Exhibit (g)(8)
AUTOMATIC REINSURANCE AGREEMENT
Between the
IDS LIFE INSURANCE COMPANY OF NEW YORK
Albany, New York
And the
[name of reinsurance company]
[city and state of reinsurance company]
AUTOMATIC REINSURANCE AGREEMENT
Contents
ARTICLE I Basis of Reinsurance
Automatic Coverage
Special Automatic Coverage
Limited Retention
Exceptions to Automatic Reinsurance
Facultative Reinsurance
ARTICLE II Facultative Submissions
Confirmation of Reinsurance
Policy Forms, Rate Book
ARTICLE III Commencement & Termination of Liability
ARTICLE IV Oversights - Clerical Errors
ARTICLE V Plan of Reinsurance
ARTICLE VI Reinsurance Administration
ARTICLE VII Reinsurance Premiums
ARTICLE VIII Experience Refunds
ARTICLE IX Tax Credits
ARTICLE X Reductions
ARTICLE XI Retention Limit Increases (Recapture)
ARTICLE XII Reinstatements
ARTICLE XIII Policy Changes
ARTICLE XIV Settlement of Claims
ARTICLE XV Inspection of Records
ARTICLE XVI Insolvency
ARTICLE XVII Arbitration
ARTICLE XVIII Parties to Agreement
ARTICLE XIX Duration of Agreement
Signature Page
EXHIBIT A - Bordereau Report Forms
EXHIBIT B - Reinsurance Premiums
EXHIBIT C - Individual Cession Report Forms
SCHEDULE I - Limits of Retention and Automatic Reinsurance Coverage
AUTOMATIC REINSURANCE AGREEMENT
THIS AGREEMENT between the IDS LIFE INSURANCE COMPANY OF NEW YORK, a corporation
organized under the laws of the State of New York, hereinafter referred to as
the "Company", and the [name of reinsurance company], a corporation organized
under the laws of the State of [state], hereinafter referred to as the "[name of
reinsurance company]", WITNESSETH AS FOLLOWS:
ARTICLE I
Basis of Reinsurance
1. On and after the 1st day of January, 1986, amounts of Individual Life
and Waiver of Premium Disability Insurance which are in excess of the Company's
retention and which have been issued directly by the Company on lives whose
surnames are spelled commencing with any letter from A to Z, inclusive, on the
plans of insurance stated in Exhibit B, shall be reinsured with the [name of
reinsurance company]. At the option of the Company, reinsurance may be ceded to
the [name of reinsurance company] on an automatic basis as provided in
Paragraphs 2, 3, and 4 of this Article or applications for reinsurance may be
made to the [name of reinsurance company] on a facultative basis as provided in
Paragraph 6 of this Article.
Automatic Coverage
2. Except as specified in Paragraph 5, whenever the Company retains its
maximum limit of retention, as indicated in Schedule I, the Company shall cede
and the [name of reinsurance company] shall
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automatically accept such Life reinsurance as provided herein with a
corresponding amount of Waiver of Premium, if any, on the same terms and for an
amount not exceeding the limits specified in Schedule I.
Special Automatic Coverage
3. Even though the Company may already be on a risk for its maximum limit
of retention under policies previously issued and therefore unable to retain any
part of the insurance currently applied for, the Company, without retaining any
more for its own account, shall still have the right to cede automatically the
full amount of new insurance, within the limits specified above, on the same
terms on which it would be willing to accept the risk for its own account if it
did not already have its maximum limit of retention.
Limited Retention
4. When the Company retains for its own account less than its regular
maximum limit of retention for the risk, the automatic coverage shall be for an
amount equal to the amount retained by the Company on the current application.
Exceptions to Automatic Coverage
5. Reinsurance shall not be ceded automatically to the [name of
reinsurance company] on any life if:
(a) The amount of Life insurance in force plus
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the amount currently being applied for on that life in all
companies exceeds [dollar amount], or
(b) The substandard mortality rating assessed to the risk exceeds
Class P ([percentage]) or its equivalent on an extra premium
basis, or
(c) The insurance is the result of a group conversion where full
evidence of insurability has not been secured, or
(d) The Company has submitted the risk to another reinsurer for
facultative consideration.
Facultative Reinsurance
6. Applications for reinsurance of amounts in excess of the automatic
limits provided above, and any risks which the Company does not care to cede to
the [name of reinsurance company] automatically or which may not be so ceded
under the terms of this Agreement, may be submitted for reinsurance upon a
facultative basis.
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ARTICLE II
Facultative Submissions
1. When the Company submits a risk to the [name of reinsurance company]
on a facultative basis, copies of the original application, all medical
examinations, microscopical reports, inspection reports and all other
information the Company may have pertaining to the insurability of the risk
shall be sent to the [name of reinsurance company]. If the amount at risk to be
ceded to [name of reinsurance company] does not exceed [dollar amount], the
underwriting papers should be accompanied by an executed Bordereau Facultative
Application, Form L(POL)B- FAC, as shown in Exhibit A. If the amount at risk to
be ceded exceeds [dollar amount], the papers should be accompanied by a
Facultative Application, page 1 of Form L(POL)100, as shown in Exhibit C. The
[name of reinsurance company] shall promptly notify the Company of its decision
on the risk.
Confirmation of Reinsurance
2. When a policy is placed in force on which reinsurance is to be ceded
to [name of reinsurance company], the Company shall notify [name of reinsurance
company] that the reinsurance has been effected in one of the following ways:
(a) If the amount of reinsurance being ceded to [name of
reinsurance company], including amounts previously ceded, is
[dollar amount] or less, no special new business report to
[name of reinsurance company] is necessary. An entry for the
reinsurance should simply be included in the next Quarterly
Premium Report, as described in Article VI, paragraph 2.(b).
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(b) If the amount of reinsurance being ceded to [name of
reinsurance company], including amounts previously ceded, is
more than [dollar amount] but less than [dollar amount],
notice of the reinsurance should be sent to [name of
reinsurance company] at the end of the month in which the
reinsurance is effected, as outlined in Article VI, paragraph
2. (a), Monthly Large Amount New Business Report.
(c) If the amount of reinsurance being ceded to [name of
reinsurance company], including amounts previously ceded,
exceeds [dollar amount], the first [dollar amount] will be
ceded on a bordereau basis and the excess over [dollar amount]
will be ceded on an individual cession basis. Accordingly,
confirmation of the reinsurance in these cases will be
reported to [name of reinsurance company] in a dual fashion.
The bordereau portion shall be reported on the next Monthly
Large Amount New Business Report referred to in subparagraph
(b), above, and the excess over [dollar amount] of reinsurance
to [name of reinsurance company] on a life shall be reported
by the Company completing and sending to [name of reinsurance
company], as soon as possible after reinsurance has been
effected, a Confirmation of Reinsurance form, page 2 of Form
L(POL)100, as shown in Exhibit C. The Cession Certificate,
Form L(POL) 100A, for this portion of the reinsurance shall be
prepared by the [name of reinsurance company] and promptly
returned to the Company.
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Policy Forms, Rate Book
3. The Company shall file with the [name of reinsurance company] copies
of all its present policy forms, its rate book and reserve factors for special
plans of insurance which are not readily available in published volumes. If new
forms are published or if changes are made in the material already filed as
provided above, the Company agrees to promptly file the new or revised copies of
such material with the [name of reinsurance company].
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ARTICLE III
Commencement & Termination of Liability
1. On automatic reinsurance coverage, the liability of the [name of
reinsurance company] shall commence simultaneously with that of the Company.
2. On facultative reinsurance coverage, the liability of the [name of
reinsurance company] shall commence simultaneously with that of the Company
provided the Company has accepted, during the lifetime of the insured, a
facultative offer made by the [name of reinsurance company] on that life.
3. The liability of the [name of reinsurance company] shall terminate
simultaneously with that of the Company, unless it is terminated earlier in
accordance with Articles X or XI.
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ARTICLE IV
Oversights - Clerical Errors
1. Should the Company fail to cede reinsurance that otherwise would have
been ceded on an automatic basis in accordance with the provisions of this
Agreement, or should either the Company or the [name of reinsurance company]
fail to comply with any of the other terms of this Agreement, and if this is
shown to be unintentional and the result of a misunderstanding, oversight or
clerical error on the part of either the Company or the [name of reinsurance
company], then this Agreement shall not be deemed abrogated thereby, but both
companies shall be restored to the position they would have occupied had no such
oversight, misunderstanding, or clerical error occurred.
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ARTICLE V
Plan of Reinsurance
1. Life reinsurance shall be on the risk premium basis. The risk amount
on the policy reinsured shall be calculated monthly and shall be equal to the
death benefit less the cash value. At the time of issue, the Company shall cede
to the [name of reinsurance company] the portion of the initial risk amount in
excess of its retention. Thereafter, the Company and the [name of reinsurance
company] shall keep the same proportionate shares of the risk amount developed
each month.
2. Reinsurance of Disability benefits shall be on a coinsurance basis in
accordance with the original forms of the Company.
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ARTICLE VI
Reinsurance Administration
1. Reinsurance shall be ceded using a combination of self -administration
bordereau reports and individual cessions. The first [dollar amount] of initial
reinsurance risk amount on any one life shall be ceded on a bordereau basis and
any excess initial reinsurance risk amount shall be ceded on an individual
cession basis. Any subsequent fluctuations in the total reinsurance risk amount
shall be reflected in the bordereau portion of the reinsurance with the risk
amount on the individual cession remaining level. Should the bordereau risk
amount ultimately be reduced to zero, the individual cession shall be amended
and up to [dollar amount] of the cession risk amount shall be transferred to a
bordereau basis.
2. For the bordereau portion of the reinsurance account, the Company shall
furnish the [name of reinsurance company] periodic reports in substantial
agreement with the following:
(a) Monthly Large Amount New Business Report: At the end of each month
the Company shall send to [name of reinsurance company] a listing of
those policies issued during the month where the total amount of
reinsurance to be ceded to [name of reinsurance company], including
amounts previously ceded, exceeds [dollar amount]. The listing shall
indicate:
i) policy number
ii) full name of insured
iii) date of birth
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iv) sex and issue age
v) effective date
vi) underwriting classification
vii) plan
viii) total initial risk amount
ix) initial reinsured risk amount
(b) Quarterly Premium Report: At the end of each quarter the Company
shall send [name of reinsurance company] a listing of all reinsured
policies that were inforce during any part of the quarter
accompanied by the reinsurance premiums for such policies. The
listing should be segregated into first year issues and renewals and
should provide the following information:
i) thru viii) in 2.(a), above
ix) reinsured risk amount at the end of the quarter
x) total net reinsurance premium due for each reinsured
policy for the quarter
(c) Quarterly Change Report: The Company shall report the details of all
policy terminations and changes, other than fluctuations in the
reinsured risk amount due to changes in the cash value, on reinsured
policies. In addition to the data indicated in 2.(a), above, the
report should provide information about the nature, the effective
date, and the financial result of the change with respect to the
reinsurance.
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(d) Quarterly Policy Exhibit Report: A summary of new business,
terminations, changes, death claims and reinstatements during the
quarter and the inforce reinsurance at the end of the quarter.
(e) Quarterly Reserve Report: If the Company takes a reserve credit for
reinsurance ceded under this Agreement, the Company shall provide
[name of reinsurance company] with a quarterly listing of the mean
reserves attributable to the reinsured portion of each policy
reinsured.
(f) Claims: Shall be reported individually as incurred.
3. For the portion of the reinsurance account ceded to the [name of
reinsurance company] on an individual cession basis, promptly at the beginning
of each calendar month the [name of reinsurance company] shall send to the
Company a statement of premiums for all outstanding new reinsurances upon which
cessions have been prepared by the [name of reinsurance company] and renewal
premiums for all renewal reinsurances falling due within such month. The
statement shall also include any adjustments in reinsurance premiums. The
Company shall verify the statement and return it to the [name of reinsurance
company] within a reasonable time together with a remittance covering the amount
due.
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ARTICLE VII
Reinsurance Premiums
Life Premiums
1. Until further notice, reinsurance premiums shall be at the rates given
in the attached Exhibit B. The [name of reinsurance company] guarantees that
premium rates for a given attained age, rating and duration shall not exceed the
higher of the rate shown in the attached schedule (Exhibit B) for that age,
rating and duration or the one year term rate on the appropriate multiple of the
1958 CSO table at [percentage].
2. Premiums for the bordereau portion of the reinsurance account are
calendar month premiums payable at the end of the quarter in which they become
due. Premiums for the individual cession portion of the account are annual
policy year premiums payable in advance at the beginning of the month following
issue and at the beginning of the month in which a renewal anniversary occurs.
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ARTICLE VIII
Experience Refunds
1. The schedule of reinsurance premiums applicable to reinsurance ceded
under the terms of this Agreement has been especially designed to require
minimum cash outlay. Therefore, reinsurance ceded under the terms of this
Agreement will not be considered eligible for participation in experience
refunds.
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ARTICLE IX
Tax Credits
1. The percentage reductions in Exhibit B have been calculated to reflect
the Company's premium tax liability. [name of reinsurance company] shall not
make any additional reimbursement for premium taxes.
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ARTICLE X
Reductions
1. If on a life reinsured hereunder any portion of the insurance carried
by the Company shall be reduced or terminated, the amount of reinsurance carried
by the Company on that life shall be reduced by a like amount as of the date and
time of the termination of the original insurance. Should the amount of
insurance terminated exceed the total amount of reinsurance carried by the
Company on the life, all such reinsurance shall be terminated.
2. The reduction shall be applied first to the reinsurance directly
applicable to the Company's policy which is reduced or cancelled, the
reinsurance of the [name of reinsurance company] being reduced by an amount
which shall be the same proportion of the amount of insurance terminated that
the [name of reinsurance company]'s reinsurance bore to the total amount of
reinsurance under that particular policy.
3. If any portion of the terminated insurance was retained by the
Company, a reduction equal to the amount of such retention shall be made in the
reinsurance in force under all other policies on the life, if any, each
reinsurer sharing in the reduction according to its proportion of that
reinsurance on the life not directly applicable to the policy of the Company
which was terminated. The principle to be observed being always that the
retention of the Company is to be maintained unchanged.
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4. it is agreed however, that in no case shall the Company be required to
assume a risk for an amount in excess of its regular retention limit for the age
at issue and mortality rating of the policy under which reinsurance is being
terminated. If the cancellation of reinsurance in accordance with the above
rules would have this result, the amount of reinsurance to be cancelled shall be
such that the Company shall be placed upon the risk for its regular limit of
retention.
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ARTICLE XI
Retention Limit Increases (Recapture)
1. If the Company increases its limit of retention, a corresponding
reduction may be made at the option of the Company in the reinsurance in force
on all lives on which the Company had its maximum limit of retention at the time
reinsurance was ceded. However:
(a) No risk shall be recaptured prior to the earliest recapture
date specified in Exhibit B.
2. Recapture shall be effected as follows:
(a) After the retention increase is effected, the Company shall
promptly notify the [name of reinsurance company] of its
intention to recapture.
(b) Eligible policies shall be recaptured on the first renewal
date following the notice of intention to recapture.
(c) All eligible policies shall be recaptured unless there is
mutual agreement to the contrary ex-pressed in writing.
(d) If the Company has reinsured any portion of the risk in
another company, the reduction in reinsurance ceded under this
Agreement shall be in the same proportion to the total
reduction in reinsurance as the amount reinsured under the
Agreement bears to the total reinsurance on the risk.
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(e) In determining the new retention for a particular policy, the
age and rating at issue should be used.
(f) if at the time of recapture the risk is on active claim for
Waiver of Premium Disability, the Life risk shall still be
considered eligible for recapture. However, the Disability
reinsurance shall remain in force until the claim is
terminated, at which time the Disability risk shall be
recaptured. However, if within [number] years of said
recapture the Waiver of Premium claim is resumed due to an
extension of the initial disablement, the [name of reinsurance
company] shall be liable for payment of its share of premiums
waived by the Company, subject to collection of Disability
premiums on [name of reinsurance company]'s share of the risk
for the period following recapture of the Disability risk.
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ARTICLE XII
Reinstatements
1. Should an insured under a lapsed or surrendered policy apply for
reinstatement of that policy in accordance with the terms of the policy or the
practices of the Company, the Company may automatically reinstate any
reinsurance on that policy provided the reinsurance was originally ceded on an
automatic basis or the application for reinstatement is made within 90 days of
the date of lapse. Otherwise, the reinstatement application shall be submitted
to the [name of reinsurance company] for facultative consideration.
2. Premiums and interest on reinstated reinsurance shall be payable only
to the extent that the Company collects premiums and interest on such insurance.
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ARTICLE XIII
Policy Changes
1. If any change which affects the reinsurance hereunder shall be made in
the policy issued by the Company to the insured, the Company shall notify the
[name of reinsurance company] of such change within a reasonable time.
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ARTICLE XIV
Settlement of Claims
1. In the case of a claim on a reinsured policy, whether claim payment is
made under the strict policy conditions or compromised for a lesser amount, the
settlement made by the Company shall be unconditionally binding upon the [name
of reinsurance company]. If the Company has no part of the risk on a contestable
claim, the [name of reinsurance company] shall be consulted before admission or
acknowledgement of the claim is made by the Company. However, such consultation
shall not impair the Company's freedom to determine the proper action on the
claim and the settlement made by the Company shall still be unconditionally
binding on the [name of reinsurance company].
2. The Company shall furnish the [name of reinsurance company] with
copies of the proofs of claim, together with any information the Company may
possess in connection with the claim. Payment in settlement of the reinsurance
under a claim approved and paid by the Company for a life reinsured hereunder
shall be made by the [name of reinsurance company] upon the receipt of the claim
papers.
3. The [name of reinsurance company] shall share in the expense of any
contest or compromise of a claim in the same proportion that the net amount at
risk reinsured with the [name of reinsurance company] bears to the total net
risk of the Company under all policies on that life being contested by the
Company and shall share in the total amount of any reduction in liability in the
same proportion.
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Compensation of salaried officers and employees of the Company and any possible
extracontractual damages shall not be considered claim expenses.
4. In the event of an increase or reduction in the amount of the
Company's insurance on any policy reinsured hereunder because of a misstatement
of age or sex being established after the death of the Insured, the Company and
the [name of reinsurance company] shall share in such increase or reduction in
proportion to their respective net amounts at risk under such policy.
5. If a claim is approved for Waiver of Premium benefit on a reinsured
policy, the Company shall continue to pay the premiums for reinsurance except
the premium for Disability reinsurance. The [name of reinsurance company] shall
pay its pro rata portion of the premiums waived on the original policy including
the premiums for benefits that remain in effect during disability.
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ARTICLE XV
Inspection of Records
1. The [name of reinsurance company] shall have the right at all
reasonable times and for any reasonable purpose to inspect at the office of the
Company all books and documents referring to reinsurance ceded to the [name of
reinsurance company].
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ARTICLE XVI
Insolvency
1. In the event of the insolvency of the Company all reinsurance made,
ceded, renewed or otherwise becoming effective under this Agreement shall be
payable by the [name of reinsurance company] directly to the Company or to its
liquidator, receiver, or statutory successor on the basis of the liability of
the Company under the contract or contracts reinsured without diminution because
of the insolvency of the Company. It is understood, however, that in the event
of the insolvency of the Company, the liquidator or receiver or statutory
successor of the insolvent Company shall give written notice of the pendency of
a claim against the insolvent Company on the policy reinsured within a
reasonable time after such claim is filed in the insolvency proceeding and that
during the pendency of such claim the [name of reinsurance company] may
investigate such claim and interpose, at its own expense, in the proceeding
where such claim is to be adjudicated any defense or defenses which it may deem
available to the Company or to its liquidator or receiver or statutory
successor.
2. It is further understood that the expense thus incurred by the [name
of reinsurance company] shall be chargeable, subject to court approval, against
the insolvent Company as part of the expense of liquidation to the extent of a
proportionate share of the benefit which may accrue to the Company solely as a
result of the defense undertaken by the [name of reinsurance company]. Where two
or more assuming insurers are involved in the same claim and a majority
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in interest elect to interpose defense to such claim, the expense shall be
apportioned in accordance with the terms of the Reinsurance Agreement as though
such expense had been incurred by the Company.
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ARTICLE XVII
Arbitration
1. In the event of any difference arising hereafter between the
contracting parties with reference to any transaction under this Agreement, the
same shall be referred to three arbitrators who must be executive officers of
life insurance or life reinsurance companies other than the two parties to this
Agreement or their affiliates, each of the contracting companies to appoint one
of the arbitrators and such two arbitrators to select the third. Should the two
arbitrators not be able to agree on the choice of the third, then the
appointment shall be left to the President of the American Council of Life
Insurance or its successor organization.
2. The arbitrators shall consider this Reinsurance Agreement not merely
as a legal document but also as a gentlemen's agreement. They shall decide by a
majority vote of the arbitrators. There shall be no appeal from their written
decision.
3. Each party shall bear the expense of its own arbitration, including
its arbitrator and outside attorney fees, and shall jointly and equally bear
with the other party the expense of the third arbitrator. Any remaining costs of
the arbitration proceedings shall be apportioned by the Board of Arbitrators.
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ARTICLE XVIII
Parties to Agreement
1. This is an Agreement solely between the Company and the [name of
reinsurance company]. The acceptance of reinsurance hereunder shall not create
any right or legal relation whatever between the [name of reinsurance company]
and the insured or the beneficiary under any policies of the Company which may
be reinsured hereunder.
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ARTICLE XIX
Duration of Agreement
1. This Agreement shall be unlimited as to its duration but may be
cancelled at any time, insofar as it pertains to the handling of new business
thereafter by either party giving ninety (90) days' notice of cancellation in
writing. The [name of reinsurance company] shall continue to accept reinsurance
in accordance with this Agreement during the ninety (90) day period aforesaid.
The reinsurance with the [name of reinsurance company] on all policies reinsured
under this Agreement shall be maintained in force as long as such policies shall
remain inforce and reinsurance premiums are paid when due (except as provided
under Article X and XI) and the [name of reinsurance company] shall remain
liable thereon until the termination or expiry of the insurance reinsured.
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IN WITNESS WHEREOF, the Company and the [name of reinsurance company] have
caused their names to be subscribed and duly attested hereunder by their
respective Authorized Officers.
IDS LIFE INSURANCE COMPANY OF NEW YORK
By /s/ Xxxxxx X. Xxxxxxx , Underwriting Officer
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Authorized Officer Title
Attest:
By ,
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Authorized Officer Title
Date:
[NAME OF REINSURANCE COMPANY]
By , President
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Authorized Officer Title
Attest:
By ,
---------------------------- ----------------------------------------
Authorized Officer Title
Date:
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EXHIBIT A
BORDEREAU REPORT FORMS
AUTOMATIC BORDEREAU REPORTING
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[NAME OF REINSURANCE COMPANY] REPORT AS OF (MONTH--YEAR)
[ADDRESS, CITY AND STATE OF REINSURANCE COMPANY]
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COMPANY NAME AND STATE
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PREPARED BY NAME TITLE DATE
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MODE OF REINSURANCE
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A. CATEGORY PREMIUMS
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LIFE DISABILITY ACCIDENT TOTAL
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PRM. 1st YR.
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POLICY FEE 1st YR.
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ACCOUNTING PRM. RENEWAL
SUMMARY ----------------------------------------------------------------------------------------------------
(Reinsurance POLICY FEE RENEWAL
Only) ----------------------------------------------------------------------------------------------------
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COMM. & ALLOW. 1st YR.
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COMM. & ALLOW. REN.
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DIVIDENDS
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CASH VALUES
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CLAIMS
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TOTAL
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NUMBER AMOUNT OF
B. CLASSIFICATION OF POLICIES REINSURANCE
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In Force As of Last Report
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New Business
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Reinstatements
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Increase (Net)
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DEDUCT, CEASED BY:
Death
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POLICY Maturities
EXHIBIT ----------------------------------------------------------------------------------------------------
SUMMARY Expiries
(Reinsurance ----------------------------------------------------------------------------------------------------
Only) Surrenders
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Lapses
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Conversions
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Recapture
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Decrease Other
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Decrease (Net)
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In Force as of Current Report
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NOTE: Amounts of Reinsurance are based on Risk Amounts (Death Benefits).
FORM L (ACC) 141: Rev. 4/83 PLEASE RETAIN COPY FOR COMPANY FILES
[NAME OF REINSURANCE COMPANY] AUTOMATIC BORDEREAU REPORTING
[address, city and state of reinsurance company]
Report As Of
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MONTH YEAR
Company Name and State
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Prepared By
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(Name) (Title) (Date)
MODE OF REINSURANCE
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PLAN
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C. RESERVE SUMMARY (REINSURANCE ONLY) RESERVE BASIS
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Life Only
---------------------------------------------------------- Annual
Year Age No. of Classifica- Mean Mean Disability Accident
of at Poli- Policy tion Amt if Reserve Reserve Premium
Issue Iss. cies Exhibit Amt Different Factor Amount Waived Amount
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Note: For Accident Show Maximum Amount of Accident Coverage
FORM L (ACC) 141: Rev. 4/83 Please Retain Copy For Company Files
[logo][name of reinsurance company] [address, city and state of reinsurance
company]
BORDEREAU - FACULTATIVE APPLICATION
HAS THIS RISK BEEN SUBMITTED TO NARe BEFORE EITHER FORMALLY OR INFORMALLY |_| Yes |_| No
STATE OF
INSURED'S LAST NAME FIRST MIDDLE DATE OF BIRTH STATE OF BIRTH RESIDENCE SEX AGE
PAYOR OR JOINT INSURED
PLEASE INDICATE |_| YES |_| NO SECOND LIFE TO BE CONSIDERED FOR REINSURANCE
LIFE *ADD'L LIFE BENEFIT DISABILITY BENEFIT ACCIDENT BENEFIT OTHER (SPECIFY)
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INSURANCE IN FORCE OUR COMPANY
OF WHICH WE RETAIN
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NEW INSURANCE APPLIED FOR
OF WHICH WE WILL RETAIN
REINSURANCE APPLIED FOR
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* PLEASE INDICATE LIABILITY UNDER ADDITIONAL LIFE BENEFITS SUCH AS: INCREASING TERM, DIVIDEND OPTIONS, CASH VALUE
RIDER, ETC.
IT IS UNDERSTOOD THAT THE ABOVE NAMED APPLICANT HAS BEEN GIVEN PRE-NOTICE OF THE MEDICAL INFORMATION BUREAU AND
THAT THE CEDING COMPANY HAS IN ITS HOME OFFICE AN APPROVED AUTHORIZATION FORM SIGNED BY THIS APPLICANT.
PLEASE REPLYBY |_| TELEPHONE |_| DATAPHONE |_| TELETYPE |_| MAIL
NAME OF CEDING COMPANY STATE DATE UNDERWRITER RESPONSIBLE FOR CASE
REMARKS:
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EXHIBIT B
REINSURANCE PREMIUMS
REINSURANCE PREMIUMS
I. Plans and Riders: XX 00
XX 000
Xxxxx Insured Rider
Waiver of Monthly Deduction Rider
II. Monthly Standard Reinsurance Risk Premiums: Reinsurance on the above plans
of insurance and riders ceded on a bordereau basis shall employ monthly
reinsurance premiums equal to one twelfth the greater of:
a) the annual cost of insurance rates attached to this Exhibit B,
or
b) the annual cost of insurance rates actually charged the
insured,
less the following percentage reductions:
Policy Year
-----------
1 2-10 11+
--- ------ -----
Nonsmoker [percentage] [percentage] [percentage]
Smoker [percentage] [percentage] [percentage]
III. Multiple Table Substandard Reinsurance Risk Premiums: The percentage
premium reductions specified in Section II, above shall apply to multiple
table substandard premiums.
IV. Annual Premiums: Reinsurance on the above plans of insurance and riders
ceded on an individual cession basis shall employ annual reinsurance
premiums as attached to this Exhibit.
V. Flat Extra Substandard Reinsurance Premiums:
a) Permanent Flat Extra Premiums are ones assessed for more than
[number] years. [name of reinsurance company] should receive
its proportionate share of any such premiums less the
percentage premium reductions specified in Section II., above.
b) Temporary Flat Extra Premiums are ones assessed for [number]
years or less. [name of reinsurance company] should receive
its proportionate share of any such premiums less a
[percentage] reduction in all policy years.
EXHIBIT B
Page 1 of 2
VI. Premiums For Disability Waiver Benefit: [name of reinsurance company]
shall receive its proportionate share of disability premiums less the
percentage reductions specified in Section II., above.
VII. Reinsurance Premiums For Policies Converted To The Above Plans: Any
reinsurance in force with the [name of reinsurance company] on policies
converted to or reissued on the above plans shall be continued with the
[name of reinsurance company]. The reinsured risk amount shall be
determined as described in Article V following the conversion or reissue.
The applicable reinsurance premiums will be determined as described in
this Exhibit B, with age and duration measured from the date of issue of
the original policy.
VIII. Recapture: Reinsurance ceded on these rates shall not be eligible for
recapture before the tenth policy anniversary.
EXHIBIT B
Page 2 of 2
IDS LIFE INSURANCE COMPANY OF NEW YORK
UNIVERSAL LIFE 50
OTHER INSURED RIDER
UL-50
RATE MALE
ANNUAL COST OF INSURANCE PER $1,000
STANDARD NON-SMOKER
-------------------------------------- ----------------------------
ALL. CURRENT WAIVER OF CURRENT WAIVER OF
AGE RATE MO. DED. RATE MO. DED.
-------------------------------------- ----------------------------
0
1
2
3
4
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5
6
7
8
9
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10
11
12
13
14
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15
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17
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19
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20
21
22
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24
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25
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29
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30
31
32
33
34
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35
36
37
38
39
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40
41
42
43
44
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IDS LIFE INSURANCE COMPANY OF NEW YORK
UNIVERSAL LIFE 50
OTHER INSURED RIDER
UL-50
RATE MALE
ANNUAL COST OF INSURANCE PER $1,000
STANDARD NON-SMOKER
---------------------------------------- ------------------------------
ALL. CURRENT WAIVER OF CURRENT WAIVER OF
AGE RATE MO. DED. RATE MO. DED.
---------------------------------------- ------------------------------
45
40
47
48
49
---------------------------------------- ------------------------------
60
51
52
53
54
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56
56
57
58
59
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60
61
62
63
64
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65
66
67
68
69
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70
71
72
73
74
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75
78
77
78
79
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80
81
82
83
84
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86
86
87
88
89
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90
91
92
93
94
95
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IDS LIFE INSURANCE COMPANY OF NEW YORK
UNIVERSAL LIFE 50
OTHER INSURED RIDER
UL-50
RATE FEMALE
ANNUAL COST OF INSURANCE PER $1,000
---------------------------------------- ------------------------------
ALL. CURRENT WAIVER OF CURRENT WAIVER OF
AGE RATE MO. DED. RATE MO. DED.
---------------------------------------- ------------------------------
0
1
2
3
4
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5
6
7
8
9
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10
11
12
13
14
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15
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17
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19
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20
21
22
23
24
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25
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29
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30
31
32
33
34
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35
36
37
38
39
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40
41
42
43
44
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DS LIFE INSURANCE COMPANY OF NEW YORK
UNIVERSAL LIFE 50
OTHER INSURED RIDER
UL-50
RATE FEMALE
ANNUAL COST OF INSURANCE PER $1,000
STANDARD NON-SMOKER
------------------------------------ ----------------------------
ALL. CURRENT WAIVER OF CURRENT WAIVER OF
AGE RATE MO. DED. RATE MO. DED.
------------------------------------ ----------------------------
45
40
47
48
49
------------------------------------ ----------------------------
60
51
52
53
54
------------------------------------ ----------------------------
56
56
57
58
59
------------------------------------ ----------------------------
60
61
62
63
64
------------------------------------ ----------------------------
65
66
67
68
69
------------------------------------ ----------------------------
70
71
72
73
74
------------------------------------ ----------------------------
75
78
77
78
79
------------------------------------ ----------------------------
80
81
82
83
84
------------------------------------ ----------------------------
86
86
87
88
89
------------------------------------ ----------------------------
90
91
92
93
94
95
------------------------------------ ----------------------------
DS LIFE INSURANCE COMPANY OF NEW YORK
UNIVERSAL LIFE 100
OTHER INSURED RIDER
UL-100
RATE MALE
ANNUAL COST OF INSURANCE PER $1,000
STANDARD NON-SMOKER
----------------------------------- ----------------------------
ALL. CURRENT WAIVER OF CURRENT WAIVER OF
AGE RATE MO. DED. RATE MO. DED.
----------------------------------- ----------------------------
0
1
2
3
4
----------------------------------- -----------------------------
5
6
7
8
9
----------------------------------- -----------------------------
10
11
12
13
14
----------------------------------- -----------------------------
15
16
17
18
19
----------------------------------- -----------------------------
20
21
22
23
24
----------------------------------- -----------------------------
25
26
27
28
29
----------------------------------- -----------------------------
30
31
32
33
34
----------------------------------- -----------------------------
35
36
37
38
39
----------------------------------- -----------------------------
40
41
42
43
44
----------------------------------- -----------------------------
DS LIFE INSURANCE COMPANY OF NEW YORK
UNIVERSAL LIFE 100
OTHER INSURED RIDER
UL-100
RATE MALE
ANNUAL COST OF INSURANCE PER $1,000
STANDARD NON-SMOKER
----------------------------------- ----------------------------
ALL. CURRENT WAIVER OF CURRENT WAIVER OF
AGE RATE MO. DED. RATE MO. DED.
----------------------------------- ----------------------------
45
46
47
48
49
------------------------------------- ----------------------------
60
51
52
53
54
------------------------------------ -----------------------------
56
56
57
58
59
------------------------------------ -----------------------------
60
61
62
63
64
------------------------------------ -----------------------------
65
66
67
68
69
------------------------------------ -----------------------------
70
71
72
73
74
------------------------------------ -----------------------------
75
78
77
78
79
------------------------------------ -----------------------------
80
81
82
83
84
------------------------------------ -----------------------------
86
86
87
88
89
------------------------------------ -----------------------------
90
91
92
93
94
95
------------------------------------- -----------------------------
DS LIFE INSURANCE COMPANY OF NEW YORK
UNIVERSAL LIFE 100
OTHER INSURED RIDER
UL-100
RATE FEMALE
ANNUAL COST OF INSURANCE PER $1,000
STANDARD NON-SMOKER
---------------------------------- ----------------------------
ALL. CURRENT WAIVER OF CURRENT WAIVER OF
AGE RATE MO. DED. RATE MO. DED.
---------------------------------- ----------------------------
0
1
2
3
4
--------------------------------- ----------------------------
5
6
7
8
9
--------------------------------- ----------------------------
10
11
12
13
14
--------------------------------- ----------------------------
15
16
17
18
19
--------------------------------- ----------------------------
20
21
22
23
24
--------------------------------- ----------------------------
25
26
27
28
29
--------------------------------- ----------------------------
30
31
32
33
34
--------------------------------- ----------------------------
35
36
37
38
39
--------------------------------- ----------------------------
40
41
42
43
44
---------------------------------- ----------------------------
DS LIFE INSURANCE COMPANY OF NEW YORK
UNIVERSAL LIFE 100
OTHER INSURED RIDER
UL-100
RATE FEMALE
ANNUAL COST OF INSURANCE PER $1,000
STANDARD NON-SMOKER
------------------------------------- -----------------------------
ALL. CURRENT WAIVER OF CURRENT WAIVER OF
AGE RATE MO. DED. RATE MO. DED.
------------------------------------- -----------------------------
45
46
47
48
49
------------------------------------ ------------------------------
60
51
52
53
54
------------------------------------ ------------------------------
56
56
57
58
59
------------------------------------ ------------------------------
60
61
62
63
64
------------------------------------ ------------------------------
65
66
67
68
69
------------------------------------ ------------------------------
70
71
72
73
74
------------------------------------ ------------------------------
75
78
77
78
79
------------------------------------ ------------------------------
80
81
82
83
84
------------------------------------ ------------------------------
86
86
87
88
89
------------------------------------ ------------------------------
90
91
92
93
94
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EXHIBIT C
INDIVIDUAL CESSION REPORT FORMS
SCHEDULE I
LIMITS OF RETENTION AND AUTOMATIC REINSURANCE COVERAGE
IDS Life Insurance Company of New York
Limits of Retention:
A. Life:
Standard Table D Table E and above
Ages F.E. up to $10/M F.E. $10.01 and above
---- ---------------- ---------------------
0-55 [dollar amount] [dollar amount]
56-65 [dollar amount] [dollar amount]
66 and Over [dollar amount] [dollar amount]
Retention Corridor: The Company, in addition to the amounts shown
above, will retain an additional $25,000 whenever possible to avoid
reinsurance of small amounts.
Military Aviation Risk: For military aviation risks, the Company
will cede one-half of all policies of [dollar amount] or more. If
two plans are involved, the Company will cede one-half of each
plan. If the first year decreased amount at risk is under $10,000
no reinsurance will be required. However, if there is previous
military reinsurance, the Company will cede one-half of all cases
regardless of the first year risk amount.
B. Waiver of Premium: The amount of Waiver of Premium ceded is based on a
proportionate part of the total premium for the policy exclusive of any
premium for Waiver of Premium and exclusive of any premium for Family or
Children's Riders. Such proportionate part is determined by dividing the
initial amount of reinsurance ceded by the total initial amount of
insurance.
Automatic Reinsurance Coverage:
A. Life:
1. Standard thru Table D: [dollar amount] less the retention specified
in I. A., above.
2. Table E and above[dollar amount] less the retention specified in I.
A., above.
B. Waiver of Premium: Same as Life
