The NAIC Annual Statement Blank – Fraternal is the year-end financial report that every fraternal benefit society licensed in the United States must file with its home state insurance department and transmit to the National Association of Insurance Commissioners on or before March 1 each year. It is the fraternal version of the Life blank, and it shows regulators the society’s assets, liabilities, surplus, reserves, and operations for the calendar year that just ended.
This article walks through the 2025 reporting-year blank, filed by March 1, 2026, page by page and line by line. Get a number wrong, miss a cross-check, or skip a signature, and the NAIC’s electronic filing system can flag the statement as “not filed,” which exposes the society to state fines and a black mark at the next financial exam. The blank changes a little every year through the Blanks (E) Working Group, so always confirm you are using the current revision before you start.
Across all four statement types, more than 4,000 insurers and societies push their data through the NAIC’s electronic gateway each spring, and a single failed cross-check can hold up the entire submission. Here is what you will learn:
- 📋 What the fraternal blank is, who must file it, and the statute behind it
- 🗂️ Every document and number to gather before you open the software
- 🧮 A line-by-line walkthrough of the Jurat, Assets, Liabilities, Summary of Operations, and key schedules
- 🧑💼 Three full filled-out examples following real societies from start to finish
- ⚠️ The mistakes that trigger rejections, fines, and exam findings
What the Form Is and Who Must File It
The NAIC Annual Statement Blank – Fraternal is a statutory financial statement, not a tax return. It reports the society’s financial condition as of December 31 using statutory accounting principles from the Accounting Practices and Procedures Manual, which differ from GAAP. The receiving parties are the society’s state of domicile and the NAIC, which warehouses the data for all state regulators.
A fraternal benefit society is a nonprofit membership organization that provides life insurance, annuities, and accident and health coverage to its members through a lodge system. Examples include groups like the Knights of Columbus, Thrivent, and Modern Woodmen of America. Because these societies sell insurance, every state requires them to file an annual statement, and the Uniform Fraternal Code (NAIC Model 675) sets the baseline rule that each society must file with the commissioner on or before March 1, along with a valuation of its certificates.
The statute that requires the filing is the fraternal insurance code in each state, modeled on Model 675. The plain-English meaning is simple: if you are a licensed fraternal, you file. The consequence of ignoring it is severe, since a society that fails to file can lose its certificate of authority and face daily penalties. A common misconception is that small single-state lodges are exempt, but they are not; the size of the society changes which supplements apply, not whether the statement is due.
Who must file:
- Domestic fraternal societies licensed in their home state
- Foreign fraternals licensed to do business in other states
- U.S. branches of alien (non-U.S.) fraternal societies, which report only the business done by the U.S. branch in the United States
Before You Start: Documents and Information You Need
Gather everything before you open the annual statement software, because the blank is built from cross-checked numbers that must tie to source records. Missing one item forces you to stop mid-filing, and a number that does not match a supporting schedule produces a hard edit error that blocks transmission.
Here is the pre-filing checklist. Each item matters, and each has a consequence if it is missing:
- Prior-year filed annual statement. The blank rolls forward last year’s surplus and reserves, so without it the beginning balances and the Five-Year Historical page will not tie.
- Year-end trial balance. This feeds the Assets and Liabilities pages; an out-of-balance trial balance means the statement will not foot.
- Investment records and broker statements. These build Schedule D (bonds and stocks), Schedule A (real estate), and Schedule B (mortgages); missing CUSIPs trigger investment-schedule edits.
- Actuarial reserve report. The appointed actuary’s numbers feed Exhibit 5 and the Aggregate Reserve lines; without them the liabilities are unsupported.
- The signed Actuarial Opinion (PDF). It must be filed as a separate PDF by March 1, and an unsigned opinion is treated as not filed.
- Premium and claims registers by state. These build Schedule T and the State Page; a missing state breaks the Schedule T allocation cross-check.
- General expense, tax, and dividend ledgers. These feed Exhibits 2, 3, and 4; gaps here distort the Summary of Operations.
- NAIC company code and FEIN. These identify the filer on the Jurat; a wrong code routes the filing to the wrong company record.
- Officer and director roster with titles. The Jurat and General Interrogatories need current officers; a stale roster invites an exam finding.
- Reinsurance treaties and balances. These build Schedule S; omitting a treaty understates ceded reserves.
Where to Get the Form and How to Access It
You do not type the fraternal blank into a blank PDF. The official statement structure lives in the NAIC Annual Statement Blank – Life/Fraternal publication, but the actual filing is produced inside vendor software approved by the NAIC. The reporting entity buys a license from an annual statement vendor, enters its data, and the software generates the formatted blank plus the electronic data file.
The completed filing is transmitted to the NAIC over the internet only, through the NAIC’s financial filing gateway. Photocopied or faxed pages are not acceptable for the NAIC copy. The official instruction manual that explains every line is the NAIC Annual Statement Instructions – Fraternal, which you should keep open beside the software the entire time.
Two access rules trip up new preparers. First, certain detailed investment schedules (Schedules A, B, BA, D Parts 1–6, DA, DB, DL, and E) are filed in paper with the state of domicile only, unless another state specifically requests them. Second, the alphabetized index is required only on the March 1 hardcopy and excludes supplements. A common misconception is that everything goes to the NAIC; in reality, some pieces go only to your home state, and sending them to the NAIC can clutter the record.
Step-by-Step: How to Fill Out the Fraternal Annual Statement Line by Line
The blank is large, with a Jurat page, financial statement pages, exhibits, notes, interrogatories, and dozens of schedules. This walkthrough covers the sections preparers ask about most. Use the exact line numbers and captions printed on the blank, because the format is built for automated data capture and you may not insert lines or rename captions between pre-printed items.
Jurat Page (Page 1)
The Jurat page is the cover sheet that identifies the society and carries the sworn signatures. In plain English, it asks “who are you, where are you, and do your officers swear this statement is true?”
To answer it, enter the society’s full legal name exactly as it appears on the certificate of authority, the NAIC company code, the FEIN, the state of domicile, and the complete statutory home-office and mailing addresses. Then have the required officers sign and have the signatures notarized where the state requires it. For example, Heritage Fraternal Life Society, NAIC #98765, FEIN 47-1234567, domiciled in Illinois prints across the top of the page.
A nuance applies to U.S. branches of alien fraternals: they still complete the Jurat, but they report only U.S. branch business, and the difference between Assets Line 28, Column 3 and total liabilities flows to Liabilities Line 29. A common mistake is having the wrong officers sign or skipping notarization, and the direct consequence is that the statement is treated as unsworn and not properly filed. The misconception here is that any executive can sign; in fact, the blank names which officers must sign, and substitutes do not satisfy the jurat.
Assets Page (Page 2)
The Assets page lists everything the society owns that has value under statutory accounting. In plain English, it asks “what do you own, and how much of it counts toward solvency?”
Fill it in by category in the pre-printed order: Line 1 Bonds, Line 2 Stocks, Line 3 Mortgage loans, Line 4 Real estate, Line 5 Cash and short-term investments, and so on down to Line 28, the grand total of admitted assets. You report assets in three columns: Column 1 (Assets), Column 2 (Nonadmitted Assets), and Column 3 (Net Admitted Assets), where Column 1 minus Column 2 equals Column 3. For example, Heritage Fraternal enters bonds of $42,500,000 in Column 1, $0 nonadmitted, and $42,500,000 net admitted on Line 1.
A nuance is the write-in handling: items with no pre-printed line go on the Line 25 write-in section, capped at three detail lines, with the rest spilling to the Overflow page (Page 52). A common mistake is reporting a nonadmitted asset (like furniture or an overdue agent balance) in Column 3 anyway, and the consequence is overstated surplus, which the cross-checks and examiners will catch. The misconception is that market value always governs; many bonds are reported at amortized cost under statutory rules, not market.
Liabilities, Surplus and Other Funds Page (Page 3)
This page lists what the society owes and what is left over as surplus. In plain English, it asks “what are your obligations, and how much cushion protects your members?”
Enter the aggregate reserves first: Line 1 Aggregate reserve for life contracts (tied to Exhibit 5), Line 2 Aggregate reserve for accident and health contracts (Exhibit 6), and Line 3 Liability for deposit-type contracts (Exhibit 7). Continue down through policy and contract claims, interest maintenance reserve, the asset valuation reserve, and other liabilities, then report unassigned funds (surplus) near the bottom. For example, Heritage Fraternal enters an aggregate life reserve of $30,000,000 on Line 1 that must match Exhibit 5 to the dollar.
A nuance for fraternals is that they show “surplus” rather than capital stock, because they have no shareholders. A common mistake is letting Line 1 disagree with Exhibit 5, and the consequence is an immediate cross-check failure that blocks the filing. The misconception is that surplus is spare cash the society can spend freely; in reality, most of it backs future benefit promises and is watched closely by regulators.
Summary of Operations (Page 4)
The Summary of Operations is the income statement. In plain English, it asks “what came in, what went out, and did surplus grow or shrink this year?”
Report income at the top: premiums and annuity considerations (tied to Exhibit 1), net investment income (from the Exhibit of Net Investment Income), and other income. Then report deductions: benefits paid, the increase in reserves, commissions, general expenses (Exhibit 2), and taxes (Exhibit 3). The bottom shows net gain from operations, which then flows into the Capital and Surplus Account. For example, Heritage Fraternal reports premium income of $8,200,000 and net investment income of $2,100,000, then subtracts benefits and expenses to reach its net gain.
A nuance is that the increase in reserves line can be negative when a block of business is running off, which lowers deductions. A common mistake is double-counting refunds to members instead of routing them through Exhibit 4 dividends, and the consequence is an overstated expense and a distorted gain. The misconception is that this page must match the society’s GAAP income; it follows statutory rules, so the two will differ.
Cash Flow (Page 5)
The Cash Flow page shows the actual movement of cash during the year. In plain English, it asks “where did your cash come from and where did it go?”
Complete the three sections in order: cash from operations (premiums collected minus benefits and expenses paid), cash from investments (proceeds from sales and maturities minus cost of acquisitions), and cash from financing and miscellaneous sources. The net change must reconcile to the cash and short-term investment balances on the Assets page. For example, Heritage Fraternal shows net cash from operations of $1,300,000 that ties back to its Schedule E cash lines.
A nuance is that this page is prepared on a cash basis, not the accrual basis used elsewhere, so it will not mirror the Summary of Operations. A common mistake is forcing the page to balance by plugging a figure, and the consequence is a reconciliation failure the examiner will probe. The misconception is that cash flow is optional for small societies; it is a required page for every filer.
Exhibit 5 – Aggregate Reserve for Life Contracts
Exhibit 5 develops the life reserve that appears on Liabilities Line 1. In plain English, it asks “how much must you hold today to pay future life insurance benefits?”
The appointed actuary supplies the valuation, broken out by valuation basis, mortality table, and interest rate, and you report the totals so they tie to the balance sheet. The Interrogatories that follow Exhibit 5 ask about participating versus non-participating policies and non-guaranteed elements, each requiring a separate actuarial opinion filed as a PDF. For example, Heritage Fraternal reports a $30,000,000 aggregate life reserve split across its whole-life and term blocks.
A nuance for 2026 filings is the updated General Interrogatory reserve lines 27.6 and 27.7, recently modified by the Blanks (E) Working Group. A common mistake is reporting a reserve that does not equal Liabilities Line 1, and the consequence is a hard edit that stops the filing. The misconception is that the preparer can estimate reserves; only the appointed actuary’s certified numbers belong here.
Schedule T – Premium and Annuity Considerations
Schedule T allocates the society’s premium by state. In plain English, it asks “in which states did you collect premium, and how much in each?”
List every U.S. state, territory, and the District of Columbia, then enter the direct premium written in each jurisdiction, with the total tying to the premium reported on the Summary of Operations and the State Page. For example, Heritage Fraternal reports $6,000,000 of Illinois premium and $2,200,000 spread across Wisconsin, Iowa, and Indiana.
A nuance is that a society licensed in a state but writing no business there still lists that state with a zero. A common mistake is leaving the total out of balance with Exhibit 1 premium, and the consequence is a cross-check failure plus questions about unlicensed activity. The misconception is that Schedule T is just informational; states use it to confirm you are licensed everywhere you collect premium.
General Interrogatories
The General Interrogatories are a yes/no and fill-in questionnaire about the society’s operations, ownership, and investments. In plain English, it asks “tell us about your structure, your affiliates, and your investment practices.”
Answer every interrogatory truthfully, including questions about custodial agreements, related-party transactions, and the recently updated reserve interrogatories. For example, Heritage Fraternal answers “No” to the question on pledged assets and lists its custodian bank where prompted.
A nuance is that a “Yes” answer often triggers a required schedule or attachment, so a yes without the backup is incomplete. A common mistake is rushing these as boilerplate, and the consequence is an inaccurate interrogatory that becomes an exam finding. The misconception is that these questions are minor; regulators treat false interrogatory answers seriously.
Five-Year Historical Data
This page shows five years of key figures side by side. In plain English, it asks “how have your premium, assets, reserves, and surplus trended over five years?”
Roll forward the prior years from last year’s filed statement and add the current year in the newest column, keeping each line consistent year over year. For example, Heritage Fraternal shows surplus growing from $11,000,000 five years ago to $14,000,000 this year.
A nuance is that restatements must be explained in the Notes to Financial Statements so the trend remains honest. A common mistake is re-keying prior years and introducing a typo, and the consequence is a trend that contradicts the prior filing. The misconception is that nobody reviews this page; analysts use it to spot sudden, unexplained jumps.
Three Filled-Out Examples Using Real Scenarios
These three societies show how the same blank flexes for different filers. Each follows one named preparer through the major sections.
Scenario 1: Maria Lopez, controller of a small single-state fraternal lodge. Her society writes only life insurance in one state with a simple bond portfolio.
| Form Section | What Maria Enters |
|---|---|
| Jurat legal name | Prairie Lodge Benefit Society |
| NAIC company code | #54321 |
| Assets Line 1 (Bonds) | $8,500,000 |
| Assets Line 28 (Total admitted) | $9,200,000 |
| Liabilities Line 1 (Life reserve) | $6,400,000 (ties to Exhibit 5) |
| Summary of Operations premium | $1,100,000 |
| Schedule T | 100% of premium in one state |
| Surplus (unassigned funds) | $2,500,000 |
Scenario 2: David Chen, CFO of a mid-size multi-state fraternal society. His society writes life and annuity business in twelve states and runs a separate account.
| Form Section | What David Enters |
|---|---|
| Jurat legal name | Heritage Fraternal Life Society |
| Assets Line 1 (Bonds) | $42,500,000 |
| Assets Line 28 (Total admitted) | $58,000,000 |
| Liabilities Line 1 (Life reserve) | $30,000,000 |
| Liabilities Line 3 (Deposit-type) | $4,000,000 (Exhibit 7) |
| Summary of Operations premium | $8,200,000 |
| Separate Accounts statement | Filed by March 1, 2026 |
| Schedule T | Premium split across 12 states |
Scenario 3: Aisha Rahman, statement preparer for a U.S. branch of an alien fraternal. She reports only the branch’s U.S. business.
| Form Section | What Aisha Enters |
|---|---|
| Jurat reporting basis | U.S. branch business only |
| Assets Line 28, Column 3 | $15,000,000 net admitted |
| Liabilities Line 29 | Difference between Assets Line 28 Col. 3 and total liabilities |
| Liabilities Line 1 (Life reserve) | $9,500,000 |
| Summary of Operations premium | $2,400,000 (U.S. only) |
| Trusteed Surplus Statement | Filed by March 1, 2026 |
| Schedule T | U.S. states only |
| Actuarial Opinion | Filed as separate PDF |
How to File the Completed Form
The fraternal statement moves through more than one channel, and each piece has its own destination. The core data goes to the NAIC, while some schedules and PDFs go only to your state of domicile.
- NAIC electronic filing (internet only). The vendor software transmits the annual statement data plus the bulk of supplements through the NAIC financial filing system. There is no NAIC fee for the filing itself, though you pay your software vendor a license fee. The expected turnaround is immediate confirmation of receipt, and you should keep the electronic acknowledgment as proof of filing.
- State of domicile (paper). Detailed investment Schedules A, B, BA, D Parts 1–6, DA, DB, DL, and E, plus items like the Trusteed Surplus Statement and Schedule SIS, are filed in paper with the home state only, unless another state requests them. Mail or deliver these per the state’s checklist and keep a stamped or certified-mail receipt.
- PDF-only filings. The Actuarial Opinion, Audited Financial Report, and several actuarial certifications must be filed as separate PDFs, not as data. Confirm each PDF uploaded successfully and retain the confirmation.
The anchor deadline is March 1, 2026 for the 2025 statement and the bulk of supplements, per the NAIC filing-deadline schedule. Later dates follow: April 1 for items like the Regulatory Asset Adequacy Issues Summary and the Supplemental Investment Risks Interrogatories, April 30 for the Actuarial Guideline XXXVIII 8D memorandum, June 1 for the Audited Financial Report, and August 1 for the internal control communication.
What Happens After You File
Once the NAIC receives the electronic file, automated edit checks run against the data within minutes. If every cross-check passes, the filing posts to the company’s record and becomes available to all state regulators. If an edit fails, the filing carries an error status until you correct and refile.
Your state of domicile then reviews the statement as part of ongoing financial surveillance. Analysts compare the Five-Year Historical trends, run the Risk-Based Capital Report due March 1, and flag any ratios that fall outside normal ranges. A weak result can trigger questions, a targeted exam, or a request for a corrective plan.
A common misconception is that filing ends the obligation. In reality, the March 1 statement is followed by quarterly filings (due May 15, August 15, and November 15) and by the later annual supplements. The society stays in a continuous reporting cycle all year, and a late quarterly can draw the same penalties as a late annual.
Mistakes to Avoid When Filling Out the Form
Each field on this blank is a potential error, and the cross-checks are unforgiving. Watch for these:
- Liabilities Line 1 not tying to Exhibit 5. This is the most common hard edit, and it blocks transmission until fixed.
- Reporting nonadmitted assets in Column 3. This overstates surplus and draws an immediate exam finding.
- Wrong officers signing the Jurat. The statement is treated as unsworn and not properly filed.
- Skipping notarization where required. The home state can reject the entire submission.
- Schedule T total not matching Exhibit 1 premium. This raises questions about unlicensed activity and fails a cross-check.
- Renaming or inserting lines between pre-printed captions. This breaks automated data capture and corrupts the file.
- Filing the Actuarial Opinion as data instead of a separate PDF. The opinion is treated as missing.
- Forgetting states written at zero on Schedule T. This understates your licensed footprint.
- Re-keying prior years on the Five-Year Historical page. A typo creates a trend that contradicts last year’s filing.
- Missing CUSIPs on Schedule D. This produces investment-schedule edits that hold up the filing.
- Sending domicile-only schedules to the NAIC. This clutters the record and is not the prescribed channel.
- Using a stale officer and director roster. It creates an interrogatory mismatch and an exam note.
Do’s and Don’ts
Do:
- Do confirm the current revision of the blank, because the Blanks (E) Working Group changes it yearly.
- Do tie every total to its supporting exhibit, because cross-checks compare them automatically.
- Do keep the Fraternal Instructions open beside the software, since they explain every ambiguous line.
- Do save your electronic acknowledgment, because it is your proof of timely filing.
- Do reconcile to the prior-year statement first, so beginning balances and trends agree.
- Do have the appointed actuary sign off on all reserve figures before you lock the statement.
Don’t:
- Don’t insert write-ins between pre-printed lines, because it breaks data capture.
- Don’t report market value where statutory cost applies, since that misstates assets.
- Don’t plug figures to force a page to balance, because examiners trace every reconciliation.
- Don’t file blank schedules, since you must write “None” instead.
- Don’t miss the March 1 deadline, because late filings draw state penalties.
- Don’t treat interrogatories as boilerplate, since false answers are exam findings.
Pros and Cons of Filing on Your Own vs. With Help
Filing in-house (pros):
- Lower cost, because you avoid outside preparer fees.
- Faster internal questions, since your staff knows the society’s records.
- Better year-round control, because the team stays close to the data.
- Direct ownership of cross-checks, so you learn the edits over time.
- Easier quarterly continuity, since the same team handles all filings.
Using a professional preparer or actuary (cons of going it alone):
- Reduced error risk, because specialists know the cross-checks cold.
- Reserve accuracy, since a qualified actuary must certify Exhibit 5 regardless.
- Audit alignment, because the same firm can coordinate the June 1 audited report.
- Regulatory credibility, since examiners trust experienced preparers.
- Time savings, because outside teams file these blanks every year.
NAIC Annual Statement Blank – Fraternal vs. Life Blank
| Feature | Fraternal Blank |
|---|---|
| Who files | Fraternal benefit societies with a lodge system |
| Capital structure shown | Surplus and unassigned funds (no capital stock) |
| Governing model law | Uniform Fraternal Code, Model 675 |
| Member returns | Reported as refunds/dividends in Exhibit 4 |
| Core financial pages | Nearly identical to the Life blank |
| Deadline | March 1, per NAIC schedule |
Frequently Asked Questions
Is the fraternal annual statement due March 1?
Yes. The 2025 annual statement and most supplements are due to the NAIC and the state of domicile on or before March 1, 2026, per the official NAIC filing-deadline schedule.
Do I file the fraternal blank on paper with the NAIC?
No. The NAIC accepts the filing over the internet only. Paper or faxed pages are not acceptable for the NAIC copy, though some schedules go to your state on paper.
Must a small single-state lodge still file?
Yes. Every licensed fraternal society files an annual statement. Size changes which supplements apply, not whether the statement itself is required.
Does Liabilities Line 1 have to match Exhibit 5?
Yes. The aggregate life reserve on Liabilities Line 1 must equal the Exhibit 5 total to the dollar, or the filing fails a hard cross-check.
Do I report nonadmitted assets in Column 3 of the Assets page?
No. Column 3 shows net admitted assets only. Nonadmitted amounts go in Column 2, and including them in Column 3 overstates surplus.
Should I list a state on Schedule T if I wrote no premium there?
Yes. If you are licensed in that state, list it with a zero. Schedule T confirms where you are authorized to collect premium.
Can any officer sign the Jurat page?
No. The blank names which officers must sign, and the signatures must be notarized where the state requires. Substitute signers do not satisfy the jurat.
Do U.S. branches of alien fraternals report worldwide business?
No. A U.S. branch reports only the business done in the United States, with the balancing difference flowing to Liabilities Line 29.
Is the Actuarial Opinion filed as part of the data file?
No. The Actuarial Opinion is filed as a separate PDF by March 1. Filing it as data leaves the opinion treated as missing.
Can I insert my own write-in lines between pre-printed items?
No. You may not change captions or insert lines between pre-printed items. Write-ins go in the designated write-in sections and overflow to Page 52.
Does the cash flow page have to match the Summary of Operations?
No. The cash flow page uses a cash basis while the Summary of Operations uses accrual, so the two pages will not mirror each other.
Are detailed investment schedules sent to the NAIC?
No. Schedules A, B, BA, D Parts 1–6, DA, DB, DL, and E go in paper to the state of domicile only, unless another state specifically requests them.
Is there a filing fee paid to the NAIC for the statement?
No. The NAIC does not charge a fee for the statement filing itself, but you pay a license fee to your approved annual statement software vendor.
Does filing on March 1 end my reporting for the year?
No. Quarterly statements follow on May 15, August 15, and November 15, along with later annual supplements, so reporting continues all year.
Related reading
- How to Fill Out NAIC Form F (w/Examples) + FAQs
- How to Fill Out the NAIC Annual Statement Blank
- How to Fill Out the NAIC Annual Statement – Health (Complete Line-by-Line Guide + FAQs)
- How to Fill Out the NAIC Annual Statement — Life and Accident & Health + FAQs
- How to Fill Out the NAIC Annual Statement – Property and Casualty + FAQs
- How to Fill Out NAIC MAR Filing (w/Examples) + FAQs
- How to Fill Out NAIC Form C (w/Examples) + FAQs