Item 405 of
Regulation S-K (§ 229.405 of this chapter) is not contained herein, and will not
be contained, to the best of registrant’s knowledge, in definitive proxy or
information statements incorporated by reference in Part III of this Form 10-K
or any amendment to this Form 10-K. [X]
Indicate
by check mark whether the registrant is a large accelerated filer, an
accelerated filer, a non-accelerated filer, or a smaller reporting company. See
the definitions of “large accelerated filer,” “accelerated filer” and “smaller
reporting company” in Rule 12b-2 of the Exchange Act.
|
Large
accelerated filer [_]
|
Accelerated
filer [_]
|
|
Non-accelerated
filer [_]
|
Smaller
reporting company [X]
|
(Do not
check if a smaller reporting company)
Indicate
by check mark whether the registrant is a shell company (as defined in Rule
12b-2 of the Exchange Act) Yes [_] No [x]
The
aggregate market value of the voting stock held by non-affiliates of the
registrant as of September 15, 2008 was $25,944,000. This
valuation is based on the closing sale price of common stock as quoted on the
OTCBB on September 15, 2008 ($1.60). This calculation does not reflect a
determination that persons are affiliates for any other purposes.
APPLICABLE
ONLY TO REGISTRANTS INVOLVED IN BANKRUPTCY
PROCEEDINGS
DURING THE PRECEDING FIVE YEARS:
Indicate
by check mark whether the registrant has filed all documents and reports
required to be filed by Section 12, 13 or 15(d) of the Securities Exchange Act
of 1934 subsequent to the distribution of securities under a plan confirmed by a
court. Yes [_] No [_]
(APPLICABLE
ONLY TO CORPORATE REGISTRANTS)
Indicate
the number of shares outstanding of each of the registrant’s classes of common
stock, as of the latest practicable date. The number of shares
outstanding of the registrant's common stock as of September 15, 2008 was
176,715,000.
(DOCUMENTS
INCORPORATED BY REFERENCE)
None
LIFE
EXCHANGE, INC.
FORM
10-K
INDEX
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Page
|
||
|
PART
I
|
||
|
Item
1.
|
Business
|
1
|
|
Item
1A.
|
Risk
Factors
|
9
|
|
Item
1B.
|
Unresolved
Staff Comments
|
N/A
|
|
Item
2.
|
Properties
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12
|
|
Item
3.
|
Legal
Proceedings
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12
|
|
Item
4.
|
Submission
of Matters to a Vote of Security Holders
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12
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|
|
||
|
PART
II
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||
|
Item
5.
|
Market
for Registrant’s Common Equity, Related Stockholder Matters and Issuer
Purchases of Equity Securities
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12
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|
Item
6.
|
Selected
Financial Data
|
|
|
Item
7.
|
Management’s
Discussion and Analysis of Financial Condition and Results of
Operations
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13
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|
Item
7A.
|
Quantitative
and Qualitative Disclosures About Market Risk
|
|
|
Item
8.
|
Financial
Statements and Supplementary Data
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16
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|
Item
9.
|
Changes
in and Disagreements with Accountants on Accounting and Financial
Disclosure
|
18
|
|
Item
9A.
|
Controls
and Procedures
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18
|
|
Item
9B.
|
Other
Information
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19
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|
PART
III
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||
|
Item
10.
|
Directors,
Executive Officers and Corporate Governance
|
19
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Item
11.
|
Executive
Compensation
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20
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|
Item
12.
|
Security
Ownership of Certain Beneficial Owners and Management and Related
Stockholder Matters
|
21
|
|
Item
13.
|
Certain
Relationships and Related Transactions, and Director
Independence
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21
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|
Item
14.
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Principal
Accounting Fees and Services
|
22
|
|
22
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||
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PART
IV
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||
|
Item
15.
|
Exhibits
and Financial Statement Schedules
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22
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|
Signatures
|
24
|
|
PART
I
This annual report on Form 10-K
contains forward-looking statements that are based on current expectations,
estimates, forecasts and projections about the Company, us, our future
performance, our beliefs and our Management's assumptions. In addition, other
written or oral statements that constitute forward-looking statements may be
made by us or on our behalf. Words such as "expects," "anticipates," "targets,"
"goals," "projects," "intends," "plans," "believes," "seeks," "estimates,"
variations of such words and similar expressions are intended to identify such
forward-looking statements. These statements are not guarantees of future
performance and involve certain risks, uncertainties and assumptions that are
difficult to predict or assess. Therefore, actual outcomes and results may
differ materially from what is expressed or forecast in such forward-looking
statements. Except as required under the federal securities laws and the rules
and regulations of the SEC, we do not have any intention or obligation to update
publicly any forward-looking statements after the filing of this Form 10-K,
whether as a result of new information, future events, changes in assumptions or
otherwise.
Unless the context otherwise requires,
throughout this Annual Report on Form 10-K the words “Life-Exchange”, “Company,”
“we,” “us” and “our” refer to Life Exchange, Inc. and its consolidated
subsidiaries.
ITEM
1. BUSINESS
Overview
On
January 19, 2005 (“date of inception”), Life-Exchange, Inc. (“the Company”) was
organized under the laws of the State of Delaware as a
corporation. Life-Exchange, Inc. was established for the purposes of
servicing the life settlement industry by creating an on-line
business-to-business exchange platform, which will facilitate the brokering of
life insurance policies in the secondary market. On January 29, 2006,
the Company began to trade publicly under the name Life Exchange, Inc. (OTC pink
sheets: LFXG.PK).
Our Products and
Services
We are an
Internet-based, business-to-business exchange for the life settlement industry.
By providing a secure, efficient, and neutral electronic trading platform
specifically designed for life settlements, we address many of the
inefficiencies and difficulties currently facing the industry.
On the sell side of the transaction
process, licensed life settlement brokers, on behalf of the policyholders,
register and submit to us information and documentation on life insurance
policies which they are seeking to sell. We provide brokers a means by which to
shop their client's policies to the entire community of buyers and sell them to
the highest bidder. Our automated listing and auction processes encourage
bidding on policies as it allows more buyers into the marketplace, and thus, we
help to create greater value for policy owners.
By selling the policy, the
policyholder/insured receives an immediate cash payment to use as he or she
wishes. The buyer takes an ownership interest in the policy at a discount to its
face value and receives the death benefit under the policy when the insured
dies.
On the buy side of the transaction
process, licensed life settlement providers register and list the criteria that
they use in evaluating the feasibility of purchasing life insurance policies. To
that end, we provide a cost effective means to sort and filter through thousands
of policies in minutes - not months; thereby allowing providers to focus on just
those policies most appropriate to their needs.
After a policy has been registered and
submitted to auction, the policy enters a preview period which allows all
potential buyers the opportunity to underwrite the policy. After this preview
period, the policy enters a live auction period where providers are able to bid
against each other for the right to purchase the life insurance policy in a
real-time, online auction.
At such time that a provider locates
and successfully bids on a life insurance policy, the provider then negotiates
and enters into a contract with the broker. We do not participate in that
negotiation. We generate revenue based primarily on transaction
fees. Our fee structure is designed to provide both brokers (sellers)
and providers (buyers) with a compelling cost justification to use Life-Exchange
as their primary means to execute life settlement transactions.
Fee
Structure
Our
business model is based primarily on revenue streams generated via various
transaction fees associated with successful policy auctions. Our fee
structure is designed to provide both sellers and buyers with a compelling cost
justification to use Life-Exchange as their primary means to execute life
settlement transactions. Transactions fees are based on a percentage of
the face amount of the life insurance policy. This fee arrangement is
non-commission based and therefore it allows us to remain neutral in a life
settlement transaction as we are not incentivized by either a high or a low
sales price. Furthermore, because of our role in the life settlement transaction
and as validated by the neutrality of our fee structure, we do not represent or
negotiate on behalf of the policy owners and accordingly do not have a fiduciary
responsibility to the policy owner as a life settlement broker
would.
In addition to the Transaction Fees
described above, Life-Exchange also generates News Distribution Fees. The
secondary life insurance market is a niche marketplace with a unique blend of
participants. And while this marketplace is experiencing tremendous growth, it
is still difficult to target the most active firms and individuals. To address
this need, we maintain a large database of influential readers focused on life
settlements. In order to monetize this subscriber base, we provide a news
distribution service. For a fee, we will distribute press releases to our
subscriber base. The news distribution fee ranges from $500 to $2,000 per press
release depending on the specific nature of the press release.
The Life-Exchange
Automation
While the majority of the life
settlement industry is backed by technologically sophisticated, Fortune 500
financial institutions, the technological sophistication of the life settlement
industry itself is antiquated and highly inefficient. The majority of policy
transactions are labor-intensive, cumbersome and disorganized undertakings.
There is significant duplication of work, inappropriate policy transactions,
miscommunication and poor follow through. All of these factors contribute to an
unproductive and inequitable marketplace.
We have automated and modernized the
life settlement industry by introducing buyers to sellers (and vice versa) in a
virtual, online marketplace. Our features and functionality are specifically
designed to improve regulatory compliance, increase customer value, reduce
transaction costs, create new revenue models, and add efficiency to an
inefficient market.
With our web-based document management
features and scalable database, we greatly assist clients by removing the
confusion caused by different employees making changes to the same documents and
not communicating the changes explicitly. Brokers and providers have access to
the correct documents, and the ability to make and communicate changes, 24/7
from anywhere via secure internet connection. Each client's employee's
responsibilities and completed work can be tracked using the audit feature built
into our products, ensuring accountability.
Of particular importance to our
industry, is the fact that the transfer of medical information requires
adherence to the compliance procedures of the Health Insurance Portability &
Accountability Act ("HIPAA"). In order to ensure compliance with the laws
regulating the transmission of medical information, especially in electronic
format, we offer all members a secure hosting center to store, retrieve, and
exchange medical data in a manner that maintains compliance with HIPAA and state
regulations.
In addition to the above factors, there
is a significant influx of institutional capital entering the life settlement
industry and the pressure to place this capital continues to increase.
Automating the Life-Settlement transaction process and allowing more buyers and
sellers to transact business through a single, highly efficient electronic
exchange will greatly improve value for both buyer and seller by bringing
greater liquidity to the life settlement marketplace. Life settlement brokers
benefit by having equal and greater access to potential buyers, ensuring their
clients receive the highest bids for their policies while maintaining compliance
with stringent state-by-state regulations. Providers benefit by having access to
more suitable investment opportunities, and are thus able to place their capital
more rapidly and with greater efficiently, thus increasing their internal rate
of return.
Intellectual Property and
Patents
On March 31, 2006, David C. Dorr, our
president, assigned his rights in a Patent pending application for Letters
Patent of the United States filed July 21, 2004, U.S. Patent Application No.
10/895112. Said patent relates to our processes described herein.
Company
History
On July 7, 2006, the Company entered
into a note agreement with Vantage Group Ltd. to provide $300,000 of additional
financing (“Note 1”). The terms of Note 1, as modified by subsequent
amendments, provide for 7% interest payable at maturity. Note 1 is
unsecured and matures on April 15, 2010 with quarterly interest installments due
through April 15, 2010. Note 1 also provides Vantage with conversion
rights based on us attaining certain performance criteria as follows. The Holder
of this Note 1 is entitled, at its option, to convert the principal amount of
Note 1 or any portion thereof, together with accrued but unpaid interest, into
shares of our common stock based on attaining certain performance criteria
measured during December, 2006. We did not meet the performance
criteria and accordingly, no shares were converted.
On April 2, 2007, we entered into a
note agreement with Vantage Group Ltd. to provide $150,000 of additional
financing (“Note 2”). The terms of Note 2, as modified by subsequent
amendments, provide for 7% interest payable at maturity. Note 2 is
unsecured and matures on April 15, 2010. Note 2 also provides Vantage
with conversion rights based on us attaining certain performance criteria as
follows. Note 2 may be converted into shares of our common stock at
(i) $0.10 or (ii) fifty percent (50%) of the three lowest closing prices of the
Stock on the Pink Sheets (or such other principal market or exchange where the
Common Stock is listed or traded at the time of conversion) immediately
preceding the date of conversion.
On August
2, 2007, the Company was advanced an additional $5,000 under the same terms as
Note 2.
On
September 27, 2007, the Company formed LFX Insurance Services, LLC (“LFXIS”) a
Nevada limited liability corporation as a wholly-owned
subsidiary. LFXIS was formed to process “structured finance”
transactions related to the Company’s core life settlement
business. Structured finance transactions involve an extension of the
services provided to customer base for customer driven transactions executed
through the Company’s exchange platform. Structured finance
transactions involve utilizing the skill sets of the Company’s personnel to both
advise and structure an appropriate transaction that accommodates the goals of
the parties involved. The Company incurred minimal expenses in
establishing the subsidiary.
In July
2008, the Company formed four additional subsidiaries to facilitate its plans to
further expand its service offerings. Filings with the State of
Nevada began on June 3, 2008, however the organization activities were not
completed until July 2008. None of these subsidiaries were complete
and operational or record any transactions as of June 30, 2008. The
newly formed subsidiaries are as follows:
LFX
Brokerage LLC was formed to facilitate deeper market penetration into life
settlement sell-side participants. This entity will hold life settlement
brokerage licenses and life insurance general agency licenses allowing us to
offer expanded services as they relate to our core business of operating a life
settlement exchange. These licenses also give us the flexibility to
interact directly with policy owners and more efficiently address their market
needs.
LFX
Acquisitions LLC was formed to facilitate deeper market penetration into life
settlement buy-side participants. This entity will hold life settlement
provider licenses and provide better market access to financial institutions
like banks and pension funds to our life settlement exchange. This entity
will also allow us the ability to provide ongoing asset servicing to clients
that require these services.
LFX
Capital Markets LLC was formed in anticipation of further regulatory
developments that could bring greater oversight by FINRA to the life settlement
market place. This entity will be licensed as a broker/dealer and will
also be designed for providing trades in more advanced structured life
settlement products that will be classified as securities. Having a
broker/dealer license will also allow us to accept variable life insurance
contracts, a sector of the market that we have not yet tapped.
LFX
Trading, LLC was formed to hold all the technology related to our life
settlement auction platform as well as the intellectual property we will be
developing related to our electronic trading platform. This new entity
will ultimately be responsible for receiving all transaction fees as they relate
to auctions or trades through our systems.
We
operate two websites: www.life-exchange.com and
www.life-exchange.net.
The Viatical and Life
Settlement Industry
A Viatical and/or Life Settlement
(herein referred to as a "Life Settlement") is the sale to a third party of an
existing life insurance policy for more than its cash surrender value but less
than its net death benefit. The insurance industry generally uses the term
Viatical Settlement to refer to a transaction involving the terminally or
chronically ill insured and the term Life Settlement to refer to a transaction
involving an insured who is not terminally or chronically ill, but generally
over the age of sixty five (65).
The U.S. secondary market for life
insurance policies has experienced phenomenal growth over the past several
years. Life settlement buyers, also known as “providers”, purchase policies from
policyholders for immediate cash settlement. Providers will purchase life
settlement policies on their own behalf as well as on the behalf of various
investors including both domestic and international banks, hedge funds, and
private equity firms.
Once a
provider acquires a policy, the provider continues to pay the policy premiums
until the death of the insured, at which time they collect the policy's
proceeds. Some life settlement providers negotiate directly with policyholders,
but the majority of Life Settlement transactions are conducted through a life
settlement broker. Most states require providers to be licensed in the states in
which they purchase policies. Many providers are well-financed by large
institutional investors. Not only does this institutional backing provide a
secure funding source for secondary market transactions, but it also provides
the highest degree of consumer protection with regard to privacy and
confidentiality.
Life settlement sellers, also known as
“brokers”, act on behalf of the policyholders in order to secure the highest
price from the sale of the policyholder's life insurance policy. Life settlement
brokers work with the insured, the policy owner, general agencies, life
insurance agents, attorneys, and/or financial planners.
In an
attempt to secure the highest price for a policyholder, brokers will typically
present a life insurance policy to multiple providers. Brokers are required to
collect and prepare critical policy information and medical records on the
insured for use in evaluating the value a policyholder's life insurance
policy.
An important industry group is the Life
Insurance Settlement Association (LISA). This industry association promotes
self-regulation of the industry, and advises and recommends regulations to
governing bodies. They also lobby for new laws and regulations to help protect
the consumer and keep fraud out of the industry.
The Life Settlement Market
and Competition
The life settlement industry developed
out of the viatical industry which began in the late 1980s as large numbers of
AIDS patients found themselves coping with the catastrophic costs of a terminal
illness. Many had life insurance policies that seemed to be limited or
inaccessible prior to the death of the insured. A creative solution was to offer
AIDS patients; a lump sum payment of cash greater than their cash surrender
value, in exchange for transferring the ownership and beneficiary of a policy.
Viewing a life insurance policy as a financial asset which could be transferred
for value had begun and unfortunately, as with many new financial concepts, lack
of regulation lead to several incidences of fraud and other
improprieties.
Over the past several years the market
has evolved into a multi-billion dollar industry, which is heavily regulated and
institutionally backed. The demand driving the growth of this product has been
the rapid increase in the senior population, constantly changing estate planning
needs and most profoundly the awareness that these insurance policies can be
sold on a secondary market as financial instruments to institutionally-backed
buyers.
We are
aware of one direct competitor, -- LexNet (www.lexnet.com) -- that provide
consumers with the ability to auction their life insurance policies.
LexNet was launched in May, 2007 by Cantor LifeMarkets, a division of Cantor
Fitzgerald. A primary difference between LexNet and Life-Exchange is that
LexNet will not accept policy submissions directly from producers. Rather,
access to LexNet is exclusively controlled through a select group of Master
Agencies. Regardless of whether or not an insurance agent is part of the
select Master Agency’s network, they must still work through a Master Agency,
which is likely to be seen as an extra fee layer by agents, further diluting the
agent’s commission and potentially disinter mediating the relationship between
the agent and his end clients. Life-Exchange on the other hand, is
open to any life settlement broker, general agency, agent, or master general
agency which is capable of meeting our membership requirements.
As another form of indirect competition
to life settlements, the life insurance industry has responded with policy
features offering various pre-death, cash benefits (sometimes called accelerated
death benefits). While in some cases accelerated death benefits may compete with
life settlements, we do not expect the availability of accelerated death
benefits to affect the life settlement market significantly at this time. The
availability of accelerated death benefits is generally more restricted than
life settlements. For example, policies often limit such benefits to persons who
have a life expectancy of less than one year, in contrast to life settlements
that are usually available to persons with life expectancies of two to 15 years.
Life settlements generally offer sellers a greater dollar amount than they would
receive under accelerated death benefit provisions.
Finally, access to capital, the
insurance industry's addition of pre-death cash benefits, law enforcement
pressure on companies operating illegally, and increasing government regulation
have all contributed to a stabilization in the number and sophistication of life
settlement companies, both those purchasing for their own accounts and those who
act as agents for purchasers.
Sales &
Marketing
Since our
public launch on April 20, 2006, we have aggressively focused on acquiring as
clients the top life settlement sellers and buyers in our industry. As of
June 30, 2008, we have agreements with over 30 suppliers of life settlement
policies, including life settlement brokers, general agencies, and master
general agencies. On the buy side, we have agreements in place with over
40 buyers of life settlement policies, including domestic life settlement
providers, as well as both domestic and international banks, hedge funds, and
private equity firms.
A primary
theme of our user agreements is that we are an online venue for indications of
interests to buy and sell, and that the site is only an online communications
medium to facilitate registered buyers and registered sellers to exchange
information relating to proposed Life Settlement Transactions; such life
insurance policies transactions are completed off-line, outside of the
site.
Life-Exchange auction participants,
both on the buy-side and sell-side, pay a transaction fee that ranges from 0.25%
to 0.50% of the face value of a policy.
All
buy-side and sell-side member contracts are identical with regards to the
material rights and obligations of both parties and include:
|
·
|
Contracts
have no fixed contract length and parties are not obligated to use the
exchange, post policies, or provide a minimum level of business to the
exchange.
|
|
·
|
Life-Exchange
members may terminate this Agreement at any time upon thirty (30) days
advance written notice of termination provided to the other
party.
|
|
·
|
Life-Exchange
members must comply with stringent confidentiality and privacy
obligations, including those related to the
HIPAA,
|
|
·
|
Life-Exchange
members are responsible for paying for any life expectancy
reports that they order through
Life-Exchange.
|
|
·
|
Life-Exchange
members must at all times
|
|
§
|
comply
with all applicable laws and regulations applicable to its offer to
purchase, solicitation to sell, or purchase of, Policies in Life
Settlement Transactions,
|
|
§
|
obtain
and maintain in good standing all licenses and permits that
Broker/Provider may be required to hold under applicable laws and
regulations.
|
|
·
|
Life-Exchange
members agree to a non-circumvent period where neither party
shall, directly or indirectly, purchase or sell a Policy listed on the
exchange or make any offer to purchase or sell any such policy for a
period of 1 year
|
Over the next twelve months,
management's strategy is to continue with its sales and marketing strategy of
focusing efforts on establishing a “footprint” nationally with the industries
top tier firms.
Our primary marketing efforts will
continue to include:
|
·
|
Taking
advantage of our favorable position within the Life Settlement industry to
secure exclusive industry alliances thereby ensuring long term deal flow
in the form of long term use of our web-based exchange
platform.
|
|
·
|
Use
our strong industry contacts within the life settlement community to
promote the usage of Life-Exchange as an industry
standard.
|
|
·
|
Implement
website features and functionality that create user
retention.
|
|
·
|
Continual
development of products and services that anticipate the market's
evolution particularly in regards to the regulatory
landscape.
|
|
·
|
Enhancements
and modifications to our website that differentiates our product and
services by offering industry specific tools and functionality that will
become and remain the industry
standard
|
Research &
Development
Product
and development costs consist of the costs to develop and operate the online
exchange platform's web based application and transaction database and are
expensed as incurred.
We have
outsourced the development of our web application to Epiq Technologies of San
Diego, California. Epiq Technologies was chosen after an exhaustive search for
the most appropriate business-to-business exchange platform and software
developer. Our web based application is based upon industry leading technology
which has provided us with a common, secure, and scalable infrastructure for
which to base future development. Our web application was publicly launched on
April 20, 2006 and to date, our developer has delivered all milestones ahead of
schedule.
Data
transmitted between our clients and our Web servers is via the industry standard
Secure Sockets Layer (SSL), which is a mechanism to secure Internet traffic so
that it cannot be intercepted. Life-Exchange will continue to use and update its
platform with the most advanced security measures available.
Our
ongoing research and development will focus on modifications and enhancements to
meet the changing needs of our users, as well as addressing regulatory issues
encountered by the industry. This proactive approach towards customer
satisfaction will include making certain that www.Life-Exchange.com continues to
foster:
|
·
|
A
customer-first approach
|
|
·
|
Superior
and efficient execution of all web site functionality, processes, and
procedures.
|
|
·
|
Excellent,
easy to access customer support
services.
|
|
·
|
Resources
to serve both brokers and
providers.
|
|
·
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A
comprehensive range of products and services to ensure competitive
advantage and to serve current and future customer
needs.
|
|
·
|
Fast,
reliable, and accurate
functionality.
|
|
·
|
A
highly credible site which offers private and secure
transactions
|
Equipment
With
respect to equipment requirements, we employ a strategy of leasing all of its
technological hardware and software requirements through industry leading
vendors. As such, we expect no significant equipment purchases over the next 12
months.
Staffing
We operate around a core group of
highly skilled individuals with an extensive knowledge and understanding of the
life settlement industry. Besides a nominal administrative staff to support this
core group, we plan to outsource all staffing activities not directly related to
our core capabilities in the life settlement industry, including such activities
as software development, marketing, investor relations, and compliance. Based on
this outsourcing strategy, we anticipate no significant staffing level increases
within the next twelve months. As of June 30, 2008, we have 8
employees, consisting of 6 full time employees, and 2 part time employee, none
of whom are represented by a labor union. We consider our employee relations to
be satisfactory.
Government
Regulation
Although our services do not require us
to be licensed under federal or state law as a provider, broker or otherwise, we
believe these laws and regulations have generally had a positive effect on the
industry and on our ability to compete in the life settlement
marketplace.
Currently the life settlement industry
is regulated on a state-by-state basis, and at this time almost all states
regulate life settlement transactions. Depending on the state, different
licenses may be required for viatical and life settlements transactions, as well
as for life settlement brokers and life settlement providers. Of those states
that regulate the life settlement transactions, most require both the
Viatical/Life Settlement Broker and the Viatical/Life Settlement Provider to be
licensed.
The foundation for these regulations is
based largely from the NAIC Viatical Settlements Model Act (the "Model Act"),
which act encompasses a model law and regulations promulgated by the National
Association of Insurance Commissioners (the "NAIC"). Most states have now
adopted some version of this model law or another form of regulation governing
in some way viatical or life settlement companies or both. These laws generally
require the licensing of providers and brokers, require the filing and approval
of settlement agreements and disclosure statements, describe the content of
disclosures that must be made to potential viators and/or life settlors,
describe various periodic reporting requirements for settlement companies and
prohibit certain business practices deemed to be abusive.
In 1996, Congress passed the Health
Insurance Portability & Accountability Act ("HIPAA"). The purpose of HIPAA
is to prevent fraud in the health care industry and to protect confidential
patient information. HIPPA standardizes and provides enforcement mechanisms for
ROI rules and guidelines to protect personal healthcare information. HIPAA
effects entities involved with electronic health care information - including
health care providers, health plans, employers, public health authorities, life
insurers, clearinghouses, billing agencies, information systems vendors, service
organizations, universities, and even single-physician offices. The final
version of the HIPAA Privacy regulations was issued in December 2000, and went
into effect on April 14, 2001. A two-year "grace" period was included;
enforcement of the HIPAA Privacy Rules began on April 14, 2003.
Licensing in
Florida
Florida regulates both viatical and
life settlements pursuant to the Florida Viatical Settlement Act set forth in
Florida Statutes Sections 626.991--626.99295 (the "Florida Act"). The Florida
Act makes no distinction between viatical and life settlements and refers to all
settlements as viatical settlements.
The settlement process begins when the
policy owner executes a viatical settlement application and provides
authorization to the insured's attending physician and the issuing insurance
company to disclose confidential information pertaining to the insured's health
and insurance coverage. This information is necessary for a buyer to evaluate
the policy for potential purchase. If the policy owner is not also the insured,
both the viator and the insured typically will be required to review and sign
the application. In addition to the policy owner's execution of the application
documents, he or she is also required to provide some form of photo
identification, a copy of the life insurance policy to be sold, and a copy of
the application for the policy. As a general rule, policy owners are not
required to submit to a medical examination as part of the application
process.
A viator is the owner of a life
insurance policy, who seeks to sell a policy. The insured may or may not have a
catastrophic or life threatening condition.
A viatical settlement provider is a
person or company who purchases a life insurance policy from a viator A viatical
settlement provider must be licensed by the Florida Department of Financial
Services (the “Department”).
A viatical settlement broker is a
person who negotiates an agreement between a viator and a viatical settlement
provider. The broker has a fiduciary responsibility to act according to the
viator’s instructions and in the viator’s best interests and must be licensed by
the Department. Brokers typically work closely with policy owners and collect
their commissions from providers after the contract has been executed. After
October 1, 2006, a person must be licensed with the Department as a life agent
in order to act as a viatical broker.
An escrow agent or trustee is the party
who holds the documents and the money until ownership rights of the policy have
been transferred from the viator to the viatical settlement
provider. In some cases they retain investor’s funds until they have
been placed on a life insurance policy and could be the party responsible for
insuring payment to the investor. Escrow agents or trustees are not
licensed by the Department.
A viatical settlement investment, as of
July 1, 2005, is subject to the Florida Securities and Investor Protection
Act. For an investor, this means full disclosure and access to
company information. In addition, a determination of the investment’s
suitability for the investor would have to be made after considering the
investor’s financial and tax status, and the investor’s investment
objectives. It also means that the viatical settlement investment
must either be registered with the Department or exempt from
registration. In addition, the person offering or selling the
viatical settlement investment must be licensed with the Department to sell
these securities.
In order to make their medical records
available to third parties in the viatical settlement process, insured's must
authorize their physicians and other health care givers, in writing, to release
their private medical records.
The medical release allows the viatical
settlement broker to obtain current medical records from the insured's
physician. At a minimum, two years of records are required. These records are
then provided to a review company that specializes in viatical and life
settlement mortality profiles for a determination of an estimated life
expectancy. Once a medical underwriter has obtained all of the policy owner's
medical records, it can generate a preliminary estimate of the insured's life
expectancy and thereafter issue a final report. The report is then used by the
viatical settlement provider to determine if the offered policy comes within its
underwriting guidelines for purchase.
The evaluation of a viatical settlement
focuses on the specific terminal illness with which the insured has been
diagnosed. In the case of a life settlement, however, where there is no terminal
illness, other factors must be examined in order to determine estimated life
expectancy.
Once the parties agree on a price, they
will enter into a viatical settlement contract and other related agreements
necessary to close the transaction. The viatical settlement contract contains
the price to be paid to the policy owner for the policy and other important
terms and conditions of the sale, including those dealing with mandatory
disclosures, the policy owner's right to rescind the contract, and post-closing
contact with the insured for health status updates. Other related forms
typically include an escrow agreement with the entity that will hold the funds
payable to the policy owner, the forms from the issuing insurance company
necessary to record the change in the policy ownership and beneficiary(ies),
releases for execution by the existing policy beneficiary(ies), a power of
attorney and funding instructions.
The Florida Act defines a viatical
settlement contract as one in which the provider pays compensation or value to
the policy owner in an amount less than the expected death benefit of the
subject insurance policy, and the policy owner in return assigns, transfers,
sells, devises, or bequeaths ownership of all or a portion of the subject
insurance policy to the provider. The contract can also include a loan secured
primarily by a life insurance policy, or a loan secured by the cash value of the
policy, excepting loans made by life insurers to insured under the guidelines of
the subject policy.
A viatical settlement contract and the
related forms must be pre-approved by the State of Florida Office of Insurance
Regulation. By statute, the department must reject any viatical settlement
contract or related form that is unreasonable, contrary to the public interest,
discriminatory, or misleading or unfair to the policy owner. As part of the form
approval process, the department requires that each form have a unique number in
the lower left hand corner. This approval requirement provides policy owners
with a measure of protection in that the department has reviewed the provisions
of the viatical settlement contract and related forms and has required the
removal of any unfair provisions prior to use of the form.
A viatical settlement purchase
agreement is defined as a contract between a purchaser and a party other than
the policy owner to purchase an interest in a life insurance policy. This is
usually the investment contract between the purchaser and the
provider.
As a further condition to a sale,
Florida law requires the policy owner to confirm or agree in writing the
following:
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1.
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Consent
to the viatical settlement
contract;
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2.
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Represent
that he or she has a full and complete understanding of the viatical
settlement contract and the benefits of the life insurance
policy;
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3.
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Release
his or her medical records; and
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4.
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Acknowledge
that he or she has entered into the viatical settlement contract freely
and voluntarily.
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Finally,
in Florida, all viatical settlement contracts must close in escrow in order to
assure that the policy owner is paid. The independent escrow agent's role in a
viatical settlement transaction is to receive and hold the executed viatical
settlement contract and related documents, including the insurance company forms
executed by the policy owner to transfer the ownership of the policy, and to
receive and hold the funds transferred from the viatical settlement provider in
the amount of the agreed-upon purchase price for the policy. After expiration of
the policy owner's fifteen day right of rescission, the viatical settlement
provider or its agent begins tracking or monitoring the policy owner's health
status.
Florida law requires viatical
settlement providers or brokers to provide specific information to policy owners
before entering into a viatical settlement contract. Nearly all jurisdictions
that regulate viatical settlements require substantially similar disclosures,
the purpose of which is to give a person who is contemplating the sale of a life
insurance policy basic information that may be material to that decision.
Florida requires the following information to be disclosed:
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1.
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