State of Hawaii Recap of Captives As of 12/31/13 Active 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 Form S S RRG RRG S S S S S S S RRG RRG 2 S S S S RRG S S ASC S S S S S S 2 S S S 2 2 1 2 3-R 1 2 4 2 2 2 1 5 2 2 2 2 2 1 2 2 2 2 2 2 2 2 2 4 2 2 3-R 2 2 5 2 2 2 2 Captive Name Royal Hawaiian Insurance Company, Ltd. K-M Insurance Co., Inc. College Liability Insurance Company, A Reciprocal Risk Retention Group California Healthcare Insurance Company, Inc., A Risk Retention Group Pacific Century Insurance Services, Inc. CAP Insurance Co., Inc. Mid-Pacific Insurance Company, Inc. Casualty Insurance Hawaii, Ltd. Hawaiian TelCom Insurance Company, Incorporated GLIC, LLC Sutter Insurance Services Corporation The Mutual Risk Retention Group, Inc. Attorneys Insurance Mutual Risk Retention Group, Inc. Fraternal Insurance Company, Inc. National Liberty Insurance Company, Inc. Opcal Insurance, Inc. Pyramid Insurance Company, Ltd. F.L. Insurance Corporation Health Providers Insurance Reciprocal, A Risk Retention Group P&C Insurance Company, LLC Kyo-Ya Insurance Services, Ltd. STOR-Re Mutual Insurance Company, Inc. Terrace Pacific Insurance, Ltd. ASIC II Limited Oceanic Insurance, Inc. Chesapeake Assurance Limited Pacifica Insurance Corporation Edison Insurance Services, Inc. Queen's Insurance Exchange, Inc. Transamerica Pacific Insurance Company, Ltd. Commercial General Indemnity, Inc. Workers' Assurance of Hawaii, Inc. Caduceus Indemnity Insurance Corporation, Ltd. Front Range Insurance Company, Inc. Pacific Beacon Life Reassurance, Inc. Pacific Casualty Company, Inc. National Guardian Risk Retention Group, Inc. ECI Reinsurance Corporation Real State Insurance LLC WM Mortgage Reinsurance Company, Inc. Yazaki Insurance Company Inc. Triax Insurance, Inc. Reliant Structural Warranty Insurance Company, Inc. FirstMerit Mortgage Reinsurance Company, Inc. The Mutual Re, Inc. Western States Insurance Company, Inc. Sierra Underwriting Company, Ltd. CPN Insurance Corporation United Church Insurance Company, Inc. Partners Insurance Company, Inc. H&M Insurance Hawaii, Inc. KT Insurance Company, Inc. Marquis Insurance Corporation Caregivers Reinsurance, Inc. Portage Bay Insurance Providers Insurance Corporation RH Insurance Company, Inc. Lokahi Assurance, Ltd. Wynnewood Insurance Corporation Flowcom Insurance Company, Inc. Cooperative of American Physicians Insurance Company, Inc., Seamount Insurance, Inc. Pacific Unified Insurance Company, Inc. Contractors Insurance Company of North America, Inc., A Risk Retention Group Paramount Insurance, Inc. Paradigm Indemnity Corporation Insurance Company of Trinet (U.S.A.), Inc. NSP Casualty Insurance Company, Inc. Meritage Insurance Group, Inc. Vintage Insurance Inc. Granite Assurance Company, Inc. License Date 3/1/1988 6/22/1988 7/1/1988 4/10/1989 6/29/1989 8/23/1989 1/30/1990 4/19/1990 9/1/1990 5/1/1991 7/31/1991 12/31/1991 6/18/1992 4/28/1993 7/1/1993 8/28/1993 9/9/1993 9/29/1993 6/28/1994 9/28/1994 12/15/1994 1/3/1995 9/29/1995 9/23/1996 10/9/1996 6/20/1997 6/24/1997 10/17/1997 6/26/1998 7/30/1998 9/30/1998 12/31/1998 8/16/1999 9/8/1999 10/1/1999 12/21/1999 12/29/1999 1/1/2000 1/10/2000 3/2/2000 3/24/2000 5/30/2000 10/27/2000 11/16/2000 4/1/2001 4/9/2001 4/18/2001 10/30/2001 11/1/2001 11/14/2001 12/21/2001 12/26/2001 12/27/2001 1/31/2002 7/1/2002 7/1/2002 7/22/2002 7/25/2002 8/13/2002 10/11/2002 10/17/2002 12/12/2002 12/26/2002 2/27/2003 2/28/2003 5/1/2003 5/19/2003 5/27/2003 6/16/2003 8/1/2003 10/1/2003 Coverages S C-S-V C-V C-V C-S-V C-S C-S-V C C-S-V C C-P C C C-S C-P-V C-M-P-S-V C-P C-P C C-P-V C C-P C-S M-P S C-V C-P-V C-P C L (Reins.) C C C C-V L (Reins.) C C C C-P-V C (Credit only- Reins.) M-P C-P-V C-P C C C-V C-P-V C-P-V C-P-V C C P C-V C C-V C C C-P C-P-V C-P C S C C C C C-P C C C-S C State of Hawaii Recap of Captives As of 12/31/13 Active 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 Form 5 2 2 2 2 2 2 2 1 2 2 3-R 2 3-R 2 2 2 2 2 2 2 3-A 2 2 2 2 2 2 2 1 2 2 2 2 2 2 2 3-R 5 4 2 2 2 2 2 2 2 2 2 2 2 2 2 5 2 2 2 2 2 2 1 3-R 2 2 4 2 2 2 3-R 2 2 Captive Name OWLCO Indemnity Limited Cast & Crew Insurance Company, Inc. First Pacific Indemnity Company, Inc. Ho`opa`a Insurance Corporation Del Mar Indemnity Company, Inc. GC Insurance Company, Inc. CAWCD Insurance Company, Inc. Covenant Reinsurance Company, Incorporated PS Insurance Company - Hawaii, Ltd. Oakridge Insurance, Inc. National Orion Insurance Company, Inc. Sentinel Assurance Risk Retention Group, Inc. Kubota Insurance Corporation Allegiant Insurance Company, Inc., A Risk Retention Group StarAmerican Insurance Ltd. Central Valley Insurance Company, Inc. Otsuka Global Insurance, Inc. Capri Insurance Corporation American Indemnity Corporation Technology Assurance Limited Southern Oregon Insurance, Inc. Community Clinics Insurance Company, Inc. Premier Indemnity Company, Inc. Crestmont Insurance Company Marketplace Insurance Inc. Davis Pacific Indemnity Co., Inc. Plumeria Insurance Company, Inc. Eplica Insurance Company, Inc. Willamette Valley Insurance Corporation American Nutritional Casualty Insurance, Inc. Freedom Casualty Insurance Company, Inc. Captive Insurance For Public Agencies Limited Oaktree Insurance Company, Inc. HMS Insurance Company, Inc. Specialty Insurance Company of Hawaii, Inc. Constellation Insurance Company, Inc. Worldwide Risk Insurance, Inc. Clinic Mutual Insurance Company Risk Retention Group, Inc. Bishop Street Insurance Corporation Relo Global Reinsurance Inc. Sutter Physicians' Insurance Coalition Inc. Hoku-pa'a 156 Insurance Company, Inc. Global Energy Resource Insurance Corporation Denso Reinsurance America, Inc. National Risk & Safety Insurance, Inc. Sodexo Ho’okipa Insurance Company, Inc. MHC Insurance Company, Ltd. WellPoint Insurance Services, Inc. North American Builders Indemnity Company, Inc. Pacific Western Insurance LLC KWE Reinsurance, Inc. Orlando Insurance Company, Inc. Bay Front Insurance Company, Inc. Virginia Insurance Company, Inc. Marine Insurance Company, Inc. Bayshore Insurance Company, Inc. Pacific Island Indemnty, Inc. Headland Insurance Company, Inc. FUJIFILM Insurance (Hawaii), Inc. Kapolei Property Insurance LLC Advance Create Reinsurance Incorporated PIH Health Insurance Company, A Reciprocal Risk Retention Group Ramco Insurance Company, Inc. Lehua Insurance Company, Inc. Life Alliance Reassurance Corporation FreSeguro, Inc. Buena Vista Insurance Company (Hawaii Branch) Market Street Indemnity, LLC DIST-CO Insurance Company, Inc., a Risk Retention Group Bannister Insurance Company, LLC Kettlebrook Insurance Company Ltd. License Date 10/2/2003 10/10/2003 11/1/2003 11/1/2003 11/13/2003 12/1/2003 12/18/2003 12/29/2003 12/31/2003 1/5/2004 1/20/2004 3/26/2004 4/1/2004 4/16/2004 6/21/2004 7/1/2004 7/1/2004 8/3/2004 8/20/2004 9/1/2004 9/3/2004 9/15/2004 9/17/2004 9/30/2004 10/1/2004 10/8/2004 10/21/2004 10/22/2004 10/28/2004 11/30/2004 12/24/2004 2/1/2005 2/3/2005 2/16/2005 3/2/2005 3/30/2005 4/1/2005 7/11/2005 7/27/2005 9/22/2005 9/22/2005 12/2/2005 5/10/2007 3/30/2006 4/17/2006 8/25/2006 11/1/2006 10/30/2006 12/13/2006 1/4/2007 4/1/2007 8/1/2007 8/1/2007 8/1/2007 12/31/2007 12/31/2007 12/28/2007 1/1/2008 4/1/2008 6/23/2008 11/5/2008 12/17/2008 12/31/2008 5/29/2009 12/22/2009 2/26/2010 2/26/2010 4/22/2010 5/1/2010 6/4/2010 7/7/2010 Coverages C C C-S C C C C-P-V C P C-P-V C C P C C C C C-P-V C P C C C C-P-V C-P C-P-V C C C C C C C C C C C-P-V C C C-P C C-V AH-C-L C-M C C-V C C C-P-V P C-M C C C C C C-S C C-M-P S AH-L C C C-P AH-L (Reins.) C S S C S C-P State of Hawaii Recap of Captives As of 12/31/13 Active 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 Form 2 3-R 2 2 2 2 2 5 3-R 2 2 2 2 2 5 2 2 2 2 2 5 2 3-R 2 2 2 2 2 1 2 2 2 4 2 2 2 2 1 2 2 2 2 Captive Name TMUS Assurance Corporation UV Insurance Risk Retention Group, Inc. Imi Assurance Inc. KS InsuRe Corporation Alice Re, Ltd. Watumull Insurance Co., Inc. Community Pacific Insurance Company, Inc. FNL Insurance Company, Ltd. RPX Risk Retention Group, Inc. BB & B Insurance Company, Inc. G & G Insurance Company, Inc. LH & B Insurance Company, Inc. MT & B Insurance Company, Inc. Montgomery Insurance Company, Inc. Responsive Insurance Solutions Corporation Westridge Insurance Company, Inc. BRE Insurance Company, Inc. INW Insurance Company, Inc. Generations Insurance, Inc. Retail Assurance Group, Inc. Terra Mar Insurance Company, Inc. HTH Re, Ltd. Professional Exchange Assurance Company (A Risk Retention Group) Spectrum Insurance Company, Inc. RMS Insurance Company, Inc. Koa Insurance Company, Ltd. Hawaii Insurance Group Association, LLC Kekoa Insurance Company, Inc. A&L Insurance Inc. Golden Gate Insurance Company, Inc. Valren Insurance Company, Inc. Pacific Valley Insurance Company, Inc. BevCap Sponsored Captive Insurance, Inc. Noble Assurance Company, Inc. Capstone Insurance Company, LLC Anderson Heart Insurance Company, Inc. AAA Life Re, Ltd. Harbor View Re Corp. Pomona Insurance Company, Inc. DT Casualty Insurance Company Ltd. TD Casualty Insurance Company Ltd. BDS Assurance Corporation License Date 9/15/2010 12/1/2010 12/15/2010 12/21/2010 12/1/2010 3/30/2011 3/31/2011 5/20/2011 10/5/2011 12/28/2011 12/28/2011 12/28/2011 12/28/2011 12/12/2011 12/29/2011 2/13/2012 3/26/2012 3/26/2012 5/2/2012 6/29/2012 7/2/2012 8/10/2012 10/18/2012 10/31/2012 12/26/2012 4/30/2013 5/17/2013 8/13/2013 8/22/2013 8/30/2013 9/10/2013 10/2/2013 10/24/2013 12/9/2013 12/16/2013 12/19/2013 12/30/2013 12/30/2013 12/30/2013 12/31/2013 12/31/2013 12/31/2013 Coverages C V AH-C-L-P-V C-P C-V P C-P AH-L (Reins.) C C C C C C-V C P P P C C C AH (Reins.) C C C P V C-V C C-P C-P V AH (Reins.) C C C-P AH-C-L (All Reins.) L (Reins.) P C C C
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