UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 ------- FORM 10-Q (MARK ONE) [X] QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 FOR THE QUARTERLY PERIOD ENDED MARCH 31, 2004 OR [ ] TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 FOR THE TRANSITION PERIOD FROM TO Commission file number 033-37576 FORTIS BENEFITS INSURANCE COMPANY (Exact name of registrant as specified in its charter) MINNESOTA 81-0170040 (State or Other Jurisdiction (I.R.S. Employer of Incorporation or Organization) Identification No.) 576 BIELENBERG DRIVE WOODBURY, MINNESOTA 55125 (Address of Principal Executive Offices) (Zip Code) (651) 361-4000 (Registrant's Telephone Number, Including Area Code) Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes [X] No [ ] Indicate by check mark whether the registrant is an accelerated filer (as defined in Exchange Act Rule 12b-2). Yes [ ] No [X] The number of shares of the registrant's Common Stock outstanding at April 30, 2004 was 1,000,000, all of which are owned by Assurant, Inc. THE REGISTRANT MEETS THE CONDITIONS SET FORTH IN GENERAL INSTRUCTION H(1)(a) AND (b) OF FORM 10-Q AND IS THEREFORE FILING THIS FORM WITH REDUCED DISCLOSURE FORMAT. FORTIS BENEFITS INSURANCE COMPANY QUARTERLY REPORT ON FORM 10-Q FOR THE QUARTERLY PERIOD ENDED MARCH 31, 2004 TABLE OF CONTENTS ITEM PAGE NUMBER NUMBER PART I FINANCIAL INFORMATION 1. FINANCIAL STATEMENTS ................................................................... 2 Unaudited interim consolidated balance sheets of Fortis Benefits Insurance Company at March 31, 2004 and December 31, 2003 2 Unaudited interim consolidated statements of operations of Fortis Benefits Insurance Company for the three months ended March 31, 2004 and 2003 4 Unaudited interim consolidated statements of changes in stockholder's equity of Fortis Benefits Insurance Company for the three months ended March 31, 2004 5 Unaudited interim consolidated statement of cash flows of Fortis Benefits Insurance Company for the three months ended March 31, 2004 and 2003 6 Notes to the unaudited consolidated financial statements of Fortis Benefits Insurance Company 7 2. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS ............................................................................. 9 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK * ........................... 11 4. CONTROLS AND PROCEDURES ................................................................ 11 PART II OTHER INFORMATION 1. LEGAL PROCEEDINGS ...................................................................... 12 2. CHANGES IN SECURITIES, USE OF PROCEEDS AND ISSUER PURCHASES OF EQUITY SECURITIES * ..... 12 3. DEFAULTS UPON SENIOR SECURITIES * ...................................................... 12 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS * .................................. 12 5. OTHER INFORMATION ...................................................................... 12 6. EXHIBITS AND REPORTS ON FORM 8-K ....................................................... 12 SIGNATURES ................................................................................... 14 * NOT REQUIRED UNDER REDUCED DISCLOSURE PURSUANT TO GENERAL INSTRUCTION H(1) (A) AND (B) OF FORM 10Q 1 FORTIS BENEFITS INSURANCE COMPANY CONSOLIDATED BALANCE SHEETS AT MARCH 31, 2004 (UNAUDITED) AND DECEMBER 31, 2003 - -------------------------------------------------------------------------------- MARCH 31, DECEMBER 31, 2004 2003 ---------- ------------ (IN THOUSANDS) ASSETS Investments: Fixed maturities available for sale, at fair value (amortized cost - $ 3,211,724 in 2004 and $ 3,227,043 in 2003) $3,506,938 3,452,299 Equity securities available for sale, at fair value (cost - $219,660 in 2004 and $199,287 in 2003) 230,883 208,149 Commercial mortgage loans on real estate at amortized cost 678,527 634,615 Policy loans 10,686 10,678 Short-term investments 121,116 71,057 Other investments 58,237 51,831 ---------- ---------- Total investments 4,606,387 4,428,629 Cash and cash equivalents 40,921 29,176 Premiums and accounts receivable 69,209 77,094 Reinsurance recoverables 1,219,508 1,210,299 Accrued investment income 54,582 49,756 Deferred acquisition costs 110,641 92,117 Property and equipment, at cost less accumulated depreciation 2,291 2,566 Deferred income taxes, net 24,401 54,249 Goodwill 156,915 156,985 Value of business acquired 44,035 45,710 Other assets 40,443 41,710 Assets held in separate accounts 3,510,489 3,516,070 ---------- ---------- Total assets $9,879,822 $9,704,361 ========== ========== 2 See the accompanying notes to the consolidated financial statements FORTIS BENEFITS INSURANCE COMPANY CONSOLIDATED BALANCE SHEETS AT MARCH 31, 2004 (UNAUDITED) AND DECEMBER 31, 2003 - -------------------------------------------------------------------------------- MARCH 31, DECEMBER 31, 2004 2003 ---------- ------------ (IN THOUSANDS EXCEPT NUMBER OF SHARES) LIABILITIES Future policy benefits and expenses $2,878,386 $2,869,324 Unearned premiums 56,451 50,002 Claims and benefits payable 1,852,880 1,810,847 Commissions payable 16,809 15,918 Reinsurance balances payable 7,573 5,138 Funds held under reinsurance 102 100 Deferred gain on disposal of businesses 238,623 249,481 Due to affiliates 5,824 3,478 Accounts payable and other liabilities 190,118 141,309 Tax payable 32,411 22,112 Liabilities related to separate accounts 3,510,489 3,516,070 ---------- ---------- Total liabilities 8,789,666 8,683,779 STOCKHOLDER'S EQUITY Common stock, $5 par value, 1,000,000 shares authorized, issued and outstanding 5,000 5,000 Additional paid-in capital 516,570 516,570 Retained earnings 365,323 342,610 Accumulated other comprehensive income 203,263 156,402 ---------- ---------- Total stockholder's equity 1,090,156 1,020,582 ---------- ---------- Total liabilities and stockholder's equity $9,879,822 $9,704,361 ========== ========== 3 See the accompanying notes to the consolidated financial statements FORTIS BENEFITS INSURANCE COMPANY CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) THREE MONTHS ENDED MARCH 31, 2004 AND 2003 - -------------------------------------------------------------------------------- THREE MONTHS ENDED MARCH 31, --------------------------- 2004 2003 -------- --------- (IN THOUSANDS) REVENUES Net earned premiums and other considerations $438,558 $ 431,048 Net investment income 67,096 62,099 Net realized gain (loss) on investments 3,592 (4,557) Amortization of deferred gain on disposal of businesses 10,858 14,971 Fees and other income 3,890 3,271 -------- --------- Total revenues 523,994 506,832 BENEFITS, LOSSES AND EXPENSES Policyholder benefits 355,278 343,378 Amortization of deferred acquisition costs and value of business acquired 14,950 13,266 Underwriting, general and administrative expenses 119,015 122,126 -------- --------- Total benefits, losses and expenses 489,243 478,770 -------- --------- Income before income taxes 34,751 28,062 Income taxes 12,038 9,762 -------- --------- Net income $ 22,713 $ 18,300 ======== ========= 4 See the accompanying notes to the consolidated financial statements FORTIS BENEFITS INSURANCE COMPANY CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDER'S EQUITY FROM DECEMBER 31, 2003 THROUGH MARCH 31, 2004 (UNAUDITED) - -------------------------------------------------------------------------------- ACCUMULATED ADDITIONAL OTHER COMMON PAID-IN RETAINED COMPREHENSIVE STOCK CAPITAL EARNINGS INCOME (LOSS) TOTAL ------------ ------------ ------------ -------------- ------------ (IN THOUSANDS) Balance, December 31, 2003 $ 5,000 $ 516,570 $ 342,610 $ 156,402 $ 1,020,582 Comprehensive income: Net income -- -- 22,713 -- 22,713 Net change in unrealized gains on securities -- -- -- 47,152 47,152 Foreign currency translation -- -- -- (291) (291) ------------ Total comprehensive income 69,574 ------------ ------------ ------------ ------------ ------------ Balance, March 31, 2004 $ 5,000 $ 516,570 $ 365,323 $ 203,263 $ 1,090,156 ============ ============ ============ ============ ============ 5 See the accompanying notes to the consolidated financial statements FORTIS BENEFITS INSURANCE COMPANY CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) THREE MONTHS ENDED MARCH 31, 2004 AND 2003 - -------------------------------------------------------------------------------- THREE MONTHS ENDED MARCH 31, --------------------------- 2004 2003 --------- --------- (IN THOUSANDS) OPERATING ACTIVITIES Net cash provided by operating activities 116,403 62,126 INVESTING ACTIVITIES Sales of: Fixed maturities available for sale 244,024 201,199 Equity securities available for sale 10,995 6,660 Property and equipment -- 106 Other invested assets 2,292 2,769 Maturities, prepayments, and scheduled redemption of: Fixed maturities available for sale -- -- Purchases of: Fixed maturities available for sale (228,066) (370,950) Equity securities available for sale (30,957) (66,147) Other invested assets (8,716) (2,236) Change in commercial mortgage loans on real estate (44,171) (4,605) Change in short-term investments (50,059) 136,506 --------- --------- Net cash (used in) investing activities (104,658) (96,698) Change in cash and cash equivalents 11,745 (34,572) Cash and cash equivalents at beginning of period 29,176 49,575 --------- --------- Cash and cash equivalents at end of period $ 40,921 $ 15,003 ========= ========= 6 See the accompanying notes to the consolidated financial statements FORTIS BENEFITS INSURANCE COMPANY NOTES TO CONSOLIDATED FINANCIAL STATEMENTS THREE MONTHS ENDED MARCH 31, 2004 AND 2003 (UNAUDITED) - -------------------------------------------------------------------------------- 1. NATURE OF OPERATIONS Fortis Benefits Insurance Company (the "Company") is a provider of life and health insurance products. At January 1, 2004, the Company was an indirect wholly owned subsidiary of Assurant, Inc. (formerly Fortis, Inc), which itself was an indirect, wholly owned subsidiary of Fortis N.V. of the Netherlands and Fortis SA/NV of Belgium (collectively, "Fortis") through their affiliates, including their wholly owned subsidiary, Fortis Insurance N.V. On February 5, 2004, Fortis sold approximately 65% of its ownership interest in Assurant, Inc. via an Initial Public Offering ("IPO"). In connection with the IPO, Fortis, Inc. was merged into Assurant, Inc., a Delaware corporation, which was formed solely for the purpose of the redomestication of Fortis, Inc. After the merger, Assurant, Inc. became the successor to the business, operations and obligations of Fortis, Inc. Assurant, Inc. is traded on the New York Stock Exchange under the symbol AIZ. The Company is incorporated in Minnesota and distributes its products in all states except New York. The Company's revenues are derived principally from group employee benefits products and from individual pre-funded funeral products. The Company offers insurance products, including life insurance policies, annuity contracts, and group life, accident and health insurance policies. 2. BASIS OF PRESENTATION The accompanying unaudited interim consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America ("GAAP") for interim financial information. Accordingly, these statements do not include all of the information and footnotes required by generally accepted accounting principles for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Certain prior period amounts have been reclassified to conform to the 2004 presentation. Dollar amounts are presented in U.S. dollars and all amounts are in thousands except for number of shares and per share amounts. The consolidated financial statements include the accounts of the Company and all of its wholly owned subsidiaries. All significant inter-company transactions and balances are eliminated in consolidation. Operating results for the three months ended March 31, 2004 are not necessarily indicative of the results that may be expected for the year ending December 31, 2004. The accompanying interim consolidated financial statements should be read in conjunction with the audited consolidated financial statements and related notes on form 10K for the year ended December 31, 2003. 3. RECENT ACCOUNTING PRONOUNCEMENTS On July 7, 2003, the Accounting Standards Executive Committee (AcSEC) of the American Institute of Certified Public Accountants (AICPA) issued Statement of Position 03-1, Accounting and Reporting by Insurance Enterprises for Certain Nontraditional Long Duration Contracts and for Separate Accounts 7 FORTIS BENEFITS INSURANCE COMPANY NOTES TO CONSOLIDATED FINANCIAL STATEMENTS THREE MONTHS ENDED MARCH 31, 2004 AND 2003 (UNAUDITED) - -------------------------------------------------------------------------------- ("SOP 03-1"). SOP 03-1 provides guidance on a number of topics unique to insurance enterprises, including separate account presentation, interest in separate accounts, gains and losses on the transfer of assets from the general account to a separate account, liability valuation, returns based on a contractually referenced pool of assets or index, accounting for contracts that contain death or other insurance benefit features, accounting for reinsurance and other similar contracts, accounting for annuitization benefits and sales inducements to contract holders. SOP 03-1 will be effective for the Company's financial statements on January 1, 2004. The adoption of this statement did not have a material impact on the Company's financial position or the results of operations. 4. RETIREMENT AND OTHER EMPLOYEE BENEFITS The Company is an indirect wholly-owned subsidiary of Assurant, Inc., which sponsors a defined benefit pension plan covering employees and certain agents who meet eligibility requirements as to age and length of service. Pension cost allocated to the Company amounted to approximately $1,751 and $1,482 for March 31, 2004 and 2003, respectively. The Company participates in a contributory profit sharing plan, sponsored by Assurant, Inc. covering employees and certain agents who meet eligibility requirements as to age and length of service. The amount expensed was approximately $1,548 and $1,764 for March 31, 2004 and 2003, respectively. In addition to retirement benefits, the Company participates in other health care and life insurance benefit plans (postretirement benefits) for retired employees, sponsored by Assurant, Inc. There were no net postretirement benefit costs allocated to the Company for the three months ended March 31, 2004 and 2003. The Company made contributions to the postretirement benefit plans of approximately $410 and $403 for March 31, 2004 and 2003, respectively, as claims were incurred. For the three months ended March 31, 2004 and 2003, the Company incurred expenses related to retirement benefits of $461 and $474, respectively. 5. INCOME TAXES The effective tax rate for the three months ended March 31, 2004 was 34.6% as compared to 34.8% for the three months ended March 31, 2003. 6. SUBSEQUENT EVENTS There are no subsequent events to report. 7. COMMITMENTS AND CONTINGENCIES The Company is regularly involved in litigation in the ordinary course of business, both as a defendant and as a plaintiff. The Company may from time to time be subject to a variety of legal and regulatory actions relating to the Company's current and past business operations. While the Company cannot predict the outcome of any pending or future litigation, examination or investigation, the Company does not believe that any pending matter will have a material adverse effect on the Company's financial condition or results of operations. 8 PART I FINANCIAL INFORMATION ITEM 2. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS. Management's Discussion and Analysis of Financial Condition and Results of Operations (MD&A) addresses the financial condition of Fortis Benefits Insurance Company and its subsidiaries (collectively, FBIC or the Company) as of March 31, 2004, compared with December 31, 2003, and its results of operations for the three months ended March 31, 2004, compared with the equivalent 2003 period. This discussion should be read in conjunction with FBIC's MD&A and annual audited financial statements as of December 31, 2003 filed with the Company's Form 10-K for the year ended December 31, 2003 filed with the U.S. Securities and Exchange Commission (hereafter referred to as the Company's 2003 Form 10-K) and unaudited consolidated financial statements and related notes included elsewhere in this Form 10-Q. Some of the statements in this MD&A and elsewhere in this report may contain forward-looking statements that reflect our current views with respect to, among other things, future events and financial performance. You can identify these forward-looking statements by the use of forward-looking words such as "outlook," "believes," "expects," "potential," "continues," "may," "will," "should," "seeks," "approximately," "predicts," "intends," "plans," "estimates," "anticipates" or the negative version of those words or other comparable words. Any forward-looking statements contained in this report are based upon our historical performance and on current plans, estimates and expectations. The inclusion of this forward-looking information should not be regarded as a representation by us or any other person that the future plans, estimates or expectations contemplated by us will be achieved. Such forward-looking statements are subject to various risks and uncertainties. Accordingly, there are or will be important factors that could cause our actual results to differ materially from those indicated in this report. If one or more of these or other risks or uncertainties materialize, or if our underlying assumptions prove to be incorrect, actual results may vary materially from what we projected. Any forward-looking statements you read in this report reflect our current views with respect to future events and are subject to these and other risks, uncertainties and assumptions relating to our operations, results of operations, financial condition, growth strategy and liquidity. 9 RESULTS OF OPERATIONS CONSOLIDATED OVERVIEW The table below presents information regarding our consolidated results of operations: FOR THE THREE MONTHS ENDED MARCH 31, 2004 2003 ------ ------ (IN MILLIONS) REVENUES: Net earned premiums and other considerations $ 439 $ 431 Net investment income 67 62 Net realized gains (losses) on investments 4 (4) Amortization of deferred gain on disposal of businesses 11 15 Fees and other income 3 3 ------ ------ Total revenues 524 507 ------ ------ BENEFITS, LOSSES AND EXPENSES: Policyholder benefits (355) (343) Selling, underwriting and general expenses(1) (134) (136) ------ ------ Total benefits, losses and expenses (489) (479) ------ ------ INCOME BEFORE INCOME TAXES 35 28 Income taxes (12) (10) ------ ------ NET INCOME $ 23 $ 18 ====== ====== - --------------- (1) Includes amortization of DAC and VOBA. THREE MONTHS ENDED MARCH 31, 2004 COMPARED TO THREE MONTHS ENDED MARCH 31, 2003 Total Revenues Total revenues increased by $17 million, or 3%, from $507 million for the three months ended March 31, 2003, to $524 million for the three months ended March 31, 2004. Net earned premiums and other considerations increased by $8 million, or 2%, from $431 million for the three months ended March 31, 2003, to $439 million for the three months ended March 31, 2004. The increase in net earned premiums and other considerations is primarily due to increases of $8 million and $5 million in small group health insurance and disability premiums, respectively, with offsetting decreases of $3 million, $1 million and $1 million in dental, life and pre-funded funeral premiums, respectively. The increase in small group health insurance business is primarily due to membership growth and premium rate increases. The increase in disability premiums is primarily due to the transition of a block of business from administrative fee only business to fully insured business. The decrease in dental was primarily driven by slightly lower sales. Net investment income increased by $5 million, or 8%, from $62 million for the three months ended March 31, 2003, to $67 million for the three months ended March 31, 2004. The increase was primarily due to an increase in invested assets, offset by a decrease in investment yields driven by the lower interest rate environment. Net realized gains (losses) on investments improved by $8 million from net realized losses of $4 million for the three months ended March 31, 2003, to net realized gains of $4 million for the three months ended March 31, 2004. 10 Amortization of deferred gain on disposal of businesses decreased by $4 million, or 27%, from $15 million for the three months ended March 31, 2003, to $11 million for the three months ended March 31, 2004. The decrease was consistent with the run-off of the businesses ceded to The Hartford in 2001 and John Hancock in 2000. Total Benefits, Losses and Expenses Total benefits, losses and expenses increased by $10 million, or 2%, from $479 million for the three months ended March 31, 2003, to $489 million for the three months ended March 31, 2004. Policyholder benefits increased by $12 million, or 3%, from $343 million for the three months ended March 31, 2003, to $355 million for the three months ended March 31, 2004. The increase was due to increases of $9 million, $3 million, $3 million and $2 million in small group health insurance, pre-funded funeral, dental and disability benefits, respectively, with offsetting decreases of $3 million in life and $2 million in consumer protection benefits. The increase in small group health insurance and disability benefits is consistent with the increases in the net earned premiums. The increase in pre-funded funeral benefits is primarily due to the normal growth in the inforce block of business. The increase in dental benefits is due to a slight deterioration in experience compared to an unusually favorable year in 2003. The decrease in life benefits is consistent with the decrease in earned premiums. The total policyholder benefit to premium ratio increased slightly from 79.7% for the three months ended March 31, 2003, to 80.9% for the three months ended March 31, 2004. Selling, underwriting and general expenses decreased by $2 million, or 1%, from $136 million for the three months ended March 31, 2003, to $134 million for the three months ended March 31, 2004. The decrease was primarily due to the capitalization of additional types of deferred acquisition costs in the first quarter of 2004 and non-recurring costs incurred in the first quarter of 2003 within the dental, disability and life business. Net Income Net income increased by $5 million, or 28%, from $18 million for the three months ended March 31, 2003, to $23 million for the three months ended March 31, 2004. Income taxes increased by $2 million, or 20%, from $10 million for the three months ended March 31, 2003, to $12 million for the three months ended March 31, 2004, which is consistent with the increase in pre-tax income. ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK. Not required under reduced disclosure format. ITEM 4. CONTROLS AND PROCEDURES. Under the supervision and with the participation of our Chief Executive Officer and our Chief Financial Officer, we have evaluated the effectiveness of our disclosure controls and procedures as of March 31, 2004. Based on this evaluation, our Chief Executive Officer and our Chief Financial Officer have concluded that our disclosure controls and procedures were effective as of that date in providing a reasonable level of assurance that information we are required to disclose in reports we file or furnish under the Securities Exchange Act of 1934 is recorded, processed, summarized and reported within the time periods in SEC rules and forms. Further, our disclosure controls and procedures were effective in providing a reasonable level of assurance that information required to be disclosed by us in such reports is accumulated and communicated to our management, including our Chief Executive Officer and our Chief Financial Officer, as appropriate to allow timely decisions regarding required disclosure. 11 PART II OTHER INFORMATION ITEM 1. LEGAL PROCEEDINGS. NONE. ITEM 2. CHANGES IN SECURITIES, USE OF PROCEEDS AND ISSUER PURCHASES OF EQUITY SECURITIES. Not required under reduced disclosure format. ITEM 3. DEFAULTS UPON SENIOR SECURITIES. Not required under reduced disclosure format. ITEM 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS. Not required under reduced disclosure format. ITEM 5. OTHER INFORMATION. (a) None. (b) Because all of the Company's outstanding common stock is held indirectly by Assurant, Inc., the Company does not file a Schedule 14A and has not adopted any procedures by which security holders may recommend nominees to the registrant's board of directors. ITEM 6 EXHIBITS AND REPORTS ON FORM 8-K. (A) EXHIBITS The following exhibits either (a) are filed with this report or (b) have previously been filed with the SEC and are incorporated herein by reference to those prior filings. Exhibits are available upon request at the investor relations section of our website at www.assurant.com EXHIBIT NUMBER EXHIBIT DESCRIPTION 3.1 Articles of Incorporation of Fortis Benefits Insurance Company (incorporated by reference from the Registrant's Registration Statement on Form S-6 and Variable Account C filed on March 17, 1986, File No. 33-03919). 3.2 By-laws of Fortis Benefits Insurance Company (incorporated by reference from the Registrant's Registration Statement on Form S-6 and Variable Account C filed on March 17, 1986, File No. 33-03919). 3.3 Amendments to Articles of Incorporation and By-laws of Fortis Benefits Insurance Company dated November 21, 1991 (incorporated by reference from the Registrant's Post-Effective Amendment No. 1 to the Registration Statement on Form N-4 and Variable Account D filed on March 2, 1992, File No. 33-37577). 3.4 Amendment to By-laws of Fortis Benefits Insurance Company dated May 1, 1999 (incorporated by reference from Exhibit 3(d) to the Registrant's Form 10-K filed on March 30, 2001, File No. 33-63799). 12 4.1 Form of Combination Fixed and Variable Group Annuity Contract (incorporated by reference from Registrant's Post-Effective Amendment No. 1 to the Registration Statement on Form N-4 and Variable Account D filed on March 2, 1992, File No. 33-37577). 4.2 Form of Certificate to be used in connection with Form of Combination Fixed and Variable Group Annuity Contract filed as Exhibit 4.1 to this report (incorporated by reference from Registrant's Post-Effective Amendment No. 1 to the Registration Statement on Form N-4 and Variable Account D filed on March 2, 1992, File No. 33-37577). 4.3 Form of Application to be used in connection with Form of Certificate filed as Exhibit 4.2 to this report (incorporated by reference from Registrant's Post-Effective Amendment No. 1 to the Registration Statement on Form N-4 and Variable Account D filed on March 2, 1992, File No. 33-37577). 4.4 Form of IRA Endorsement (incorporated by reference from Registrant's Post-Effective Amendment No. 1 to the Registration Statement on Form N-4 and Variable Account D filed on March 2, 1992, File No. 33-37577). 4.5 Form of Section 403(b) Annuity Endorsement (incorporated by reference from Registrant's Post-Effective Amendment No. 3 to the Registration Statement on Form N-4 and Variable Account D filed on March 1, 1990, File No. 33-19421). 4.6 Annuity Contract Exchange Form (incorporated by reference from Registrant's Pre-Effective Amendment No. 1 to the Registration Statement on Form N-4 and Variable Account D filed on April 19, 1988, File No. 33-19421). 31.1 Rule 13a-14(a)/15d-14(a) Certification of Principal Executive Officer. 31.2 Rule 13a-14(a)/15d-14(a) Certification of Principal Financial Officer. 32.1 Certification of Chief Executive Officer of Fortis Benefits Insurance Company pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. 32.2 Certification of Chief Financial Officer of Fortis Benefits Insurance Company pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. (B) REPORTS ON FORM 8-K None. 13 SIGNATURES Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized. FORTIS BENEFITS INSURANCE COMPANY Date: May 14, 2004 By: /s/ Robert Pollock --------------------------------------- Name: Robert Pollock Title: President and Chief Executive Officer (Principal Executive Officer) Date: May 14, 2004 By: /s/ Ranell Jacobson --------------------------------------- Name: Ranell Jacobson Title: Treasurer 14