SECRETARY OF HOUSING AND ECONOMIC DEVELOPMENT

COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation DIVISION OF INSURANCE 1000 Washington Street, Suite 810 Boston, MA 02118-6200 (617) 521-7794 Toll-free (877) 563-4467 http://www.mass.gov/doi CHARLES D. BAKER GOVERNOR KARYN E. POLITO LIEUTENANT GOVERNOR JAY ASH SECRETARY OF HOUSING AND ECONOMIC DEVELOPMENT JOHN C. CHAPMAN UNDERSECRETARY OF CONSUMER AFFAIRS AND BUSINESS REGULATION DANIEL R. JUDSON COMMISSIONER OF INSURANCE INDIVIDUAL DISABILITY INCOME INSURANCE POLICIES THAT MEET THE REQUIREMENTS OF MASSACHUSETTS REGULATION 211 CMR 42.00 Company Name 1. ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA P.O. Box 59060 300 South Highway 169 Minneapolis, MN 55459 (800) 950-5872 2-P-A 1 disability income policy 06/09/99 2. ACE AMERICAN INSURANCE COMPANY P.O. Box 1000 436 Walnut Street WA09G Philadelphia, PA 19106 (215) 640-5123 AH-1400-MA disability income policy 10/23/06 AH-1500-MA disability income policy 06/19/13 3. AMALGAMATED LIFE INSURANCE COMPANY 333 Westchester Avenue White Plains, NY 10604 (914) 367-5581 AMINDDI-10 (MA) disability income policy 10/12/12 1 Effective November 6, 2001, Allianz Life Insurance Company of North America ceased offering its approved individual disability income policy in Massachusetts. Page 1 As of August 18, 2015

4. AMERICAN BANKERS LIFE ASSURANCE COMPANY OF FLORIDA 11222 Quail Roost Drive Miami, FL 33157-6596 (800) 852-2244 AC6398PH-1098 disability income policy 05/23/00 5. AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS 1932 Wynnton Road Columbus, GA 31999 (800) 992-3522 A-57200-MA disability income policy 04/28/00 A-57400-MA disability income policy 09/26/03 A-57500-MA disability income policy 06/24/09 A57600MA disability income policy 01/17/13 6. AMERICAN FAMILY LIFE ASSURANCE COMPANY OF NEW YORK One Marcus Boulevard Albany, New York 12205 (800) 366-3436 NY-57000 MA disability income policy 09/03/96 NY-57200 MA disability income policy 04/13/99 7. AMERICAN FIDELITY ASSURANCE COMPANY 2000 N. Classen Blvd. Oklahoma City, Oklahoma 73106 (800) 323-3748 DI-99(MA) 2 disability income policy 04/27/00 8. AMERICAN GENERAL LIFE INSURANCE COMPANY 2727-A Allen Parkway Houston, Texas 77019 (800) 811-2696 04500-22 disability income policy 05/23/05 2 American Fidelity Assurance Company notified the Division that it has not marketed the approved individual disability income policy in Massachusetts. Page 2 As of August 18, 2015

9. AMERICAN GENERAL LIFE AND ACCIDENT INSURANCE COMPANY American General Center Nashville, Tennessee 32750 (615) 749-1139 AGLA 12LSD MA disability income policy 07/26/13 10. AMERICAN HERITAGE LIFE INSURANCE COMPANY 1776 American Heritage Life Drive Jacksonville, FL 32224 (800) 521-3535 DI-3MA disability income policy 03/29/89 DI-4MA disability income policy 10/06/93 DI5WMA disability income policy 11/27/01 DI61MA disability income policy 01/31/02 11. AMERICAN INCOME LIFE INSURANCE COMPANY P.O. Box 2608 Waco, Tx 76797 (254) 761-6400 D50000 disability income policy 04/22/81 12. AMERICAN NETWORK INSURANCE COMPANY 3 AON Select Company 110 Gibraltar Road, Suite #116 Horsham, PA 19044 (800) 343-3133 GR-78-87-MA disability income policy 10/27/87 RA-GR-83-87-MA disability income policy 02/25/88 2GR-90-MA disability income policy 08/13/90 GRST-91-MA disability income policy 08/06/91 4GR-94-MA disability income policy 09/15/93 ANIC-DI (96) MA disability income policy 08/12/97 5GR-RPD-97-MA disability income policy 10/08/97 ANIC-DI 2000 (MA) disability income policy 01/04/00 3 Effective January 6, 2009, American Network Insurance Company was placed in rehabilitation per order of the Pennsylvania Insurance Commissioner and the company is no longer marketing approved individual disability income policies in Massachusetts. Page 3 As of August 18, 2015

13. AMERICAN PHOENIX LIFE AND REASSURANCE COMPANY 100 Bright Meadow Boulevard P.O. Box 1900 Enfield, CT 06083-1900 (860) 403-2360 ENTDIS97 MA disability income policy 07/21/98 14. AMERICAN STATES LIFE INSURANCE COMPANY P.O. Box 34690 Seattle, WA 98124 (877) 4-SAFECO L0071-20 (10-93) disability income policy 03/24/94 L0060-00 (9-93) disability income policy 03/20/95 L0076-20 (10-93) disability income policy 03/20/95 15. AMERITAS LIFE INSURANCE CORP. 5900 O Street P. O. Box 81889 Lincoln, NE 68501-1889 (800) 756-1112 4501NC MA disability income policy 03/23/12 4502GR MA disability income policy 03/23/12 4503NCBOE MA 4 overhead expense disability income policy 06/02/15 4504LS MA disability income policy 02/28/14 16. ASSURITY LIFE INSURANCE COMPANY 1526 K Street Lincoln, NE 68501-2533 (800) 627-7212 A-D 100 MA disability income policy 07/07/98 A-D 106 MA disability business expense policy 07/07/98 A-D 103 MA disability income policy 12/11/01 AAW-D112 MA disability income policy 04/22/03 AAW-D113 MA disability income policy 04/22/03 A-D 120 MA disability income policy 03/18/04 W D210 MA disability income policy 04/08/09 I H0920 MA disability income policy 08/18/11 4 Form #4503NCBOE MA replaces Form #4503BOE MA previously approved on March 23, 2012. Page 4 As of August 18, 2015

17. BALBOA LIFE INSURANCE COMPANY P.O. Box 19702 Irvine, CA 92623-9702 (800) 854-6115 20A15P E496 5 disability income policy 06/15/98 18. BALTIMORE LIFE INSURANCE COMPANY 10075 Red Run Boulevard Owings Mills, Maryland 21117-4871 (800) 628-5433 6204S (MA) 6 disability income policy 02/23/00 6216S (MA) 6 disability income policy 02/23/00 6219S (MA/RI) 6 disability business expense policy 02/23/00 6248S (MA/RI) 6 disability business expense policy 02/23/00 19. BANKERS FIDELITY LIFE INSURANCE COMPANY 4370 Peachtree Road, N.E. Atlanta, GA 30319 (404) 266-5600 B 8721 MA disability income policy 12/01/06 B 8721 DR MA disability income policy 12/01/06 20. BANKERS LIFE & CASUALTY COMPANY 222 Merchandise Mart Plaza Chicago, IL 60654-2013 (312) 396-6000 GR-D025 disability income policy 11/04/94 5 6 Balboa Life Insurance Company notified the Division that it has not marketed its approved individual disability income policy in Massachusetts. Baltimore Life Insurance Company notified the Division that it has not marketed its approved individual disability income policies in Massachusetts. Page 5 As of August 18, 2015

21. BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA 700 South Street Pittsfield, MA 01201-8285 (413) 499-4321 0100MA (06/01) disability income policy 04/11/01 1100MA (06/01) disability income policy 04/11/01 3100MA (06/01) disability business buyout policy 04/11/01 4100MA (06/01) disability business expense policy 04/11/01 5100MA (06/01) 7 disability business expense policy 04/11/01 6100MA (06/01) disability income policy 04/11/01 755 (7-2001) disability income policy 02/15/02 1200 (01/11) MA 8 disability income policy 11/30/10 1500 (03/07) MA disability income policy 10/31/07 1500 (06/10) MA disability income policy 04/09/10 3200 (01/10) MA disability buy-out policy 05/10/10 1600 (06/10) MA disability income policy 05/25/10 4200 (01/10) MA overhead expense disability income policy 05/26/10 1400 (06/10) MA 9 disability income policy 09/01/10 22. BOSTON MUTUAL LIFE INSURANCE COMPANY 120 Royall Street Canton, MA 02021-9968 (800) 669-2668 D.I.-Acc-6/93 disability income policy 09/22/93 D.I.-A&S-6/93 disability income policy 09/22/93 ESO-DIS-1/95 disability income policy 03/02/95 D.I.-IMPR-7/98 disability income policy 04/15/99 23. CENTRAL STATES HEALTH & LIFE COMPANY OF OMAHA P.O. Box 34350 Omaha NE 68134-0350 (402) 397-1111 D03 MA 10 disability income policy 03/02/95 D05 MA 11 disability income policy 05/29/96 7 8 9 10 11 Effective September 6, 2005, Berkshire Life Insurance Company of America ceased offering the above-noted approved individual disability income policy in Massachusetts. Form #1200 (01/11) MA replaces form #1200 (09/04) MA, previously approved on June 24, 2004. Form# 1400 (06/10) MA replaces Form# 1400 (03/07) MA previously approved on October 31, 2007. Effective December 1, 2002, Central States Health & Life Insurance Company ceased offering the above-noted individual disability income policy in Massachusetts. Effective January 2, 2002, Central States Health & Life Insurance Company ceased offering the above-noted individual disability income policy in Massachusetts. Page 6 As of August 18, 2015

24. CENTRAL STATES INDEMNITY INSURANCE COMPANY OF OMAHA 1212 N. 96 th Street Omaha NE 68134-22748 (888) 642-4340 11615 disability income policy 08/23/05 25. THE CHESAPEAKE LIFE INSURANCE COMPANY 9151 Boulevard 26 North Richland Hills, TX 76180 (817) 255-3100 CH-26115-IP (01/10) MA disability income policy 05/13/11 26. THE CINCINNATI LIFE INSURANCE COMPANY P.O. Box 15496 Cincinnati, OH 45250-5496 (513) 870-2000 CLI-507-MA (3/01) disability income policy 11/27/01 27. COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 1200 Colonial Life Boulevard Columbia, SC 29202 (800) 325-4368 SASD-MA disability income policy 10/12/99 ENHANCE-MA disability income policy 02/17/00 DIS 1000-MA disability income policy 02/18/04 ISTD3000-MA disability income policy 07/16/15 Page 7 As of August 18, 2015

28. COMBINED INSURANCE COMPANY OF AMERICA 123 North Wacker Drive Chicago, IL 60606 (312) 701-3242 12475 disability income policy 08/25/87 19700-MA disability income policy 11/09/89 19824-MA-809 12 disability income policy 09/08/97 19819-MA-1208 13 disability income policy 12/04/97 19841-MA disability income policy 06/18/98 DI P69003-MA 0401 disability income policy 01/17/02 DI P69004-MA 0401 disability income policy 01/17/02 14135-MA disability income policy 01/21/15 29. CONTINENTAL GENERAL INSURANCE COMPANY 8901 Indian Hills Drive P.O. Box 247007 Omaha, NE 68124-7007 (402) 397-3200 208 14 disability income policy 01/07/94 30. FARM FAMILY LIFE INSURANCE COMPANY P.O. Box 656 Albany, NY 12201 (518) 431-5000 40-150 disability income policy 10/03/83 40-151 disability income policy 10/18/84 40-156(MA) disability income policy 09/24/98 40-182 1101 (MA) disability income policy 07/08/03 40-183 1101 (MA) disability income policy 07/08/03 40-184 1101 (MA) disability income policy 07/08/03 40-185 1101 (MA) disability business expense policy 07/08/03 12 13 14 The original certificate (Form#19824-MA) was originally approved on September 8, 1997. Carrier replaced the original certificate with the above-noted revised certificate (Form# 19824-MA 809) on October 28, 2009. The original certificate (Form#19819-MA) was originally approved on December 4, 1997. Carrier replaced the original certificate with the above-noted revised certificate (Form# 19819-MA-1208) on April 6, 2009. Effective June 2008, Continental General Insurance Company ceased offering its above-noted approved individual disability income policy in Massachusetts. Page 8 As of August 18, 2015

31. FEDERATED LIFE INSURANCE COMPANY 121 E. Park Square P.O. Box 328 Owatonna, MN 55060 (800) 533-0472 DI(MA) (05-96) disability income policy 03/30/99 DI(MA) (01-01) disability income policy 05/17/01 32. GOVERNMENT PERSONNEL MUTUAL LIFE INSURANCE COMPANY 2211 N.E. Loop 410 P.O. Box 659567 San Antonio, TX 78217 (800) 938-4765 GDI113-MA-R disability income policy 05/21/14 33. THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA 7 Hanover Square New York, NY 10004-2616 (800) 441-6455 AH55-A disability income policy 05/19/81 NC56-A disability income policy 05/19/81 AH84 15 disability buyout policy 12/21/86 NC97 15 disability income policy 03/07/88 NC111-MA 15 disability income policy 10/06/98 NC112-MA 15 disability income policy 02/05/99 OE102-MA 15 disability business expense policy 03/10/99 34. HCC LIFE INSURANCE COMPANY 225 TownPark Drive, Suite 145 Kennesaw, GA 30144-5509 (770) 973-9851 Policy #s HCCSU IND-13-MA 16 disability income policy 08/18/15 HCCSU TPI-13 SP PTD-MA 16 disability income policy 08/18/15 HCCSU TPI-13 SP TTD-MA 16 disability income policy 08/18/15 HCCSU TPI-13 EE PTD-MA 16 disability income policy 08/18/15 HCCSU TPI-13 MLB TTD-MA 16 disability income policy 08/18/15 15 16 Effective July 1, 2001, The Guardian Life Insurance Company of America ceased offering these above-noted approved individual disability income policies in Massachusetts. Policy will be marketed primarily to executives, entertainers and athletes of various sports entities. Page 9 As of August 18, 2015

35. HORACE MANN LIFE INSURANCE COMPANY 1 Horace Mann Plaza Springfield, IL 62715-0001 (217) 789-2500 Policy #s GC-S1I01K disability income policy 10/06/87 GC-S1I02X disability income policy 02/02/93 36. ILLINOIS MUTUAL LIFE INSURANCE COMPANY 300 S.W. Adams Street Peoria, IL 61634 (800) 437-7355 990 MA disability income policy 08/24/99 991 MA disability income policy 08/24/99 992 MA disability business expense policy 08/24/99 994 MA disability income policy 08/24/99 BE21 MA disability business expense policy 08/28/00 GR21 MA disability income policy 08/28/00 NC21 MA disability income policy 08/28/00 PD21 MA disability income policy 08/28/00 SR21 MA disability income policy 08/28/00 SRBE21 MA disability business expense policy 06/10/05 DI105 (MA) disability income policy 09/21/10 37. KANAWHA INSURANCE COMPANY 210 South White Street Lancaster, SC 29721-0610 (877) 378-1505 80315 8/05-MA disability income policy 06/08/07 38. KNIGHTS OF COLUMBUS One Columbus Plaza New Haven, CT 06510-3326 (203) 752-4658 DI01-MA 1-11 disability income policy 03/25/11 Page 10 As of August 18, 2015

39. LOYAL AMERICAN LIFE INSURANCE COMPANY P.O. Box 5418 Cincinnati, OH 45201-5418 (800) 633-6752 L-4187-20 17 disability income policy 04/30/96 40. MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY 18 1295 State Street Springfield, MA 01111-0001 (800) 272-2216 DP181-MA-9200 disability business expense policy 04/02/92 BOE-I-92 MA disability business expense policy 06/14/93 BOE-A-92 MA disability business expense policy 06/14/93 BOE-G-92 MA disability business expense policy 06/14/93 SBOE-I-92 MA disability business expense policy 06/14/93 SBOE-A-92 MA disability business expense policy 06/14/93 SBOE-G-92 MA disability business expense policy 06/14/93 DP188-MA-9500 disability income policy 06/14/95 DP188-MA-9500F disability income policy 06/14/95 DP288-MA-9500 disability income policy 06/14/95 DP288-MA-9500F disability income policy 06/14/95 DP388-MA-9500 disability income policy 06/14/95 DP388-MA-9500F disability income policy 06/14/95 DP488-MA-9500 disability income policy 06/14/95 DP488-MA-9500F disability income policy 06/14/95 XL-I-95 MA 18 disability income policy 11/13/95 XL-A-95 MA 18 disability income policy 11/13/95 XL-G-95 MA 18 disability income policy 11/13/95 XL-OI-91 MA disability income policy 12/01/97 XL-OA-91 MA disability income policy 12/01/97 XL-OG-91 MA disability income policy 12/01/97 XL-IS-92 MA disability income policy 12/01/97 XL-AS-92 MA disability income policy 12/01/97 XL-GS-92 MA disability income policy 12/01/97 Axis-98 MA disability income policy 09/23/98 BOE-99 (MA) disability business expense policy 10/13/99 BSELL-00(MA) disability business buyout policy 02/02/00 AP-01 (MA) disability income policy 05/21/01 XLS-IS-92 (MA) disability income policy 03/12/04 XLS-ME-04 (MA) disability income policy 05/17/04 17 18 Effective October 1, 2007, Loyal American Life Insurance Company ceased offering its approved individual disability income policy in Massachusetts. Effective March 1, 1996, Connecticut Mutual Life Insurance Company merged into Massachusetts Mutual Life Insurance Company and acquired the listed individual disability income policies that were approved on November 13, 1995. Page 11 As of August 18, 2015

41. METROPOLITAN LIFE INSURANCE COMPANY P.O. Box 30591 Tampa, FL 33630 (800) 929-1492 IDI2000-P/NC-ML disability income policy 08/07/01 IDI2000-P/NC-(MA) disability income policy 08/07/01 IDI2000-P/GR (MA) disability income policy 08/07/01 IDIP12-01-MA disability income policy 01/29/14 42. MINNESOTA LIFE INSURANCE COMPANY 400 Robert Street North St. Paul MN 55101-2098 (651) 665-3500 MHC-98-560 19 disability income policy 07/19/90 MHC-98-562 19 disability income policy 07/19/90 43. MUTUAL OF OMAHA INSURANCE COMPANY Mutual of Omaha Plaza Omaha, NE 68175 (402) 342-7600 150BE--Series 10343 disability business expense policy 03/10/80 DM44--Series 15205 disability income policy 08/01/88 D55-----Series 16486 disability income policy 08/13/90 DE45---Series 16715 disability income policy 02/01/91 D81-21062 disability income policy 03/25/08 D81-21063 disability income policy 03/25/08 D81-21064 disability income policy 03/25/08 D81-21065 disability income policy 03/25/08 D81-21066 disability income policy 03/25/08 D81-21067 disability income policy 03/25/08 D81-22990 disability income policy 01/13/11 D81-22991 disability income policy 01/13/11 D81-22992 disability income policy 01/13/11 D81-22993 disability income policy 01/13/11 D81-22994 disability income policy 01/13/11 D82-22995 disability income policy 01/13/11 D82-22996 disability income policy 01/13/11 D82-22997 disability income policy 01/13/11 D82-22998 disability income policy 01/13/11 D81-22999 disability income policy 01/13/11 19 Effective October 2000, Minnesota Life Insurance Company ceased offering its approved individual disability income policies in Massachusetts. Page 12 As of August 18, 2015

44. NATIONWIDE LIFE INSURANCE COMPANY One Nationwide Plaza Columbus, Ohio 43215-2220 (800) 535-8600 HEALTH-2150 20 disability income policy 02/10/99 45. NEW ENGLAND LIFE INSURANCE COMPANY 21 Disability Income Administration Center 18 Chestnut Street Worcester, MA 01608 (508) 799-4441 949a MA disability income policy 06/28/90 981 MA disability business buyout policy 08/20/90 933 MA disability income policy 12/18/90 908 MA disability business expense policy 01/24/91 990 MA disability income policy 01/24/91 985 MA disability business buyout policy 06/05/91 986 MA disability income policy 06/05/91 987 MA disability income policy 06/05/91 975 MA disability income policy 06/13/91 998 MA disability income policy 04/11/95 998 MA PE disability income policy 04/11/95 46. NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY 720 East Wisconsin Avenue P.O. Box 1237 Milwaukee, WI 53202-4797 (414) 271-1444 RR.GRD1.(0101) disability income policy 11/29/00 RR.NCD1.(0101) disability income policy 11/29/00 RR.BUY.(0101) disability business buyout policy 11/29/00 RR.KEY.(0101) disability income policy 11/29/00 RR.DOE.(0101) disability business expense policy 11/29/00 RR.INT.(0101) disability income policy 11/29/00 20 21 Effective January 2002 Nationwide Life Insurance Company ceased offering its approved individual disability income policy in Massachusetts. Effective January 2007, New England Life Insurance Company ceased offering its approved individual disability income policy in Massachusetts. Page 13 As of August 18, 2015

47. OHIO NATIONAL LIFE ASSURANCE CORPORATION P.O. Box 237 Cincinnati OH 45201-0237 (800) 366-6654 93-DB-23 disability business buyout policy 09/19/96 93-DE-23.1 disability business expense policy 09/19/96 95-DE-23.2 disability business expense policy 09/19/96 11DI-1.MA disability income policy 01/06/12 11DI-2.MA disability income policy 01/06/12 13DE-1.MA disability business expense policy 06/20/13 13DB-1.MA disability business buyout policy 06/20/13 48. OHIO NATIONAL LIFE INSURANCE COMPANY P.O. Box 237 Cincinnati, OH 45201-0237 (513) 794-6100 95-DI-23.1 disability income policy 09/24/96 95-DI-23.2 disability income policy 09/24/96 03-DI-23.1 disability income policy 05/10/07 03-DI-23.2 disability income policy 05/10/07 49. OLD REPUBLIC LIFE INSURANCE COMPANY 307 North Michigan Avenue Chicago, IL 60601-5382 (312) 346-8100 3-8997(MA) 22 disability income policy 09/24/96 22 Old Republic Life Insurance Company notified the Division that it is no longer marketing its individual disability income policy in Massachusetts. Page 14 As of August 18, 2015

50. THE PAUL REVERE LIFE INSURANCE COMPANY 18 Chestnut Street Worcester, MA 01608 (508) 799-4441 981 MA 23 disability buyout income policy 08/20/90 908 MA 23 disability business expense policy 01/24/91 990 MA 24 disability income policy 01/24/91 975 MA 25 disability income policy 06/11/91 998 MA 25 disability income policy 04/11/95 998 MA PE 25 disability income policy 04/11/95 51. PRINCIPAL LIFE INSURANCE COMPANY 711 High Street Des Moines, IA 50309-9979 (515) 247-5111 HH 700 MA disability income policy 03/28/00 HH 700 MA U disability income policy 03/28/00 HH 702 MA overhead expense policy 03/28/00 HH 703 MA disability business buyout policy 03/28/00 HH 750 MA disability income policy 06/16/04 HH 750 MA U disability income policy 06/16/04 HH 772 MA disability income policy 03/10/09 HH 789 MA 26 overhead expense policy 01/14/11 52. PROFESSIONAL INSURANCE COMPANY 100 Bright Meadow Blvd P.O. Box 1955 Enfield, CT 06083-1955 (800) 289-1122 HPDI2002 1-02 disability income policy 05/10/05 HPDI2009 MA disability income policy 07/17/09 23 24 25 26 Effective October 1, 1999, Paul Revere Life Insurance Company ceased offering these approved individual disability income policies in Massachusetts. Effective January 1, 1998, Paul Revere Life Insurance Company ceased offering these approved individual disability income policies in Massachusetts. Effective April 30, 2002, Paul Revere Life Insurance Company ceased offering these approved individual disability income policies in Massachusetts. Form #HH 789 MA replaces form #HH 702 MA, previously approved on March 28, 2000. Page 15 As of August 18, 2015

53. PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY One Fountain Square Chattanooga, TN 37402 (800) 633-7490 1669 disability income policy 04/19/86 297-NC-MA disability income policy 06/01/89 297-GR-MA disability income policy 06/01/89 337-MA disability income policy 06/01/89 1737-MA disability business expense policy 06/21/89 1738-MA disability business buyout policy 09/20/89 337-B-MA disability income policy 03/13/92 338-MA disability income policy 07/09/93 338-GR-MA disability income policy 11/24/93 338-LE-MA disability income policy 08/31/94 338-LE-GR-MA disability income policy 08/31/94 400NC disability income policy 12/19/95 400GR disability income policy 12/19/95 409NC disability income policy 09/19/96 450NC disability income policy 09/19/96 450GR disability income policy 09/19/96 L-21637-20 disability income policy 01/09/97 460GR disability income policy 08/05/97 500-MA disability income policy 10/06/97 500A-MA disability income policy 10/06/97 410NC disability income policy 02/23/98 475NC disability income policy 06/18/98 975P-MA disability income policy 10/19/98 975P-MA-G disability income policy 10/19/98 600-MA disability income policy 09/12/00 601-MA disability income policy 09/12/00 600-G-MA disability income policy 09/12/00 601-G-MA disability income policy 09/12/00 L-21724 disability income policy 02/14/01 1837-MA disability business expense policy 01/04/02 1838-MA disability business expense policy 01/04/02 750-MA disability income policy 05/24/10 750-GI-MA disability income policy 05/24/10 Page 16 As of August 18, 2015

54. RIVERSOURCE LIFE INSURANCE COMPANY 70100 Ameriprise Financial Center Minneapolis, MN 55474 1-800-862-7919 30205G-MA disability income policy 01/28/08 30203G-MA disability income policy 01/28/08 30200G-MA disability income policy 01/28/08 30208G-MA disability income policy 01/28/08 30207G-MA disability income policy 01/28/08 30200C-MA 27 disability income policy 08/12/94 30203C-MA 27 disability income policy 08/12/94 30207C-MA 27 disability income policy 08/12/94 30208D-MA 27 disability income policy 07/16/96 55. SIRIUS AMERICA INSURANCE COMPANY 140 Broadway, 32 nd Floor New York, NY 10005 (212) 312-2500 SHLD-13-1000MA high-limit disability income policy 03/20/15 56. STANDARD INSURANCE COMPANY P.O. Box 711 Portland, OR 97207 (800) 247-6888 B130.2(3/01)MA disability income policy 05/09/01 B128.2(11/03)MA disability buyout income policy 09/09/05 B152(5/05)MA disability income policy 08/17/06 B170(7/10)MA disability income policy 12/28/11 B170GI(7/10)MA disability income policy 12/28/11 57. SURETY LIFE INSURANCE COMPANY P.O. Box 82599 Lincoln, NE 68501-9502 (800) 669-7789 DI-P00 (09/95) MA 28 disability income policy 09/15/95 27 28 Effective December 31, 2006, IDS Life Insurance Company changed its name to RiverSource Life Insurance Company represented by these above-noted approved individual disability policies. Effective August 31, 1999, Surety Life Insurance Company ceased offering its approved individual disability income policy in Massachusetts. Page 17 As of August 18, 2015

58. THRIVENT FINANCIAL FOR LUTHERANS 29 (A Fraternal Benefit Society) 4321 North Ballard Road Appleton, Wisconsin 54919-0001 (800) 225-5225 MA12124 disability income certificate 10/24/00 MA12125 disability income certificate 10/24/00 H2-GB-GRBOE-1 disability business expense policy 03/13/01 H2-NB-NCBOE-1 disability business expense policy 03/13/01 59. TIME INSURANCE COMPANY 511 West Michigan P.O. Box 3050 Milwaukee, WI 53201-3050 (800) 800-1212 8034.POL.MA disability income policy 12/9/10 60. TRANSAMERICA ASSURANCE COMPANY 1150 South Olive Los Angeles, CA 90015 (800) 346-1608 9-H40 20-195 disability income policy 06/03/96 61. TRUSTMARK INSURANCE COMPANY 400 Field Drive Lake Forest, IL 60045 (877) 201-9373 DI-699A disability income policy 04/28/00 DI-699B disability income policy 04/28/00 DI-699C disability income policy 04/28/00 DI-699D disability income policy 04/28/00 DI-902(I) disability income policy 12/29/03 29 Effective August 6, 2002, Aid Association for Lutherans and Lutheran Brotherhood merged into the newly named Thrivent Financial for Lutherans. Page 18 As of August 18, 2015

62. UNION CENTRAL LIFE INSURANCE COMPANY 1876 Waycross Road P.O. Box 40888 Cincinnati, OH 45240 (513) 595-2200 UC 4401 MA disability income policy 05/24/99 UC 4402 MA disability income policy 05/24/99 UC 4403 MA disability business expense policy 05/24/99 63. UNIFIED LIFE INSURANCE COMPANY 30 P.O. Box 25326 Overland Park, KS 66225 (800) 237-4463 DI-98-A disability income policy 03/01/99 64. UNIVERSAL UNDERWRITERS LIFE INSURANCE COMPANY 7045 College Boulevard Overland Park, KS 66211-1523 (800) 634-6780 DMA1245 31 disability income policy 07/13/00 65. UNUM LIFE INSURANCE COMPANY OF AMERICA 2211 Congress Street Portland, ME 04122-9997 (800) 227-8138 KP86 MA 32 disability income policy 01/22/86 BS86 MA 33 disability buyout income policy 06/02/86 OP90 MA 31 disability business expense policy 04/25/90 INC95 MA 31 disability income policy 07/28/95 ISC95 MA 31 disability income policy 07/28/95 EDP98MA 31 disability income policy 02/22/99 30 31 32 33 Effective September 2001, Concord General Life Insurance Company, Inc. changed its name to Unified Life Insurance Company. Universal Underwriters Life Insurance Company notified the Division its approved individual disability income policy has not been marketed in Massachusetts. Effective December 2002, Unum Life Insurance Company ceased offering these approved individual disability income policies in Massachusetts. Effective October 1, 1999, Unum Life Insurance Company ceased offering these approved individual disability income policies in Massachusetts. Page 19 As of August 18, 2015

66. WELLCARE HEALTH INSURANCE OF ILLLINOIS 34 200 West Adams Suite 800 Chicago, IL 60606-4402 USA (813) 865-1658 HOL3-2102-MA 35 disability income policy 11/04/02 34 35 Effective September 27, 2006, Home Owner s Life Insurance Company s name was changed to WellCare Health Insurance of Illinois, Inc. Effective September 27, 2006, WellCare Health Insurance of Illinois, Inc. ceased offering the approved individual disability income policy in Massachusetts. Page 20 As of August 18, 2015