LTC REINSURANCE PCC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
LTC REINSURANCE PCC (EIN 82-0630879)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-06-14
IRS object ID
201831659349300903
Schema version
2017v2.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-06-14T09:34:36-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN521446779PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON LAMBERT LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14242 SIX FORKS RD STE 1500AddressLine1Txt
CityRALEIGHCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27609ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN820630879EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANIC PROTECTED CELL OF LTC REBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlANICBusinessNameControlTxt
Phone8028641711PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11050 CONNECTICUT AVE NW NO 700AddressLine1Txt
CityWASHINGTONCityNm
State AbbreviationDCStateAbbreviationCd
ZIP20036ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRENDA J CUSHINGPersonNm
Person TitleCFOPersonTitleTxt
Phone6127100935PhoneNum
Signature2018-06-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN HUSKINSPreparerPersonNm
PTINP01081531PTIN
Phone9197196400PhoneNum
Preparation2018-06-14PreparationDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerBRENDA J CUSHINGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11050 CONNECTICUT AVE NW NO 700AddressLine1Txt
CityWASHINGTONCityNm
State AbbreviationDCStateAbbreviationCd
ZIP20036ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$437,106,755GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption6262GroupExemptionNum
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2016FormationYr
Legal Domicile StateDCLegalDomicileStateCd
Activity Or MissionLTC RE IS A PROTECTED CELL CAPTIVE INSURANCE COMPANY FORMED BY THE NATIONAL ORGANIZATION OF LIFE AND HEALTH GUARANTY ASSOCIATIONS, WHOSE MEMBERS ARE LIFE AND HEALTH INSURANCE STATE GUARANTY ASSOCIATIONS AFFECTED BY THE INSOLVENCY OF PENN TREATY NETWORK AMERICA INSURANCE COMPANY AND/OR ITS WHOLLY OWNED SUBSIDIARY, AMERICAN NETWORK INSURANCE COMPANY. THE MEMBERS REINSURE THEIR OBLIGATIONS TO LTC RE TO SERVICE THE COVERED POLICYHOLDERS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$379,112,973CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$7,502,236CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$0PYTotalRevenueAmt
CY Total Revenue$386,615,209CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$0PYOtherExpensesAmt
CY Other Expenses$386,310,460CYOtherExpensesAmt
PY Total Expenses$0PYTotalExpensesAmt
CY Total Expenses$386,310,460CYTotalExpensesAmt
PY Revenues Less Expenses$0PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$304,749CYRevenuesLessExpensesAmt
Total Assets BOY$0TotalAssetsBOYAmt
Total Assets EOY$372,938,564TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$369,257,212TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$0NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,681,352NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionLTC RE IS A PROTECTED CELL CAPTIVE INSURANCE COMPANY FORMED BY THE NATIONAL ORGANIZATION OF LIFE AND HEALTH GUARANTY ASSOCIATIONS, WHOSE MEMBERS ARE LIFE AND HEALTH INSURANCE STATE GUARANTY ASSOCIATIONS AFFECTED BY THE INSOLVENCY OF PENN TREATY NETWORK AMERICA INSURANCE COMPANY AND/OR ITS WHOLLY OWNED SUBSIDIARY, AMERICAN NETWORK INSURANCE COMPANY. THE MEMBERS REINSURE THEIR OBLIGATIONS TO LTC RE TO SERVICE THE COVERED POLICYHOLDERS.THE GUARANTY ASSOCIATIONS PROVIDE THE INSURANCE INDUSTRY AND ITS CONSUMERS WITH A SAFETY NET IN THE EVENT AN INSURANCE COMPANY BECOMES INSOLVENT AND UNABLE TO PAY CLAIMS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE GUARANTY ASSOCIATIONS PROVIDE THE INSURANCE INDUSTRY AND ITS CONSUMERS WITH A SAFETY NET IN THE EVENT AN INSURANCE COMPANY BECOMES INSOLVENT AND UNABLE TO PAY CLAIMSDesc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BRENDA J CUSHINGBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8028641711PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11050 CONNECTICUT AVE NW STE 700AddressLine1Txt
CityWASHINGTONCityNm
State AbbreviationDCStateAbbreviationCd
ZIP20036ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
ERIC RANGEN
PRESIDENT1.002.00Yes (X)Yes (X)$0$0$0
PETER GALLANIS
SECRETARY1.001.00Yes (X)Yes (X)$0$0$0
KEITH PASSWATER
TREASURER1.001.00Yes (X)Yes (X)$0$0$0
AARON BALL
DIRECTOR1.001.00Yes (X)$0$0$0
SANDRA CALLAHAN
DIRECTOR (TO NOV '17)1.001.00Yes (X)$0$0$0
FREDERIC FUTTERMAN
DIRECTOR1.002.00Yes (X)$0$0$0
CHARLES GULLICKSON
DIRECTOR1.001.00Yes (X)$0$0$0
CARL MCDONALD
DIRECTOR1.001.00Yes (X)$0$0$0
PAMELA OLSEN
DIRECTOR1.001.00Yes (X)$0$0$0
MARGARET PARKER
DIRECTOR1.001.00Yes (X)$0$0$0
JOHN STENSON
DIRECTOR (FROM NOV '17)1.001.00Yes (X)$0$0$0
JAMES YABLECKI
DIRECTOR1.001.00Yes (X)$0$0$0
BRENDA CUSHING
CHIEF FINANCIAL OFFICER2.4021.60Yes (X)$0$0$0
JOANNE ANATOLE
CHIEF OPERATING OFFICER1.8016.20Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PENN TREATY NETWORK AMERICA
PO BOX 7066ALLENTOWNPA18105THIRD PARTY ADMINISTRATION$1,202,036
WELLINGTON ASSET MANAGEMENT
280 CONGRESS STBOSTONMA02210INVESTMENT MANAGEMENT$118,587
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescREINSURANCE PREMIUMDesc
Business900099BusinessCd
Total Revenue Column$379,112,973TotalRevenueColumnAmt
Related Or Exempt Func Income$379,112,973RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$379,112,973TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,422,398TotalRevenueColumnAmt
Exclusion$7,422,398ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$50,571,384SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$50,491,546SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$79,838SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$79,838TotalRevenueColumnAmt
Exclusion$79,838ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$386,615,209TotalRevenueColumnAmt
Related Or Exempt Func Income$379,112,973RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$7,502,236ExclusionAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$99,573TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$82,978TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$143,271TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$85,067TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,122TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$618TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$160TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$31,170TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
CHANGE IN RESERVES$366,717,222
CLAIMS PAID$17,934,853
THIRD PARTY ADMINISTRAT$1,202,036
TAXES & LICENSES$10,390

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$386,310,460TotalAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$4,212,141EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$289,235EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$77,739,167EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$6,235EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$233,539,820EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$57,151,966EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$372,938,564EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$122,352EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$2,417,638EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$366,717,222EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$369,257,212EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,681,352EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,681,352EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$372,938,564EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$304,749ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,386,603NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$10,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
ACCRUED INVESTMENT INCOME$2,956,246
FUNDS HELD IN TRUST BY RECEIVER$3,353,810
GUARANTY ASSOCIATION RECEIVABLES$50,841,910
FieldValueIRS element (for citing)
Total Book Value Other Assets$57,151,966TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
POLICY RESERVES$303,615,362
LAE RESERVE$2,528,082
CLAIMS RESERVES$60,573,778
FieldValueIRS element (for citing)
Total Liability$366,717,222TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationMANAGEMENT HAS CONCLUDED THAT LTC RE, PTNA PC AND ANIC PC HAVE PROPERLY MAINTAINED THEIR FEDERAL AND STATE TAX-EXEMPT STATUS AND HAVE NOT TAKEN ANY UNCERTAIN TAX POSITIONS WHICH WOULD JEOPARDIZE ITS FEDERAL INCOME TAX-EXEMPT STATUS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3ANIC PC CONTRACTED WITH CONSULTANTS, PROFESSIONAL SERVICE PROVIDERS, AND THIRD PARTY ADMINISTRATORS TO PERFORM SUBSTANTIALLY ALL NECESSARY CLERICAL AND MANAGERIAL FUNCTIONS.
FORM 990, PART VI, SECTION A, LINE 6THE CAPTIVE HAS ONE CLASS OF MEMBERS. EACH LIFE & HEALTH INSURANCE GUARANTY ASSOCIATION LOCATED IN THE UNITED STATES WHO IS ALSO A MEMBER OF THE NATIONAL ORGANIZATION OF LIFE & HEALTH INSURANCE GUARANTY ASSOCIATIONS AND WHO WAS IMPACTED BY THE INSOLVENCY OF PENN TREATY NETWORK AMERICA INSURANCE COMPANY AND/OR ITS WHOLLY OWNED SUBSIDIARY, AMERICAN NETWORK INSURANCE COMPANY IS ELIGIBLE TO BECOME A MEMBER.
FORM 990, PART VI, SECTION A, LINE 7ATHE FOLLOWING INDIVIDUALS WILL BE DIRECTORS: CHAIR OF THE NOLHGA PTNA/ANIC TASK FORCE, CHAIR OF THE NOLHGA MEMBERS PARTICIPATION COUNCIL, AND THE PRESIDENT OF NOLHGA.
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, LEGAL COUNSEL, CAPTIVE MANAGER, AUDIT AND RISK ADVISORY COMMITTEE, AND BY THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CCOVERED PERSONS ARE UNDER A CONTINUING OBLIGATION TO DISCLOSE ANY SITUATION THAT PRESENTS A CONFLICT OF INTEREST. ANY COVERED PERSON WHO BECOMES AWARE OF A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST IS REQUIRED TO BRING IT TO THE ATTENTION OF AN EXECUTIVE OFFICER.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT PUBLICLY AVAILABLE.
FORM 990, PART XI, LINE 9:SURPLUS DISTRIBUTIONS -10,000.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
PENN TREATY PROTECTED CELL OF LTC RE
1050 CONNECTICUT AVE NW STE 700WASHINGTONDC20036820648671REINSURANCEDC501(C)(6)N/A0
LTC REINSURANCE PCC
1050 CONNECTICUT AVE NW STE 700WASHINGTONDC20036812155730MANAGEMENT COMPANYDC501(C)(6)N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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