AMENDMENT NO. 17
to the
VARIABLE ANNUITY GMIB REINSURANCE AGREEMENT
EFFECTIVE JANUARY 1, 2002
Between
XXXXXXX NATIONAL LIFE INSURANCE COMPANY
("CEDING COMPANY")
and
ACE TEMPEST LIFE REINSURANCE LTD.
("REINSURER")
Effective April 6, 2009, this Amendment is hereby attached to and becomes a part
of the above-described Reinsurance Agreement. It is mutually agreed that the
Agreement will be amended to add new Guaranteed Minimum Death Benefit forms
designed to handle conversions of older GMDBs, to remove references to the
Perspective Rewards product which was never sold with GMIB, and to update the
reinsurance premium rates both for policies with these new Guaranteed Minimum
Death Benefits and for elimination of Tier 1 and Tier 2 rates for GMIB Forms
7344 and 7365, with issue dates on or after 5/3/2004. To effect these changes,
the following provisions of this Agreement are hereby amended:
o Schedule B-1, CONTRACTS SUBJECT TO THIS REINSURANCE AGREEMENT, Amendment
#9, is hereby replaced by the attached Schedule B-1.
o Schedule D, QUARTERLY RE PREMIUM RATE BY CONTRACT TYPE AND GMIB TYPE,
Amendment #4, is hereby replaced by the attached Schedule X.
Xxxxxxx National Life Insurance Company ACE Tempest Life Reinsurance Ltd.
By ___Lisa C. Drake_____________ By ___Huan Tseng_____________
Name__Lisa C. Drake_____________ Name__Huan Tseng_____________
Title __SVP & Chief Actuary_______ Title _SVP & Chief Pricing Officer
Date __6/15/2009_________________ Date__June 4, 2009______________
SCHEDULE B-1
ANNUITY CONTRACTS Subject to this Reinsurance Agreement
PERSPECTIVE II AND FIFTH THIRD PERSPECTIVE II
o VA250 is an individual flexible premium variable and fixed annuity
VA250 8/03 replaced VA250
VA250 5/04 replaced VA250 8/03
VA220 replaced VA250 5/04 effective 10/04
o VA250G is a group flexible premium variable and fixed annuity
VA250G 8/03 replaced VA250G
VA250G 5/04 replaced VA250G 8/03
VA220G replaced VA250G 5/04 effective 10/04
o This product has three Contract options:
o Separate Account Investment Division option;
o Fixed Account Option; and
o Indexed Fixed Option (not available on VA220 and VA220G).
A) SEPARATE ACCOUNT INVESTMENT DIVISION OPTION
o This option allows the Owner to allocate Premiums and earnings to one or
more Investment Divisions of the Separate Account.
o Separate Account I is used for this Contract.
o The Separate Account invests in shares of one of the corresponding Series
of the underlying fund of the JNL Series Trust and JNL Variable Fund LLC
(see Schedule B-2).
B) OPTIONAL BENEFITS
FORM NUMBER POLICY DESCRIPTION
7345 Earnings Protection
7360 Earnings Protection effective 10/4/2004
7427 08/03 Death Benefit Option (4% Rollup)
7461 Death Benefit Option (4% Rollup) effective 10/4/2004
7341 Death Benefit Option (5% Rollup)
7341 08/03 Death Benefit Option (5% Rollup)
7463 Death Benefit Option (5% Rollup) effective 10/4/2004
7340 Death Benefit Option (HAV)
7340 08/03 Death Benefit Option (HAV)
7470 Death Benefit Option (HAV) effective 10/4/2004
7428 08/03 Death Benefit Option (Comb HAV and 4% Rollup)
7462 Death Benefit Option (Comb HAV and 4% Rollup) effective 10/4/2004
7342 Death Benefit Option (Comb HAV and 5% Rollup)
7342 08/03 Death Benefit Option (Comb HAV and 5% Rollup)
7464 Death Benefit Option (Comb HAV and 5% Rollup) effective 10/4/2004
7595 Death Benefit Option (HQV) effective 4/6/2009
7596 Death Benefit Option (5% Rollup) effective 4/6/2009
7597 Death Benefit Option (Comb HQV and 5% Rollup) effective 4/6/2009
7598 Death Benefit Option (6% Rollup) effective 4/6/2009
7599 Death Benefit Option (Comb HQV and 6% Rollup) effective 4/6/2009
7349 Additional Free Withdrawal
7343 Shortened W/D Charge Period (5 years)
7465 Shortened W/D Charge Period (5 years) effective 10/4/2004
7429 Shortened W/D Charge Period (3 years) - not available for
contracts issued after 4/30/2006
7466 Shortened W/D Charge Period (3 years) effective 10/4/2004 - not
available for contracts issued after 4/30/2006
7346 03/03 Premium Credit (4%)
7348 03/03 Premium Credit (2%)
7352 03/03 Premium Credit (3%)
7344 Guaranteed Monthly Income Benefit (6% Roll-up)
7452 Guaranteed Monthly Income Benefit (5% Roll-up) -
Effective 5/3/2004
7454 Guaranteed Monthly Income Benefit (5% Roll-up) -
Effective 10/4/2004
Washington State Only
7471WA Death Benefit Option (3% Rollup) effective 10/4/2004
7472WA Death Benefit Option (Comb HAV and 3% Rollup) effective 10/4/2004
7600AWA Death Benefit Option (3% Rollup) effective 4/6/2009
7601AWA Death Benefit Option (Comb HQV and 3% Rollup) effective 4/6/2009
PERSPECTIVE FOCUS (no longer available for sale as of 5/2004)
o VA260 is an individual flexible Premium variable and fixed annuity
o VA260G is a group flexible premium variable and fixed annuity
o This product has two Contract options:
o Separate Account Investment Division option;
o Fixed Account Option
A) SEPARATE ACCOUNT INVESTMENT DIVISION OPTION
o This option allows the Owner to allocate Premiums and earnings to one or
more Investment Divisions of the Separate Account.
o Separate Account 1 is used for this Contract.
o The Separate Account invests in shares of one of the corresponding Series
of the underlying fund of the JNL Series Trust and JNL Variable Fund LLC
(see Schedule B-2).
B) OPTIONAL BENEFITS
FORM NUMBER POLICY DESCRIPTION
7360 Earnings Max
7361 Death Benefit Option (5% Rollup)
7362 Death Benefit Option (MAV)
7363 Death Benefit Option (Comb)
7364 Premium Credit (2%)
7365 Guaranteed Monthly Income Benefit (6% Roll-up)
7380 Reduced Administration Charge Endorsement
JNL ACE 2002 TREATY SCHEDULE B-1 AMENDMENT # 17
SCHEDULE D
QUARTERLY RE PREMIUM RATE by CONTRACT TYPE and GMIB TYPE
The Premium rate for reinsurance, subject to the terms and conditions of this
Agreement, are guaranteed while the reinsurance coverage is in effect. The
premium rate varies by GMIB form number, VALUATION DATE, and whether certain
optional death benefits were elected.
CONTRACT TYPES:
Perspective II, Perspective Focus, Perspective Rewards
GMIB TYPES:
I. GMIB FORMS 7344 AND 7365:
ANNUITY CONTRACTS with GMDB Form numbers 7340 08/03, 7341 08/03, 7342
08/03, 7427 08/03, 7428 08/03:
MONTHLY VALUATION DATE RATE
Before 5/1/2004 X.XXXX
5/1/2004 and later
Not Converted to DB Form 7596, 7597, 7598, 7599: X.XXXX
Converted to DB Form 7596, 7597, 7598, 7599: X.XXXX
ANNUITY CONTRACTS with GMDB Form numbers 7340, 7341, 7342, 7361, 7362,
7363, or if no optional death benefit is elected:
MONTHLY VALUATION DATE RATE
Before 5/1/2004 X.XXXX
5/1/2004 and later
Not Converted to DB Form 7596, 7597, 7598, 7599: X.XXXX
Converted to DB Form 7596, 7597, 7598, 7599: X.XXXX
II. GMIB FORM 7452 AND 7454, WITH ISSUE DATES ON OR AFTER 5/3/2004:
ANNUITY CONTRACTS not converted to GMDB Form numbers 7596, 7597, 7598,
7599:
RATE
X.XXXX
ANNUITY CONTRACTS converted to GMDB Form numbers 7596, 7597, 7598, 7599:
RATE
X.XXXX
SCHEDULE D AMENDMENT NO. 17
