AMENDMENT 5
EFFECTIVE JANUARY 1, 2004
TO THE
AUTOMATIC AND FACULTATIVE YEARLY RENEWABLE TERM REINSURANCE AGREEMENT
EFFECTIVE NOVEMBER 1, 2002 FOR FACULTATIVE BUSINESS
EFFECTIVE DECEMBER 1, 2002 FOR AUTOMATIC BUSINESS
BETWEEN
HARTFORD LIFE AND ANNUITY INSURANCE COMPANY
("CEDING COMPANY")
AND
EMPLOYERS REASSURANCE CORPORATION
("REINSURER")
("AGREEMENT")
WHEREAS, the Reinsurer currently reinsures the Ceding Company's plans or
policies under the Agreement; and
WHEREAS, the Ceding Company and the Reinsurer have revised Schedule A on
multiple dates since the effective dates of the Agreement; and
WHEREAS, the parties wish to reflect an updated Schedule A to accurately reflect
an updated Schedule A.
NOW, THEREFORE, for good and valuable consideration, receipt of which is hereby
acknowledged, the Ceding Company and the Reinsurer hereby agree to amend the
Agreement as follows:
1. The above recitals are true and accurate and are incorporated herein.
2. Schedule A is deleted in its entirety and replaced with the attached,
revised Schedule A.
3. Except as herein amended, all other terms and conditions of the Agreement
shall remain in full force and effect and unchanged.
Single Life Excess Treaty -- Effective 11/01/2002 Fac 12/01/2002 Auto
Between HLAIC and ERAC
Amendment #5 -- Effective 01/01/2004
1
In witness of the foregoing, the Ceding Company and the Reinsurer have, by their
respective officers, executed this Amendment in duplicate on the dates indicated
below.
EMPLOYERS REASSURANCE CORPORATION
By: /s/ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇ Attest: /s/ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇
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Name: ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇ Name: ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇
Title: Vice President ERAC Title: Team Leader
Date: 4-10-2012 Date: 4-10-2012
HARTFORD LIFE AND ANNUITY INSURANCE COMPANY
By: /s/ ▇▇▇▇ ▇▇▇▇▇▇▇ Attest: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇
---------------------------------------------- ----------------------------------------------
Name: ▇▇▇▇ ▇▇▇▇▇▇▇, FSA, MAAA Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, FSA, MAAA
Title: Assistant Vice President and Actuary Title: Senior Vice President
Individual Life Product Management Individual Life Product Management
Date: 3-30-12 Date: 3/30/12
Single Life Excess Treaty -- Effective 11/01/2002 Fac 12/01/2002 Auto
Between HLAIC and ERAC
Amendment #5 -- Effective 01/01/2004
2
SCHEDULE A
PLANS COVERED UNDER THIS AGREEMENT
EFFECTIVE JANUARY 1, 2004
TYPE OF BUSINESS INDIVIDUAL LIFE INSURANCE ISSUED BY THE CEDING COMPANY
---------------------------------------------------------------------------------------------------------------------------------
UPSCALE PRODUCTS RIDERS FOR UPSCALE PRODUCTS
Stag Protector Variable Universal Life* Other Covered Insured Rider*
Stag Variable Life Accumulator* Term Rider (base or other insured)*
Stag Universal Life* Accidental Death Benefit Rider*+
SPVL (Fully underwritten only)* Deduction Amount Waiver Rider*
ART (CW), 5 & 10 Year Term (NY)* Waiver of Monthly Deductions Rider*
One Year Term* Waiver of Specified Amount Rider*
Whole Life with Current Interest Life* Enhanced No Lapse Guarantee Rider*+
Stag Protector Variable Universal Life II (eff. December 1, Estate Tax Repeal Benefit Rider*+
2003)
Stag Variable Life Accumulator II (eff. December 1, 2003) Level Compensation Endorsement*+
Children's Life Insurance Rider*+
Maturity Date Extension Rider*+
Guaranteed COl Benefit Rider*+
Mortality and Expense Risk Rates Rider*
Cost of Living Adjustment Rider*
Foreign Travel Exclusion Rider (eff. November 1, 2002 (fac.);
December 1, 2002 (auto)+
Policy Continuation Rider (eff. December 1, 2003)+
Accelerated Death Benefit Rider (eff. January 1, 2004)+
MIDDLE AMERICA PRODUCTS RIDERS FOR MIDDLE AMERICA PRODUCTS
LBSI UL* Term Rider (base or other insured)*
Life Solutions I UL* Waiver of Premium Rider*
Life Solutions II UL* Waiver of Monthly Deduction Rider*
20 Year Term* Additional Purchase Option Rider*+
Disability Income Rider*+
WOODBURY PRODUCTS RIDERS FOR WOODBURY PRODUCTS
Hartford Stag Wall Street Variable Universal Life* Term Rider (base or other insured)*
Accidental Death Benefit Rider*+
Waiver of Monthly Deduction Rider*
Waiver of Specified Amount Rider*
Children's Life Insurance Rider*+
Accelerated Death Benefit Rider*+
Specify Monthly Deductions Rider*+
Enhanced No Lapse Guarantee Rider*+
------------
* Effective November 1, 2002 (fac.), December 1, 2002 (auto), in treaty
+ The benefit provided by this Rider is not reinsured under this Agreement.
Single Life Excess Treaty -- Effective 11/01/2002 Fac 12/01/2002 Auto
Between HLAIC and ERAC
Amendment #5 -- Effective 01/01/2004
3
DESCRIPTIONS
RIDERS FOR WHICH ADDITIONAL PREMIUM IS DUE TO THE REINSURER:
Other Covered Insured Rider: Provides term coverage for insured other than base
insured.
Term Rider (base or other insured): Provides additional term coverage.
Deduction Amount Waiver Rider: Waives monthly deduction amount if insured is
disabled.
Waiver of Monthly Deductions Rider: Waives monthly deduction amount if insured
is disabled.
Waiver of Specified Amount Rider: Waives specified amount if insured is
disabled.
Waiver of Premium Rider: Waives premium requirement if insured is disabled.
Cost of Living Adjustment Rider: This rider is available at issue only for
non-substandard issue ages 0 to 60. The rider allows for face amount increases
without underwriting biannually based on the Consumer Price Index with the
maximum amount of this increase being $50,000.
RIDERS THAT ALTER THE POLICY AND FOR WHICH NO ADDITIONAL PREMIUM IS PAID TO THE
REINSURER. IF A POLICY HAS THIS RIDER IT IS STILL COVERED UNDER THE AGREEMENT:
Accidental Death Benefit Rider: Pays an additional death benefit if the death on
the insured is caused by a qualifying accident.
Additional Purchase Option Rider: Provides additional term coverage.
Children's Life Insurance Rider: Provides additional term coverage for a child.
No separate reinsurance benefits are associated with this rider.
Disability Income Rider: This rider provides a monthly benefit while the insured
is totally and continuously disabled. The disability must continue for a period
of time which exceeds the waiting period before payments begin. Payments will
continue while the policy is inforce and the insured is totally disabled, but no
longer than the indemnity period selected.
Enhanced No Lapse Guarantee Rider: This rider guarantees that the policy will
not lapse, regardless of investment performance, provided cumulative premiums
paid less indebtedness less withdrawals are greater than or equal to the
cumulative no lapse guarantee premiums. There is a lifetime option and a limited
term option. The limited term option is the lesser of 20 years or to attained
age 80 for issue ages 0 to 70 and the minimum of 10 years or to attained age 90
for issue ages 71 to 85. Also, at the time when the no lapse guarantee
terminates or defaults, the policyholder may be eligible for an additional
amount of time they have this protection, which is based on the then current
account value.
Single Life Excess Treaty -- Effective 11/01/2002 Fac 12/01/2002 Auto
Between HLAIC and ERAC
Amendment #5 -- Effective 01/01/2004
4
Estate Tax Repeal Benefit Rider: (eff. 11/1/2002 (fac); 12/1/2002 (auto) This
rider will pay the account value less indebtedness if the Federal Estate Tax Law
is fully repealed by December 31, 2010 and we receive a request for this benefit
amount from the insured. This rider will terminate at the sooner of:
- The termination date of the policy, or
- January 31, 2011.
Level Compensation Endorsement: Surrender charges are not assessed for a full
surrender during the first three policy years. There is no charge for this
rider.
Maturity Date Extension Rider: When the policyholder reaches the maturity date
and has elected this rider, the death benefit is dropped to the account value,
no more monthly deductions are taken, interest is credited, no further premiums
are accepted, policy loans continue to accrue interest, and all other riders are
terminated.
Guaranteed COI Benefit Rider: This rider provides guaranteed cost of insurance
rates for the first 10 policy years. On each policy anniversary, we declare a
cost of insurance rate for a single policy year. This policy year is the policy
year 9 years from the then current policy anniversary. Thus the rider provides
that on any policy anniversary, cost of insurance rates over the next 10 years
will not exceed those provided by the rider. This rider is currently available
in only a few states and on variable life policy forms where the face amount is
at least thirty million dollars.
Accelerated Death Benefit Rider: With this rider, the policyholder can receive
up to 100% of his/her death benefit discounted with interest if the life
expectancy is 12 months or less.
Specify Monthly Deductions Rider: This rider allows the policyholder to specify
to take monthly deductions out of a particular account in the policy.
Mortality and Expense Risk Rates Rider: This rider guarantees that the mortality
and expense risk rate will be zero for years greater than and equal to 21.
Policy Continuation Rider: This rider is automatically added to the policy at
issue. This rider is intended to prevent the lapse of highly loaned policies.
Foreign Travel Exclusion Rider: The rider is written such that if the insured
dies while traveling to, from, or in a country NOT listed on the List of
Countries and Jurisdictions (Foreign Travel Exclusion Rider Schedule A), or dies
as a direct or indirect result of an illness or injury sustained during such
travel, the death benefit proceeds will be limited to the policy's account
value, less any outstanding indebtedness.
Single Life Excess Treaty -- Effective 11/01/2002 Fac 12/01/2002 Auto
Between HLAIC and ERAC
Amendment #5 -- Effective 01/01/2004
5
SCHEDULE A
FOREIGN TRAVEL EXCLUSION RIDER
UNDERWRITING GUIDELINES
EFFECTIVE JANUARY 1, 2004
UNDERWRITING GUIDELINES
1. A proposed insured is eligible for the rider if they have 30 days or less
of cumulative travel per year to countries and jurisdictions not list on
Schedule A Foreign Travel Exclusion Rider -- Exhibit II (Non-Schedule A
Country), as noted on an application or application amendment to be signed
on delivery of the policy. The rider will NOT be considered /used if a
proposed insured travels beyond 30 cumulative days per year to a
Non-Schedule A country. The proposed insured will either be rated or
declined for travel to Non-Schedule A countries beyond the 30-day limit.
2. If rated coverage is available for travel to a Non-Schedule A country
within the 30-day cumulative annual travel limit, a proposed insured will
have the option of choosing the rating or the exclusion rider.
3. Last Survivor Plans, Term Plans and the following riders are not eligible:
Spousal Rider, Child Rider, Premium Waiver, Disability Rider, and AD&D.
Term blends on permanent single life plans are eligible.
4. Only United States and Canadian residents are eligible for the rider.
5. Green card residents of the United States are eligible if they reside in
the United States permanently (as evidenced, for example by information
indicating the proposed insured intends to stay in the United States
indefinitely, has resided in the United States for a number of years, is
employed in the United States, or owns property in the United States).
6. For "automatic" reinsurance cases, the maximum face amount is $10 million.
7. The minimum face amount is the product's published minimum amount.
8. The maximum age is the product's published maximum age.
9. The minimum age is 18 years of age.
10. Only Preferred and Standard rating classes, including Enhanced Standard are
eligible.
11. Cases may be facultatively submitted. In these situations, the final
reinsurance offer must indicate agreement to use the rider at the final
rate class quoted.
12. Occupations and other unusual risks are still underwritten.
13. The list of countries and jurisdictions noted on Schedule A Foreign Travel
Exclusion Rider will be reviewed at least annually for changes, or earlier
if world events dictate change.
Note: There were no changes to countries listed in Schedule A during the
duration of this agreement.
14. The countries listed on Schedule A Foreign Travel Exclusion Rider will not
change once a rider is issued to an insured.
15. An amendment will be signed on delivery indicating acceptance of the rider.
SPECIAL CLAIMS HANDLING ISSUE(S):
Death claims that occur due to "diverted" flights to hazardous countries will be
eligible for payment. For example, if a person was flying to a non-excluded
country and the flight was diverted to a Non-Schedule A Country where the
insured subsequently died, the claim would not be excluded from coverage.
Single Life Treaty -- Effective 11/01/2002 Fac 12/01/2002 Auto
Between HLIC and ERC
Amendment #5 -- Effective 01/01/2004
6
SCHEDULE A
FOREIGN TRAVEL EXCLUSION RIDER
LIST OF COUNTRIES AND JURISDICTIONS
EFFECTIVE JANUARY 1, 2004
List of Countries and Jurisdictions eligible for travel under the Foreign Travel
Exclusion Rider
AFRICA EUROPE LATIN & SOUTH AMERICA NORTH AMERICA
Canary Island Andorra Argentina Anguilla
South Africa Austria Brazil Bahamas
Belgium Chile Barbados
ASIA PACIFIC Bulgaria Costa Rica Bermuda
Australia Czech Republic Ecuador British Virgin Islands
Fiji Denmark Uruguay Canada
Guam Estonia Cayman Islands
Hong Kong Finland Dominica
Japan France Dominican Republic
Macau Germany El Salvador
Marshall Islands Gibraltar Grenada
Micronesia Greece Guadeloupe
New Caledonia Greenland Jamaica
New Zealand Hungary Martinique
Niue Iceland Mexico
Okinawa Ireland Netherlands Antilles
Samoa Italy Panama
Singapore Latvia Puerto Rico
Tonga Liechtenstein Republic of Trinidad and Tobago
Tuvalu Lithuania St. Lucia
Vanuatu Luxembourg St. ▇▇▇▇▇▇▇ and the Grenadines
Malta Turks and Caicos Islands
Moldova United States Virgin Islands
Monaco United States
Netherlands
Norway
Poland
Portugal
Romania
Sicily
Slovak Republic
Slovenia
Spain
Sweden
Switzerland
United Kingdom
Single Life Treaty -- Effective 11/01/2002 Fac 12/01/2002 Auto
Between HLIC and ERC
Amendment #5 -- Effective 01/01/2004
7