Exhibit 7(d)
YRT AGREEMENT
No. 5920-5
BETWEEN
PROVIDENTMUTUAL LIFE AND
ANNUITY COMPANY OF AMERICA
OF NEWARK, DELAWARE
(CEDING COMPANY)
AND
TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY
OF CEDAR RAPIDS, IOWA
(REINSURER)
EFFECTIVE OCTOBER 1, 2001
Table of Contents
Articles
1 Preamble
2 Basis of Reinsurance
3 Automatic Reinsurance
4 Procedures for Facultative Reinsurance
5 Liability
6 Notification and Reporting of Reinsurance
7 Plans of Insurance
8 Reinsurance Premiums
9 Premium Accounting
10 Reinstatement
11 Reductions, Terminations and Changes
12 Claims
13 Extra Contractual Damages
14 Increase in Retention and Recapture
15 Insolvency
16 Arbitration
17 DAC Tax
18 Entire Agreement
19 Service of Suit
20 General Provisions
21 Commencement and Termination
22 Confidentiality
Schedules
A Specifications
B Limits
C Exceptions
D Definitions
Exhibit
I Reinsurance Premiums
II YRT Premiums
III Reports
ARTICLE 1
PREAMBLE
1.01 This Agreement is made and entered into by and between Providentmutual
Life and Annuity Company of America (hereinafter referred to as the "Ceding
Company") and Transamerica Occidental Life Insurance Company (hereinafter
referred to as the "Reinsurer").
1.02 The Ceding Company and the Reinsurer mutually agree to reinsure on the
terms and conditions stated herein. This Agreement is an indemnity reinsurance
agreement and the performance of the obligations of each party under this
Agreement shall be rendered solely to the other party.
ARTICLE 2
BASIS OF REINSURANCE
2.01 BASIS. Reinsurance under this Agreement must be life insurance as
described in Schedule A.
2.02 AUTOMATIC REINSURANCE. The Ceding Company shall cede and the Reinsurer
shall automatically reinsure policies issued under the plans of insurance and
other additional benefits described in Schedule A subject to the requirements
described in Article 3.
2.03 FACULTATIVE REINSURANCE. The Ceding Company may submit to the Reinsurer
any coverage described in Schedule A for facultative review subject to the
procedures described in Article 4.
2.04 INITIAL MINIMUM. The initial minimum amount of life reinsurance on any
individual policy must be greater than or equal to the amount stated in
Schedule A.
2.05 SUBSEQUENT MINIMUM. If the subsequent amount of life reinsurance net
amount at risk falls below the minimum amount stated in Schedule A on any
policy, as of that date all of the life reinsurance on that policy shall
terminate.
2.06 ISSUANCE OF BUSINESS. In no event shall the Reinsurer be liable for
reinsurance unless the issuance of the insurance by the Ceding Company
constituted the transacting of business in a jurisdiction in which the Ceding
Company is properly licensed.
ARTICLE 3
AUTOMATIC REINSURANCE
3.01 REQUIREMENTS.
a) The individual risk must be a permanent resident of the United States,
Canada or Puerto Rico.
b) The individual risk must be underwritten by the Ceding Company
according to its standard underwriting practices and guidelines. Any
risk falling into the category of special underwriting programs,
including the Expanded Standard Program, shall be excluded from this
Agreement. Any proposed changes to the Ceding Company's standard
underwriting practices or guidelines shall be submitted to the
Reinsurer for written approval prior to implementation.
c) Any risk offered on a facultative basis by the Ceding Company to the
Reinsurer or any other company shall not qualify for automatic
reinsurance.
d) The issue age on any risk must not exceed the limit stated in Schedule
A.
e) The mortality rating on each individual risk must not exceed the limit
stated in Schedule A.
f) The maximum amount of insurance issued and applied for in all
companies on each risk (without deductions for replacements) must not
exceed the jumbo limits as stated in Schedule B.
g) The maximum amounts of insurance to be reinsured on a life must not
exceed the automatic binding limits as stated in Schedule B.
h) On each life, the Ceding Company must retain 20% of the risk for the
plans of insurance listed in Schedule A, up to its retention limit as
stated in Schedule B. If, because of previous retention on other
plans, retaining 20% of the risk on these plans will exceed the Ceding
Company's retention limit, then the Ceding Company may retain less
than 20% of the risk on these plans. The Ceding Company may cede all
or part of its retention to an affiliate company.
ARTICLE 4
PROCEDURES FOR FACULTATIVE REINSURANCE
4.01 SUBMISSION. The Ceding Company may submit for facultative evaluation any
coverage applied for under a plan of insurance described in Schedule A that does
not qualify for Automatic Reinsurance or that the Ceding Company prefers to
submit on a facultative basis.
4.02 COVERAGE. An application for facultative reinsurance may include life
insurance with or without disability waiver of premium.
4.03 UNDERWRITING DOCUMENTATION AND ACCEPTANCE. Copies of all underwriting
documentation relating to the insurability of the individual risk submitted for
facultative reinsurance must be sent to the Reinsurer. After the Reinsurer has
examined the underwriting documentation sent, it will promptly notify the
Ceding Company of its final underwriting acceptance or its underwriting offer
subject to additional requirements. The Reinsurer's final underwriting
acceptance on the individual risk will automatically terminate when the first
of the following situations occurs:
a) The date the Reinsurer receives notice from the Ceding Company of the
withdrawal of the Ceding Company's application, or
b) Ninety (90) calendar days after the Reinsurer made its acceptance or
c) The expiration date specified in the Reinsurer's final underwriting
acceptance.
ARTICLE 5
LIABILITY
5.01 AUTOMATIC REINSURANCE. The Reinsurer's liability for automatic reinsurance
shall begin simultaneously with the Ceding Company's liability.
5.02 CONDITIONAL RECEIPT. The Reinsurer shall be liable for benefits paid under
the Ceding Company's conditional receipt, temporary insurance or other
pre-issue benefit or liability provided the requirements for automatic
reinsurance, as stated in Article 3 of this Agreement, are met.
5.03 FACULTATIVE REINSURANCE. The Reinsurer's liability for facultative
reinsurance on the individual risk shall begin simultaneously with the Ceding
Company's liability once the Reinsurer has accepted in writing the application
for facultative reinsurance and the Ceding Company has accepted the Reinsurer's
offer.
5.04 TERMINATION. The Reinsurer's liability for reinsurance on the individual
risk shall terminate when the Ceding Company's liability terminates.
5.05 LIABILITY OF REINSURER. The Reinsurer shall be liable to the Ceding
Company in the same manner as the Ceding Company is liable on the particular
policy form(s) reinsured under this Agreement to the extent such terms and
conditions are not contrary to the terms and conditions of this Agreement.
5.06 RECEIPT OF PREMIUM. The initial and subsequent reinsurance premiums must
be received by the Reinsurer as stated in Article 9 in order to maintain the
Reinsurer's liability on each individual risk.
ARTICLE 6
NOTIFICATION AND REPORTING OF REINSURANCE
6.01 NOTIFICATION. The Ceding Company shall notify the Reinsurer of all
cessions in a format or structure that would include the data described in
Exhibit III. The Ceding Company shall also notify the Reinsurer of any
increase, reduction or change in existing reinsurance in the manner described in
Exhibit III.
6.02 ELECTRONIC REPORTING. If possible, the Ceding Company shall utilize
electronic media for reporting purposes and shall consult with the Reinsurer to
determine an appropriate format. Any subsequent changes to the reporting format
shall be approved by the Reinsurer prior to implementation.
ARTICLE 7
PLANS OF INSURANCE
7.01 LIFE REINSURANCE. Life reinsurance shall be on the yearly renewable term
basis for the net amount at risk as described below:
a) LEVEL TERM PLANS (TWENTY YEARS OR LESS) -- The Reinsurer's net amount
at risk shall be the reinsurance face amount.
b) DECREASING TERM PLANS -- The Reinsurer's net amount at risk shall be
determined in accordance with the Ceding Company's table of reducing
amount or commuted values for each policy year applied to the initial
amount of reinsurance involved.
c) LEVEL TERM PLANS (MORE THAN TWENTY YEARS) OR PERMANENT PLANS -- The
Reinsurer's net amount at risk shall be the difference between the
reinsurance face amount and the cash value or terminal reserve of the
life reinsurance. The cash value shall be based on the cash value of
the corresponding life insurance and shall be rounded to the nearest
dollar amount.
d) UNIVERSAL LIFE PLANS -- The Reinsurer's net amount at risk shall be
the face amount less the account value multiplied by the Reinsurer's
share.
e) The methods of calculating the net amount at risk described above may
not be appropriate because of special options, structure of tables of
amounts, rate of accumulation of cash surrender values and provisions
guaranteeing an increase in the face amount under a given plan of
insurance. Under these circumstances, the method for calculating the
net amount at risk shall be submitted by the Ceding Company and must
be agreed to by the Reinsurer.
7.02 DISABILITY WAIVER OF PREMIUM. Disability waiver of premium reinsurance
shall be on the coinsurance basis.
7.03 ACCIDENTAL DEATH. Accidental death reinsurance shall be on the yearly
renewable term basis.
7.04 STATUTORY RESERVES. The Reinsurer will hold reserves on a 1/2cx basis
using 1980 CSO Select and Ultimate mortality tables and the prevailing
statutory interest rate.
ARTICLE 8
REINSURANCE PREMIUMS
8.01 REINSURANCE PREMIUMS. The Ceding Company shall pay the reinsurance premium
for each ceded risk to the Reinsurer on the basis described in Exhibit I,
regardless of the method in which the Ceding Company receives premiums from its
insureds.
8.02 DISCOUNTS. The reinsurance premium payable to the Reinsurer shall be
calculated on the basis of the premium rates in Exhibit II less the discounts
shown in Exhibit I.
8.03 GUARANTEED RATE. The life reinsurance rates described in 8.02 above are
guaranteed for one policy year. However, the Reinsurer anticipates continuing
to accept reinsurance premiums on the basis of the rates shown in Exhibit III.
If the Reinsurer deems it necessary to increase rates, such increased rates
cannot be higher than the valuation net premiums for yearly renewable term
insurance calculated using the minimum statutory mortality rates and maximum
statutory interest rate for each year of issue.
8.04 INCREASE IN MORTALITY CHARGE. The Ceding Company shall notify the
Reinsurer of any increase in the mortality charge for the underlying insurance
within thirty (30) calendar days of such increase. The Reinsurer shall then
have the right to revise the reinsurance premiums based on such increase.
8.05 PREMIUM TAX. The Reinsurer shall not reimburse the Ceding Company for any
premium taxes which the Ceding Company shall be required to pay but which the
Reinsurer shall not be required to pay on the reinsurance premiums payable
under this Agreement.
ARTICLE 9
PREMIUM ACCOUNTING
9.01 PAYMENT OF REINSURANCE PREMIUMS AND INTEREST PENALTIES BY THE CEDING
COMPANY.
a) The reinsurance premiums shall be paid to the Reinsurer on the basis
stated in Exhibit I.
b) Within twenty-five (25) calendar days after the close of each month,
the Ceding Company shall sent the Reinsurer a copy of a statement that
references this Agreement and lists first year and renewal reinsurance
premiums, expense allowances, benefits, statutory reserves and other
data mutually agreed upon by both parties as described in Exhibit III.
c) If the net reinsurance premium balance is payable to the Reinsurer,
the Ceding Company must include this payment with the statement. If
the net reinsurance premium balance is not received by the Reinsurer
within thirty (30) calendar days after the close of the month, the
reinsurance premiums for all of the reinsurance risks listed on the
statement will be delinquent.
d) When reinsurance premiums due the Reinsurer are deemed delinquent, as
defined in Section 9.01 c) above, a compound interest penalty may be
assessed each month the premiums remain delinquent. Interest shall be
calculated from the day following the date the premiums are due and
payable to the day such premium payment is mailed or the last day of
the accounting period, whichever comes first, regardless of
holicalendar days and weekends. The rate of interest charged each
month shall be the lesser of (i) the 30 Day Treasury Xxxx rate as
published in the Money Rate Section or any successor section of the
Wall Street Journal on the first business day following the date the
premiums are deemed delinquent or (ii) the maximum rate allowed by law
in the State of Pennsylvania. Premiums and interest penalties that
remain unpaid shall be carried forward into the next month's interest
penalty calculation.
9.02 TERMINATION BECAUSE OF NON-PAYMENT OF PREMIUM.
a) When reinsurance premiums are delinquent, the Reinsurer has the right
to terminate the reinsurance risks on the statement by giving the
Ceding Company thirty (30) calendar days written notice. As of the
close of this thirty-day period, all of the Reinsurer's liability
shall terminate for:
i) The risks describe in the preceding sentence and
ii) The risks where the reinsurance premiums became delinquent
during the thirty-day period.
b) Regardless of these terminations, the Ceding Company shall continue
to be liable to the Reinsurer for all unpaid reinsurance premiums
earned by the Reinsurer.
9.03 REINSTATEMENT OF A DELINQUENT STATEMENT. The Ceding Company may reinstate
the terminated risks within sixty (60) calendar days after the effective date
of termination by paying the unpaid reinsurance premiums, including the
interest penalty as defined above, for the risks in force prior to the
termination. However, the Reinsurer shall not be liable for any claim incurred
between the date of termination and reinstatement. The effective date of
reinstatement shall be the day the Reinsurer receives the required back
premiums and any assessed interest.
9.04 PAYMENT OF REINSURANCE PREMIUM BALANCE BY THE REINSURER. If the net
reinsurance premium balance is payable to the Ceding Company, the Reinsurer
must remit payment to the Ceding Company within thirty (30) calendar days after
receiving the statement.
9.05 IN FORCE LIST. Within sixty (60) calendar days after the close of the
calendar year, the Ceding Company shall send the Reinsurer an in force listing
of all policies reinsured under this Agreement. Such listing shall include the
data specified in Exhibit III.
ARTICLE 10
REINSTATEMENT
10.01 LAPSES. If insurance lapses for nonpayment of premium and is reinstated
under the terms of the particular policy and the Ceding Company's usual
reinstatement practices and procedures, the reinsurance shall be reinstated by
the Reinsurer as of the date of reinstatement. The Ceding Company must pay the
Reinsurer all back reinsurance premiums and interest in the same manner as the
Ceding Company received insurance premiums and interest under the particular
policy.
10.02 REINSTATEMENT. On a particular policy ceded to the Reinsurer on an
automatic basis, reinstatement of reinsurance shall be automatic. On a
particular policy ceded to the Reinsurer on a facultative basis, reinstatement
of reinsurance shall require written approval of the Reinsurer in the event
that the policy was not reinstated within the time limit mandated by the policy.
ARTICLE 11
REDUCTIONS, TERMINATIONS AND CHANGES
11.01 REPLACEMENT OR CHANGE. If there is a contractual or non-contractual
replacement or change in a particular policy reinsured under this Agreement,
including, but not limited to, conversions or exchanges where full underwriting
evidence according to the Ceding Company's regular underwriting rules is not
required or Ceding Company sponsored plans of internal replacement where full
underwriting evidence is required, the policy shall continue to be reinsured by
the Reinsurer under this Agreement provided it meets the initial minimum amount
stated in Schedule A.
11.02 EARLY RECAPTURE. If at the time of a contractual or non-contractual
replacement or change as described in 11.01 above, the Ceding Company elects not
to continue to reinsure a particular policy with the Reinsurer, the Ceding
Company must pay the Reinsurer an early recapture charge which shall be a
mutually acceptable reasonable actuarial representation of the Reinsurer's
estimated present value of future profits under this Agreement.
11.03 INCREASE IN FACE AMOUNT. If the face amount of a particular policy
reinsured under this Agreement increases and
a) The increase is subject to new underwriting evidence and
i) The original policy was reinsured automatically, the provisions of
Article 3 shall apply to the increase in reinsurance.
ii) The original policy was insured facultatively, the provisions of
Article 4 shall apply to the increase in reinsurance.
b) The increase is not subject to new underwriting evidence, the
Reinsurer shall accept automatically the increase in reinsurance but
not to exceed the automatic binding limits as stated in Schedule B.
11.04 PROCEDURE FOR INCREASE OR REDUCTION IN FACE AMOUNT. If the face amount of
a particular policy reinsured under this Agreement is increased, the
reinsurance shall first be increased proportionally on the quota share portion
for the particular policy involved and any excess portion reinsured shall then
be appropriately increased. If the face amount is reduced, the reinsurance
shall first be decreased by any excess portion reinsured for the particular
policy involved and then shall be reduced proportionally on the quota share
portion.
11.05 REDUCTION OR TERMINATION OF RETAINED AMOUNT. If any portion of the total
face amount of a particular policy retained by the Ceding Company reduces or
terminates, any excess reinsurance under this Agreement based on the same life
shall also be reduced or terminated. The Ceding Company shall reduce its excess
reinsurance by applying the maximum retention limits that were in effect at the
time the policy was issued. The Ceding Company shall not be required to retain
an amount in excess of its maximum retention limit for the age, mortality
rating and risk classification at the time of issue for any policy on which
reinsurance is being reduced.
11.06 PROCEDURE FOR REDUCTION OR TERMINATION OF RETAINED AMOUNT. The Ceding
Company must first reduce the excess reinsurance of the particular policy that
has the same mortality rating as the terminated insurance. If further reduction
is required, the excess reinsurance to be terminated or reduced shall be
effected in the inverse order in which the particular policy was first
reinsured.
11.07 MORE THAN ONE REINSURER. If the reinsurance of a particular policy is
shared by more than one reinsurer, the Reinsurer's percentage of the increased
or reduced reinsurance shall be the same as its initial percentage of
reinsurance of the policy.
11.08 TERMINATION. If a particular policy reinsured under this Agreement is
terminated, the reinsurance for the policy shall be terminated on the effective
date of termination.
11.09 FACULTATIVE CHANGE. On facultative reinsurance, if the Ceding Company
wishes to reduce the mortality rating on a particular policy, this reduction
shall be subject to the facultative provisions of this Agreement.
11.10 REFUND. The Reinsurer shall refund to the Ceding Company all unearned
reinsurance premiums, less applicable allowances by excluding policy fees,
arising from reductions, terminations and changes as described in this Article.
11.11 EXTENDED TERM OF REDUCED PAID-UP. If applicable, changes as a result of
extended term or reduced paid-up shall be handled the same as reductions as
described above.
ARTICLE 12
CLAIMS
12.01 NOTIFICATION. The Ceding Company shall promptly notify the Reinsurer in
writing whenever the Ceding Company has received notice of a claim where
reinsurance under this Agreement is involved. If a survivor life plan is
involved, the Ceding Company shall notify the Reinsurer of each death as soon
as possible after it has occurred.
12.02 LIABILITY. The Reinsurer's liability for the insurance benefits reinsured
under this Agreement shall be subject to the same terms and conditions of the
particular policy under which the Ceding Company is liable.
12.03 CONTESTABLE OR INCONTESTABLE PERIOD. If a claim is made within the
contestable or incontestable period, the Reinsurer shall accept the decision of
the Ceding Company on the payment of a claim.
12.04 PAYMENT. The Ceding Company shall provide the Reinsurer with proper claim
papers and proofs when requesting payment. The Reinsurer shall pay its share of
each claim in a lump sum without regard to the form of claim settlement by the
Ceding Company.
12.05 INTEREST. If the Ceding Company is obliged by applicable state law or
court order to pay interest from a specified date, such as the date of death of
an insured, on a particular policy, the Reinsurer shall pay its share of the
claim at the same rate and for the same period as that which the Ceding Company
is required, excluding extra-contractual obligations.
12.06 CONTEST, COMPROMISE OR LITIGATION. The Ceding Company shall promptly
notify the Reinsurer in writing of the Ceding Company's intention to contest,
compromise or litigate a claim. The Ceding Company shall provide the Reinsurer
with all papers and the Reinsurer shall have an opportunity to review the
papers. Within fifteen (15) working calendar days after receipt of all necessary
papers, the Reinsurer shall have the following options:
a) Decline to participate in the contest, compromise of litigation of the
claim. The Reinsurer shall thereafter discharge its liability with
respect to any contested, compromised or litigated claim by paying to
the Ceding Company the Reinsurer's
proportionate share of the claim as if there had been no
controversy. Upon such discharge, the Reinsurer shall not be liable
for any portion of any "routine expenses" or "non-routine expenses,"
as defined in Section 12.07 below, incurred with respect to such
claim, nor shall the Reinsurer share in any reduced settlement.
b) After consultation with the Ceding Company, the Reinsurer agrees to
pay its share based on the results of the contest, compromise or
litigation (agreement to be communicated by the Reinsurer to the
Ceding Company in writing). The Reinsurer will pay its share of all
"routine expenses" and "non-routine expenses," as defined in Section
12.07 below, of the contest, compromise or litigation.
12.07 ROUTINE/NON-ROUTINE EXPENSES. For the purpose of this Article, the
term "routine expenses" shall mean fees, charges, costs and expenses of
retained legal and investigative personnel, excluding employees, that are
incurred in rescinding a policy, contesting a policy or litigating a claim. The
term "non-routine expenses" of the contest shall mean nay penalties, attorney's
fees and interest imposed automatically by statute against the Ceding Company
which arise solely out of any judgment rendered against the Ceding Company in a
suit for policy benefits. However, "non-routine expenses" shall not include
extra-contractual damages. Notwithstanding the foregoing definitions, the
Reinsurer shall not be liable for any office expenses or salaries or expenses
of employees of the Ceding Company, or of any subsidiary or affiliate of the
Ceding Company, incurred in connection with the administration of the business
reinsured pursuant to this Agreement or the disposition of a claim, loss or
legal proceeding (including investigation, negotiation, legal expenses and
court costs).
12.08 MISSTATEMENT OF AGE OR SEX. If the amount of insurance provided by
any policy or policies reinsured hereunder is increased or reduced because of a
misstatement of age or sex that is established after the death of the insured,
the Reinsurer shall share in the increase or reduction in the proportion that
the net liability of the Reinsurer bears to the total of the net liability of
the Ceding Company and the net liability of all reinsurers, including the
Reinsurer, immediately prior to such increase or reduction. The reinsurance
shall be restructured from commencement on the basis of the adjusted amount
using premiums and reserves for the correct age or sex. The adjustment for the
difference in reinsurance premiums and any associated commissions or
allowances, dividends, policy value or reserves shall be made without interest.
12.09 WAIVER OF PREMIUM. In the case of a disability waiver of premium
claim, the Reinsurer shall reimburse the Ceding Company for its proportionate
share of the Ceding Company's annual liability actually waived. The Ceding
Company shall continue to pay the Reinsurer the reinsurance premiums on the
policy.
ARTICLE 13
EXTRA-CONTRACTUAL DAMAGES
13.01 DEFINITIONS. For purposes of this Article, the following are
definitions of elements of extra-contractual damages:
a) "Punitive Damages" are those damages awarded as a penalty, the
amount of which is not governed or fixed by statute;
b) "Statutory Damages" are those amounts awarded as a penalty, but are
fixed in amount by statute;
c) "Compensatory Damages" are those amounts awarded to compensate for
actual damages sustained and are not awarded as a penalty or fixed
in amount by statute.
13.02 EXTRA-CONTRACTUAL DAMAGES. Extra-contractual damages are defined as
punitive, statutory or compensatory damages due to the Ceding Company's
negligence, oppression, malice, fault, wrongdoing or bad faith in connection
with an award against the Ceding Company in excess of the limits of the policy
reinsured as a result of, but not limited to, an act, omission or course of
conduct committed solely by the Ceding Company in connection with the benefits
payable under a particular policy reinsured under this Agreement.
13.03 EXCEPTION. Except as provided in Section 13.04 below, the Reinsurer
shall not be liable for any extra-contractual damages.
13.04 ASSESSMENT OF DAMAGES. The Reinsurer recognizes that circumstances may
arise under which the Reinsurer, in equity, should share, to the extent
permitted by law, in paying certain assessed damages. The Reinsurer may be
liable for any punitive, statutory or compensatory damages awarded or assessed
against the Ceding Company if the Reinsurer elected to join in the contest,
litigation or denial of the claim, in writing, and actively directed,
participated in, consented to or ratified the act, error, omission or course
of conduct of the Ceding Company that ultimately resulted in the award or
assessment of punitive, statutory or compensatory damages. The extent of such
sharing is dependent on the good faith assessment of culpability in each case,
but all factors being equal, the division of such assessment would be in
proportion to what impact the Reinsurer's opinion had on such damages.
13.05 LEGAL FEES. If the Reinsurer has liability for damages as stated in
Section 13.04 above, the Reinsurer shall reimburse the Ceding Company for its
share of reasonable legal fees incurred in defense of punitive, statutory or
compensatory damages.
ARTICLE 14
INCREASE IN RETENTION AND RECAPTURE
14.01 The reinsurance under this Agreement shall be maintained in force without
reduction except as specifically provided for in this Agreement.
14.02 The Ceding Company may increase its retention limit on new business
being issued at any time by giving written notice to the Reinsurer of the new
retention limit and the effective date of such increase.
14.03 The Ceding Company shall have the option of recapturing the
reinsurance under this Agreement in the event the Ceding Company increases its
retention limit. The Ceding Company may exercise its option to recapture by
giving written notice to the Reinsurer within ninety (90) calendar days after
the effective date of the retention limit increase. If the recapture option is
not exercise of within ninety (90) calendar days after the effective date of the
retention limit increase, the Ceding Company may choose to recapture not later
than two (2) years after the date the retention limit increases.
14.04 If the Ceding Company exercises its option to recapture, then the
following rules apply;
a) The Ceding Company shall reduce all eligible excess reinsurance
on each individual risk on which it retained its retention limit
for the age and mortality rating that was in effect at the time
the excess reinsurance was ceded.
b) The Ceding Company shall increase its total amount of insurance
on the individual risk up to its new retention limit by reducing
the amount of excess reinsurance. If an individual risk is shared
by more than one reinsurer, the Reinsurer's percentage of the
reduced excess reinsurance shall be the same as the Reinsurer's
initial percentage of the excess reinsurance on the individual
risk.
c) No reduction of excess reinsurance due to recapture shall occur
until the later of the following dates:
i) The policy anniversary date immediately following the
effective date the recapture program begins and
ii) The number of years stated in Schedule A starting with the
original "policy date."
14.05 Reinsurance shall not be eligible for recapture on an individual risk
if (a) the Ceding Company retained less than its retention limit for the age and
mortality rating in effect at the time the reinsurance was ceded to the
Reinsurer, or if (b) the Ceding Company did not retain any of the individual
risk.
14.06 In the event the Ceding Company overlooks any reduction in the amount
of reinsurance on a particular policy because of an increase in the Ceding
Company's retention limit, the acceptance by the Reinsurer of reinsurance
premiums under these circumstances shall not constitute a liability on the part
of the Reinsurer of such reinsurance. The Reinsurer shall be liable only for a
refund of premiums.
14.07 If there is a Waiver of Premium claim in effect when recapture takes
place, the Waiver of Premium claim shall continue in effect until the Waiver of
Premium claim terminates. The Reinsurer shall not be liable for any other
benefits, including the basic life risks that are eligible for recapture. All
such eligible benefits shall be recaptured as if there were no Waiver of
Premium claim.
14.08 If there is an extension of that Waiver of Premium claim under the
terms of the Ceding Company's policy, the Reinsurer shall pay its share of the
Waiver of Premium claim, provided the Ceding Company continues to pay to the
Reinsurer all Waiver of Premium reinsurance premiums for the period from the
date of recapture.
ARTICLE 15
INSOLVENCY
15.01 In the event of the Ceding Company's insolvency and the appointment of
a conservator, liquidator, or statutory successor, the portion of any risk or
obligation assumed by the Reinsurer shall be payable to the conservator,
liquidator, or statutory successor on the basis of claims allowed against the
Ceding Company by any court of competent jurisdiction or by any conservator,
liquidator, or statutory successor of the company having authority to allow
such claims, without diminution because of that insolvency, or because the
conservator, liquidator, or statutory successor has failed to pay all or a
portion of any claims. Payments by the Reinsurer as set forth in this Section
shall be made directly to the Ceding Company or to its conservator, liquidator,
or statutory successor, except where the contract of insurance or reinsurance
specifically provides another payee of such reinsurance in the event of the
Ceding Company's insolvency.
15.02 In the event of the Ceding Company's insolvency, the conservator,
liquidator, or statutory successor shall give written notice of the pendency of
a claim against the Ceding Company on any policies reinsured within a reasonable
time after such claim is filed. The Reinsurer may 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 Ceding Company or its conservator,
liquidator, or statutory successor.
15.03 The expenses incurred by the Reinsurer shall be chargeable, subject to
court approval, against the Ceding Company as part of the expense of
conservation or liquidation to the extent of a proportionate share of the
benefit which may accrue to the Ceding Company in conservation or liquidation,
solely as a result of the defense undertaken by the Reinsurer. Where two or
more reinsurers are involved in the same claim and a majority in interest elect
to interpose a defense or defenses to this claim, the expense shall be shared
as though such expense had been incurred by the Ceding Company.
ARTICLE 16
ARBITRATION
16.01 As a condition precedent to any right of action hereunder, any dispute
or difference between the Ceding Company and the Reinsurer relating to the
interpretation or performance of this Agreement, including its formation or
validity, or any transaction under this Agreement, whether arising before or
after termination, shall be submitted to arbitration. Arbitration shall be the
method of dispute resolution, regardless of the insolvency of either party,
unless the conservator, receiver, liquidator or statutory successor is
specifically exempted from arbitration proceeding by applicable state law of the
insolvency.
16.02 Arbitration shall be initiated by the delivery of written notice of demand
for arbitration by one party to another. Such written notice shall contain a
brief statement of the issue(s), the failure on behalf of the parties to reach
amicable agreement and the date of demand for arbitration.
16.03 The arbitrators and umpire shall be present or former disinterested
officers of life reinsurance or insurance companies other than the two parties
to the Agreement or any company owned by, or affiliated with, either party.
Each party shall appoint an individual as arbitrator and the two so appointed
shall then appoint the umpire. If either party refuses or neglects to appoint
an arbitrator within thirty (30) calendar days, the other party may appoint the
second arbitrator. If the two arbitrators do not agree on an umpire within
sixty (60) calendar days of the appointment of the second appointed arbitrator,
each of the two arbitrators shall nominate three individuals. Each arbitrator
shall then decline two of the nominations presented by the other arbitrator.
The umpire shall be chosen from the remaining two nominations by drawing lots.
16.04 The arbitration hearings shall be held in the city in which the Ceding
Company's head office is located or any such other place as may be mutually
agreed. Each party shall submit its case to the arbitrators and umpire within
one hundred and eighty (180) calendar days of the selection of the umpire or
within such longer period as may be agreed.
16.05 The arbitration panel shall make its decision with regard to the custom
and usage of the insurance and reinsurance business. The arbitration panel
shall interpret this Agreement as an honorable engagement; they are relieved of
all judicial formalities and may abstain from following strict rules of law.
The arbitration panel shall be solely responsible for determining what shall be
considered and what procedure they deem appropriate and necessary in the
gathering of such facts or data to decide the dispute.
16.06 The decision in writing of the majority of the arbitration panel shall be
final and binding upon the parties. Judgment may be entered upon the final
decision of the arbitration panel in any court having jurisdiction.
16.07 The jointly incurred costs of the arbitration are to be borne equally by
both parties. Jointly incurred costs are specifically defined as any costs that
are not solely incurred by one of the parties (e.g., attorney's fees, expert
witness fees, travel to the hearing site, etc.). Costs incurred solely by one
of the parties shall be borne by that party. Once the panel has been selected,
the panel shall agree on one billable rate for each of the arbitrators and
umpire and that sole cost shall be disclosed to the parties and become payable
as a jointly incurred cost as described above.
16.08 If more than one reinsurer is involved in the same dispute, all such
reinsurers shall constitute and act as one party for the purposes of this
Arbitration Article, provided however, that nothing herein shall impair the
rights of such reinsurers to assert several, rather than joint, defenses or
claims, nor be construed as changing the liability under the terms of the
Agreement from several to joint.
ARTICLE 17
DAC TAX
SECTION 1.848-2(g)(8) ELECTION
17.01 If applicable, both parties agree to the following pursuant to Section
1.848-2(g)(8) of the Income Tax Regulations issued December 1992, under Section
848 of the Internal Revenue Code of 1986, as amended. This election shall be
effective for all subsequent taxable years for which this Agreement remains in
effect.
17.02 The term "party" shall refer to either the Ceding Company or the
Reinsurer as appropriate.
17.03 The terms used in this Article are defined by reference to Section
1.848-2 of the Income Tax Regulations in effect December 1992.
17.04 The party with the net positive consideration for this Agreement for each
taxable year shall capitalize specified policy acquisition expenses with
respect to this Agreement without regard to the general deductions limitation
of Section 848(c)(1) of the Internal Revenue Code of 1986.
17.05 Both parties agree to exchange information pertaining to the amount of
net consideration under this Agreement each year to ensure consistency or as
otherwise required by the Internal Revenue Service.
17.06 The Ceding Company shall submit a schedule to the Reinsurer by April 1 of
each year of its calculation of the net consideration for the preceding
calendar year. This schedule of calculations shall be accompanied by a
statement signed by one of the Ceding Company's officers stating that the
Ceding Company shall report such net consideration in its tax return for the
preceding calendar year.
17.07 The Reinsurer may contest such calculation by providing an alternative
calculation to the Ceding Company in writing within thirty (30) calendar days
of the Reinsurer's receipt of the Ceding Company's calculation. If the
Reinsurer does not so notify the Ceding Company, the Reinsurer shall report the
net consideration as determined by the Ceding Company in the Reinsurer's tax
return for the previous calendar year.
17.08 If the Reinsurer contests the Ceding Company's calculation of the net
consideration, both parties shall act in good faith to reach an agreement as to
the correct amount within thirty (30) calendar days of the date the Reinsurer
submits its alternative calculation. If both parties reach agreement on an
amount of net consideration, each party shall report such amount in its
respective tax returns for the previous calendar year.
ARTICLE 18
ENTIRE AGREEMENT
18.01 This Agreement supersedes any and all prior discussions and
understandings between the parties and, upon its execution, constitutes the
sole and entire Agreement with respect to the reinsurance provided hereunder.
There are no understandings between the parties other than as expressed in this
Agreement. Any change or modifications to the Agreement shall be null and void
unless effected by a writing subscribed by both the Ceding Company and the
Reinsurer. Any waiver shall constitute a waiver only in the circumstances for
which it was given and shall not be a waiver of any future circumstance.
ARTICLE 19
SERVICE OF SUIT
19.01 It is agreed that in the event the obligations under this Agreement are
not performed by the Reinsurer, at the request of the Ceding Company, the
Reinsurer shall submit to the jurisdiction of any court of competent
jurisdiction within the United States and shall comply with all the
requirements necessary to give that court jurisdiction. All matters arising
under this Agreement shall be determined in accordance with the law and
practice of such court. Nothing in this clause constitutes or should be
understood to constitute a waiver of the Reinsurer's rights to commence an
action in any court of competent jurisdiction in the United States, to remove
an action to a United States District Court, or to seek a transfer of a case to
another court as permitted by the laws of the United States or of any state in
the United States. Service of process, in any such suit, may be made upon any
then duly elected officer of the Reinsurer (agent for service of process) at
000 Xxxxx Xxxxx Xxxxxx, Xxxxx 000, Xxxxxxxxx, Xxxxx Xxxxxxxx 00000. The
Reinsurer shall abide by the final decision of such court or of any appellate
court in the event of an appeal, for any suit instituted against the Reinsurer
under this Agreement.
19.02 The agent for service of process is authorized and directed to accept
service of process on behalf of the Reinsurer in any such suit and/or upon the
request of the Ceding Company, give a written undertaking to the Ceding Company
that the agent will enter a general appearance on behalf of the Reinsurer in
the event such a suit is instituted.
19.03 The Reinsurer hereby designates the Superintendent, Commissioner or
Director of Insurance or his successor or successors in office, for the State
of New York, as its true and lawful agent for service of process (in addition
to the above named agent), who may be served any lawful process in any action,
suit or proceeding instituted by or on behalf of the Ceding Company or any
beneficiary arising out of this Agreement, and hereby designates the above
named as the person to whom the Ceding Company is authorized to mail such
process or a true copy thereof.
ARTICLE 20
GENERAL PROVISIONS
20.01 INSPECTION OF RECORDS. Either company, their respective employees or
authorized representatives, may audit, inspect and examine, during regular
business hours, at the home office of either company, any and all books,
records, statements, correspondence, reports, trust accounts and their related
documents or other documents that relate to the policies covered hereunder. The
audited party agrees to provide a reasonable work space for such audit,
inspection or examination and to cooperate fully and to faithfully disclose the
existence of and produce any and all necessary and reasonable materials
requested by such auditors, investigators, or examiners. The company performing
a routine audit shall provide five (5) working calendar days advance notice to
the other party. The expense of the respective party's employee(s) or
authorized representative(s) engaged in such activities will be borne solely by
such party.
20.02 REPRESENTATIONS AND WARRANTS. The Ceding Company and the Reinsurer agree
that all matters with respect to this Agreement require their utmost good
faith. Each party represents and warrants to the other party that it is solvent
on a statutory basis in all jurisdictions in which it does business or is
licensed. Each party agrees to promptly notify the other party of any material
change in its financial condition. The Reinsurer has entered into this
Agreement in reliance upon the Ceding Company representations and warranties.
Each party affirms that it has and will continue to disclose all matters
material to this Agreement and each cession. Examples of such matters are a
material change in underwriting or issue practices or philosophy or a change in
each party's ownership or control.
20.03 ASSIGNMENT OF TRANSFER. Neither this Agreement nor any reinsurance under
this Agreement shall be sold, assigned or transferred by the Ceding Company
without prior written consent of the Reinsurer. Such approval shall not
unreasonably be withheld. If it is determined that such sale, assignment or
transfer would result in a material adverse economic impact to the Reinsurer,
and the Reinsurer so objects, this Agreement shall be terminated with respect
to all policies reinsured under this Agreement. The Ceding Company and the
Reinsurer agree to mutually calculate a termination charge that shall be paid
by the Ceding Company to the Reinsurer upon the transfer. The provisions of
this Section 20.03 are not intended to preclude the Reinsurer from retroceding
the reinsurance on an indemnity basis.
20.04 SEVERABILITY. If any term or provision under this Agreement shall be held
or made invalid, illegal or unenforceable by a court decision, statute, rule or
otherwise, such term or provision shall be amended to the extent necessary to
conform with the law and all of the other terms and provisions of this
Agreement shall remain in full force and effect. If the term or provision held
to be invalid, illegal or unenforceable is also held to be a material part of
this Agreement, such that the party in whose favor the material or provision
was stipulated herein would not have entered into this Agreement without such
term or provision, then the party in whose favor the material term or provision
was stipulated shall have the right, upon such holding, to terminate this
Agreement.
20.05 PARTIES TO AGREEMENT. This Agreement is solely between the Ceding Company
and the Reinsurer. There is no third party to this Agreement. Reinsurer under
this Agreement shall not create any right of legal relationship between the
Reinsurer and any other person, for example, any insured, policy owner, agent,
beneficiary or assignee. The Ceding Company further agrees that it will not
make the Reinsurer a party to any litigation between any such third party and
the Ceding Company.
20.06 OFFSET. All monies due either company under this Agreement may be offset
against each other, dollar for dollar, regardless of any insolvency of either
party unless otherwise prohibited by law. If the Reinsurer advances payment
through offset of any claim it is contesting and prevails in the contest the
Ceding Company shall return such payment plus interest calculated as per the
provisions of Section 9.01 d)of this Agreement.
20.07 GOVERNING LAW. In the event of litigation, the parties shall submit to
the competent jurisdiction of a court in the State of Pennsylvania and shall
abide by the final decision of such court. This Agreement shall be governed as
to performance, administration and interpretation by the laws of the State of
Pennsylvania, exclusive of the rules with respect to conflicts of law. In all
cases, the State of Pennsylvania applies with respect to rules for credit for
reinsurance.
20.08 EXPENSES. The Ceding Company shall pay the expense of all medical
examinations, inspection fees and other charges in connection with the issuance
of the insurance.
20.09 ERRORS AND OMISSIONS. Unintentional clerical errors, omissions or
misunderstanding in the administration of this Agreement by either the Ceding
Company or the Reinsurer shall not invalidate the reinsurance hereunder provided
the error, omission or misunderstanding is corrected promptly after discovery.
Both companies shall be restored, to the extent possible, to the position they
would have occupied had the error, omission or misunderstanding not occurred,
but the liability of the Reinsurer under this Agreement shall in no event exceed
the limits specified herein.
20.10 SCHEDULES, EXHIBITS AND SECTION HEADINGS. Schedules and Exhibits
attached hereto are made a part of this Agreement. Section headings are
provided for reference purposes only and are not made a part of this Agreement.
20.11 DEFINITIONS. The definitions that apply in the interpretation of this
Agreement are located in Schedule D.
ARTICLE 21
COMMENCEMENT AND TERMINATION
21.01 This Agreement shall be effective as of October 1, 2001 and shall remain
in force for an indefinite period. Either the Ceding Company or the Reinsurer
may terminate the Agreement by giving ninety (90) calendar days written notice
by certified, registered, or return receipt requested mail to the other party.
The day the notice is deposited in the mail addressed to an officer of the
other company shall be the first day of the ninety-day period.
21.02 During this ninety-day period, the Reinsurer shall continue to accept and
the Ceding Company shall continue to cede any new policies issued prior to the
termination of this ninety-day period.
21.03 All automatic reinsurance that has been placed in effect prior to the
expiration date set forth in the notice and all facultative reinsurance
approved by the Reinsurer based upon an application the Reinsurer received
prior to the expiration date set forth in the notice shall remain in effect in
accordance with the terms of this Agreement until the reinsured policy's
natural expiration or as specified otherwise in this Agreement.
21.04 This Agreement may be executed simultaneously in any number of
counterparts, each of which shall be deemed an original, but all of which shall
constitute one and the same instrument.
ARTICLE 22
CONFIDENTIALITY
The Reinsurer agrees to protect and hold all nonpublic personal policyholder
information provided to the Reinsurer by the Ceding Company in conjunction with
a reinsurance agreement in strict confidence and to take reasonable steps
necessary to protect the nonpublic personal information from unauthorized or
inadvertent disclosure. Nonpublic personal information includes health
information, financial information and other information as defined under state
and/or federal law and provided to the Reinsurer in conjunction with carrying
out our obligations under a reinsurance agreement with the Ceding Company. It
is understood and the parties agree that the Reinsurer will not be prohibited
from disclosing such nonpublic personal information as might be necessary for
purposes of retrocession of the reinsured business, during the course of
external audits, or as required by applicable law or court order. The
reinsurer's obligation to maintain the confidentiality of nonpublic personal
information provided to the Reinsurer shall survive termination of the
reinsurance agreement and shall remain in effect for as long as the nonpublic
personal information remains in the Reinsurer's possession.
Executed in duplicate by Executed in duplicate by
Providentmutual Life and Transamerica Occidental
Annuity Company of America Life Insurance Company
at Berwyn, Pennsylvania, at Charlotte, North Carolina,
on 12-26, 2001. on 12-20, 2001.
By: [Signature] By: [Signature]
---------------------------- ----------------------------
Title: Vice President & Actuary Vice President
By: [Signature] By: [Signature]
---------------------------- ----------------------------
Title: Vice President & Actuary Vice President and Associate
General Counsel
SCHEDULE A
Specifications
1. Type of Business Life insurance benefits issued directly by the
Ceding Company.
2. Plans of Insurance
Base Plans A. Option Premier
B. Whole Life II
C. Portfolio II
D. Special Term
E. ProvFlex UL
F. Face Amount Increases
Riders G. Additional Insurance Benefit
H. Other Insured Term
I. Waiver of Premium
J. Waiver of Monthly Deductions
K. Long Term Care Acceleration Benefit
L. Long Term Care Waiver
M. Change of Insured
3. Basis of Reinsurance First Dollar Quota Share on policies with face
amounts greater than $100,000 and Excess of
retention.
The Reinsurer's share 20% first dollar quota share, and
25% of the excess
4. Maximum Issue Age 85
5. Maximum Mortality Each individual risk must not exceed Table 16,
Table P, 500% or its equivalent on a flat extra
premium basis.
6. Minimum Amounts
Initial - Automatic $ 25,000
Initial - Facultative $100,000
7. Years to Recapture 20
SCHEDULE B
Limits
1. Binding:
Life Sixteen times retention
Waiver of Premium $ 5,000,000
2. Jumbo:
Life $50,000,000
Disability Waiver of Premium $ 5,000,000 - maximum
3. Ceding Company's Retention:
Life
Substandard
Tables A-G
------------------------------------
Issue Ages Standard Flat Extra $10
---------------------------------------------------------------------
0-31 calendar $25,000 0 0
days
---------------------------------------------------------------------
32 calendar 750,000 500,000 375,000
days - 2 years
---------------------------------------------------------------------
3 - 65 years 1,250,000 875,000 625,000
---------------------------------------------------------------------
66 - 70 years 1,000,000 750,000 500,000
---------------------------------------------------------------------
71 - 75 years 500,000 375,000 250,000
---------------------------------------------------------------------
76 - 80 years 250,000 0 0
---------------------------------------------------------------------
81 - 85 years 125,000 0 0
---------------------------------------------------------------------
86+ years 0 0 0
---------------------------------------------------------------------
Waiver of Premium Same as Life
* lesser than or equal to
SCHEDULE C
Exceptions
There are no exceptions to this Agreement.
SCHEDULE D
Definitions
1. Automatic Insurance which must be ceded by the Ceding
Company in accordance with the terms of the
Agreement and must be accepted by the Reinsurer.
2. Excess The Reinsurer agrees to reimburse the Ceding
Company for all losses or a large portion of the
losses over the Ceding Company's maximum retention
limit. The Reinsurer becomes involved in a loss
only after the loss has exceeded the Ceding
Company's maximum retention limit.
3. Facultative Insurance which the Ceding Company has the option
to cede and the Reinsurer has the option to accept
or decline individual risks.
4. Initial Minimum Amount The smallest amount of reinsurance permitted at
the inception of the reinsurance transaction.
5. Life Premiums Yearly Renewable Term (YRT) - Under the YRT
method, the Reinsured transfers to the Reinsurer
the mortality risk on either a net amount at risk
basis or on an approximation of the net amount at
risk basis.
Flat Extra - Flat extra ratings usually apply to
applicants in hazardous occupations or avocations
or with certain physical impairments of a temporary
nature.
Substandard Table Extra - Substandard table extra
ratings usually apply to physically impaired lives.
6. Pool An organization of insurers or reinsurers through
which particular types of risks are underwritten
with premiums, losses and expenses shared in agreed
amounts.
7. Quota Share A form of reinsurance indemnifying the Ceding
Company against a fixed percentage of loss on each
risk covered in the Agreement.
8. Ceding Company A company which transfers all or part of the
insurance it has written to another company.
9. Reinsurer A company which assumes all or part of the
insurance written by another company.
10. Retention The amount of insurance which the Ceding Company
keeps for its own account and does not reinsure in
any way.
11. Risk Insurance on an individual life.
12. Subsequent
Minimum Amount The smallest amount of reinsurance permitted after
the inception of the reinsurance transaction.
13. Point-In-Scale Reinsurance premiums are based on the issue age
and duration of the original reinsured policy.
EXHIBIT I
INSTRUCTIONS FOR THE PREMIUMS PER $1,000 OF REINSURANCE
1. Reinsurance premiums under this Agreement shall be payable on the annual
basis regardless of how the Ceding Company receives premiums from its
insured.
2. Life -- Standard & Substandard
Table Extra Premiums The reinsurance premiums for the base plans and
the Additional Insured and Other Insured Term
Riders shall be an amount equal to the reinsurance
rates shown in Exhibit II multiplied by the
following percentages:
RENEWAL YEARS
--------------------------------------------------------------------------------
FIRST YEAR PREFERRED NONSMOKER SMOKER
---------- --------- --------- ------
0% 32% 47% 90%
The substandard table extra premium shall be an
additional 25% per table rating of the rates set
forth in this Exhibit, less the discounts stated
above.
3. Flat Extra Premiums The flat extra premium shall be the annual flat
extra premium which the Ceding Company charges its
insured on that amount of the insurance less the
following allowances:
TERMS OF YOUR FIRST RENEWAL
FLAT EXTRA PREMIUM YEAR YEARS
------------------ ----- -------
More than 5 years 75% 10%
5 years or less 10% 10%
4. Riders The reinsurance premiums for waiver of premium,
waiver of monthly deductions, long term care
acceleration benefit and long term care waiver
shall be the premiums the Ceding Company charges
its insured on that amount of insurance reinsured
less the following allowances:
FIRST YEAR RENEWAL YEARS
---------- -------------
75% 10%
5. Renewal, Conversion or
Exchange of Insurance The renewal, conversion or exchange of insurance
shall be considered as a continuation of the
original insurance. Future premiums shall be
calculated on a point-in-scale basis using the
applicable rates in the Agreement.
EXHIBIT II
YRT PREMIUMS
Providentmutual Life and Annuity Company of America
SOA 75-80 TABLE -- Male -- Age Nearest Birthday
DURATION
ISSUE AGE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
0 1.23 0.74 0.48 0.43 0.38 0.34 0.33 0.29 0.27 0.27 0.25 0.28 0.31 0.38 0.54 0.68
1 0.48 0.47 0.42 0.36 0.28 0.23 0.22 0.22 0.24 0.24 0.27 0.30 0.38 0.54 0.68 1.01
2 0.35 0.37 0.33 0.28 0.23 0.22 0.21 0.24 0.24 0.27 0.30 0.37 0.54 0.68 1.01 1.14
3 0.35 0.29 0.25 0.23 0.22 0.20 0.22 0.24 0.27 0.30 0.37 0.53 0.68 1.01 1.14 1.22
4 0.29 0.25 0.23 0.22 0.20 0.22 0.24 0.27 0.30 0.36 0.52 0.85 0.99 1.11 1.22 1.31
5 0.25 0.23 0.22 0.20 0.22 0.24 0.27 0.30 0.36 0.50 0.66 0.98 1.09 1.16 1.31 1.37
6 0.23 0.22 0.20 0.22 0.24 0.27 0.30 0.36 0.50 0.66 0.94 1.07 1.14 1.21 1.37 1.40
7 0.19 0.20 0.22 0.24 0.27 0.30 0.35 0.50 0.66 0.87 1.05 1.13 1.19 1.23 1.40 1.41
8 0.18 0.21 0.21 0.27 0.29 0.35 0.50 0.66 0.87 1.05 1.13 1.19 1.23 1.30 1.39 1.40
9 0.19 0.20 0.24 0.29 0.35 0.50 0.65 0.87 1.05 1.13 1.19 1.23 1.30 1.35 1.38 1.38
10 0.18 0.22 0.27 0.35 0.50 0.65 0.87 1.05 1.13 1.19 1.23 1.30 1.35 1.36 1.32 1.34
11 0.20 0.25 0.34 0.50 0.65 0.87 1.05 1.13 1.19 1.23 1.30 1.35 1.36 1.30 1.27 1.29
12 0.23 0.32 0.50 0.65 0.87 1.05 1.13 1.19 1.23 1.30 1.35 1.35 1.30 1.25 1.20 1.24
13 0.30 0.46 0.63 0.87 1.05 1.12 1.19 1.22 1.24 1.28 1.31 1.30 1.25 1.20 1.16 1.20
14 0.44 0.59 0.87 1.05 1.12 1.17 1.22 1.23 1.23 1.24 1.28 1.25 1.19 1.16 1.13 1.17
15 0.58 0.87 1.05 1.12 1.17 1.21 1.23 1.22 1.20 1.20 1.19 1.18 1.13 1.12 1.11 1.14
16 0.87 1.05 1.12 1.17 1.21 1.20 1.21 1.19 1.16 1.14 1.12 1.12 1.09 1.09 1.09 1.12
17 1.05 1.12 1.17 1.21 1.20 1.18 1.18 1.15 1.11 1.07 1.05 1.06 1.05 1.06 1.08 1.11
18 1.03 1.10 1.13 1.15 1.14 1.11 1.11 1.07 1.04 1.01 1.00 1.02 1.01 1.03 1.07 1.12
19 1.00 1.05 1.06 1.07 1.05 1.04 1.02 0.96 0.96 0.96 0.97 0.97 0.96 1.01 1.07 1.14
20 0.93 0.97 0.97 0.97 0.97 0.95 0.93 0.90 0.90 0.91 0.93 0.94 0.95 1.01 1.06 1.17
21 0.84 0.87 0.87 0.87 0.87 0.86 0.85 0.83 0.85 0.86 0.90 0.92 0.96 1.02 1.11 1.22
22 0.73 0.76 0.78 0.76 0.77 0.77 0.77 0.77 0.80 0.83 0.88 0.91 0.96 1.04 1.15 1.28
23 0.73 0.76 0.76 0.75 0.75 0.76 0.77 0.77 0.80 0.84 0.90 0.94 1.00 1.10 1.21 1.36
24 0.73 0.74 0.73 0.73 0.74 0.76 0.77 0.78 0.82 0.87 0.93 0.97 1.05 1.17 1.29 1.45
25 0.72 0.72 0.72 0.72 0.74 0.76 0.77 0.79 0.84 0.90 0.96 1.03 1.12 1.25 1.38 1.56
26 0.70 0.70 0.71 0.72 0.73 0.76 0.78 0.82 0.88 0.95 1.02 1.09 1.20 1.35 1.49 1.70
27 0.68 0.68 0.70 0.71 0.73 0.77 0.81 0.85 0.92 1.01 1.08 1.17 1.30 1.47 1.63 1.87
28 0.66 0.68 0.71 0.73 0.76 0.81 0.86 0.92 1.00 1.08 1.17 1.28 1.42 1.61 1.81 2.07
29 0.65 0.68 0.73 0.76 0.81 0.86 0.92 1.00 1.08 1.17 1.28 1.42 1.58 1.81 2.03 2.31
30 0.64 0.68 0.76 0.81 0.86 0.92 1.00 1.06 1.17 1.28 1.42 1.58 1.81 2.03 2.26 2.58
31 0.63 0.69 0.79 0.86 0.92 1.00 1.08 1.17 1.28 1.42 1.58 1.81 2.03 2.26 2.53 2.89
32 0.63 0.71 0.84 0.92 1.00 1.06 1.17 1.28 1.40 1.58 1.81 2.03 2.26 2.53 2.83 3.24
33 0.63 0.72 0.88 0.98 1.06 1.17 1.28 1.40 1.58 1.78 2.01 2.25 2.53 2.83 3.17 3.61
34 0.63 0.73 0.93 1.05 1.17 1.25 1.40 1.58 1.78 2.01 2.24 2.53 2.81 3.16 3.54 4.02
35 0.63 0.76 0.99 1.14 1.28 1.40 1.58 1.78 2.01 2.24 2.53 2.80 3.13 3.52 3.94 4.45
36 0.65 0.79 1.06 1.25 1.40 1.58 1.78 2.01 2.24 2.53 2.80 3.10 3.48 3.91 4.36 4.92
37 0.67 0.84 1.15 1.37 1.58 1.78 2.01 2.24 2.53 2.80 3.06 3.43 3.56 4.32 4.82 5.44
38 0.70 0.89 1.23 1.47 1.70 1.91 2.16 2.41 2.72 3.04 3.35 3.76 4.25 4.78 5.33 6.00
39 0.74 0.95 1.33 1.59 1.83 2.07 2.33 2.60 2.93 3.27 3.64 4.10 4.67 5.28 5.88 6.61
40 0.79 1.02 1.45 1.73 2.00 2.23 2.51 2.79 3.13 3.51 3.94 4.47 5.13 5.82 6.48 7.27
41 0.85 1.11 1.58 1.90 2.17 2.42 2.70 2.98 3.33 3.75 4.24 4.65 5.82 6.41 7.12 8.01
42 0.92 1.22 1.76 2.09 2.37 2.62 2.89 3.18 3.52 3.99 4.57 5.28 6.15 7.05 7.85 8.82
43 0.99 1.37 1.92 2.30 2.61 2.88 3.18 3.47 3.83 4.33 4.96 5.71 6.83 7.61 8.50 9.73
44 1.08 1.53 2.11 2.52 2.86 3.17 3.47 3.79 4.17 4.70 5.37 6.16 7.16 8.20 9.22 10.75
45 1.17 1.72 2.31 2.75 3.13 3.47 3.79 4.14 4.56 5.06 5.80 6.65 7.73 8.85 10.02 11.80
46 1.28 1.94 2.51 3.00 3.40 3.75 4.14 4.56 4.91 5.45 6.28 7.19 8.35 9.56 10.89 13.17
47 1.38 2.17 2.73 3.25 3.68 4.13 4.56 4.89 5.31 5.93 6.79 7.78 9.03 10.34 11.85 14.87
48 1.49 2.27 2.84 3.40 3.90 4.38 4.87 5.28 5.80 6.49 7.53 8.64 9.94 11.30 12.79 16.07
49 1.60 2.35 2.95 3.54 4.09 4.62 5.18 5.70 6.33 7.12 8.36 9.60 10.96 12.32 13.75 17.71
50 1.70 2.42 3.04 3.66 4.29 4.87 5.51 6.15 6.93 7.83 9.30 10.69 12.06 13.40 14.77 19.60
51 1.80 2.48 3.12 3.77 4.47 5.12 5.66 6.65 7.59 8.61 10.35 11.89 13.24 14.56 15.83 21.47
52 1.90 2.52 3.17 3.85 4.65 5.38 6.23 7.20 8.32 9.48 11.51 13.18 14.52 15.80 16.96 23.66
53 2.06 2.75 3.45 4.23 5.08 5.90 6.84 7.89 9.11 10.43 12.63 14.52 15.80 18.96 19.16 26.05
54 2.23 2.99 3.78 4.64 5.57 6.47 7.52 8.86 9.96 11.44 13.85 15.80 16.96 19.16 21.52 28.69
55 2.41 3.27 4.12 5.10 6.11 7.11 8.27 9.50 10.66 12.54 15.17 16.96 19.16 21.62 24.39 31.57
56 2.61 3.56 4.51 5.61 6.71 7.83 9.09 10.38 11.83 13.73 16.82 19.16 21.62 24.39 27.47 34.68
57 2.82 3.89 4.94 6.18 7.38 8.60 9.96 11.33 12.87 15.03 18.21 21.38 24.39 27.15 30.87 36.00
58 2.95 4.13 5.44 6.74 8.10 9.20 10.59 12.05 13.66 15.94 19.22 22.43 25.64 28.58 32.76 41.60
59 3.10 4.37 6.00 7.34 8.87 9.82 11.23 12.79 14.47 16.88 20.25 23.49 26.85 29.94 34.70 45.64
60 3.23 4.63 6.61 7.97 9.71 10.46 11.89 13.57 15.32 17.85 21.28 24.48 27.97 31.28 36.71 49.90
61 3.37 4.89 7.26 8.64 10.48 11.59 12.58 14.38 16.18 18.82 22.26 25.39 29.04 32.81 38.82 54.71
62 3.50 5.14 7.97 9.36 11.59 11.83 13.29 15.21 17.05 19.77 23.18 26.21 30.06 33.93 41.03 60.03
63 3.89 5.77 8.74 10.48 11.83 13.29 15.21 17.05 20.11 22.42 25.79 28.87 33.14 37.76 44.86 65.85
64 4.32 6.47 9.57 11.73 13.29 15.21 17.06 20.11 22.42 25.79 28.69 32.93 38.55 42.02 48.60 72.18
65 4.80 7.28 10.50 13.13 15.21 17.05 20.11 22.42 25.79 28.69 32.93 35.12 40.34 46.75 52.83 79.02
66 5.32 8.14 11.51 14.89 17.05 20.11 22.42 25.79 28.69 32.93 34.69 38.78 44.51 51.97 57.68 86.35
67 5.91 9.12 12.62 16.42 20.11 22.42 25.79 28.69 32.93 34.47 38.42 42.80 49.06 57.58 62.18 94.12
68 6.51 10.04 13.89 18.04 22.04 24.54 28.23 31.44 34.47 37.82 42.14 46.91 53.73 62.18 67.77 102.35
69 7.17 11.05 15.25 19.76 24.12 26.87 30.94 34.47 37.82 41.49 48.20 51.36 56.72 67.77 73.69 111.41
70 7.89 12.14 16.72 21.64 26.41 29.44 33.92 37.82 41.49 45.48 50.57 56.13 64.00 73.69 80.22 121.31
Providentmutual Life and Annuity Company of America
SOA 75-80 Table - Male - Age Nearest Birthday
DURATION
ISSUE
AGE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
71 9.53 14.60 19.60 24 97 29.44 34.32 41.78 48.80 57.45 65.58 74.51 84.52 95.47 107.84 121.31 132.05
72 11.40 15.64 22.87 28.77 34.15 39.89 48.34 56.16 65.58 74.61 84.52 95.39 107.57 121.31 132.05 143.63
73 13.52 19.13 26.61 33.20 39.52 48.21 55.72 64.40 74.61 84.52 95.39 107.62 121.31 132.05 143.63 156.05
74 15.94 22 46 30.70 38.25 45.60 53.35 64.01 73.58 84.52 95.39 107.62 121.31 132.05 143.63 156.05 169.12
75 18.71 26.25 35.35 43.95 52.45 61.35 73.23 83.67 95.39 107.62 121.31 132.05 143.63 156.05 169.12 182.61
76 21.88 30.82 40.61 50.35 50.12 70.26 83.39 94.78 107.62 121.31 132.05 143.63 156.05 169.12 182.61 196.52
77 25.51 34.90 46.52 57.51 68.65 80.09 94.57 107.29 121.31 132.05 143.63 156.05 169.12 182.61 196.52 210.85
78 29.63 40.42 53.12 65.47 78.04 90.90 107.18 121.31 132.05 143.63 156.05 169.12 182.61 196.52 210.85 225.60
79 34.65 45.62 60.45 74.20 88.36 103.10 121.31 132.05 143.63 156.05 169.12 182.61 196.52 210.85 225.60 240.77
80 40.30 53.54 88.50 83.78 99.99 116.79 132.05 143.63 156.05 169.12 182.61 196.52 210.85 225.60 240.77 256.36
81 46.33 61.18 77.33 94.56 113.02 132.05 143.63 156.05 169.12 182.61 196.52 210.85 225.60 240.77 256.36 272.37
82 53.85 69.50 87.27 106.64 127.54 143.63 156.05 169.12 182.61 196.52 210.85 225.60 240.77 256.36 272.37 288.80
83 61.41 79.10 96.40 120.07 143.63 156.05 169.12 182.61 196.52 210.85 225.60 240.77 256.36 272.37 288.80 305.65
84 72.42 89.77 110.78 134.94 156.05 169.12 182.61 196.52 210.85 225.60 240.77 256.36 272.37 288.80 305.65 322.92
85 84.92 104.32 124.48 151.33 169.12 182.61 196.52 210.85 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61
86 99.04 117.78 139.58 169.12 182.61 196.52 210.85 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00
87 114.90 134.20 155.97 182.61 196.52 210.85 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00
88 132.64 152.21 173.48 196.52 210.85 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00
89 143.75 164.35 186.59 210.85 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00
90 155.22 176.57 200.31 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00
91 196.52 210.85 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00
92 210.85 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00
93 225.60 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
94 240.77 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
95 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
96 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
97 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
98 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
99 322.92 340.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PROVIDENTMUTAL LIFE AND ANNUITY COMPANY OF AMERICA
SOA 75-80 TABLE -- FEMALE -- AGE NEAREST BIRTHDAY
ISSUE DURATION
AGE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
0 0.93 0.34 0.30 0.27 0.24 0.22 0.20 0.18 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36
1 0.34 0.30 0.27 0.24 0.22 0.20 0.18 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40
2 0.28 0.27 0.24 0.22 0.20 0.18 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44
3 0.24 0.24 0.22 0.20 0.18 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47
4 0.22 0.22 0.20 0.18 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49
5 0.20 0.20 0.18 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51
6 0.19 0.18 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51 0.52
7 0.17 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51 0.52 0.53
8 0.16 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51 0.52 0.53 0.53
9 0.16 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51 0.52 0.53 0.53 0.53
10 0.16 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51 0.52 0.53 0.53 0.53 0.53
11 0.17 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51 0.52 0.53 0.53 0.53 0.53 0.53
12 0.18 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51 0.52 0.53 0.53 0.53 0.53 0.53 0.53
13 0.21 0.31 0.35 0.38 0.42 0.45 0.47 0.49 0.52 0.53 0.53 0.53 0.53 0.53 0.53 0.53
14 0.25 0.33 0.37 0.40 0.43 0.45 0.47 0.48 0.53 0.53 0.53 0.53 0.53 0.53 0.53 0.54
15 0.28 0.35 0.39 0.41 0.43 0.45 0.46 0.48 0.53 0.53 0.53 0.53 0.53 0.53 0.54 0.55
16 0.32 0.37 0.39 0.41 0.42 0.43 0.45 0.46 0.53 0.53 0.53 0.53 0.53 0.54 0.55 0.56
17 0.36 0.37 0.39 0.40 0.41 0.42 0.43 0.44 0.53 0.53 0.53 0.53 0.54 0.55 0.56 0.61
18 0.36 0.37 0.39 0.40 0.41 0.42 0.43 0.44 0.51 0.52 0.53 0.54 0.55 0.56 0.61 0.65
19 0.36 0.37 0.39 0.40 0.41 0.42 0.43 0.44 0.50 0.50 0.54 0.55 0.56 0.61 0.65 0.70
20 0.35 0.36 0.36 0.39 0.41 0.41 0.43 0.44 0.48 0.50 0.55 0.56 0.61 0.65 0.70 0.77
21 0.34 0.36 0.37 0.38 0.40 0.41 0.43 0.44 0.47 0.49 0.56 0.61 0.65 0.70 0.77 0.84
22 0.32 0.34 0.36 0.38 0.40 0.41 0.43 0.45 0.46 0.50 0.61 0.65 0.70 0.77 0.84 0.93
23 0.32 0.34 0.37 0.39 0.41 0.42 0.45 0.46 0.50 0.56 0.65 0.70 0.77 0.84 0.93 1.03
24 0.31 0.34 0.38 0.40 0.42 0.45 0.46 0.50 0.55 0.59 0.70 0.77 0.84 0.93 1.03 1.15
25 0.31 0.35 0.39 0.41 0.44 0.46 0.50 0.55 0.56 0.63 0.77 0.84 0.93 1.03 1.15 1.29
26 0.30 0.35 0.39 0.43 0.46 0.50 0.55 0.59 0.63 0.69 0.84 0.93 1.03 1.15 1.29 1.45
27 0.30 0.35 0.41 0.45 0.50 0.55 0.59 0.63 0.66 0.76 0.83 1.03 1.15 1.29 1.45 1.62
28 0.31 0.36 0.42 0.48 0.53 0.59 0.63 0.66 0.76 0.86 1.03 1.15 1.29 1.45 1.62 1.79
29 0.32 0.37 0.44 0.51 0.57 0.63 0.66 0.76 0.86 0.97 1.15 1.29 1.45 1.62 1.79 1.96
30 0.33 0.39 0.47 0.54 0.62 0.66 0.76 0.86 0.97 1.06 1.29 1.45 1.62 1.79 1.96 2.14
31 0.35 0.41 0.50 0.59 0.66 0.76 0.86 0.97 1.06 1.19 1.45 1.62 1.79 1.96 2.14 2.33
32 0.36 0.44 0.54 0.65 0.76 0.86 0.97 1.06 1.19 1.31 1.62 1.79 1.96 2.14 2.33 2.52
33 0.39 0.46 0.57 0.69 0.82 0.93 1.07 1.19 1.31 1.48 1.77 1.94 2.12 2.33 2.52 2.72
34 0.41 0.49 0.60 0.74 0.86 1.02 1.18 1.31 1.48 1.64 1.92 2.10 2.30 2.51 2.72 2.83
35 0.43 0.51 0.63 0.79 0.95 1.12 1.30 1.45 1.64 1.81 2.07 2.27 2.48 2.71 2.92 3.17
36 0.45 0.54 0.67 0.85 1.04 1.23 1.43 1.63 1.81 2.00 2.23 2.43 2.64 2.92 3.16 3.43
37 0.48 0.58 0.71 0.92 1.13 1.35 1.56 1.77 1.96 2.19 2.39 2.60 2.82 3.16 3.42 3.71
38 0.51 0.64 0.80 1.04 1.26 1.49 1.70 1.92 2.14 2.35 2.56 2.78 3.02 3.38 3.66 4.04
39 0.55 0.72 0.89 1.16 1.39 1.63 1.85 2.06 2.30 2.52 2.74 2.95 3.23 3.52 3.94 4.40
40 0.60 0.80 1.00 1.28 1.52 1.78 2.01 2.24 2.45 2.69 2.94 3.19 3.46 3.91 4.25 4.80
41 0.65 0.89 1.10 1.41 1.66 1.94 2.17 2.41 2.63 2.89 3.15 3.42 3.72 4.23 4.56 5.23
42 0.70 0.96 1.20 1.54 1.80 2.10 2.33 2.58 2.83 3.10 3.38 3.89 4.01 4.57 4.94 5.70
43 0.76 1.05 1.29 1.63 1.90 2.20 2.45 2.74 3.01 3.31 3.64 3.96 4.34 4.94 5.37 6.22
44 0.81 1.12 1.39 1.71 2.00 2.30 2.59 2.90 3.21 3.55 3.92 4.30 4.59 5.37 5.85 6.78
45 0.86 1.19 1.48 1.79 2.10 2.42 2.73 3.07 3.43 3.82 4.23 4.64 5.07 5.83 6.36 7.37
46 0.91 1.26 1.58 1.86 2.22 2.53 2.88 3.28 3.67 4.11 4.55 5.01 5.49 6.32 6.69 8.00
47 0.96 1.33 1.68 1.95 2.34 2.65 3.06 3.49 3.94 4.41 4.90 5.41 5.94 6.84 7.46 8.67
48 1.00 1.39 1.76 2.04 2.45 2.82 3.27 3.76 4.20 4.70 5.23 5.77 6.31 7.25 7.86 9.38
49 1.05 1.46 1.83 2.13 2.58 3.00 3.50 4.04 4.48 5.02 5.57 6.13 6.70 7.67 8.30 10.15
50 1.10 1.53 1.91 2.24 2.72 3.20 3.74 4.35 4.78 5.34 5.92 6.50 7.09 8.09 8.75 10.99
51 1.15 1.60 2.01 2.35 2.86 3.40 4.00 4.58 5.09 5.67 6.26 6.86 7.49 8.53 9.21 11.91
52 1.20 1.68 2.10 2.47 3.01 3.61 4.28 5.03 5.40 6.01 6.84 7.27 7.91 9.00 9.70 12.92
53 1.26 1.76 2.22 2.65 3.23 3.87 4.57 5.34 5.77 6.41 7.05 7.75 8.47 9.58 10.50 14.03
54 1.32 1.85 2.35 2.84 3.47 4.15 4.87 5.65 6.15 6.81 7.49 8.26 9.07 10.43 11.37 15.25
55 1.38 1.93 2.48 3.05 3.72 4.43 5.15 5.97 6.55 7.25 7.96 8.81 9.72 11.24 12.33 16.83
56 1.45 2.02 2.62 3.27 3.97 4.72 5.50 5.29 6.97 7.71 8.46 9.40 10.43 12.13 13.41 18.21
57 1.51 2.11 2.76 3.49 4.24 5.02 5.82 5.62 7.42 8.21 9.00 10.04 11.20 13.13 14.65 20.04
58 1.63 2.29 2.99 3.76 4.54 5.34 6.18 7.03 7.88 8.71 9.76 10.86 12.11 14.18 15.64 22.17
59 1.75 2.48 3.24 4.04 4.85 5.69 6.57 7.46 8.36 9.25 10.60 11.79 13.14 15.40 17.21 24.65
60 1.88 2.68 3.50 4.34 5.18 6.06 6.98 7.93 8.59 9.83 11.55 12.85 14.33 16.80 18.78 27.53
61 2.01 2.90 3.77 4.86 5.54 6.45 7.42 8.43 9.45 10.47 12.64 14.06 15.70 18.42 20.59 30.86
62 2.15 3.12 4.07 5.01 5.93 6.88 7.90 8.97 10.07 11.19 13.90 15.50 17.30 20.26 22.64 34.69
63 2.27 3.27 4.26 5.24 6.21 7.22 8.30 9.49 10.75 12.11 15.04 16.80 18.79 22.06 24.73 39.07
64 2.40 3.43 4.45 5.48 6.50 7.57 8.75 10.07 11.53 13.17 16.34 18.28 20.47 24.09 27.05 44.00
65 2.53 3.59 4.66 5.73 6.80 7.95 9.24 10.72 12.43 14.38 17.83 19.94 22.34 26.30 29.55 49.48
66 2.67 3.76 4.83 5.99 7.12 8.37 9.60 11.47 13.45 15.78 19.51 21.61 24.41 28.69 32.20 55.51
67 2.82 3.94 5.10 6.77 7.46 8.85 10.43 12.32 14.81 17.37 21.40 23.87 26.64 31.21 34.96 62.09
68 3.06 4.28 5.56 6.87 8.23 9.79 11.60 13.76 16.38 19.53 23.67 26.64 29.95 34.96 39.13 69.22
69 3.33 4.67 6.08 7.56 9.11 10.89 12.85 15.42 18.41 21.99 26.64 29.98 33.61 39.13 43.62 76.90
70 3.63 5.11 6.70 8.36 10.13 12.16 14.52 17.34 20.73 24.77 29.96 33.61 37.59 43.62 46.46 85.13
Providentmutual Life and Annuity Company of America
SOA 75-80 Table -- Female -- Age Nearest Birthday
ISSUE DURATION
AGE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
71 5.11 6.70 8.36 10.13 12.16 14.52 17.34 20.73 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91
72 6.70 8.36 10.13 12.16 14.52 17.34 20.73 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24
73 8.36 10.13 12.16 14.52 17.34 20.73 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12
74 10.13 12.16 14.52 17.34 20.73 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55
75 12.16 14.52 17.34 20.73 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53
76 14.52 17.34 20.73 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06
77 17.34 20.73 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06 152.14
78 20.73 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77
79 24.77 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95
80 29.96 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68
81 33.61 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96
82 37.59 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79
83 43.62 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17
84 48.46 85.13 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10
85 85.13 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58
86 93.91 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00
87 103.24 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00 0.00
88 113.12 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00 0.00 0.00
89 123.55 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00 0.00 0.00 0.00
90 134.53 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00 0.00 0.00 0.00 0.00
91 146.06 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00 0.00 0.00 0.00 0.00 0.00
92 158.14 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00 0.00 0.00 0.00 0.00 0.00 0.00
93 170.77 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
94 183.95 197.68 211.96 226.79 242.17 258.10 274.58 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
95 256.36 272.37 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
96 272.37 288.80 305.65 322.92 340.81 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
97 288.80 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
98 305.65 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
99 322.92 340.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
PROVCARE LONG TERM CAR WAIVER RIDER
COST OF INSURANCE
MALE RIDER RATE PER 1000
REVISED 1/19/01
ATTAINED ATTAINED
AGE ANNUAL MONTHLY AGE ANNUAL MONTHLY
--------- ----------- ---------- ----------- ---------- -----------
21 0.12 0.01 61 0.24 0.02
22 0.12 0.01 62 0.24 0.02
23 0.12 0.01 63 0.24 0.02
24 0.12 0.01 64 0.36 0.03
25 0.12 0.01 65 0.36 0.03
26 0.12 0.01 66 0.36 0.03
27 0.12 0.01 67 0.48 0.04
28 0.12 0.01 68 0.48 0.04
29 0.12 0.01 69 0.60 0.05
30 0.12 0.01 70 0.72 0.06
31 0.12 0.01 71 0.84 0.07
32 0.12 0.01 72 0.96 0.08
33 0.12 0.01 73 1.08 0.09
34 0.12 0.01 74 1.32 0.11
35 0.12 0.01 75 1.56 0.13
36 0.12 0.01 76 2.04 0.17
37 0.12 0.01 77 2.52 0.21
38 0.12 0.01 78 3.00 0.25
39 0.12 0.01 79 3.72 0.31
40 0.12 0.01 80 4.44 0.37
41 0.12 0.01 81 5.40 0.45
42 0.12 0.01 82 6.48 0.54
43 0.12 0.01 83 7.80 0.65
44 0.12 0.01 84 9.36 0.78
45 0.12 0.01 85 10.68 0.89
46 0.12 0.01 86 11.88 0.99
47 0.12 0.01 87 13.44 1.12
48 0.12 0.01 88 15.36 1.28
49 0.12 0.01 89 17.40 1.45
50 0.12 0.01 90 20.16 1.68
51 0.12 0.01 91 23.16 1.93
52 0.12 0.01 92 26.40 2.20
53 0.12 0.01 93 29.76 2.48
54 0.12 0.01 94 33.00 2.75
55 0.12 0.01 95 36.24 3.02
56 0.12 0.01 96 39.12 3.26
57 0.12 0.01 97 41.28 3.44
58 0.24 0.02 98 41.64 3.47
59 0.24 0.02 99 41.64 3.47
60 0.24 0.02
PROVCARE LONG TERM CARE WAIVER RIDER
COST OF INSURANCE
FEMALE RIDER RATE PER 1000
REVISED 1/19/01
ATTAINED ATTAINED
AGE ANNUAL MONTHLY AGE ANNUAL MONTHLY
--------- ----------- ---------- ----------- ---------- -----------
21 0.12 0.01 61 0.24 0.02
22 0.12 0.01 62 0.24 0.02
23 0.12 0.01 63 0.24 0.02
24 0.12 0.01 64 0.24 0.02
25 0.12 0.01 65 0.36 0.03
26 0.12 0.01 66 0.36 0.03
27 0.12 0.01 67 0.36 0.03
28 0.12 0.01 68 0.36 0.03
29 0.12 0.01 69 0.48 0.04
30 0.12 0.01 70 0.48 0.04
31 0.12 0.01 71 0.60 0.05
32 0.12 0.01 72 0.72 0.06
33 0.12 0.01 73 0.84 0.07
34 0.12 0.01 74 1.08 0.09
35 0.12 0.01 75 1.32 0.11
36 0.12 0.01 76 1.56 0.13
37 0.12 0.01 77 1.92 0.16
38 0.12 0.01 78 2.52 0.21
39 0.12 0.01 79 3.12 0.26
40 0.12 0.01 80 4.08 0.34
41 0.12 0.01 81 4.92 0.41
42 0.12 0.01 82 6.00 0.50
43 0.12 0.01 83 7.32 0.61
44 0.12 0.01 84 8.88 0.74
45 0.12 0.01 85 10.68 0.89
46 0.12 0.01 86 12.48 1.04
47 0.12 0.01 87 14.64 1.22
48 0.12 0.01 88 16.80 1.40
49 0.12 0.01 89 19.08 1.59
50 0.12 0.01 90 21.35 1.78
51 0.12 0.01 91 23.64 1.97
52 0.12 0.01 92 26.16 2.18
53 0.12 0.01 93 28.68 2.39
54 0.12 0.01 94 31.08 2.59
55 0.12 0.01 95 33.48 2.79
56 0.12 0.01 96 35.28 2.94
57 0.12 0.01 97 36.24 3.02
58 0.12 0.01 98 36.24 3.02
59 0.12 0.01 99 36.24 3.02
60 0.24 0.02
PROVCARE LONG TERM CARE ACCELERATION RIDER
COST OF INSURANCE
MALE 2% RIDER RATE PER 1000
REVISED 1/19/01
ATTAINED ATTAINED
AGE ANNUAL MONTHLY AGE ANNUAL MONTHLY
-------- ------ ------- -------- ------ -------
21 0.24 0.02000 61 2.68 0.22333
22 0.24 0.02000 62 2.87 0.23917
23 0.24 0.02000 63 3.05 0.25417
24 0.24 0.02000 64 3.16 0.26333
25 0.24 0.02000 65 3.36 0.28000
26 0.24 0.02000 66 3.61 0.30083
27 0.24 0.02000 67 3.86 0.32167
28 0.24 0.02000 68 4.30 0.35833
29 0.24 0.02000 69 4.72 0.39333
30 0.24 0.02000 70 5.20 0.43333
31 0.24 0.02000 71 5.61 0.46750
32 0.24 0.02000 72 6.07 0.50583
33 0.24 0.02000 73 6.65 0.55417
34 0.24 0.02000 74 7.15 0.59583
35 0.24 0.02000 75 8.18 0.68167
36 0.24 0.02000 76 9.37 0.78083
37 0.24 0.02000 77 10.52 0.87667
38 0.24 0.02000 78 11.64 0.97000
39 0.24 0.02000 79 12.63 1.04417
40 0.24 0.02000 80 13.39 1.11583
41 0.30 0.02500 81 14.32 1.19333
42 0.36 0.03000 82 15.39 1.28250
43 0.45 0.03750 83 16.38 1.36500
44 0.54 0.04500 84 17.36 1.44667
45 0.64 0.05333 85 17.74 1.47833
46 0.72 0.06000 86 17.73 1.47750
47 0.79 0.06583 87 17.78 1.48167
48 0.86 0.07167 88 17.81 1.48417
49 0.92 0.07667 89 17.99 1.49917
50 1.00 0.08333 90 18.18 1.51500
51 1.11 0.09250 91 17.94 1.49500
52 1.22 0.10167 92 17.38 1.44833
53 1.34 0.11167 93 16.63 1.38583
54 1.49 0.12417 94 15.61 1.30083
55 1.69 0.14083 95 13.89 1.15750
56 1.90 0.15833 96 11.01 0.91750
57 2.07 0.17250 97 8.85 0.73750
58 2.13 0.17750 98 8.49 0.70750
59 2.30 0.19167 99 8.49 0.70750
60 2.47 0.20583
PROVCARE LONG TERM CARE ACCELERATION RIDER
COST OF INSURANCE
MALE 4% RIDER RATE PER 1000
REVISED 1/19/01
ATTAINED ATTAINED
AGE ANNUAL MONTHLY AGE ANNUAL MONTHLY
--------- ----------- ---------- ----------- ---------- -----------
21 0.31 0.02583 61 3.55 0.29583
22 0.31 0.02583 62 3.81 0.31750
23 0.31 0.02583 63 3.97 0.33083
24 0.31 0.02583 64 4.07 0.33917
25 0.31 0.02583 65 4.29 0.35750
26 0.31 0.02583 66 4.61 0.38417
27 0.31 0.02583 67 4.95 0.41250
28 0.31 0.02583 68 5.49 0.45750
29 0.31 0.02583 69 6.05 0.50417
30 0.32 0.02667 70 6.68 0.55667
31 0.33 0.02750 71 7.23 0.60250
32 0.33 0.02750 72 7.83 0.65250
33 0.34 0.02833 73 8.58 0.71500
34 0.35 0.02917 74 9.27 0.77250
35 0.36 0.03000 75 10.61 0.88417
36 0.36 0.03000 76 12.22 1.01833
37 0.37 0.03083 77 13.78 1.14833
38 0.38 0.03167 78 15.29 1.27417
39 0.38 0.03167 79 16.59 1.38250
40 0.39 0.03250 80 17.85 1.48750
41 0.49 0.04083 81 19.25 1.60417
42 0.57 0.04750 82 20.86 1.73833
43 0.70 0.05833 83 22.43 1.86917
44 0.83 0.06917 84 24.04 2.00333
45 0.98 0.08167 85 24.85 2.07083
46 1.09 0.09083 86 25.14 2.09500
47 1.19 0.09917 87 25.59 2.13250
48 1.29 0.10750 88 26.11 2.17583
49 1.37 0.11417 89 26.84 2.23667
50 1.50 0.12500 90 27.76 2.31333
51 1.65 0.13750 91 28.22 2.35167
52 1.81 0.15083 92 28.32 2.36000
53 1.98 0.16500 93 28.23 2.35250
54 2.20 0.18333 94 27.76 2.31333
55 2.45 0.20417 95 26.42 2.20167
56 2.71 0.22583 96 23.54 1.96167
57 2.90 0.24167 97 21.38 1.78167
58 2.99 0.24917 98 21.02 1.75167
59 3.16 0.26333 99 21.02 1.75167
60 3.33 0.27750
PROVCARE LONG TERM CARE ACCELERATION RIDER
COST OF INSURANCE
FEMALE 2% RIDER RATE PER 1000
REVISED 1/19/01
ATTAINED ATTAINED
AGE ANNUAL MONTHLY AGE ANNUAL MONTHLY
--------- ----------- ---------- ----------- ---------- -----------
21 0.24 0.02000 61 2.79 0.23250
22 0.24 0.02000 62 3.24 0.27000
23 0.24 0.02000 63 3.73 0.31083
24 0.24 0.02000 64 4.20 0.35000
25 0.24 0.02000 65 4.55 0.37917
26 0.24 0.02000 66 4.91 0.40917
27 0.24 0.02000 67 5.37 0.44750
28 0.24 0.02000 68 5.62 0.46833
29 0.24 0.02000 69 5.83 0.46917
30 0.24 0.02000 70 6.02 0.50167
31 0.24 0.02000 71 6.59 0.54917
32 0.24 0.02000 72 7.17 0.59750
33 0.24 0.02000 73 7.82 0.65167
34 0.24 0.02000 74 8.39 0.69917
35 0.24 0.02000 75 9.06 0.75500
36 0.26 0.02167 76 10.45 0.87083
37 0.31 0.02583 77 11.96 0.99667
38 0.37 0.03083 78 13.21 1.10083
39 0.41 0.03417 79 14.61 1.21750
40 0.46 0.03833 80 15.93 1.32750
41 0.51 0.04250 81 17.48 1.45667
42 0.56 0.04667 82 18.89 1.57417
43 0.62 0.05167 83 20.52 1.71000
44 0.66 0.05500 84 22.05 1.83750
45 0.73 0.06083 85 23.49 1.95750
46 0.80 0.06667 86 24.95 2.07917
47 0.88 0.07333 87 26.00 2.16667
48 0.96 0.08000 88 26.63 2.21917
49 1.09 0.09083 89 26.90 2.24167
50 1.19 0.09917 90 26.80 2.23333
51 1.33 0.11083 91 26.32 2.19333
52 1.44 0.12000 92 25.55 2.12917
53 1.49 0.12417 93 24.61 2.05083
54 1.63 0.13583 94 23.32 1.94333
55 1.72 0.14333 95 21.07 1.75583
56 1.83 0.15250 96 19.27 1.60583
57 1.93 0.16083 97 18.31 1.52583
58 2.07 0.17250 98 18.31 1.52583
59 2.25 0.18750 99 18.31 1.52583
60 2.45 0.20417
PROVCARE LONG TERM CARE ACCELERATION RIDER
COST OF INSURANCE
FEMALE 4% RIDER RATE PER 1000
REVISED 1/19/01
ATTAINED ATTAINED
AGE ANNUAL MONTHLY AGE ANNUAL MONTHLY
-------- ------ ------- -------- ------ -------
21 0.28 0.02333 61 3.91 0.32583
22 0.28 0.02333 62 4.53 0.37750
23 0.28 0.02333 63 5.20 0.43333
24 0.28 0.02333 64 5.85 0.48750
25 0.28 0.02333 65 6.37 0.53083
26 0.28 0.02333 66 6.86 0.57167
27 0.28 0.02333 67 7.49 0.62417
28 0.28 0.02333 68 7.83 0.65250
29 0.28 0.02333 69 7.89 0.65750
30 0.28 0.02333 70 8.29 0.69083
31 0.28 0.02333 71 8.97 0.74750
32 0.28 0.02333 72 9.61 0.80083
33 0.29 0.02417 73 10.33 0.86083
34 0.30 0.02500 74 10.94 0.91167
35 0.30 0.02500 75 11.66 0.97167
36 0.34 0.02833 76 13.45 1.12083
37 0.40 0.03333 77 15.43 1.28583
38 0.49 0.04083 78 17.14 1.42833
39 0.54 0.04500 79 19.04 1.58667
40 0.62 0.05167 80 20.94 1.74500
41 0.69 0.05750 81 23.08 1.92333
42 0.78 0.06500 82 25.11 2.09250
43 0.87 0.07250 83 27.48 2.29000
44 0.94 0.07833 84 29.78 2.48167
45 1.05 0.08750 85 32.03 2.66917
46 1.14 0.09500 86 34.31 2.85917
47 1.24 0.10333 87 36.16 3.01333
48 1.36 0.11333 88 37.48 3.12333
49 1.54 0.12833 89 38.39 3.19917
50 1.67 0.13917 90 38.84 3.23667
51 1.87 0.15583 91 38.81 3.23417
52 2.02 0.16833 92 38.47 3.20583
53 2.08 0.17333 93 37.94 3.16167
54 2.27 0.18917 94 36.92 3.07667
55 2.40 0.20000 95 34.70 2.89167
56 2.55 0.21250 96 32.90 2.74167
57 2.69 0.22417 97 31.94 2.66167
58 2.88 0.24000 98 31.94 2.66167
59 3.13 0.26083 99 31.94 2.66167
60 3.44 0.28667
DISABILITY PREMIUM WAIVER RATES
% OF BENEFIT PREMIUMS
ISSUE AGE RATE ISSUE AGE RATE
--------- ------ --------- ------
1 - 7 2.0% 36 3.0%
8 - 13 2.1 37 3.1
14 - 17 2.2 38 3.2
18 - 20 2.3 39 3.3
40 3.3
21 2.4 41 3.4
22 2.4 42 3.5
23 2.4 43 3.6
24 2.5 44 3.8
25 2.5 45 3.9
26 2.5 46 4.0
27 2.6 47 4.2
28 2.6 48 4.3
29 2.6 49 4.5
30 2.7 50 4.7
31 2.7 51 4.9
32 2.8 52 5.1
33 2.8 53 5.3
34 2.9 54 5.6
35 3.0 55 5.8
WAIVER OF MONTHLY DEDUCTIONS RIDER
Cost of Insurance
The cost of this rider is determined on each Policy Processing Day by
multiplying the Rate Factor for the Insured's Attained Age by the net amount at
risk divided by 1,000.
ATTAINED AGE RATE FACTOR
------------ -----------
15-45 0.01
46-48 0.02
49-50 0.03
51 0.04
52 0.05
53 0.07
54 0.09
55 0.13
56 0.18
57 0.24
58 0.32
59 0.44
If the Insured is in a Special Premium Class, the rate factor shown above will
be multiplied by the Risk Factor.
EXHIBIT III
REPORTS
------------------------------
(Reporting Period/Ending Date)
Treaty Date Termination Date
Treaty Number Reinstatement Date
Reinsurance Method
Client Policy Number SPECIAL PRODUCTS (required if applicable)
Automatic/Facultative Indicator If Joint, Type (i.e., last survivor, 1st to die)
Joint Life Indicator Joint Insured Name
Name Joint Last Name
Last Name Joint First Name
First Name Joint Middle Initial
Middle Initial Joint Issue Age
Date of Birth Term Additions Indicator
Issue Age Accelerated Benefit Indicator
Gender Long Term Care Indicator
State of Residency Purchase Options
Table Rating Dividends
Smoker Indicator Policy Fee
Preferred Risk Indicator Cash Value
Issue Month/Day/Century/Year
Age Basis ADDITIONAL DATA ITEMS (not required)
Original Plan Code Par/NonPar Indicator
Plan Description (i.e., WL. R&C GPWL) Social Security Number
Plan Type (i.e., perm, term, UL, End, Xxx.) Years From Issue to Conversion
Face Amount Issued Reinsurance Premium Mode
Original Amount Reinsured Retention Amount
Current Amount Reinsured Cash Value
Life Standard Premium First Year/Renewal Indicator
Life Substandard Premium
Flat Extra Premium
Length of Flat Extra Premium
W.P. Premium
ADB Premium
Rider Premium
Life Standard Discount
Life Substandard Discount
Flat Extra Allowance
W.P. Allowance
ADB Discount
Rider Discount
POLICY EXHIBIT
CURRENT PERIOD YEAR-TO-DATE
------------------------------------------------------------ --------------------------------------------------------------
NO. OF AMOUNT OF NO. OF AMOUNT OF
POLICIES REINSURANCE POLICIES REINSURANCE
-------- ----------- -------- -----------
In Force Beg. Of Period In Force Beg. Of Year
Issues-Automatic Issues-Automatic
Issues-Facultative Issues-Facultative
Cancellations (NTO's) Cancellations (NTO's)
Reinstatements Reinstatements
Other Increases Other Increases
Total Increases Total Increases
Deaths Deaths
Recaptures Recaptures
Expiries & Maturities Expiries & Maturities
Lapses & Surrender Lapses & Surrender
Other Decreases Other Decreases
Total Decreases Total Decreases
In Force Year-to-Date In Force Year-to-Date
VALUATION RESERVE FOR
SELF-ADMINISTERED BUSINESS
AS OF MM/DD/YY
LIFE RESERVES
ISSUE REINSURANCE UNITS ANNUALIZED NET VALUATION ---------------
TREATY # YEAR TYPE # OF POLICIES REINSURED GROSS PREMIUMS PREMIUMS STATUTORY TAX
-------- ----- ------------- ------------- --------- -------------- ------------- --------- ---
TA001 1991 YRT/
1992 Co-insurance/
1993 Modco
1998
1999
Total
TA002 1993
1994
1995
1998
1999
Total
TA003 1997
1998
1999
Total
SUPPLEMENTARY RESERVES
ISSUE RESERVE ------------------------------------------------------
TREATY # YEAR METHOD* SUBSTANDARD WP AL DEFICIENCY OTHER
-------- ----- ------- ----------- ---- ---- ---------- -----
TA001 1991
1992
1993
1998
1999
Total
TA002 1993
1994
1995
1998
1999
Total
TA003 1997
1998
1999
Total
* Please describe exact method of calculating reinsurance reserves, i.e.,
unearned gross premiums or 1/2 Cx. If the business is co-insured, specify
mortality table, interest rate and method used (ourtale or continuous CRVM) but
not less than 1/2 Cx, or CRVM humpback. Mean or interpolated. Used XXX or
Regulation 147. Does it include provision for immediate payment of claims?
As the valuation actuary of the below named company, I certify that the
information above is correct as shown.
Company:
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Signature:
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Name:
---------------------------------------
Title:
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Date:
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