Document:

EX-10.8

 Exhibit 10.8 
 LICENSE AGREEMENT 
 This Agreement is made the 1st day of October, 2012, (“Effective Date”) by and between
Fidelity Life Association, (hereinafter referred to as (“FLA” or “Licensor”), an Illinois insurance corporation, James Harkensee (hereinafter referred to as “Inventor”), an individual, both having a place of business at
8700 W. Bryn Mawr Avenue, Chicago, Illinois, and Combined Insurance Company of America, a corporation (hereinafter referred to as “Combined” or “Licensee”), having its principal place of business at 1000 N. Milwaukee Avenue,
Glenview, Illinois, individually referred to as “Party” and collectively as the “Parties”. 
 WITNESSED
THAT 
 WHEREAS, Licensor has the right to provide a license under a certain patent as herein identified; and 

WHEREAS, Inventor is a named inventor in said patent; and 
 WHEREAS, Licensee desires to obtain, and Licensor is willing to grant Licensee, an exclusive license as hereafter defined and under the terms and provisions herein specified. 

NOW, THEREFORE, in consideration of the premises and mutual agreements herein contained Licensor, Inventor and Licensee agree as follows:

 TERMS 
  

	1.	 DEFINITIONS 

  

	1.1	 The term “consist” limits and covers only the elements expressly recited. By contrast, the utilization of the terms
“include”, “such as”, and “for example” are not limited and therefore cover more elements than those recited. 

  

	1.2	 “Affiliate” shall mean any corporation or the like at least fifty percent (50%) of whose voting share capital is owned or
directly or indirectly controlled by or under common control with a Party as of the Effective Date of this Agreement or at any time during the term of this Agreement and any other entity over which a Party exercises effective managerial control.

  

	1.3	 “Agreements” shall mean (i) the 50% quota share Indemnity Reinsurance Agreement (Combined Block), and (ii) the 50% quota
share Indemnity Reinsurance Agreement (Transition Block). 

  

	1.4	 “Block of Business” shall mean the group of in force Lifetime Benefit Term Product policies in force with Fidelity Life.

  

	1.5	 “Combined Block” shall mean Licensee’s policy forms, its own version of the LBT Product and riders desired for sale.

	1.6	 “Confidential Information” shall mean any and all technical and non-technical information of a Party, including without limitation,
information concerning financial, accounting or marketing reports, business plans, analyses, forecasts, predictions, projections, intellectual property, trade secrets and know-how. “Information” may take the form of documentation,
drawings, specifications, software, technical or engineering data, and other forms, and may be communicated orally, in writing, by electronic or magnetic media, by visual observation and by other means. “Information” includes any reports,
analyses, studies or other materials, whether prepared by the Licensor or Licensee, that contain or are based upon proprietary Information covered in this Agreement. 

 

	1.7	 “Days” shall mean calendar days. 

  

	1.8	 “ LBT Product” shall mean: (i) LifeTime Benefit Term Product, i.e., a method of insuring a group of individuals which includes
a guaranteed insurance component and a decreasing term insurance component using a level premium received for each individual. 

  

	1.9	 “Patent” shall mean US Patent No. 7,962,352 B2, date of patent June 14, 2011, Method of Insuring Individuals using
Guaranteed Insurance, Term Insurance and Non-Guaranteed Insurance. 

  

	1.10	 “Transition Block” shall mean the business written under Licensee’s direction by Licensor on FLA’s paper in the period
prior to Licensee’s ability to issue its own policy forms. 

  

	1.11	 “Sale or Sold” shall mean selling, otherwise providing LBT Product either directly or through a chain of distribution.

  

	1.12	 “Service or Servicing Agreement” shall mean an agreement between Licensor and Licensee which discusses the description, delivery
point, availability, underwriting, quality levels, measurement procedures and escalation levels of the LBT Product. 

  

	2.	 LICENSE GRANT 

  

	2.1	 Subject to the terms and provisions of this Agreement, and to Licensee entering into a series of Agreements, Licensor grants to Licensee an
exclusive, personal, non-transferable, worldwide right and license under the Patent to make, have made, use, distribute, offer for sale, sell, and/or otherwise dispense the LBT Product. 

 

	2.2	 Subject to Licensee entering into the required Agreements under Section 5.1 to Licensor and Vision Financial, Licensor and Inventor
release and forever discharge Licensee (and its direct and indirect distributors, suppliers, dealers and customers) from any and all claims, liens, demands, causes of action, obligations, losses, damages, and liabilities, known or unknown, suspected
or unsuspected, liquidated or unliquidated, fixed or contingent, that they have had in the past or now have or may have in the future under any of the claims in the Patent based on or arising out of LBT Products sold by Licensee, prior to and
including the Effective Date, in, or for, the United States and its territories and possessions. 

  
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	2.3	 Subject to the terms and provisions of this Agreement, and to Licensee entering in to the required Agreements under Section 5.1 and
during the term of the life of this Agreement, Licensor and Inventor further represent, covenant and agree that neither they nor any entity directly or indirectly controlled by either will bring suit or otherwise assert a claim for infringement
under the Patent against Licensee before any court or administrative agency in any country of the world based on or arising out of LBT Products sold by Licensee in, or for, the United States and its territories and possessions.

  

	2.4	 The release and covenant not to sue provided in Sections 2.2 and 2.3, as well as any other releases or covenants not to sue set out in this
Agreement, shall bind any assignee or other person to whom a claim in the Patent, or any interest therein, may be conveyed. 

  

	3.	 LIMITS ON SCOPE OF LICENSE GRANT 

  

	3.1	 Combined Block. Licensee will develop, on its own policy forms, its own version of the LBT Product, including all riders desired for sale. The
initial sale of the Combined LBT product shall be on or after January 1, 2013. The Combined Block will be subject to a Quota Share Agreement as provided in Section 5.1. 

 

	3.2	 Transition Block. Licensor’s LBT product shall be written under the direction of Licensee in the time period prior to Licensee’s
ability to issue its own policy forms and riders subject to a reinsurance agreement covering the issuance of this product. Licensor shall cease writing any new policies or certificates in connection with the LBT Product upon the earliest of the date
(i) Licensee has received any necessary state approval of the aforementioned forms and has notified Licensor of its intent to begin marketing and using such forms or (ii) Licensor and Licensee agree, in writing, to cease writing of the LBT
Product. 

  

	3.3	 Licensor shall be able to write any new or renewal LBT Product if (i) notice of non-renewal was not timely provided in accordance with
and to the extent required by specific policy, provisions, insurance laws or regulations, (ii) to the extent necessary to honor quotes of Licensor’s outstanding policies, (iii) as specifically authorized in writing by Licensee.

  

	4.	 SALE OF BLOCK OF BUSINESS 

  

	4.1.	 Licensor agrees to not sell Block of Business for a period of 3 years from April 1, 2013, unless Licensee agrees in writing. During this
3 year period, Licensee will a) keep the Block of Business on its own contract forms, b) refrain from soliciting or accessing its LBT Product Policyholders and Certificateholders in a coordinated manner for purposes of sales or solicitation of other
products, and c) refrain from any action to transfer the Block of Business to another insurer’s contract forms, Throughout and following this 3 year period, Licensor shall provide notice to Licensee of its active pursuit to sell the Block of
Business. 

  
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	4.2	 Grant of Right of First Refusal. The Licensor does hereby grant unto the Licensee an exclusive right of first refusal and first option to
purchase the inforce LBT Product Block of Business, upon the event of a proposed sale of the Block of Business. This is a one-time option and right of first refusal that will expire if not exercised in accordance with paragraph 4.3 and the
subsequent completion of the sale of the block. 

  

	4.3.	 Exercise of First Option. This right of first refusal or first option to purchase may only be exercised by Licensee within 30 days from
notification by Licensor that Licensor has received a bona fide offer to purchase said Block of Business at the price offered by a third party. Such notification to Licensee shall include purchase terms. Licensor is further obligated to wait 30 days
for a reply from Licensee, unless received earlier. Licensor shall have no further obligation of notification and Licensee has no further rights under this section even if said purchase is not consummated. 

 

	4.4	 Termination of Right of First Refusal. Licensee’s right of first refusal and option to purchase under this Agreement shall terminate upon
expiry of the 30 day period following the first notification of a bona fide offer to purchase the Block of Business. 

  

	5.	 PAYMENT 

  

	5.1	 A 50% coinsurance reinsurance agreement for the Combined Block will be signed by Licensee. A 50% coinsurance reinsurance agreement for the
Transition Block will be signed by Licensee. Licensee will finalize a contract with Vision Financial that covers administration for the Combined Block by February 1, 2013. 

 

	5.2	 In consideration for the license, covenants not to sue, the agreements referenced in 5.1, and other agreements granted by Licensor and
Inventor to Licensee under this Agreement relative to US Patent No. 7,962,352 B2 Dated June 14, 2011 by Licensee in, or for, the United States and its territories and possessions after the Effective Date, Licensee agrees to develop and
market its own version of the LBT product, sign Agreements, manage the LBT Product and its policy administration, and provide underwriting support for the LBT Product. 

 

	6.	 TERM AND TERMINATION 

  

	6.1	 This Agreement shall continue in full force and effect, unless sooner terminated by specific provisions in this Agreement upon written Notice
by terminating party to the other party. 

  

	6.2	 Licensee may terminate this Agreement at any time by sixty (60) Days written notice to Licensor. 

 

	6.3	 Licensor may terminate this Agreement forthwith, unless otherwise provided herein, upon written notice to Licensee if:

 (a) Licensee fails to sell more than $1,000,000 of annualized first year premium, prior to any cession for
reinsurance, of the product in a calendar year with the termination effective as of the date the notice is given by the licensor; 

  
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 (b) Licensee discontinues its relationships under the Agreements. In each case after written
notice of such default or failure is given by Licensor to Licensee, unless a genuine and good faith dispute exists as to the existence of the relationship. This agreement shall terminate 36 months after the date of the notice by the Licensor.

 (c) Licensee shall make an assignment for the benefit of creditors, or any order for the compulsory liquidation of Licensee
shall be made by any court or regulatory body with the termination effective as of the date the notice is given by the Licensor; 

(d) Licensee shall be finally determined by a court of competent jurisdiction to have 

(i) willfully or deliberately violated any material provision of this Agreement; 

(ii) concealed from Licensor any failure to comply with this Agreement and/or 

(iii) acted in bad faith in breaching any material provision of this Agreement. 

In such an event, the termination shall be effective as of the date of notice given by Licensor. 

(e) If Licensee cannot come to an agreement with Vision Financial by February 1, 2013, this Agreement shall be immediately
terminated. 
 (f) If Licensee notifies Licensor pursuant to Section 10.4 that it has decided to no longer use the LBT
Product or exits the worksite business market, this Agreement shall be immediately terminated. 
 (g) The worldwide license for
the LBT Product will terminate upon written notice by Licensor after 12 months have passed since Licensee’s last sale of their LBT Product. 
  

	6.4	 Loss of Exclusivity. If Licensee’s sales volume, as measured by annualized first year sold premium, falls below $5 million for any
calendar year starting on or after January 1, 2015, Licensee shall lose its rights to exclusive use of the LBT Product. Loss of exclusivity does not affect Licensee’s rights with respect to Licensor’s sale of the Block of Business.

  

	6.5	 Termination of License. At the termination of this License Agreement, Licensee will cease marketing the LBT Product to new policyholders until
such time as a new License Agreement or Service Agreement is negotiated. Licensee may continue to issue new Certificates to members of existing Policyholders for a period of 3 years following termination of this License Agreement.

  

	6.6	 Service Rights. Licensee shall retain the right to service Policies issued by Licensee for the life of the Policies during the term of this
License and without diminution following the termination of the License. 

  
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	7.	 LIMITATION OF LIABILITY 

  

	7.1	 LICENSEE AGREES THAT LICENSOR’S TOTAL LIABILITY FOR ALL CLAIMS OF ANY KIND ARISING AS A RESULT OF, OR RELATED TO THIS AGREEMENT, WHETHER
BASED ON CONTRACT, TORT (INCLUDING BUT NOT LIMITED TO STRICT LIABILITY AND NEGLIGENCE), WARRANTY OR ON OTHER LEGAL OR EQUITABLE GROUNDS, SHALL BE LIMITED TO GENERAL MONEY DAMAGES. ANY SUCH DAMAGES SHALL NOT EXCEED AN AMOUNT EQUAL TO THE TOTAL
LICENSE FEE PAYABLE UNDER THE AGREEMENT, PROVIDED SUCH LIMITATION SHALL NOT APPLY TO CLAIMS OF INFRINGEMENT OR CLAIMS OF NEGLIGENCE RELATED TO PERSONAL INJURY OR TANGIBLE PROPERTY DAMAGE. 

 

	8.	 COVENANTS, REPRESENTATIONS AND WARRANTIES 

 

	8.1	 Licensor and Inventor warrant and covenant that they have the entire right, title and interest in and to the Patent.

  

	8.2	 Licensor and Inventor make no representation or warranty that the LBT Product will not infringe, directly, contributorily or by inducement
under the laws of the United States or any foreign country, any patent or other intellectual property right of a third party. 

  

	8.3	 Any dispute arising under or relating to this Agreement or in any dispute arising with respect to or related to the subject matter of the
claims in the Patent, shall be resolved by an action brought in Cook County, Illinois and the Parties and their Affiliates who have agreed to be bound by this Agreement consent to the jurisdiction and venue of a court in the State of Illinois.

  

	8.4	 Licensee represents and warrants that Licensee assumes responsibility for obtaining all necessary official governmental approval, validation,
and/or consent from the appropriate governmental authorities for the performance of this Agreement and for remittance of payment pursuant hereto and for registering or recording this Agreement as required; provided, however, that Licensee shall use
its best efforts to provide that Licensor shall have the right to participate or be represented in any proceeding, hearing, negotiation or the like with governmental authorities relating to such approval, validation and/or consent.

  

	8.5	 Every Party represents and warrants that it is not presently the subject of a voluntary or involuntary petition in bankruptcy or the
equivalent thereof, is not presently contemplating filing any such voluntary petition, and does not presently have reason to believe that such an Involuntary petition will be filed against it. 

 

	8.6	 Other than the express warranties of this Article, there are no other warranties, express or implied. 

  
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	9.	 CONFIDENTIAL INFORMATION 

  

	9.1	 For a period of three (3) years as measured from the first date of disclosure of Confidential Information pursuant to this Agreement,
Licensor and Inventor agree to use reasonable care and discretion, at least commensurate with that degree of reasonable care they use to protect similar information of their own, to avoid disclosure, publication, or dissemination of Confidential
Information, outside of those employees, attorneys or consultants of Licensor, and independent public accountants selected by Licensor, who have a need to know Confidential Information, and are bound by the terms of this Article to keep Confidential
Information in confidence. 

  

	9.2	 Disclosure by Licensor or Inventor of Confidential Information under Section 9.1 of this Agreement shall be permitted in the following
circumstances; provided, that Licensor and Inventor shall have first given reasonable notice to Licensee that such disclosure is to be made: 

 (a) In response to an order of a court, government or governmental body; 
 (b)
Otherwise as required by law; or 
 (c) To the independent public accountants who agree in writing to maintain Confidential
Information in confidence. 
  

	9.3	 Notwithstanding any other provisions of this Agreement, the obligations specified in Section 9.1 of this Agreement will not apply to any
Confidential Information that: 

 (a) is or becomes publicly available without breach of this Agreement;

 (b) is released for disclosure by written consent of Licensor; 

(c) can be shown by written documentation to have already been in Licensor’s or Inventors possession at the time of its receipt from
Licensee; or 
 (d) is disclosed to Licensor or Inventor by a third party without Licensor’s or Inventor’s knowledge of
any breach of any obligation or confidentiality owed to Licensee. 
  

	10.	 MISCELLANEOUS 

  

	10.1	 Licensee and Licensor shall furnish or cause to be furnished to each other and their employees, counsel, auditors and representatives access,
during normal business hours, to such information and assistance relating to the LBT Product (to the extent within the control of such Party) as is reasonably necessary for financial reporting and accounting matters. 

 

	10.2	 Licensor acknowledges that unilateral actions on Nonguaranteed Policy Elements on its Block of Business may have negative implications for the
value of the LBT License granted under this agreement. Therefore, Licensor shall communicate and confer with 

  
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Licensee in any decision process whereby changes are proposed to the Nonguaranteed Policy Elements, as outlined in the Transition Reinsurance Agreement, for any changes proposed in the first 7
years following effective date of this agreement. Proposed changes must be reasonable in relation to the future expectations of the performance of the product on which they are based. Licensor shall provide 180 days notice to Licensee of its
decision to change the Nonguaranteed Policy Elements on the Block of Business. Following such notice, and at Licensee’s request, Licensor shall delay implementation of any proposed change for an additional 6 month period.

  

	10.4	 Licensor shall furnish to Licensee materials identified in Exhibit A relating to the LBT Product in order to create a robust and sustainable
business. Access to such information shall be requested during normal business hours and shall be provided to Licensee within a reasonable timeframe on or around January 1, 2013. 

 

	10.5	 All notices to, demands, consents, and communications that any Party may desire to give to the other, and/or may be required under this
Agreement, must be in writing. The notice shall be effective upon receipt in the United States after having been sent by registered or certified mail or sent by facsimile transmission; and shall be effective upon receipt outside the United States
after having been delivered prepaid to a reputable international delivery service or courier or sent by facsimile transmission; and addressed to the address designated below: 

For notice to Licensor: 
 Mr. James Harkensee 
 Fidelity Life Association 

8700 W. Bryn Mawr Avenue, Suite 9005 

Chicago, IL 60631 
 Fax: (866) 375-8175 
 For notice to Licensee: 

Mr. Chris Martin 
 Combined Insurance 
 1000 N. Milwaukee Avenue 

Glenview, IL 60025 
 Fax: (847) 953-8100 
 or to such address that the Party to whom notices are to be
sent may from time to time designate in writing. 
  

	10.6	 No failure or delay to act upon any default or to exercise any right, power or remedy under this Agreement will operate as a waiver of any
such default, right, power or remedy. 

  
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	10.7	 This Agreement constitutes the entire understanding of the Parties with respect to its subject matter and supersedes all prior oral or written
negotiations, agreements and understandings. This Agreement may not be modified or amended except in writing duly signed by authorized persons on behalf of the Parties. 

 

	10.8	 The validity, construction, interpretation and performance of this Agreement, and any disputes or legal actions arising under or from this
Agreement, shall be governed by the laws and regulations of the United States of America as to patent law, and the State of Illinois as applied to contracts. 

 

	10.9	 Each of the terms and provisions of this Agreement is material. Without such terms and provisions the Parties would not have entered into this
Agreement. If any term or provision of this Agreement is, becomes, or is deemed invalid, illegal or unenforceable under the applicable laws or regulations of the United States or any of its jurisdictions, such term or provision may be amended, by
mutual agreement between Licensor and Licensee, to the extent necessary to conform to applicable laws or regulations without materially altering the intention of the parties or, if it cannot be so amended by good-faith negotiations and agreement
between Licensor and Licensee then this Agreement shall be terminated sixty (60) days following such term or provision becoming or being deemed invalid, illegal or unenforceable. 

 

	10.10	 This Agreement does not constitute either Party the agent of the other Party for any purpose whatsoever, nor does either Party have the right
or authority to assume, create or incur any liability of any kind, express or implied, against or in the name or on behalf of the other Party. 

  

	10.11	 The English language form of this Agreement shall control and determine its interpretation. 

Signature page follows. 

  
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 IN WITNESS WHEREOF, the parties hereto have caused this License Agreement to be executed by
their respective duly authorized officers as of the Effective Date. 
  

			
	FIDELITY LIFE ASSOCIATION, Licensor
		
	By:	 	/s/ Jim Harkensee
	Name:	 	Jim Harkensee
	Title:	 	President & COO
	Date:	 	November 30, 2012

  

			
	 JAMES HARKENSEE, Inventor

		
	By:	 	/s/ Jim Harkensee
	Name:	 	Jim Harkensee
	Title:	 	President & COO
	Date:	 	November 30, 2012

 COMBINED INSURANCE COMPANY OF AMERICA, Licensee 

 

			
	By:	 	/s/ Chris Martin
	Name:	 	Chris Martin
	Title:	 	President, Worksite Solutions
	Date:	 	November 30, 2012

 This Agreement shall not be effective unless an original or a fax copy of this signature page fully executing this
Agreement is received by Licensor within seventy-five (75) Days of the Effective Date. 

  
 10EX-10.11

 Exhibit 10.11 

 
 

 
 Reinsurance Agreement #I486326US-14 

This Automatic Self Administered Coinsurance Reinsurance Agreement 

Effective February 21, 2014 (the “Effective Date”), subject to Exhibit A 

(hereinafter referred to as the “Agreement”) 
 is made
between 
 Fidelity Life Association, A Legal Reserve Life Insurance Company 

an Illinois insurance company 
 (hereinafter referred to as the
“Company”) 
 and 
 Swiss Re Life &
Health America Inc. 
 a Connecticut insurance company 

(hereinafter referred to as the “Reinsurer”) 

  

					
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 Table of Contents 

 

			
	 Article 1

	1.1	  	General
	1.2	  	Scope of Coverage
	
	 Article 2

	2.1	  	Automatic Reinsurance
	2.2	  	Facultative Reinsurance
	
	 Article 3

	3.1	  	Automatic Submissions
	3.2	  	Facultative Submissions
	
	 Article 4

	4.1	  	Commencement of Automatic Reinsurance Liability
	4.2	  	Commencement of Facultative Reinsurance Liability
	4.3	  	Conditional Receipt or Temporary Insurance Agreement Liability
	
	 Article 5

	5.1	  	Premium Accounting
	5.2	  	Currency
	5.3	  	Non-Payment of Premiums
	
	 Article 6

	6.1	  	Right of Offset
	
	 Article 7

	7.1	  	Conversions
	7.2	  	Policy Changes
	7.3	  	Reductions
	7.4	  	Lapses
	7.5	  	Reinstatements
	7.6	  	Reinsurance Limits
	7.7	  	Backdating
	
	 Article 8

	8.1	  	Retention Limit Change
	8.2	  	Recapture
	8.3	  	Waiver of Premium Claims
	
	 Article 9

	9.1	  	Claims Notice and Consultation
	9.2	  	Claims Payment
	9.3	  	Claims Practices
	9.4	  	Contested Claims
	9.5	  	Claims Expenses
	9.6	  	Extra Contractual Obligations
	9.7	  	Misstatement of Age or Sex

  

					
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	 Article 10

	10.1	  	Errors and Omissions in Administration of Reinsurance
	10.2	  	Dispute Resolution
	10.3	  	Arbitration
	10.4	  	Expedited Dispute Resolution Process
	
	 Article 11

	11.1	  	Insolvency
	
	 Article 12

	12.1	  	DAC Tax Election
	12.2	  	Taxes and Expenses
	
	 Article 13

	13.1	  	Entire Agreement
	13.2	  	Inspection of Records
	13.3	  	Utmost Good Faith
	13.4	  	Confidentiality
	13.5	  	OFAC Compliance
	
	 Article 14

	14.1	  	Representations and Warranties
	
	 Article 15

	15.1	  	Business Continuity
	
	 Article 16

	16.1	  	Duration of Agreement
	16.2	  	Severability
	16.3	  	Construction
	16.4	  	Credit for Reinsurance
	16.5	  	Non-Waiver
	16.6	  	Retrocession
	16.7	  	Governing Law
	16.8	  	Interest
	16.9	  	Counterparts
	
	 Article 17

	17.1	  	Financial Conditions
	
	 Execution

	 Exhibits

	A	  	Business Covered
	A-1	  	Business Guidelines
	B	  	Reinsurance Application
	C	  	General Terms
	C-1	  	Rates and Terms for Specific Plans
	D	  	The Company’s Retention Limits
	E	  	Automatic Issue and Acceptance Limits
	F	  	Reinsurance Reports

  

					
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 Article 1 
  

	1.1	 General 

This Agreement is an indemnity reinsurance agreement solely between the Company and the Reinsurer. The acceptance of risks under this Agreement
by the Reinsurer will create no right or legal relation between the Reinsurer and the insured, owner, beneficiary, or assignee of any insurance policy of the Company. 

This Agreement will be binding upon the parties hereto and their respective successors and assigns including any rehabilitator, conservator,
liquidator or statutory successor of either party. Neither party may effect any novation of this Agreement without the other party’s prior written consent. 

Day or days, when used in this Agreement, will mean calendar days. 
  

	1.2	 Scope of Coverage 

This Agreement applies to all directly issued insurance policies and supplemental benefits and riders listed in Exhibit A (hereinafter referred
to as “policies” or “policy”) and issued in a jurisdiction in which the Company is properly licensed. On and after the Effective Date of this Agreement, the Company will cede and the Reinsurer will accept its share of the
benefits specified in Exhibit A in accordance with the terms of this Agreement. The policies accepted by the Reinsurer will be hereinafter referred to as “Reinsured Policies.” 

The Company may not reinsure the retained amounts specified in Exhibit D on any basis without the Reinsurer’s prior written consent. 

This Agreement does not cover the following unless specified elsewhere: 

 

	 	a)	 Noncontractual conversions or group conversions; or 

 

	 	b)	 Policies issued where conventional selection criteria are not applied in underwriting the risk; or

  

	 	c)	 Any conversion of a previously issued policy that had been reinsured with another reinsurer.

 Each Reinsured Policy must provide for the maximum periods of suicide and contestability protection permitted by
applicable law. 

  

					
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 Article 2 
  

	2.1	 Automatic Reinsurance 

The Company will automatically cede and the Reinsurer will automatically accept its share of the Company’s policies provided that, to the
best of the Company’s knowledge: 
  

	 	a)	 The Company has retained on each life the amount set out in Exhibit D according to the age and mortality rating
at the time of underwriting; and 

  

	 	b)	 The total of the new ultimate face amount of reinsurance required, including any contractual increases and the
amount already reinsured on that life under this Agreement and all other life agreements between the Reinsurer and the Company, does not exceed the Automatic Acceptance Limits set out in Exhibit E; and 

 

	 	c)	 The total new ultimate face amount of insurance, including any contractual increases on that life in force with
all companies, including the Company, does not exceed the In Force Limits set out in Exhibit E; and 

  

	 	d)	 The application is on a life for which the current or any previous application had not been submitted by the
Company on a facultative basis to the Reinsurer or any other reinsurer within the last five years, unless the reason for the previous facultative submission was for exceeding Automatic Acceptance Limits or exceeding In Force Limits and no longer
applies; and 

  

	 	e)	 The Policy is not purchased as part of a premium financing program or third party investment program, unless
such programs have been approved in writing by the Reinsurer. 

 For purposes of this Article, “ultimate face
amount” will mean, to the best of the Company’s knowledge, the projected maximum face amount at the time of underwriting, including any contractual increases, that could be reached based on reasonable assumptions made about the policy.

 If the Company is already on the risk for its retention under previously issued policies, the Reinsurer will automatically accept
reinsurance for newly issued policies according to the limits set out in Exhibit E, provided the Company has complied with the business guidelines specified in Exhibit A-1 (hereinafter the “Business
Guidelines”) that would have applied if the new policy had been fully retained by the Company. 
  

	2.2	 Facultative Reinsurance Not applicable. 

 

	2.3	 Exclusions from Automatic Coverage 

Exclusions from automatic coverage under this Agreement shall follow the exclusions in the original policy or rider form. 

  

					
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 Article 3 
  

	3.1	 Automatic Submissions  

The Company will report Reinsured Policies ceded automatically to the Reinsurer according to the terms specified in Exhibit F. 

Upon request, the Company will provide the Reinsurer copies of the application, underwriting papers and other information pertaining to any
automatic cession under this Agreement. 
  

	3.2	 Facultative Submissions  

Not applicable. 

  

					
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 Article 4 
  

	4.1	 Commencement of Automatic Reinsurance Liability 

The Reinsurer’s liability for any Reinsured Policy accepted automatically will begin simultaneously with the Company’s contractual
liability for that policy. 
  

	4.2	 Commencement of Facultative Reinsurance Liability 

Not applicable. 
  

	4.3	 Conditional Receipt or Temporary Insurance Agreement Liability 

Not applicable. 

  

					
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 Article 5 
  

	5.1	 Premium Accounting 

The Company will pay the Reinsurer premiums in accordance with the terms specified in Exhibit C-1. 

The method and requirements for reporting and remitting premiums are specified in Exhibit F. 

 

	5.2	 Currency 

All payments due under this Agreement will be made in U.S. Dollars. 
  

	5.3	 Non-Payment of Premiums 

The payment of reinsurance premiums is a condition to the liability of the Reinsurer for reinsurance provided by this Agreement. If reinsurance
premiums are not paid within 60 days of the due date, the Reinsurer may terminate reinsurance for all Reinsured Policies having reinsurance premiums in arrears. If the Reinsurer elects to terminate any Reinsured Policies after such 60 day period, it
will then give the Company at least 45 days’ prior written notice, to be sent via overnight delivery from a major carrier (Federal Express, USPS, UPS, DHL, etc.) of its intention to terminate such reinsurance. If all reinsurance premiums in
arrears, including any which may become in arrears during such 45 day notice period, are not paid before the end of the notice period, the Reinsurer’s obligations for those Reinsured Policies will be limited to obligations relating to events
arising on or before the last date for which reinsurance premiums have been paid in full for each Reinsured Policy. 
 If reinsurance is
terminated according to this Article, the appropriate amount of benefit reserves to be held in respect of the reinsured amounts being terminated will be paid by the party with the positive balance, determined as of the effective date of termination,
based on U.S. generally accepted accounting principles (“GAAP”) consistent with FASB Accounting Standard Codification Topic 944, Financial Services–Insurance computed using the Reinsurer’s original pricing assumptions without
provision for adverse deviation, less any amount of unamortized deferred acquisition cost assets related thereto and excluding any provisions for adverse deviations or similar deficiency or special reserves net of outstanding balances. 

The Reinsurer’s right to terminate reinsurance will not prejudice its right to collect premiums, and applicable interest as specified in
Exhibit C, for the period reinsurance was in force, through and including the 45 day notice period. 
 The Company may not force termination
through the non-payment of reinsurance premiums to avoid the Agreement’s requirements or to transfer the Reinsured Policies to another party. 

  

					
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 Article 6 
  

	6.1	 Right of Offset 

The Company and the Reinsurer will have the right to offset any undisputed balances, whether on account of premiums, allowances, credits,
claims or otherwise due from one party to the other under this Agreement or under any other reinsurance agreement between the Company and the Reinsurer. 

The rights provided under this Article are in addition to any rights of offset that may exist at common law. The parties’ offset rights
may be enforced notwithstanding any other provision of this Agreement including, without limitation, the provisions of Article 11. 

  

					
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 Article 7 
  

	7.1	 Conversions 

Not applicable. 
  

	7.2	 Policy Changes 

“Policy changes” refers to the variety of actions that may be made to a policy after issue as long as a similar change is made on the
base life policy to which the covered riders, specified in Exhibit A. are attached. These actions include, but are not limited to, replacements, changes in plans, a change in the face amount of the policy or the addition of a covered rider. If there
is a change to the reinsurance on a Reinsured Policy, the Company will inform the Reinsurer in the subsequent Changes and Terminations Report specified in Exhibit F. 

Except as provided in this Article, whenever a Reinsured Policy is changed and the Company’s underwriting guidelines do not require that
full evidence of insurability be obtained, the reinsurance will remain in effect with the Reinsurer, whether the change is made before or after any cancellation of this Agreement for new business. The suicide and contestability periods applicable to
the original Reinsured Policy will apply to the reissued Reinsured Policy and the duration will be measured from the effective date of the original Reinsured Policy. 

Whenever a Reinsured Policy is changed and the Company’s underwriting guidelines require that full evidence of insurability be obtained,
and the suicide and contestability periods are based on the reissued policy date, the reinsurance will remain in effect with the Reinsurer only if the change is made before any cancellation of this Agreement for new business. 

Policy changes to Reinsured Policies will be subject to the Reinsurer’s prior written approval, if: 

 

	 	a)	 The new ultimate face amount of the policy, including any contractual increases, would be in excess of the
Automatic Acceptance Limit in effect at the time of the change, as set out in Exhibit E; or 

  

	 	b)	 The new ultimate face amount of the policy, including any contractual increases, and the amount already in
force in all companies on the same life exceeds the In Force Limits stated in Exhibit E; or 

  

	 	c)	 Evidence of insurability is not obtained if required in the Company’s underwriting guidelines.

 First year premium rates and allowances as specified in Exhibit C-1 will apply
to the amount underwritten for a non-contractual increase. 

  

					
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	7.3	 Reductions 

Unless specified otherwise in this Agreement, if the amount of a Reinsured Policy issued by the Company is reduced and: 

 

	 	a)	 The amount of reinsurance is on an excess basis, then the amount of reinsurance on that life will be reduced
effective the same date by the full amount of the reduction under the original Reinsured Policy. If the amount of insurance terminated equals or exceeds the amount of reinsurance, the full amount of reinsurance will be terminated; or

  

	 	b)	 The amount of reinsurance is on a quota share basis, then the amount of reinsurance on that Reinsured Policy
will be reduced effective the same date by the same proportion as the reduction under the original Reinsured Policy. 

 The
reduction will first apply to any reinsurance on the Reinsured Policy being reduced and then, if applicable, in chronological order according to policy date (“first in, first out”) to any reinsurance on other policies in force on the life.
However, the Company will not be required to assume a risk for an amount in excess of its regular retention for the age at issue and the mortality rating of the policy under which reinsurance is being terminated. 

If the reinsurance for a Reinsured Policy has been placed with more than one reinsurer, the reduction will be applied to all reinsurers pro
rata to the amounts originally reinsured with each reinsurer. 
 A reduction to one of the Company’s policies not reinsured hereunder
will require that the Company maintain its required retention as specified in Exhibit D of this Agreement. 
  

	7.4	 Lapses 

When a policy issued by the Company lapses, after the greater of the number of days for all state mandated grace periods and the number of days
for the Company’s administrative procedures for lapsing policy to take place, the corresponding reinsurance on the Reinsured Policy will be terminated effective the same date. Unless specified otherwise in this Agreement, if a policy fully
retained by the Company lapses, the terms of Article 7.3 will apply. Full retention shall be defined as specified in Exhibit D of this Agreement. 

If a policy issued by the Company lapses and extended term insurance is elected under the terms of that policy, the corresponding reinsurance
on the Reinsured Policy will continue on the same basis as the original Reinsured Policy until the expiry of the extended term period. 
 If
a policy issued by the Company lapses and reduced paid-up insurance is elected under the terms of that policy, the amount of the corresponding reinsurance on the Reinsured Policy will be reduced according to
the terms of Article 7.3. 
 If the Company allows the policy to remain in force under its automatic premium loan regulations, the
corresponding reinsurance on the Reinsured Policy will continue unchanged and in force as long as such regulations remain in effect, except as otherwise provided in this Agreement. 

  

					
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	7.5	 Reinstatements 

If a policy reinsured on an automatic basis is reinstated according to its terms and the Company’s reinstatement rules, the Reinsurer
will, upon notification, automatically reinstate the reinsurance. 
 To the extent the Reinsured Policy requires payment of premiums in
arrears, the Company will pay all reinsurance premiums in arrears on reinstated policies and such premiums will be subject to Article 16.8 and Exhibit F. 
  

	7.6	 Reinsurance Limits 

The Company will not submit a policy to the Reinsurer unless the amount of reinsurance on the policy equals or exceeds the Minimum Initial
Reinsurance Limit ceded to the Reinsurer as specified in Exhibit C. 
  

	7.7	 Backdating 

The Company will have the right to backdate policies up to six (6) months for the purpose of saving age. Such backdated policies will be
covered by this Agreement even if the backdated issue date precedes the effective date of this Agreement. 

  

					
	 I486326US-14 (02-21-2014)
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 Article 8 
  

	8.1	 Retention limit Change 

If the Company changes its retention limit (hereinafter “Retention Limit”), it will provide the Reinsurer with written notice of the
new Retention Limit at least 90 days prior to the effective date. Changes to the Company’s Retention Limits in Exhibit D will not affect the Reinsured Policies in force at the time of such a change except as specifically provided for elsewhere
in this Agreement, and will not affect the Automatic Acceptance Limits in Exhibit E unless mutually agreed in writing by the Company and the Reinsurer. 

If the Company decreases its Retention Limit, no reinsurance may be ceded on an automatic basis until the parties have reviewed and either
expressly affirmed or revised the terms specified in Exhibit C-1 and the Automatic Acceptance Limits set out in Exhibit E. 
  

	8.2	 Recapture 

Reinsured Policies will not be eligible for recapture, whether due to an increase in the Company’s retention or otherwise. The Reinsurer
will consider a request by the Company to recapture, but will agree to the request only if the Company and the Reinsurer agree upon recapture terms. 
  

	8.3	 Waiver of Premium Claims 

Not applicable. 

  

					
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 Article 9 
  

	9.1	 Claims Notice and Consultation 

The Company is responsible for the settlement of claims in accordance with applicable law and policy terms. It is the Company’s sole
decision to determine whether a claim is payable under the policy. For purposes of this Article, Reinsured Policies include conditional receipts and temporary insurance agreements covered under the terms of this Agreement. It is a condition to the
Reinsurer’s obligation to pay a claim that the Company notify the Reinsurer in writing as soon as possible, but in any event not later than 12 months after the Company receives notice of a claim on a Reinsured Policy. The Company will promptly
provide the Reinsurer with copies of all claims documents in its possession. 
 As a condition to the Reinsurer’s obligation to pay a
claim, before making a claim decision or settlement offer, the Company will seek the Reinsurer’s recommendation on such matters to the extent specified in Exhibit C-1. The Reinsurer will promptly make a
recommendation; failing such, the Company may settle the claim without further consultation. The terms of Exhibit C-1 notwithstanding, the Company may request a recommendation from the Reinsurer on any claim
on a Reinsured Policy. The Company will provide the Reinsurer all information in its possession, including underwriting files, reasonably requested by the Reinsurer for consideration of any claim on a Reinsured Policy. 

The Company, if notified, will notify the Reinsurer of deaths that do not trigger policy benefits. 

 

	9.2	 Claims Payment 

The Reinsurer will be liable to the Company for its share of the benefits owed under the express contractual terms of the Reinsured Policies
and as specified under the terms of this Agreement. The Reinsurer will not participate in any ex gratia payments made by the Company (i.e., payments the Company is not required to make under the Reinsured Policy terms.) The payment of death benefits
by the Reinsurer will be in one lump sum regardless of the mode of settlement under the Reinsured Policy. Benefit payments from the Reinsurer will be due within 30 days of the claim satisfying the requirements established under this Agreement. The
Reinsurer’s share of any interest payable under the terms of a Reinsured Policy or applicable law which is based on the death benefits paid by the Company, will be payable provided that the Reinsurer will not be liable for interest accruing on
or after the date of the Company’s payment of benefits. The Reinsurer’s share will be based upon the same interest rate and days used by the Company to calculate their interest paid. 

The Reinsurer will make payment to the Company for each such claim. 

  

					
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	9.3	 Claims Practices 

It is the Company’s sole decision to determine whether to investigate, contest, compromise or litigate a claim; however, the Company is
responsible for investigating, contesting, compromising or litigating Reinsured Policy claims in accordance with applicable law and policy terms. 

The Company acknowledges that it obtains certified death certificates for death claims, and follows industry standard and investigates claims
with any of the following criteria: 
  

	 	a)	 If the claim occurs within the contestable period as defined by the Reinsured Policy; or 

 

	 	b)	 If there is a reasonable question regarding the validity of the insured’s death or the authenticity of the
proofs of death; or 

  

	 	c)	 If the death occurs outside the United States or Canada; or 

 

	 	d)	 If the insured is missing or presumed dead; or 

 

	 	e)	 If there is a reasonable suspicion of fraud. 

A claim investigation generally includes confirming proof of death, medical records to validate the insured’s medical disclosures and, if
material, financial condition at the time of Policy application. Investigations may also include obtaining police reports, coroner’s reports, financial records, or other information that would be appropriate under the circumstances. 

The Company acknowledges that it does defend against claims meeting the following criteria: 

 

	 	f)	 If a material misrepresentation is found in the Policy application and the policy is within the contestable
period; or 

  

	 	g)	 If fraud is found and there is a legal remedy available; or 

 

	 	h)	 If there is insufficient proof of death. 

 

	9.4	 Contested Claims 

The Company will notify the Reinsurer promptly of its intention to investigate, contest, compromise, or litigate any claim involving a
Reinsured Policy (hereinafter a “Contested Claim”). The Company will provide the Reinsurer all relevant information and documents in its possession, as such become available, pertaining to Contested Claims and will promptly report any
developments during the Reinsurer’s review. If the Reinsurer: 
  

	 	a)	 Does not support the contest of the Claim, the Reinsurer will pay the Company its full share of the reinsurance
benefit, and will not share in any subsequent reduction or increase in liability or in any subsequent expenses incurred by the Company; or 

  

					
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	 	b)	 Supports the Company’s decision to contest the claim and the Contested Claim results in a reduction or
increase in liability, the Reinsurer will share in any reduction or increase in proportion to its share of the risk on the Contested Claim. 

If the Reinsurer supports the decision to contest the claim, the Company will promptly advise the Reinsurer of all significant developments it
has been made aware of, including notice of legal proceedings (including, but not limited to, consumer complaints or actions by governmental authorities) initiated in connection with the Contested Claim. 

If the Company returns premiums to the policy owner or beneficiary as a result of rescinding a policy, or if the Company pays a suicide
benefit, the Reinsurer will refund net reinsurance premiums received on that policy to the Company. 
  

	9.5	 Claims Expenses 

The Reinsurer will pay its share of reasonable investigation and legal expenses incurred in investigating, adjudicating or litigating a claim,
except as otherwise provided in this Agreement. The Reinsurer will not be liable for any routine investigative or administrative claim expenses (such as compensation of salaried employees) or for any expenses incurred in connection with conflicting
claims of entitlement to Reinsured Policy benefits that the Company admits are payable. 
  

	9.6	 Extra Contractual Obligations 

For purposes of this Agreement, “Extra Contractual Obligations” are any obligations or expenses other than contractual obligations
incurred by the Company, its affiliates, directors, officers, employees, agents or other representatives and arising under the express written terms and conditions of a policy, including but not limited to, punitive damages, bad faith damages,
compensatory damages, and other damages or fines or penalties which may arise from the acts, errors or omissions of the Company or its affiliates, directors, officers, employees, agents or other representatives. 

The Reinsurer is not liable for Extra Contractual Obligations associated with a contested claim unless it concurred in writing and in advance
with the claim actions which were the basis for the Extra Contractual Obligations or where the claim was contested based on Section 9.3 f, g or h. In these situations, the Company and the Reinsurer will share in Extra Contractual Obligations;
the Reinsurer’s assessments would be in proportion to the risk accepted for the Reinsured Policy involved. 
 The Reinsurer will not be
liable for any Extra Contractual Obligations resulting from the Company’s failure to implement the agreed upon course of action, such as the filing of timely pleadings or meeting court or statutory deadlines, etc. 

  

					
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	9.7	 Misstatement of Age or Sex  

In the event of a change in the amount payable under a Reinsured Policy due to a misstatement in age or sex, the Reinsurer’s liability
will change proportionately. The Reinsured Policy will be rewritten from commencement on the basis of the adjusted amounts using premiums and amounts at risk for the correct ages and sex, and the proper adjustment for the difference in reinsurance
premiums, without interest, will be made. 

  

					
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 Article 10 
  

	10.1	 Errors and Omissions in Administration of Reinsurance 

Any unintentional or accidental failure to comply with the terms of this Agreement which can be shown to be the result of an oversight,
administrative system error, or clerical error relating to the administration of reinsurance by either party will not constitute a breach of this Agreement. Upon discovery, the error will be promptly corrected so that both parties are restored to
the position they would have occupied had the oversight, administrative system error, or clerical error not occurred. In the event a payment is corrected, the party receiving the payment may charge interest, calculated according to the terms
specified in Exhibit C. Should it not be possible to restore both parties to this position, the party responsible for the oversight or clerical error will be responsible for any resulting liabilities and expenses. The Reinsurer will not be
responsible for deliberate acts of the Company or for recurring errors made by the Company. Both parties will use their best efforts to detect any oversight errors, administrative system errors, or clerical errors it believes are occurring, and will
promptly notify the other party of any such errors. 
 If the Company has failed to cede reinsurance as provided under this Agreement or has
failed to comply with reporting requirements with respect to business ceded hereunder, the Reinsurer may require the Company to audit its records for similar errors and take reasonable actions necessary to correct errors and avoid similar errors.
Failing prompt correction, the Reinsurer may limit its liability to the correctly reported Reinsured Policies. 
  

	10.2	 Dispute Resolution 

As a condition to the parties’ right to arbitration under this Agreement, either the Company or the Reinsurer will give written
notification to the other party of any dispute relating to or arising from this Agreement, including, but not limited to, the formation or breach thereof. Within 45 days of notification, both parties must designate an officer of their respective
companies to attempt to resolve the dispute. The officers will meet at a mutually agreeable location as soon as possible and as often as necessary to attempt to negotiate a resolution of the dispute. During the negotiation process, all reasonable
requests made for information concerning the dispute will be promptly honored. The format for discussions will be determined mutually by the officers. 

If these officers are unable to resolve the dispute within 30 days of their first meeting, the parties may agree in writing to extend the
negotiation period for an additional 30 days. If the matter is not resolved within 30 days of the first meeting or the additional 30 day period, if any, then either party may demand arbitration pursuant to Article 10.3. The discussions and all
information exchanged for the purposes of such discussions will be confidential and without prejudice. 
  

	10.3	 Arbitration 

Except with respect to disputes subject to the Expedited Dispute Resolution Process in Article 10.4, if the Company and Reinsurer are unable to
resolve any dispute arising from this Agreement, including but not limited to the formation or breach thereof, pursuant to Article 10.2, the matter will be referred to arbitration. 

  

					
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 The arbitration will be conducted in accordance with the Procedures for Resolution of U.S.
Insurance and Reinsurance Disputes, Neutral Panel Version, April 2004 (the “Procedures”) available at www.arbitrationtaskforce.org, except as modified herein. 

The arbitration will be held in New York City or another place as the parties may mutually agree. The arbitration will be conducted before a
three person Panel qualified as: 
  

	 	a)	 Current or former officers of life insurance or reinsurance companies, or 

 

	 	b)	 Professionals with no less than 10 years of experience in or serving the life insurance or reinsurance
industries. 

 The parties will select such candidates from the ARIAS-US Certified
Arbitrators List available at www.ARIAS-US.org. 
 The customs and practices of the life
insurance and reinsurance industries may be considered by the Panel to resolve any ambiguities in the Agreement but only insofar as such customs and practices are consistent with the terms of this Agreement. The Panel will not have the authority to
award punitive or exemplary damages. 
 The Panel will award the remedy sought by the party seeking relief to the extent the remedy is
provided for in this Agreement or otherwise reasonably compensates the damaged party for the economic effect of any demonstrated breach. Such remedies may include, but will not be limited to, monetary damages, revisions to the terms of the
Agreement, including adjustments to premiums or allowances paid or to be paid, or any combination of the foregoing. 
 The Panel shall issue
an order, appropriate for confirmation in a court of competent jurisdiction, to resolve all matters in dispute. In addition, the Panel shall issue a written opinion setting forth the reasons for the award, with citations to the record of the hearing
that support the reasoning. 
 The decision of the Panel will be final and binding upon the parties and their respective successors and
assigns. Each party hereby consents to the entry of a judgment confirming or enforcing the award in the United States District Court for the Southern District of New York and/or in any other court of competent jurisdiction. 

Within 20 days after the transmittal of an award, either party, upon notice to the other party, may request the Panel to correct any clerical,
typographical, or computational errors in the award. The other party will be given ten days to respond to the request. The Panel will dispose of the request within 20 days of its receipt of such request and any response thereto. The Panel will not
be empowered to re-determine the merits of any claim already decided. 
 Each party will: 

 

	 	c)	 Bear its own fees and expenses in connection with the arbitration, including the fees of any outside counsel
and witness fees, and 

  

	 	d)	 Share equally in the fees for the members of the Panel and the costs of the arbitration, such as hearing rooms,
court reporters, etc. 

  

					
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 It is the intent of the parties that these arbitration provisions replace and be in lieu of
any statutory arbitration provision, if permitted by law. 
  

	10.4	 Expedited Dispute Resolution Process 

The parties agree that the following types of issues and disputes will be subject to arbitration under the expedited procedures set forth in
this Article: 
  

	 	a)	 Any dispute regarding the obligations of the parties with respect to a single Reinsured Policy, regardless of
the amount in controversy; or 

  

	 	b)	 Any dispute in which the amount in controversy, exclusive of interest or costs, is less than $1 million.

 Arbitration proceedings under this Article will be commenced as specified in Article 10.3, and shall be subject to the
requirements of Article 10.3 to the extent they are not inconsistent with this Article. 
 The proceedings will be held before a single
neutral umpire meeting the qualifications set forth in Article 10.3. If the parties are unable to agree on an umpire within 30 days following commencement of the action, the selection will be made pursuant to the Umpire Selection Procedure of the ARIAS-US Certified Arbitrators List available at www.ARIAS-US.org. No ex parte communication will be permitted with the umpire at any time prior to the conclusion of
the proceedings. 
 Within 21 days from the date the selection of the umpire is agreed upon, the parties and umpire will conduct an
organizational meeting by teleconference to familiarize the umpire with the dispute and to set a timetable for submission of briefs. There will be no discovery, and the dispute will be submitted on briefs and documentary evidence only, unless
otherwise agreed by the parties or ordered by the umpire for good cause. 
 Within 30 days of submission of briefs by the parties, the umpire
will render a written award which will be final and binding on the parties. 

  

					
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 Article 11 
  

	11.1	 Insolvency 

A party to this Agreement will be deemed “insolvent” when it: 

 

	 	a)	 Applies for or consents to the appointment of a receiver, rehabilitator, conservator, liquidator or statutory
successor (hereinafter referred to as the Authorized Representative) of its properties or assets; or 

  

	 	b)	 Is adjudicated as bankrupt or insolvent; or 

 

	 	c)	 Files or consents to the filing of a petition in bankruptcy, seeks reorganization or an arrangement with
creditors or takes advantage of any bankruptcy, dissolution, liquidation, rehabilitation, conservation or similar law or statute; or 

  

	 	d)	 Becomes the subject of an order to rehabilitate or an order to liquidate as defined by the insurance code of
the jurisdiction of the party’s domicile. 

 In the event of the insolvency of the Company, all reinsurance ceded,
renewed or otherwise becoming effective under this Agreement will be payable by the Reinsurer directly to the Company or to its Authorized Representative on the basis of the liability of the Company for benefits under the Reinsured Policies without
diminution because of the insolvency of the Company. 
 The Reinsurer will be liable only for benefits reinsured as benefits become due under
the terms of the Reinsured Policies and will not be or become liable for any amounts or reserves to be held by the Company as to the Reinsured Policies or for any damages or payments resulting from the termination or restructure of the Policies that
are not otherwise expressly covered by this Agreement. The Company or its Authorized Representative will give written notice to the Reinsurer of all pending claims against the Company on any Reinsured Policies within a reasonable time after filing
in the insolvency proceedings. While a claim is pending, the Reinsurer may investigate such claim and interpose, at its own expense, in the proceedings where the claim is to be adjudicated, any defense or defenses which it may deem available to the
Company or its Authorized Representative. 
 The expense incurred by the Reinsurer will be chargeable, subject to court approval, against the
Company as part of the expense of its insolvency proceedings to the extent of a proportionate share of the benefit which may accrue to the Company solely as a result of the defense undertaken by the Reinsurer. Where two or more reinsurers are
involved in the same claim and a majority in interest elect to interpose a defense to such claim, the expense will be apportioned in accordance with the terms of the Agreement as though such expense had been incurred by the Company. 

In the event of the insolvency of the Reinsurer, the Company may cancel this Agreement for new business by promptly providing the Reinsurer or
its Authorized Representative with written notice of cancellation, to be effective as of the date on which the Reinsurer’s insolvency is established by the authority responsible for such determination, as long as written notice is provided by
the Reinsurer within 90 days of the action resulting in the insolvency or Reinsurer. 

  

					
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 In addition, in the event of the insolvency of the Reinsurer, the Company may provide the
Reinsurer or its Authorized Representative with written notice of its intent to recapture all reinsurance in force under this Agreement regardless of the duration the reinsurance has been in force or the amount retained by the Company on the
Reinsured Policies. The effective date of a recapture due to insolvency will be at the election of the Company but may not be earlier than the date on which the Reinsurer’s insolvency is established by the authority responsible for such
determination. If the Company elects to recapture reinsurance under this Article, the appropriate amount of benefit reserves to be held in respect of the reinsured amounts being recaptured will be paid by the party with the positive balance,
determined as of the effective date of the recapture, based on U.S. generally accepted accounting principles (“GAAP”) consistent with FASB Accounting Standard Codification Topic 944, Financial Services – Insurance computed using the
Reinsurer’s original pricing assumptions without provision for adverse deviation, less any amount of unamortized deferred acquisition cost assets related thereto and excluding any provisions for adverse deviations or similar deficiency or
special reserves, net of outstanding balances. 
 In the event of the insolvency of either party, the rights or remedies of this Agreement
will remain in full force and effect. 

  

					
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 Article 12 
  

	12.1	 DAC Tax Election (If applicable to the Company) 

The Company and the Reinsurer agree to the election pursuant to Section 1.848-2(g)(8) of the
Income Tax Regulations effective December 29, 1992, under Section 848 of the Internal Revenue Code of 1986, as amended (such election being referred to as the “DAC Tax Election”), whereby: 

 

	 	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 Section 848(c)(1) of the Internal Revenue Code of 1986, as amended (the “Code”); 

 

	 	b)	 The parties agree to exchange information pertaining to the amount of net consideration under this Agreement
each year to ensure consistency. If requested, the Company will provide supporting information reasonably requested by the Reinsurer. (The term “net consideration” means “net consideration” as defined in Regulation Section 1.848-2(f)); 

  

	 	c)	 This DAC Tax Election will be effective for the first taxable year in which this Agreement is effective and for
all years for which this Agreement remains in effect. 

 The Company and the Reinsurer will each attach a schedule to their
respective federal income tax returns filed for the first taxable year for which this DAC Tax Election is effective. Such schedule will identify the Agreement as a reinsurance agreement for which the DAC Tax Election under Regulation Section 1.848-2(g)(8) has been made. 
 The Company and the Reinsurer represent and warrant that each
is respectively subject to U.S. taxation under either the provisions of subchapter L of Chapter 1 or the provisions of subpart F of subchapter N of Chapter 1 of the Code. 
  

	12.2	 Taxes and Expenses 

No taxes, allowances, or expense will be paid by the Reinsurer to the Company for any Reinsured Policy, except as specifically referred to in
this Agreement. 

  

					
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 Article 13 
  

	13.1	 Entire Agreement 

This Agreement and the Exhibits hereto constitute the entire agreement between the parties with respect to the business reinsured hereunder and
supersede any and all prior representations, warranties, prior agreements or understandings between the parties pertaining to the subject matter of this Agreement. There are no understandings between the parties other than as expressed in this
Agreement and the Exhibits hereto. In the event of any express conflict between the Agreement and the Exhibits hereto, the Exhibits hereto will control. 

Any change or modification to this Agreement and the Exhibits hereto will be null and void unless made by written amendment and signed by both
parties. 
  

	13.2	 Inspection of Records 

The Reinsurer or its duly appointed representatives will have access to records of the Company, whether written or electronic, and including
system view access, concerning the business reinsured hereunder for the purpose of inspecting, auditing and photocopying those records. Such access will be provided at the office of the Company and will be during reasonable business hours. Assuming
the Reinsurer has continued to perform the undisputed portion of its obligations under this Agreement, the Company may not withhold access to information and records on the grounds that the Reinsurer is in breach. The Reinsurer will pay all costs
(such salaries of Reinsurer’s employees, costs of any consultants Reinsurer uses, travel costs for any individuals Reinsurer involves, etc.) of any audits it undertakes. 

The Reinsurer’s right of access as specified above will survive until all of the Reinsurer’s obligations under this Agreement have
terminated or been fully discharged. 
  

	13.3	 Utmost Good Faith 

All matters with respect to this Agreement require the utmost good faith of each of the parties. 

 

	13.4	 Confidentiality 

The parties will keep confidential and not disclose or make competitive use of any shared Proprietary Information, as defined below, unless:

  

	 	a)	 The information becomes publicly available or is obtained other than through unauthorized disclosure by the
party seeking to disclose or use such information; 

  

	 	b)	 The information is independently developed by the recipient; 

 

	 	c)	 The disclosure is required for the purpose of any reinsurance, retrocession, securitization, or structured,
asset-backed or asset-based financing; or 

  

	 	d)	 The disclosure is required by law. 

  

					
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 “Proprietary Information” includes, but is not limited to, underwriting manuals
and guidelines, applications, contract forms, and premium rates and allowances of the Reinsurer and the Company, but shall not include the existence of this Agreement and the identity of the parties. Nothing herein shall preclude either party from
using Proprietary Information for ordinary business operations or developing pricing models and actuarial analyses. Additionally, Proprietary Information may be shared by either party on a need-to-know basis with its employees, affiliates, third party service providers, auditors, consultants or retrocessionaires, or in connection with the dispute process specified in this Agreement. 

In addition, the Reinsurer and its representatives and service providers will protect the confidentiality and security of Non-Public Personal Information, as defined below, by: 
  

	 	e)	 Holding all Non-Public Personal Information in strict confidence;

  

	 	f)	 Maintaining appropriate measures that are designed to protect the security, integrity and confidentiality of Non-Public Personal Information; 

  

	 	g)	 Disclosing and using Non-Public Personal Information received under
this Agreement for purposes of carrying out the Reinsurer’s obligations under this Agreement, for purposes of retrocession, or as may be required or permitted by law. 

“Non-Public Personal Information” is personally identifiable medical, financial, and other
personal information about proposed, current and former applicants, policy owners, contract holders, insureds, annuitants, claimants, and beneficiaries of Reinsured Policies or contracts issued by the Company, and their representatives, that is not
publicly available. Non-Public Personal Information does not include de-identified personal data, i.e., information that does not identify, or could not reasonably be
associated with, an individual. 
 The Company will obtain, as required by law, appropriate consents from its insureds to enable the parties
to fully exercise their rights and perform their obligations under this Agreement. 
  

	13.5	 OFAC Compliance 

The parties represent that they are using, and shall use, best efforts to continue to be in compliance with all laws, regulations, judicial and
administrative orders applicable to the Reinsured Policies as they pertain to the sanction laws administered by the U.S. Treasury Department’s Office of Foreign Assets Control (“OFAC”), as such laws may be amended from time to time
(collectively the “Laws”). Neither party shall be required to take any action under this Agreement that would violate said Laws, including, but not limited to, making any payments in violation of the Laws. 

Should either party discover or otherwise become aware that a reinsurance transaction has been entered into or a payment has been made in
violation of the Laws, the party who first becomes aware of the violation of the Laws shall notify the other party, and the parties shall cooperate in order to take all necessary corrective actions. 

  

					
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 The parties agree that such reinsurance transaction shall be null, void and of no effect from its inception,
to the same extent as if the reinsurance transaction had never been entered into. In such event, each party shall be restored to the position it would have occupied if the violation had not occurred, including the return of any payments received,
unless prohibited by law. 

  

					
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 Article 14 
  

	14.1	 Representations and Warranties 

The Company makes no representations and warranties as to the future experience or profitability arising from the Reinsured Policies. 

Each party represents and warrants that as of the Effective Date of this Agreement and at the time of executing this Agreement, if later, it is
solvent on a statutory basis in all states in which it does business or is licensed. 
 “Material” or “materially” for
purposes of Articles 14 and 15 will mean facts that a prudent reinsurer or insurer would consider as reasonably likely to affect the Reinsurer’s experience under the Agreement. Prior to the execution of this Agreement, the Company has provided
to the Reinsurer the Business Guidelines for use in its assessment of the risks covered hereunder. The Company represents and warrants that, to the best of its knowledge: 
  

	 	a)	 It has disclosed to the Reinsurer all information which is material to the risks being assumed hereunder; and

  

	 	b)	 The Business Guidelines were complete and accurate when disclosed; and 

 

	 	c)	 There has been no material change in the Business Guidelines between the “as of” dates of the
information and the date of Agreement execution. 

 This Article will not terminate or expire until all Reinsured Policies
have been discharged or terminated in full. 

  

					
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 Article 15 
  

	15.1	 Business Continuity 

All Reinsured Policies will be issued and administered in accordance with the Business Guidelines. The Company will notify the Reinsurer of any
change that materially affects the reinsured business, including changes to the Business Guidelines. This Agreement will not cover policies affected by such changes unless the Reinsurer has agreed in writing and in advance with the changes.
Outsourcing of underwriting functions, administrative functions or claims administration with respect to the Reinsured Policies will constitute a material change. If the Reinsurer agrees to accept policies affected by the outsourcing, the Company
will secure the Reinsurer’s right to audit and inspect the party performing such outsourced services. 
 If Reinsured Policies are not
covered due to an unapproved material change, all payments between the Company and the Reinsurer with respect to the affected Policies shall be refunded, excluding items relating to reserves or interest on reserves. No liability shall remain with
the Reinsurer with respect to such Policies. 

  

					
	 I486326US-14 (02-21-2014)
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 Article 16 
  

	16.1	 Duration of Agreement 

This Agreement is unlimited as to its duration. 

The Reinsurer or the Company may terminate this Agreement or any plan listed in Exhibit A with respect to the reinsurance of new business by
giving at least 60 days’ written notice of termination to the other party or pursuant to Article 15.1 or Article 17.1 of this Agreement. During the 60 day notification period, the Company will continue to cede and the Reinsurer will continue to
accept policies covered under the terms of this Agreement. 
 In the event the Company terminates the Agreement with respect to new business
within three (3) years after February 21, 2014, the Company will pay the Reinsurer a fee based on the following schedule: 
  

					
	 Termination Within:
	  	Fee	 
	 First twelve months
	  	$	100,000	 
	 Months thirteen through twenty-four
	  	$	50,000	 
	 Months twenty-five through thirty-six
	  	$	25,000	 

 Any fee owed to the Reinsurer under this Article 16.1 will be due on the effective date of termination for new
business. 
 In exchange for product development support provided, the Reinsurer will have a three (3) year exclusive to reinsure the
plans specified in Exhibit A or any plans replacing the same by the Company or an affiliate. If the Reinsurer exercises any contractual rights that have a material impact on new business terms within three (3) years after February 21,
2014, the fee schedule above and the three (3) year reinsurance exclusivity period will no longer be in effect. 
 In the event that the
Company pays the Reinsurer a fee as described above, the three (3) year reinsurance exclusive will no longer apply. 
 The Reinsurer
remains liable for all Reinsured Policies in force as of the date of the termination, until their natural expiration, unless the parties mutually decide otherwise or as specified otherwise in this Agreement. All provisions of this Agreement will
survive its termination to the extent necessary to carry out its purpose. 
  

	16.2	 Severability 

Determination that any provision of this Agreement is invalid or unenforceable will not affect or impair the validity or the enforceability of
the remaining provisions of this Agreement. 

  

					
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	16.3	 Construction 

This Agreement will be construed and administered without regard to authorship and without any presumption or rule of construction in favor of
either party. This Agreement is between sophisticated parties, each of which has reviewed the Agreement and is fully knowledgeable about its terms and conditions. 
  

	16.4	 Credit for Reinsurance 

The parties intend that the Company will receive statutory reserve credit in its state of domicile for reinsurance provided under this
Agreement. The parties agree to use reasonable efforts to ensure that such reserve credit will remain available to the Company. 
  

	16.5	 Non-Waiver 

A waiver by either party of any violation, or the default by the other party in its adherence to any term of this Agreement, will not
constitute a waiver of any other or subsequent violation or default. No prior transaction or dealing between the parties will establish any custom, usage or precedent waiving or modifying any provision of the Agreement. The failure of either party
to enforce any part of this Agreement will not constitute a waiver of any right to do so. 
  

	16.6	 Retrocession 

The Reinsurer may reinsure or retrocede any risks or business assumed hereunder. 

 

	16.7	 Governing Law 

This Agreement shall be governed by the laws of the State of Illinois. 

 

	16.8	 Interest 

Each party reserves the right to charge interest on undisputed overdue balances, pursuant to the terms of this Agreement. If applicable,
interest will be calculated according to the terms specified in Exhibit C. 
  

	16.9	 Counterparts 

This Agreement may be executed in any number of counterparts, all of which taken together shall constitute one Agreement, and any of the
parties hereto may execute this Agreement by signing any such counterpart. When this Agreement has been fully executed by the Company and the Reinsurer, it will become effective as of the Effective Date specified in Exhibit A. 

  

					
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 Article 17 
  

	17.1	 Financial Conditions 

If the Company’s surplus falls below 300% of the authorized control level, as such RBC control level is defined at inception of this
Agreement, or the Company’s statutory capital and surplus falls below $100,000,000, then the following actions will occur: 
  

	 	a)	 The Reinsurer’s right to terminate this Agreement for new business will be reduced from sixty
(60) days to thirty (30) days. 

  

	 	b)	 For new business written after the trigger event, the allowance structure will move to that outlined in Exhibit
C-1, Section 14.c, Reinsurance Allowance Structure. 

 The Company agrees to
notify the Reinsurer within fifteen (15) business days of the occurrence of a triggering event. In addition, the Company agrees to provide quarterly estimates of RBC control level and statutory capital and surplus levels. 

  

					
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 Execution 

This Agreement has been made in duplicate and hereby executed by both parties. 

Signed for and on behalf of Fidelity Life Association, A Legal Reserve Life Insurance Company  

 

									
	By:	 	/s/ Jim Harkensee	 		 	By:	 	/s/ Chris Kim
					
	Title:	 	President & COO	 		 	Title:	 	CAO
					
	Date:	 	6/16/2014	 		 	Date:	 	6/16/2014

 Signed for and on behalf of Swiss Re Life & Health America Inc.  

 

									
	By:	 	UNDICIPHERABLE	 		 	By:	 	UNDICIPHERABLE
					
	Title:	 	SVP	 		 	Title:	 	VP
					
	Date:	 	5/30/2014	 		 	Date:	 	5/30/2014

  

					
	 I486326US-14 (02-21-2014)
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 Exhibit A 

Business Covered 
 Agreement Effective Date: 

February 21, 2014. The commencement dates for specific plans are shown below. 

Coverage: 
 The policies and riders on the plans shown
below which have policy issue dates falling in the period that begins with the Commencement Date and ends with the Termination Date and that qualify for automatic reinsurance are covered according to the Basis specified below, provided that the
policies are issued to citizens of the United States or legal permanent residents thereof. 
 Basis: 

 

	1.	 80% on a First Dollar Quota Share basis (100% of the total reinsurance) to the maximum Automatic Acceptance
Limits stated in Exhibit E, applicable to policies on lives with surnames commencing with the letters A to Z inclusive. 

Company’s State of Domicile: Illinois 
 Plans,
Riders and Benefits: 
  

											
	 Plan
 Identification
	  	 Exhibit Reference

for Rates
	  	Basis No.	  	 Commencement

Date
	  	 Termination

Date
	 
	 Simplified Issue Final Expense Whole Life to Age 121 (Level Death Benefit)
	  	C-1	  	1.	  	February 21, 2014	  			
	 Accelerated Death Benefit Rider (Terminal Illness)
	  	C-1	  	1.	  	February 21, 2014	  			
	 Guaranteed Issue Graded Benefit Whole Life to Age 121
	  	C-1	  	1.	  	February 21, 2014	  			
	 Accelerated Death Benefit Rider (Terminal Illness)
	  	C-1	  	1.	  	February 21, 2014	  			

  

					
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 Exhibit A-1 

Business Guidelines 
 The Company affirms that the
following have been supplied to the Reinsurer and are in use as of the effective date of this Agreement: 
  

	1.	 Policy Form(s) 

F3010 Accelerated Death Benefit Rider.pdf 

FLA Policy Form – Final Expense (ICC13 F3300).pdf 

FLA Policy Form – Guar Issue GDB (ICC12-F3200-02).pdf 

 

	2.	 Policy Application Form(s) 

FLA_ICC13-F1008E_2013-11-20_2.docx (Final Expense-only App for
the Compact) 
 New Universal Application (SRE only) 20131120.docx (Common App) 

 

	3.	 Premium Rates 

Final Expense Premiums - Second Cut 2013-07-03.xlsx 

GDB Premiums - Second Cut 2013-10-01.xlsx 

FLA_SIFE_AdminFactors_CSV.xls 

FLA_Gl_GDB_AdminFactors_CSV.xls 
  

	4.	 Underwriting Guidelines/Rules 

RD Sr Life UW Guidelines August 2013.doc 

Build Chart - RDSL.docx 

  

					
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 Exhibit B 

Reinsurance Application 
 Not applicable. 

  

					
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 Exhibit C 

General Terms 
  

	1.	 Premium Tax: 

The Reinsurer will not reimburse the Company for premium taxes. 
  

	2.	 Dividend Payments: 

The Reinsurer will not reimburse the Company for dividends paid to policyholders. 

 

	3.	 Policy Loans: The Reinsurer will not participate in policy loans or other forms of indebtedness as
respects the Reinsured Policies. 

  

	4.	 Cash Surrender Values: 

The Reinsurer will reimburse the Company for the Reinsurer’s proportionate share of cash surrender values paid to the policyholder. 

 

	5.	 Reinsurance Limits: 

Minimum Initial Reinsurance Limit ceded to the Reinsurer: $0 

Minimum Final Reinsurance Limit ceded to the Reinsurer: $0 
  

	6.	 Interest Calculation on late Payments: Interest will accrue from the due date at a rate equal to
the Three Month London Interbank Offering Rate (LIBOR) as published in the Wall Street Journal (or if not available, a comparable publication) on the due date or, if the due date is not a business day, on the next business day after the due date,
plus 50 basis points per annum to be compounded and adjusted every three months after such due date. 

  

	7.	 Rates Applicable to Increases: Non-contractual increases which
are underwritten consistently with the Business Guidelines and have the same sales compensation paid as a new issue will be reinsured as a new issue. First year reinsurance premium rates and allowances will apply. 

  

					
	 I486326US-14 (02-21-2014)
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 Exhibit C-1 

Rates and Terms for Simplified Issue Final Expense Whole Life to Age 121 (Level Death Benefit) and Guaranteed Issue Graded Benefit Whole Life to Age 121

  

	1.	 Reinsurance Structure: Coinsurance 

 

	2.	 Age Basis: Age Last Birthday 

 

	3.	 Premium Mode: Reinsurance premium mode will follow the premium mode of the underlying policy, with the
Reinsurer collecting its proportionate share of policy fees and modal loads. 

  

	4.	 Billing Frequency: Monthly 

 

	5.	 Premiums: 

Basic Premiums: 
 The
Company will pay to the Reinsurer a basic premium calculated by multiplying the net amount at risk of the Reinsured Policy, as defined in the Net Amounts At Risk provision of this Exhibit, by the appropriate rate from the set of rates included at
the end of this Exhibit, subject to the allowances shown below. The Company will continue to pay the appropriate premium to the Reinsurer as long as the Reinsured Policy is in force. 

The Reinsurer will pay the following allowances to the Company on the premiums payable hereunder: 

Simplified Issue Final Expense Whole Life to Age 121 (Level Death Benefit): 

 

					
	 Issue Age
	  	First Year	 	Durations 2+
	50 – 85	  	140%	 	23%

 Guaranteed Issue Graded Benefit Whole Life to Age 121: 

 

					
	 Issue Age
	  	First Year	 	Durations 2+
	50 – 79	  	110%	 	9%
	80 – 85	  	110%	 	5%

 Table Extra Premiums/Multiple Extra Premiums: 

Not applicable. 
 Supplementary
Rider(s): 
 The Terminal Illness Rider specified in Exhibit A will be reinsured at no additional cost to the Company. 

  

					
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 Exhibit C-1 

Page 2 
  

	6.	 Other Allowances: 

On Multiple Extra Premiums: Not applicable 

On Supplementary Riders: Not applicable 

On Flat Extra Premiums: Not applicable. 
  

	7.	 Policy Fee: 

The Company will pay the Reinsurer its share of the annual policy fee, subject to the same allowances applicable to that basic Reinsured
Policy. 
  

	8.	 Reinsured Net Amounts At Risk: 

The net amount at risk will be based on the policy face amount, as shown in the policy. 

 

	9.	 Rate Basis: 

The rates in this subsection are on a non-participating basis. 

 

	10.	 Rate Guarantee: The Company’s direct premiums are fully guaranteed for the life of the policy.
Likewise, the reinsurance allowances set out in this Exhibit are guaranteed for the life of the policy. 

  

	11.	 Minimum Recapture Period: 

Recapture not available. 
  

	12.	 YRT Rates for Conversions: 

Not applicable. 
  

	13.	 Conditions Requiring Claims Consultation: Before conceding liability or making settlement to the
claimant, the Company will seek the Reinsurer’s recommendation if: 

  

	 	a)	 The claim occurs during the contestable period and the Company is not contesting the claim; or

  

	 	b)	 The death occurs outside of the United States or Canada; or 

 

	 	c)	 The claim is one for which there is no body, i.e. the insured is missing and presumed dead.

  

					
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 Exhibit C-1 

Page 3 
  

	14.	 Special Conditions: 

 

	 	a)	 Volume Limitations: This Agreement has been approved for new business issued from February 21, 2014
forward, subject to a volume cap on new business issues of $200,000,000 in any calendar year. If new business issues reach this limit, then all additional new business will move to the Reinsurance Allowance Structure described in Section 14.c
below. 

  

	 	b)	 Administration: The Company and the Reinsurer agree to exercise best efforts to get reinsurance
administration fully implemented prior to June 30, 2014. If reinsurance administration is not in place by September 30, 2014, all future reinsurance will move to the Reinsurance Allowance Structure described in Section 14.c below.

  

	 	c)	 Reinsurance Allowance Structure: If any of the conditions described in 

 

	 	i)	 Article 17.1, Financial Conditions, or 

 

	 	ii)	 Exhibit C-1, Section 14.a, Volume Limitations, or

  

	 	iii)	 Exhibit C-1, Section 14.b, Administration 

are met, the following Reinsurance Allowance Structure will be used: 

Simplified Issue Final Expense Whole life to Age 121 (Level Death Benefit): 

 

					
	 Issue Age
	  	First Year	 	Durations 2+
	50 – 85	  	100%	 	30%

 Guaranteed Issue Graded Benefit Whole Life to Age 121: 

 

					
	 issue Age
	  	First Year	 	Durations 2+
	50 – 79	  	100%	 	11%
	80 – 85	  	100%	 	7%

  

					
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 FLA Pricing Results - Final Expense Premiums 

6/27/2013 
  

															
	 Key
	  	Gender	  	Class	  	Band	  	Term	  	Age	  	Prem Rate	 
	 M_StdNT_0_WL_50
	  	M	  	StdNT	  	0	  	WL	  	50	  	 	38.68	 
	 M_StdNT_0_WL_51
	  	M	  	StdNT	  	0	  	WL	  	51	  	 	40.29	 
	 M_StdNT_0_WL_52
	  	M	  	StdNT	  	0	  	WL	  	52	  	 	41.90	 
	 M_StdNT_0_WL_53
	  	M	  	StdNT	  	0	  	WL	  	53	  	 	43.51	 
	 M_StdNT_0_WL_54
	  	M	  	StdNT	  	0	  	WL	  	54	  	 	45.11	 
	 M_StdNT_0_WL_55
	  	M	  	StdNT	  	0	  	WL	  	55	  	 	46.72	 
	 M_StdNT_0_WL_56
	  	M	  	StdNT	  	0	  	WL	  	56	  	 	48.33	 
	 M_StdNT_0_WL_57
	  	M	  	StdNT	  	0	  	WL	  	57	  	 	49.94	 
	 M_StdNT_0_WL_58
	  	M	  	StdNT	  	0	  	WL	  	58	  	 	51.55	 
	 M_StdNT_0_WL_59
	  	M	  	StdNT	  	0	  	WL	  	59	  	 	53.16	 
	 M_StdNT_0_WL_60
	  	M	  	StdNT	  	0	  	WL	  	60	  	 	54.77	 
	 M_StdNT_0_WL_61
	  	M	  	StdNT	  	0	  	WL	  	61	  	 	57.07	 
	 M_StdNT_0_WL_62
	  	M	  	StdNT	  	0	  	WL	  	62	  	 	59.37	 
	 M_StdNT_0_WL_63
	  	M	  	StdNT	  	0	  	WL	  	63	  	 	61.67	 
	 M_StdNT_0_WL_64
	  	M	  	StdNT	  	0	  	WL	  	64	  	 	63.97	 
	 M_StdNT_0_WL_65
	  	M	  	StdNT	  	0	  	WL	  	65	  	 	66.26	 
	 M_StdNT_0_WL_66
	  	M	  	StdNT	  	0	  	WL	  	66	  	 	69.83	 
	 M_StdNT_0_WL_67
	  	M	  	StdNT	  	0	  	WL	  	67	  	 	73.39	 
	 M_StdNT_0_WL_68
	  	M	  	StdNT	  	0	  	WL	  	68	  	 	76.95	 
	 M_StdNT_0_WL_69
	  	M	  	StdNT	  	0	  	WL	  	69	  	 	80.52	 
	 M_StdNT_0_WL_70
	  	M	  	StdNT	  	0	  	WL	  	70	  	 	84.08	 
	 M_StdNT_0_WL_71
	  	M	  	StdNT	  	0	  	WL	  	71	  	 	90.40	 
	 M_StdNT_0_WL_72
	  	M	  	StdNT	  	0	  	WL	  	72	  	 	96.72	 
	 M_StdNT_0_WL_73
	  	M	  	StdNT	  	0	  	WL	  	73	  	 	103.05	 
	 M_StdNT_0_WL_74
	  	M	  	StdNT	  	0	  	WL	  	74	  	 	109.37	 
	 M_StdNT_0_WL_75
	  	M	  	StdNT	  	0	  	WL	  	75	  	 	115.69	 
	 M_StdNT_0_WL_76
	  	M	  	StdNT	  	0	  	WL	  	76	  	 	125.34	 
	 M_StdNT_0_WL_77
	  	M	  	StdNT	  	0	  	WL	  	77	  	 	135.00	 
	 M_StdNT_0_WL_78
	  	M	  	StdNT	  	0	  	WL	  	78	  	 	144.66	 
	 M_StdNT_0_WL_79
	  	M	  	StdNT	  	0	  	WL	  	79	  	 	154.31	 
	 M_StdNT_0_WL_80
	  	M	  	StdNT	  	0	  	WL	  	80	  	 	163.97	 
	 M_StdNT_0_WL_81
	  	M	  	StdNT	  	0	  	WL	  	81	  	 	178.45	 
	 M_StdNT_0_WL_82
	  	M	  	StdNT	  	0	  	WL	  	82	  	 	192.93	 
	 M_StdNT_0_WL_83
	  	M	  	StdNT	  	0	  	WL	  	83	  	 	207.41	 
	 M_StdNT_0_WL_84
	  	M	  	StdNT	  	0	  	WL	  	84	  	 	221.90	 
	 M_StdNT_0_WL_85
	  	M	  	StdNT	  	0	  	WL	  	85	  	 	236.38	 
	 M_StdT_0_WL_50
	  	M	  	StdT	  	0	  	WL	  	50	  	 	52.52	 
	 M_StdT_0_WL_51
	  	M	  	StdT	  	0	  	WL	  	51	  	 	54.86	 
	 M_StdT_0_WL_52
	  	M	  	StdT	  	0	  	WL	  	52	  	 	57.20	 
	 M_StdT_0_WL_53
	  	M	  	StdT	  	0	  	WL	  	53	  	 	59.54	 

															
	 Key
	  	Gender	  	Class	  	Band	  	Term	  	Age	  	Prem Rate	 
	 M_StdT_0_WL_54
	  	M	  	StdT	  	0	  	WL	  	54	  	 	61.88	 
	 M_StdT_0_WL_55
	  	M	  	StdT	  	0	  	WL	  	55	  	 	64.22	 
	 M_StdT_0_WL_56
	  	M	  	StdT	  	0	  	WL	  	56	  	 	66.56	 
	 M_StdT_0_WL_57
	  	M	  	StdT	  	0	  	WL	  	57	  	 	68.90	 
	 M_StdT_0_WL_58
	  	M	  	StdT	  	0	  	WL	  	58	  	 	71.37	 
	 M_StdT_0_WL_59
	  	M	  	StdT	  	0	  	WL	  	59	  	 	73.84	 
	 M_StdT_0_WL_60
	  	M	  	StdT	  	0	  	WL	  	60	  	 	76.31	 
	 M_StdT_0_WL_61
	  	M	  	StdT	  	0	  	WL	  	61	  	 	80.16	 
	 M_StdT_0_WL_62
	  	M	  	StdT	  	0	  	WL	  	62	  	 	84.02	 
	 M_StdT_0_WL_63
	  	M	  	StdT	  	0	  	WL	  	63	  	 	87.87	 
	 M_StdT_0_WL_64
	  	M	  	StdT	  	0	  	WL	  	64	  	 	91.72	 
	 M_StdT_0_WL_65
	  	M	  	StdT	  	0	  	WL	  	65	  	 	95.57	 
	 M_StdT_0_WL_66
	  	M	  	StdT	  	0	  	WL	  	66	  	 	100.52	 
	 M_StdT_0_WL_67
	  	M	  	StdT	  	0	  	WL	  	67	  	 	105.46	 
	 M_StdT_0_WL_68
	  	M	  	StdT	  	0	  	WL	  	68	  	 	110.40	 
	 M_StdT_0_WL_69
	  	M	  	StdT	  	0	  	WL	  	69	  	 	115.34	 
	 M_StdT_0_WL_70
	  	M	  	StdT	  	0	  	WL	  	70	  	 	120.29	 
	 M_StdT_0_WL_71
	  	M	  	StdT	  	0	  	WL	  	71	  	 	129.71	 
	 M_StdT_0_WL_72
	  	M	  	StdT	  	0	  	WL	  	72	  	 	139.14	 
	 M_StdT_0_WL_73
	  	M	  	StdT	  	0	  	WL	  	73	  	 	148.56	 
	 M_StdT_0_WL_74
	  	M	  	StdT	  	0	  	WL	  	74	  	 	157.99	 
	 M_StdT_0_WL_75
	  	M	  	StdT	  	0	  	WL	  	75	  	 	167.41	 
	 M_StdT_0_WL_76
	  	M	  	StdT	  	0	  	WL	  	76	  	 	177.76	 
	 M_StdT_0_WL_77
	  	M	  	StdT	  	0	  	WL	  	77	  	 	188.10	 
	 M_StdT_0_WL_78
	  	M	  	StdT	  	0	  	WL	  	78	  	 	198.45	 
	 M_StdT_0_WL_79
	  	M	  	StdT	  	0	  	WL	  	79	  	 	208.79	 
	 M_StdT_0_WL_80
	  	M	  	StdT	  	0	  	WL	  	80	  	 	219.14	 
	 M_StdT_0_WL_81
	  	M	  	StdT	  	0	  	WL	  	81	  	 	238.68	 
	 M_StdT_0_WL_82
	  	M	  	StdT	  	0	  	WL	  	82	  	 	258.22	 
	 M_StdT_0_WL_83
	  	M	  	StdT	  	0	  	WL	  	83	  	 	277.76	 
	 M_StdT_0_WL_84
	  	M	  	StdT	  	0	  	WL	  	84	  	 	297.30	 
	 M_StdT_0_WL_85
	  	M	  	StdT	  	0	  	WL	  	85	  	 	316.84	 
	 F_StdNT_0_WL_50
	  	F	  	StdNT	  	0	  	WL	  	50	  	 	28.62	 
	 F_StdNT_0_WL_51
	  	F	  	StdNT	  	0	  	WL	  	51	  	 	29.83	 
	 F_StdNT_0_WL_52
	  	F	  	StdNT	  	0	  	WL	  	52	  	 	31.03	 
	 F_StdNT_0_WL_53
	  	F	  	StdNT	  	0	  	WL	  	53	  	 	32.24	 
	 F_StdNT_0_WL_54
	  	F	  	StdNT	  	0	  	WL	  	54	  	 	33.45	 
	 F_StdNT_0_WL_55
	  	F	  	StdNT	  	0	  	WL	  	55	  	 	34.66	 
	 F_StdNT_0_WL_56
	  	F	  	StdNT	  	0	  	WL	  	56	  	 	36.15	 
	 F_StdNT_0_WL_57
	  	F	  	StdNT	  	0	  	WL	  	57	  	 	37.64	 
	 F_StdNT_0_WL_58
	  	F	  	StdNT	  	0	  	WL	  	58	  	 	39.14	 
	 F_StdNT_0_WL_59
	  	F	  	StdNT	  	0	  	WL	  	59	  	 	40.63	 
	 F_StdNT_0_WL_60
	  	F	  	StdNT	  	0	  	WL	  	60	  	 	42.13	 

															
	 Key
	  	Gender	  	Class	  	Band	  	Term	  	Age	  	Prem Rate	 
	 F_StdNT_0_WL_61
	  	F	  	StdNT	  	0	  	WL	  	61	  	 	44.20	 
	 F_StdNT_0_WL_62
	  	F	  	StdNT	  	0	  	WL	  	62	  	 	46.26	 
	 F_StdNT_0_WL_63
	  	F	  	StdNT	  	0	  	WL	  	63	  	 	48.33	 
	 F_StdNT_0_WL_64
	  	F	  	StdNT	  	0	  	WL	  	64	  	 	50.40	 
	 F_StdNT_0_WL_65
	  	F	  	StdNT	  	0	  	WL	  	65	  	 	52.47	 
	 F_StdNT_0_WL_66
	  	F	  	StdNT	  	0	  	WL	  	66	  	 	55.23	 
	 F_StdNT_0_WL_67
	  	F	  	StdNT	  	0	  	WL	  	67	  	 	57.99	 
	 F_StdNT_0_WL_68
	  	F	  	StdNT	  	0	  	WL	  	68	  	 	60.75	 
	 F_StdNT_0_WL_69
	  	F	  	StdNT	  	0	  	WL	  	69	  	 	63.51	 
	 F_StdNT_0_WL_70
	  	F	  	StdNT	  	0	  	WL	  	70	  	 	66.26	 
	 F_StdNT_0_WL_71
	  	F	  	StdNT	  	0	  	WL	  	71	  	 	70.54	 
	 F_StdNT_0_WL_72
	  	F	  	StdNT	  	0	  	WL	  	72	  	 	74.82	 
	 F_StdNT_0_WL_73
	  	F	  	StdNT	  	0	  	WL	  	73	  	 	79.10	 
	 F_StdNT_0_WL_74
	  	F	  	StdNT	  	0	  	WL	  	74	  	 	83.38	 
	 F_StdNT_0_WL_75
	  	F	  	StdNT	  	0	  	WL	  	75	  	 	87.66	 
	 F_StdNT_0_WL_76
	  	F	  	StdNT	  	0	  	WL	  	76	  	 	95.11	 
	 F_StdNT_0_WL_77
	  	F	  	StdNT	  	0	  	WL	  	77	  	 	102.55	 
	 F_StdNT_0_WL_78
	  	F	  	StdNT	  	0	  	WL	  	78	  	 	110.00	 
	 F_StdNT_0_WL_79
	  	F	  	StdNT	  	0	  	WL	  	79	  	 	117.44	 
	 F_StdNT_0_WL_80
	  	F	  	StdNT	  	0	  	WL	  	80	  	 	124.89	 
	 F_StdNT_0_WL_81
	  	F	  	StdNT	  	0	  	WL	  	81	  	 	136.38	 
	 F_StdNT_0_WL_82
	  	F	  	StdNT	  	0	  	WL	  	82	  	 	147.87	 
	 F_StdNT_0_WL_83
	  	F	  	StdNT	  	0	  	WL	  	83	  	 	159.37	 
	 F_StdNT_0_WL_84
	  	F	  	StdNT	  	0	  	WL	  	84	  	 	170.86	 
	 F_StdNT_0_WL_85
	  	F	  	StdNT	  	0	  	WL	  	85	  	 	182.36	 
	 F_StdT_0_WL_50
	  	F	  	StdT	  	0	  	WL	  	50	  	 	42.77	 
	 F_StdT_0_WL_51
	  	F	  	StdT	  	0	  	WL	  	51	  	 	44.46	 
	 F_StdT_0_WL_52
	  	F	  	StdT	  	0	  	WL	  	52	  	 	46.15	 
	 F_StdT_0_WL_53
	  	F	  	StdT	  	0	  	WL	  	53	  	 	47.84	 
	 F_StdT_0_WL_54
	  	F	  	StdT	  	0	  	WL	  	54	  	 	49.53	 
	 F_StdT_0_WL_55
	  	F	  	StdT	  	0	  	WL	  	55	  	 	51.22	 
	 F_StdT_0_WL_56
	  	F	  	StdT	  	0	  	WL	  	56	  	 	52.91	 
	 F_StdT_0_WL_57
	  	F	  	StdT	  	0	  	WL	  	57	  	 	54.60	 
	 F_StdT_0_WL_58
	  	F	  	StdT	  	0	  	WL	  	58	  	 	56.68	 
	 F_StdT_0_WL_59
	  	F	  	StdT	  	0	  	WL	  	59	  	 	58.76	 
	 F_StdT_0_WL_60
	  	F	  	StdT	  	0	  	WL	  	60	  	 	60.84	 
	 F_StdT_0_WL_61
	  	F	  	StdT	  	0	  	WL	  	61	  	 	62.92	 
	 F_StdT_0_WL_62
	  	F	  	StdT	  	0	  	WL	  	62	  	 	65.00	 
	 F_StdT_0_WL_63
	  	F	  	StdT	  	0	  	WL	  	63	  	 	68.40	 
	 F_StdT_0_WL_64
	  	F	  	StdT	  	0	  	WL	  	64	  	 	71.80	 
	 F_StdT_0_WL_65
	  	F	  	StdT	  	0	  	WL	  	65	  	 	75.20	 
	 F_StdT_0_WL_66
	  	F	  	StdT	  	0	  	WL	  	66	  	 	78.60	 
	 F_StdT_0_WL_67
	  	F	  	StdT	  	0	  	WL	  	67	  	 	82.00	 

															
	 Key
	  	Gender	  	Class	  	Band	  	Term	  	Age	  	Prem Rate	 
	 F_StdT_0_WL_68
	  	F	  	StdT	  	0	  	WL	  	68	  	 	84.58	 
	 F_StdT_0_WL_69
	  	F	  	StdT	  	0	  	WL	  	69	  	 	87.16	 
	 F_StdT_0_WL_70
	  	F	  	StdT	  	0	  	WL	  	70	  	 	89.74	 
	 F_StdT_0_WL_71
	  	F	  	StdT	  	0	  	WL	  	71	  	 	95.91	 
	 F_StdT_0_WL_72
	  	F	  	StdT	  	0	  	WL	  	72	  	 	102.07	 
	 F_StdT_0_WL_73
	  	F	  	StdT	  	0	  	WL	  	73	  	 	108.24	 
	 F_StdT_0_WL_74
	  	F	  	StdT	  	0	  	WL	  	74	  	 	114.41	 
	 F_StdT_0_WL_75
	  	F	  	StdT	  	0	  	WL	  	75	  	 	120.57	 
	 F_StdT_0_WL_76
	  	F	  	StdT	  	0	  	WL	  	76	  	 	127.64	 
	 F_StdT_0_WL_77
	  	F	  	StdT	  	0	  	WL	  	77	  	 	134.71	 
	 F_StdT_0_WL_78
	  	F	  	StdT	  	0	  	WL	  	78	  	 	141.78	 
	 F_StdT_0_WL_79
	  	F	  	StdT	  	0	  	WL	  	79	  	 	148.85	 
	 F_StdT_0_WL_80
	  	F	  	StdT	  	0	  	WL	  	80	  	 	155.92	 
	 F_StdT_0_WL_81
	  	F	  	StdT	  	0	  	WL	  	81	  	 	172.01	 
	 F_StdT_0_WL_82
	  	F	  	StdT	  	0	  	WL	  	82	  	 	188.10	 
	 F_StdT_0_WL_83
	  	F	  	StdT	  	0	  	WL	  	83	  	 	204.20	 
	 F_StdT_0_WL_84
	  	F	  	StdT	  	0	  	WL	  	84	  	 	220.29	 
	 F_StdT_0_WL_85
	  	F	  	StdT	  	0	  	WL	  	85	  	 	236.38	 

 Exhibit D 

The Company’s Retention Limits 
 Life: 

The Company will retain 20% of each Reinsured Policy, not to exceed its Retention Limits stated below. This applies to all business reinsured under this
Agreement. 
  

			
	 Issue Ages
	  	Preferred/Standard to Table D
	16 – 75	  	$300,000

 It is understood that the amount retained by the Company includes its retention under any in force policies without the
benefit of other reinsurance. 
 Any change in the net amount at risk due to changes in the cash value applicable to the policy will be shared
proportionately between the Company and its reinsurers. 

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit E 

Automatic Issue and Acceptance Limits 
 The Reinsurer will
automatically accept 80% of each Policy, not to exceed the limits specified below on a per life basis. If the Company has filled its maximum retention on the life as specified in Exhibit D, the percentage the Reinsurer will automatically accept will
increase to 100%, but the limits stated below will not change. 
  

					
	 Simplified Issue Final Expense Whole Life to Age 121 (Level Death Benefit):
	  	$	35,000	 
		
	 Guaranteed Issue Graded Benefit Whole Life to Age 121:
	  	$	20,000	 

 In Force Limits: 
 In
force and applied for on any one life: $300,000 
 Conditional Receipt or Temporary Insurance Agreement Liability: Not applicable 

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit F 

Reinsurance Reports 
 The Company acknowledges that timely
and correct compliance with the reporting requirements of this Agreement are a material element of the Company’s responsibilities hereunder and an important basis of the Reinsurer’s ability to reinsure the risks hereunder. Consistent and
material non-compliance with reporting requirements, including extended delays, will constitute a material breach of the terms of this Agreement. 

Remittance Reporting: 
 The Company will self-administer
reinsurance transactions. Reinsurance premiums are payable as specified in the Premium Mode provision of Exhibit C-1. During each accounting period, as defined below, the Company will report to the Reinsurer
all first year and renewal premiums which became due during the previous accounting period. Reporting of business transactions should begin within 90 days of the latter of the effective date or the execution date of the Agreement, including policies
with zero first year premium. Any adjustments made necessary by changes in reinsurance effective during a previous accounting period will also be reported. 

The Company will take credit, without interest, for any unearned premiums arising due to reductions, cancellations or death claims. The unearned premiums
refunded will be net of allowances and policy fees. 
 The Company will pay the balance of premiums in arrears due under a reinstated Reinsured Policy. 

If a net balance is due to the Reinsurer, the Company will forward a remittance in settlement with its report. If the net balance is due to the Company, the
Reinsurer will forward a remittance in settlement within 30 days of receipt of the report. 
 Report Requirements: 

The Company will send to the Reinsurer the following reports electronically, by the times indicated below: 

 

							
	 	  	Report	  	Accounting Period	  	Due Date
	1.	  	 New Business
 (New issues only – first time
policy reported to the Reinsurer)
	  	Monthly	  	21st day after month end
				
	2.	  	 Renewal Business
 (Policies with renewal dates
within Accounting Period)
	  	Monthly	  	21st day after month end
				
	3.	  	 Changes & Terminations
 (including
conversions, replacements reinstatements, increases, decreases, recaptures, lapses, claims, etc.)
	  	Monthly	  	21st day after month end
				
	4.	  	 lnforce List
 (Listing of each policy in
force)
	  	Quarterly	  	21st day after quarter end

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit F 

Page 2 
  

							
	5.	  	Accounting Information	  	Monthly	  	21st day after month end
		  	 (only required for Paper Reporting)
 (See
Exhibit F-1 for Sample Summary Reporting Form, Section I)
	  		  	
				
	6.	  	Statutory Reserves	  	Quarterly	  	21st day after quarter end
		  	(See Exhibit F-1 for Sample Summary Reporting Form, Section II)	  		  	
				
	7.	  	Policy Exhibit	  	Monthly	  	21st day after month end
		  	(only required for Paper Reporting)
(See Exhibit F-1 for Sample Summary Reporting Form, Section Ill)	  		  	
				
	8.	  	Valuation Reserve Certification	  	Annually	  	October 31st
		  	(See Exhibit F-2 for Sample)	  		  	
				
	9.	  	Tax Reserve Certification	  	Annually	  	June 1st
		  	(See Exhibit F-3 for Sample)	  		  	

 Minimum Data Requirements for Electronic Administration: 

Policy record details for new business, renewal business and changes and terminations (Reports #1, 2 and 3 in Report Requirements, above) may be reported as
separate reports or combined into one report, hereinafter referred to as the Billings and Transactions Report. Nonetheless, the data elements specified below for the Billings and Transactions Report must be provided for each reported record. 

Billings and Transactions Report: 
  

					
	 General
	  	
	1.	  	Reporting Period Dates	  	Specifies the beginning and ending date of the reporting period represented on the statement file.
	Insured Data	  	
	2.	  	Last Name	  	Represents the surname or family name of the insured; must be specified for each insured on joint policy types; name fields are required to be parsed out into these listed components
			
	3.	  	First Name	  	Represents the given name of the insured; must be specified for each insured on joint policy types; name fields are required to be parsed out into these listed components.
			
	4.	  	Middle Name or Middle Initial (if available)	  	Represents the middle name of the insured; must be specified for each insured on joint policy types; name fields are required to be parsed out into these listed
components.

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit F 

Page 3 
  

					
	5.	  	Date of Birth	  	Specifies the date on which the insured was born; this field must be provided on each insured on a joint policy.
			
	6.	  	Sex	  	Indicates the gender of the insured; this field must be provided on each insured on a joint policy.
			
	7.	  	Tobacco Use Code	  	Indicates whether the insured is a smoker or user of tobacco products.
			
	8.	  	Rating	  	Indicates whether the insured is standard, substandard, or uninsurable.
			
	9.	  	Residence	  	State, province, or other geographical code that indicates where the insured resides.
			
	10.	  	Insured Sequence Number	  	Specifies the number assigned by the ceding company to delineate one insured from another on a policy with multiple insureds.
		
	Coverage Data	  	
			
	11.	  	Currency	  	Indicates the currency to be applied in calculating monetary amounts, if currency within this treaty is a variable on a by policy basis.
			
	12.	  	Reinsurance Method	  	Indicates whether the policy is being ceded on an automatic or facultative basis.
			
	13.	  	Policy Number	  	Specifies the number assigned by the ceding company to the policy record.
			
	14.	  	Coverage Sequence Number	  	Specifies the number assigned by the ceding company to delineate one coverage or benefit from another on a policy with multiple coverages or benefits.
			
	15.	  	Issue Date	  	The date the policy or benefit was issued.
			
	16.	  	Reinsurance Effective Date (if different than issue date)	  	Specifies the date upon which the reinsurance coverage goes into effect, if it goes into effect on a date other than the issue date. Can also be used to specify the original Policy Issue Date on a contractual policy
conversion.
			
	17.	  	Plan Code	  	Specifies the plan of insurance being provided to the insured; there must be a separate plan code for each coverage.
			
	18.	  	Joint Life Indicator	  	Indicates that the coverage is a joint coverage and that multiple lives are involved with the coverage.
			
	19.	  	Smoker Code	  	Indicates that the coverage has been issued at either non-smoker or smoker rates.
			
	20.	  	Preferred Risk Class	  	Indicates the level of classification between the preferred and standard categories; there may be more than one level of the preferred classification available, and this will indicate the specific level for this policy.
			
	21.	  	Mortality Rating	  	Specifies the exact rating assigned to the policy; premium rates will be based on this rating; this rating is generally expressed as a percentage.
			
	22.	  	Flat Extra Rate	  	Specifies a flat rate per thousand to be charged on the policy.
			
	23.	  	Flat Extra Duration	  	Specifies the number of years that the flat extra rating will be charged.

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit F 

Page 4 
  

					
	24.	  	Direct Face Amount	  	Specifies the face amount of the benefit issued to the insured before the purchase of any reinsurance.
			
	25.	  	Reinsured Face Amount	  	Specifies the face amount of the reinsurance purchased.
			
	26.	  	Reinsured Amount at Risk	  	Specifies the net amount at risk for the current year’s reinsurance benefits.
			
	27.	  	Death Benefit Option	  	Specifies the option used to calculate the policy net amount at risk on Universal Life products, only.
			
	28.	  	Coverage Maturity or Expiry Date	  	Specifies the date on which the insurance coverage will cease, based on the type of plan issued to the insured.
			
	29.	  	Issue Age	  	From date of issue, the age at which premiums will be charged when the case does not use a rated age.
			
	30.	  	Rated Age	  	From the date of issue, the age at which premiums will be charged when the age is increased for substandard reasons, or when the age is an equivalent age for joint products.
			
	31.	  	Transaction Code	  	Indicates the specific action that has occurred to cause a policy to appear on the billing or transaction report, such as New Business, Renewal, Lapse, Death etc.
			
	32.	  	Transaction Effective Date	  	Specifies the date on which the transaction is applied to the insured’s policy.
			
	33.	  	Standard Premium	  	The premium to be paid for the reinsured benefit; this must be specified for each benefit provided on a policy record.
			
	34.	  	Substandard Premium	  	In the event that a mortality rating has been assigned, this is the substandard portion of the premium to be paid for the reinsured benefit; this must be specified for each benefit provided on a policy record.
			
	35.	  	Flat Extra Premium	  	The premium to be paid the reinsurer for any flat extra premiums assigned to the policy.
			
	36.	  	Fees	  	Any additional fees to be charged, such as policy fees
			
	37.	  	Standard Allowance	  	The allowance to be taken for the reinsured benefit; this must be specified for each benefit provided on a policy record.
			
	38.	  	Substandard Allowance	  	In the event that a mortality rating has been assigned, this is the portion of the allowance to be taken for the substandard premium; this must be specified for each benefit provided on a policy record.
			
	39.	  	Flat Extra Allowance	  	In the event a flat extra rating has been assigned to the policy, this is the portion of the allowance to be taken on the flat extra premium; this must be specified for each flat extra premium provided on a policy record.
			
	40.	  	Fee Allowance	  	The allowance to be taken for any fees paid on the record.
			
	41.	  	Underwriting Method (mandatory if Agreement covers policies with less than full underwriting)	  	The underwriting method applies to the reinsured policies, i.e., Simplified or Guaranteed Issue

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit F 

Page 5 
  

 lnforce list: 

As required, a complete listing of all policy records considered to be in force under this Agreement must also be provided to the Reinsurer (Report #4 in
Report Requirements, above). Each record on the lnforce List must contain data elements 1–30, as specified in the above listing of data requirements. 

Reporting System: The system used by the Company to administer its reinsurance is: TAI. 

The Company will inform the Reinsurer at least one reporting period in advance of any change in the reporting format or data prior to its use in reports to
the Reinsurer. The Company will provide the Reinsurer with a test file containing such a change prior to its implementation in the production of reports. 

Additional Information: Upon request, the Company will promptly provide the Reinsurer with any additional information related to the Reinsured Policies
and which the Reinsurer requires in order to complete its financial statements. 

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit F-1 

Swiss Re Life & Health America Inc. 

SELF ADMINISTERED REINSURANCE SUMMARY REPORTING FORM 
  

			
	Ceding Company                                   
                          	  	Reinsurer
                                         
                          
		
	Treaty/Account #
                                         
                    	  	Period Experience is for
                                         
   
		
	Coin          YRT          Mod Co         
Other         	  	Interest Sensitive: Yes          No         

									
	
	Reinsurance Premium Mode:           Monthly           
          Quarterly           
        Annual              In Advance         
    In Arrears       
	
	Reinsurance Reporting Mode:         Monthly            
          Quarterly                    Annual
        

					
			
	Contact                                     
                	  	Date                             	  	Phone #                                    
                         

 SECTION I – ACCOUNTING 
  

													
	 	  	 * * Premiums * *
	  	 * * Allowances Other * *
	  	 
	 	  	 First Year
	  	 Renewal Year
	  	 First Year
	  	 Renewal Year Benefit
	  	 Total

	 Life
	  		  		  		  		  		  	
	 ADB
	  		  		  		  		  		  	
	 Waiver of Premium
	  		  		  		  		  		  	
	 TOTAL
	  		  		  		  		  		  	

 SECTION II – RESERVE INFORMATION 

 

															
	 Amount of Rein (000)
	  	Issue	  	 Reserves Reinsured

	 Life
	  	 ADB
	  	 Year
	  	 Life
	  	 ADB
	  	 Waiver
	  	 Subst’d
	  	 Deficiency

		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  	

 SECTION III – POLICY EXHIBIT INFORMATION 

 

																					
	 	 	 	  	Current Period	 	  	 	  	Year to Date	 
	 	 	 	  	No. of
Policies	 	  	Amt of *
Rein (000)	 	  	 	  	No. of
Policies	 	  	Amt. of *
Rein (000)	 
	A. In force Beg. of Period	 		  				  				  	A.	  				  			
	   1. New Business
	 	Auto	  				  				  	1. Auto	  				  			
		 	Fac	  				  				  	    Fac	  				  			
	   2. Conversions/Replacements - On
	  				  				  	2.	  				  			
	   3. Reinstatements
	 		  				  				  	3.	  				  			
	   4. Other Increases
	  				  				  	4.	  				  			
	   5. Not Takens
	  				  				  	5.	  				  			
	 a) Total Inc (1 + 2 + 3 + 4-5)
	  				  				  	   a)	  				  			
	   6. Death
	 		  				  				  	6.	  				  			
	   7. Conversions/Replacements - Off
	  				  				  	7.	  				  			
	   8. Lapses
	 		  				  				  	8.	  				  			
	   9. Surrenders
	 		  				  				  	9.	  				  			
	 10. Expiry
	 		  				  				  	10.	  				  			
	 11. Recapture
	 		  				  				  	11.	  				  			
	 12. Other Decreases
	  				  				  	12.	  				  			
	 b) Total Dec (6 + 7 + 8 + 9 + 10 + 11 + 12)
	  				  				  	   b)	  				  			
	B. In force End of Period (A + a-b)	  				  				  	B.	  				  			

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit F-2 

Valuation Reserve for Self-Administered Business Ceded to Swiss Re Life & Health America Inc. from Fidelity Life Association, A Legal Reserve Life
Insurance Company 
  

			
	In force and Reserves at	  	200x:
		
	Plan:	  	Type: SM/NSM/AGGR/TOTAL
		
	In force Reinsured Amount:                         	  	
	
	In force Number of Reinsured Policies:                         
		
	Valuation Reserve as at	  	200x:

  

									
	Type	  	 Reserve

Amount ($)
	 	  	 Reserve Basis

(Table, interest

rate and method)
	 
	 Active Life Reserve
	  				  			
	 Unearned Premium Reserve
	  				  			
	 Disabled Life Reserve
	  				  			
	 Liability for Incurred But Not Reported Claims (IBNR)
	  				  			
	 Liability for Due and Unpaid Claims
	  				  			
	 Liability for claims in Course of Settlement
	  				  			
	 Other* * (specify)
	  				  			
	 Total
	  				  			

  

	* *	 If credit for deficiency reserves is being taken, please specify under “other”.

 As the valuation actuary of the above named company I certify that the information above is correct as shown. * 

Name: 
 Signature: 

Actuarial Designation: 
 Title: 

Date: 
  

	*	 Required only for Year End Valuation Reserves. 

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)
	  		  	

 Exhibit F-3 

Tax Reserve Certification for Self Administered Business Ceded to Swiss Re Life & Health America Inc. from Fidelity Life Association, A Legal
Reserve Life Insurance Company 
 In force and Reserves at December 31, 200x: 

 

			
	Plan:	  	Type: SM/NSM/AGGR/TOTAL
		
	In force Reinsured Amount:                            	  	
		
	In force Number of Reinsured
Policies:                                	  	
		
	Tax Reserve as at December 31, 200x:	  	

  

									
	Type	  	 Reserve

Amount ($)
	 	  	Reserve Basis
(Table, interest
rate and method)	 
	Active Life Reserve	  				  			
	Unearned Premium Reserve	  				  			
	Disabled Life Reserve	  				  			
	Liability for Incurred But Not Reported Claims (IBNR)	  				  			
	Liability for Due and Unpaid Claims	  				  			
	Liability for Claims in Course of Settlement	  				  			
	Other* * (specify)	  				  			
	Total	  				  			

  

	* *	 If credit for deficiency reserves is being taken, please specify under “other”.

 As the valuation actuary of the above named company I certify that the information above is correct as shown. 

Name: 
 Signature: 

Actuarial Designation: 
 Title: 

Date: 

  

					
	 I486326US-14 (02-21-2014)
 (QT
#06655US13)

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