www.bestreview.com BEST S REVIEW August 2014 Monthly Insurance News Magazine The Mutual Insurers Agents & Brokers Reinsurers Life Advantage Despite diminished numbers, mutual life mainstays endure. by Angelo John Lewis An uninformed observer watching the wave of life insurance demutualizations that crested around the turn of the century might have wondered if the mutual form of ownership was soon headed to the dustbin of history. One by one, some of the largest life insurers in the United States Prudential, MetLife and John Hancock among them changed their structure from mutual to stock companies or mutual holding companies. By the turn of the century, the number of pure mutuals had dwindled to less than 50, from more than 300 less than 100 years before. And the majority of the survivors were small or midsize mutuals with combined capital and surplus of $250 million or less. Despite their diminished numbers, the major companies that remain in the sector are steadfast to their commitment to what they call mutuality. For them, their stock brethren might as well be occupying a parallel universe. We continue to find huge advantages for us to be a mutual company and stay a mutual company, said David Simbro, senior vice president of life and annuity products for Northwestern Mutual, the second-largest life mutual based on combined capital and surplus, according to BestLink, A.M. Best Co. s online financial system. We are certainly committed to this business model, as it allows our interests to be completely aligned with our policyholders and do what s in their best interest for the long term. That s why we value our mutuality. Simbro s sentiment on the participatory structure of mutual companies, in which policyholders share the company s profits, was echoed by his industry colleague Mutuals Among the Top Life Companies Market share of total life. (Mutuals are market with an *) Market Share (DPW) () Company 2011 2010 2009 70192 Metropolitan Life and Affiliated Cos. 8.18 8.03 8.72 8.52 9.06 69515 *Northwestern Mutual Group 6.73 6.43 6.40 6.52 6.24 70189 Prudential of America Group 5.94 7.03 5.38 5.31 5.79 69714 *New York Life Group 5.57 5.42 6.08 6.23 5.46 70351 Lincoln Financial Group 4.36 4.14 4.60 4.26 4.00 69702 *MassMutual Financial Group 3.59 3.38 2.96 2.79 2.82 69542 John Hancock Life Insurance Group 3.44 3.71 3.66 3.90 4.31 69707 Aegon USA Group 2.88 2.93 2.98 3.37 3.34 70126 State Farm Life Group 2.86 2.76 2.76 2.74 2.75 70342 AIG Life & Retirement Group 2.48 2.53 2.62 2.70 2.94 69685 *Guardian Life Group 2.40 2.37 2.35 2.35 2.31 Source: State/Line (Life Lines) Key Points The Trend: Large mutual insurers are among the most successful whole life writers. Beyond the Trend: One key to their success involves using career captive agents with expertise at selling longterm products. What s Ahead: Mutuals may expand their offerings to include other longterm products, such as long-term care. and competitor Mike Fanning, MassMutual s U.S. Insurance Group executive vice president. For us, it s always been about helping families manage risk and taking advantage of opportunities, Fanning observed. And we think the mutual structure helps us do so by putting them first. The strength of the mutual approach, characterized by a focus on long-term products, greater reliance on career distribution and lack of reliance on capital markets, was evident in the wake of the financial crisis. Some stock companies, with revenues fueled in part by investment products juiced by stock market returns, suffered during this period. Some of the stock companies were challenged during the financial crisis, said Stephen O Hearn, European insurance leader of PricewaterhouseCoopers, who previously led the firm s New York insurance practice. They weathered the storm and learned some lessons, but it was
the variable annuity guarantees that challenged the industry. That was largely a stock company issue: The mutuals had less exposure. Just in terms of perception, mutuals certainly fared better, added A.M. Best Vice President Stephen Irwin. There was this flight to quality concept where there was the perception that stock companies were encountering more financial difficulties than companies with a mutual structure who benefited from their longer term perspectives. Sales of safe products, like whole life, have generally done very well post-financial crisis. New York Life, Northwestern Mutual, Mass Mutual and Guardian are among the top 10 sellers of whole life insurance, according to Limra, while none are among the leaders in sales of variable annuity products. People were concerned during that time about the equity markets and even the fixed-income markets and so gravitated to low volatility insurance products, said A.M. Best Assistant Vice President Thomas Rosendale. Many were looking to get a decent fixed-income return and weren t interested in taking a lot of equity market risk, and whole life products seemed to fit the bill. The level of guarantees you could get were substantially more than what you could get with some Future Focus Looking ahead, life mutuals think long-term products. Looking at the market share of the major mutual life insurers, a case could be made that there s very little reason to change a winning formula when it comes to product design and fashioning new products. In other words, fine-tune life offerings and expand around the edges. Although it s not always the case, [mutuals] would not be the first to the market with a new type of product, said A.M. Best Vice President Stephen Irwin. They would generally focus more on traditional life insurance and not commodity type products. When Michael Fanning, MassMutual s U.S. Insurance Group executive vice president, talks about future direction for his company, he talks about cracking the underserved market that has long vexed life insurers. This includes increasing sales to multicultural and younger consumers. By 2040, we re going to be a majority-minority country, Fanning said. Without a doubt, we need to better engage with multicultural consumers. I think historically we ve done a decent job, but there s a much bigger opportunity as we grow. Minority groups account for almost 92 of the U.S. population growth during the last decade. We think that s a major trend and we need to be prepared for the demographic shift. The second challenge Fanning sees is engaging the millennial generation. Really positive returns in the life insurance space typically come from companies that have career agency systems. Mike Fanning, MassMutual of the other products and they became more attractive, Rosendale noted. Plus, mutual companies did not receive a lot of press regarding concerns about capitalization because they were generally holding higher levels of capital to begin with on a risk-adjusted basis. Thinking Longer Term Fast forward to today. A look at the product-mix emphasis and financials provides a good contrast between mutual and stock We think that still means face-to face distribution but that has to be enhanced by things like social, mobile, and the use of big data: those types of things and tools that they re used to working with. I don t think the competition for us are other life insurance companies. It s a share-of-wallet question: How do we create a buying experience as compelling as they receive from Apple or Amazon, for life insurance? If we don t figure out ways to engage these consumers, that s going to be a really difficult long-term challenge for the industry. Stephen O Hearn, of PricewaterhouseCoopers insurance practice, believes that future product design from life mutuals will reflect their focus on serving long-term needs. You might see a commitment to similar long-term products from them, like long-term care, for example. The mutuals seem to have more staying power in that product than the stock companies, although that s a product where it is less clear what future benefits are going to look like. Whatever their future product design focus, O Hearn thinks that life mutuality will endure. As long as they are selling a product that the policyholders want and they continue to provide as much value to their policyholders as they are, they will be around for a long time. 2
Life life insurers. Although all of the larger companies in both categories sell a variety of products, large mutuals focus more on longer term products, while public companies focus more on commodity-type products such as term life and, to a lesser extent, universal life with secondary guarantees. Last year, for example, more than one-third of the $124 billion in premiums written by mutuals were for ordinary life insurance and 30 for annuities. Stock companies earned less than 11 of their $558 billion in premiums from ordinary life and nearly 24 from annuities, according to BestLink. How the two types of companies manage their assets reveals parallel distinctions. As one might expect for participatory companies, mutuals profitability return-on-revenue ratios, 3.2, were lower than those of stock companies, 7.9, according to BestLink. That s because mutuals return a portion of their revenues to policyholders in the form of dividends. Their investment practices also differ, mirroring their contrasting liability profiles and market sensitivities. Mutuals generally have longer tail liabilities and are less pressured by Wall Street. Our mutual structure allows us to employ a longer term investment approach, rather than focusing on meeting the shortsighted expectations of quarterly earnings reports. This strategy has served us well in all economic environments, Northwestern Mutual s Simbro said. We are responsible for managing the company in the best interest of our policyholders and we don t have a responsibility to stockholders as publicly traded stock companies do, he added. Our longterm strategies give us flexibility in selecting investments and asset classes that help minimize shortterm risk and volatility. The whole life insurance investment portfolio can have a longer Our long-term strategies give us flexibility in selecting investments and asset classes that help minimize shortterm risk and volatility. David Simbro, Northwestern Mutual perspective and that leads to longer dated bonds, more real estate, more equities, PwC s O Hearn added. They can do more with their portfolios because they have a longer investment horizon than someone who, for example, is providing a shorter term retirement guarantee. According to BestLink, mutuals last year invested less of their assets in bonds than publics (69 vs. 76) and more of the bonds they invested were noninvestment grade (6.9 vs. 5.6). They also had higher allocations in stocks (2.9 vs. 2.2), mortgage loans (11.9 vs. 9.6) and Schedule BA alternative assets (5.2 vs. 3.9). Bench Strength Another clear distinguishing feature between stock and mutual insurers is the degree to which mutuals rely on career captive agents. The recent recruitment drives of companies that include Northwestern Mutual and New York Life go against the grain of what s going on in the insurance industry in general, where the agency affiliation model is being challenged. According to Limra, today s affiliated insurance sales force is now less than 150,000, down 40 from the 1980s. Whole life insurance, O Hearn said, is a product that needs to be sold and the thing that characterizes the big mutuals is their career distribution networks. What makes them distinctive is having sales forces that sit across the kitchen table and sell sophisticated longterm products. It s a different sales process than retirement annuities or term insurance, which are more readily bought. It s not lost on us that there are not a lot of Americans who wake up every morning and think, I ve got to buy whole life insurance today, added MassMutual s Fanning. They know they have financial responsibilities to their families and their business partners and the first thing they really buy is an agent, or a relationship with somebody that they trust. And I think some companies have really gotten away from thinking about that as part of the value proposition and trying to compete on price. I think when you look at the data and see where companies have had really positive returns in the individual life insurance space, it typically comes from companies that have career agency systems. One of the frequent critiques of the mutual structure is the lack of transparency among its managers and concurrent lack of accountability and effectiveness. These critiques, which have been echoed elsewhere, were summed up in a 2006 paper, Demutualization in the Life Insurance Industry: A Study of Effectiveness, by University of Massachusetts professors Lal Chugh and Joseph W. Meador. The management of a mutual may be disposed to seek personal benefits or to indulge in expense preference behavior due to a lack of policyholder monitoring, the authors wrote. The large numbers of policyholders, who are widely dispersed, and the limited availability of information about mutuals, make the cost of monitoring the behavior and performance of management very high. Indeed, policyholders are 3
Life not inclined to monitor management closely. I think back in the 90s some of the mutuals [that demutualized] were in need of increased focus, O Hearn said. Making them public brought them increased focus. But the ones that remained mutuals and prospered would not have been able to maintain their prosperity had they not been well-focused companies to begin with. By the Numbers: 4 Mutual Companies Guardian Life Insurance Company of America Total $42,065,979 $5,011,885 $6,705,587 Fanning believes the participatory structure of mutuals encourages efficiency and accountability. All of us are incredibly focused on running efficiently, because if we don t, those expenses get passed back to the policy owner. I would say for us and the other mutuals as well, it s a big part of our value proposition and our product pricing to be efficient and effective. Group A&H $2,384,919 Ordinary Life $3,471,178 A level of accountability that Northwestern Mutual uses is a policyholder examining committee that annually visits the company, interviews officers, examines the company s books and reports their findings to other policyholders, Simbro said. Their view on how they feel about the quality of the operation adds another nice outside perspective. We feel we get additional value continued on page 6 Group Life $425,152 Individual A&H $399,100 Individual Annuity $24,228 All Other Lines $0 New York Life Insurance Co. Total $252,522,965 $17,853,770 $23,486,482 Individual Annuity $8,994,085 Ordinary Life $7,475,447 Group Annuity $4,457,107 Group Life $2,047,913 Group A&H $274,014 All Other Lines $237,916 Massachusetts Mutual Life Insurance Co. Total $182,776,471 $12,524,447 $20,418,821 Individual Annuity $3,312,423 Ordinary Group Life $1,058,795 Life Individual A&H $524,477 $4,399,010 Group Annuity $11,124,117 The Northwestern Mutual Life Insurance Co. Total $215,165,006 $17,198,785 Group Annuity $145,551 All Other Lines $0 Individual Annuity $2,384,595 Individual A&H $1,010,075 $15,995,244 Ordinary Life $12,391,100 Group A&H $52,912 Source: Company Overviews 4
Top 200 U.S. Combined Life & Health Insurers ed by admitted assets. ($ Thousands) Company/Group 1 1 Metropolitan Life & Affiliated Cos Group 069169 585,768,346 4.1 2 2 Prudential of America Group 070189 531,977,237 8.3 3 3 John Hancock Life Insurance Group 069542 264,181,879 4.8 4 4 AIG Life & Retirement Group 070342 263,529,042 6.7 5 5 TIAA Group* 070362 258,109,020 6.5 6 6 New York Life Group 069714 252,522,965 6.1 7 8 Northwestern Mutual Group 069515 217,171,402 7.2 8 9 Lincoln Finl Group 070351 213,168,994 10.9 9 11 Aegon USA Group 069707 198,490,222 7.6 10 12 MassMutual Finl Group 069702 195,081,176 16.4 11 10 Voya Finl Group 070153 194,235,111 3.7 12 7 Hartford Life Group 070116 189,499,738-11.3 13 14 Jackson Natl Group 069578 171,971,769 20.0 14 13 Axa Finl Group 070194 162,555,157 8.4 15 15 Principal Financial Group 020516 143,852,287 10.6 16 17 Nationwide Mutual Life Group 070822 127,458,061 12.9 17 18 Pacific Life Group 069720 114,388,899 8.1 18 19 Ameriprise Finl Group 069689 110,420,928 8.0 19 16 Aflac Inc Group 069824 108,668,941-6.3 20 20 Allianz Life Ins Group 070187 107,297,532 11.2 21 21 Thrivent Finl for Lutherans Group 069600 75,467,151 5.5 22 23 Genworth Finl Group 069555 66,092,014 0.2 23 25 State Farm Life Group 070126 62,776,163 6.3 24 22 Athene Life Ins Group 070454 62,222,652-6.6 25 26 Kaiser Fndn Group of Health Plans 070936 61,057,620 7.4 26 28 Guardian Life & Health Group 020389 59,937,841 13.7 27 27 Great-West Life Group 070366 58,427,400 5.3 28 24 Allstate Finl Cos 070106 55,974,726-6.8 29 29 Protective Life Group 069728 54,438,116 7.9 30 30 Sammons Finl Group 069731 52,462,703 14.4 31 31 Sun Life Assur Group 069798 42,073,816-7.9 32 33 Western & Southern Finl Group 069754 37,994,869 5.7 33 32 Unum Ins Group 069743 37,864,654 0.1 34 38 Securian Finl Group 069763 33,297,091 16.6 35 39 Amer Equity Investment Group 070406 32,783,190 15.4 36 35 UnitedHealth Group 020442 32,052,178 3.7 37 36 Aetna Health & Life Group 069015 31,399,500 3.5 38 34 Cigna Group 069194 30,370,159-6.2 39 37 GE Capital Corporation 070421 29,943,907 0.5 40 55 Global Atlantic Ins Group 070075 29,104,916 58.7 41 43 OH Natl Life Group 069717 28,802,407 15.8 42 40 WellPoint Health Networks Group 069158 28,169,567 3.9 43 41 Symetra Life Group 070123 27,943,234 7.0 44 44 Oneamerica Group 070399 27,778,102 13.6 45 42 CNO Group 069862 26,130,102 3.4 46 46 Guggenheim Life Group 070464 25,509,988 14.6 47 48 Fidelity Investments Group 070020 24,680,351 18.4 48 49 GAFRI Group 070220 24,221,845 19.5 49 47 Mutual of Omaha Group 070203 23,600,398 6.9 50 45 RGA Group 069611 23,456,255 2.3 51 50 USAA Life Group 070364 21,692,180 7.5 52 62 Security Benefit Group 069882 21,319,400 35.2 53 53 Natl Life Group 069953 20,756,020 8.0 54 51 Knights of Columbus 006616 20,534,434 5.8 55 52 Amer Natl Group 070166 19,693,404 1.6 56 54 Phoenix Life Group 070171 19,562,789 1.8 57 58 Standard Ins Group 070398 19,384,249 10.8 58 56 Health Care Service Corp Group 069154 18,953,799 5.2 59 60 Penn Mutual Group 069722 17,941,724 11.0 60 57 Sun Life Finl Group 069740 17,929,912 1.5 Company/Group 61 59 Fidelity & Guaranty Life Group 070403 17,864,900 4.3 62 66 Berkshire Hathaway Group 070158 17,390,552 23.2 63 61 Ameritas Mutual Hldg Life Group 070476 17,283,684 8.8 64 65 Mutual of America Life Ins Co 008851 16,666,682 13.8 65 63 Torchmark Cos 070265 15,851,832 3.4 66 64 CMFG Life Group 070262 15,664,958 6.8 67 69 Modern Woodmen of America 006737 13,398,446 8.2 68 68 Liberty Life Assur Co of Boston 006627 13,115,091 5.7 69 67 Zurich Amer Life Group 070470 12,969,021 1.6 70 71 Swiss Re Life Group 070469 12,796,980 8.7 71 70 Southern Farm Bureau Life Ins Co 007053 12,679,325 3.5 72 72 Humana Group 020169 12,203,165 4.9 73 73 COUNTRY Financial Life Group 070142 10,662,105 7.4 74 75 Woodmen of the World Life 007259 10,067,533 5.8 75 74 Highmark Inc. Group 069155 9,813,147-0.9 76 77 Natl Western Life Ins Co 006811 9,771,161 6.6 77 76 Assurant Inc Group 069152 9,351,682 1.6 78 78 BC/BS of MI Group 069165 8,503,965 2.4 79 79 Farm Bureau Life Group 070472 7,723,578 4.2 80 82 Horace Mann Life Group 069919 7,299,720 15.5 81 80 Farmers New World Life Ins Co 006373 7,140,964 2.1 82 81 Munich Amer Reassurance Co 006746 6,981,203 9.7 83 84 BCBS of FL Group 070909 6,879,721 12.2 84 83 Blue Shield of CA Group 020415 6,553,714 6.4 85 85 Reliance Standard Life Group 069825 6,156,308 15.0 86 86 Americo Life Group 069676 5,156,686 0.4 87 88 Wilton Re US Group 070435 5,134,909 6.2 88 87 Amer Family Life Ins Co 006052 5,074,042 4.8 89 91 Sentry Life Ins Group 070125 5,056,068 12.4 90 98 Heritage Life Ins Co 060720 4,872,444 25.1 91 92 Amer Fidelity Group 069640 4,790,170 8.1 92 94 Philadelphia Finl Life Group 070450 4,746,897 14.2 93 89 Hannover Life Reassur America 068031 4,527,958-1.9 94 90 Independence Blue Cross Group 070982 4,527,538 0.1 95 93 Horizon Healthcare Svcs Cos 070932 4,479,311 3.7 96 95 Lifetime Healthcare Group 069168 4,466,521 10.2 97 96 Kemper Life & Health Group 070340 4,071,160 1.2 98 100 BCBS of MA Group 020455 3,951,571 4.0 99 99 Kansas City Life Group 069692 3,937,178 1.6 100 97 CareFirst Inc Group 070916 3,926,287 0.0 101 103 BCBS of NC 064070 3,786,788 8.2 102 101 Cincinnati Life Ins Co 006568 3,737,512 4.7 103 104 Cambia Health Group 020223 3,593,755 6.6 104 105 Auto-Owners Life Ins Co 006140 3,509,213 6.4 105 102 Health Net L&H Group 069187 3,465,439-2.0 106 112 BCBS of SC Group 069149 3,184,726 8.7 107 111 Physicians Mutual Group 069724 3,176,566 5.9 108 106 HIP Group 020434 3,171,389-3.1 109 136 CVS Caremark Group 070851 3,139,829 65.6 110 115 NGL Ins Group 070358 3,105,410 6.9 111 108 BCBS of Minnesota Gr 070913 3,064,595-0.9 112 124 Jefferson Natl Life Ins Co 006475 3,053,451 35.2 113 109 Beneficial Life Ins Co 006162 3,011,214-2.6 114 110 Senior Health Ins Co of PA 007910 2,985,939-3.1 115 116 Independent Order of Foresters USB 006551 2,940,123 2.8 116 107 Continental Assur Co 006280 2,937,872-5.1 117 117 BCBS of AL Group 069177 2,886,134 8.0 118 114 Ullico Life Group 070003 2,813,980-3.2 119 113 Scor Life US Group 070253 2,723,229-6.5 120 118 Security Mutual Life Ins Co of NY 007034 2,676,400 2.0 5
Life Company/Group 121 119 Legal & Gen America Group 069539 2,625,939 0.3 122 123 Gerber Life Ins Co 007299 2,548,126 10.5 123 121 Savings Bank Life Ins Co of MA 006696 2,534,372 5.3 124 122 BCBS of TN Group 070915 2,484,192 6.5 125 130 Centene Group 069166 2,478,273 20.5 126 120 Assurity Life Ins Co 007374 2,449,282 1.2 127 125 Homesteaders Life Co 006534 2,378,064 5.7 128 126 Farm Bureau Life Ins Co of MI 006363 2,293,989 2.1 129 128 Wellmark Group 064437 2,292,867 9.3 130 131 AAA Life Group 070388 2,168,857 7.2 131 127 WellCare Mgmt Group Inc 070897 2,168,145 0.8 132 129 IN Farm Bureau Group 070368 2,148,310 4.0 133 134 Premera Group 020411 2,136,116 10.8 134 132 Lincoln Benefit Life Co 006657 2,070,874 3.1 135 133 Erie Family Life Ins Co 007276 2,021,441 4.6 136 138 Combined A&H Group 070178 1,935,449 3.2 137 140 TN Farmers Life Group 070467 1,930,313 7.0 138 139 Centre Life Ins Co 007367 1,927,672 6.2 139 141 MTL Ins Co 006756 1,894,920 6.4 140 135 Scottish Re (US) Inc 008785 1,808,187-5.0 141 148 HealthPartners Inc Group 070930 1,791,269 19.6 142 137 Primerica Group 070183 1,789,265-5.0 143 146 LifeCare Assur Co 009200 1,779,983 11.5 144 142 Trustmark Ins Group 069845 1,742,658 2.9 145 145 LA Health Svcs & Life Group 069179 1,736,915 7.9 146 143 Medical Mutual of OH LH Group 069185 1,715,253 1.5 147 158 Group Health Cooperative of Puget Sound 070960 1,660,516 18.3 148 144 United Life Ins Co 007178 1,648,019-1.7 149 162 First Investors Life Ins Co 006413 1,641,447 22.4 150 155 Delta Dental of CA Group 070892 1,609,351 11.3 151 169 Molina Healthcare Group 069161 1,586,173 24.9 152 153 Blue Cross Blue Shield of AZ Inc 064465 1,578,948 8.4 153 147 Columbian Finl Group 069961 1,558,283 3.5 154 160 Arkansas Blue Cross/Blue Shield Group 070971 1,553,262 12.8 155 156 BC & BS of KS Grp 070031 1,551,834 7.6 156 152 Vision Service Plan Group 070966 1,544,611 5.1 157 150 Manhattan Ins Group 070357 1,522,047 2.7 158 161 Capital Blue Cross Companies 020393 1,492,645 9.8 159 149 SBLI USA Group 060345 1,484,512-0.5 160 164 Federated Life Ins Co 006381 1,435,524 9.6 161 154 Pan-Amer Life Ins Group 069617 1,434,294-1.4 162 157 Gleaner Life Ins Society 006459 1,417,182-1.4 163 176 GBU Finl Life 008161 1,411,611 19.1 164 165 Alfa Life Ins Corp 006293 1,357,175 4.8 165 166 Triple-S Mgmt Group 020218 1,340,734 3.8 continued from page 4 from it, and it adds an additional layer of accountability. This is always something we ve had built into our process. Which One s Preferable? Because of their contrasting operational philosophies, comparing the efficiency of stock and mutual insurers is an area that has long fascinated organizational theorists. David L. Eckles, an associate professor of the University of Georgia s Risk Management and Insurance Program, was one of three professors who attempted to make such a comparison. The trio summed up their findings in a paper, Ownership Form and Efficiency: The Co- Existence of Stock and Mutual Life Insurers. The researchers analyzed the financial statements of 267 mutual and stock life insurers and how their economic inputs (such as agent labor) translated into economic outputs (such as insurance products). They concluded that it s sort of an apple and oranges comparison if you re talking about efficiency, Eckles said. Stocks do some things better and mutuals do other things better. Both of these structures do their own thing. The researchers found that the Company/Group 166 167 IL Mutual Life Ins Co 006542 1,329,426 3.1 167 159 Prosperity Life Group 070471 1,324,860-5.2 168 168 Catholic Finl Life 008188 1,320,446 2.5 169 175 Pekin Life Ins Co 006901 1,301,555 7.6 170 172 Liberty Bankers Group 070410 1,298,629 5.6 171 173 Boston Mutual Group 069993 1,284,220 5.0 172 182 UPMC Health Ins Group 070898 1,254,551 19.1 173 170 Medica Hldg Companies 070902 1,247,472-1.6 174 233 Local Initiative Health Authority of LA 064652 1,233,876 142.2 175 163 Pavonia Life Ins Group 069573 1,229,250-7.2 176 151 Centurion Life Ins Co 006276 1,209,043-18.0 177 174 Tufts Associated Health Plans Group 070875 1,200,524-0.8 178 178 Sagicor Life Ins Co 006057 1,176,198 6.9 179 185 Oxford Group 070367 1,156,266 11.9 180 179 Amica Life Ins Co 007464 1,133,127 3.1 181 193 CareSource Group 070853 1,130,700 20.6 182 231 Express Scripts Ins Group 070794 1,109,332 108.4 183 187 Baltimore Life Ins Co 006143 1,085,736 8.1 184 184 Shelter Life Ins Co 006675 1,078,448 3.2 185 181 Harvard Pilgrim Health Care Group 070985 1,054,335-1.0 186 171 Universal Amer Group 020522 1,037,977-17.7 187 183 EMC Natl Life Co 006339 1,030,170-2.2 188 189 Catholic Life Ins 008827 1,019,071 4.2 189 180 BCBS of KC Group 020446 1,015,166-6.5 190 186 HealthNow NY Inc 064602 1,009,521-0.1 191 195 Catholic Order of Foresters 006191 990,082 7.2 192 198 Funeral Directors Group 070016 989,904 10.7 193 177 Axa Corporate Solutions Life Reins 009083 978,031-16.7 194 196 Citizens Inc Group 069688 977,215 7.9 195 191 GPM Life Group 070452 973,645-0.1 196 188 Citi Assur Svcs Group 070434 969,036-2.9 197 199 HI Medical Service Assn 064035 945,226 9.4 198 192 Amer Republic Group 069597 917,589-3.7 199 197 Vantis Life Group 070058 898,559-0.2 200 204 UCare Group 070852 876,304 8.7 Top 200 Insurers $6,353,085,662 6.5 Total U.S. Life, Health and HMO $6,422,012,949 6.4 * TIAA s assets are significantly understated. Most of its separate account assets are in its affiliate, CREF. Note: Data for some companies in this report has been received from the NAIC. Source: Combined Life and Health, US; Data as of: June 6, 2014 mutual organization form allows them to be more competitive and efficient in life insurance, Eckles said, while the stock structure provides insurers with advantages in group lines, annuities and accident and health insurance for cost efficiency, but only in accident and health insurance for revenue efficiency. Mutuality, O Hearn said, has served this handful of players well. But those who demutualized have benefited from the stock structure as well in terms of an entirely different agenda. And, frankly, the capital markets have imposed a discipline that some of them needed. BR Financial information for Massachusetts Mutual Life Insurance Company (MassMutual) is as of 12/31/13. Total (Net ) and for MassMutual. and are consolidated statutory results of MassMutual that includes its U.S.-domiciled wholly owned life insurance subsidiaries: C.M. Life Insurance Company and MML Bay State Life Insurance Company. Visit www.massmutual.com/financials for more information. Reprint provided courtesy of MassMutual, Springfield, MA 01111. COR1261 Copyright 2014 by A.M. Best Company, Inc. All Rights Reserved. Reprinted with Permission, www.ambest.com Best s Review, August 2014. CRN201608-185149