~~~~~~~~~~8,!105 ~~~~~~~~~~_10,785

~~~~~~~~~~~~9.545 ~~~~~~~~~~.94,978 -~-~~~~~~~.92. 753 ~~~~~~~~~~.fill. 710 ~~~~~~~~~j07 187

... 2 000 000 3,750,000

........ I ,500, 000 ·-·-·-·-·-·-·13,052 ·· -·· ·-·· -··1,812 ·-·-·-·-·-·-·11,980 ·-·-·-·-·-·-··2,880 ·· -·· ···· -·J,772 ·-·-·-·-·-·-·J,212 ·-·-·-·-·-·-·12,500 ............ .1,8111 ·-·-·-·-·-·-25,436 ·-·-·-·-·-·-·-8,101! .... ......... .3,028 ·-·-·-·-·-·-·.2,400 ·-·-·-·-·-·-·-4, 197 ·· -·· ·-·· -·_3,B77 ·-·-·-·-·-·-36,451 ·-·-·-·-·-·-·.7,222 ·· - ·· ·· ·· ·- ~7.718 ·-·-·-·-·-·-·-'·984 ·-·-·-·-·-·-·-'·905 ............ 10,785 ·-·-·-·-·-·-·J,545 ·-·-·-·-·-·-94,97U .... ........ 92,753 ·-·-·-·-·-·-60,710 ·-·-·-·-·-·107 187

.. 2 211 480 .... 2 01!8 801 4 '151 '110 3, 794,730

-·-·-·-·1 ,613,490 -·-·-·-·-·-·13 ,048 ··· -·· ·-·· -·1,811 -·-·-·-·-·-·11,976 -·-·-·-·-·-·-.2,725 ··· -·· ···· -.11,1134 -·-·-·-·-·-·-.9,365 -·-·-·-·-·-·12 ,678

............ 1,1117 -·-·-·-·-·-·25 ,793 -·-·-·-·-·-·-.11,088 ..... ........ .3,01!1 -·-·-·-·-·---2.394 -·-·-·-·-·-·-·4,244 ··· -·· ·-·· -.3,1121 -·-·-·-·-·-·36 ,862 -·-·-·-·-·-·-1,303 ... . .. .... !18,255 -·-·-·-·-·-·-.9,095 -·-·-·-·-·-·-.8,238

.......... 11,167 -·-·-·-·-·-·-.9,902 -·-·-·-·-·-'il ,485 ..... ...... 85,181 -·-·-·-·-·-·62 ,299 -·-·-·-·-·.111 574

........ I ,514, 088 ·-·-·-·-·-·-·13,044 -·· ·-·· -·· ·.1,811 ·-·-·-·-·-·--11.972 ·-·-·-·-·-·-·.2,717 -·· ···· -·· ·J,905 ·-·-·-·-·-·-·J,337 ·-·-·-·-·-·-·12,843 ............. .1,912 ·-·-·-·-·-·-25, 726 ·-·-·-·-·-·-·-8,088 .. ........ ... .3,01!1 ·-·-·-·-·-·-·.2,394 ·-·-·-·-·-·-·-4,238 -·· ·-·· -·· ·.3,918 ·-·-·-·-·-·-36,817 ·-·-·-·-·-·-·.7,294 . .. .... . .. !18, IUS ·-·-·-·-·-·-·J,084 ·-·-·-·-·-·-·j,215 ............ II, 138 ·-·-·-·-·-·-·J,B77 ·-·-·-·-·-·-97' 287 .. ........ .. 85,007 ·-·-·-·-·---62. 185 ·-·-·-·-·-·111 258

JJ .... 128 801) ... .0 0 (44,730)

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~JJ

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~JJ

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~JJ ~~~~~~~~~~~~~~~JJ

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~-~~~~~~~-~~~~~JJ ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~JJ ~~~~~~~~~~~~~~~JJ

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~JJ

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~JJ ~~~~~~~~~~~~~~~JJ

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~-~~~~~~~-~~~~~JJ ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0

....... 113, 160) -·-·-·-·-·-·-·-.0 -·-·-·-·-·-·-·-.8 -·-·-·-·-·-·-·-.0 -·· ·-·· -- ·· ·-·· -1 · -- ·· ·-·· -- ·· ·· .0 -·-·-·-·-·-·-·-.8 -·-·-·-·-·-·-·-.0 -·-·-·-·-·-·_(38) -·-·-·-·-·-·-·-.0 .. ...... (133) ... ...... .. .0

-·-·-·-·-·-·(125) -·-·-·-·-·-·-·-.0 -·-·-·-·----<143) -·-·-·-·-·-·-·-.0 ............. (22) ............... .0 -·-·-·-·-·-.(291) -·-·-·-·-·-·-·-.0 -·-·-·-·-·-·-·14 -·-·-·-·-·-·-·-.0 . ........ ...... .7 . .. ........ .... .0 -·-·-·-·-·-·-·--' -·-·-·-·-·-·-·-.0 -·-·-·-·-·-·_(42) -·-·-·-·-·-·-·-.0 ·· ·-·· .. . (38) . ·· ·-·· .. .. .0

-·-·-·-·-·-·(366) -·-·-·-·-·-·-·-.0 -·-·-·-·-----<72) -·-·-·-·-·-·-·-.0 .. ...... (477) ... ...... .. .0

-·-·-·-·-·-·-'90) -·-·-·-·-·-·-·-.0 -·-·-·-·----<310) -·-·-·-·-·-·-·-.0 ........... (374) ............... .0 -·-·-·-·-·-·(332) -·-·-·-·-·-·-·-_0 -·-·-·---<2,307) -·-·-·-·-·-·-·-.0 ....... (2,253) . .. ........ .... .0

-·-·-·---<1.475) -·-·-·-·-·-·-·-.0 -·-·-·---<4 071) -·-·-·-·-·-·-·-.0

.128 1101) . ... 0 .. .. 2000000 (44,730) 0 3,750,000

~~~~~~~m.1filll _______________ .o ~~~~~~~~~~~~~~~-' ·-·-·-·-·-·-·-·-0 ~~~~~~~~~~~~~~~_1 ·· -- ···-·· -- ···.0 ~~~~~~~~~~~~~~~.! ·-·-·-·-·-·-·-·.0 ~~~~~~~~~~~~-<38l ·-·-·-·-·-·-·-·-0 ~~~~~~~~~~~1133) ........ .. . JJ ~~~~~~~~~~~~ 125) ·-·-·-·-·-·-·-·.0 ~~~~~~~~~~~.( 143) ·-·-·-·-·-·-·-·-0 ~~~~~~~~~~~~~(22) .............. JJ ~~~~~~~~~~~~281 ) ·-·-·-·-·-·-·-·.0 ~~~~~~~~~~~~~~j4 ·-·-·-·-·-·-·-·-0 ~~~~-~~~~~~~-~~1 .... ........ .. . JJ ~~~~~~~~~~~~~~~-' ·-·-·-·-·-·-·-·.0 ~~~~~~~~~~~~-<42l ·-·-·-·-·-·-·-·-0 ~~~~~~~~~~~~~(38) ·· -- ···-·· -- ···.0 ~~~~~~~~~~~~366) ·-·-·-·-·-·-·-·.0 ~~~~~~~~~~~~-<72l ·-·-·-·-·-·-·-·-0 ~~~~~~~~~~~1477) .... .... .. . JJ ~~~~~~~~~~~~~(90) ·-·-·-·-·-·-·-·.0 ~~~~~~~~~~~.1310) ·-·-·-·-·-·-·-·-0 ~~~~~~~~~~~1374) .............. JJ ~~~~~~~~~~~~332) ·-·-·-·-·-·-·-·.0 ~~~~~~~~-<2,307) ·-·-·-·-·-·-·-·-0 ~~~~-~~~-<2.253) .... ........ .. . JJ ~~~~~~~~~< 1,475) ·-·-·-·-·-·-·-·.0 ~~~~~~~~-<4 071) ·-·-·-·-·-·-·-·-0

........ 1 ,500,928 ·-·-·-·-·-·-13,052 . ·· -·· ·-····1,812 ·-·-·-·-·-·-j1,980 ·-·-·-·-·-·-·.2,1180 .... . .. .... .11,772 ·-·-·-·-·-·-·.9,212 ·-·-·-·-·-·-12,500

........... 1,8111 ·-·-·-·-·-·-25,436 ·-·-·-·-·-·-·.11,101! ...... ....... .3,028 ·-·-·-·-·-·-·2,400 ·-·-·-·-·-·-·-4,197 ... . .. .... .3,B77 ·-·-·-·-·-·-36,451 ·-·-·-·-·-·-·1,222 .... . .. .... ~7.718 ·-·-·-·-·-·-·.8,984 ·-·-·-·-·-·-·.8,905

......... 10,785 ·-·-·-·-·-·-·.9,545 ·-·-·-·-·-·-94,978 ...... ...... 112,753 ·-·-·-·-·-·-fi0,710 ·-·-·-·-·-·107 187

... 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

-·-·-·-·-·1,096 -·-·-·-·-·-·-·-.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

JJ

~~~~~~~~~~ 1,096 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.D ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~-~~~~~~~-.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.D ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0

~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0 ~~~~~~-~~~~~~~-.0 ~~~~~~~~~~~~~~~.0 ~~~~~~~~~~~~~~~.0

.... 50 000 06/0112012 . 1FE. . ... 98, 125 XXX XXX

·-·-·-·-·-·-72,500 ·-·-·-·-·-·-·-·-.238 . ·· -- ·· ·-·· -- ·· ·-37 ·-·-·-·-·-·-·-·-328 ·-·-·-·-·-·-···-·-54 ·· ·· -- ·· ·· ·· -- ·· .244 ·-·-·-·-·-·-·-·-Z/6 ·-·-·-·-·-·-·-·-.250

............... 47 ·-·-·-·-·-·-·-·-763 ·-·-·-·-·-·-·-·-·112 -····· ········ ···-"' ·-·-·-·-·-·-·-·-·-66 ·-·-·-·-·-·-·-·-·-77 ···-- ·· ·-·· -- ·· ·-"' ·-·-·-·-·-·-·.1,002 ·-·-·-·-·-·-·-·-·132 .... . .. .... . .1,0114 ·-·-·-·-·-·-·-·-247 ·-·-·-·-·-·-·-·-·134

............. 202 ·-·-·-·-·-·-·-·-.215 ·-·-·-·-·-·-·.1,425 ..... ....... .1,738 ·-·-·-·-·-·-·.1,366 ·-·-·-·-·-·-·.1 808

~07/0112012 -· 1FE. ......... . ~04/0112021 .. L .......... . _04/0112021 -· L ...... -··· ~04/01/2021 .. L .......... . ~ 10/0112021 .. L .......... . ~10/0112021 .. L ...... ... . ~ 10/01/2021 .. L .......... . ~ 10/0112021 .. L .......... . ~ 10/0112021 .. 1. ............ . ~ 10/01/2021 .. L .......... . ~07/0112021 .. L .......... . _07/0112021 -· 1. .. . ~07/01/2021 .. L .......... . ~04/0112023 .. L .......... . _04/0112023 -· L ...... -··· ~04/0112023 .. L .......... . ~06/0112023 .. L .......... . ~08/0112023 .. L ...... -··· ~08/0112023 .. L .......... . ~09/0112024 .. L .......... . _09/0112024 .. 1. ............ . ~08/0112024 .. L .......... . ~07/0112024 .. L .......... . _07/0112024 -· 1. .. . ~07/0112024 .. L .......... . ~09/0112024 .. L .......... .

statement as of june 30, 2012 of the unitedhealthcare plan

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