1120-L U.S. Life Insurance Company Income Tax Return

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Form

1120-L

Department of the Treasury
Internal Revenue Service

U.S. Life Insurance Company Income Tax Return

For calendar year 2021 or tax year beginning

1 Consolidated return
(attach Form 851)
2 Life-nonlife
consolidated return

Please
print
or
type

2021

, 20

Go to www.irs.gov/Form1120L for instructions and the latest information.

▶

A Check if:

, 2021, ending

OMB No. 1545-0123

Name

B Employer identification number

Number, street, and room or suite no. If a P.O. box, see instructions.

C Date incorporated

DRAFT AS OF
September 29, 2021
DO NOT FILE
3 Schedule M-3 (Form
1120-L) attached

Final return

(2)

(3)

Name change

(4)

Address change

Amended return

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2
3a
3b

Investment income (Schedule B, line 6) (see instructions) .
Capital gain net income (Schedule D (Form 1120)) . . .
Other income (attach statement) . . . . . . . .
Life insurance company gross income. Add lines 1 through 7

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7

9
10

Death benefits, etc. . . . . . . . . . .
Net increase, if any, in reserves (Schedule F, line 12)

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8
9
10

11a
b
12

Increase in reserves under section 807(f) . . . . . .
Deduction from Reserve Transition Relief (see instructions)
Deductible policyholder dividends under section 808 . .

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11a
11b
12

13
14
15a

Assumption by another person of liabilities under insurance, etc., contracts
Dividends reimbursable by taxpayer . . . . . . . . . . . .
Interest ▶
b Less tax-exempt interest expense ▶

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c Balance ▶

13
14
15c

16
17
18

Deductible policy acquisition expenses (Schedule G, line 20) .
Reserved for future use . . . . . . . . . . . .
Other deductions (see instructions) (attach statement) . . .

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16
17
18

19
20
21a

Add lines 9 through 18 . . . . . . . . . . . . . . .
Subtotal. Subtract line 19 from line 8 . . . . . . . . . . .
Dividends-received and other special deductions (Schedule A, line 22) .

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21a

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19
20

22
23
24

Plus: b. Net operating loss deduction (see instructions) (attach statement) . .
Gain or (loss) from operations. Subtract line 21c from line 20 . . . . . .
Life insurance company taxable income (LICTI). Enter line 22 here . . . .
Phased inclusion of balance of policyholders surplus account (see instructions)

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25
26

Taxable income. Add lines 23 and 24 (see instructions)
Total tax (Schedule K, line 10) . . . . . . . .

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24
25
26

27
28a
c

Reserved for future use . . . .
2020 overpayment credited to 2021

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28a
28c

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Line 28b is
reserved.

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) 28e
28f
28g

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28h
28i
28j

Tax, Refundable Credits, and Payments

Income (line 6 is reserved)

(1)

1

Deductions (See instructions for limitations on deductions.)

E Check if:

D Check applicable box if an
election has been made under
section(s):
953(c)(3)(C)
953(d)

City or town, state or province, country, and ZIP or foreign postal code

Gross premiums, etc., less return premiums, etc. Enter balance .

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2
3a
b

Net decrease, if any, in reserves (Schedule F, line 12) .
Decrease in reserves under section 807(f)
. . . .
Income from Reserve Transition Relief (see instructions)

4
5
7
8

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Less 2021 refund applied for on Form 4466 .
Tax deposited with Form 7004 . . . . .
Credits: (1) Form 2439 ▶

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d
f
g
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U.S. income tax paid or withheld at source (attach Form 1042-S) .
Reserved for future use . . . . . . . . . . . . .
Reserved for future use . . . . . . . . . . . . .

29
30
31
32

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2021 estimated tax payments

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28d (
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(2) Form 4136 ▶

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21b
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Estimated tax penalty. Check if Form 2220 is attached . . . . . . . . . . .
Amount owed. If line 28k is smaller than the total of lines 26 and 29, enter amount owed
Overpayment. If line 28k is larger than the total of lines 26 and 29, enter amount overpaid
Enter amount from line 31: Credited to 2022 estimated tax . ▶

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. . .
Refunded

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31

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32

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▲

Paid
Preparer
Use Only

28k
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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below?
See instructions. Yes
No
Date
Title
Signature of officer
▲

Sign
Here

21c
22
23

Print/Type preparer’s name

Firm’s name

▶

Firm’s address

▶

Preparer’s signature

For Paperwork Reduction Act Notice, see separate instructions.

Date

PTIN
Check
if
self-employed
Firm’s EIN

▶

Phone no.
Cat. No. 11480E

Form 1120-L (2021)

Form 1120-L (2021)

Schedule A

Page 2
Dividends, Inclusions, Dividends-Received Deduction, and Other Special Deductions (see instructions)
(a) Dividends and
inclusions

Dividends subject to proration
1

Dividends from less-than-20%-owned domestic corporations (other than
debt-financed stock) . . . . . . . . . . . . . . . . .

(c) Deductions
((a) times (b))

(b) %

50

1

DRAFT AS OF
September 29, 2021
DO NOT FILE
2

Dividends from 20%-or-more-owned domestic corporations (other than
debt-financed stock) . . . . . . . . . . . . . . . . .

3

Dividends on certain debt-financed stock of domestic and foreign
corporations . . . . . . . . . . . . . . . . . . .

4
5

Dividends on certain preferred stock of less-than-20%-owned public utilities
Dividends on certain preferred stock of 20%-or-more-owned public utilities .

6

Dividends from less-than-20%-owned foreign corporations and certain
foreign sales corporations (FSCs) . . . . . . . . . . . . .

7
8
9
10
11
12

Dividends from 20%-or-more-owned foreign corporations and certain FSCs
Dividends from wholly owned foreign subsidiaries and certain FSCs . . .
Dividends from certain affiliated companies . . . . . . . . . .
Gross dividends-received deduction. Add lines 1 through 9
. . . . .
Company share percentage . . . . . . . . . . . . . . .
Prorated amount. Line 10 times line 11
. . . . . . . . . . .

13

Affiliated company dividends

14
15

Dividends from foreign corporations not included on line 3, 6, 7, 8, or 14
(including hybrid dividends) . . . . . . . . . . . . . . .

16

Reserved for future use .

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16

17a

Subpart F inclusions derived from the sale by a controlled foreign
corporation (CFC) of the stock of a lower-tier foreign corporation treated as
a dividend (attach Form(s) 5471) (see instructions) . . . . . . . .

17a

b

Subpart F inclusions derived from hybrid dividends of tiered corporations
(attach Form(s) 5471) (see instructions)
. . . . . . . . . . .

17b

c

Other inclusions from CFCs under subpart F not included on line 17a, 17b,
or 18 (attach Form(s) 5471) (see instructions) . . . . . . . . . .

2

65

3
4
5

see instructions
23.3
26.7

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7
8
9
10
11
12

50
65
100
100

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13

see instructions

Foreign-source portion of dividends received from a specified 10%-owned
foreign corporation (excluding hybrid dividends) (see instructions)
. . .

14

100

0.7

Dividends not subject to proration

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17c
18
19

18
19

Global intangible low-taxed income (GILTI) (attach Form(s) 5471 and 8992) .
Other corporate dividends . . . . . . . . . . . . . . .

20

Total dividends and inclusions. Add lines 1 through 19, column (a). Enter
here and on Schedule B, line 2 . . . . . . . . . . . . . .

21

Section 250 deduction (attach Form 8993)

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21

22

Total deductions. Add lines 12, 13, 14, 17a, and 21, column (c). Enter here
and on page 1, line 21a . . . . . . . . . . . . . . . .

22

Schedule B

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100

Investment Income (see instructions)

1

Interest (excluding tax-exempt interest)

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1

2
3
4

Total dividends and inclusions (Schedule A, line 20, column (a))
Rents . . . . . . . . . . . . . . . . .
Royalties . . . . . . . . . . . . . . . .

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2
3
4

5
6

Leases, terminations, etc. . . . . . . . . . . . . . . .
Investment income. Add lines 1 through 5. Enter here and on page 1, line 4 .

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Form 1120-L (2021)

Page 3

Form 1120-L (2021)

Schedule F

Increase (Decrease) in Reserves (section 807) (see instructions)
(a) Beginning
of tax year

1
2
3
4
5
6
7

Life insurance reserves . . . . . .
Unearned premiums and unpaid losses .
Supplementary contracts
. . . . .
Dividend accumulations and other amounts
Advance premiums . . . . . . .
Special contingency reserves . . . .
Add lines 1 through 6 . . . . . . .

8
9a

Increase (decrease) in reserves under section 807. Subtract line 7, column (a), from line 7, column (b)
Tax-exempt interest . . . . . . . . . . . . . . . . . . . .
9a

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(b) End of tax year

1
2
3
4
5
6
7

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DRAFT AS OF
September 29, 2021
DO NOT FILE
b
c

10

Increase in policy cash value of section 264(f) policies as defined in section 805(a)(4)(F)
Add lines 9a and 9b . . . . . . . . . . . . . . . . . . . .
Policyholders’ share percentage . . . . . . . . . . . . . . . .

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9c
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8

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10

11

Policyholders’ share of tax-exempt interest and the increase in policy cash value of section 264(f) policies as
defined in section 805(a)(4)(F). Multiply line 9c by line 10
. . . . . . . . . . . . . . . . .

11

12

Net increase (decrease) in reserves. Subtract line 11 from line 8. If an increase, enter here and on page 1,
line 10. If a decrease, enter here and on page 1, line 2 . . . . . . . . . . . . . . . . . .

12

Schedule G

Policy Acquisition Expenses (section 848) (see instructions)

(a) Annuity

1

Gross premiums and other consideration .

2

Return premiums and premiums and other consideration incurred for
reinsurance
. . . . . . . . . . . . . . . . . .

3
4
5

Net premiums. Subtract line 2 from line 1
Net premium percentage (see instructions)
Multiply line 3 by line 4 . . . . . .

6
7
8
9

Combine line 5, columns (a), (b), and (c), and enter here. If zero or less, enter -0- on lines 7 and 8
Unused balance of negative capitalization amount from prior years . . . . . . . . .
Combine lines 6 and 7. If zero or less, enter -0- . . . . . . . . . . . . . . .
General deductions (attach statement) . . . . . . . . . . . . . . . . . .

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(b) Group life
insurance

2
3
4
5

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6
7
8
9

10
11
12

Enter the lesser of line 8 or line 9 . . . . . . . . . . . . . . . . . . . . . . .
Deductible general deductions. Subtract line 10 from line 9. Enter here and include on page 1, line 18 . . .
If the amount on line 6 is negative, enter it as a positive amount. If the amount on line 6 is positive, enter -0- .

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10
11
12

13
14

Unamortized specified policy acquisition expenses from prior years . . . .
Deductible negative capitalization amount. Enter the lesser of line 12 or line 13 .

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13
14

15a

Tentative 60-month specified policy acquisition expenses. Enter amount from line 10,
but not more than $5 million . . . . . . . . . . . . . . . . . .

b
16

Limitation . . . . . . . . . . . . . . . . . . . .
Phase-out amount. Subtract line 15b from line 10. If zero or less, enter -0- .

17a

Current year 60-month specified policy acquisition expenses. Subtract line 16 from line
15a. If zero or less, enter -0. . . . . . . . . . . . . . . . .

18a
b
19
20

Enter 10% (0.10) of line 17a .

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15a
15b
16

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(

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$10,000,000

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17b

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18a
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18b

Current year 180-month specified policy acquisition expenses. Subtract line 17a from
line 10 . . . . . . . . . . . . . . . . . . . . . . . .
Enter 3.34% (0.0334) of line 18a

(c) Other

1

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b

30%

Enter the applicable amount of amortization from specified policy acquisition expenses capitalized in prior years
and deductible this year. Attach statement . . . . . . . . . . . . . . . . . . . . .
Deductible policy acquisition expenses. Add lines 14, 17b, 18b, and 19. Enter here and on page 1, line 16 . .

19
20
Form 1120-L (2021)

Page 4

Form 1120-L (2021)

Schedule K

Tax Computation (see instructions)

1
2
3

Check if the corporation is a member of a controlled group (attach Schedule O (Form 1120)) .
Income tax . . . . . . . . . . . . . . . . . . . . . . . . .
Base erosion minimum tax amount (attach Form 8991) . . . . . . . . . . . .

4
5a
b

Add lines 2 and 3 . . . . . . . .
Foreign tax credit (attach Form 1118) . .
Credit from Form 8834 (attach Form 8834)

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General business credit (attach Form 3800) . . .
Credit for prior year minimum tax (attach Form 8827)
Bond credits from Form 8912 . . . . . . .

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Total credits. Add lines 5a through 5e
. . . . . . . . . . . . .
Subtract line 6 from line 4 . . . . . . . . . . . . . . . . .
Foreign corporations—tax on income not effectively connected with U.S. business

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▶

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2
3

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5a
5b

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4

DRAFT AS OF
September 29, 2021
DO NOT FILE
c
d
e

6
7
8

9
10

Other taxes. Check if from:
Form 4255
Form 8611
Total tax. Add lines 7 through 9. Enter here and on page 1, line 26

Schedule L

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5c
5d
5e

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6
7
8

Other (attach statement) .
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9
10

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Part I—Total Assets (see instructions)

(a) Beginning
of tax year

1
2
3
4
5

Real property . . . . . . . . . . .
Stocks . . . . . . . . . . . . .
Proportionate share of partnership and trust assets
Other assets (attach statement) . . . . . .
Total assets. Add lines 1 through 4 . . . .

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(b) End of tax year

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Part II—Total Assets and Total Insurance Liabilities (section 842(b)(2)(B)(i)) (see instructions)
Note: The information provided in Part II should conform with the “Assets” and “Liabilities, Surplus, and Other Funds” sections of
the NAIC Annual Statement.
(a) Beginning
of tax year

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11

Subtotals for assets . . . . . . . . . . . . . . . .
Total assets . . . . . . . . . . . . . . . . . .
Reserve for life policies and contracts . . . . . . . . . . .
Reserve for accident and health policies . . . . . . . . . .
Liability for deposit-type contracts . . . . . . . . . . . .
Life policy and contract claims . . . . . . . . . . . . .
Accident and health policy and contract claims . . . . . . . .
Policyholder’s dividend and coupon accumulations . . . . . . .
Premiums and annuity considerations received in advance less discount
Surrender values on canceled policies . . . . . . . . . . .
Part of other amounts payable on reinsurance assumed
. . . . .

12

Part of aggregate write-ins for liabilities. (Only include items or amounts includible in “total
insurance liabilities on U.S. business” as defined in section 842(b)(2)(B)(i)) . . . . . .

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14

Separate accounts statement . . . . . . .
Total insurance liabilities. Add lines 3 through 13 .

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(b) End of tax year

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Form 1120-L (2021)

Page 5

Form 1120-L (2021)

Schedule M

Other Information (see instructions)
Yes

1
a
b

Check accounting method:
Accrual

No

Yes
8c

Other (specify) ▶

No

The corporation may have to file Form 5472,
Information Return of a 25% Foreign-Owned U.S.
Corporation or a Foreign Corporation Engaged in a
U.S. Trade or Business. Enter number of Forms
5472 attached. ▶

DRAFT AS OF
September 29, 2021
DO NOT FILE
2

Check if the corporation is a:

a

Legal reserve company—if checked
Kind of company:
(1)
Stock
(2)
Mutual

9

Does the corporation discount any of the loss
reserves shown on its annual statement? . . .

10a

Enter the total unpaid losses shown on the
corporation’s annual statement:
(1) For the current year:
$
(2) For the previous year:
$

b

Enter the total unpaid loss adjustment expenses
shown on the corporation’s annual statement:
$
(1) For the current year:
$
(2) For the previous year:

Principal business:
(1)
Life insurance
(2)
Health and accident insurance

b
c

3

Fraternal or assessment association
Burial or other insurance company

Enter the percentage that the total of the
corporation’s life insurance reserves (section 816(b))
plus unearned premiums and unpaid losses
(whether or not ascertained) on noncancelable life,
health, or accident policies not included in life
insurance reserves bears to the corporation’s total
reserves (section 816(c)) . . ▶
%.

11

Enter the available net operating loss carryover from
prior tax years. (Do not reduce it by any deduction
on page 1, line 21b.) . . ▶ $

Attach a statement showing the computation.

12a

Enter the corporation’s state of domicile. ▶

4

Does the corporation have any variable annuity
contracts outstanding? . . . . . . . .

5

At the end of the tax year, did the corporation own,
directly or indirectly, 50% or more of the voting
stock of a domestic corporation? (For rules of
attribution, see section 267(c).) . . . . . .
If “Yes,” attach a statement showing (a) name and
employer identification number (EIN), (b) percentage
owned, and (c) taxable income or (loss) before NOL
and special deductions of such corporation for the
tax year ending with or within your tax year.

6

7

At the end of the tax year, did any individual,
partnership, corporation, estate, or trust own, directly
or indirectly, 50% or more of the corporation’s voting
stock? (For rules of attribution, see section 267(c).)
If “Yes,” complete a and b below.

a

b
8

Attach a statement showing name and identifying
number. (Do not include any information already
entered on line 6 above.)
Enter percentage owned. ▶
At any time during the year, did one foreign person
own, directly or indirectly, at least 25% of (a) the
total voting power of all classes of stock of the
corporation entitled to vote, or (b) the total value of
all classes of stock of the corporation?
. . .

Was the annual statement used to prepare the tax
return filed with the state of domicile? . . . .
If “No,” complete c below.

c

Enter the state where the annual statement used to
prepare the tax return was filed. ▶

13

Is the corporation required to file Schedule UTP
(Form 1120), Uncertain Tax Position Statement?
See instructions
. . . . . . . . . .
If “Yes,” complete and attach Schedule UTP.

14

Does the corporation have gross receipts of at least
$500 million in any of the 3 preceding tax years?
(See section 59A(e)(2) and (3).) . . . . . .
If “Yes,” complete and attach Form 8991.

15

During the tax year, did the corporation pay or
accrue any interest or royalty for which the
deduction is not allowed under section 267A? See
instructions . . . . . . . . . . . .

Is the corporation a subsidiary in an affiliated group
or a parent-subsidiary controlled group? . . .
If “Yes,” enter name and EIN of the parent
corporation. ▶

b

If “Yes,” enter the total amount of the disallowed
▶ $
deductions . . . .
16

Did the corporation have an election under section
163(j) for any real property trade or business or any
farming business in effect during the tax year? See
instructions . . . . . . . . . . . .

17

Is the corporation required to file Form 8990,
Limitation on Business Interest Expense Under
Section 163(j), to calculate the amount of deductible
business interest? See instructions . . . . .

If “Yes,” enter:
a Percentage owned and ▶
b Owner’s country. ▶
Form 1120-L (2021)