Table of Contents CITIZENS, INC. HOME SERVICE INSURANCE Our Home Service Insurance segment provides pre-need and final expense ordinary life insurance and annuities to middle and lower income individuals primarily in Louisiana, Mississippi and Arkansas. Our policies in this segment are sold and serviced through a home service marketing distribution system and through funeral homes utilizing over 444 employees and independent agents. Premiums. The premiums in this segment remained relatively flat in 2019 compared to 2018 and 2017. The following table sets forth our direct premiums by state for the periods indicated. Net Investment Income.   Net investment income decreased slightly in 2019 as a fall in yields and an increase in investment expenses offset a slight increase in average invested assets. As previously described, it has been challenging to find attractive yields in the current low interest rate environment. See  Investments  below for more detailed information on our investments. December 31, 2019 | 10-K 43 Years ended December 31, (In thousands, except for %) 2019 2018 2017 State Louisiana $ 42,867 90.2% $ 42,898 90.2% $ 42,837 89.6% Mississippi 2,037 4.3 2,105 4.4 2,369 5.0 Arkansas 1,660 3.5 1,675 3.5 1,716 3.6 Other States 938 2.0 857 1.9 906 1.8 Total premiums $ 47,502 100.0% $ 47,535 100.0% $ 47,828 100.0% Years ended December 31, (In thousands) 2019 2018 2017 Revenue: Premiums $ 46,681 46,714 47,012 Net investment income 13,058 13,125 13,132 Realized investment gains (losses), net 1,470 (46) 979 Other income (loss) 4 (1) 3 Total revenue 61,213 59,792 61,126 Benefits and expenses: Insurance benefits paid or provided: Claims and surrenders 23,863 21,954 22,512 Increase in future policy benefit reserves 1,839 4,276 5,246 Policyholders' dividends 36 46 42 Total insurance benefits paid or provided 25,738 26,276 27,800 Commissions 14,094 14,883 15,564 Other general expenses 19,517 20,435 23,395 Capitalization of deferred policy acquisition costs (4,807) (5,501) (5,963) Amortization of deferred policy acquisition costs 4,436 4,320 4,395 Amortization of cost of insurance acquired 1,054 1,875 1,534 Total benefits and expenses 60,032 62,288 66,725 Income (loss) before income tax expense $ 1,181 (2,496) (5,599)