Exhibit 7(e)
AUTOMATIC REINSURANCE AGREEMENT NO. 2727
EFFECTIVE JANUARY 1, 1999
between
PROVIDENT MUTUAL LIFE INSURANCE COMPANY
of
BERWYN, PENNSYLVANIA
as Ceding Company: referred to as You and Your
and
PHOENIX HOME LIFE MUTUAL INSURANCE COMPANY
of
East Greenbush, New York
(Administrative Offices in Enfield, Connecticut)
as Reinsurer: referred to as We, Us and Our
[PHOENIX LOGO]
TABLE OF CONTENTS
ARTICLES
Article I Scope of the Agreement Page 1
Parties to the Agreement
Effective Date of the Agreement
Scope of the Agreement
Duration of the Agreement
Article II Reinsurance Coverage Page 2
Automatic Reinsurance
Facultative Reinsurance
Basis of Reinsurance
Article III Procedures Page 3
Article IV Liability Page 4
Article V Reinsurance Rates and Payments Page 5
Tax Reimbursement
Experience Refund
Article VI Changes to the Reinsurance Page 7
Errors and Oversights
Misstatement of Age or Sex
Changes to the Underlying Policy
Reductions, Terminations and
Reinstatements
Article VII Recapture Page 9
Article VIII Claims Page 11
Article IX Arbitration Page 14
Article X Insolvency Page 15
Article XI Inspection of Records Page 16
Article XII Execution of the Agreement Page 17
Continued...
TABLE OF CONTENTS
EXHIBITS
Exhibit A Reinsurance Coverage
Retention Limits
Automatic Acceptance Limits
Exclusions to Automatic Reinsurance Coverage,
including Jumbo Limits
Exhibit B Reinsurance Reporting Forms and Reinsurance Administration
Exhibit C Reinsurance Rates and Allowances
Net Amount at Risk Calculation
Exhibit D Reinsurance Claim Form
Exhibit E Conditional Receipt Liability
ARTICLE I - SCOPE OF THE AGREEMENT
1. PARTIES TO THE AGREEMENT
We mutually agree to transact reinsurance according to the terms of this
Agreement. This Agreement is for indemnity reinsurance and we are the only
two parties to the Agreement. There will be no right or legal relationship
whatsoever between us as reinsurer and any other person having an interest
of any kind in policies reinsured under this Agreement.
2. EFFECTIVE DATE OF THE AGREEMENT
This Agreement will go into effect at 12:01 A.M., January 1, 1999, and will
cover policies effective on and after that date.
3. SCOPE OF THE AGREEMENT
The text of this Agreement and all Exhibits, Schedules and Amendments are
considered to be the entire agreement between us. There are no other
understandings or agreements between us regarding the policies reinsured
other than as expressed in this Agreement. We may make changes or additions
to this Agreement, but they will not be considered to be in effect unless
they are made by means of a written amendment which has been signed by both
of us.
4. DURATION OF THE AGREEMENT
The duration of this Agreement will be unlimited. However, either one of us
may terminate the Agreement at any time by giving the other ninety days
prior written notice. We will continue to accept new reinsurance during the
ninety-day period.
Existing reinsurance will not be affected by the termination of this
Agreement for new reinsurance. Existing reinsurance will remain in force
until the termination or expiry of the underlying policy on which
reinsurance is based, as long as you continue to pay reinsurance premiums
as shown in Article V (Reinsurance Rates and Payment). However, we will not
be liable for any claims or premium refunds which are not reported to us
within one hundred eighty days following the termination or expiry of the
last cession reinsured under this Agreement.
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ARTICLE II - REINSURANCE COVERAGE
1. AUTOMATIC REINSURANCE
We will accept automatically reinsurance of life benefits for your
individually underwritten ordinary life policies on any permanent resident
of the United States or Canada, in agreement with the provisions and
limitations shown in Exhibit A (Reinsurance Coverage).
We will also accept automatically reinsurance of riders and supplementary
benefits written with the covered life benefits, but only to the extent
that the riders and supplementary benefits are specifically shown in
Exhibit A (Reinsurance Coverage), Part I.
You have the right to modify your retention limits shown in Exhibit A
(Reinsurance Coverage), Part II at any time. If your retention limits are
reduced as a result of the modification, you will need to notify us in
writing before you can cede reinsurance on the basis of the reduced
retention limits. We will prepare a treaty amendment which will serve as
our written approval of the reduction.
We reserve the right to amend the Automatic Acceptance Limits shown in
Exhibit A (Reinsurance Coverage), Part III if you modify your retention
limits. We also reserve the right to modify the Automatic Acceptance Limits
if you elect to participate in another arrangement or arrangements to
secure additional automatic binding capacity.
Changes in your issue limits or underwriting guidelines will be subject to
our review. Significant changes to your underwriting guidelines which will
affect future reinsurance will be subject to our written approval.
2. FACULTATIVE REINSURANCE
If you wish to submit a risk not covered automatically under this
Agreement, or if you wish our advice on any application, you may submit and
we will consider the risk on a facultative basis.
3. BASIS OF REINSURANCE
Life reinsurance under this Agreement will be on a Yearly Renewable Term
plan for the net amount at risk on the portion of the original policy that
is reinsured
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ARTICLE II - REINSURANCE COVERAGE
3. BASIS OF REINSURANCE - (CONTINUED)
with us. The net amount at risk for any policy period will be calculated
according to Exhibit C (Reinsurance Rates and Allowances), Part I.
Riders or supplementary benefits ceded with life benefits will be reinsured
as shown in Exhibit C. Any differences in the net amount at risk
calculation for these benefits will be shown in Exhibit C.
ARTICLE III - PROCEDURES
1. AUTOMATIC REINSURANCE
No individual notification will be necessary for placing automatic
reinsurance. Subject to Article V (Reinsurance Rates and Payment) and
Exhibit B (Reinsurance Reporting Forms and Reinsurance Administration), new
business or changes to existing reinsurance will be shown on your periodic
billing report.
2. FACULTATIVE REINSURANCE
You may submit to us one or more policies not covered automatically under
the Agreement, and we will consider such reinsuring such policies on a
facultative basis.
In order to submit a policy for consideration on a facultative basis, you
will submit to us a reinsurance application in substantially the form set
forth in Exhibit B hereto. We will review the information and promptly
notify you of whether we will reinsure such policy. If we require
additional information, we will promptly request that you provide such
additional information.
If we agree to reinsure the policy, we will provide you an unconditional
written offer to reinsure such policy. You are not required to confirm
acceptance of each offer at the time the offer is received, but you will
confirm acceptance of each offer and placement of the facultative
reinsurance with us on the monthly report; provided, however, you must
confirm the acceptance no later than the termination date shown on our
written offer, which termination date will not be less than ninety days
after the date on which you receive the written offer. We may extend the
termination date if you request an extension in writing and we agree to the
extension in writing.
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ARTICLE III - PROCEDURES
3. POLICY EXPENSES
You will bear the expenses of all medical examinations, inspection fees and
other charges incurred in connection with policy issues, reinstatements or
reentries.
4. REFERENCE MATERIALS
Upon request you will provide us with any reference materials which we may
require for proper administration of reinsurance ceded under this
Agreement.
ARTICLE IV - LIABILITY
1. AUTOMATIC REINSURANCE
Our liability for reinsurance placed automatically under this Agreement
will begin and end simultaneously with your liability for the underlying
policy on which reinsurance is based.
2. FACULTATIVE REINSURANCE
Our liability for facultative reinsurance will begin and end simultaneously
with your liability of the policy on which facultative reinsurance is
based, provided we make an unconditional written offer that is accepted in
accordance with Article III, Section 2.
If our offer depends on your approval of further information about the
insurability of the risk, we will have no liability unless you have
requested and approved the information and documented your policy file
accordingly.
3. CONDITIONAL RECEIPT LIABILITY
Our liability for losses under the terms of a Conditional Receipt or
Temporary Insurance Receipt is shown in Exhibit E (Conditional Receipt
Liability).
4. CONTINUATION OF LIABILITY
Continuation of our liability is conditioned on your payment of reinsurance
premiums as shown in Article V (Reinsurance Rates and Payment) and is
subject to Article VI (Changes to the Reinsurance) and Article VII
(Recapture).
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ARTICLE V - REINSURANCE RATES AND PAYMENTS
1. REINSURANCE RATES
-----------------
Reinsurance rates that you will pay us for business covered under this
Agreement are shown in Exhibit C. The reinsurance rate payable for any
cession for any accounting period will be calculated on the basis of the
net amount risk reinsured as of that period.
For reasons relating to deficiency reserve requirements by the various
state insurance departments, the rates shown in Exhibit C cannot be
guaranteed for more than one year. While we anticipate that reinsurance
rates shown in Exhibit C will continue to be charged, it may become
necessary for us to charge a guaranteed rate that is the greater of the
rate from Exhibit C or the corresponding statutory net premium rate based
on the 1980 CSO Table at 4.5% interest for the applicable mortality rating.
If the original policy is issued with interim insurance, you will pay us a
reinsurance rate for the interim period that is the same percentage of the
first year premium that the interim period bears to twelve months. The
rate that you pay us for the first policy year after the interim period
will be calculated on the basis of the full annual reinsurance rate.
Procedures and details of reinsurance rate calculation for any benefits or
riders ceded under this Agreement are shown in Exhibit C.
All financial transactions under this Agreement will be in United States
dollars, unless we mutually agree to use other currencies. Specifications
of the currencies and details of currency conversion procedures will be
shown in Exhibit C if necessary.
2. PAYMENTS
--------
You will self-administer the periodic reporting of your statements of
account and payments of balances due to us a shown in Exhibit B.
Within thirty days following the end of each month during which this
Agreement is in effect, you will submit to us a report substantially in
the form set forth at Exhibit B hereto. The report will contain such
additional information as we may mutually agree in writing.
In the event the report shows an amount due to you, we will pay you such
amount within thirty days after we receive the report.
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ARTICLE V - REINSURANCE RATES AND PAYMENTS
2. PAYMENTS - (CONTINUED)
Your timely payment of reinsurance premiums is a condition precedent to our
continued liability. If you have not paid the balance due us by the
thirty-first day following the close of the reporting period, we have the
right to give you thirty days' written notice of our intention to terminate
the reinsurance on which the balance is due and unpaid. At the end of this
thirty-day period, our liability will automatically terminate for all
reinsurance on which balances remain due and unpaid, including reinsurance
on which balances became due and unpaid during and after the thirty-day
notice period. Even though we have terminated the reinsurance, you will
continue to be liable for the payment of unpaid balances along with
interest charges calculated from the due date shown above to the date of
payment. The interest rate payable will be the same that we charge for
delinquent premiums on our individual life insurance policies.
You may reinstate reinsurance terminated for non-payment of balances due at
any time within sixty days of the date of termination, by paying us all
balances due and interest charged in full. However, we will have no
liability for claims incurred between the termination date and the
reinstatement date.
3. TAX REIMBURSEMENTS
Details of any reimbursement of premium taxes that you pay on behalf of
reinsurance payments to us are shown in Exhibit C, Section VIII. (Premium
Taxes).
We mutually agree to the following pursuant to Section 1.848-2(g)(8) of the
Income Tax Regulation issued December 29, 1992 under Section 848 of the
Internal Revenue Code of 1986, as amended. This election will be effective
for all taxable years for which this Agreement remains in effect.
The terms used in this Section are defined in Regulation Section 1.848-2 in
effect as of December 29, 1992. The term "net consideration" will refer to
either net consideration as defined in Section 1.848-2(f) or "gross premium
and other consideration" as defined in Section 1.848-3(b), as appropriate.
a) The party with the net positive consideration for this Agreement for
each taxable year will capitalize specified policy acquisition expenses
with respect to this Agreement without regard to the General Deductions
Limitation of IRC Section 848(c)(1).
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ARTICLE V - REINSURANCE RATES AND PAYMENTS
3. TAX REIMBURSEMENTS - (CONTINUED)
b) We mutually agree to exchange information pertaining to the amount of
net consideration under this Agreement each year to ensure consistency.
We also mutually agree to exchange information otherwise required by
the Internal Revenue Service.
4. EXPERIENCE REFUND
Details of any Experience Refund payable to you will be shown in Exhibit C.
Section XI. (Experience Refund).
ARTICLE VI - CHANGES TO THE REINSURANCE
1. ERRORS AND OVERSIGHTS
If either of us fail to comply with any of the provisions of this Agreement
because of an unintentional oversight or misunderstanding, the underlying
status of this Agreement will not be changed. Both of us will be restored
to the position we would have occupied had no such oversight nor
misunderstanding occurred.
2. MISSTATEMENT OF AGE OR SEX
If the misstatement of the age or sex of a reinsured life causes an
increase or reduction in the amount of insurance in your underlying policy,
we will both share in the change in proportion to our original liabilities
at the time the policy was issued.
3. CHANGES TO THE UNDERLYING POLICY
a) All changes. If any change is made to the underlying policy, the
reinsurance will change accordingly. You will give us prompt written
notification of the change, including details and the effective date of
the change.
b) Increases. If the amount at risk increases because of a change in the
underlying policy, you will promptly send us copies of all papers
relating to the change in plan. Our approval will be necessary if the
increase causes the amount reinsured to exceed the Automatic Acceptance
Limits shown in Exhibit A, Part III., if the policy was reinsured on a
facultative basis, or if the underwriting classification of a
substandard risk reinsured on a facultative basis was changed.
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ARTICLE VI - CHANGES TO THE REINSURANCE
3. CHANGES TO THE UNDERLYING POLICY - (CONTINUED)
c) Extended Term and Reduced Paid-Up Insurance. If any policy reinsured
under this Agreement converts to Extended Term Insurance or Reduced
Paid-Up Insurance, the net amount at risk reinsured will be adjusted as
appropriate and reinsurance will be continued in accordance with the
provisions of the underlying policy. Reinsurance payments for the
adjusted policy will be calculated on the basis of the original issue
age of the insured and the duration of the original policy at the time
the adjustment became effective, i.e. point-in-scale basis.
4. REDUCTIONS, TERMINATIONS AND REINSTATEMENTS
If any part of the underlying coverage on a life reinsured under this
Agreement is reduced or terminated, the amount of reinsurance will also be
reduced or terminated to the extent that you will continue to maintain your
appropriate retention limit as shown in Exhibit A for the issue age and
table rating of the insured. You will not be required to assume amounts in
excess of the retention limit that was in force when the affected policy or
policies were issued.
The total amount of the reduction of a reinsured policy will be applied
directly to our net amount at risk. If reinsurance on the policy was placed
with more than one reinsurer, our net amount at risk will be reduced in the
same proportion that our initial amount of reinsurance bore to the total
initial amount reinsured in all companies.
If a policy reinsured under this Agreement is lapsed or terminated, the
reinsurance will also terminate. If additional policies on the same life are
reinsured with us, and if the termination causes you to maintain less than
the retention limit shown in Exhibit A, the policy(ies) issued next in
sequence to the terminated policy will be decreased until you maintain your
full retention on the risk. This procedure will not apply to any policies
reinsured on a facultative basis where you have not kept your full
retention.
You will also follow the procedures shown in the above paragraphs when the
reduction or termination applies to a policy or policies that you have fully
retained, and where the reduction or termination will cause you to maintain
less than your current retention for any policy or policies reinsured.
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ARTICLE VI - CHANGES TO THE REINSURANCE
4. REDUCTIONS, TERMINATIONS AND REINSTATEMENTS - (CONTINUED)
If a policy reinsured automatically lapses and is reinstated in accordance
with your standard rules and procedures, reinsurance for the amount at risk
effective at the time of the lapse will be reinstated automatically at the
date of reinstatement of the policy. You will notify us of the reinstatement
on your periodic statement of account. You will send us copies of your
reinstatement papers only upon request.
We will not need to approve reinstatement of a policy reinsured under this
Agreement on a facultative basis when:
a) you have kept your full retention on the policy; and
b) the reinsured amount falls within the Automatic Acceptance Limits shown
in Exhibit A.
Otherwise, you will need our prior review and approval for reinstatement of
any facultative reinsurance. You will send us prompt written notice of your
intention to reinstate the policy along with copies of the reinstatement
papers required by your standard rules and procedures. The reinsurance will
be reinstated at the same time as the policy, subject to our written
approval of the reinstatement.
You will notify us of all reinstatements on your periodic statement of
account, and you will pay all reinsurance payments due from the date of
reinstatement to the date of the current statement of account, including a
proportionate share of interest collected. Thereafter, reinsurance payments
will be in accordance with Article V. (Reinsurance Rates and Payments).
ARTICLE VII - RECAPTURE
1. BASIS OF RECAPTURE
If you increase the retention limits shown in Exhibit A, you may make a
corresponding reduction in eligible reinsurance cessions. Policies are
eligible for recapture if:
a) you have maintained the maximum retention limit for the age and
mortality rating of the insured when the underlying policy was issued.
Policies on which you retained a reduced retention or no retention will
not be eligible for recapture.
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ARTICLE VII - RECAPTURE
1. BASIS OF RECAPTURE - (CONTINUED)
b) the policy has been in force under this Agreement for the Recapture
Period shown in Exhibit C, Section IX. The recapture period will always
be measured from the original policy issue date. For converted policies
the recapture period will be the greater of the recapture period in the
original reinsurance agreement, or the recapture period in the agreement
to which the policy has converted.
2. METHOD OF RECAPTURE
You will give us written notice of your intention to recapture within
ninety days of the effective date of your retention increase. If you elect
to recapture at a later date, you will give us additional written notice
before you begin the recapture.
When you have given us written notice of your intent to recapture, and the
date that the recapture will begin:
a) All eligible policies will be recaptured;
b) Reinsurance will be reduced on the next anniversary date of each
eligible policy;
c) Reinsurance on each eligible policy will be reduced by an amount that
will increase your retention to the current limit set forth in Exhibit
A.
d) If there is reinsurance in force in other companies on any one insured
life, the reduction of the reinsurance in force under this Agreement
will be in the same proportion that the amount reinsured with us bears
to the total reinsurance on the life;
e) If at the time of recapture the insured is disabled and premiums are
being waived under any type of Disability Benefit Rider, only the life
benefit will be recaptured. The reinsured portion of the Disability
Benefit Rider will remain in force until the policy is returned to
premium-paying status, at which time it will be eligible for recapture.
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ARTICLE VII - RECAPTURE
2. METHOD OF RECAPTURE - (CONTINUED)
If you omit or overlook the recapture of any eligible policy or policies,
our acceptance of reinsurance payments after the date the recapture would
have taken place will not cause us to be liable for the amount of the risk
that would have been recaptured. We will be liable only for a refund of
reinsurance payments received, without interest.
If your retention increase is due to your purchase by or purchase of
another company, or your merger, assumption or any other affiliation with
another company, no immediate recapture will be allowed. However, you may
recapture eligible policies once the Recapture Period set out in Exhibit C,
Section IX, has expired.
ARTICLE VIII - CLAIMS
1. NOTICE OF CLAIM
When you receive notice that a claim has been incurred on a policy
reinsured under this Agreement, you will submit to us a claims report
substantially in form set forth in Exhibit B hereto. You will also forward
copies of the death certificate and the claimant's statement, as each
document becomes available. Copies of the application and underwriting
papers will be sent only for a claim incurred during the contestable
period of the policy; otherwise you will send us only the claim documents
we specifically request.
2. SETTLEMENT OF CLAIMS
We will accept your good faith decision in settling any claim except as
specified in this Article. Once we have received the proofs cited in
Section 1 and upon evidence of your settlement with the claimant, we will
discharge our net reinsurance liability by paying you one lump sum,
regardless of the method of settlement you use. For the settlement of
Waiver of Premium Disability or other Disability Rider benefits, we will
pay you our proportional share of the gross premium waived annually.
You will consult with us before conceding any liability or making any
settlement with the claimant whenever the amount reinsured exceeds the
amount that you retained.
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ARTICLE VIII - CLAIMS
2. SETTLEMENT OF CLAIMS - (CONTINUED)
Your claim settlements will be administered in good faith, according to the
standard procedures you apply to all claims, whether reinsured or not.
3. CONTESTABLE CLAIMS
You will immediately notify us if you intend to contest, compromise or
litigate a claim involving reinsurance. If we prefer not to participate in
the contest, we will notify you of our decision within fifteen days of our
receipt of all documents requested, and we will immediately pay you the full
amount of reinsurance due. Once we have paid our reinsurance liability, we
will not be liable for legal and/or investigative expenses and we will have
no further liability for expenses associated with the contest, compromise or
litigation.
When we agree to participate in a contest, compromise or litigation involving
reinsurance, you will give us a prompt notice of the beginning of any legal
proceedings involving the contested policy. You will promptly furnish us with
copies of all documents pertaining to a lawsuit or notice of intent to file a
lawsuit by any of the claimants or parties to the policy.
We will share in the payment of legal or investigative expenses relating to a
contested claim in the same proportion as our liability bears to your
liability. We will not reimburse expenses associated with non-reinsured
policies.
If your contest, compromise or litigation results in a reduction in the
liability of the contested policy, we will share in the reduction in the same
proportion that the amount of reinsurance bore to the amount payable under
the terms of the policy on the date of death of the insured.
4. CLAIM EXPENSES
We will pay our proportionate share of the following expenses arising out of
the settlement or litigation of a claim, providing that the expenses are
reasonable.
a) investigative expenses;
b) attorneys' fees;
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ARTICLE VIII - CLAIMS
4. CLAIM EXPENSES - (CONTINUED)
c) penalties and interest imposed automatically against you by statute and
rising solely out of a judgment rendered against you in a suit for policy
benefits.
d) interest paid to the claimant on death benefit proceeds according to your
practices. Reimbursement of interest in excess of 9%, unless otherwise
dictated by local legislation, will require our approval.
Our share of claim expenses will be in the same proportion that our
liability bears to your liability.
You will be responsible for payment of the following claim expenses, which
are not considered items of "net reinsurance liability" as referenced in
Section 2. of this Article:
a) routine administrative expenses for the home office or elsewhere,
including your employees' salaries;
b) expenses incurred in connection with any dispute or contest arising out
of a conflict in claims of entitlement to policy proceeds or benefits
which you admit are payable.
5. EXTRA CONTRACTUAL DAMAGES
We will not be liable for nor will we pay any extra contractual damages;
including but not limited to consequential, compensatory, exemplary or
punitive damages which are awarded against you, or which you pay
voluntarily, in settlement of a dispute or claim where damages were awarded
as the result of any direct or indirect act, omission or course of conduct
undertaken by you, your agents or representatives, in connection with any
aspect of the policies reinsured under this Agreement.
We recognize that special circumstances may arise in which we should
participate to the extent permitted by law in certain assessed damages.
These circumstances are difficult to describe or define in advance but could
include those situations in which we were an active party in the act,
omission or course of conduct which ultimately resulted in the assessment of
the damages. The extent of our participation is dependent upon a good-faith
assessment of the relative culpability in each case, but all factors being
equal, the division of any such assessment would generally be in the same
proportion of the net liability accepted by each party.
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ARTICLE IX - ARBITRATION
1. BASIS FOR ARBITRATION
We mutually understand and agree that the wording and interpretation of this
Agreement is based on the usual customs and practices of the insurance and
reinsurance industry. While we agree to act in good faith in our dealings
with each other, it is understood and recognized that situations arise in
which we cannot reach an agreement.
In the event that any dispute cannot be resolved to our mutual satisfaction,
the dispute will first be subject to good-faith negotiation as described
below in an attempt to resolve the dispute without the need to institute
formal arbitration proceedings.
2. NEGOTIATION
Within ten days after one of us has given the other the first written
notification of the specific dispute, each of us will appoint a designated
officer to attempt to resolve the dispute. The officers will meet at a
mutually agreeable location as early as possible and as often as necessary,
in order to gather and furnish the other with all appropriate and relevant
information concerning the dispute. The officers will discuss the problem
and will negotiate in good faith without the necessity of any formal
arbitration proceedings. During the negotiation process, all reasonable
requests made by one officer to the other for information will be honored.
The specific format for such discussions will be decided by the designated
officers.
If the officers cannot resolve the dispute within thirty days of their first
meeting, we agree that we will submit the dispute to formal arbitration.
However, we may agree in writing to extend the negotiation period for an
additional thirty days.
3. ARBITRATION PROCEEDINGS
All disputes arising under this Agreement or Amendment will be referred to
arbitration before three disinterested arbitrators, one to be chosen by you
and one to be chosen by us, with the third selected by the two appointed
arbitrators. Each arbitrator will be a past or present officer of a life
insurance company. If either of us fails to appoint an arbitrator within
thirty days of that date the written demand for arbitration is first
received, the other may select a second arbitrator. If the two chosen
arbitrators do not designate a third arbitrator within thirty days of the
appointment of the second, either of us may request the Philadelphia office
of the American Arbitration Association to immediately select a third
arbitrator in accordance with the requirements of this provision.
Arbitration under this Article will relate to all aspects of this Agreement
and the Amendment, including its formation and execution, and will survive
the termination of the Agreement.
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ARTICLE IX - ARBITRATION
3. ARBITRATION PROCEEDINGS - (CONTINUED)
Arbitration proceedings will be held in Philadelphia, Pennsylvania, and,
except as otherwise provided herein, will be conducted in accordance with
the Commercial Arbitration Rules of the American Arbitration Association
unless the arbitrators unanimously agree to a different procedure. The
arbitrators will interpret the Agreement in accordance with usual business
and reinsurance practices rather than on a strict technical or legal basis.
Upon the request of either party, the arbitrators will issue their decision
and the basis therefore in writing. The majority decision of the arbitrators
will be final and binding on the parties, and judgment thereon may be
entered in any court of competent jurisdiction. The parties will each bear
their own costs but the expenses of the arbitration, including the
arbitrators' fees, will be shared equally.
ARTICLE X - INSOLVENCY
1. All reinsurance under this Agreement is payable directly to you, your
liquidator, receiver or statutory successor, only on the basis of your
liability under the reinsured policies. It is understood, however, that in
the event of your insolvency the liquidator, receiver or statutory successor
will provide us written notice of the pendency of any claim against you on a
reinsured policy within a reasonable time after such claim is filed in the
insolvency or other proceedings, and during the pendency of the claim we may
investigate such and interpose at our own expense in the proceedings where
the claim is to be adjudicated, any defense which we may deem available to
you, your liquidator, receiver or statutory successor. It is further
understood that any expense we incur will be chargeable, subject to court
approval, against you as part of the expense of liquidation or other
proceeding to the extent of a proportionate share of the benefit which may
accrue to you by reason of the defense undertaken by us.
2. In the event of our insolvency, you may, at your option and with ninety days
written notice to us and to our liquidator, receiver or statutory successor,
terminate this Agreement and recapture immediately and completely all
reinsured policies covered under the provisions of this Agreement. The
termination and recapture will be without penalty, regardless of the
duration of time that the reinsurance has been in force. The termination and
recapture will be effective upon the earlier of the following:
a) the date on which we are deemed insolvent; or
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ARTICLE X - INSOLVENCY
2. (CONTINUED)
b) the date on which our insolvency has been established by the Insurance
Department of the State of New York.
In the event that either party is judged insolvent, any debts or credits
due to the other party, whether matured or unmatured, under this Agreement
or any other agreement, which exist on the date of the entry of a
receivership or liquidator order, will be deemed mutual debts or credits as
the case may be and will be set off and only the balance will be allowed or
paid.
ARTICLE XI - INSPECTION OF RECORDS
1. Either one of us will have the right at any reasonable time to inspect the
original papers, records, books, files or other documents relating directly
or indirectly to the reinsurance coverage under this Agreement.
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ARTICLE XII - EXECUTION OF THE AGREEMENT
In witness whereof, we have caused this Agreement to be executed in duplicate
at the dates and places shown below, by our respective officers duly authorized
to do so.
PROVIDENT MUTUAL LIFE INSURANCE COMPANY
BERWYN, PENNSYLVANIA
/s/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇
---------------------------------------
Signature
Vice President & Actuary
---------------------------------------
Title
3/2/99
---------------------------------------
Date of Signature
PHOENIX HOME LIFE MUTUAL INSURANCE COMPANY
ENFIELD, CONNECTICUT
/s/ [Illegible Signature]
---------------------------------------
Signature
Director, Treaties and Compliance
---------------------------------------
Title
November 6, 1998
---------------------------------------
Date of Signature
-17-
EXHIBIT A
(EFFECTIVE JANUARY 1, 1999)
REINSURANCE COVERAGE
I. REINSURANCE COVERAGE
This Agreement will cover a 25% percent quota share in excess of your
retention of
Life Benefits;
Disability Waiver Benefits issued with Life Benefits;
Other Supplementary Benefits or Riders issued with Life Benefits and
specifically listed below;
on the following policy forms:
PLANS
Whole Life 2
Portfolio 2
Chancellor
Intersector Plus 2
Special Term
Options
Options Plus
Special Product
RIDERS
Additional Insurance Benefit
Other Insured Term
Waiver of Premium
Waiver of Monthly Deductions
Change of Insured
Guaranteed Purchase Option
Paid-up Additions
Reinsurance coverage will provide neither loan nor cash surrender values.
Continued...
EXHIBIT A - CONTINUED
(EFFECTIVE JANUARY 1, 1999)
II. RETENTION LIMITS OF CEDING COMPANY
A. LIFE
Special Classes A-G Special Classes H-K
Age at Issue Standard Flat Extra $0-$10.00 Flat Extras $10.01+
------------ ---------- -------------------- --------------------
0-31 days $25,000 None None
32 days-2 years 750,000 $500,000 $375,000
3-65 1,250,000 875,000 625,000
66-70 1,000,000 750,000 500,000
71-75 500,000 375,000 250,000
76-80 250,000 None None
81-85 125,000 None None
86+ None None None
The above limits may be exceeded by as much as $25,000 in order to avoid
reinsurance.
The maximum retention for aviation risks is one-half the normal retention.
B. DISABILITY WAIVER
Same as Life
C. ACCIDENTAL DEATH BENEFITS
Not reinsured under this Agreement.
III. AUTOMATIC ACCEPTANCE LIMITS
A. LIFE
We will accept automatically the lesser of 2.5 times your retention or
$3,125,000 per insured life. However, the maximum amount of reinsurance
per life that we will accept under all
automatic reinsurance agreements
written between our two companies will not exceed the largest individual
acceptance limit shown in the agreements. For the purposes of this
Agreement, the maximum binding in all companies is $12,500,000.
The binding limits are exclusive of your retention.
Continued...
EXHIBIT A - CONTINUED
(EFFECTIVE JANUARY 1, 1999)
B. DISABILITY WAIVER
We will participate in Disability Waiver Benefits to a maximum
$2,000,000 of Benefit face amount per insured life.
IV. EXCLUSIONS TO AUTOMATIC REINSURANCE COVERAGE
Automatic reinsurance coverage will not be available in the following
situations:
1. The policy has been submitted on a facultative, facultative obligatory
or initial inquiry basis to us or to any other reinsurer;
2. The risk is categorized as a "Jumbo Risk", where your underwriting
papers indicate that the total life insurance in force and applied for
on the insured's life exceeds $30,000,000.
3. The policy is part of any special program that you offer, including:
a) experimental or limited retention programs, including but not limited
to cancer, diabetes, aviation or coronary risks;
b) external replacement and/or conversion programs other than
contractual conversions or exchanges of the original policy.
4. You have retained an amount less than your usual retention limits for
the age and table rating of the insured.
5. The policy is a result of a conversion from group insurance, unless we
agree otherwise.
EXHIBIT B
(EFFECTIVE JANUARY 1, 1999)
REINSURANCE ADMINISTRATION
Reinsurance administration and premium accounting will be on a self-administered
basis. Premiums will be paid annually in advance and reported monthly. For each
reporting period you will submit to us a statement containing information in
general compliance with the following:
I. MONTHLY DETAIL REPORT
Policy Number
Name of Insured
Date of Birth
Sex
Smoker/Non Smoker Code
Automatic/Facultative/Facultative Obligatory Code
YRT/Coinsurance Code
Original Issue Date
Issue Date
Flat Extra Rate
Flat Extra Duration
Flat Extra Premium
Flat Extra Allowances
Age Nearest/Last Indicator
Treaty Code
Substandard Percentage
Plan Name (Your Product Name)
Plan Type (Whole Life, Term, UL, Variable UL, etc.)
Joint Policy Indicator*
Original Amount of Insurance (amount you issued)
Amount Reinsured (original amount reinsured with us)
Net Amount at Risk Reinsured (current amount at risk)
*Joint Policies
---------------
For all Insureds Covered Under the Policy:
Names of Insureds
Dates of Birth
Sex of Insureds
Smoker/Non Smoker Codes
Substandard Percentages
Continued...
EXHIBIT B - CONTINUED
(EFFECTIVE JANUARY 1, 1999)
II. MONTHLY BILLING INFORMATION
Policy Number
Billing Date
Transaction Code (New Business, Lapse, Amendment, etc.)
Transaction Date
Current Net Amount at Risk
Billed Premium (Life, WP, ADB, Flat Extra, etc.)
Billed Allowances (Life, WP, ADB, Flat Extra, etc.)
III. PREMIUM SUMMARY REPORT
(Information should be summarized)
FY RY TOTAL
Life Premium
WP Premium
ADB Premium
Flat Extra Premium
Total Premium
Policy Fees
Life Allowances
WP Allowances
ADB Allowances
Flat Extra Allowances
Total Allowances
Premium Taxes (if applicable)
Total Amount Due = (Total Premium + Policy Fees) - (Total Allowances +
Premium Taxes)
The premium summary should balance to the Monthly Detail Report.
Continued...
EXHIBIT B - CONTINUED
(EFFECTIVE JANUARY 1, 1999)
IV. QUARTERLY VALUATION REPORT
Statutory Tax Reserves
Reserves (annual only)
--------- -------------
Basic
Waiver
Disabled Lives
ADB
Deficiency
Total
V. POLICY EXHIBIT
From Reporting Period:
-------------------------- -------------
Activity For Period
---------------------
Case
Count Volume
----- ------
Beginning In Force
New Business
Reinstatements
Other Increases
Conversions On
Conversions Off
Not Takens
Deaths
Lapses
Cancellations
Surrenders
Recaptures
Other Decreases
Ending In Force
Continued...
EXHIBIT B - CONTINUED
---------------------
(EFFECTIVE JANUARY 1, 1999)
NOTE:
1. Any activity resulting from the insured having exercised a conversion
privilege or any similar option granted under policy provisions should
be reflected in the "Conversion Off" or "Conversion On" categories,
rather than being reflected in the "New Business or "Lapse" categories.
"Conversion Off" denotes policies terminated as a result of a conversion
for which reinsurance with Phoenix Home Life will be continued under a
new policy; "Conversion On" denotes new policies resulting from such
conversions.
For the purposes of this Agreement, any such change will be considered a
continuation of the original policy.
The combination of "Conversion Off" and "Conversion On" will normally
net to zero for both policy count and volume in the Policy Exhibit
totals.
2. A separate Policy Exhibit should be prepared for each Premium Summary
Report.
[PHOENIX HOME LIFE LOGO] APPLICATION FOR REINSURANCE
INSTRUCTIONS TO CEDING COMPANY
1. Retain copies 1 and 2 - Return copy 3 to Phoenix Home Life
2. When case is put in force - Return copy 2 to Phoenix Home Life
3. To cancel case, complete bottom of 1 and return to Phoenix Home Life
------------------------------------------------------------------------------------------------------------------------------------
PLEASE TYPE SEND TO PHOENIX HOME LIFE APP. PREPARED BY
, 19
------------------------------------------------------------------------------------------------------------------------------------
CEDING COMPANY NUMBER OF ORIGINAL POLICY CESSION NUMBER [ ] AUTOMATIC
[ ] FACULTATIVE
------------------------------------------------------------------------------------------------------------------------------------
PRIMARY INSURED (LAST, FIRST, MIDDLE INITIAL) SEX STATE OF STATE OF BIRTH DATE OF BIRTH AGE OCCUPATION SMOKER
RESIDENCE [ ] YES [ ] NO
------------------------------------------------------------------------------------------------------------------------------------
SECOND INSURED
[ ] YES [ ] NO
------------------------------------------------------------------------------------------------------------------------------------
PAYOR BENEFIT NAME OF PAYOR POLICY DATE PLAN OF INSURANCE RESERVE SHORT TERM
[ ] PD & D [ ] Payor Death Only BASIS FROM:
====================================================================================================================================
1ST INSURED 2ND INSURED
RATING -------------------------------------------------------
LIFE DISABILITY ADB LIFE DISABILITY ADB
------------------------------------------------------------------------------------------------------------------------------------
Previous insurance in force DIS. RATE FOR $1,000 OF BASIC
INSURANCE
------------------------------------------------------------------------------------------------------------------------------------
Of which we retained PREVIOUS CESSION NUMBERS,
IF ANY
------------------------------------------------------------------------------------------------------------------------------------
Insurance now applied for MIB CODES BEING REPORTED
------------------------------------------------------------------------------------------------------------------------------------
Of which we will retain IS THIS AN AMENDMENT? [ ] YES [ ] NO
IF YES, GIVE CESSION NUMBER:
------------------------------------------------------------------------------------------------------------------------------------
Reinsurance this application HAS CASE BEEN OFFERED TO OTHER
COMPANIES? [ ] YES [ ] NO
------------------------------------------------------------------------------------------------------------------------------------
REMARKS: FOR CANCELLATION
[ ] Filed as incomplete
[ ] Policy not placed
[ ] Reinsurance placed elsewhere
[ ] Within our retention
[ ] Pre-notice given to the proposed insured(s) and we have MIB authorization(s).
------------------------------------------------------------------------------------------------------------------------------------
DO NOT TYPE BELOW THIS LINE
------------------------------------------------------------------------------------------------------------------------------------
EXHIBIT B-1
HO ▇▇▇ ▇▇-▇▇
COPY 1
[PHOENIX HOME LIFE LOGO] APPLICATION FOR REINSURANCE
---------------------------------------------------------------------------------------------------------------------------------
PLEASE TYPE SEND TO PHOENIX HOME LIFE APP. PREPARED BY
, 19
---------------------------------------------------------------------------------------------------------------------------------
CEDING COMPANY NUMBER OF ORIGINAL POLICY CESSION NUMBER / / AUTOMATIC
/ / FACULTATIVE
---------------------------------------------------------------------------------------------------------------------------------
PRIMARY INSURED (LAST, FIRST, MIDDLE INITIAL) SEX STATE OF STATE OF BIRTH DATE OF BIRTH AGE OCCUPATION SMOKER
RESIDENCE
/ /YES / / NO
---------------------------------------------------------------------------------------------------------------------------------
SECOND INSURED
/ /YES / / NO
---------------------------------------------------------------------------------------------------------------------------------
PAYOR BENEFIT NAME OF PAYOR POLICY DATE PLAN OF INSURANCE RESERVE SHORT TERM
/ / PD & D / / Payor Death Only BASIS FROM:
---------------------------------------------------------------------------------------------------------------------------------
1ST INSURED 2ND INSURED
--------------------------------------------------------------
RATING LIFE DISABILITY ADB LIFE DISABILITY ADB
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
DIS. RATE FOR $1,000 OF BASIC
Previous insurance in force INSURANCE
---------------------------------------------------------------------------------------------------------------------------------
PREVIOUS CESSION NUMBERS, IF ANY
Of which we retained
---------------------------------------------------------------------------------------------------------------------------------
MIB CODES BEING REPORTED
Insurance now applied for
---------------------------------------------------------------------------------------------------------------------------------
IS THIS AN AMENDMENT? / / YES / / NO
Of which we will retain IF YES, GIVE CESSION NUMBER:
---------------------------------------------------------------------------------------------------------------------------------
Reinsurance this application HAS CASE BEEN OFFERED TO OTHER
COMPANIES? / / YES / / NO
---------------------------------------------------------------------------------------------------------------------------------
REMARKS:
FOR CANCELLATION
/ / FILED AS INCOMPLETE
/ / POLICY NOT PLACED
/ / REINSURANCE PLACED ELSEWHERE
/ / WITHIN OUR RETENTION
/ / Pre-notice given to the proposed insured(s) and we have MIB
authorization(s).
---------------------------------------------------------------------------------------------------------------------------------
DO NOT TYPE BELOW THIS LINE
---------------------------------------------------------------------------------------------------------------------------------
SUBST TERM OF PAYOR OR CO REEX- RECAP REMARKS
TABLE REINS. DIS CODE NUMBER TENSION CODE PLAN CODE
---------------------------------------------------------------------- ------------------------------------
RATING
---------------------------------------------------------------------------------------------------------------------------------
POL AMOUNT POL AMOUNT POL AMOUNT POL AMOUNT POL AMOUNT AGE
YR YR YR YR YR CODE
---------------------------------------------------------------------------------------------
AMOUNT AT RISK
---------------------------------------------------------------------------------------------------------------------------------
DIS RATE/M DIS FLAT EXTRA
----------- TERM FLAT EXTRA FLAT EXTRA FLAT EXTRA FLAT EXTRA FLAT EXTRA --------------
PAYOR OR DIS GROSS 1ST YR RENL AGE YRS PERM
PREM ------------------------------- ---------- ---------- ----------- ---------- --------------
---------------------------------------------------------------------------------------------------------------------------------
ADB RATE/M ADB
PREMIUM WAIVED ----------- TERM LO HI
1ST YR RENL AGE POS POS
-------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
COPY 2
[PHOENIX HOME LIFE LOGO] APPLICATION FOR REINSURANCE
------------------------------------------------------------------------------------------------------------------------------------
PLEASE TYPE SEND TO PHOENIX HOME LIFE APP. PREPARED BY
,19
------------------------------------------------------------------------------------------------------------------------------------
CEDING COMPANY NUMBER OF ORIGINAL POLICY CESSION NUMBER / / AUTOMATIC
/ / FACULTATIVE
------------------------------------------------------------------------------------------------------------------------------------
PRIMARY INSURED (LAST, FIRST, MIDDLE INITIAL) SEX STATE OF STATE OF BIRTH DATE OF BIRTH AGE OCCUPATION SMOKER
RESIDENCE / /YES / /NO
------------------------------------------------------------------------------------------------------------------------------------
SECOND INSURED
/ /YES / /NO
------------------------------------------------------------------------------------------------------------------------------------
PAYOR BENEFIT NAME OF PAYOR POLICY DATE PLAN OF INSURANCE RESERVE SHORT TERM
/ / PD & D / / Payor Death Only BASIS FROM:
------------------------------------------------------------------------------------------------------------------------------------
1ST INSURED 2ND INSURED
------------------------------ ------------------------
RATING LIFE DISABILITY ADB LIFE DISABILITY ADB
------------------------------------------------------------------------------------------------------------------------------------
DIS. RATE FOR $1,000 OF BASIC
Previous insurance in force INSURANCE
------------------------------------------------------------------------------------------------------------------------------------
PREVIOUS CESSION NUMBERS,
Of which we retained IF ANY
------------------------------------------------------------------------------------------------------------------------------------
Insurance now applied for MIB CODES BEING REPORTED
------------------------------------------------------------------------------------------------------------------------------------
IS THIS AN AMENDMENT? / /YES / / NO
Of which we will retain IF YES, GIVE CESSION NUMBER:
------------------------------------------------------------------------------------------------------------------------------------
HAS CASE BEEN OFFERED TO OTHER
Reinsurance this application COMPANIES? / / YES / / NO
------------------------------------------------------------------------------------------------------------------------------------
REMARKS:
FOR CANCELLATION
/ / FILED AS INCOMPLETE
/ / POLICY NOT PLACED
/ / REINSURANCE PLACED ELSEWHERE
/ / WITHIN OUR RETENTION
/ / Pre-notice given to the proposed insured(s) and we have MIB authorization(s).
------------------------------------------------------------------------------------------------------------------------------------
DO NOT TYPE BELOW THIS LINE
------------------------------------------------------------------------------------------------------------------------------------
COPY 3
EXHIBIT C
(EFFECTIVE JANUARY 1, 1999)
REINSURANCE RATES AND ALLOWANCES
I. NET AMOUNT AT RISK CALCULATION
The Net Amount at Risk in any policy year will be the difference between
the face amount of life benefit reinsured and the total cash value, taken
to the nearest dollar, as of the policy anniversary occurring in that
year. When the original policy is issued on a decreasing term plan or on a
level term plan with a duration of twenty years or less, the cash values
will be disregarded. You will maintain a level retention in all years.
II. RATES FOR LIFE REINSURANCE
The YRT Rates (the 1975-80 Basic Select and Ultimate Aggregate Age Nearest
Birthday Mortality Table) shown in this Exhibit are annual rates for
standard risks and are per $1,000 of the life benefit reinsured. You will
pay us these rates multiplied by the following percentages:
==========================================================================
YEAR PREFERRED STANDARD AGGREGATE
NONSMOKER NONSMOKER NONSMOKER SMOKER
--------------------------------------------------------------------------
1 0% 0% 0% 0%
Thereafter 37% 56% 46% 109%
==========================================================================
Aggregate Nonsmoker rates are to be used with plans that do not have a
Preferred Nonsmoker class. These rates are guaranteed to a maximum
reinsured amount of $20,000,000 per life under this Agreement. Amounts in
excess of $20,000,000 will be reinsured using rates that are mutually
acceptable.
III. POLICY FEE
No policy fee will be charged.
Continued...
EXHIBIT C - CONTINUED
(EFFECTIVE JANUARY 1, 1999)
IV. RATES FOR SUBSTANDARD TABLE RATINGS
For substandard risks issued at table ratings, the standard rate will be
multiplied by the appropriate mortality factor:
------------------------------ ------------------------------
Table Mortality Table Mortality
Rating Factor Rating Factor
============================== ==============================
1 or A 125% 5 or E 225%
1 1/2 or AA 137.5% 6 or F 250%
2 or B 150% 8 or H 300%
2 1/2 or BB 162.5% 10 or J 350%
3 or C 175% 12 or L 400%
4 or D 200% 16 or P 500%
------------------------------ ------------------------------
V. RATES FOR FLAT EXTRA RATINGS
Substandard risks issued at flat extra ratings will be coinsured. You will
pay us the appropriate portion of the flat extra premium charged the
insured less the following allowances:
-----------------------------------------------------------------
Duration First Year Renewal Years
=================================================================
Over Five Years 75% 10%
Five Years or Less 10% 10%
-----------------------------------------------------------------
VI. RATES FOR WAIVER OF PREMIUM DISABILITY BENEFIT
Waiver of Premium Disability Benefits will be coinsured. You will pay us
the appropriate portion of the annual Waiver of Premium Disability Benefit
premium charged the insured less the following allowances:
-----------------------------------
First Year Renewal Years
===================================
75% 10%
-----------------------------------
Continued...
EXHIBIT C - (CONTINUED)
-----------------------
(EFFECTIVE JANUARY 1, 1999)
VII. RATES FOR ACCIDENTAL DEATH BENEFIT
Accidental Death Benefits are not available under this Agreement.
VIII. PREMIUM TAXES
We will not reimburse premium taxes for reinsurance ceded under this
Agreement.
IX. RECAPTURE PERIOD
Recapture will be allowed after 10 years.
X. CONVERSIONS
For the purposes of this Agreement, and unless otherwise specifically
covered elsewhere, "conversions" will mean continuations, rollovers,
exchanges and/or internal replacements.
a) The rates charged for conversions to plans reinsured under this
Agreement will be based on the original issue age of the insured and
the current duration of the original policy at the time of the
conversion, i.e. point-in-scale basis.
b) Conversions from plans reinsured under this Agreement to plans
reinsured under other Reinsurance Agreements in force between us will
be subject to the provisions of the other Agreements, including
provisions covering rates, allowances and/or discounts. The rates
charged will be based on the original issue age of the insured and the
current duration of the original policy, i.e. point-in-scale basis.
c) Conversions from plans reinsured under this Agreement to plans that we
do not reinsure will remain under this Agreement. Rates charged will be
the YRT Rates shown in this Exhibit, based on the original issue age of
the insured and the current duration of the policy at the time of the
conversion, i.e. point-in-scale basis.
Continued ...
EXHIBIT C - CONTINUED
---------------------
(EFFECTIVE JANUARY 1, 1999)
X. CONVERSIONS - (CONTINUED)
d) Reinsurance under the provisions of this Agreement will include coverage
for conversions of the Step-1 Plan originally issued under Automatic YRT
Agreement No. 729 to plans of insurance covered under this Agreement.
Such conversions will not be subject to the twenty-five percent quota
share set forth in Article II. For Conversions of policies originally
ceded on an automatic basis, you shall recapture at the time of
conversion the excess of your retention at issue on the policy being
converted up to a maximum of the lessor of:
i) the full face amount of the policy; or
ii) your retention at the time of conversion.
Premiums charges for such conversions will be the premiums set forth in
Exhibit C, based on the original issue age of the insured and the
current duration of the policy, i.e. point-in-scale basis. You shall
also pay to Phoenix Home Life Mutual Insurance Company a recapture
charge, which shall be a single premium calculated at the rates set
forth in Exhibit C, for an amount equal to the difference between the
amount retained by you at issue and the lesser of:
i) the full face amount of the policy; or
ii) your retention at the time of recapture.
The recapture charge will be payable to Phoenix Home Life Mutual
Insurance Company at the time the conversion is reported.
At the your option, an approximation of the above calculation may be
made.
For facultative business ceded under the provisions of Article III, you
will not recapture any insurance at the time of conversion.
EXHIBIT C - CONTINUED
(EFFECTIVE JANUARY 1, 1999)
PROVIDENT MUTUAL LIFE INSURANCE COMPANY
SELECT & ULTIMATE ART
RECAPTURE CHARGES
FOR $1,000 RECAPTURES UPON CONVERSION
SMOKER
YEAR ISSUE TO
OF CONVERSION AGE 30 30-39 40-49 50-59 60+
------------- --- -- ----- ----- ----- ---
1 .95 1.23 2.28 5.15 8.25
2 1.10 1.42 2.64 5.97 9.57
3 1.18 1.52 2.82 6.39 10.23
4 1.22 1.57 2.91 6.59 10.56
5 1.14 1.47 2.73 6.18 9.90
6 1.06 1.37 2.55 5.77 9.24
7 .91 1.18 2.18 4.94 7.92
8 .65 .83 1.55 3.50 5.61
9 .23 .29 .55 1.24 1.98
NON-SMOKER
YEAR ISSUE
OF CONVERSION AGE 30 30-39 40-49 50-59 60+
------------- --- -- ----- ----- ----- ---
1 .53 .69 1.27 2.88 4.62
2 .72 .93 1.73 3.91 6.27
3 .76 .98 1.82 4.12 6.60
4 .76 .98 1.82 4.12 6.60
5 .68 .88 1.94 3.71 5.94
6 .57 .74 1.37 3.00 4.95
7 .46 .59 1.09 2.47 3.96
8 .27 .34 .64 1.44 2.31
9 .08 .10 .18 .41 .66
Continued...
EXHIBIT C - CONTINUED
(EFFECTIVE JANUARY 1, 1999)
PROVIDENT MUTUAL LIFE INSURANCE COMPANY
SELECT & ULTIMATE ART
RECAPTURE CHARGES
FOR $1,000 RECAPTURES UPON CONVERSION
PREFERRED
YEAR ISSUE
OF CONVERSION AGE ▇▇ ▇▇-▇▇ ▇▇-▇▇ 50-59 60+
------------- --- -- ----- ----- ----- ---
1 .46 .59 1.09 2.47 3.96
2 .61 .78 1.46 3.30 5.28
3 .67 .86 1.59 3.61 5.78
4 .65 .83 1.55 3.50 5.61
5 .61 .78 1.46 3.30 5.28
6 .53 .69 1.27 2.88 4.62
7 .42 .54 1.00 2.27 3.63
8 .27 .34 .64 1.44 2.31
9 .08 .10 .18 .41 .66
XI. EXPERIENCE REFUND
Reinsurance under this Agreement is not eligible for an Experience Refund.
Effective January 1, 1999
1975-80 BASIC SELECT AND ULTIMATE MORTALITY TABLES - FEMALE ANB
Age/Dur 1 2 3 4 5 6 7 8 9
0 0.93 0.34 0.30 0.27 0.24 0.22 0.20 0.18 0.18
1 0.34 0.30 0.27 0.24 0.22 0.20 0.18 0.18 0.18
2 0.28 0.27 0.24 0.22 0.20 0.18 0.18 0.18 0.19
3 0.24 0.24 0.22 0.20 0.18 0.18 0.18 0.19 0.21
4 0.22 0.22 0.20 0.18 0.18 0.18 0.19 0.21 0.24
5 0.20 0.20 0.18 0.18 0.18 0.19 0.21 0.24 0.27
6 0.19 0.18 0.18 0.18 0.19 0.21 0.24 0.27 0.32
7 0.17 0.18 0.18 0.19 0.21 0.24 0.27 0.32 0.36
8 0.16 0.18 0.19 0.21 0.24 0.27 0.32 0.36 0.40
9 0.16 0.19 0.21 0.24 0.27 0.32 0.36 0.40 0.44
10 0.16 0.21 0.24 0.27 0.32 0.36 0.40 0.44 0.47
11 0.17 0.24 0.27 0.32 0.36 0.40 0.44 0.47 0.49
12 0.18 0.27 0.32 0.36 0.40 0.44 0.47 0.49 0.51
13 0.21 0.31 0.35 0.38 0.42 0.45 0.47 0.49 0.52
14 0.25 0.33 0.37 0.40 0.43 0.45 0.47 0.48 0.53
15 0.28 0.35 0.39 0.41 0.43 0.45 0.46 0.48 0.53
16 0.32 0.37 0.39 0.41 0.42 0.43 0.45 0.46 0.53
17 0.36 0.37 0.39 0.40 0.41 0.42 0.43 0.44 0.53
18 0.36 0.37 0.39 0.40 0.41 0.42 0.43 0.44 0.51
19 0.36 0.37 0.39 0.40 0.41 0.42 0.43 0.44 0.50
20 0.35 0.36 0.38 0.39 0.41 0.41 0.43 0.44 0.48
21 0.34 0.36 0.37 0.39 0.40 0.41 0.43 0.44 0.47
22 0.32 0.34 0.36 0.38 0.40 0.41 0.43 0.45 0.46
23 0.32 0.34 0.37 0.39 0.41 0.42 0.45 0.46 0.50
24 0.31 0.34 0.38 0.40 0.42 0.45 0.46 0.50 0.55
25 0.31 0.35 0.39 0.41 0.44 0.46 0.50 0.55 0.59
26 0.30 0.35 0.39 0.43 0.46 0.50 0.55 0.59 0.63
27 0.30 0.35 0.41 0.45 0.50 0.55 0.59 0.63 0.66
28 0.31 0.36 0.42 0.48 0.53 0.59 0.63 0.66 0.76
29 0.32 0.37 0.44 0.51 0.57 0.63 0.66 0.76 0.86
30 0.33 0.39 0.47 0.54 0.62 0.66 0.76 0.86 0.97
31 0.35 0.41 0.50 0.59 0.66 0.76 0.86 0.97 1.08
32 0.38 0.44 0.54 0.65 0.76 0.86 0.97 1.08 1.19
33 0.39 0.46 0.57 0.69 0.82 0.93 1.07 1.19 1.31
34 0.41 0.49 0.60 0.74 0.88 1.02 1.18 1.31 1.48
35 0.43 0.51 0.63 0.79 0.95 1.12 1.30 1.48 1.64
36 0.45 0.54 0.67 0.85 1.04 1.23 1.43 1.63 1.81
37 0.48 0.58 0.71 0.92 1.13 1.35 1.56 1.77 1.98
38 0.51 0.64 0.80 1.04 1.26 1.49 1.70 1.92 2.14
39 0.55 0.72 0.89 1.16 1.39 1.63 1.85 2.08 2.30
40 0.60 0.80 1.00 1.28 1.52 1.78 2.01 2.24 2.46
41 0.65 0.89 1.10 1.41 1.66 1.94 2.17 2.41 2.63
42 0.70 0.98 1.20 1.54 1.80 2.10 2.33 2.58 2.83
43 0.76 1.05 1.29 1.63 1.90 2.20 2.45 2.74 3.01
44 0.81 1.12 1.39 1.71 2.00 2.30 2.59 2.90 3.21
45 0.86 1.19 1.48 1.79 2.10 2.42 2.73 3.07 3.43
Effective January 1, 1999
1975-80 BASIC SELECT AND ULTIMATE MORTALITY TABLES - FEMALE ANB
----------------------------------------------------------------------------------------------------
Age/Dur 1 2 3 4 5 6 7 8 9
----------------------------------------------------------------------------------------------------
46 0.91 1.26 1.58 1.86 2.22 2.53 2.88 3.28 3.67
----------------------------------------------------------------------------------------------------
47 0.96 1.33 1.68 1.95 2.34 2.65 3.06 3.49 3.94
----------------------------------------------------------------------------------------------------
48 1.00 1.39 1.76 2.04 2.45 2.82 3.27 3.76 4.20
----------------------------------------------------------------------------------------------------
49 1.05 1.46 1.83 2.13 2.58 3.00 3.50 4.04 4.48
----------------------------------------------------------------------------------------------------
50 1.10 1.53 1.91 2.24 2.72 3.20 3.74 4.35 4.78
----------------------------------------------------------------------------------------------------
51 1.15 1.60 2.01 2.35 2.86 3.40 4.00 4.68 5.09
----------------------------------------------------------------------------------------------------
52 1.20 1.68 2.10 2.47 3.01 3.61 4.28 5.03 5.40
----------------------------------------------------------------------------------------------------
53 1.26 1.76 2.22 2.65 3.23 3.87 4.57 5.34 5.77
----------------------------------------------------------------------------------------------------
54 1.32 1.85 2.35 2.84 3.47 4.15 4.87 5.65 6.15
----------------------------------------------------------------------------------------------------
55 1.38 1.93 2.48 3.05 3.72 4.43 5.18 5.97 6.55
----------------------------------------------------------------------------------------------------
56 1.45 2.02 2.62 3.27 3.97 4.72 5.50 6.29 6.97
----------------------------------------------------------------------------------------------------
57 1.51 2.11 2.76 3.49 4.24 5.02 5.82 6.62 7.42
----------------------------------------------------------------------------------------------------
58 1.63 2.29 2.99 3.76 4.54 5.34 6.18 7.03 7.88
----------------------------------------------------------------------------------------------------
59 1.75 2.48 3.24 4.04 4.85 5.69 6.57 7.46 8.36
----------------------------------------------------------------------------------------------------
60 1.18 2.68 3.50 4.34 5.18 6.06 6.98 7.93 8.89
----------------------------------------------------------------------------------------------------
61 2.01 2.90 3.77 4.66 5.54 6.45 7.42 8.43 9.45
----------------------------------------------------------------------------------------------------
62 2.15 3.12 4.07 5.01 5.93 6.88 7.90 8.97 10.07
----------------------------------------------------------------------------------------------------
63 2.27 3.27 4.26 5.24 6.21 7.22 8.30 9.49 10.75
----------------------------------------------------------------------------------------------------
64 2.40 3.43 4.46 5.48 6.50 7.57 8.75 10.07 11.53
----------------------------------------------------------------------------------------------------
65 2.53 3.59 4.66 5.73 6.80 7.95 9.24 10.72 12.43
----------------------------------------------------------------------------------------------------
66 2.67 3.76 4.88 5.99 7.12 8.37 9.80 11.47 13.45
----------------------------------------------------------------------------------------------------
67 2.82 3.94 5.10 6.27 7.48 8.85 10.43 12.32 14.61
----------------------------------------------------------------------------------------------------
68 3.06 4.28 5.56 6.87 8.23 9.79 11.60 13.76 16.38
----------------------------------------------------------------------------------------------------
69 3.33 4.67 6.09 7.56 9.11 10.89 12.95 15.42 18.41
----------------------------------------------------------------------------------------------------
70 3.63 5.11 6.70 8.36 10.13 12.16 14.52 17.34 20.73
----------------------------------------------------------------------------------------------------
71 5.01 7.70 10.44 13.52 16.24 19.36 24.15 28.95 35.02
----------------------------------------------------------------------------------------------------
72 6.01 8.87 12.38 15.87 19.26 23.05 28.68 34.23 41.07
----------------------------------------------------------------------------------------------------
73 7.20 10.35 14.68 18.73 22.84 27.42 33.97 40.33 47.96
----------------------------------------------------------------------------------------------------
74 8.63 12.39 17.32 22.10 27.06 32.52 40.08 47.30 55.76
----------------------------------------------------------------------------------------------------
75 10.32 14.81 20.43 26.07 31.97 38.41 47.07 55.20 64.51
----------------------------------------------------------------------------------------------------
76 12.34 17.69 24.09 30.69 37.65 45.16 55.01 64.10 74.28
----------------------------------------------------------------------------------------------------
77 14.74 20.71 28.36 36.01 44.13 52.83 63.96 74.06 85.13
----------------------------------------------------------------------------------------------------
78 17.58 24.64 33.26 42.08 51.48 61.48 73.98 85.13 93.91
----------------------------------------------------------------------------------------------------
79 21.12 29.19 38.86 48.95 59.76 71.17 85.13 93.91 103.24
----------------------------------------------------------------------------------------------------
80 25.23 34.42 45.19 56.66 69.02 81.96 93.91 103.24 113.12
----------------------------------------------------------------------------------------------------
81 29.98 40.36 52.30 65.27 79.31 93.91 103.24 113.12 123.55
----------------------------------------------------------------------------------------------------
82 35.39 47.07 60.24 74.83 90.70 103.24 113.12 123.55 134.53
----------------------------------------------------------------------------------------------------
83 41.53 54.60 69.05 85.39 103.24 113.12 123.55 134.53 146.06
----------------------------------------------------------------------------------------------------
84 49.99 63.00 78.78 97.00 113.12 123.55 134.53 146.06 158.14
----------------------------------------------------------------------------------------------------
85 59.59 74.19 89.47 109.70 123.55 134.53 146.06 158.14 170.77
----------------------------------------------------------------------------------------------------
86 70.43 84.66 101.18 123.55 134.53 146.06 158.14 170.77 183.95
----------------------------------------------------------------------------------------------------
87 82.59 97.28 113.94 134.53 146.06 158.14 170.77 183.95 197.68
----------------------------------------------------------------------------------------------------
88 96.15 111.20 127.80 146.06 158.14 170.77 183.95 197.68 211.96
----------------------------------------------------------------------------------------------------
89 105.02 121.08 138.76 158.14 170.77 183.95 197.68 211.96 226.79
----------------------------------------------------------------------------------------------------
90 114.35 131.45 150.23 170.77 183.95 197.68 211.96 226.79 242.17
----------------------------------------------------------------------------------------------------
Effective January 1, 1999
1975-80 BASIC SELECT AND ULTIMATE MORTALITY TABLES - FEMALE ANB
------------------------------------------------------------------------------------------
Ultimate
Age/Dur 10 11 12 13 14 15 Rate Age
------------------------------------------------------------------------------------------
0 0.18 0.19 0.21 0.24 0.27 0.32 0.36 15
------------------------------------------------------------------------------------------
1 0.19 0.21 0.24 0.27 0.32 0.36 0.40 16
------------------------------------------------------------------------------------------
2 0.21 0.24 0.27 0.32 0.36 0.40 0.44 17
------------------------------------------------------------------------------------------
3 0.24 0.27 0.32 0.36 0.40 0.44 0.47 18
------------------------------------------------------------------------------------------
4 0.27 0.32 0.36 0.40 0.44 0.47 0.49 19
------------------------------------------------------------------------------------------
5 0.32 0.36 0.40 0.44 0.47 0.49 0.51 20
------------------------------------------------------------------------------------------
6 0.36 0.40 0.44 0.47 0.49 0.51 0.52 21
------------------------------------------------------------------------------------------
7 0.40 0.44 0.47 0.49 0.51 0.52 0.53 22
------------------------------------------------------------------------------------------
8 0.44 0.47 0.49 0.51 0.52 0.53 0.53 23
------------------------------------------------------------------------------------------
9 0.47 0.49 0.51 0.52 0.53 0.53 0.53 24
------------------------------------------------------------------------------------------
10 0.49 0.51 0.52 0.53 0.53 0.53 0.53 25
------------------------------------------------------------------------------------------
11 0.51 0.52 0.53 0.53 0.53 0.53 0.53 26
------------------------------------------------------------------------------------------
12 0.52 0.53 0.53 0.53 0.53 0.53 0.53 27
------------------------------------------------------------------------------------------
13 0.53 0.53 0.53 0.53 0.53 0.53 0.53 28
------------------------------------------------------------------------------------------
14 0.53 0.53 0.53 0.53 0.53 0.53 0.54 29
------------------------------------------------------------------------------------------
15 0.53 0.53 0.53 0.53 0.53 0.54 0.55 30
------------------------------------------------------------------------------------------
16 0.53 0.53 0.53 0.53 0.54 0.55 0.58 31
------------------------------------------------------------------------------------------
17 0.53 0.53 0.53 0.54 0.55 0.58 0.61 32
------------------------------------------------------------------------------------------
18 0.52 0.53 0.54 0.55 0.58 0.61 0.65 33
------------------------------------------------------------------------------------------
19 0.50 0.54 0.55 0.58 0.61 0.65 0.70 34
------------------------------------------------------------------------------------------
20 0.50 0.55 0.58 0.61 0.65 0.70 0.77 35
------------------------------------------------------------------------------------------
21 0.49 0.58 0.61 0.65 0.7 0.77 0.84 36
------------------------------------------------------------------------------------------
22 0.50 0.61 0.65 0.70 0.77 0.84 0.93 37
------------------------------------------------------------------------------------------
23 0.55 0.65 0.70 0.77 0.84 0.93 1.03 38
------------------------------------------------------------------------------------------
24 0.59 0.70 0.77 0.84 0.93 1.03 1.15 39
------------------------------------------------------------------------------------------
25 0.63 0.77 0.84 0.93 1.03 1.15 1.29 40
------------------------------------------------------------------------------------------
26 0.69 0.84 0.93 1.03 1.15 1.29 1.45 41
------------------------------------------------------------------------------------------
27 0.76 0.93 1.03 1.15 1.29 1.45 1.62 42
------------------------------------------------------------------------------------------
28 0.86 1.03 1.15 1.29 1.45 1.62 1.79 43
------------------------------------------------------------------------------------------
29 0.97 1.15 1.29 1.45 1.62 1.79 1.96 44
------------------------------------------------------------------------------------------
30 1.08 1.29 1.45 1.62 1.79 1.96 2.14 45
------------------------------------------------------------------------------------------
31 1.19 1.45 1.62 1.79 1.96 2.14 2.33 46
------------------------------------------------------------------------------------------
32 1.31 1.62 1.79 1.96 2.14 2.33 2.52 47
------------------------------------------------------------------------------------------
33 1.48 1.77 1.94 2.12 2.33 2.52 2.72 48
------------------------------------------------------------------------------------------
34 1.64 1.92 2.10 2.30 2.51 2.72 2.93 49
------------------------------------------------------------------------------------------
35 1.81 2.07 2.27 2.46 2.71 2.92 3.17 50
------------------------------------------------------------------------------------------
36 2.00 2.23 2.43 2.64 2.92 3.16 3.43 51
------------------------------------------------------------------------------------------
37 2.19 2.39 2.60 2.82 3.15 3.42 3.71 52
------------------------------------------------------------------------------------------
38 2.35 2.56 2.78 3.02 3.38 3.66 4.04 53
------------------------------------------------------------------------------------------
39 2.52 2.74 2.98 3.23 3.62 3.94 4.40 54
------------------------------------------------------------------------------------------
40 2.69 2.94 3.19 3.46 3.91 4.25 4.80 55
------------------------------------------------------------------------------------------
41 2.89 3.15 3.42 3.72 4.23 4.58 5.23 56
------------------------------------------------------------------------------------------
42 3.10 3.38 3.69 4.01 4.57 4.94 5.70 57
------------------------------------------------------------------------------------------
43 3.31 3.64 3.98 4.34 4.94 5.37 6.22 58
------------------------------------------------------------------------------------------
44 3.55 3.92 4.30 4.69 5.37 5.85 6.78 59
------------------------------------------------------------------------------------------
45 3.82 4.23 4.64 5.07 5.83 6.36 7.37 60
------------------------------------------------------------------------------------------
Effective January 1, 1999
1975-80 BASIC SELECT AND ULTIMATE MORTALITY TABLES - FEMALE ANB
--------------------------------------------------------------------------------------------
Ultimate
Age/Dur 10 11 12 13 14 15 Rate Age
--------------------------------------------------------------------------------------------
46 4.11 4.55 5.01 5.49 6.32 6.89 8.00 61
--------------------------------------------------------------------------------------------
47 4.41 4.90 5.41 5.94 6.84 7.46 8.67 62
--------------------------------------------------------------------------------------------
48 4.70 5.23 5.77 6.31 7.25 7.88 9.38 63
--------------------------------------------------------------------------------------------
49 5.02 5.57 6.13 6.70 7.67 8.30 10.15 64
--------------------------------------------------------------------------------------------
50 5.34 5.92 6.50 7.09 8.09 8.75 10.99 65
--------------------------------------------------------------------------------------------
51 5.67 6.28 6.88 7.49 8.53 9.21 11.91 66
--------------------------------------------------------------------------------------------
52 6.01 6.64 7.27 7.91 9.00 9.70 12.92 67
--------------------------------------------------------------------------------------------
53 6.41 7.05 7.75 8.47 9.68 10.50 14.03 68
--------------------------------------------------------------------------------------------
54 6.81 7.49 8.26 9.07 10.43 11.37 15.25 69
--------------------------------------------------------------------------------------------
55 7.25 7.96 8.81 9.72 11.24 12.33 16.63 70
--------------------------------------------------------------------------------------------
56 7.71 8.46 9.40 10.43 12.13 13.41 18.21 71
--------------------------------------------------------------------------------------------
57 8.21 9.00 10.04 11.20 13.13 14.65 20.04 72
--------------------------------------------------------------------------------------------
58 8.71 9.76 10.86 12.11 14.18 15.84 22.17 73
--------------------------------------------------------------------------------------------
59 9.25 10.60 11.79 13.14 15.40 17.21 24.65 74
--------------------------------------------------------------------------------------------
60 9.83 11.55 12.85 14.33 16.80 18.78 27.53 75
--------------------------------------------------------------------------------------------
61 10.47 12.64 14.08 15.70 18.42 20.59 30.86 76
--------------------------------------------------------------------------------------------
62 11.19 13.90 15.50 17.30 20.28 22.64 34.69 77
--------------------------------------------------------------------------------------------
63 12.11 15.04 16.80 18.79 22.08 24.73 39.07 78
--------------------------------------------------------------------------------------------
64 13.17 16.34 18.28 20.47 24.09 27.05 44.00 79
--------------------------------------------------------------------------------------------
65 14.38 17.83 19.94 22.34 26.30 29.55 49.48 80
--------------------------------------------------------------------------------------------
66 15.78 19.51 21.81 24.41 28.69 32.20 55.51 81
--------------------------------------------------------------------------------------------
67 17.37 21.40 23.87 26.64 31.21 34.98 62.09 82
--------------------------------------------------------------------------------------------
68 19.53 23.87 26.64 29.96 34.98 39.13 69.22 83
--------------------------------------------------------------------------------------------
69 21.99 26.64 29.96 33.61 39.13 43.62 76.90 84
--------------------------------------------------------------------------------------------
70 24.77 29.96 33.61 37.59 43.62 48.46 85.13 85
--------------------------------------------------------------------------------------------
71 41.07 47.96 55.76 64.57 74.44 85.13 93.91 86
--------------------------------------------------------------------------------------------
72 47.96 55.76 64.51 74.32 85.13 93.91 103.24 87
--------------------------------------------------------------------------------------------
73 55.76 64.51 74.28 85.13 93.91 103.24 113.12 88
--------------------------------------------------------------------------------------------
74 64.51 74.28 85.13 93.91 103.24 113.12 123.55 89
--------------------------------------------------------------------------------------------
75 74.28 85.13 93.91 103.24 113.12 123.55 134.53 90
--------------------------------------------------------------------------------------------
76 85.13 93.91 103.24 113.12 123.55 134.53 146.06 91
--------------------------------------------------------------------------------------------
77 93.91 103.24 113.12 123.55 134.53 146.06 158.14 92
--------------------------------------------------------------------------------------------
78 103.24 113.12 123.55 134.53 146.06 158.14 170.77 93
--------------------------------------------------------------------------------------------
79 113.12 123.55 134.53 146.06 158.14 170.77 183.95 94
--------------------------------------------------------------------------------------------
80 123.55 134.53 146.06 158.14 170.77 183.95 197.68 95
--------------------------------------------------------------------------------------------
81 134.53 146.06 158.14 170.77 183.95 197.68 211.96 96
--------------------------------------------------------------------------------------------
82 146.06 158.14 170.77 183.95 197.68 211.96 226.79 97
--------------------------------------------------------------------------------------------
83 158.14 170.77 183.95 197.68 211.96 226.79 242.17 98
--------------------------------------------------------------------------------------------
84 170.77 183.95 197.68 211.96 226.79 242.17 258.10 99
--------------------------------------------------------------------------------------------
85 183.95 197.68 211.96 226.79 242.17 258.10 274.58 100
--------------------------------------------------------------------------------------------
86 197.68 211.96 226.79 242.17 258.10 274.58 291.61 101
--------------------------------------------------------------------------------------------
87 211.96 226.79 242.17 258.10 274.58 291.61 309.19 102
--------------------------------------------------------------------------------------------
88 226.79 242.17 258.10 274.58 291.61 309.19 327.32 103
--------------------------------------------------------------------------------------------
89 242.17 258.10 274.58 291.61 309.19 327.32 346.00 104
--------------------------------------------------------------------------------------------
90 258.10 274.58 291.61 309.19 327.32 346.00 365.23 105
--------------------------------------------------------------------------------------------
Effective January 1, 1999
1975-80 BASIC SELECT AND ULTIMATE MORTALITY TABLES - MALE ANB
Age/Dur 1 2 3 4 5 6 7 8 9
0 1.23 0.74 0.48 0.43 0.38 0.34 0.33 0.29 0.27
1 0.49 0.47 0.42 0.36 0.28 0.23 0.22 0.22 0.24
2 0.35 0.37 0.33 0.28 0.23 0.22 0.21 0.24 0.24
3 0.35 0.29 0.25 0.23 0.22 0.2 0.22 0.24 0.27
4 0.29 0.25 0.23 0.22 0.20 0.22 0.24 0.27 0.30
5 0.25 0.23 0.22 0.20 0.22 0.24 0.27 0.30 0.36
6 0.23 0.22 0.20 0.22 0.24 0.27 0.30 0.36 0.50
7 0.19 0.20 0.22 0.24 0.27 0.30 0.35 0.50 0.66
8 0.18 0.21 0.21 0.27 0.29 0.35 0.50 0.66 0.87
9 0.19 0.20 0.24 0.29 0.35 0.50 0.66 0.87 1.05
10 0.18 0.22 0.27 0.35 0.50 0.66 0.87 1.05 1.13
11 0.20 0.25 0.34 0.50 0.66 0.87 1.05 1.13 1.19
12 0.23 0.32 0.50 0.66 0.87 1.05 1.13 1.19 1.23
13 0.30 0.46 0.63 0.87 1.05 1.12 1.19 1.22 1.24
14 0.44 0.59 0.87 1.05 1.12 1.17 1.22 1.23 1.23
15 0.58 0.87 1.05 1.12 1.17 1.21 1.23 1.22 1.20
16 0.87 1.05 1.12 1.17 1.21 1.20 1.21 1.19 1.16
17 1.05 1.12 1.17 1.21 1.2 1.18 1.18 1.15 1.11
18 1.03 1.10 1.13 1.15 1.14 1.11 1.11 1.07 1.04
19 1.00 1.05 1.06 1.07 1.05 1.04 1.02 0.98 0.96
20 0.93 0.97 0.97 0.97 0.97 0.95 0.93 0.90 0.90
21 0.84 0.87 0.87 0.87 0.87 0.86 0.85 0.83 0.85
22 0.73 0.76 0.76 0.76 0.77 0.77 0.77 0.77 0.80
23 0.73 0.76 0.75 0.75 0.75 0.76 0.77 0.77 0.80
24 0.73 0.74 0.73 0.73 0.74 0.76 0.77 0.78 0.82
25 0.72 0.72 0.72 0.72 0.74 0.76 0.77 0.79 0.84
26 0.70 0.70 0.71 0.72 0.73 0.76 0.78 0.82 0.88
27 0.68 0.68 0.70 0.71 0.73 0.77 0.81 0.86 0.92
28 0.66 0.68 0.71 0.73 0.76 0.81 0.86 0.92 1.00
29 0.65 0.68 0.73 0.76 0.81 0.86 0.92 1.00 1.08
30 0.64 0.68 0.76 0.81 0.86 0.92 1.00 1.08 1.17
31 0.63 0.69 0.79 0.86 0.92 1.00 1.08 1.17 1.28
32 0.63 0.71 0.84 0.92 1.00 1.08 1.17 1.28 1.40
33 0.63 0.72 0.88 0.98 1.08 1.17 1.28 1.40 1.58
34 0.63 0.73 0.93 1.05 1.17 1.28 1.40 1.58 1.78
35 0.63 0.76 0.99 1.14 1.28 1.40 1.58 1.78 2.01
36 0.65 0.79 1.06 1.25 1.40 1.58 1.78 2.01 2.24
37 0.67 0.84 1.15 1.37 1.58 1.78 2.01 2.24 2.53
38 0.70 0.89 1.23 1.47 1.70 1.91 2.16 2.41 2.72
39 0.74 0.95 1.33 1.59 1.83 2.07 2.33 2.60 2.93
40 0.79 1.02 1.45 1.73 2.00 2.23 2.51 2.79 3.13
41 0.85 1.11 1.59 1.90 2.17 2.42 2.70 2.98 3.33
42 0.92 1.22 1.76 2.09 2.37 2.62 2.89 3.18 3.52
43 0.99 1.37 1.92 2.30 2.61 2.88 3.18 3.47 3.83
44 1.08 1.53 2.11 2.52 2.86 3.17 3.47 3.79 4.17
45 1.17 1.72 2.31 2.75 3.13 3.47 3.79 4.14 4.56
Effective January 1, 1999
1975-80 BASIC SELECT AND ULTIMATE MORTALITY TABLES - MALE ANB
----------------------------------------------------------------------------------------------------
Age/Dur 1 2 3 4 5 6 7 8 9
----------------------------------------------------------------------------------------------------
46 1.28 1.94 2.51 3.00 3.40 3.78 4.14 4.56 4.91
----------------------------------------------------------------------------------------------------
47 1.39 2.17 2.73 3.25 3.69 4.13 4.56 4.89 5.31
----------------------------------------------------------------------------------------------------
48 1.49 2.27 2.84 3.40 3.90 4.38 4.87 5.28 5.80
----------------------------------------------------------------------------------------------------
49 1.60 2.35 2.95 3.54 4.09 4.62 5.18 5.70 6.33
----------------------------------------------------------------------------------------------------
50 1.70 2.42 3.04 3.66 4.29 4.87 5.51 6.15 6.93
----------------------------------------------------------------------------------------------------
51 1.80 2.48 3.12 3.77 4.47 5.12 5.86 6.65 7.59
----------------------------------------------------------------------------------------------------
52 1.90 2.52 3.17 3.85 4.65 5.38 6.12 7.20 8.32
----------------------------------------------------------------------------------------------------
53 2.06 2.75 3.46 4.23 5.08 5.90 6.84 7.89 9.11
----------------------------------------------------------------------------------------------------
54 2.23 2.99 3.78 4.64 5.57 6.47 7.52 8.66 9.96
----------------------------------------------------------------------------------------------------
55 2.41 3.27 4.12 5.10 6.11 7.11 8.27 9.50 10.86
----------------------------------------------------------------------------------------------------
56 2.61 3.56 4.51 5.61 6.71 7.83 9.09 10.38 11.83
----------------------------------------------------------------------------------------------------
57 2.82 3.89 4.94 6.18 7.38 8.60 9.96 11.33 12.87
----------------------------------------------------------------------------------------------------
58 2.96 4.13 5.44 6.74 8.10 9.20 10.59 12.05 13.66
----------------------------------------------------------------------------------------------------
59 3.10 4.37 6.00 7.34 8.87 9.82 11.23 12.79 14.47
----------------------------------------------------------------------------------------------------
60 3.23 4.63 6.61 7.97 9.71 10.46 11.89 13.57 15.32
----------------------------------------------------------------------------------------------------
61 3.37 4.89 7.26 8.64 10.46 11.59 12.58 14.38 16.18
----------------------------------------------------------------------------------------------------
62 3.50 5.14 7.97 9.36 11.59 11.83 13.29 15.21 17.05
----------------------------------------------------------------------------------------------------
63 3.89 5.77 8.74 10.48 11.83 13.29 15.21 17.05 20.11
----------------------------------------------------------------------------------------------------
64 4.32 6.47 9.57 11.73 13.29 15.21 17.05 20.11 22.42
----------------------------------------------------------------------------------------------------
65 4.80 7.26 10.50 13.13 15.21 17.05 20.11 22.42 25.79
----------------------------------------------------------------------------------------------------
66 5.32 8.14 11.51 14.69 17.05 20.11 22.42 25.79 28.61
----------------------------------------------------------------------------------------------------
67 5.91 9.12 12.62 16.42 20.11 22.42 25.79 28.69 32.93
----------------------------------------------------------------------------------------------------
68 6.51 10.04 13.89 18.04 22.04 24.54 28.23 31.44 34.47
----------------------------------------------------------------------------------------------------
69 7.17 11.05 15.25 19.76 24.12 26.87 30.94 34.47 37.82
----------------------------------------------------------------------------------------------------
70 7.89 12.14 16.72 21.64 26.41 29.44 33.92 37.82 41.49
----------------------------------------------------------------------------------------------------
71 9.53 14.60 19.60 24.97 29.44 34.32 41.78 48.80 57.45
----------------------------------------------------------------------------------------------------
72 11.40 16.64 22.87 28.77 34.15 39.89 48.34 56.16 65.58
----------------------------------------------------------------------------------------------------
73 13.52 19.13 26.61 33.20 39.52 46.21 55.72 64.40 74.61
----------------------------------------------------------------------------------------------------
74 15.94 22.46 30.70 38.25 45.60 53.35 64.01 73.58 84.52
----------------------------------------------------------------------------------------------------
75 18.71 26.26 35.35 43.95 52.45 61.35 73.23 83.67 95.39
----------------------------------------------------------------------------------------------------
76 21.88 30.62 40.61 50.35 60.12 70.26 83.39 94.78 107.62
----------------------------------------------------------------------------------------------------
77 25.51 34.90 46.52 57.51 68.66 80.09 94.57 107.29 121.31
----------------------------------------------------------------------------------------------------
78 29.63 40.42 53.12 65.47 78.04 90.90 107.18 121.31 132.05
----------------------------------------------------------------------------------------------------
79 34.65 46.62 60.45 74.20 88.36 103.10 121.31 132.05 143.63
----------------------------------------------------------------------------------------------------
80 40.30 53.54 68.50 83.78 99.99 116.79 132.05 143.63 156.05
----------------------------------------------------------------------------------------------------
81 46.63 61.18 77.33 94.56 113.02 132.05 143.63 156.05 169.12
----------------------------------------------------------------------------------------------------
82 53.65 69.60 87.27 106.64 127.54 143.63 156.05 169.12 182.61
----------------------------------------------------------------------------------------------------
83 61.41 79.10 98.40 120.07 143.63 156.05 169.12 182.61 196.52
----------------------------------------------------------------------------------------------------
84 72.42 89.77 110.78 134.94 156.05 169.12 182.61 196.52 210.85
----------------------------------------------------------------------------------------------------
85 84.92 104.32 124.48 151.33 169.12 182.61 196.52 210.85 225.60
----------------------------------------------------------------------------------------------------
86 99.04 117.78 139.58 169.12 182.61 196.52 210.85 225.60 240.77
----------------------------------------------------------------------------------------------------
87 114.90 134.20 155.97 182.61 196.52 210.85 225.60 240.77 256.36
----------------------------------------------------------------------------------------------------
88 132.64 152.21 173.48 196.52 210.85 225.60 240.77 256.36 272.37
----------------------------------------------------------------------------------------------------
89 143.75 164.35 186.69 210.85 225.60 240.77 256.36 272.37 288.80
----------------------------------------------------------------------------------------------------
90 155.22 176.87 200.31 225.60 240.77 256.36 272.37 288.80 305.65
----------------------------------------------------------------------------------------------------
Effective January 1, 1999
1975-80 BASIC SELECT AND ULTIMATE MORTALITY TABLES - MALE ANB
--------------------------------------------------------------------------------------------
Ultimate
Age/Dur 10 11 12 13 14 15 Rate Age
--------------------------------------------------------------------------------------------
0 0.27 0.25 0.28 0.31 0.38 0.54 0.68 15
--------------------------------------------------------------------------------------------
1 0.24 0.27 0.30 0.38 0.54 0.68 1.01 16
--------------------------------------------------------------------------------------------
2 0.27 0.30 0.37 0.54 0.68 1.01 1.14 17
--------------------------------------------------------------------------------------------
3 0.30 0.37 0.53 0.68 1.01 1.14 1.22 18
--------------------------------------------------------------------------------------------
4 0.36 0.52 0.66 0.99 1.11 1.22 1.31 19
--------------------------------------------------------------------------------------------
5 0.50 0.66 0.96 1.09 1.16 1.31 1.37 20
--------------------------------------------------------------------------------------------
6 0.66 0.94 1.07 1.14 1.21 1.37 1.40 21
--------------------------------------------------------------------------------------------
7 0.87 1.05 1.13 1.19 1.23 1.40 1.41 22
--------------------------------------------------------------------------------------------
8 1.05 1.13 1.19 1.23 1.30 1.39 1.40 23
--------------------------------------------------------------------------------------------
9 1.13 1.19 1.23 1.30 1.35 1.36 1.38 24
--------------------------------------------------------------------------------------------
10 1.19 1.23 1.30 1.35 1.36 1.32 1.34 25
--------------------------------------------------------------------------------------------
11 1.23 1.30 1.35 1.36 1.30 1.27 1.29 26
--------------------------------------------------------------------------------------------
12 1.30 1.35 1.36 1.30 1.25 1.20 1.24 27
--------------------------------------------------------------------------------------------
13 1.28 1.31 1.30 1.25 1.20 1.16 1.20 28
--------------------------------------------------------------------------------------------
14 1.24 1.26 1.25 1.19 1.16 1.13 1.17 29
--------------------------------------------------------------------------------------------
15 1.20 1.19 1.18 1.13 1.12 1.11 1.14 30
--------------------------------------------------------------------------------------------
16 1.14 1.12 1.12 1.09 1.09 1.09 1.12 31
--------------------------------------------------------------------------------------------
17 1.07 1.05 1.06 1.05 1.06 1.08 1.11 32
--------------------------------------------------------------------------------------------
18 1.01 1.00 1.02 1.01 1.03 1.07 1.12 33
--------------------------------------------------------------------------------------------
19 0.95 0.97 0.97 0.98 1.01 1.07 1.14 34
--------------------------------------------------------------------------------------------
20 0.91 0.93 0.94 0.96 1.01 1.08 1.17 35
--------------------------------------------------------------------------------------------
21 0.86 0.90 0.92 0.96 1.02 1.11 1.22 36
--------------------------------------------------------------------------------------------
22 0.83 0.88 0.91 0.96 1.04 1.15 1.28 37
--------------------------------------------------------------------------------------------
23 0.84 0.90 0.94 1.00 1.10 1.21 1.36 38
--------------------------------------------------------------------------------------------
24 0.87 0.93 0.97 1.05 1.17 1.29 1.45 39
--------------------------------------------------------------------------------------------
25 0.90 0.96 1.03 1.12 1.25 1.38 1.56 40
--------------------------------------------------------------------------------------------
26 0.95 1.02 1.09 1.20 1.35 1.49 1.70 41
--------------------------------------------------------------------------------------------
27 1.01 1.08 1.17 1.30 1.47 1.63 1.87 42
--------------------------------------------------------------------------------------------
28 1.08 1.17 1.28 1.42 1.61 1.81 2.07 43
--------------------------------------------------------------------------------------------
29 1.17 1.28 1.42 1.58 1.81 2.03 2.31 44
--------------------------------------------------------------------------------------------
30 1.28 1.42 1.58 1.81 2.03 2.26 2.58 45
--------------------------------------------------------------------------------------------
31 1.42 1.58 1.81 2.03 2.26 2.53 2.89 46
--------------------------------------------------------------------------------------------
32 1.58 1.81 2.03 2.26 2.53 2.83 3.24 47
--------------------------------------------------------------------------------------------
33 1.78 2.01 2.25 2.53 2.83 3.17 3.61 48
--------------------------------------------------------------------------------------------
34 2.01 2.24 2.53 2.81 3.16 3.54 4.02 49
--------------------------------------------------------------------------------------------
35 2.24 2.53 2.8 3.13 3.52 3.94 4.45 50
--------------------------------------------------------------------------------------------
36 2.53 2.80 3.10 3.48 3.91 4.36 4.92 51
--------------------------------------------------------------------------------------------
37 2.80 3.08 3.43 3.86 4.32 4.82 5.44 52
--------------------------------------------------------------------------------------------
38 3.04 3.35 3.76 4.25 4.78 5.33 6.00 53
--------------------------------------------------------------------------------------------
39 3.27 3.64 4.10 4.67 5.28 5.88 6.61 54
--------------------------------------------------------------------------------------------
40 3.51 3.94 4.47 5.13 5.82 6.48 7.27 55
--------------------------------------------------------------------------------------------
41 3.75 4.24 4.86 5.62 6.41 7.12 8.01 56
--------------------------------------------------------------------------------------------
42 3.99 4.57 5.28 6.15 7.05 7.85 8.82 57
--------------------------------------------------------------------------------------------
43 4.33 4.96 5.71 6.63 7.61 8.50 9.73 58
--------------------------------------------------------------------------------------------
44 4.70 5.37 6.16 7.16 8.20 9.22 10.75 59
--------------------------------------------------------------------------------------------
45 5.08 5.80 6.66 7.73 8.85 10.02 11.89 60
--------------------------------------------------------------------------------------------
Effective January 1, 1999
1975-80 BASIC SELECT AND ULTIMATE MORTALITY TABLES - MALE ANB
-------------------------------------------------------------------------------------------------------------
Ultimate
Age/Dur 10 11 12 13 14 15 Rate Age
-------------------------------------------------------------------------------------------------------------
46 5.48 6.28 7.19 8.35 9.56 10.89 13.17 61
-------------------------------------------------------------------------------------------------------------
47 5.93 6.79 7.78 9.03 10.34 11.85 14.57 62
-------------------------------------------------------------------------------------------------------------
48 6.49 7.53 8.64 9.94 11.30 12.79 16.07 63
-------------------------------------------------------------------------------------------------------------
49 7.12 8.36 9.60 10.96 12.32 13.75 17.71 64
-------------------------------------------------------------------------------------------------------------
50 7.83 9.30 10.69 12.06 13.40 14.77 19.50 65
-------------------------------------------------------------------------------------------------------------
51 8.61 10.35 11.89 13.24 14.56 15.83 21.47 66
-------------------------------------------------------------------------------------------------------------
52 9.48 11.51 13.18 14.52 15.80 16.96 23.65 67
-------------------------------------------------------------------------------------------------------------
53 10.43 12.63 14.52 15.80 16.96 19.16 26.05 68
-------------------------------------------------------------------------------------------------------------
54 11.44 13.85 15.80 16.96 19.16 21.62 28.69 69
-------------------------------------------------------------------------------------------------------------
55 12.54 15.17 16.96 19.16 21.62 24.39 31.57 70
-------------------------------------------------------------------------------------------------------------
56 13.73 16.62 19.16 21.62 24.39 27.47 34.68 71
-------------------------------------------------------------------------------------------------------------
57 15.03 18.21 21.36 24.39 27.15 30.87 38.00 72
-------------------------------------------------------------------------------------------------------------
58 15.94 19.22 22.43 25.64 28.58 32.76 41.60 73
-------------------------------------------------------------------------------------------------------------
59 16.88 20.25 23.49 26.85 29.94 34.70 45.54 74
-------------------------------------------------------------------------------------------------------------
60 17.85 21.28 24.48 27.97 31.28 36.71 49.90 75
-------------------------------------------------------------------------------------------------------------
61 18.82 22.26 25.39 29.04 32.61 38.82 54.71 76
-------------------------------------------------------------------------------------------------------------
62 19.77 23.18 26.21 30.06 33.93 41.03 60.03 77
-------------------------------------------------------------------------------------------------------------
63 22.42 25.79 28.87 33.14 37.75 44.66 65.85 78
-------------------------------------------------------------------------------------------------------------
64 25.79 28.69 32.93 36.55 42.02 48.60 72.18 79
-------------------------------------------------------------------------------------------------------------
65 28.69 32.93 35.12 40.34 46.75 52.83 79.02 80
-------------------------------------------------------------------------------------------------------------
66 32.93 34.69 38.78 44.51 51.97 57.68 86.36 81
-------------------------------------------------------------------------------------------------------------
67 34.47 38.42 42.80 49.08 57.68 62.18 94.12 82
-------------------------------------------------------------------------------------------------------------
68 37.82 42.14 46.91 53.73 62.18 67.77 102.35 83
-------------------------------------------------------------------------------------------------------------
69 41.49 46.20 51.36 58.72 67.77 73.69 111.41 84
-------------------------------------------------------------------------------------------------------------
70 45.48 50.57 56.13 64.00 73.69 80.22 121.31 85
-------------------------------------------------------------------------------------------------------------
71 65.58 74.61 84.52 95.47 107.84 121.31 132.05 86
-------------------------------------------------------------------------------------------------------------
72 74.61 84.52 95.39 107.67 121.31 132.05 143.63 87
-------------------------------------------------------------------------------------------------------------
73 84.52 95.39 107.62 121.31 132.05 143.63 156.05 88
-------------------------------------------------------------------------------------------------------------
74 95.39 107.62 121.31 132.05 143.63 156.05 169.12 89
-------------------------------------------------------------------------------------------------------------
75 107.62 121.31 132.05 143.63 156.05 169.12 182.61 90
-------------------------------------------------------------------------------------------------------------
76 121.31 132.05 143.63 156.05 169.12 182.61 196.52 91
-------------------------------------------------------------------------------------------------------------
77 132.05 143.63 156.05 169.12 182.61 196.52 210.85 92
-------------------------------------------------------------------------------------------------------------
78 143.63 156.05 169.12 182.61 196.52 210.85 225.60 93
-------------------------------------------------------------------------------------------------------------
79 156.05 169.12 182.61 196.52 210.85 225.60 240.77 94
-------------------------------------------------------------------------------------------------------------
80 169.12 182.61 196.52 210.85 225.60 240.77 256.36 95
-------------------------------------------------------------------------------------------------------------
81 182.61 196.52 210.85 225.60 240.77 256.36 272.37 96
-------------------------------------------------------------------------------------------------------------
82 196.52 210.85 225.60 240.77 256.36 272.37 288.80 97
-------------------------------------------------------------------------------------------------------------
83 210.85 225.60 240.77 256.36 272.37 288.80 305.65 98
-------------------------------------------------------------------------------------------------------------
84 225.60 240.77 256.36 272.37 288.80 305.65 322.92 99
-------------------------------------------------------------------------------------------------------------
85 240.77 256.36 272.37 288.80 305.65 322.92 340.61 100
-------------------------------------------------------------------------------------------------------------
86 256.36 272.37 288.80 305.65 322.92 340.61 358.72 101
-------------------------------------------------------------------------------------------------------------
87 272.37 288.80 305.65 322.92 340.61 358.72 377.25 102
-------------------------------------------------------------------------------------------------------------
88 288.80 305.65 322.92 340.61 358.72 377.25 396.20 103
-------------------------------------------------------------------------------------------------------------
89 305.65 322.92 340.61 358.72 377.25 396.20 415.57 104
-------------------------------------------------------------------------------------------------------------
90 322.92 340.61 358.72 377.25 396.20 415.57 435.36 105
-------------------------------------------------------------------------------------------------------------
Exhibit D
[PHOENIX LOGO] REQUEST FOR REINSURANCE BENEFITS
________________________________________________________________________________
SEND COMPLETED REQUEST TO: COMPANY:
Phoenix Home Life Mutual Insurance Company Toll Free: ▇-▇▇▇-▇▇▇-▇▇▇▇ [ ] Phoenix Home Life Mutual Insurance Company
Insurance Claims 3E302 1-860-403-1000 [ ] American Phoenix Life and Reassurance
▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇., ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ FAX: ▇-▇▇▇-▇▇▇-▇▇▇▇ [ ] Phoenix Life and Reassurance of New York
________________________________________________________________________________
FULL NAME OF INSURED DATE OF BIRTH
________________________________________________________________________________
DATE OF DEATH CAUSE OF DEATH DATE OF DISABILITY CAUSE OF DISABILITY
________________________________________________________________________________
LINE OF BUSINESS (Check Appropriate): [ ] Individual Life/Cession
[ ] Bulk/Self Administration [ ] Group Life/ADD [ ] ADB [ ] Waiver Premium
________________________________________________________________________________
RATING INFO: (Check Appropriate): REINSURANCE DATA
[ ] Smoker [ ] Standard [ ] Auto Pool Number _____
[ ] Non-Smoker [ ] Substandard Rating ___ [ ] Fac. Pool % ____
[ ] Flat Extra Date Premium Last
Reported ______
________________________________________________________________________________
List all policies issued on this insured, with date of termination if not in
force at the date of death. Also indicate whether any policies have been
reinstated within two years prior to date of death.
___________________________________________________________________________________________________________________________________
FACE AMOUNT LAPSED WITHIN FACE AMOUNT REINSURANCE
CEDING COMPANY INSURED DATE OF PAST TWO YEARS (NOT NET RISK)
POLICY NUMBER ISSUE DATE ___________________ TERMINATION _____________________________ ____________________________
LIFE ADS DATE
(CHECK ONE) REINSTATED LIFE ADS
___________________________________________________________________________________________________________________________________
[ ] Yes [ ] No
___________________________________________________________________________________________________________________________________
[ ] Yes [ ] No
___________________________________________________________________________________________________________________________________
[ ] Yes [ ] No
___________________________________________________________________________________________________________________________________
[ ] Yes [ ] No
___________________________________________________________________________________________________________________________________
[ ] Yes [ ] No
___________________________________________________________________________________________________________________________________
TOTAL ISSUED AMOUNT REINSURED WITH PHOENIX
___________________ ____________________________
LESS TOTAL TERMINATED REINSURED WITH OTHERS
___________________ ____________________________
INSURANCE NOW IN FORCE AMOUNT RETAINED AT OWN RISK
___________________ ____________________________
TOTAL
____________________________
___________________________________________________________________________________________________________________________________
FRAUD STATEMENT REINSURANCE CESSION PLAN NAME AMOUNT OF REINSURANCE WITH PHOENIX
REQUIRED BY SOME STATES NUMBER (CURRENT NAR)
ANY PERSON WHO KNOWINGLY AND WITH ________________________________________________________________________________________________
INTENT TO DEFRAUD ANY INSURANCE
COMPANY OR OTHER PERSON FILES A ________________________________________________________________________________________________
STATEMENT OF CLAIM CONTAINING ANY
MATERIALLY FALSE INFORMATION, OR ________________________________________________________________________________________________
CONCEALS FOR THE PURPOSE OF
MISLEADING, INFORMATION CONCERNING ________________________________________________________________________________________________
ANY FACT MATERIAL THERETO, COMMITS
A FRAUDULENT INSURANCE ACT, WHICH ________________________________________________________________________________________________
IS A CRIME. TOTAL REQUESTED
________________________________________________________________________________________________
[ ] Contestable [ ] Yes [ ] No [ ] Conversion, Exchange or Replacement
[ ] Routine Investigation [ ] Yes [ ] No [ ] Reentry
[ ] Initial Notification List:
[ ] Additional Information Enclosed Policy No. ______________ Plan Name ____________________
[ ] Copies of all claim papers enclosed includes: Orig. Issue date ________ Reins. with Phoenix [ ] Yes [ ] No
Contestable Claims - Application and all underwriting Conversion or Reentry Underwritten [ ] Yes [ ] No
papers, investigation, claimant statement, death
certificate and proof of payment. [ ] We have paid our claim in full on ________ and request payment
Non-Contestable - reinsured for $250,000 plus also include of $ _________
application and underwriting. [ ] Interest expense at ____% per annum for ____ days $ __________.
Waivers - application and underwriting, claimant statement, [ ] Investigation expense $ ________
attending physician statement, waiver premium provision and [ ] Legal Expense $ ________
any investigation.
[ ] Copies of investigation are enclosed. REMARKS:
[ ] We are awaiting your consultation before completing
settlement
________________________________________________________________________________
CEDING COMPANY NAME PHONE NUMBER
( )
________________________________________________________________________________
ADDRESS
________________________________________________________________________________
DATE COMPLETED BY TITLE
________________________________________________________________________________
White copy - Return to Phoenix Yellow Copy - Client Company
Pink copy - Request for payment
EXHIBIT E
(EFFECTIVE JANUARY 1, 1999)
CONDITIONAL RECEIPT LIABILITY
I. AUTOMATIC REINSURANCE
We will be liable for losses under the terms of a Conditional Receipt or
Temporary Insurance Receipt only when the following qualifications are met:
a) we have reviewed your Conditional Receipt or Temporary Insurance Receipt
Form and related procedures submitted by you to us and have consented in
writing to the use of such forms and procedures.
b) the risk insured under either the Conditional Receipt or Temporary
Insurance Receipt meets your underwriting guidelines applicable to
conditional or temporary insurance and would have qualified for
automatic coverage under this Agreement;
c) you have retained the full retention required under the Agreement
(except for reinsurance placed with one of the YRT Reinsurers) without
reduction for the age and table rating of the insured; and
d) the amount ceded to us does not exceed the Automatic Acceptance Limits
applicable to us set forth in Exhibit A (Reinsurance Coverage), Part
III.
You will provide us prompt notice of any changes to the Conditional Receipt
and Temporary Insurance Receipt forms and procedures. We have the right to
consent to or reject any such changes, but such consent will not be
unreasonably withheld. We will not be liable for claims under any changed
conditional receipt or temporary insurance receipt unless we have consented
to the change in accordance with this section.
We will maintain copies of your Conditional Receipt or Temporary Receipt
Forms and our written consent in our Home Office.
II. FACULTATIVE REINSURANCE
We will not be liable for a claim incurred under the terms of a Conditional
Receipt or Temporary Insurance Receipt for a risk which has been submitted
to us on a facultative basis.
Continued...
EXHIBIT E - Continued
(Effective January 1, 1999)
III. FACE AMOUNT INCREASES FOR INTERSECTOR PLUS PLAN
1. Any increase in the face amount of a Reinsured Policy that is an
Intersector Plus Policy (each, an "Intersector Plus Policy") resulting
when premium and/or dividends with respect to such policy are used to
purchase paid-up additions ("PUA") will not be ceded to us
automatically but may be submitted to us on a facultative basis. PUA
may be used to convert the term insurance portion of an Intersector
Plus Policy to permanent insurance, in which event we will share
proportionately in the changes in the net amount at risk resulting
from such converted permanent insurance.
2. The term insurance portion of the Intersector Plus Policy may increase
according to a schedule determined at issue and; in the event of such
increase, you will retain the portion of such policy equal the product
of (a) and (b), where (a) equals the face amount of the policy in
force (including the increase), and (b) equals a fraction, the
numerator of which is your retention at issue with respect to such
policy before the increase, and the denominator of which is the total
death benefit after the schedule.
3. Any unscheduled increase in the face amount of an Intersector Plus
Policy will be treated as a new Reinsured Policy.
PHOENIX HOME LIFE MUTUAL INSURANCE COMPANY
▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇
▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
(▇▇▇) ▇▇▇-▇▇▇▇
(▇▇▇) ▇▇▇-▇▇▇▇
FAX: (▇▇▇) ▇▇▇-▇▇▇▇/2380 (UNDERWRITING)
(▇▇▇) ▇▇▇-▇▇▇▇ (GENERAL)
NAIC #: 67814
FEDERAL ID #: ▇▇-▇▇▇▇▇▇▇
Dallas Regional Sales Office:
PHOENIX HOME LIFE MUTUAL INSURANCE COMPANY
▇▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇
▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇
(▇▇▇) ▇▇▇-▇▇▇▇
FAX: (▇▇▇) ▇▇▇-▇▇▇▇
Please send general correspondence and paid reinsurance notices to:
PHOENIX HOME LIFE MUTUAL INSURANCE COMPANY
REINSURANCE DEPARTMENT 3E302
▇.▇. ▇▇▇ ▇▇▇▇
▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
Please send facultative applications only to:
PHOENIX HOME LIFE MUTUAL INSURANCE COMPANY
REINSURANCE DEPARTMENT UNDERWRITING 3E302
▇.▇. ▇▇▇ ▇▇▇▇
▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
Please send premium remittance checks to:
PHOENIX HOME LIFE MUTUAL INSURANCE COMPANY
▇.▇. ▇▇▇ ▇▇▇▇▇
▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
Continued...
Contacts:
Marketing Services:
▇▇▇▇ ▇▇▇▇▇, FSA, REGIONAL VICE PRESIDENT
(▇▇▇) ▇▇▇-▇▇▇▇
Facultative Submissions:
▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇, UNDERWRITING OFFICER, REGIONAL MANAGER
(▇▇▇) ▇▇▇-▇▇▇▇
▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇, SUPERVISOR, REINSURANCE UNDERWRITING SERVICES
(▇▇▇) ▇▇▇-▇▇▇▇
Client Administration:
▇▇▇▇▇ ▇▇▇▇▇, FLMI, ACS, MANAGER
(▇▇▇) ▇▇▇-▇▇▇▇
▇▇▇ ▇▇▇▇▇▇▇
(▇▇▇) ▇▇▇-▇▇▇▇
Claims
▇▇▇▇▇▇ ▇. ▇▇▇▇▇, ASSISTANT VICE PRESIDENT, CLAIMS AND AUDIT
(▇▇▇) ▇▇▇-▇▇▇▇
Treaties
▇▇▇▇▇ ▇. ▇▇▇▇▇▇, DIRECTOR, TREATIES AND COMPLIANCE
(▇▇▇) ▇▇▇-▇▇▇▇
▇▇▇▇▇ ▇. ▇▇▇▇, CONTRACT ADMINISTRATOR
(▇▇▇) ▇▇▇-▇▇▇▇
[PROVIDENT MUTUAL LOGO]
▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
▇.▇. ▇▇▇ ▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
TELEPHONE (▇▇▇) ▇▇▇-▇▇▇▇, (▇▇▇) ▇▇▇-▇▇▇▇, FAX (▇▇▇) ▇▇▇-▇▇▇▇
▇▇▇▇▇ ▇. ▇▇▇▇▇▇, FSA, MAAA
VICE PRESIDENT AND ACTUARY
March 9, 1999
▇▇. ▇▇▇▇▇ ▇. ▇▇▇▇
Reinsurance Contract Administrator
Phoenix Home Life
▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇.
P.O. Box 1900
▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇
Dear ▇▇. ▇▇▇▇:
Enclosed are the fully executed automatic agreements. I greatly appreciated the
special wording showing the section revisions. Also, attached is the
conditional receipt for your review and written approval.
Thank you for your assistance in putting together this arrangement.
Sincerely,
/s/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇
----------------------------
▇▇▇▇▇ ▇. ▇▇▇▇▇▇
Vice President and Actuary
SVC/mjd
Enclosures
cc: ▇▇▇ ▇▇▇▇▇▇▇▇
▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇
A HERITAGE OF STRENGTH FOR TOMORROW'S FINANCIAL NEEDS
[ ] Providentmutual Life and Annuity Company, A Stock Life Insurance Company
AGREEMENT FOR TEMPORARY LIFE INSURANCE OF A LIMITED AMOUNT
This agreement provides a Limited Amount of life insurance protection, for a
Limited Period of time, subject to the terms of this Agreement. No one is
authorized to change or waive any of the provisions of this Agreement.
-------------------------------------------------------------------------------
Proposed Insured(s) Amount Received
-------------------------------------------------------------------------------
HEALTH QUESTIONS
Has the person(s) above as Proposed Insured:
1. within the past 90 days, been admitted to a hospital or other medical
facility, or been advised to be admitted or had surgery performed or
recommended? [ ] Yes [ ] No
2. within the past 2 years, been treated for heart trouble, stroke or cancer,
or had such treatment recommended by a physician or other medical
practitioner? [ ] Yes [ ] No
If either of the above questions is answered "YES" or LEFT BLANK, no
representative of the Company is authorized to accept money, and NO COVERAGE
will take effect under this Agreement.
TERMS AND CONDITIONS
THE $500,000 TOTAL BENEFIT LIMIT BELOW APPLIES TO ALL INSURANCE APPLIED FOR
UNDER THIS POLICY, INCLUDING ALL TERM INSURANCE RIDERS TO BE ATTACHED THERETO,
AS WELL AS ANY OTHER CURRENT APPLICATIONS TO THE COMPANY AND ANY OTHER
TEMPORARY LIFE INSURANCE AGREEMENTS FOR LIMITED AMOUNTS.
Amount applied for is subject to a $500,000 maximum for all applications and
agreements. If the two health questions above are answered NO with respect to
all Proposed Insureds and the full first premium has been accepted by the
Company as advance payment for an application for life insurance, the Company
will be obligated as follows:
1. For a Single Life Policy: If a Proposed Insured dies while this temporary
insurance is in effect, the Company will pay to the designated beneficiary
the SMALLER of (a) the amount of all death benefits applied for as to the
Proposed Insured in this Application, or (b) $500,000.
2. For a Survivorship Policy (if two persons named as Proposed Insureds):
a. If both Proposed Insureds die while this temporary insurance is in
effect, the Company will pay the designated beneficiary the SMALLER
of: the amount of all death benefits applied for in the Application
(including term riders); or $500,000.
b. If one Proposed Insured dies while this temporary insurance is in
effect and no term rider on his or her life has been applied for in
conjunction with the application for the survivorship policy, no
death benefit is payable.
c. If one of the Proposed Insured dies while this temporary insurance is
in effect and such Proposed Insured has applied for a term rider on
his or her life in conjunction with the application for the
survivorship policy, the company will pay the designated beneficiary
the SMALLER of: the amount of the death benefit under the term rider
on such insured's life applied for in the Application; or $500,000.
DATE COVERAGE BEGINS
1. For a Single Life Policy: Temporary life insurance under this Agreement
will begin on the date of this Agreement but only if the application for
the Proposed Insured(s) above has been completed on the same date or
before the date of this Agreement, and the Health Questions above are
answered "NO" and the full first premium has been collected.
2. For a Survivorship Policy: Temporary life insurance under this Agreement
will begin on the date of this Agreement but only if the Application has
been completed for both Proposed Insureds on the same date or before the
date of this Agreement, and the Health Questions above are answered "NO"
for both Proposed Insureds and the full first premium has been collected.
DATE COVERAGE ENDS - 90 DAY MAXIMUM
Temporary life insurance under this Agreement will end automatically on the
EARLIEST of:
a. the 90th day from the date of this Agreement, or
b. the date that insurance takes effect under the policy applied for, or
c. the date a policy, other than as applied for, is offered to the Applicant,
or
d. the date the Company mails notice of termination of coverage under this
Agreement to the premium billing address designated in the Application.
The Company may terminate coverage at any time, by such written notice. In
cases where the temporary coverage is terminated and no policy is
immediately issued by the Company, the advance payment will be refunded.
For Survivorship Policies: If one of the Proposed Insureds dies while this
temporary insurance is in effect, this agreement will automatically end upon
such death and the application for the survivorship insurance policy will be
declined.
SPECIAL LIMITATIONS
Fraud or material misrepresentations in the Application or in the answers to the
Health Questions of this Agreement invalidate this Agreement and the Company's
only liability is for refund of any advance payment made.
No one is authorized to accept money on Proposed Insureds under 32 days of age
or over insurance age 70 on the date of this Agreement, nor will any coverage
take effect on any such Proposed Insured.
If the Proposed Insured dies by suicide, the Company's liability under this
Agreement is limited to a refund of the payment made.
There is no coverage under this Agreement if the check or draft submitted as
advance payment is not paid on presentation.
I (WE) HAVE RECEIVED A COPY OF AND HAVE READ THIS AGREEMENT AND DECLARE THAT
THE ANSWERS ARE TRUE TO THE BEST OF MY (OUR) KNOWLEDGE AND BELIEF. I (WE)
UNDERSTAND AND AGREE TO ALL ITS TERMS.
----------------------------------- --------------------------------
Proposed First Proposed Second
Insured's Signature Insured's Signature
----------------------------------- -------------------------------- --------
Applicant's or Owner's Signature(s) Agent's Signature Date
(if other than Proposed Insured) Signed
ALL PREMIUM CHECKS MUST BE MADE PAYABLE TO THE COMPANY SELECTED ABOVE - DO NOT
MAKE CHECK PAYABLE TO THE AGENT OR LEAVE THE PAYEE BLANK
A5 1.99