Form of
REINSURANCE AGREEMENT
(hereinafter called Agreement)
between
SAFECO Life Insurance Company
(hereinafter called SAFECO)
and
The Undersigned
Reinsurer
It is agreed by the two companies as follows:
ARTICLE I PARTIES TO THE AGREEMENT
This Agreement shall be binding upon and shall inure solely to the benefit of
SAFECO and Reinsurer. This Agreement shall not and is not intended to
create any right or interest in any third party and shall not and is not
intended to create any legal relationship between either party and any third
party, including, without limitation, annuitants, insured, certificate holders,
employees, dependents, beneficiaries, policy owners, applicants or assignees
under any policy or contract issued by SAFECO.
ARTICLE II AMOUNTS AT RISK
A. Refer to Schedule C for a full description of the guaranteed minimum death
benefit.
B. The contract value represents the owner's invested assets in the funds in
Schedule B as it appears in the records of SAFECO before application of any
surrender charges, on any given date.
C. This policy is sold as an Internal Revenue Code (IRC) Section 408 (XXX)
annuity, Section 457 (Government Deferred Compensation) annuity, Section
403(b) (TSA) annuity and as a non-qualified annuity. Reinsurer will
reinsure 50% of both qualified and non-qualified annuities.
ARTICLE III AUTOMATIC EXCESS REINSURANCE
A. On and after the Effective Date of this Agreement, subject to the limit of
Reinsurer's liability set forth in Schedule A and all other terms,
conditions and limitations set forth in this Agreement and the Schedules
attached to and made a part hereof, SAFECO shall cede and the Reinsurer
shall accept 50% of SAFECO's guaranteed death benefit liability under the
Variable Annuity Contracts, as described in Article II A.
B. This Agreement covers only SAFECO's liability for claims paid under
Variable Annuity Contracts written on forms and investment in funds which
were reviewed and approved by the Reinsurer prior to their issuance. Forms,
as supplemented by additional materials, and funds approved as of the date
of this Agreement are listed on Schedule B, attached hereto and made a part
hereof. If SAFECO intends to use a new form or fund, or revise an approved
form or fund, the Reinsurer shall have reinsurance liability under this
Agreement only after having approved the use of the proposed form, fund, or
revision after receipt of written notice of such intention together with a
copy of the proposed form, fund or revision. The Reinsurer has the right to
approve or reject the proposed form, fund or revision. Such approval or
rejection shall be in writing. SAFECO shall provide Reinsurer a revised
Schedule B whenever a form, fund or revision is approved for use by the
Reinsurer.
C. SAFECO shall provide written notice to Reinsurer of any changes in its
published limits and rules identified on Schedule C, and Reinsurer.
Reinsurer shall have no liability pursuant to revised limits and rules
unless and until Reinsurer provides written notice to SAFECO that such
revised limits and rules are acceptable.
ARTICLE IV LIABILITY OF REINSURER
Reinsurer's liability for reinsurance under this Agreement shall
follow that of SAFECO in every case, and be subject to all respects to the
general stipulations, terms, clauses, conditions, waivers and modifications of
the Variable Annuity Contracts.
In no event shall Reinsurer have any reinsurance liability unless the
Variable Annuity Contract issued by SAFECO is in force and the underwriting and
issuance of coverage by SAFECO constitutes the doing of business in a state of
the United States of America in which SAFECO is properly licensed and
authorized to do business.
ARTICLE V REINSURANCE PREMIUMS
The quarterly premiums for reinsurance subject to the terms and conditions of
this Agreement shall be determined by application of the rates set forth in
Schedule D to the amount of reinsurance coverage provided for each annuity
insured by SAFECO, subject to the following:
1. The reinsurance premiums shall be based on the owner's age at the end of
each quarter. If the contract is jointly owned, the reinsurance premiums
shall be based on the age of the older owner. SAFECO shall determine the
owner's age at the time it prepares the quarterly exposure data submission
for the variable annuity guaranteed death benefit, as set forth in Schedule
E, attached hereto.
2. The Age Adjusted Aggregate Contract Value is the sum of the contract values
in all of SAFECO's variable annuities subject to this Agreement, minus
contract values attributable to amounts in excess of the maximum purchase
amounts listed in Schedule A. 50% of the Age Adjusted Aggregate Contract
Values times one fourth (1/4) of the minimum premium rate will be remitted
to Reinsurer in advance for the current quarter, at the time of settlement
for the prior quarter.
3. For contract holders with attained ages less than 65 and for qualified
business only, the reinsurance premium over each calendar year will be at
least equivalent to _______________, subject to the funds set forth in
Schedule B.
4. For contract holders with attained ages less than 65 and for qualified
business only, the reinsurance premium over each calendar year will be
_______________________, subject to the funds set forth in Schedule B.
5. For contract holders with attained ages 65 and above and for qualified
business only, the reinsurance premium over each calendar year will be
_______________, subject to the funds set forth in Schedule B.
6. For contract holders with attained ages less than 65 and for non-qualified
business only, the reinsurance premium over each calendar year will be
_______________, subject to the funds set forth in Schedule B.
7. For contract holders with attained ages less than 65 and for non-qualified
business only, the reinsurance premium over each calendar year will
be _______________, subject to the funds set forth in Schedule B.
8. For contract holders with attained ages 65 and above and for non-qualified
business only, the reinsurance premium over each calendar year will be
_______________, subject to the funds set forth in Schedule B.
9. The reinsurance premium during any quarter will be the product of the
quarterly exposure, as described in paragraph 10 below, and the age and sex
specific rate from Schedule D, the Quarterly Reinsurance Premium Rate
table. The actual reinsurance premium earned by the Reinsurer will be
subject to the minimum and maximum amounts described above.
10. For calculating quarterly exposure, the account value is subtracted from
the Minimum Guaranteed Death Benefit (MGDB) for every annuitant at the
beginning of each quarter and at the end of each quarter. Negative amounts
are not included. The average of these two values is the quarterly
exposure.
11. For calculating the minimums and maximums described in paragraphs 2-8
above, the Age Adjusted Aggregate Contract Value is the average of the
values taken on the beginning of each quarter and the end of each quarter.
ARTICLE VI PREMIUM ACCOUNTING
SAFECO shall forward to Reinsurer within 30 days of the end of the reporting
period a quarterly statement as set forth in Schedule E. SAFECO shall also remit
any premium due for the prior quarter along with an advance minimum premium for
the current quarter, in accordance with Article V.
ARTICLE VII CLAIMS
A. SAFECO is solely responsible for payment of its claims under the Underlying
Annuity Contracts, policies, master contracts or certificates identified on
Schedule B. SAFECO shall provide Reinsurer with proof of claim, proof of
claim payment and any other claim documentation requested by Reinsurer.
Payment of reinsurance shall be made by Reinsurer in one sum regardless of
the method of payment by SAFECO and within thirty (30) calendar days
following receipt of the quarterly reinsurance statement, as set forth in
Schedule E.
B. SAFECO shall notify Reinsurer of its intentions to contest, compromise, or
litigate a claim involving reinsurance.
ARTICLE VIII RESERVES
The reserve held by Reinsurer for reinsurance of the variable annuity death
benefit will be determined as follows:
The amount determined not to be less than the recognized statutory required
reserve (or that required by model law, regulation or Actuarial Guideline
adopted by the National Association of Insurance Commissioners (NAIC) if no
statutory requirement exists).
In the absence of any of the above, reserving will follow that recommended in
the American Academy of Actuaries June 1996 report on Reserving for Minimum
Guaranteed Death Benefits for Variable Annuities.
ARTICLE IX EXTRA CONTRACTUAL OBLIGATIONS
A. In no event shall Reinsurer be liable for extra contractual damages
(whether they constitute Compensatory damages, Statutory penalties,
Exemplary or Punitive damages) which are awarded against SAFECO as a result
of an act, omission or course of conduct by SAFECO in connection with
policies subject to this Agreement, unless the Reinsurer shall have
received notice of and concurred with the actions taken or not taken by
SAFECO which led to its liability, in which case the Reinsurer shall pay
its share of such liability. For this purpose, the Reinsurer's share will
be proportionate with its risk under the business reinsured hereunder.
B. The following definitions shall apply:
(1) Punitive damages and Exemplary damages are those damages awarded as a
penalty, the amount of which is not governed nor fixed by statute.
(2) Statutory penalties are those amounts that are awarded as a penalty
but fixed in amount by statute.
(3) Compensatory damages are those amounts awarded to compensate for the
actual damages sustained and are not awarded as a penalty nor fixed in
amount by statute.
ARTICLE X LITIGATION
A. In the event of any action brought against SAFECO under any Underlying
Annuity Contract that is subject to the terms and conditions of this
Agreement, SAFECO shall provide a copy of such action and written notice of
such action within seven (7) business days to Reinsurer. If Reinsurer is a
party to action brought against SAFECO, SAFECO shall seek agreement by
Reinsurer on the selection and appointment of local counsel to represent
SAFECO in such action.
B. SAFECO and Reinsurer agree that all litigation costs, excluding the
salaries of employees of SAFECO and Reinsurer, shall be borne by SAFECO.
ARTICLE XI OFFSET
Either party shall have, and may exercise at any time and from time to time, the
right to offset any balance or amounts whether on account of premiums or on
account of losses or otherwise, due from one party to the other under the terms
of this Agreement. However, in the event of insolvency of SAFECO subject to the
provisions of Article XVI, offset shall only be allowed in accordance with the
statutes and/or regulations of the state having jurisdiction over the
insolvency.
ARTICLE XII ACCESS TO RECORDS
Either party, or its duly authorized representative, shall have access (at any
reasonable time) to all records of SAFECO (including the right to photocopy
documents) which pertain in any way to this reinsurance. The right of access
shall survive the termination of this Agreement.
ARTICLE XIII DELAYS, ERRORS OR OMISSIONS
No accidental delay, errors or omissions on the part of SAFECO shall relieve
Reinsurer of liability provided such delay, errors or omissions are rectified as
soon as possible after discovery. However, Reinsurer shall not be liable with
respect to any reinsurance which may have been inadvertently included in the
premium computation but which ought not to have been included by reason of the
terms and conditions of this Agreement. It is expressly understood and agreed
that if failure to comply with any terms of this Agreement is hereby shown to be
unintentional or the result of misunderstanding or oversight on the part of
either party, both parties shall be restored to the position they would have
occupied had no such error or oversight occurred, subject always to the
correction of the error or oversight.
ARTICLE XIV CURRENCY
All retentions and limits hereunder are expressed United States dollars and all
premium and loss payments shall be made in United States currency. For the
purposes of this Agreement, amounts paid or received by Reinsurer in any other
currency shall be converted into United States dollars at the rates of exchange
on the date such transactions are entered on the books of Reinsurer.
ARTICLE XV HOLD HARMLESS
A. Reinsurer shall indemnify and hold SAFECO harmless from any and all
liability, loss, damage, fines, punitive damages, penalties and costs,
including expenses and attorney's fees, which results from any negligence
or willful misconduct of Reinsurer in fulfilling its duties and obligations
under this Agreement or which results from any action which exceeds its
authority under this Agreement.
B. SAFECO shall indemnify and hold Reinsurer harmless from any and all
liability, loss, damage, fines, punitive damages, penalties and costs,
including expenses and attorney's fees, which results from any negligence
or willful misconduct of SAFECO in fulfilling its duties and obligations
under this Agreement or which results from any action which exceeds its
authority under this Agreement.
ARTICLE XVI INSOLVENCY
In the event of insolvency of SAFECO, the reinsurance under this Agreement shall
be payable directly by Reinsurer to SAFECO or to its liquidator, receiver,
conservator or statutory successor on the basis of Reinsurer's liability to
SAFECO without diminution because of the insolvency of SAFECO or because the
liquidator, receiver, conservator or statutory successor of SAFECO has failed to
pay all or a portion of any claim. It is agreed, however, that the liquidator,
receiver, conservator or statutory successor of SAFECO has failed to pay all or
a portion of any claim. It is agreed, however, that the liquidator, receiver,
conservator or statutory successor of SAFECO shall give prompt written notice to
Reinsurer of the pendency of a claim against SAFECO within a reasonable time
after such claim is filed in the receivership, conservation, insolvency or
liquidation proceeding and that during the pendency of such claim, Reinsurer may
investigate such claim and interpose, at its own expense, in the proceeding
where such claim is to be adjudicated, any defense or defenses that it may deem
available to SAFECO or its liquidator, receiver, conservator or statutory
successor. The expense thus incurred by Reinsurer shall be chargeable, subject
to the approval of the Court, against SAFECO as part of the expense of
conservation or liquidation to the extent of a pro-rate share of the benefit
which may accrue to SAFECO solely as a result of the defense undertaken by
Reinsurer.
Where two or more reinsurers are involved in the same claim and a majority in
interest elect to interpose defense to such claim, the expense shall be
apportioned in accordance with the terms of this Agreement as though such
expense had been incurred by SAFECO.
ARTICLE XVII ARBITRATION
A. As a condition precedent to any right of action hereunder, any dispute
between the parties with respect to the interpretation of this Agreement or
any right, obligation or liability of either party, whether such dispute
arises before or after termination of this Agreement, shall be submitted to
arbitration upon the written request of either party. Each party shall
select an arbitrator within thirty (30) days of the written request for
arbitration. If either party refuses or neglects to appoint an arbitrator
within thirty (30) days of the written request for arbitration, the other
party may appoint the second arbitrator. The two arbitrators shall select
an umpire within thirty (30) days of the appointment of the second
arbitrator. If the two arbitrators fail to agree on the selection of the
umpire within thirty (30) days of the appointment of the second arbitrator,
each arbitrator shall submit to the other a list of three umpire
candidates, each arbitrator shall select one name from the list submitted
by the other and the umpire shall be selected from the two names chosen by
a lot drawing procedure to be agreed upon by the arbitrators.
B. The arbitrators and the umpire all shall be active or retired,
disinterested executive officers of insurance or reinsurance companies.
C. The arbitration panel shall interpret this Agreement as an honorable
engagement rather than merely as a legal obligation and shall make its
decision considering the custom and practice of the applicable insurance
and reinsurance business. The arbitration panel is released from judicial
formalities and shall not be bound by strict rules of procedure and
evidence.
D. The decision of the arbitration panel shall be final and binding on both
parties. The arbitration panel may, at its discretion, award costs and
expenses as it deems appropriate, including, but not limited to, attorney's
fees and interest. Judgment may be entered upon the final decision of the
arbitration panel in any court of competent jurisdiction.
E. All meetings and hearings before the arbitration panel shall take place in
_______________________ unless some other place is mutually agreed upon by
the parties.
F. Each party shall bear the expense of its own arbitrator and shall jointly
and equally bear with the other party the expenses of the umpire and of the
arbitration.
ARTICLE XVIII DAC TAX REGULATION ELECTION
Reinsurer and SAFECO hereby agree to make an election pursuant to Internal
Revenue Code Regulation Section 1.848-2(g)(8). This election shall be effective
for all taxable years for which the Reinsurance Agreement remains in effect.
The terms used in this article are defined by reference to Regulation Section
1.848-2 promulgated on December 28, 1992.
Reinsurer and SAFECO agree that the entity with net positive consideration for
the reinsurance agreement for each taxable year will capitalize specified policy
acquisition expenses with respect to the reinsurance agreement without regard to
the general deductions limitation of Section 848(c)(1) of the Internal Revenue
Code of 1986, as amended.
Reinsurer and SAFECO agree to exchange information pertaining to the amount of
net consideration under the reinsurance agreement each year to ensure
consistency. To achieve this, SAFECO shall provide Reinsurer with a schedule of
its calculation of the net consideration for all reinsurance agreements in force
between them for a taxable year by no later than April 30 of the succeeding
year. Reinsurer shall advise SAFECO if it disagrees with the amounts provided by
no later than May 31, otherwise the amounts will be presumed correct and shall
be reported by both parties in their respective tax returns for such tax year.
If Reinsurer contests SAFECO's calculations of the net consideration, the
Parties agree to act in good faith to resolve any differences within thirty (30)
days of the date Reinsurer submits its alternative calculation and report the
amounts agreed upon in their respective tax returns for such tax year.
Reinsurer represents and warrants that it is subject to U.S. taxation under
either Subchapter L or Subpart F of Part III of Subchapter N of the Internal
Revenue Code of 1986, as amended.
ARTICLE XIX EFFECTIVE DATE: TERM AND TERMINATION
A. The effective date of this Agreement is _____________. This Agreement
remains effective for all business written by SAFECO through ____________,
unless terminated pursuant to the paragraphs listed below:
B. Once each calendar year, SAFECO shall have the option to recapture existing
contracts beginning with the twentieth (20) anniversary of their
reinsurance hereunder. Recapture must be made on an issue year basis, and
no contracts can be recaptured unless all contracts with earlier issue
years are recaptured.
C. Reinsurer shall have the option of not accepting additional contracts under
this Agreement, at any time, upon delivery of thirty (30) calendar days
written notice to SAFECO, within thirty (30) days of the happening of any
of the following events:
(1) SAFECO's assignment rating by A.M Best is modified by a Best's Rating
Modifier of "w" Rating Watch List; or SAFECO's A.M. Best rating is
reduced to a "C" or lower.
(2) SAFECO is placed upon a "watch list" by its domiciliary state's
insurance regulators;
(3) An order appointing a receiver, conservator or trustee for management
of SAFECO is entered or a proceeding is commenced for rehabilitation,
liquidation, supervision or conservation of SAFECO;
(4) SAFECO is merged, purchased or there is any other change (in whole or
in part) in the ownership of SAFECO;
(5) SAFECO withdraws from or substantially reduces the active marketing of
policy forms identified in Schedule B.
(6) The Securities and Exchange Commission revokes the licenses of SAFECO
to conduct business.
(7) Failure by SAFECO to pay premium in accordance with Article V. If,
during the thirty (30) days notice period, Reinsurer receives all
premiums in arrears and all premiums which may become due within the
thirty (30) days notice period, the notice of termination shall be
deemed withdrawn. In the event of termination under this paragraph,
this Agreement may be reinstated upon the written consent of Reinsurer
if, at any time within sixty (60) days of termination, SAFECO pays and
Reinsurer receives all premiums due and payable up to the date of
reinstatement. In the event Reinsurer consents to reinstatement, it
shall have no liability for claims incurred between the date of
termination and the date of reinstatement.
D. SAFECO may terminate this Agreement upon 30 days written notice in the
event of any of the following:
(1) Reinsurer's assigned rating by A.M. Best is modified by a Best's
Rating Modifier of "w" Rating Watch list; or Reinsurer's A.M
Best rating is reduced to a "C" or lower.
(2) Reinsurer is placed upon a "watch list" by its domiciliary state's
insurance regulators;
(3) An order appointing a receiver, conservator or trustee for management
of Reinsurer is entered or a proceeding is commenced for
rehabilitation, liquidation, supervision or conservation of Reinsurer;
(4) Reinsurer is merged, purchased or there is any other change
in its ownership;
E. If this Agreement is terminated, Reinsurer shall be relieved of all
liability to SAFECO:
(1) for claims incurred following the termination date of this Agreement
under such Underlying Annuity Contracts issued by SAFECO, and
(2) for claims incurred prior to the termination date of this Agreement,
but proof of claim approved by SAFECO and proof of claim payment made
by SAFECO is not provided to Reinsurer within twelve (12) calendar
months following the end of the month in which termination of the
Agreement is effective.
F. Reinsurer shall continue to be entitled to all offset credits provided by
Article XI for the entire amount of premiums due and payable by SAFECO up
to the effective date of termination.
G. SAFECO shall not have the right to assign or transfer any portion of the
rights, duties and obligations of SAFECO under the terms and conditions of
this Agreement without the written approval of Reinsurer.
ARTICLE XX NOTICES
All notices required to be given hereunder shall be in writing and shall be
deemed delivered if personally delivered, sent via facsimile, or dispatched by
certified or registered mail, return receipt requested, postage prepaid,
addressed to the parties as follows:
Address:
Address:
Notice shall be deemed given on the date it is deposited in the mail or sent via
facsimile in accordance with the foregoing. Any party may change the address to
which to send notices by notifying the other party of such change of address in
writing in accordance with the foregoing.
This Agreement constitutes the entire contract between the parties and shall be
deemed to have been made under and governed by the laws of the State of ________
________. Any amendment or modification hereto shall be in writing, endorsed
upon or attached hereto and signed by both SAFECO and Reinsurer.
In witness whereof, the parties hereto have caused this Agreement to be signed
in duplicate on the dates indicated to be effective as of the date specified
above.
SAFECO Life Insurance Company
Date: By:
Reinsurer
Date: By:
SCHEDULE A
Maximum Limits of Reinsurance in Reinsurer
SCHEDULE B
Contracts and Funds Subject to this Reinsurance Agreement
SCHEDULE C
Limits and Rules of SAFECO
1) (a) The Minimum Guaranteed Death Benefit: The initial Minimum Guaranteed
Death Benefit shall be equal to the initial Net Purchase Payment.
Additional Net Purchase Payments are added to the Minimum Guaranteed
Death Benefit. The Minimum Guaranteed Death Benefit will be adjusted
after any Withdrawal by multiplying it by the ratio of the Contract
Value after the Withdrawal to the Contract Value before the
Withdrawal. The Minimum Guaranteed Death Benefit shall be redetermined
on each Eight Year Contract Anniversary by taking the greater of the
Contract Value on that Eight Year Contract Anniversary or the previous
Minimum Guaranteed Death Benefit. After the Owner's death, the Minimum
Guaranteed Death Benefit will be reduced dollar for dollar by any
Withdrawals.
(b) Death Benefit Options: Upon the death of the Owner prior to the
annuity date, the Beneficiary may elect a Settlement Option or to
receive a single lump sum payment.
(c) Death Benefit (Prior to age 72)
If the Owner dies prior to age 72 and before a Settlement Option has
commenced, and provided that the Beneficiary provides due proof of
death in a form satisfactory to SAFECO and has elected a Death
Benefit Option within six (6) months of the date of death, the amount
of the Death Benefit will be the greater of:
(i) the Contract Value on the date of election of a Death Benefit
Option by the Beneficiary; or
(ii) the Minimum Guaranteed Death Benefit.
(d) Death Benefit (After age 71)
If the Owner dies after age 71 and before a Settlement Option has
commenced, and provided that the Beneficiary provides due proof of
death in a form satisfactory to SAFECO and has elected a Death Benefit
Option within (6) months of the date of death, the amount of the Death
Benefit will be the greater of:
(i) The Contract Value on the date of election of a Death Benefit
Option by the Beneficiary; or
(ii) the Minimum Guaranteed Death Benefit established on the last
Eight Year Contract anniversary preceding the Owner's 72nd
birthday, adjusted for any Net Purchase Payments received or
Withdrawals taken since that Eight Year Contract Anniversary.
(e) Death Benefit (Death notification or Death Benefit Option election
more than Six Months after Date of Death).
If notification of death or election of a Death Benefit Option occurs
after the six month anniversary of the date of death, the death
benefit will be the Contract Value on the date of election of a Death
Benefit Option determined as follows: the Contract Value calculated as
of the six-month anniversary of the date of death will be compared
with the last calculated Minimum Guaranteed Death Benefit to determine
if additional funds are required to be added by SAFECO to equal such
Minimum Guaranteed Death Benefit. SAFECO will supplement any
deficiency in Contract Value, such that Contract Value will equal the
Minimum Guaranteed Death Benefit. Thereafter, until the date of
election of a Death Benefit Option, the Contract Value attributable to
SAFECO's contribution will be guaranteed and interest paid thereon at
prevailing money market rates; the portion of the Contract Value
existing on the six month anniversary of the date of death will be
subject to adjustment reflecting the investment experience for the
period from the six-month anniversary to the date of election of a
Death Benefit Option. In addition, the amount of the death benefit
will be reduced dollar for dollar by any Withdrawal after the Owner's
death.
(f) Election Period: The election of a Settlement Option must be made by
the Beneficiary during the 60-day period commencing with the date of
receipt by SAFECO of notification of the Owner's death. If no election
is made within the 60-day period, then a single sum payment will be
made to the Beneficiary.
(g) The death benefit must be distributed:
(i) By the fifth anniversary of the Owner's death; or
(ii)Over a designated Beneficiary's life or over a period not
extending beyond the Beneficiary's life expectancy, in equal
or substantially equal payments, with payments beginning within
one year of the death of the Owner.
(h) If the Beneficiary is the spouse of the Owner, the Contract may be
continued by the spouse, and the spouse will become the Owner.
(i) Joint Owners:
(i) The Minimum Guaranteed Death Benefit will only be payable on the
death of the older joint Owner. Upon the death of the older joint
Owner, if the contract is continued, no Minimum Guaranteed Death
Benefit applies for the remaining duration of the Contract.
(ii) Upon the death of a joint Owner, the surviving Owner shall be the
designated Beneficiary. Any other named Beneficiary shall be a
contingent Beneficiary.
(iii)Upon the death of a joint Owner, the surviving Owner may elect a
Settlement Option or a lump sum payment, or may elect to continue
the Contract.
2) The maximum purchase payment without SAFECO's approval is ____________.
3) The minimum initial purchase payment varies from ___ to ___ per month.
SCHEDULE D
Quarterly Reinsurance Premium Rates
SCHEDULE E
Quarterly Reporting Format
1. Following the end of each calendar quarter, the Quarterly Detail Page,
Fund/Exposure-Based exhibit (attached) must be prepared for each reinsured
plan.
2. The tabulation should be on an Adjusted Basis, which requires omission of
excess contract values due to an issue amount in excess of _________
__________.
3. The tabulation is on a seriatim basis, with each contract contributing
toward the totals for both exposure and aggregate contract value.
4. The tabulation is necessary to assess the correct amount at risk for
accurate calculation of reinsurance premium. SAFECO can choose to report
values a) as weighted averages during the quarter, or b) as of the end of
the quarter. This election must be denoted on the submission.
5. At year end reporting, a tabulation of exposures by age and sex based on a
percentage decrease in account value specified in Reinsurer must
be submitted for reserve purposes.
VARIABLE ANNUITY DEATH BENEFIT
Quarterly Input Page, Fund/Exposure-Based
Qualified
Calendar Year
------------
Reporting Quarter
------------
Male Female
Male Female Annuity Annuity Male Female Male GMDB Female
Age Band Exposure Exposure Value Value Claims Claims GMDB
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
0 - 34
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
35 - 39
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
40 - 44
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
45 - 49
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
50 - 54
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
55 - 59
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
60 - 64
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
65 - 69
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
70 - 74
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
75 - 79
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
80 - 84
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
85 - 89
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
90 - 94
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
95 - 99
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
0 - 64 0 0 0 0 0 0 0 0
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
65+ 0 0 0 0 0 0 0 0
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
Totals 0 0 0 0 0 0 0 0
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
Total Male/Female:
------------ ------------ ------------ ------------
0 - 64 0 0 0 0
------------ ------------ ------------ ------------
65+ 0 0 0 0
------------ ------------ ------------ ------------
Totals 0 0 0 0
------------ ------------ ------------ ------------
Please use end of the period values.
Age Band Male Female
Male Male Exposure Female Female Exposure
Exposure Rates /1,000 Premium Exposure Rates /1,000 Premium
---------------- ---------------- --------------- ---------------- ---------------- ---------------
0 - 34 0 0 0 0
35 - 39 0 0 0 0
40 - 44 0 0 0 0
45 - 49 0 0 0 0
50 - 54 0 0 0 0
55 - 59 0 0 0 0
60 - 64 0 0 0 0
65 - 69 0 0
70 - 74 0 0
75 - 79 0 0
80 - 84 0 0
85 - 89 0 0
---------------- ---------------- --------------- ---------------- ---------------- ---------------
0 - 64 0 0 0 0
---------------- ---------------- --------------- ---------------- ---------------- ---------------
65+ 0 0 0 0
---------------- ---------------- --------------- ---------------- ---------------- ---------------
Totals 0 0 0 0
---------------- ---------------- --------------- ---------------- ---------------- ---------------
VARIABLE ANNUITY DEATH BENEFIT
Quarterly Input Page, Fund/Exposure-Based
Non-Qualified
---------------
Calendar Year
---------------
---------------
Reporting Quarter
---------------
Male Female
Male Female Annuity Annuity Male Female Male Female
Age Band Exposure Exposure Value Value Claims Claims GMDB GMDB
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
0 - 34
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
35 - 39
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
40 - 44
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
45 - 49
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
50 - 54
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
55 - 59
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
60 - 64
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
65 - 69
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
70 - 74
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
75 - 79
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
80 - 84
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
85 - 89
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
90 - 94
-------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
95 - 99
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
0 - 64 0 0 0 0 0 0 0 0
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
65+ 0 0 0 0 0 0 0 0
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
Totals 0 0 0 0 0 0 0 0
------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------
Total Male/Female:
------------ ------------ ------------ ------------
0 - 64 0 0 0 0
------------ ------------ ------------ ------------
65+ 0 0 0 0
------------ ------------ ------------ ------------
Totals 0 0 0 0
------------ ------------ ------------ ------------
Please use end of the period values.
Age Band Male Female
Male Male Exposure Female Female Exposure
Exposure Rates /1,000 Premium Exposure Rates /1,000 Premium
---------------- ---------------- --------------- ---------------- ---------------- ---------------
0 - 34 0 0 0 0
35 - 39 0 0 0 0
40 - 44 0 0 0 0
45 - 49 0 0 0 0
50 - 54 0 0 0 0
55 - 59 0 0 0 0
60 - 64 0 0 0 0
65 - 69 0 0
70 - 74 0 0
75 - 79 0 0
80 - 84 0 0
85 - 89 0 0
---------------- ---------------- --------------- ---------------- ---------------- ---------------
0 - 64 0 0 0 0
---------------- ---------------- --------------- ---------------- ---------------- ---------------
65+ 0 0 0 0
---------------- ---------------- --------------- ---------------- ---------------- ---------------
Totals 0 0 0 0
---------------- ---------------- --------------- ---------------- ---------------- ---------------
VARIABLE ANNUITY DEATH BENEFIT
Quarterly Input Page, Fund/Exposure-Based
--------------
Calendar Year
--------------
--------------
Reporting Quarter
--------------
Quarterly Reinsurance Premium Calculation
Part I.
A. Ages Subject to Exposure Calculation (to 65)
Qualified Non-Qualified
----------- ----------------
1 Adjusted Aggregate Annuity Value (BOQ) Prior E-2
----------- ----------------
2 Adjusted Aggregate Annuity Value (EOQ) 0 0 Current E-2
----------- ----------------
3 Average Annuity Value (1+2)/2 0 0
4 Minimum Fund-Based Premium Rate
5 Minimum Premium (4*3) 0 0
6 Maximum Fund-Based Premium Rate
7 Maximum Premium (6*3) 0 0
----------- ----------------
8 Actual Exposure Premium (BOQ) Prior E-2
----------- ----------------
9 Actual Exposure Premium (EOQ) 0 0 Current E-2
----------- ----------------
10 Average Exposure Premium (8+9)/2 0 0
11 Earned premium [max[5,min(10,7)] 0 0
12 Advance Premium Current Quarter (4*2) 0 0
----------- ----------------
13 Advance Premium Prior Quarter Prior E-3
----------- ----------------
14 Net Premium Due (11+12-13) 0 0
B. Ages Not Subject to Exposure Calculation (65+)
----------- ----------------
15 Adjusted Aggregate Annuity Value (BOQ) Prior E-2
----------- ----------------
16 Adjusted Aggregate Annuity Value (EOQ) 0 0 Current E-2
----------------
17 Average Annuity Value (15+16)/2 0 0
18 Quarterly Fund Based Premium Rate
19 Quarterly Earned Premium [17*18] 0 0
20 Advanced Premium Current Quarter [16*18] 0 0
----------- ----------------
21 Advanced Premium Prior Quarter
----------------
22 Net Premium Due [19+20-21] 0 0
23 Total Part I. Net Premium Due All Ages [Sum lines 0
14+22]
Part II.
Actual Claims
-------------- ----------------
24 Quarterly Reinsurance Amount Current E-2
----------------
Part III.
Net Transactions
25 Premium Due Reinsurer [Sum 23] 0
26 Quarterly Reinsurance Claims [Sum 24] 0
---------------
---------------
00 Xxxxxx Xxxxxxx Xxxxxxxx Year Premium Adjustment Attach
explanation
---------------
28 Prior Adjustment Attach
explanation
---------------
29 Amount Due Ceding Company [26-25+27+28]
