Document:

EX-10.5

 Exhibit 10.5 

AUTOMATIC COINSURANCE AGREEMENT 

(the “Agreement”) 

Effective: January 1, 2012 

between 
 FIDELITY LIFE
ASSOCIATION 
 Chicago, ILLINOIS 

(the “Company”) 
 and

 HANNOVER LIFE REASSURANCE COMPANY OF AMERICA 

ORLANDO, FLORIDA 
 (the
“Reinsurer”) 
 Treaty No. HA-FKLA-07/HA3351

 December 4, 2012 

 Table of Contents 

 

					
	Article I	  	Preamble	  	1
	Article II	  	Automatic Reinsurance	  	3
	Article III	  	Facultative Reinsurance	  	5
	Article IV	  	Liability	  	6
	Article V	  	Reinsured Risk Amount	  	7
	Article VI	  	Premium Accounting	  	8
	Article VII	  	Reserves	  	10
	Article VIII	  	Reductions, Terminations and Changes	  	11
	Article IX	  	Conversions, Exchanges and Replacements	  	13
	Article X	  	Claims	  	14
	Article XI	  	Retention Limit Changes	  	17
	Article XII	  	Recapture	  	18
	Article XIII	  	General Provisions	  	19
	Article XIV	  	DAC Tax	  	21
	Article XV	  	Insolvency	  	22
	Article XVI	  	Reinsurer’s Right of Notice of Unusual Practices	  	24
	Article XVII	  	Arbitration	  	25
	Article XVIII	  	Confidentiality	  	27
	Article XIX	  	Duration of Agreement	  	28
	Article XX	  	Execution	  	29
			
	Exhibit A	  	Retention Limits of the Company	  	30
	Exhibit B	  	Plans Covered	  	31
	Exhibit C	  	Automatic Binding Limits	  	33
	Exhibit D-1	  	Procedures for Reporting	  	35
	Exhibit D-2	  	Financial Reporting Requirements	  	37
	Exhibit E	  	Reinsurance Premium Rates	  	38
	Exhibit F	  	Underwriting Guidelines	  	40

 ARTICLE I 

PREAMBLE 
  

	1)	 Parties to the Agreement. This is a Coinsurance Agreement for indemnity reinsurance (the
“Agreement”) solely between Hannover Life Reassurance Company of America, Orlando, Florida (the “Reinsurer”), and Fidelity Life Association, Chicago, Illinois, (the “Company”), collectively referred to as the
“parties”. 

 The acceptance of risks under this Agreement will create no right or legal relationship between the
Reinsurer and any other party, including the insured, owner or beneficiary of any insurance policy or other contract of the Company. 
 The
Agreement will be binding upon the Company and the Reinsurer and their respective successors and assigns. 
  

	2)	 Compliance. This Agreement applies only to the issuance of insurance by the Company in a
jurisdiction in which it is properly licensed. 

 The Company represents that it is in compliance with all state and
federal laws applicable to the business reinsured under this Agreement. In the event that the Company is found to be in non-compliance with any law material to this Agreement, the Agreement will remain in
effect and the Company will indemnify the Reinsurer for any loss the Reinsurer suffers as a result of the non-compliance, and will seek to remedy the non-compliance
immediately upon discovery thereof. 
  

	3)	 Construction. This Agreement will be construed in accordance with the laws of the state of
Illinois. Furthermore, this Agreement is a freely negotiated contract between the Company and the Reinsurer and will not be construed against either party due to the fact that it was the party that drafted the Agreement. 

 

	4)	 Entire Agreement. This Agreement constitutes the entire agreement between the parties with
respect to the business reinsured hereunder. There are no understandings between the parties other than as expressed in this Agreement. Any change or modification to this Agreement will be null and void unless made by amendment to this Agreement and
signed by both parties. 

  

	5)	 Severability. If any provision of this Agreement is determined to be invalid or
unenforceable, such determination will not impair or affect the validity or the enforceability of the remaining provisions of this Agreement. 

  

	6)	 Non-waiver. No waiver by either party of any violation or
default by the other party in the performance of any promise, term or condition of this Agreement shall be construed to be a waiver by such party of any other or subsequent default in performance of the same or any other promise, term or condition
of this Agreement. No prior transactions or dealings between the Parties shall be deemed to establish any custom or usage waiving or modifying any provision hereof. The failure of either party to enforce any part of this Agreement shall not
constitute a waiver by such party of its right to do so, nor shall it be deemed to be an act of ratification or consent. 

  
 ARTICLE I
CONTINUES... 

  
 1 

	7)	 Survival. All provisions of this Agreement shall survive its termination to the extent necessary to
carry out the purposes of this Agreement or to ascertain and enforce the Parties’ rights and/or obligations hereunder existing at the time of termination. 

 

	8)	 Assignment. Neither party may assign, transfer, sell, convey or otherwise dispose of any of its rights,
duties or obligations under this Agreement without the prior written consent of the other party, which consent shall not be unreasonably withheld; provided, however, that the parties acknowledge and agree that the Reinsurer may retrocede any or all
of its reinsured net amount at risk hereunder. 

  
 ...END OF ARTICLE I

  
 2 

 ARTICLE II 

AUTOMATIC REINSURANCE 
  

	1)	 General Conditions. On and after the effective date of this Agreement, the Company will automatically
cede to the Reinsurer a portion of the life insurance policies, supplementary benefits, and riders listed in Exhibit B. 

The Reinsurer will automatically accept its share of the above-referenced policies up to the limits shown in Exhibit C, provided that: 

 

	 	a.	 the Company keeps its full retention, as specified in Exhibit A, or otherwise holds its full retention on a
life under previously issued inforce policies and does not transfer, assign, convey, reinsure or otherwise dispose of such retention without the Reinsurer’s written consent; 

 

	 	b.	 the Company applies its normal underwriting guidelines as were delivered to the Reinsurer, in accordance with
the Company’s current underwriting guidelines as described in the Hybrid Life Underwriting Guide 1/2012, using the Reinsurer’s MERICA system for obtaining and interpreting third party data. Initial Nonmedical underwriting in accordance
with the Company’s current underwriting guidelines as described in the Hybrid Life Underwriting Guide 1/2012. For medically-underwritten policies, full underwriting in accordance with the Company’s current underwriting guidelines as
described in the Hybrid Life Underwriting Guide 1/2012. 

  

	 	c.	 The insured is a resident of a country listed in Exhibit C. 

 

	 	d.	 OFAC Compliance. The Company and the Reinsurer each represents and warrants that it is in compliance with all
laws, regulations, judicial and administrative orders applicable to the party and to the business reinsured under this Agreement, as they pertain to sanction laws administered by the U.S. Treasury Department’s Office of Foreign Assets Control
(“OFAC”), and with Trade Embargo Laws, as such laws may be amended from time to time (collectively, the “Laws”). Neither party will 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. 

 The Company agrees to, prior to ceding any risk to the
Reinsurer under this Agreement, screen, in accordance with current industry standards for the U.S. life insurance industry, each risk to ensure that an owner, insured, or beneficiary is not on the OFAC List of Specially Designated National and
Blocked Persons (a “Prohibited Person”). 
 The Company will not cede or otherwise transfer to the Reinsurer, and the Reinsurer
will have no obligation to reinsure or indemnify the Company for any liabilities under any policy if an owner, insured, or beneficiary of such policy is a Prohibited Person. 

  
 ARTICLE II
CONTINUES... 

  
 3 

 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 will notify the other party within five (5) business days of such discovery, and the Company will provide to the Reinsurer
written notice of all information known by the Company regarding the identity of the Prohibited Person, including the name, date of birth, country, state or province and street address of the residence and/or business, social security number,
driver’s license number or other governmental identification number, and telephone number(s) of such Prohibited Person. The parties will cooperate in order to take all necessary corrective actions. 

The parties agree that such reinsurance transaction will be null, void and of no effect from its inception, to the same extent as if the
reinsurance transaction had never occurred. In such event, each party will be restored to the position it would have occupied if the violation had not occurred. 

  
 .....END OF ARTICLE
II 

  
 4 

 ARTICLE III 

FACULTATIVE REINSURANCE 
 The
Company may submit a policy not satisfying the conditions set forth in Article II, Automatic Reinsurance” or Policies it does not wish to cede as automatic reinsurance, for facultative reinsurance consideration. 

 

	1)	 Application. An application form acceptable by the Reinsurer shall be submitted for each facultative
consideration. 

  

	2)	 Underwriting Papers. Copies of the original insurance application, medical examiner’s reports,
attending physician statements, inspection reports, financial information and ail other papers and information obtained by the Company concerning insurability of the risk shall accompany the application for reinsurance. If there are outstanding
underwriting requirements not yet available, the Company shall notify the Reinsurer of such requirements; in addition, the Company agrees to provide any subsequent information received pertinent to the risk assessment to the Reinsurer as soon as
possible following receipt of such information by the Company. 

  

	3)	 Reinsurer’s Actions. Following receipt of the application for reinsurance and the information as
described above, the Reinsurer agrees to promptly examine the underwriting information and notify the Company of any one of the following: 

  

	 	•	 	 an offer to reinsure the policy; 

 

	 	•	 	 an offer to reinsure the policy other than as applied for; 

 

	 	•	 	 an offer to reinsure the policy subject to additional underwriting requirements; 

 

	 	•	 	 a need for additional underwriting information to further consider making a facultative reinsurance offer; or

  

	 	•	 	 a declination to make any facultative reinsurance offer. 

 

	4)	 Expiration of Facultative Offer. Any offer from the Reinsurer to reinsure the policy expires one hundred
twenty (120) days after the offer is made, unless the facultative offer specifies otherwise or the Reinsurer extends the offer period in writing. The Company may accept the Reinsurer’s facultative reinsurance offer within the offer period
and shall notify the Reinsurer of such acceptance subject to the Company’s allocation rules for placement of facultative cases. 

  

	5)	 Conflicts. The terms and conditions of any facultative offer shall supersede the terms of the Agreement
in case of conflicts between the two; otherwise reinsurance of a policy on a facultative reinsurance basis shall comply with the terms of this Agreement. 

  
 ...END OF ARTICLE
III 

  
 5 

 ARTICLE IV 

LIABILITY 
  

	1)	 Automatic Reinsurance. For automatic reinsurance, the Reinsurer’s liability will commence at the
same time as the Company’s liability, and will continue in accordance with the terms and conditions of this Agreement, and will end at the same time as that of the Company. Payment by the Company to the Reinsurer of reinsurance premium is a
condition precedent to the Reinsurer’s liability hereunder. 

  

	2)	 Facultative Reinsurance. The liability of the Reinsurer on any facultative reinsurance under this
Agreement will commence at the same time as that of the Company, provided that the Reinsurer has given the Company a written unconditional offer on the application for reinsurance, and the Company has notified the Reinsurer in writing of its
acceptance within one-hundred twenty (120) days of the offer and acts in accordance with the Reinsurer’s offer and the terms of this Agreement. The Reinsurer will become liable for its share,
provided that the policy has been delivered according to the usual procedures of the Company and that the Company has followed its facultative rules for reinsurance placement. 

 

	3)	 Dividends. The Reinsurer shall have no liability for any dividends paid by the Company on participating
policies. 

  
 ...END OF ARTICLE
IV 

  
 6 

 ARTICLE V 

REINSURED RISK AMOUNT 
  

	1)	 Life. Reinsurance under this Agreement is on a Coinsurance basis. The reinsurance benefit will be
determined in the manner described below. 

 The reinsurance benefit is the death benefit of the policy times the
Reinsurer’s quota share percentage, as stated in Exhibit C. 

  
 ...END OF ARTICLE V

  
 7 

 ARTICLE VI 

PREMIUM ACCOUNTING 
  

	1)	 Premiums. Reinsurance premium rates for life insurance and other benefits reinsured under this Agreement
are shown in Exhibit E. Premium rates will be applied to the amount at risk reinsured and paid by the Company to the Reinsurer. Rates are guaranteed over the level premium paying period. 

 

	2)	 Payment of Premiums and Reporting. Reinsurance premiums are payable (annually in advance and reported
monthly). Each reporting period, the Company will self-administer the calculation and payment of reinsurance premium due and, within thirty (30) days after the end of the reporting period, will send the Reinsurer a report that contains the
information shown in Exhibit D-1 and Exhibit D-2, showing reinsurance premiums due for that reporting period. If an amount is due the Reinsurer, the Company will remit
that amount together with the statement. If an amount is due the Company, the Reinsurer will remit such amount within thirty (30) days of receipt of the statement. 

 

	3)	 Delayed Payment. Any balances, due either from Company to Reinsurer or from Reinsurer to Company, that
remain unpaid for more than thirty (30) days from the due date will incur interest from the end of the reporting period. Interest will be calculated at the rate shown in Article XIII.4. 

 

	4)	 Failure to Pay Premiums. The payment of reinsurance premiums is a condition precedent to the liability
of the Reinsurer for reinsurance covered by this Agreement. Net unearned premiums will be refunded to the Company by the Reinsurer upon death and lapse. In the event that reinsurance premiums are not paid within thirty (30) days of the
Remittance Date, the Reinsurer will have the right to terminate the reinsurance under all policies having reinsurance premiums in arrears. If the Reinsurer elects to exercise its right of termination, it will give the Company thirty
(30) days written notice of its intention. 

 If all reinsurance premiums in arrears, including any that become
in arrears during the thirty-day notice period, are not paid before the expiration of the notice period, the Reinsurer will be relieved of all liability under those policies as of the last date to which premiums have been paid for each policy, less
any cash values or recapture reserve amounts due. Reinsurance on policies on which reinsurance premiums subsequently fall due will automatically terminate as of the last date to which premiums have been paid for each policy, unless reinsurance
premiums on those policies are paid on or before their Remittance Dates. 
 Terminated reinsurance may be reinstated, subject to approval by
the Reinsurer, within sixty (60) days of the date of termination, and upon payment of all reinsurance premiums in arrears including any interest accrued thereon. The Reinsurer will have no liability for any claims incurred between the date of
termination and the date of the reinstatement of the reinsurance. The right to terminate reinsurance will not prejudice the Reinsurer’s right to collect premiums for the period during which reinsurance was in force prior to the expiration of
the thirty (30) day notice. 

  
 ARTICLE VI
CONTINUES... 

  
 8 

 The Company will not force termination under the provisions of this Article solely to avoid
the recapture provisions of this Agreement, or to transfer the reinsured policies to another reinsurer. 
  

	5)	 Premium Rate Guarantee. The Reinsurer anticipates that the premiums and allowances shown in Exhibit E
will apply indefinitely. However, the following provisions apply. 

  

	 	a.	 If the Company increases the current policyowner premiums on any block of policies, the Reinsurer reserves the
right not to increase the coinsurance allowances. The occurrence of this event does not constitute a right for the Company to recapture the reinsured business. The Company agrees to notify the Reinsurer within ninety (90) days of any increase
in its retail premium. 

  

	 	b.	 If the Company decreases the current policyowner premiums on any block of policies, the Reinsurer reserves the
right to decrease the coinsurance allowances such that the net coinsurance premium paid by the Company to the Reinsurer remains unchanged. The occurrence of this event does not constitute a right for the Company to recapture the business. If the
Company decreases the current policyowner premiums and the Reinsurer’s adjustment to the coinsurance allowances results in a larger net coinsurance premium, then the Reinsurer will give the Company 90 days’ prior notice and Company has the
right to immediately recapture any business affected by such change. 

  

	 	c.	 If, after the guaranteed level premium period, the Company hasn’t adjusted policyowner premiums, the
Reinsurer may elect to decrease the coinsurance allowances. If the Reinsurer elects to decrease the allowances, then the Reinsurer will give the Company 90 days’ prior notice and the Company has the right to immediately recapture any business
affected by such change. 

 Any recapture will be on terms mutually acceptable to the Company and to the Reinsurer. 

 

	6)	 Electronic Data Transmission. The Company shall report its reinsurance transactions via electronic
media. The Company shall consult with the Reinsurer to determine the appropriate reporting format. Should the Company subsequently desire to make changes in the data format or the code structure, the Company shall communicate such changes to the
Reinsurer in writing prior to the use of such changes in reports to the Reinsurer and shall describe in reasonable detail such proposed changes. 

  

	7)	 Unearned Premium. The Reinsurer will follow the practices of the Company with respect to refund of
premium upon death, surrender, or other termination. 

  
 ...END OF ARTICLE
VI 

  
 9 

 ARTICLE VII 

RESERVES 
  

	1)	 Reserve Credit. The Reinsurer will hold reserves in accordance with all applicable laws/regulations that
the Reinsurer deems controlling. The Reinsurer is a licensed/accredited reinsurer in all states. 

  

	2)	 Reserve Methodology. The Company will provide its X-factors to
the Reinsurer and will notify the Reinsurer, in advance, of any change to such X-factors. 

  
 ...END OF ARTICLE
VII 

  
 10 

 ARTICLE VIII 

REDUCTIONS, TERMINATIONS AND CHANGES 

Whenever a change is made in the status, plan, amount or other material feature of a policy reinsured under this Agreement, the Reinsurer will, upon receipt
of notification of the change, provide adjusted reinsurance coverage in accordance with the provisions of this Agreement. The Company will notify the Reinsurer of any such change with the next statement following the month in which the change was
made. 
  

	1)	 Reductions and Terminations. In the event of the reduction, lapse, or termination of a policy or
policies reinsured under this Agreement or any other agreement, the Company will reduce or terminate reinsurance on that life. The reinsured amount on the life with all reinsurers will be reduced, effective on the same date, by the amount required
such that the Company maintains its retention as defined under this Agreement. 

 The reinsurance reduction will apply
first to the policy or policies being reduced and then, on a chronological basis, to other reinsured policies on the life, beginning with the oldest policy. If a fully retained policy on a life that is reinsured under this Agreement is terminated or
reduced, the Company will reduce the existing reinsurance on that life by a corresponding amount, with the reinsurance on the oldest policy being reduced first. If the amount of reduction exceeds the risk amount reinsured, the reinsurance on the
policy or policies will be terminated. 
 The Reinsurer will refund any unearned reinsurance premiums, including its proportionate share of
the policy fee, net of allowances. 
  

	2)	 Increases 

a.    Noncontractual Increases. If the amount of insurance is increased as a result of a noncontractual change, the
increase will be underwritten by the Company in accordance with its customary standards and procedures and will be considered new reinsurance under this Agreement. The Reinsurer’s written approval is required if the original policy was
reinsured on a facultative basis or if the new amount will cause the reinsured amount on the life to exceed either the Automatic Binding Limits or the Jumbo Limits shown in Exhibit C. Premiums for the additional reinsurance will be at the new issue
rate from the point of increase. 
 b.    Contractual Increases. For policies reinsured on an automatic basis,
reinsurance of increases in amount resulting from contractual policy provisions will be accepted only up to the Automatic Binding Limits shown in Exhibit C. 
  

	3)	 Risk Classification Changes. If the insured requests a reduction or removal of a table rating or flat
extra premium charge, such change shall be underwritten according to the Company’s normal underwriting practices. 

  
 ARTICLE VIII
CONTINUES... 

  
 11 

 Risk classification changes on facultative policies shall be subject to the Reinsurer’s
approval. Any such change shall result in a corresponding change in the reinsurance premium amount. 
  

	3)	 Reinstatement. If a policy reinsured on an automatic basis is reinstated in accordance with its terms
and in accordance with Company rules and procedures (a copy of which shall have been provided to the Reinsurer prior to any such reinstatement), the Reinsurer will, upon notification of reinstatement, reinstate the reinsurance coverage. If a policy
reinsured on a facultative basis is reinstated, written approval by the Reinsurer will be required prior to the reinstatement of the reinsurance. 

Upon reinstatement of the reinsurance coverage, the Company will pay the contractual reinsurance premiums plus accrued interest for the period
and at the interest rate stated in the policy from the date of reinstatement to the date of the current statement of account, including a proportional share of any interest collected. Thereafter, reinsurance payments will be in accordance with
Article VI Premium Accounting. 
 If a policy reinsured is restored pursuant to any state law or regulation that requires reinstatement or
restoration of a policy following a “free look” period allowed to the policyholder for a proposed replacement policy, and said replacement policy is subsequently rejected by the policyholder, the Reinsurer agrees to restore reinsurance of
the policy under its original terms and conditions as set forth herein. The foregoing shall apply to automatic and facultative reinsurance. 

  
 ...END OF ARTICLE
VIII 

  
 12 

 ARTICLE IX 

CONVERSIONS, EXCHANGES AND REPLACEMENTS 

Conversions, exchanges and replacements are not reinsured under this Agreement. 

  
 ....END OF ARTICLE
IX 

  
 13 

 ARTICLE X 

CLAIMS 
 Claims covered under this
Agreement include only death claims, which are those due to the death of the insured on a policy reinsured under this Agreement, and any additional benefits specified in Exhibit B, which are provided by the underlying policy and are reinsured under
this Agreement. 
  

	1)	 Notice. The Company will notify the Reinsurer, as soon as reasonably possible, after it receives a claim
on a policy reinsured under this Agreement. 

  

	2)	 Proofs. The Company will promptly provide the Reinsurer with proper claim proofs, including a copy of
the proof of payment by the Company, and a copy of the insured’s death certificate. In addition, for contestable claims, the Company will send to the Reinsurer a copy of all papers and information in connection with the claim.

  

	3)	 Amount and Payment of Reinsurance Benefits. As soon as the Reinsurer receives proper claim notice and
proof of the claim, the Reinsurer will promptly pay the reinsurance benefits due the Company. The Company’s contractual liability for policies reinsured under this Agreement is binding on the Reinsurer. 

The maximum reinsurance death benefit payable to the Company under this Agreement is the risk amount specifically reinsured with the Reinsurer.
The Reinsurer will also pay its proportional share of statutory interest that the Company pays on the death proceeds until the date of settlement except if settlement is delayed as a result of a dispute or contest arising out of conflicting claims
of entitlement to policy proceeds or benefits, then the Reinsurer will pay its share of interest to the date settlement would have been made if there were no dispute or contest. 

The total reinsurance recoverable from all companies will not exceed the Company’s total contractual liability on the policy, less the
amount retained. The maximum reinsurance death benefit payable to the Company under this Agreement is the risk amount specifically reinsured with the Reinsurer. The Reinsurer will also pay its proportionate share of the statutory interest that the
Company pays on the death proceeds until the date of settlement except if settlement is delayed as a result of a dispute or contest arising out of conflicting claims of entitlement to policy proceeds or benefits, then the Reinsurer will pay its
share of interest to the date settlement would have been made if there were no dispute or contest. 
 Life benefit payments will be made in a
single sum, regardless of the Company’s settlement options; provided, however, that such single sum will exclude interest that accrues on settlement options other than single pay. 

 

	4)	 Contested Claims. The Company will promptly notify the Reinsurer of its intention to contest,
compromise, or litigate a claim involving a reinsured policy. The Company acknowledges and agrees that its obligation to consult with the Reinsurer on contestable claims is a material inducement to the Reinsurer agreeing to provide reinsurance
hereunder and that absent such an obligation, the Reinsurer would not have agreed to provide 

  
 ARTICLE X
CONTINUES... 

  
 14 

	 	
reinsurance hereunder. The Company will also promptly and fully disclose all information relating to the claim. Upon receipt of all documents, the Reinsurer will have five (5) working days
to notify the Company in writing of its decision to accept participation in the contest, compromise, or litigation. If the Reinsurer has accepted participation, the Company will promptly advise the Reinsurer of all significant developments in the
claim investigation, including notification of any legal proceedings against it in response to denial of the claim. Failure by the Reinsurer to respond in writing in five (5) days shall not be deemed to constitute the Reinsurer’s
willingness to participate in the contest, compromise or litigation. 

 If the Reinsurer elects to opt out of the contest,
compromise, or litigation, the Reinsurer will then fulfill its obligation by paying the Company its full share of the reinsurance amount and proportional share of the covered expenses to date, and will not share in any subsequent reduction or
increase in liability, and will not share in loss adjustment expenses or extracontractual obligations. 
 If the Reinsurer does not opt out
and the Company’s contest, compromise, or litigation results in a reduction or increase in liability, the Reinsurer will share in any such reduction or increase in proportion to its share of the risk on the contested policy. 

 

	5)	 Claim Expenses. The Reinsurer will pay its share of reasonable claim investigation and legal expenses
connected with the litigation or settlement of contractual liability claims unless the Reinsurer has discharged its liability pursuant to Section 4 above. If the Reinsurer has so discharged its liability, the Reinsurer will not participate in
any expenses incurred thereafter. 

 The Reinsurer will not reimburse the Company for routine claim and administration
expenses, including but not limited to the Company’s home office expenses, compensation of salaried officers and employees, and any legal expenses other than third party expenses (e.g. outside legal and investigative services) incurred by the
Company. Claim investigation expenses do not include expenses incurred by the Company as a result of a dispute or contest arising out of conflicting claims of entitlement to policy proceeds or benefits. 

 

	6)	 Misrepresentation or Suicide. If the Company returns premium to the policyowner or beneficiary as a
result of misrepresentation or suicide of the insured, the Reinsurer will refund reinsurance premium less allowances (hereinafter “Net Reinsurance Premiums”) received on that policy to the Company in lieu of any other form of reinsurance
benefit payable under this Agreement. If the Company is required by state law or regulation to pay interest on the payment to the policyowner or beneficiary, then the Reinsurer will include this amount of interest in the refund of reinsurance
premiums to the Company. If interest is not required by state law or regulation, the refund by the Reinsurer will be without interest. 

  

	7)	 Misstatement of Age or Sex. In the event of a change in the amount of the Company’s liability on a
reinsured policy due to a misstatement of age or sex, the Reinsurer’s liability will change proportionately. The face amount of the reinsured policy will be adjusted from the inception of the policy, and any difference in premiums net of
allowances will be settled. If there is a refund due the policyowner or insured and the Company is required by state law or regulation to pay interest to the policyowner or insured, then the Reinsurer will include this amount of interest to the
Company in the settlement. If interest is not required by state law or regulation, then the refund by the Reinsurer will be without interest. 

  
 ARTICLE X
CONTINUES... 

  
 15 

	8)	 Extra-Contractual Damages. The Reinsurer will not participate in punitive or compensatory damages that
are awarded against the Company as a result of an act, omission, or course of conduct committed by the Company, its agents, or representatives in connection with claims covered under this Agreement. The Reinsurer will, however, pay its share of
statutory penalties awarded against the Company in connection with claims covered under this Agreement only if the Reinsurer did not elect to opt out in writing of the contest, compromise, or litigation. 

The Parties recognize that circumstances may arise in which equity would require the Reinsurer, to the extent permitted by law, to share
proportionately in Punitive and Compensatory damages that result from the claims denial decision. The Parties agree that such circumstances are limited to those situations in which the Reinsurer recommended in writing, or acknowledged in writing the
act or course of conduct of the Company that ultimately resulted in the assessment of the extra-contractual damages. In such situations, the Reinsurer shall reimburse the Company in an amount equal to the lesser of the proportional amount relating
to the Reinsurer’s direct and proximate participation in the actions that led to the extra-contractual damages and the Reinsurer’s share of the extra-contractual damages. 

For purposes of this Article, the following definitions will apply. 

“Punitive Damages” are those damages awarded as a penalty, the amount of which is neither governed nor fixed by statute. 

“Compensatory Damages” are those amounts awarded to compensate for the actual damages sustained, and are not awarded as a penalty,
nor fixed in amount by statute. 
 “Statutory Penalties” are those amounts awarded as a penalty, but are fixed in amount by
statute. In no event, for purposes of this Agreement, does the term include Punitive Damages. 

  
 ...END OF ARTICLE X

  
 16 

 ARTICLE XI 

RETENTION LIMIT CHANGES 
 If the
Company changes its maximum retention limits as shown in Exhibit A, it will provide the Reinsurer with written notice of the intended changes thirty (30) days in advance of their effective date. 

A change to the Company’s maximum retention limits will not affect the reinsured Policies in force except as specifically provided
elsewhere in this Agreement. Furthermore, unless agreed in writing, between the parties, an increase in the Company’s retention schedule will not effect an increase in the total risk amount that it may automatically cede to the Reinsurer. 

...END OF ARTICLE XI 

  
 17 

 ARTICLE XII 

RECAPTURE 
  

	1)	 In addition to any other recapture rights provided herein, the Company has the option to recapture certain risk
amounts after the level premium period of each plan only upon an increase in the Company’s maximum retention limit as set forth in Exhibit A. The Company will maintain the existing quota share percentage of retention; however it may apply the
percentage to the new increased limits. The amount eligible for recapture will be the difference between the amount originally retained and the amount the Company would have retained on the same quota share basis had the new retention schedule been
in effect at the time of issue. The Company may apply its increased retention limits to reduce the amount of reinsurance in force as follows: 

  

	 	a.	 The Company must give the Reinsurer ninety (90) days written notice prior to its intended date of the
commencement of recapture. 

  

	 	b.	 The reduction of reinsurance on affected policies will become effective on the policy anniversary date
immediately following the notice of election to recapture; however, no reduction will be made prior to the policy anniversary specified in Exhibit D. 

  

	 	c.	 If any reinsured policy is recaptured, all reinsured policies eligible for recapture under the provisions of
this Article must be recaptured up to the Company’s new maximum retention limits in a consistent manner and the Company must increase its total amount of insurance on each reinsured life. The Company may not revoke its election to recapture for
policies becoming eligible at future anniversaries. 

 When performed in accordance with the terms of this Agreement, there
shall be no fee or penalty to the Company for exercising the Company’s increase in retention and recapture rights. 
 If portions of the
reinsured policy have been ceded to more than one reinsurer, the Company must allocate the reduction in reinsurance so that the amount reinsured by each reinsurer after the reduction is proportionately the same as if the new maximum dollar retention
limits had been in effect at the time of issue. 
 The amount of reinsurance eligible for recapture is based on the current amount at risk as
of the date of recapture. For a policy issued as a result of exchange, conversion, or re-entry, the recapture terms of the reinsurance agreement covering the original policy will apply, and the duration period
for the purpose of recapture will be measured from the effective date of the reinsurance on the original policy. 
 After the effective date
of recapture, the Reinsurer will not be liable for any reinsured policies or portions of such reinsured policies eligible for recapture that the Company has overlooked. 

...END OF ARTICLE XII 

  
 18 

 ARTICLE XIII 

GENERAL PROVISIONS 
  

	1)	 Currency. All payments and reporting by both parties under this Agreement will be made in the currency
specified in Exhibit C. 

  

	2)	 Premium Tax. The Reinsurer will not reimburse the Company for premium taxes. 

 

	3)	 Minimum Cession. The Company will not cede a policy to the Reinsurer unless the amount to be reinsured
at issue exceeds the Initial Minimum Cession amount shown in Exhibit C. Reinsurance will be cancelled on any policy when its reinsured net amount at risk falls below the Trivial Amount limit shown in Exhibit C. 

 

	4)	 Interest Rate. If under the terms of this Agreement, interest is accrued on amounts due either the
Company or the Reinsurer, such interest will be calculated from the due date using the 13-week Treasury Bill rate reported for the last business day of the calendar month in the “Money Rates” section
of the Wall Street Journal or comparable publication. 

  

	5)	 Inspection of Records. The Reinsurer and the Company, or their duly authorized representatives, will
have the right to inspect and audit original papers, records, and all documents relating to the business reinsured under this Agreement including but not limited to underwriting, claims processing, and administration. Such access will be provided
during regular business hours at the office of the inspected party. The Reinsurer may suspend payments relating to matters in dispute that arise from such inspection and audit until such dispute is resolved by the parties either through mutual
agreement or by arbitration. In the event the dispute is settled by mutual agreement, the appropriate party shall pay the other party the agreed upon amount, if any, plus interest at the rate stated in Article XIII, Section 4, Interest Rate. In
the event the dispute is settled by arbitration in accordance with Article XVII, Arbitration, the arbitration panel will determine any amounts and interest that are payable. 

 

	6)	 Off-Set. Any debts or credits, in favor of or against either the
Reinsurer or the Company with respect to this Agreement are deemed mutual debts or credits and may be offset, and only the balance will be allowed or paid. 

  

	    	 The right of offset will not be affected or diminished because of the insolvency of either party.

  

	7)	 Errors and Omissions. If through unintentional error, oversight, omission, or misunderstanding
(collectively “errors”), the Reinsurer or the Company fails to comply with the terms of this Agreement and if, upon discovery of the error by either party, the other is promptly notified, each thereupon will be restored to the position it
would have occupied if the error had not occurred, including interest. For the avoidance of doubt, the parties agree that the term errors relates only to clerical and ministerial errors. 

 

	    	 If it is not possible to restore each party to the position it would have occupied but for the error, the
parties will endeavor in good faith to promptly resolve the situation in a manner that is fair and reasonable, and most closely approximates the intent of the parties as evidenced by this Agreement. 

ARTICLE XIII CONTINUES... 

  
 19 

 The Reinsurer will not provide reinsurance for policies that do not satisfy the parameters
of this Agreement, nor will the Reinsurer be responsible for negligent or deliberate acts or for repetitive errors in administration by the Company. If either party discovers that the Company has failed to cede reinsurance as provided in this
Agreement, or failed to comply with its reporting requirements, the Reinsurer may require the Company to audit its records for similar errors and to take the actions necessary to avoid similar errors in the future. 

 

	8)	 Company Forms and Rates. The Company agrees to keep the Reinsurer informed of the identity and terms of
its policies, riders and contracts reinsured under this Agreement, as well as any special programs affecting reinsurance hereunder. The Company will provide the Reinsurer with a copy of its application forms, policy and rider forms, premium and
nonforfeiture values, reserve tables, and any other forms or tables needed for proper handling of reinsurance under this contract. The Company will advise the Reinsurer in writing of any changes to existing forms, nonforfeiture values and reserve
tables, or new forms it may adopt. 

 ...END OF ARTICLE XIII 

  
 20 

 ARTICLE XIV 

DAC TAX 
 The parties to this
Agreement agree to the following provisions 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: 
  

	 	a.	 The term “party” refers to either the Company or the Reinsurer, as appropriate.

  

	 	b.	 The terms used in this Article are defined by reference to Regulation
Section 1.848-2, effective December 29, 1992. 

  

	 	c.	 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). 

  

	 	d.	 Both parties agree to exchange information pertaining to the amount of net consideration under this Agreement
each year to ensure consistency, or as otherwise required by the Internal Revenue Service. 

  

	 	e.	 The Company will submit a schedule to the Reinsurer by May of each year with its calculation of the net
consideration for the preceding calendar year. This schedule of calculations will be accompanied by a statement signed by an officer of the Company stating that the Company will report such net consideration in its tax return for the preceding
calendar year. The Reinsurer may contest such calculation by providing an alternative calculation to the Company in writing within thirty (30) days of the Reinsurer’s receipt of the Company’s calculation. If the Reinsurer does not so
notify the Company within the required timeframe, the Reinsurer will report the net consideration as determined by the Company in the Reinsurer’s tax return for the previous calendar year. 

 

	 	f.	 If the Reinsurer contests the Company’s calculation of the net consideration, the parties will act in good
faith to reach an agreement as to the correct amount within thirty (30) days of the date the Reinsurer submits its alternative calculation. If the Company and the Reinsurer reach an agreement on an amount of net consideration, each party will
report the agreed upon amount in its tax return for the previous calendar year. 

  

	 	g.	 Both the Company and the Reinsurer represent and warrant that they are subject to United States taxation under
either Subchapter L or Subpart F of Part III of Subchapter N of the Internal Revenue Code of 1986, as amended. 

 ...END OF
ARTICLE XIV 

  
 21 

 ARTICLE XV 

INSOLVENCY 
  

	1)	 Definition of 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 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 to avoid insolvency or makes
formal application for any bankruptcy, dissolution, liquidation 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. 

  

	2)	 Insolvency of the Company. In the event of the insolvency of the Company, all reinsurance payments due
under this Agreement will be payable directly to the liquidator, rehabilitator, receiver, or statutory successor of the Company, without diminution because of the insolvency, for those claims allowed against the Company by any court of competent
jurisdiction or by the liquidator, rehabilitator, receiver or statutory successor having authority to allow such claims. 

In the event of Insolvency of the Company, the liquidator, rehabilitator, receiver, or statutory successor will give written notice to the
Reinsurer of all pending claims against the Company on any policies reinsured within a reasonable time after such claim is filed in the Insolvency proceeding. While a claim is pending, the Reinsurer may investigate and interpose, at its own expense,
in the proceeding where the claim is adjudicated, any defense or defenses that it may deem available to the Company or its liquidator, rehabilitator, receiver, or statutory successor. 

The expense incurred by the Reinsurer will be chargeable, subject to court approval, against the Company as part of the expense of liquidation
to the extent of a proportionate share of the benefit that may accrue to the Company solely as a result of the defense undertaken by the Reinsurer. Where two or more reinsurers are participating in the same claim and a majority in interest elects to
interpose a defense or defenses to any such claim, the expense will be apportioned in accordance with the terms of this Agreement as though such expense had been incurred by the Company. 

The Reinsurer will be liable only for the amounts reinsured and will not be or become liable for any amounts or reserves to be held by the
Company on policies reinsured under this Agreement. 
 ARTICLE XV CONTINUES... 

  
 22 

	3)	 Insolvency of the Reinsurer. In the event of the insolvency of the Reinsurer, the Company may, upon 90
days’ written notice to the Reinsurer, its liquidator, receiver or statutory successor, recapture all of the business reinsured under this Agreement. 

In this event of recapture the Reinsurer will return any unearned reinsurance premiums to the Company and the Company will return any
unamortized first year allowances on policies in force at the date of recapture to the Reinsurer. 
 The unamortized first year allowance on
an in force policy will be calculated as: 
 Max {0, [1—(Recapture date—effective date of policy) divided by (10 years)] 

times (first year allowance paid by the reinsurer on policy)} 

...END OF ARTICLE XV 

  
 23 

 ARTICLE XVI 

REINSURER’S RIGHT OF NOTICE OF UNUSUAL PRACTICES 

In providing reinsurance facilities to the Company under this Agreement, the Reinsurer has granted the Company considerable authority with respect to
automatic binding power, reinstatements, claim settlements, and the general administration of the reinsurance account. To facilitate transactions, the Reinsurer has required the minimum amount of information and documentation possible, reflecting
its utmost faith and confidence in the Company. The Reinsurer assumes that, except as otherwise notified in writing by the Company, and agreed to in writing by the Reinsurer, the underwriting, claims and other insurance practices employed by the
Company with respect to reinsurance ceded under this Agreement are generally consistent with the customary and usual practices of the insurance industry as a whole. Where the Company does engage in exceptional or uncustomary practices or implements
a change in its underwriting rules or guidelines, with respect to business covered under this Agreement, the Company agrees to advise the Reinsurer in writing forty-five (45) days prior to implementing such practice or change and receive a
written acceptance of said practice or change from the Reinsurer before assigning any liability to the Reinsurer with respect to any reinsurance issued under such practice or change. The Company acknowledges and agrees that its covenant to the
Reinsurer to so advise the Reinsurer of any exceptional or uncustomary practice or implementation of such a significant change is a material incentive to the Reinsurer agreeing to enter into this Agreement, and absent such a covenant, the Reinsurer
would not have entered into this Agreement. 
 ...END OF ARTICLE XVI 

  
 24 

 ARTICLE XVII 

ARBITRATION 
  

	1)	 Intention. It is the intention of the Reinsurer and the Company that the customs and practices of the
life insurance and reinsurance industry will be given full effect in the operation and interpretation of this Agreement. The parties agree to act in all matters with the highest good faith. However, if the Reinsurer and the Company cannot mutually
resolve a dispute that arises out of or relates to this Agreement, the dispute will be decided through arbitration as a precedent to any right of action hereunder. 

 

	2)	 Process. To initiate arbitration, either the Company or the Reinsurer will notify the other party in
writing of its desire to arbitrate, stating the nature of its dispute and the remedy sought. The party to which the notice is sent will respond to the notification in writing within fifteen (15) days of its receipt. 

There will be three arbitrators who will be current or former senior officers of life insurance or life reinsurance companies other than the
parties to this Agreement, their affiliates or subsidiaries. Each of the parties will be impartial with respect to the dispute. Each of the parties will appoint one of the arbitrators and these two arbitrators will select the third. If either party
refuses or neglects to appoint an arbitrator within sixty (60) days of the initiation of the arbitration, the other party may appoint the second arbitrator. If the two arbitrators do not agree on a third arbitrator within thirty (30) days of
the appointment of the second arbitrator, then each arbitrator shall nominate three individuals selected from the ARIAS-US list of certified arbitrators. Each arbitrator shall then decline two of the
nominations presented by the other arbitrator. The third arbitrator shall then be chosen from the remaining two nominations by drawing lots. 
  

	3)	 Arbitration Hearing. Once chosen, the arbitrators are empowered to select the site of the arbitration,
in no event will this be more that 6 months after the appointment of the third arbitrator. As soon as possible, the arbitrators will establish arbitration procedures as warranted by the facts and issues of the particular case. The arbitrators will
have the power to determine all procedural rules of the arbitration, including but not limited to inspection of documents, examination of witnesses and any other matter relating to the conduct of the arbitration. The arbitrators may consider any
relevant evidence; they will weigh the evidence and consider any objections. Each party may examine any witnesses who testify at the arbitration hearing. 

  

	4)	 Governance. Notwithstanding that this Agreement shall be governed by the law of Illinois in accordance
with Article 1.3, the rights and procedures applicable to any arbitration commenced under this Article shall be governed by the Federal Arbitration Act rather than any state arbitration act. This Article will survive termination of this Agreement.

  

	5)	 Decision. The arbitrators will base their decision on the terms and conditions of this Agreement and the
customs and practices of the life insurance and reinsurance industries. The arbitrators, however, shall consider this Agreement an honorable engagement rather than merely a legal obligation; they are relieved of all judicial formalities and may
abstain from following the strict rules of law. The decision of the arbitrators will be made by majority 

 ARTICLE XVII
CONTINUES... 

  
 25 

	 	
rule and will be submitted in writing. The decision will be final and binding on both parties and there will be no appeal from the decision. Either party to the arbitration may petition any court
having jurisdiction over the parties to reduce the decision to judgment. 

  

	6)	 Costs of Arbitration. Unless the arbitrators decide otherwise, each party will bear the expense of its
own arbitration activities, including its appointed arbitrator and any outside attorney and witness fees. The parties will jointly and equally bear the expense of the third arbitrator and other costs of the arbitration. 

 

	7)	 This Article XVII shall survive termination of this Agreement. 

...END OF ARTICLE XVII 

  
 26 

 ARTICLE XVIII 

CONFIDENTIALITY 
 The Company and
the Reinsurer agree that Customer and Proprietary Information will be treated as confidential. Customer Information Includes, but is not limited to, medical, financial, and other personal information about proposed, current, and former policyowners,
insureds, applicants, and beneficiaries of policies issued by the original Company. Proprietary Information includes, but is not limited to, business plans and trade secrets, mortality and lapse studies, underwriting manuals and guidelines,
applications and contract forms, and the specific and conditions of this Agreement. 
 Customer and Proprietary Information will not include information
that: 
  

	a.	 is or becomes available to the general public through no fault of the party receiving the Customer or
Proprietary Information (the “Recipient”); 

  

	b.	 is independently developed by the Recipient; 

 

	c.	 is acquired by the Recipient from a third party not covered by a confidentiality agreement; or

  

	d.	 is disclosed under a court order, law or regulation. 

The parties will not disclose such information to any other parties unless agreed to in writing, except as necessary for retrocession purposes, as requested
by external auditors, as required by court order, or as required or allowed by law or regulation. 
 The Company acknowledges that the Reinsurer can
aggregate data with other companies reinsured with the Reinsurer as long as the data cannot be identified as belonging to the Company. 

...END OF ARTICLE XVIII 

  
 27 

 ARTICLE XIX 

DURATION OF AGREEMENT 
 This
Agreement is indefinite as to its duration. The Company or the Reinsurer may terminate this Agreement with respect to the reinsurance of new business by giving ninety (90) days written notice of termination to the other party, in which case the
termination data of this Agreement shall be the ninetieth (90th) day after the date notice is given. 
 During the notification period, the Company will
continue to cede and the Reinsurer will continue to accept policies covered under the terms of this Agreement. The Reinsurer shall not be liable for policies with issue dates on end after the termination data of this Agreement. Reinsurance coverage
on all reinsured policies will remain in force until the termination or expiry of the policies or until the contractual termination of reinsurance under the terms of this Agreement, whichever occurs first. 

...END OF ARTICLE XIX 

  
 28 

 ARTICLE XX 

EXECUTION 
 This Agreement is
effective as of 12:01 a.m. on January 1, 2012, and applies to all eligible with issue dates on or after such date. The Company and the Reinsurer acknowledge and agree that the Company may backdate policies up to six (6) months only for the
purpose of saving age. 
 Counterparts. This Agreement may be executed simultaneously in any number of counterparts, each of which shall be deemed an
original, but all of which shall constitute one end the same instrument. 
 This Agreement has been made in duplicate and is hereby executed by both
parties. 
  

							
	 HANNOVER LIFE REASSURANCE COMPANY

OF AMERICA
 ORLANDO, FLORIDA
	    	 FIDELITY LIFE ASSOCIATION

Chicago, ILLINOIS

				
	 Date:
	 	 Dec 12, 2012
	    	Date:	 	 December 14, 2012

				
	 By:
	 	 UNDICIPHERABLE
	    	By:	 	 /s/ Mark Wray

				
	 Title:
	 	 Vice President
	    	Title:	 	 Sr. VP/CFO

				
	 By:
	 	 UNDICIPHERABLE
	    	By:	 	 UNDICIPHERABLE

				
	 Title:
	 	 AVP, Marketing
	    	Title:	 	 Financial Actuary

 ...END OF ARTICLE XX 

  
 29 

 EXHIBIT A 

RETENTION LIMITS OF THE COMPANY 
  

	(a)	 Retention Limit 

The Company’s maximum dollar retention is $300,000 (all cause and ADB combined) per life for all plans written. 

 

	 	(b)	 First Dollar Quota Share - Company’s Quota Share Percentage 

The Company will retain fifty (50) percent of the face amount of each policy, but not to exceed the above maximum dollar retention limits
per life. 
 However, the Company may retain more than fifty (50) percent of the face amount on any one life to the extent necessary to
satisfy the Jumbo Limits shown in Exhibit B, or to satisfy any other provision in this Agreement that causes a reduction in the amount ceded to any Reinsurer in the Pool that is sharing the risk on the same life under a like Agreement.
Notwithstanding this paragraph, the amount ceded to the Reinsurer under this Agreement is governed by the amount in the first paragraph. 
  

	 	(c)	 Proportional Risk 

The Company shall retain an equal proportion of all cause and accidental death benefit amounts on policies reinsured under this agreement. 

  
 30 

 EXHIBIT B 

PLANS COVERED 
 Policy plans,
riders and benefits issued on plans with effective dates within the applicable period shown below may qualify for automatic reinsurance under the terms of this Agreement. 
  

							
	B.1	 	   Plan Identification	  	Issue Ages	  	Start Date
				
		 	 10 Year Term MED
	  	18 – 65	  	January 1, 2012
		 	 10 Year Term NMD
	  	18 – 65	  	January 1, 2012
		 	 15 Year Term MED
	  	18 – 65	  	January 1, 2012
		 	 15 Year Term NMD
	  	18 – 65	  	January 1, 2012
		 	 20 Year Term MED
	  	18 – 60	  	January 1, 2012
		 	 20 Year Term NMD
	  	18 – 60	  	January 1, 2012
		 	 30 Year Term MED
	  	18 – 50	  	January 1, 2012
		 	 30 Year Term NMD
	  	18 – 50	  	January 1, 2012

 It is noted here that there are 59 policies, with policy numbers as shown below, that were issued after January 1, 2012,
but were issued under the (generally higher) gross premium scale in effect prior to January 1, 2012. These policies are part of this agreement, and the premiums from Company to Reinsurer will be based on the direct premiums Company receives on these
59 policies 
  

					
	 0100337358
	  	0100342099	  	0100343252
	 0100339158
	  	0100342243	  	0100343339
	 0100340027
	  	0100342336	  	0100343351
	 0100340238
	  	0100342401	  	0100343359
	 0100340680
	  	0100342476	  	0100343395
	 0100341015
	  	0100342620	  	0100343418
	 0100341026
	  	0100342719	  	0100343444
	 0100341203
	  	0100342833	  	0100343480
	 0100341299
	  	0100342859	  	0100343505
	 0100341431
	  	0100342938	  	0100343538
	 0100341445
	  	0100342939	  	0100343570
	 0100341535
	  	0100342973	  	0100343598
	 0100341696
	  	0100343095	  	0100343723
	 0100341738
	  	0100343139	  	0100343731
	 0100341857
	  	0100343143	  	0100343734
	 0100341865
	  	0100343153	  	0100343743
	 0100341867
	  	0100343171	  	0100343746
	 0100342036
	  	0100343208	  	0100346466
	 0100342039
	  	0100343230	  	0100406981
	 0100342041
	  	0100343242	  	

 Exhibit B CONTINUES... 

  
 31 

	B.2	 Waiver of Premium Disability Benefits 

Not Applicable 
  

	B.3	 Accidental Death Benefit Riders 

There are no accidental death benefit separate premium riders on this policy. Given the nature of the covered policy form, where the coverage
is a mixture of all-cause and accidental death benefit coverage, Reinsurer is responsible for its pro-rata-share of any accidental death benefits. 

 

	B.4	 Other Riders 

Not Applicable 
 ...END OF Exhibit
B 

  
 32 

 EXHIBIT C 

AUTOMATIC BINDING LIMITS 
  

	C.1	 Life Reinsurance 

The limits in this Exhibit C refer to insured lives are who are United States or Canadian citizens residing in the United States and Canada:

  

	C.1	 Life Reinsurance 

 

					
	 Issue Ages
	  	 Maximum Dollar

Retention Limits
	 
	 18 – 65
	  	$	1,000,000	 

 Reinsurer’s Quota Share Percentage – 1st
Dollar Quota Share 
 The Reinsurer’s share will be fifty percent (50%) of the first $600,000 issue amount and 100% of the amount
over $600,000 not to exceed the Reinsurer’s maximum per life Automatic Binding Limit shown above. 
  

	C.2	 Waiver of Premium Disability Benefits 

Not Applicable 
  

	C.3	 Accidental Death Benefits 

Not Applicable 
  

	C.4	 Other Riders 

Not Applicable 
  

	C.5	 Jumbo Limits – Automatic coverage of any risk will be granted only if the total amount inforce and
applied for on the life in all insurance companies, including any amount to be replaced, does not exceed the amount below. 

$10,000,000 
  

	C.6	 Minimum Cession 

$5,000 

  
 33 

	C.7	 Recapture Period 

Execpt as noted in Article XV, Section 3, Insolvency of the Reinsurer, recapture is allowed only after the end of level premium period.
Recapture allowed for an increase in the Company’s maximum dollar retention, applicable only to policies where the maximum dollar retention was held at issue. 
  

	C.8	 Currency 

United States Dollars 
  

	C.9	 Professions 

Full-time professional athletes and full-time professional entertainers, as disclosed on the life application, are excluded from automatic
reinsurance under this Agreement but may be submitted for facultative consideration. 
  

	C.10	 Territories 

United States policies, issued to United States or Canadian citizens residing in the United States and Canada. 

 

	C.11	 Conditional Receipt or Temporary Insurance Limit 

Not Applicable 

  
 34 

 EXHIBIT D-1 

PROCEDURES FOR REPORTING 

PLACING REINSURANCE INTO EFFECT: 
 For automatic
reinsurance, the Company agrees to include all required information with respect to a policy on the new business segment of the report or with a new business identifier on its next monthly or quarterly report submitted in accordance with the
“Reporting” section of this Exhibit following issuance of the policy. 
 For facultative reinsurance, the Company agrees to submit an application
form for facultative reinsurance, as mutually agreed upon by the Parties. The Company agrees to place and allocate reinsurance for Facultative policies in accordance with its allocation rules for placement of facultative cases among its reinsurers
making a facultative offer to reinsure a policy. The Company shall reinsure the policy by including all required information with respect to a policy on the new business segment of the report or with a new business identifier on its next monthly or
quarterly report submitted in accordance with the “Reporting” section of this Exhibit following issuance of the Policy, but in no event later than one hundred twenty (120) days from the date of the Reinsurer’s final facultative offer
or the date specified in the Reinsurer’s facultative offer. The Company may request an extension beyond the one hundred twenty (120) period; however, such an extension shall require the Reinsurer’s written approval 

The Company will maintain adequate records to administer the reinsurance accounts and will cede reinsurance under this Agreement on a bordereau
self-administration basis. The Company will provide the Reinsurer with an activity report on computer disk or other mutually agreed upon electronic media, substantially in conformity with the following: 

Exhibit D-1 CONTINUES... 

  
 35 

	A)	 Monthly New Business and Renewals Premium Statement 

The Company will provide the Reinsurer with a report of all reinsurance policies issued or renewing during the past month(s) accompanied by
reinsurance premiums for such policies, which should include the following: 
  

					
	 1)   The report should be segregated into new issues, balance of
first year policies and renewals and each segment should state the gross premium, allowances and resultant net premium due for each life reinsurance policy.

	
	 2)   Premium due for supplemental benefits should be stated
separately.

		
	 3)   transaction code
	  	 11)  plan of insurance

		
	 4)   transaction effective date
	  	 12)  policy amount

		
	 5)   policy number
	  	 13)  reinsurance amount

			
	 6)   insured’s name:  surname
	 		  	 14)  reinsured risk amount

			
	 first name
	 		  	 15)  table rating

			
	 middle initial
	 		  	 16)  flat extra amount and duration

			
	 7)   date of birth
	 		  	 17)  underwriting class (smoker class)

			
	 8)   sex
	 		  	 18)  country/state of residence

			
	 9)   issue age
	 		  	 19)  automatic/facultative indicator

			
	 10)  policy date (original and back date)
	 		  	
20)  DWP, ADB, Rider reinsurance amount (if applicable)

			
	 10.5)  issue date
	 		  	

  

	B)	 Monthly Adjustment Report 

The Company will report the details of all policy terminations and changes on the reinsurance policies. In addition to the information in A
above, the report should provide information about the type of change, the effective date, and the monetary result of the change with respect to reinsurance. 
  

	C)	 Monthly Policy Exhibit Report 

The Company will provide a summary of new issues, terminations, recaptures, changes, death claims and reinstatements during the month(s) and
the in force reinsurance at the end of the month. 
  

	D)	 Quarterly In force and Reserve Listing 

Within fifteen (15) days after the close of each calendar quarter, the Company will furnish the Reinsurer with a list of reinsurance by
policy, which should include the following information: 
  

	 	1)	 1-4, 10.5, and 19 in Section A above 

...END OF Exhibit D-1 

  
 36 

 EXHIBIT D-2 

FINANCIAL REPORTING REQUIREMENTS 

Please provide the following information as soon as practical after the close of the quarter but not later than the due date as stated in the treaty. Please
provide monthly or other interim reports if available. All reports should include both the Reinsurer’s Treaty Number as well as the Company’s reference number. The Company must maintain and provide upon request, sufficiently
detailed reports such that reserve calculations can be independently verified by the Reinsurer’s auditors and examiners. 
  

	A)	 Quarterly Reporting 

 

	 	1)	 Policy counts and face amount ceded. 

 

	 	2)	 Statutory reserves should be split between YRT and coinsurance reserves and by type of reserve and issue year.

  

	 	3)	 Claim information – Claim Number, Policy number, Insured’s Name, Business or Policy Type. Type of
Reinsurance (Co or YRT), Notification Date, Date of Death, Date of Birth, Cause of Death, Claim Amount, States (paid, pending, resisted). 

  

	 	4)	 Estimated tax reserves corresponding to the statutory reserves described above (4th quarter only). 

  

	 	5)	 Policy level detail statutory reserve listing via electronic media. 

 

	B)	 Annual Statutory Reporting 

 

	 	1)	 Actuarial Opinion signed by the appointed actuary 

 

	 	2)	 For reserves using X-factors that are less than 100% in any duration,
an actuarial opinion supported by an actuarial report with sufficient supporting documentation and detailed data to allow an independent review of the X-factors. 

 

	 	3)	 Policy Exhibit 

  

	 	4)	 Policy level detail statutory reserve listing via electronic media. 

 

	 	5)	 Exhibit reconciling detail listing to summary reports. 

Items 1-3 in this Exhibit D-2. Section B will be the relevant
reports for Company’s entire business portfolio; no separate documents will be prepared covering only the business ceded under this Agreement. 
  

	C)	 Annual Tax reporting 

 

	 	1)	 Actual tax reserves by tax valuation basis. 

 

	 	2)	 DAC tax information as stated in the treaty. 

 

	 	3)	 Policy level detail tax reserve listing via electronic media. 

 

	D)	 Statutory Annual Statement when published. 

  
 37 

 EXHIBIT E 

REINSURANCE PREMIUM RATES 
  

	E.1	 Life 

Reinsurance premiums during the level term period will be the proportionate share of the retail premium charged the insured, including a
proportionate share of any policy fees. Hybrid Term Allowances are attached, and will also apply to policy fees during the level premium period. After the level premium period, the allowance rate on policy fees will be 100%. 

 

	E.2	 Waiver of Premium Disability Benefits 

Not Applicable 
  

	E.3	 Accidental Death Benefit 

Not Applicable 
  

	E.4	 Other Riders 

Not Applicable 
  

	E.5	 Age Basis 

Age Nearest Birthday 
  

	E.6	 Policy Fees 

$65.00 in all years, subject to the allowances as described above. 
  

	E.7	 Substandard Risks 

For Nonmed policies, Tier 3 reinsurance premium rates will be defined as two times the Tier 2 premium rates. For Medical policies, reinsurance
premium rates are increased by 25% for each table assigned and applied to the Standard non-tobacco/Standard tobacco risk class. 
  

	E.8	 Flat Extras 

Reinsurance premiums are equal to the annual fiat extra premium charged to the insured on the amount of insurance reinsured less a 10%
allowance in all years. 

  
 38 

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 10 Year Term - Under $100,000 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual Policy
Fee 
  

																																									
	 Issue
Age
	  	Male	  	Female
	  	Non-Nicotine	  	Nicotine	  	Non-Nicotine	  	Nicotine
	  	Pref	  	Std	  	Pref	  	Std	  	Pref	  	Std	  	Pref	  	Std
	 18
	  	 	 	0.56		  	 	 	1.10		  	 	 	1.83		  	 	 	2.42		  	 	 	0.46		  	 	 	0.87		  	 	 	1.56		  	 	 	1.77	
	 19
	  	 	 	0.56		  	 	 	1.10		  	 	 	1.83		  	 	 	2.43		  	 	 	0.46		  	 	 	0.87		  	 	 	1.56		  	 	 	1.77	
	 20
	  	 	 	0.56		  	 	 	1.10		  	 	 	1.83		  	 	 	2.43		  	 	 	0.46		  	 	 	0.87		  	 	 	1.56		  	 	 	1.77	
	 21
	  	 	 	0.58		  	 	 	1.10		  	 	 	1.83		  	 	 	2.44		  	 	 	0.46		  	 	 	0.87		  	 	 	1.56		  	 	 	1.77	
	 22
	  	 	 	0.58		  	 	 	1.10		  	 	 	1.83		  	 	 	2.45		  	 	 	0.48		  	 	 	0.87		  	 	 	1.56		  	 	 	1.77	
	 23
	  	 	 	0.59		  	 	 	1.11		  	 	 	1.83		  	 	 	2.47		  	 	 	0.48		  	 	 	0.87		  	 	 	1.58		  	 	 	1.79	
	 24
	  	 	 	0.61		  	 	 	1.11		  	 	 	1.83		  	 	 	2.48		  	 	 	0.48		  	 	 	0.87		  	 	 	1.58		  	 	 	1.79	
	 25
	  	 	 	0.62		  	 	 	1.11		  	 	 	1.83		  	 	 	2.49		  	 	 	0.49		  	 	 	0.87		  	 	 	1.58		  	 	 	1.79	
	 26
	  	 	 	0.62		  	 	 	1.11		  	 	 	1.86		  	 	 	2.52		  	 	 	0.49		  	 	 	0.87		  	 	 	1.58		  	 	 	1.85	
	 27
	  	 	 	0.62		  	 	 	1.13		  	 	 	1.87		  	 	 	2.54		  	 	 	0.49		  	 	 	0.87		  	 	 	1.58		  	 	 	1.91	
	 28
	  	 	 	0.62		  	 	 	1.13		  	 	 	1.90		  	 	 	2.55		  	 	 	0.49		  	 	 	0.87		  	 	 	1.59		  	 	 	2.00	
	 29
	  	 	 	0.63		  	 	 	1.13		  	 	 	1.93		  	 	 	2.58		  	 	 	0.49		  	 	 	0.87		  	 	 	1.59		  	 	 	2.06	
	 30
	  	 	 	0.63		  	 	 	1.14		  	 	 	1.97		  	 	 	2.62		  	 	 	0.49		  	 	 	0.87		  	 	 	1.59		  	 	 	2.07	
	 31
	  	 	 	0.63		  	 	 	1.14		  	 	 	1.97		  	 	 	2.67		  	 	 	0.51		  	 	 	0.90		  	 	 	1.59		  	 	 	2.08	
	 32
	  	 	 	0.65		  	 	 	1.14		  	 	 	1.99		  	 	 	2.72		  	 	 	0.54		  	 	 	0.94		  	 	 	1.59		  	 	 	2.10	
	 33
	  	 	 	0.66		  	 	 	1.14		  	 	 	1.99		  	 	 	2.77		  	 	 	0.55		  	 	 	0.98		  	 	 	1.61		  	 	 	2.11	
	 34
	  	 	 	0.68		  	 	 	1.15		  	 	 	1.99		  	 	 	2.86		  	 	 	0.58		  	 	 	1.00		  	 	 	1.61		  	 	 	2.13	
	 35
	  	 	 	0.69		  	 	 	1.15		  	 	 	2.00		  	 	 	2.96		  	 	 	0.61		  	 	 	1.00		  	 	 	1.61		  	 	 	2.14	
	 36
	  	 	 	0.72		  	 	 	1.23		  	 	 	2.11		  	 	 	2.97		  	 	 	0.63		  	 	 	1.06		  	 	 	1.69		  	 	 	2.28	
	 37
	  	 	 	0.75		  	 	 	1.31		  	 	 	2.25		  	 	 	3.20		  	 	 	0.66		  	 	 	1.10		  	 	 	1.80		  	 	 	2.44	
	 38
	  	 	 	0.79		  	 	 	1.39		  	 	 	2.41		  	 	 	3.49		  	 	 	0.70		  	 	 	1.17		  	 	 	1.92		  	 	 	2.61	
	 39
	  	 	 	0.82		  	 	 	1.49		  	 	 	2.56		  	 	 	3.66		  	 	 	0.75		  	 	 	1.24		  	 	 	2.04		  	 	 	2.82	
	 40
	  	 	 	0.86		  	 	 	1.59		  	 	 	2.73		  	 	 	3.85		  	 	 	0.79		  	 	 	1.32		  	 	 	2.20		  	 	 	3.06	
	 41
	  	 	 	0.94		  	 	 	1.72		  	 	 	2.99		  	 	 	4.24		  	 	 	0.86		  	 	 	1.41		  	 	 	2.38		  	 	 	3.31	
	 42
	  	 	 	1.04		  	 	 	1.87		  	 	 	3.25		  	 	 	4.66		  	 	 	0.94		  	 	 	1.52		  	 	 	2.59		  	 	 	3.59	
	 43
	  	 	 	1.15		  	 	 	2.03		  	 	 	3.55		  	 	 	5.13		  	 	 	1.04		  	 	 	1.63		  	 	 	2.83		  	 	 	3.93	
	 44
	  	 	 	1.27		  	 	 	2.20		  	 	 	3.86		  	 	 	5.63		  	 	 	1.14		  	 	 	1.77		  	 	 	3.10		  	 	 	4.30	
	 45
	  	 	 	1.39		  	 	 	2.39		  	 	 	4.21		  	 	 	6.20		  	 	 	1.27		  	 	 	1.93		  	 	 	3.39		  	 	 	4.72	
	 46
	  	 	 	1.52		  	 	 	2.61		  	 	 	4.49		  	 	 	6.72		  	 	 	1.37		  	 	 	2.04		  	 	 	3.63		  	 	 	5.11	
	 47
	  	 	 	1.66		  	 	 	2.83		  	 	 	4.79		  	 	 	7.31		  	 	 	1.46		  	 	 	2.17		  	 	 	3.92		  	 	 	5.54	
	 48
	  	 	 	1.82		  	 	 	3.10		  	 	 	5.14		  	 	 	7.96		  	 	 	1.58		  	 	 	2.30		  	 	 	4.21		  	 	 	6.00	
	 49
	  	 	 	2.00		  	 	 	3.39		  	 	 	5.51		  	 	 	8.68		  	 	 	1.70		  	 	 	2.45		  	 	 	4.52		  	 	 	6.51	
	 50
	  	 	 	2.20		  	 	 	3.72		  	 	 	5.93		  	 	 	9.48		  	 	 	1.83		  	 	 	2.61		  	 	 	4.86		  	 	 	7.04	
	 51
	  	 	 	2.42		  	 	 	4.04		  	 	 	6.65		  	 	 	10.21		  	 	 	1.99		  	 	 	2.83		  	 	 	5.32		  	 	 	7.80	
	 52
	  	 	 	2.69		  	 	 	4.39		  	 	 	7.45		  	 	 	11.03		  	 	 	2.15		  	 	 	3.07		  	 	 	5.80		  	 	 	8.62	
	 53
	  	 	 	2.99		  	 	 	4.82		  	 	 	8.34		  	 	 	11.94		  	 	 	2.34		  	 	 	3.31		  	 	 	6.32		  	 	 	9.46	
	 54
	  	 	 	3.32		  	 	 	5.27		  	 	 	9.34		  	 	 	12.96		  	 	 	2.52		  	 	 	3.59		  	 	 	6.86		  	 	 	10.38	
	 55
	  	 	 	3.69		  	 	 	5.79		  	 	 	10.41		  	 	 	14.06		  	 	 	2.73		  	 	 	3.87		  	 	 	7.44		  	 	 	11.32	
	 56
	  	 	 	4.04		  	 	 	6.21		  	 	 	11.32		  	 	 	15.04		  	 	 	2.94		  	 	 	4.23		  	 	 	8.01		  	 	 	12.31	
	 57
	  	 	 	4.42		  	 	 	6.66		  	 	 	12.30		  	 	 	16.07		  	 	 	3.15		  	 	 	4.59		  	 	 	8.61		  	 	 	13.34	
	 58
	  	 	 	4.85		  	 	 	7.15		  	 	 	13.32		  	 	 	17.17		  	 	 	3.39		  	 	 	5.00		  	 	 	9.25		  	 	 	14.42	
	 59
	  	 	 	5.31		  	 	 	7.70		  	 	 	14.44		  	 	 	18.35		  	 	 	3.65		  	 	 	5.42		  	 	 	9.93		  	 	 	14.95	
	 60
	  	 	 	5.80		  	 	 	8.30		  	 	 	15.62		  	 	 	19.62		  	 	 	3.93		  	 	 	5.89		  	 	 	10.66		  	 	 	15.67	
	 61
	  	 	 	6.56		  	 	 	9.34		  	 	 	17.30		  	 	 	21.85		  	 	 	4.30		  	 	 	6.66		  	 	 	11.63		  	 	 	16.85	
	 62
	  	 	 	7.38		  	 	 	10.46		  	 	 	19.07		  	 	 	24.20		  	 	 	4.69		  	 	 	7.51		  	 	 	12.68		  	 	 	18.32	
	 63
	  	 	 	8.30		  	 	 	11.70		  	 	 	20.97		  	 	 	26.72		  	 	 	5.13		  	 	 	8.10		  	 	 	13.82		  	 	 	20.17	
	 64
	  	 	 	9.28		  	 	 	13.07		  	 	 	22.97		  	 	 	29.38		  	 	 	5.62		  	 	 	8.18		  	 	 	15.07		  	 	 	21.06	
	 65
	  	 	 	10.37		  	 	 	14.55		  	 	 	25.07		  	 	 	32.17		  	 	 	6.15		  	 	 	8.99		  	 	 	16.44		  	 	 	22.64	
	        Semi-Annual

       0.520
	  

 
	  	 	 
 
	                        Quarterly

                        
0.280
	
 
	  	 	 
 
	                Monthly

                0.087
	
 
	  	 				  	 				  	 			

  

			
	Page 1 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 10 Year Term - $100,000 - $249,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.40	 	  	 	0.78	 	  	 	1.30	 	  	 	1.83	 	  	 	0.33	 	  	 	0.68	 	  	 	1.11	 	  	 	1.43	 
	 19
	  	 	0.40	 	  	 	0.78	 	  	 	1.30	 	  	 	1.84	 	  	 	0.33	 	  	 	0.68	 	  	 	1.11	 	  	 	1.43	 
	 20
	  	 	0.40	 	  	 	0.78	 	  	 	1.30	 	  	 	1.84	 	  	 	0.33	 	  	 	0.68	 	  	 	1.11	 	  	 	1.43	 
	 21
	  	 	0.41	 	  	 	0.78	 	  	 	1.30	 	  	 	1.84	 	  	 	0.33	 	  	 	0.68	 	  	 	1.11	 	  	 	1.43	 
	 22
	  	 	0.41	 	  	 	0.78	 	  	 	1.30	 	  	 	1.85	 	  	 	0.34	 	  	 	0.68	 	  	 	1.11	 	  	 	1.44	 
	 23
	  	 	0.42	 	  	 	0.79	 	  	 	1.30	 	  	 	1.85	 	  	 	0.34	 	  	 	0.69	 	  	 	1.12	 	  	 	1.44	 
	 24
	  	 	0.43	 	  	 	0.79	 	  	 	1.30	 	  	 	1.86	 	  	 	0.34	 	  	 	0.69	 	  	 	1.12	 	  	 	1.45	 
	 25
	  	 	0.44	 	  	 	0.79	 	  	 	1.30	 	  	 	1.86	 	  	 	0.35	 	  	 	0.69	 	  	 	1.12	 	  	 	1.45	 
	 26
	  	 	0.44	 	  	 	0.79	 	  	 	1.32	 	  	 	1.86	 	  	 	0.35	 	  	 	0.69	 	  	 	1.12	 	  	 	1.45	 
	 27
	  	 	0.44	 	  	 	0.80	 	  	 	1.33	 	  	 	1.86	 	  	 	0.35	 	  	 	0.69	 	  	 	1.12	 	  	 	1.46	 
	 28
	  	 	0.44	 	  	 	0.80	 	  	 	1.35	 	  	 	1.86	 	  	 	0.35	 	  	 	0.70	 	  	 	1.13	 	  	 	1.46	 
	 29
	  	 	0.45	 	  	 	0.80	 	  	 	1.37	 	  	 	1.86	 	  	 	0.35	 	  	 	0.70	 	  	 	1.13	 	  	 	1.47	 
	 30
	  	 	0.45	 	  	 	0.81	 	  	 	1.40	 	  	 	1.86	 	  	 	0.35	 	  	 	0.70	 	  	 	1.13	 	  	 	1.47	 
	 31
	  	 	0.45	 	  	 	0.81	 	  	 	1.40	 	  	 	1.90	 	  	 	0.36	 	  	 	0.70	 	  	 	1.13	 	  	 	1.48	 
	 32
	  	 	0.46	 	  	 	0.81	 	  	 	1.41	 	  	 	1.94	 	  	 	0.38	 	  	 	0.70	 	  	 	1.13	 	  	 	1.49	 
	 33
	  	 	0.47	 	  	 	0.81	 	  	 	1.41	 	  	 	2.00	 	  	 	0.39	 	  	 	0.71	 	  	 	1.14	 	  	 	1.50	 
	 34
	  	 	0.48	 	  	 	0.82	 	  	 	1.41	 	  	 	2.07	 	  	 	0.41	 	  	 	0.71	 	  	 	1.14	 	  	 	1.51	 
	 35
	  	 	0.49	 	  	 	0.82	 	  	 	1.42	 	  	 	2.16	 	  	 	0.43	 	  	 	0.71	 	  	 	1.14	 	  	 	1.52	 
	 36
	  	 	0.51	 	  	 	0.87	 	  	 	1.50	 	  	 	2.25	 	  	 	0.45	 	  	 	0.75	 	  	 	1.20	 	  	 	1.62	 
	 37
	  	 	0.53	 	  	 	0.93	 	  	 	1.60	 	  	 	2.36	 	  	 	0.47	 	  	 	0.78	 	  	 	1.28	 	  	 	1.73	 
	 38
	  	 	0.56	 	  	 	0.99	 	  	 	1.71	 	  	 	2.48	 	  	 	0.50	 	  	 	0.83	 	  	 	1.36	 	  	 	1.85	 
	 39
	  	 	0.58	 	  	 	1.06	 	  	 	1.82	 	  	 	2.60	 	  	 	0.53	 	  	 	0.88	 	  	 	1.45	 	  	 	2.00	 
	 40
	  	 	0.61	 	  	 	1.13	 	  	 	1.94	 	  	 	2.73	 	  	 	0.56	 	  	 	0.94	 	  	 	1.56	 	  	 	2.17	 
	 41
	  	 	0.67	 	  	 	1.22	 	  	 	2.12	 	  	 	3.01	 	  	 	0.61	 	  	 	1.00	 	  	 	1.69	 	  	 	2.35	 
	 42
	  	 	0.74	 	  	 	1.33	 	  	 	2.31	 	  	 	3.31	 	  	 	0.67	 	  	 	1.08	 	  	 	1.84	 	  	 	2.55	 
	 43
	  	 	0.82	 	  	 	1.44	 	  	 	2.52	 	  	 	3.64	 	  	 	0.74	 	  	 	1.16	 	  	 	2.01	 	  	 	2.79	 
	 44
	  	 	0.90	 	  	 	1.56	 	  	 	2.74	 	  	 	4.00	 	  	 	0.81	 	  	 	1.26	 	  	 	2.20	 	  	 	3.05	 
	 45
	  	 	0.99	 	  	 	1.70	 	  	 	2.99	 	  	 	4.40	 	  	 	0.90	 	  	 	1.37	 	  	 	2.41	 	  	 	3.35	 
	 46
	  	 	1.08	 	  	 	1.85	 	  	 	3.19	 	  	 	4.77	 	  	 	0.97	 	  	 	1.45	 	  	 	2.58	 	  	 	3.63	 
	 47
	  	 	1.18	 	  	 	2.01	 	  	 	3.40	 	  	 	5.19	 	  	 	1.04	 	  	 	1.54	 	  	 	2.78	 	  	 	3.93	 
	 48
	  	 	1.29	 	  	 	2.20	 	  	 	3.65	 	  	 	5.65	 	  	 	1.12	 	  	 	1.63	 	  	 	2.99	 	  	 	4.26	 
	 49
	  	 	1.42	 	  	 	2.41	 	  	 	3.91	 	  	 	6.16	 	  	 	1.21	 	  	 	1.74	 	  	 	3.21	 	  	 	4.62	 
	 50
	  	 	1.56	 	  	 	2.64	 	  	 	4.21	 	  	 	6.73	 	  	 	1.30	 	  	 	1.85	 	  	 	3.45	 	  	 	5.00	 
	 51
	  	 	1.72	 	  	 	2.87	 	  	 	4.72	 	  	 	7.25	 	  	 	1.41	 	  	 	2.01	 	  	 	3.78	 	  	 	5.54	 
	 52
	  	 	1.91	 	  	 	3.12	 	  	 	5.29	 	  	 	7.83	 	  	 	1.53	 	  	 	2.18	 	  	 	4.12	 	  	 	6.12	 
	 53
	  	 	2.12	 	  	 	3.42	 	  	 	5.92	 	  	 	8.48	 	  	 	1.66	 	  	 	2.35	 	  	 	4.49	 	  	 	6.72	 
	 54
	  	 	2.36	 	  	 	3.74	 	  	 	6.63	 	  	 	9.20	 	  	 	1.79	 	  	 	2.55	 	  	 	4.87	 	  	 	7.37	 
	 55
	  	 	2.62	 	  	 	4.11	 	  	 	7.39	 	  	 	9.98	 	  	 	1.94	 	  	 	2.75	 	  	 	5.28	 	  	 	8.04	 
	 56
	  	 	2.87	 	  	 	4.41	 	  	 	8.04	 	  	 	10.68	 	  	 	2.09	 	  	 	3.00	 	  	 	5.69	 	  	 	8.74	 
	 57
	  	 	3.14	 	  	 	4.73	 	  	 	8.73	 	  	 	11.41	 	  	 	2.24	 	  	 	3.26	 	  	 	6.11	 	  	 	9.47	 
	 58
	  	 	3.44	 	  	 	5.08	 	  	 	9.46	 	  	 	12.19	 	  	 	2.41	 	  	 	3.55	 	  	 	6.57	 	  	 	10.25	 
	 59
	  	 	3.77	 	  	 	5.47	 	  	 	10.25	 	  	 	13.03	 	  	 	2.59	 	  	 	3.85	 	  	 	7.05	 	  	 	11.08	 
	 60
	  	 	4.12	 	  	 	5.89	 	  	 	11.09	 	  	 	13.93	 	  	 	2.79	 	  	 	4.18	 	  	 	7.57	 	  	 	11.97	 
	 61
	  	 	4.66	 	  	 	6.63	 	  	 	12.28	 	  	 	15.51	 	  	 	3.05	 	  	 	4.73	 	  	 	8.26	 	  	 	12.85	 
	 62
	  	 	5.24	 	  	 	7.43	 	  	 	13.54	 	  	 	17.18	 	  	 	3.33	 	  	 	5.33	 	  	 	9.00	 	  	 	13.81	 
	 63
	  	 	5.89	 	  	 	8.31	 	  	 	14.89	 	  	 	18.97	 	  	 	3.64	 	  	 	5.99	 	  	 	9.81	 	  	 	14.85	 
	 64
	  	 	6.59	 	  	 	9.28	 	  	 	16.31	 	  	 	20.86	 	  	 	3.99	 	  	 	6.72	 	  	 	10.70	 	  	 	15.99	 
	 65
	  	 	7.36	 	  	 	10.33	 	  	 	17.80	 	  	 	22.84	 	  	 	4.37	 	  	 	7.53	 	  	 	11.67	 	  	 	17.24	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 2 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 10 Year Term - $250,000 - $499,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.49	 	  	 	0.25	 	  	 	0.46	 	  	 	1.01	 	  	 	1.10	 
	 19
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.49	 	  	 	0.25	 	  	 	0.46	 	  	 	1.01	 	  	 	1.10	 
	 20
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.49	 	  	 	0.25	 	  	 	0.46	 	  	 	1.01	 	  	 	1.10	 
	 21
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.50	 	  	 	0.25	 	  	 	0.46	 	  	 	1.01	 	  	 	1.10	 
	 22
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.50	 	  	 	0.25	 	  	 	0.46	 	  	 	1.01	 	  	 	1.10	 
	 23
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.51	 	  	 	0.25	 	  	 	0.46	 	  	 	1.02	 	  	 	1.11	 
	 24
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.51	 	  	 	0.25	 	  	 	0.46	 	  	 	1.02	 	  	 	1.11	 
	 25
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.52	 	  	 	0.25	 	  	 	0.46	 	  	 	1.02	 	  	 	1.11	 
	 26
	  	 	0.30	 	  	 	0.61	 	  	 	1.09	 	  	 	1.54	 	  	 	0.25	 	  	 	0.46	 	  	 	1.02	 	  	 	1.12	 
	 27
	  	 	0.30	 	  	 	0.61	 	  	 	1.10	 	  	 	1.56	 	  	 	0.25	 	  	 	0.46	 	  	 	1.02	 	  	 	1.14	 
	 28
	  	 	0.30	 	  	 	0.62	 	  	 	1.11	 	  	 	1.57	 	  	 	0.26	 	  	 	0.46	 	  	 	1.03	 	  	 	1.15	 
	 29
	  	 	0.30	 	  	 	0.63	 	  	 	1.13	 	  	 	1.60	 	  	 	0.26	 	  	 	0.46	 	  	 	1.03	 	  	 	1.17	 
	 30
	  	 	0.30	 	  	 	0.64	 	  	 	1.15	 	  	 	1.63	 	  	 	0.26	 	  	 	0.46	 	  	 	1.03	 	  	 	1.19	 
	 31
	  	 	0.30	 	  	 	0.65	 	  	 	1.16	 	  	 	1.64	 	  	 	0.27	 	  	 	0.48	 	  	 	1.03	 	  	 	1.22	 
	 32
	  	 	0.31	 	  	 	0.66	 	  	 	1.16	 	  	 	1.66	 	  	 	0.28	 	  	 	0.50	 	  	 	1.03	 	  	 	1.26	 
	 33
	  	 	0.32	 	  	 	0.67	 	  	 	1.17	 	  	 	1.68	 	  	 	0.29	 	  	 	0.52	 	  	 	1.04	 	  	 	1.30	 
	 34
	  	 	0.33	 	  	 	0.68	 	  	 	1.19	 	  	 	1.71	 	  	 	0.30	 	  	 	0.54	 	  	 	1.04	 	  	 	1.34	 
	 35
	  	 	0.34	 	  	 	0.70	 	  	 	1.20	 	  	 	1.74	 	  	 	0.31	 	  	 	0.57	 	  	 	1.04	 	  	 	1.38	 
	 36
	  	 	0.36	 	  	 	0.73	 	  	 	1.27	 	  	 	1.88	 	  	 	0.32	 	  	 	0.59	 	  	 	1.09	 	  	 	1.46	 
	 37
	  	 	0.38	 	  	 	0.77	 	  	 	1.35	 	  	 	2.04	 	  	 	0.34	 	  	 	0.62	 	  	 	1.15	 	  	 	1.56	 
	 38
	  	 	0.41	 	  	 	0.82	 	  	 	1.43	 	  	 	2.22	 	  	 	0.35	 	  	 	0.65	 	  	 	1.21	 	  	 	1.66	 
	 39
	  	 	0.44	 	  	 	0.86	 	  	 	1.52	 	  	 	2.40	 	  	 	0.37	 	  	 	0.69	 	  	 	1.28	 	  	 	1.79	 
	 40
	  	 	0.47	 	  	 	0.91	 	  	 	1.62	 	  	 	2.60	 	  	 	0.39	 	  	 	0.73	 	  	 	1.37	 	  	 	1.93	 
	 41
	  	 	0.52	 	  	 	0.98	 	  	 	1.80	 	  	 	2.88	 	  	 	0.43	 	  	 	0.79	 	  	 	1.48	 	  	 	2.11	 
	 42
	  	 	0.58	 	  	 	1.07	 	  	 	2.00	 	  	 	3.18	 	  	 	0.48	 	  	 	0.86	 	  	 	1.61	 	  	 	2.32	 
	 43
	  	 	0.65	 	  	 	1.15	 	  	 	2.22	 	  	 	3.50	 	  	 	0.53	 	  	 	0.94	 	  	 	1.75	 	  	 	2.55	 
	 44
	  	 	0.72	 	  	 	1.25	 	  	 	2.45	 	  	 	3.86	 	  	 	0.59	 	  	 	1.04	 	  	 	1.92	 	  	 	2.82	 
	 45
	  	 	0.80	 	  	 	1.36	 	  	 	2.71	 	  	 	4.25	 	  	 	0.66	 	  	 	1.14	 	  	 	2.10	 	  	 	3.12	 
	 46
	  	 	0.86	 	  	 	1.49	 	  	 	2.95	 	  	 	4.59	 	  	 	0.72	 	  	 	1.21	 	  	 	2.27	 	  	 	3.37	 
	 47
	  	 	0.94	 	  	 	1.64	 	  	 	3.21	 	  	 	4.97	 	  	 	0.78	 	  	 	1.28	 	  	 	2.46	 	  	 	3.64	 
	 48
	  	 	1.02	 	  	 	1.80	 	  	 	3.50	 	  	 	5.39	 	  	 	0.85	 	  	 	1.37	 	  	 	2.67	 	  	 	3.93	 
	 49
	  	 	1.11	 	  	 	1.98	 	  	 	3.82	 	  	 	5.85	 	  	 	0.92	 	  	 	1.46	 	  	 	2.89	 	  	 	4.25	 
	 50
	  	 	1.21	 	  	 	2.19	 	  	 	4.18	 	  	 	6.37	 	  	 	1.00	 	  	 	1.56	 	  	 	3.12	 	  	 	4.59	 
	 51
	  	 	1.32	 	  	 	2.39	 	  	 	4.57	 	  	 	6.88	 	  	 	1.08	 	  	 	1.69	 	  	 	3.48	 	  	 	4.92	 
	 52
	  	 	1.44	 	  	 	2.62	 	  	 	5.01	 	  	 	7.45	 	  	 	1.17	 	  	 	1.84	 	  	 	3.85	 	  	 	5.26	 
	 53
	  	 	1.58	 	  	 	2.88	 	  	 	5.49	 	  	 	8.08	 	  	 	1.26	 	  	 	1.99	 	  	 	4.25	 	  	 	5.63	 
	 54
	  	 	1.74	 	  	 	3.17	 	  	 	6.03	 	  	 	8.79	 	  	 	1.36	 	  	 	2.16	 	  	 	4.68	 	  	 	6.01	 
	 55
	  	 	1.91	 	  	 	3.49	 	  	 	6.62	 	  	 	9.55	 	  	 	1.46	 	  	 	2.33	 	  	 	5.12	 	  	 	6.42	 
	 56
	  	 	2.11	 	  	 	3.81	 	  	 	7.22	 	  	 	10.25	 	  	 	1.59	 	  	 	2.51	 	  	 	5.52	 	  	 	7.02	 
	 57
	  	 	2.32	 	  	 	4.17	 	  	 	7.86	 	  	 	10.99	 	  	 	1.72	 	  	 	2.71	 	  	 	5.95	 	  	 	7.65	 
	 58
	  	 	2.55	 	  	 	4.55	 	  	 	8.54	 	  	 	11.77	 	  	 	1.87	 	  	 	2.91	 	  	 	6.39	 	  	 	8.31	 
	 59
	  	 	2.80	 	  	 	4.97	 	  	 	9.26	 	  	 	12.62	 	  	 	2.02	 	  	 	3.14	 	  	 	6.88	 	  	 	9.03	 
	 60
	  	 	3.08	 	  	 	5.43	 	  	 	10.04	 	  	 	13.52	 	  	 	2.19	 	  	 	3.38	 	  	 	7.39	 	  	 	9.79	 
	 61
	  	 	3.56	 	  	 	6.05	 	  	 	11.26	 	  	 	15.01	 	  	 	2.43	 	  	 	3.82	 	  	 	7.95	 	  	 	10.59	 
	 62
	  	 	4.08	 	  	 	6.73	 	  	 	12.55	 	  	 	16.59	 	  	 	2.68	 	  	 	4.30	 	  	 	8.55	 	  	 	11.46	 
	 63
	  	 	4.66	 	  	 	7.48	 	  	 	13.93	 	  	 	18.28	 	  	 	2.97	 	  	 	4.82	 	  	 	9.21	 	  	 	12.40	 
	 64
	  	 	5.29	 	  	 	8.29	 	  	 	15.39	 	  	 	20.06	 	  	 	3.28	 	  	 	5.41	 	  	 	9.92	 	  	 	13.43	 
	 65
	  	 	5.97	 	  	 	9.18	 	  	 	16.92	 	  	 	21.94	 	  	 	3.63	 	  	 	6.05	 	  	 	10.71	 	  	 	14.56	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 3 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 10 Year Term - $500,000 - $999,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.30	 	  	 	0.59	 	  	 	1.07	 	  	 	1.48	 	  	 	0.25	 	  	 	0.46	 	  	 	0.95	 	  	 	1.10	 
	 19
	  	 	0.30	 	  	 	0.59	 	  	 	1.07	 	  	 	1.48	 	  	 	0.25	 	  	 	0.46	 	  	 	0.95	 	  	 	1.10	 
	 20
	  	 	0.30	 	  	 	0.59	 	  	 	1.07	 	  	 	1.48	 	  	 	0.25	 	  	 	0.46	 	  	 	0.95	 	  	 	1.10	 
	 21
	  	 	0.30	 	  	 	0.59	 	  	 	1.07	 	  	 	1.49	 	  	 	0.25	 	  	 	0.46	 	  	 	0.95	 	  	 	1.10	 
	 22
	  	 	0.30	 	  	 	0.59	 	  	 	1.07	 	  	 	1.50	 	  	 	0.25	 	  	 	0.46	 	  	 	0.96	 	  	 	1.10	 
	 23
	  	 	0.30	 	  	 	0.59	 	  	 	1.07	 	  	 	1.51	 	  	 	0.25	 	  	 	0.46	 	  	 	0.96	 	  	 	1.11	 
	 24
	  	 	0.30	 	  	 	0.59	 	  	 	1.07	 	  	 	1.51	 	  	 	0.25	 	  	 	0.46	 	  	 	0.97	 	  	 	1.11	 
	 25
	  	 	0.30	 	  	 	0.59	 	  	 	1.07	 	  	 	1.52	 	  	 	0.25	 	  	 	0.46	 	  	 	0.97	 	  	 	1.11	 
	 26
	  	 	0.30	 	  	 	0.60	 	  	 	1.08	 	  	 	1.53	 	  	 	0.25	 	  	 	0.46	 	  	 	0.98	 	  	 	1.12	 
	 27
	  	 	0.30	 	  	 	0.60	 	  	 	1.09	 	  	 	1.55	 	  	 	0.25	 	  	 	0.46	 	  	 	0.98	 	  	 	1.13	 
	 28
	  	 	0.30	 	  	 	0.61	 	  	 	1.10	 	  	 	1.56	 	  	 	0.26	 	  	 	0.46	 	  	 	0.99	 	  	 	1.15	 
	 29
	  	 	0.30	 	  	 	0.62	 	  	 	1.12	 	  	 	1.58	 	  	 	0.26	 	  	 	0.46	 	  	 	1.00	 	  	 	1.16	 
	 30
	  	 	0.30	 	  	 	0.63	 	  	 	1.14	 	  	 	1.61	 	  	 	0.26	 	  	 	0.46	 	  	 	1.01	 	  	 	1.18	 
	 31
	  	 	0.30	 	  	 	0.64	 	  	 	1.14	 	  	 	1.62	 	  	 	0.27	 	  	 	0.48	 	  	 	1.01	 	  	 	1.20	 
	 32
	  	 	0.31	 	  	 	0.65	 	  	 	1.15	 	  	 	1.64	 	  	 	0.28	 	  	 	0.50	 	  	 	1.02	 	  	 	1.21	 
	 33
	  	 	0.32	 	  	 	0.66	 	  	 	1.16	 	  	 	1.67	 	  	 	0.29	 	  	 	0.52	 	  	 	1.02	 	  	 	1.23	 
	 34
	  	 	0.33	 	  	 	0.67	 	  	 	1.17	 	  	 	1.70	 	  	 	0.30	 	  	 	0.54	 	  	 	1.03	 	  	 	1.25	 
	 35
	  	 	0.34	 	  	 	0.69	 	  	 	1.18	 	  	 	1.73	 	  	 	0.31	 	  	 	0.57	 	  	 	1.03	 	  	 	1.27	 
	 36
	  	 	0.36	 	  	 	0.72	 	  	 	1.25	 	  	 	1.87	 	  	 	0.32	 	  	 	0.59	 	  	 	1.08	 	  	 	1.34	 
	 37
	  	 	0.38	 	  	 	0.76	 	  	 	1.33	 	  	 	2.02	 	  	 	0.34	 	  	 	0.62	 	  	 	1.14	 	  	 	1.42	 
	 38
	  	 	0.40	 	  	 	0.79	 	  	 	1.42	 	  	 	2.19	 	  	 	0.35	 	  	 	0.65	 	  	 	1.20	 	  	 	1.52	 
	 39
	  	 	0.42	 	  	 	0.84	 	  	 	1.51	 	  	 	2.37	 	  	 	0.37	 	  	 	0.69	 	  	 	1.27	 	  	 	1.62	 
	 40
	  	 	0.45	 	  	 	0.88	 	  	 	1.61	 	  	 	2.56	 	  	 	0.39	 	  	 	0.73	 	  	 	1.36	 	  	 	1.75	 
	 41
	  	 	0.50	 	  	 	0.95	 	  	 	1.79	 	  	 	2.79	 	  	 	0.43	 	  	 	0.78	 	  	 	1.47	 	  	 	1.95	 
	 42
	  	 	0.56	 	  	 	1.04	 	  	 	1.99	 	  	 	3.04	 	  	 	0.47	 	  	 	0.85	 	  	 	1.59	 	  	 	2.19	 
	 43
	  	 	0.63	 	  	 	1.12	 	  	 	2.21	 	  	 	3.31	 	  	 	0.53	 	  	 	0.92	 	  	 	1.73	 	  	 	2.46	 
	 44
	  	 	0.70	 	  	 	1.22	 	  	 	2.44	 	  	 	3.60	 	  	 	0.58	 	  	 	1.00	 	  	 	1.89	 	  	 	2.76	 
	 45
	  	 	0.78	 	  	 	1.33	 	  	 	2.70	 	  	 	3.92	 	  	 	0.65	 	  	 	1.09	 	  	 	2.07	 	  	 	3.10	 
	 46
	  	 	0.85	 	  	 	1.45	 	  	 	2.93	 	  	 	4.30	 	  	 	0.70	 	  	 	1.16	 	  	 	2.23	 	  	 	3.35	 
	 47
	  	 	0.92	 	  	 	1.59	 	  	 	3.18	 	  	 	4.73	 	  	 	0.75	 	  	 	1.25	 	  	 	2.40	 	  	 	3.62	 
	 48
	  	 	1.01	 	  	 	1.74	 	  	 	3.46	 	  	 	5.19	 	  	 	0.81	 	  	 	1.34	 	  	 	2.59	 	  	 	3.93	 
	 49
	  	 	1.10	 	  	 	1.91	 	  	 	3.77	 	  	 	5.71	 	  	 	0.88	 	  	 	1.43	 	  	 	2.79	 	  	 	4.25	 
	 50
	  	 	1.21	 	  	 	2.10	 	  	 	4.11	 	  	 	6.29	 	  	 	0.95	 	  	 	1.54	 	  	 	3.00	 	  	 	4.59	 
	 51
	  	 	1.32	 	  	 	2.29	 	  	 	4.50	 	  	 	6.69	 	  	 	1.04	 	  	 	1.67	 	  	 	3.26	 	  	 	4.91	 
	 52
	  	 	1.44	 	  	 	2.50	 	  	 	4.94	 	  	 	7.13	 	  	 	1.13	 	  	 	1.81	 	  	 	3.54	 	  	 	5.26	 
	 53
	  	 	1.57	 	  	 	2.73	 	  	 	5.42	 	  	 	7.63	 	  	 	1.22	 	  	 	1.96	 	  	 	3.83	 	  	 	5.62	 
	 54
	  	 	1.73	 	  	 	3.00	 	  	 	5.96	 	  	 	8.17	 	  	 	1.33	 	  	 	2.11	 	  	 	4.14	 	  	 	6.01	 
	 55
	  	 	1.90	 	  	 	3.30	 	  	 	6.55	 	  	 	8.77	 	  	 	1.44	 	  	 	2.28	 	  	 	4.47	 	  	 	6.41	 
	 56
	  	 	2.10	 	  	 	3.63	 	  	 	7.15	 	  	 	9.53	 	  	 	1.57	 	  	 	2.46	 	  	 	4.97	 	  	 	7.01	 
	 57
	  	 	2.31	 	  	 	4.00	 	  	 	7.78	 	  	 	10.34	 	  	 	1.70	 	  	 	2.65	 	  	 	5.49	 	  	 	7.64	 
	 58
	  	 	2.54	 	  	 	4.39	 	  	 	8.45	 	  	 	11.20	 	  	 	1.85	 	  	 	2.85	 	  	 	6.04	 	  	 	8.31	 
	 59
	  	 	2.79	 	  	 	4.83	 	  	 	9.18	 	  	 	12.12	 	  	 	2.00	 	  	 	3.07	 	  	 	6.63	 	  	 	9.02	 
	 60
	  	 	3.07	 	  	 	5.30	 	  	 	9.95	 	  	 	13.10	 	  	 	2.17	 	  	 	3.31	 	  	 	7.27	 	  	 	9.79	 
	 61
	  	 	3.54	 	  	 	5.89	 	  	 	11.19	 	  	 	14.67	 	  	 	2.40	 	  	 	3.75	 	  	 	7.77	 	  	 	10.39	 
	 62
	  	 	4.05	 	  	 	6.53	 	  	 	12.49	 	  	 	18.32	 	  	 	2.66	 	  	 	4.23	 	  	 	8.32	 	  	 	11.05	 
	 63
	  	 	4.61	 	  	 	7.24	 	  	 	13.89	 	  	 	18.09	 	  	 	2.94	 	  	 	4.76	 	  	 	8.92	 	  	 	11.76	 
	 64
	  	 	5.23	 	  	 	8.01	 	  	 	15.36	 	  	 	19.96	 	  	 	3.26	 	  	 	5.35	 	  	 	9.57	 	  	 	12.54	 
	 65
	  	 	5.90	 	  	 	8.85	 	  	 	16.91	 	  	 	21.93	 	  	 	3.60	 	  	 	6.00	 	  	 	10.28	 	  	 	13.39	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	  Monthly
   0.087
	 
  
	  				  				  			

  

			
	Page 4 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 10 Year Term - $1,000,000 and over Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.27	 	  	 	0.56	 	  	 	1.02	 	  	 	1.40	 	  	 	0.22	 	  	 	0.42	 	  	 	0.71	 	  	 	0.99	 
	 19
	  	 	0.27	 	  	 	0.56	 	  	 	1.02	 	  	 	1.40	 	  	 	0.22	 	  	 	0.42	 	  	 	0.71	 	  	 	0.99	 
	 20
	  	 	0.27	 	  	 	0.56	 	  	 	1.02	 	  	 	1.40	 	  	 	0.22	 	  	 	0.42	 	  	 	0.71	 	  	 	0.99	 
	 21
	  	 	0.27	 	  	 	0.56	 	  	 	1.02	 	  	 	1.40	 	  	 	0.22	 	  	 	0.42	 	  	 	0.72	 	  	 	1.00	 
	 22
	  	 	0.27	 	  	 	0.56	 	  	 	1.02	 	  	 	1.40	 	  	 	0.22	 	  	 	0.42	 	  	 	0.73	 	  	 	1.02	 
	 23
	  	 	0.28	 	  	 	0.56	 	  	 	1.03	 	  	 	1.40	 	  	 	0.22	 	  	 	0.42	 	  	 	0.74	 	  	 	1.04	 
	 24
	  	 	0.28	 	  	 	0.56	 	  	 	1.03	 	  	 	1.40	 	  	 	0.22	 	  	 	0.42	 	  	 	0.76	 	  	 	1.06	 
	 25
	  	 	0.28	 	  	 	0.56	 	  	 	1.03	 	  	 	1.40	 	  	 	0.22	 	  	 	0.42	 	  	 	0.77	 	  	 	1.08	 
	 26
	  	 	0.28	 	  	 	0.56	 	  	 	1.04	 	  	 	1.41	 	  	 	0.22	 	  	 	0.42	 	  	 	0.78	 	  	 	1.09	 
	 27
	  	 	0.28	 	  	 	0.56	 	  	 	1.06	 	  	 	1.42	 	  	 	0.22	 	  	 	0.42	 	  	 	0.79	 	  	 	1.09	 
	 28
	  	 	0.28	 	  	 	0.56	 	  	 	1.07	 	  	 	1.42	 	  	 	0.23	 	  	 	0.42	 	  	 	0.80	 	  	 	1.10	 
	 29
	  	 	0.28	 	  	 	0.56	 	  	 	1.09	 	  	 	1.44	 	  	 	0.23	 	  	 	0.42	 	  	 	0.81	 	  	 	1.11	 
	 30
	  	 	0.28	 	  	 	0.56	 	  	 	1.11	 	  	 	1.45	 	  	 	0.23	 	  	 	0.42	 	  	 	0.82	 	  	 	1.12	 
	 31
	  	 	0.28	 	  	 	0.57	 	  	 	1.11	 	  	 	1.46	 	  	 	0.23	 	  	 	0.43	 	  	 	0.84	 	  	 	1.14	 
	 32
	  	 	0.29	 	  	 	0.58	 	  	 	1.12	 	  	 	1.48	 	  	 	0.23	 	  	 	0.43	 	  	 	0.86	 	  	 	1.16	 
	 33
	  	 	0.29	 	  	 	0.59	 	  	 	1.12	 	  	 	1.50	 	  	 	0.24	 	  	 	0.44	 	  	 	0.88	 	  	 	1.19	 
	 34
	  	 	0.29	 	  	 	0.61	 	  	 	1.13	 	  	 	1.52	 	  	 	0.24	 	  	 	0.45	 	  	 	0.90	 	  	 	1.21	 
	 35
	  	 	0.30	 	  	 	0.63	 	  	 	1.14	 	  	 	1.55	 	  	 	0.24	 	  	 	0.46	 	  	 	0.92	 	  	 	1.24	 
	 36
	  	 	0.32	 	  	 	0.66	 	  	 	1.22	 	  	 	1.66	 	  	 	0.25	 	  	 	0.49	 	  	 	0.98	 	  	 	1.32	 
	 37
	  	 	0.34	 	  	 	0.70	 	  	 	1.30	 	  	 	1.79	 	  	 	0.27	 	  	 	0.53	 	  	 	1.05	 	  	 	1.40	 
	 38
	  	 	0.37	 	  	 	0.73	 	  	 	1.40	 	  	 	1.94	 	  	 	0.29	 	  	 	0.56	 	  	 	1.12	 	  	 	1.50	 
	 39
	  	 	0.39	 	  	 	0.78	 	  	 	1.50	 	  	 	2.09	 	  	 	0.31	 	  	 	0.61	 	  	 	1.21	 	  	 	1.61	 
	 40
	  	 	0.42	 	  	 	0.82	 	  	 	1.60	 	  	 	2.25	 	  	 	0.33	 	  	 	0.66	 	  	 	1.32	 	  	 	1.74	 
	 41
	  	 	0.47	 	  	 	0.88	 	  	 	1.78	 	  	 	2.51	 	  	 	0.37	 	  	 	0.71	 	  	 	1.43	 	  	 	1.92	 
	 42
	  	 	0.52	 	  	 	0.95	 	  	 	1.98	 	  	 	2.79	 	  	 	0.42	 	  	 	0.77	 	  	 	1.56	 	  	 	2.13	 
	 43
	  	 	0.57	 	  	 	1.03	 	  	 	2.19	 	  	 	3.09	 	  	 	0.47	 	  	 	0.83	 	  	 	1.71	 	  	 	2.37	 
	 44
	  	 	0.63	 	  	 	1.12	 	  	 	2.42	 	  	 	3.43	 	  	 	0.53	 	  	 	0.91	 	  	 	1.88	 	  	 	2.65	 
	 45
	  	 	0.70	 	  	 	1.21	 	  	 	2.68	 	  	 	3.79	 	  	 	0.60	 	  	 	0.99	 	  	 	2.07	 	  	 	2.95	 
	 46
	  	 	0.77	 	  	 	1.32	 	  	 	2.81	 	  	 	4.18	 	  	 	0.65	 	  	 	1.07	 	  	 	2.22	 	  	 	3.16	 
	 47
	  	 	0.84	 	  	 	1.44	 	  	 	2.96	 	  	 	4.62	 	  	 	0.71	 	  	 	1.16	 	  	 	2.39	 	  	 	3.39	 
	 48
	  	 	0.92	 	  	 	1.58	 	  	 	3.12	 	  	 	5.10	 	  	 	0.77	 	  	 	1.26	 	  	 	2.57	 	  	 	3.64	 
	 49
	  	 	1.02	 	  	 	1.74	 	  	 	3.29	 	  	 	5.64	 	  	 	0.84	 	  	 	1.36	 	  	 	2.77	 	  	 	3.90	 
	 50
	  	 	1.12	 	  	 	1.91	 	  	 	3.49	 	  	 	6.23	 	  	 	0.91	 	  	 	1.48	 	  	 	2.98	 	  	 	4.19	 
	 51
	  	 	1.24	 	  	 	2.09	 	  	 	3.97	 	  	 	6.63	 	  	 	0.99	 	  	 	1.59	 	  	 	3.20	 	  	 	4.48	 
	 52
	  	 	1.37	 	  	 	2.29	 	  	 	4.51	 	  	 	7.07	 	  	 	1.07	 	  	 	1.71	 	  	 	3.44	 	  	 	4.78	 
	 53
	  	 	1.53	 	  	 	2.51	 	  	 	5.10	 	  	 	7.56	 	  	 	1.16	 	  	 	1.84	 	  	 	3.69	 	  	 	5.10	 
	 54
	  	 	1.70	 	  	 	2.77	 	  	 	5.76	 	  	 	8.11	 	  	 	1.26	 	  	 	1.97	 	  	 	3.95	 	  	 	5.44	 
	 55
	  	 	1.89	 	  	 	3.05	 	  	 	6.48	 	  	 	8.70	 	  	 	1.36	 	  	 	2.12	 	  	 	4.23	 	  	 	5.80	 
	 56
	  	 	2.08	 	  	 	3.33	 	  	 	7.09	 	  	 	9.44	 	  	 	1.49	 	  	 	2.30	 	  	 	4.62	 	  	 	6.23	 
	 57
	  	 	2.28	 	  	 	3.63	 	  	 	7.73	 	  	 	10.24	 	  	 	1.63	 	  	 	2.50	 	  	 	5.04	 	  	 	6.68	 
	 58
	  	 	2.50	 	  	 	3.96	 	  	 	8.41	 	  	 	11.07	 	  	 	1.77	 	  	 	2.71	 	  	 	5.48	 	  	 	7.15	 
	 59
	  	 	2.74	 	  	 	4.32	 	  	 	9.14	 	  	 	11.97	 	  	 	1.93	 	  	 	2.94	 	  	 	5.95	 	  	 	7.66	 
	 60
	  	 	3.00	 	  	 	4.71	 	  	 	9.92	 	  	 	12.93	 	  	 	2.10	 	  	 	3.18	 	  	 	6.45	 	  	 	8.21	 
	 61
	  	 	3.44	 	  	 	5.32	 	  	 	11.16	 	  	 	14.35	 	  	 	2.33	 	  	 	3.45	 	  	 	7.01	 	  	 	8.86	 
	 62
	  	 	3.93	 	  	 	5.99	 	  	 	12.47	 	  	 	15.85	 	  	 	2.58	 	  	 	3.75	 	  	 	7.61	 	  	 	9.57	 
	 63
	  	 	4.46	 	  	 	6.72	 	  	 	13.87	 	  	 	17.45	 	  	 	2.85	 	  	 	4.08	 	  	 	8.27	 	  	 	10.34	 
	 64
	  	 	5.04	 	  	 	7.53	 	  	 	15.35	 	  	 	19.14	 	  	 	3.15	 	  	 	4.45	 	  	 	8.98	 	  	 	11.19	 
	 65
	  	 	5.67	 	  	 	8.40	 	  	 	16.90	 	  	 	20.92	 	  	 	3.49	 	  	 	4.85	 	  	 	9.77	 	  	 	12.11	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 5 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 15 Year Term - Under $100,000 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual Policy
Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.77	 	  	 	1.31	 	  	 	2.79	 	  	 	3.28	 	  	 	0.75	 	  	 	1.11	 	  	 	2.04	 	  	 	2.56	 
	 19
	  	 	0.77	 	  	 	1.31	 	  	 	2.79	 	  	 	3.30	 	  	 	0.75	 	  	 	1.11	 	  	 	2.04	 	  	 	2.58	 
	 20
	  	 	0.77	 	  	 	1.31	 	  	 	2.79	 	  	 	3.30	 	  	 	0.75	 	  	 	1.11	 	  	 	2.04	 	  	 	2.58	 
	 21
	  	 	0.77	 	  	 	1.31	 	  	 	2.82	 	  	 	3.32	 	  	 	0.75	 	  	 	1.11	 	  	 	2.04	 	  	 	2.58	 
	 22
	  	 	0.77	 	  	 	1.31	 	  	 	2.83	 	  	 	3.35	 	  	 	0.75	 	  	 	1.11	 	  	 	2.04	 	  	 	2.58	 
	 23
	  	 	0.77	 	  	 	1.31	 	  	 	2.83	 	  	 	3.38	 	  	 	0.76	 	  	 	1.11	 	  	 	2.04	 	  	 	2.58	 
	 24
	  	 	0.79	 	  	 	1.32	 	  	 	2.85	 	  	 	3.42	 	  	 	0.76	 	  	 	1.11	 	  	 	2.04	 	  	 	2.58	 
	 25
	  	 	0.79	 	  	 	1.32	 	  	 	2.85	 	  	 	3.45	 	  	 	0.76	 	  	 	1.11	 	  	 	2.04	 	  	 	2.58	 
	 26
	  	 	0.79	 	  	 	1.32	 	  	 	2.85	 	  	 	3.52	 	  	 	0.76	 	  	 	1.11	 	  	 	2.10	 	  	 	2.62	 
	 27
	  	 	0.79	 	  	 	1.32	 	  	 	2.86	 	  	 	3.61	 	  	 	0.76	 	  	 	1.11	 	  	 	2.14	 	  	 	2.66	 
	 28
	  	 	0.79	 	  	 	1.32	 	  	 	2.86	 	  	 	3.69	 	  	 	0.76	 	  	 	1.11	 	  	 	2.21	 	  	 	2.70	 
	 29
	  	 	0.79	 	  	 	1.32	 	  	 	2.86	 	  	 	3.75	 	  	 	0.76	 	  	 	1.11	 	  	 	2.27	 	  	 	2.75	 
	 30
	  	 	0.79	 	  	 	1.32	 	  	 	2.87	 	  	 	3.85	 	  	 	0.76	 	  	 	1.11	 	  	 	2.34	 	  	 	2.80	 
	 31
	  	 	0.79	 	  	 	1.32	 	  	 	2.87	 	  	 	3.91	 	  	 	0.76	 	  	 	1.11	 	  	 	2.38	 	  	 	2.89	 
	 32
	  	 	0.80	 	  	 	1.32	 	  	 	2.89	 	  	 	4.00	 	  	 	0.76	 	  	 	1.13	 	  	 	2.44	 	  	 	2.97	 
	 33
	  	 	0.82	 	  	 	1.34	 	  	 	2.89	 	  	 	4.10	 	  	 	0.77	 	  	 	1.13	 	  	 	2.49	 	  	 	3.06	 
	 34
	  	 	0.82	 	  	 	1.34	 	  	 	2.90	 	  	 	4.22	 	  	 	0.77	 	  	 	1.14	 	  	 	2.55	 	  	 	3.17	 
	 35
	  	 	0.83	 	  	 	1.34	 	  	 	2.90	 	  	 	4.32	 	  	 	0.77	 	  	 	1.14	 	  	 	2.62	 	  	 	3.30	 
	 36
	  	 	0.90	 	  	 	1.42	 	  	 	3.10	 	  	 	4.54	 	  	 	0.83	 	  	 	1.21	 	  	 	2.69	 	  	 	3.42	 
	 37
	  	 	0.97	 	  	 	1.51	 	  	 	3.31	 	  	 	4.73	 	  	 	0.89	 	  	 	1.30	 	  	 	2.76	 	  	 	3.58	 
	 38
	  	 	1.04	 	  	 	1.61	 	  	 	3.54	 	  	 	4.89	 	  	 	0.96	 	  	 	1.38	 	  	 	2.85	 	  	 	3.73	 
	 39
	  	 	1.14	 	  	 	1.70	 	  	 	3.80	 	  	 	5.06	 	  	 	1.04	 	  	 	1.49	 	  	 	2.93	 	  	 	3.92	 
	 40
	  	 	1.24	 	  	 	1.83	 	  	 	4.10	 	  	 	5.25	 	  	 	1.13	 	  	 	1.61	 	  	 	3.04	 	  	 	4.13	 
	 41
	  	 	1.37	 	  	 	2.06	 	  	 	4.51	 	  	 	5.82	 	  	 	1.21	 	  	 	1.73	 	  	 	3.34	 	  	 	4.46	 
	 42
	  	 	1.51	 	  	 	2.31	 	  	 	4.97	 	  	 	6.42	 	  	 	1.30	 	  	 	1.89	 	  	 	3.68	 	  	 	4.85	 
	 43
	  	 	1.66	 	  	 	2.59	 	  	 	5.46	 	  	 	7.10	 	  	 	1.39	 	  	 	2.06	 	  	 	4.04	 	  	 	5.27	 
	 44
	  	 	1.83	 	  	 	2.90	 	  	 	6.00	 	  	 	7.83	 	  	 	1.51	 	  	 	2.24	 	  	 	4.44	 	  	 	5.73	 
	 45
	  	 	2.01	 	  	 	3.23	 	  	 	6.56	 	  	 	8.59	 	  	 	1.62	 	  	 	2.44	 	  	 	4.87	 	  	 	6.24	 
	 46
	  	 	2.20	 	  	 	3.46	 	  	 	7.13	 	  	 	9.30	 	  	 	1.73	 	  	 	2.62	 	  	 	5.24	 	  	 	6.79	 
	 47
	  	 	2.41	 	  	 	3.72	 	  	 	7.76	 	  	 	10.07	 	  	 	1.85	 	  	 	2.80	 	  	 	5.63	 	  	 	7.38	 
	 48
	  	 	2.63	 	  	 	4.01	 	  	 	8.45	 	  	 	10.93	 	  	 	1.97	 	  	 	3.01	 	  	 	6.07	 	  	 	8.01	 
	 49
	  	 	2.90	 	  	 	4.35	 	  	 	9.24	 	  	 	11.90	 	  	 	2.11	 	  	 	3.24	 	  	 	6.52	 	  	 	8.69	 
	 50
	  	 	3.20	 	  	 	4.73	 	  	 	10.11	 	  	 	13.00	 	  	 	2.27	 	  	 	3.48	 	  	 	7.00	 	  	 	9.41	 
	 51
	  	 	3.52	 	  	 	5.17	 	  	 	11.03	 	  	 	14.13	 	  	 	2.44	 	  	 	3.76	 	  	 	7.58	 	  	 	10.06	 
	 52
	  	 	3.87	 	  	 	5.65	 	  	 	12.01	 	  	 	15.35	 	  	 	2.62	 	  	 	4.06	 	  	 	8.18	 	  	 	10.75	 
	 53
	  	 	4.27	 	  	 	6.17	 	  	 	13.08	 	  	 	16.66	 	  	 	2.82	 	  	 	4.38	 	  	 	8.83	 	  	 	11.48	 
	 54
	  	 	4.69	 	  	 	6.73	 	  	 	14.21	 	  	 	18.06	 	  	 	3.03	 	  	 	4.73	 	  	 	9.52	 	  	 	12.25	 
	 55
	  	 	5.15	 	  	 	7.35	 	  	 	15.39	 	  	 	19.52	 	  	 	3.25	 	  	 	5.11	 	  	 	10.25	 	  	 	13.08	 
	 56
	  	 	5.66	 	  	 	8.11	 	  	 	16.86	 	  	 	21.00	 	  	 	3.75	 	  	 	5.79	 	  	 	11.11	 	  	 	14.46	 
	 57
	  	 	6.23	 	  	 	8.93	 	  	 	18.41	 	  	 	22.58	 	  	 	4.28	 	  	 	6.51	 	  	 	12.04	 	  	 	15.29	 
	 58
	  	 	6.85	 	  	 	9.85	 	  	 	20.07	 	  	 	24.27	 	  	 	4.86	 	  	 	7.30	 	  	 	13.04	 	  	 	15.88	 
	 59
	  	 	7.52	 	  	 	10.86	 	  	 	21.90	 	  	 	26.13	 	  	 	5.48	 	  	 	8.15	 	  	 	14.11	 	  	 	16.56	 
	 60
	  	 	8.28	 	  	 	11.99	 	  	 	23.87	 	  	 	28.13	 	  	 	6.17	 	  	 	9.08	 	  	 	14.52	 	  	 	17.33	 
	 61
	  	 	9.55	 	  	 	13.97	 	  	 	27.24	 	  	 	31.45	 	  	 	6.68	 	  	 	10.23	 	  	 	14.79	 	  	 	17.97	 
	 62
	  	 	10.93	 	  	 	16.15	 	  	 	30.83	 	  	 	35.01	 	  	 	7.24	 	  	 	11.48	 	  	 	15.53	 	  	 	19.12	 
	 63
	  	 	12.45	 	  	 	18.52	 	  	 	34.65	 	  	 	38.80	 	  	 	7.86	 	  	 	12.11	 	  	 	16.57	 	  	 	20.96	 
	 64
	  	 	14.10	 	  	 	21.10	 	  	 	38.72	 	  	 	42.83	 	  	 	8.54	 	  	 	12.55	 	  	 	17.69	 	  	 	22.96	 
	 65
	  	 	15.90	 	  	 	23.94	 	  	 	43.08	 	  	 	47.15	 	  	 	9.28	 	  	 	13.22	 	  	 	19.00	 	  	 	25.11	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	    Quarterly
     0.280
	 
  
	  	 
 
	        Monthly

        0.087
	 
  
	  				  				  			

  

			
	Page 6 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 15 Year Term - $100,000 - $249,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.55	 	  	 	0.93	 	  	 	1.99	 	  	 	2.33	 	  	 	0.53	 	  	 	0.79	 	  	 	1.45	 	  	 	1.82	 
	 19
	  	 	0.55	 	  	 	0.93	 	  	 	2.00	 	  	 	2.34	 	  	 	0.53	 	  	 	0.79	 	  	 	1.45	 	  	 	1.83	 
	 20
	  	 	0.55	 	  	 	0.93	 	  	 	2.00	 	  	 	2.34	 	  	 	0.53	 	  	 	0.79	 	  	 	1.45	 	  	 	1.83	 
	 21
	  	 	0.55	 	  	 	0.93	 	  	 	2.00	 	  	 	2.36	 	  	 	0.53	 	  	 	0.79	 	  	 	1.45	 	  	 	1.83	 
	 22
	  	 	0.55	 	  	 	0.93	 	  	 	2.01	 	  	 	2.38	 	  	 	0.53	 	  	 	0.79	 	  	 	1.45	 	  	 	1.83	 
	 23
	  	 	0.55	 	  	 	0.93	 	  	 	2.01	 	  	 	2.40	 	  	 	0.54	 	  	 	0.79	 	  	 	1.45	 	  	 	1.83	 
	 24
	  	 	0.56	 	  	 	0.94	 	  	 	2.02	 	  	 	2.43	 	  	 	0.54	 	  	 	0.79	 	  	 	1.45	 	  	 	1.83	 
	 25
	  	 	0.56	 	  	 	0.94	 	  	 	2.02	 	  	 	2.45	 	  	 	0.54	 	  	 	0.79	 	  	 	1.45	 	  	 	1.83	 
	 26
	  	 	0.56	 	  	 	0.94	 	  	 	2.02	 	  	 	2.50	 	  	 	0.54	 	  	 	0.79	 	  	 	1.49	 	  	 	1.86	 
	 27
	  	 	0.56	 	  	 	0.94	 	  	 	2.03	 	  	 	2.56	 	  	 	0.54	 	  	 	0.79	 	  	 	1.52	 	  	 	1.89	 
	 28
	  	 	0.56	 	  	 	0.94	 	  	 	2.03	 	  	 	2.63	 	  	 	0.54	 	  	 	0.79	 	  	 	1.57	 	  	 	1.92	 
	 29
	  	 	0.56	 	  	 	0.94	 	  	 	2.03	 	  	 	2.71	 	  	 	0.54	 	  	 	0.79	 	  	 	1.61	 	  	 	1.95	 
	 30
	  	 	0.56	 	  	 	0.94	 	  	 	2.04	 	  	 	2.81	 	  	 	0.54	 	  	 	0.79	 	  	 	1.66	 	  	 	1.99	 
	 31
	  	 	0.56	 	  	 	0.94	 	  	 	2.04	 	  	 	2.87	 	  	 	0.54	 	  	 	0.79	 	  	 	1.69	 	  	 	2.05	 
	 32
	  	 	0.57	 	  	 	0.94	 	  	 	2.05	 	  	 	2.93	 	  	 	0.54	 	  	 	0.80	 	  	 	1.73	 	  	 	2.11	 
	 33
	  	 	0.58	 	  	 	0.95	 	  	 	2.05	 	  	 	3.00	 	  	 	0 55	 	  	 	0.80	 	  	 	1.77	 	  	 	2.17	 
	 34
	  	 	0.58	 	  	 	0.95	 	  	 	2.06	 	  	 	3.08	 	  	 	0.55	 	  	 	0.81	 	  	 	1.81	 	  	 	2.25	 
	 35
	  	 	0.59	 	  	 	0.95	 	  	 	2.06	 	  	 	3.17	 	  	 	0.55	 	  	 	0.81	 	  	 	1.86	 	  	 	2.34	 
	 36
	  	 	0.64	 	  	 	1.01	 	  	 	2.20	 	  	 	3.26	 	  	 	0.59	 	  	 	0.86	 	  	 	1.91	 	  	 	2.43	 
	 37
	  	 	0.69	 	  	 	1.07	 	  	 	2.35	 	  	 	3.36	 	  	 	0.63	 	  	 	0.92	 	  	 	1.96	 	  	 	2.54	 
	 38
	  	 	0.74	 	  	 	1.14	 	  	 	2.51	 	  	 	3.47	 	  	 	0.68	 	  	 	0.98	 	  	 	2.02	 	  	 	2.65	 
	 39
	  	 	0.81	 	  	 	1.21	 	  	 	2.70	 	  	 	3.59	 	  	 	0.74	 	  	 	1.06	 	  	 	2.08	 	  	 	2.78	 
	 40
	  	 	0.88	 	  	 	1.30	 	  	 	2.91	 	  	 	3.73	 	  	 	0.80	 	  	 	1.14	 	  	 	2.16	 	  	 	2.93	 
	 41
	  	 	0.97	 	  	 	1.46	 	  	 	3.20	 	  	 	4.13	 	  	 	0.86	 	  	 	1.23	 	  	 	2.37	 	  	 	3.17	 
	 42
	  	 	1.07	 	  	 	1.64	 	  	 	3.53	 	  	 	4.56	 	  	 	0.92	 	  	 	1.34	 	  	 	2.61	 	  	 	3.44	 
	 43
	  	 	1.18	 	  	 	1.84	 	  	 	3.88	 	  	 	6.04	 	  	 	0.99	 	  	 	1.46	 	  	 	2.87	 	  	 	3.74	 
	 44
	  	 	1.30	 	  	 	2.06	 	  	 	4.26	 	  	 	5.56	 	  	 	1.07	 	  	 	1.59	 	  	 	3.15	 	  	 	4.07	 
	 45
	  	 	1.43	 	  	 	2.29	 	  	 	4.66	 	  	 	6.10	 	  	 	1.15	 	  	 	1.73	 	  	 	3.46	 	  	 	4.43	 
	 46
	  	 	1.56	 	  	 	2.46	 	  	 	5.06	 	  	 	6.60	 	  	 	1.23	 	  	 	1.86	 	  	 	3.72	 	  	 	4.82	 
	 47
	  	 	1.71	 	  	 	2.64	 	  	 	5.51	 	  	 	7.15	 	  	 	1.31	 	  	 	1.99	 	  	 	4.00	 	  	 	5.24	 
	 48
	  	 	1.87	 	  	 	2.85	 	  	 	6.00	 	  	 	7.76	 	  	 	1.40	 	  	 	2.14	 	  	 	4.31	 	  	 	5.69	 
	 49
	  	 	2.06	 	  	 	3.09	 	  	 	6.56	 	  	 	8.45	 	  	 	1.50	 	  	 	2.30	 	  	 	4.63	 	  	 	6.17	 
	 50
	  	 	2.27	 	  	 	3.36	 	  	 	7.18	 	  	 	9.23	 	  	 	1.61	 	  	 	2.47	 	  	 	4.97	 	  	 	6.68	 
	 51
	  	 	2.50	 	  	 	3.67	 	  	 	7.83	 	  	 	10.03	 	  	 	1.73	 	  	 	2.67	 	  	 	5.38	 	  	 	7.14	 
	 52
	  	 	2.75	 	  	 	4.01	 	  	 	8.53	 	  	 	10.90	 	  	 	1.86	 	  	 	2.88	 	  	 	5.81	 	  	 	7.63	 
	 53
	  	 	3.03	 	  	 	4.38	 	  	 	9.29	 	  	 	11.83	 	  	 	2.00	 	  	 	3.11	 	  	 	6.27	 	  	 	8.15	 
	 54
	  	 	3.33	 	  	 	4.78	 	  	 	10.09	 	  	 	12.82	 	  	 	2.15	 	  	 	3.38	 	  	 	6.76	 	  	 	8.70	 
	 55
	  	 	3.66	 	  	 	5.22	 	  	 	10.93	 	  	 	13.86	 	  	 	2.31	 	  	 	3.63	 	  	 	7.28	 	  	 	9.29	 
	 56
	  	 	4.02	 	  	 	5.76	 	  	 	11.97	 	  	 	14.91	 	  	 	2.66	 	  	 	4.11	 	  	 	7.89	 	  	 	10.27	 
	 57
	  	 	4.42	 	  	 	6.34	 	  	 	13.07	 	  	 	16.03	 	  	 	3.04	 	  	 	4.62	 	  	 	8.55	 	  	 	11.33	 
	 58
	  	 	4.86	 	  	 	6.99	 	  	 	14.25	 	  	 	17.23	 	  	 	3.45	 	  	 	5.18	 	  	 	9.26	 	  	 	12.46	 
	 59
	  	 	5.34	 	  	 	7.71	 	  	 	15.55	 	  	 	18.55	 	  	 	3.89	 	  	 	5.79	 	  	 	10.02	 	  	 	13.68	 
	 60
	  	 	5.88	 	  	 	8.51	 	  	 	16.95	 	  	 	19.97	 	  	 	4.38	 	  	 	6.45	 	  	 	10.84	 	  	 	15.00	 
	 61
	  	 	6.78	 	  	 	9.92	 	  	 	19.34	 	  	 	22.33	 	  	 	4.74	 	  	 	7.26	 	  	 	12.05	 	  	 	16.52	 
	 62
	  	 	7.76	 	  	 	11.47	 	  	 	21.89	 	  	 	24.86	 	  	 	5.14	 	  	 	8.15	 	  	 	13.35	 	  	 	18.16	 
	 63
	  	 	8.84	 	  	 	13.15	 	  	 	24.60	 	  	 	27.55	 	  	 	5.58	 	  	 	9.12	 	  	 	14.75	 	  	 	19.91	 
	 64
	  	 	10.01	 	  	 	14.98	 	  	 	27.49	 	  	 	30.41	 	  	 	6.06	 	  	 	10.18	 	  	 	16.26	 	  	 	21.81	 
	 65
	  	 	11.29	 	  	 	17.00	 	  	 	30.59	 	  	 	33.48	 	  	 	6.59	 	  	 	11.35	 	  	 	17.89	 	  	 	23.85	 
	
Semi-Annual     

0.520     
	  

 
	  	 
 
	        Quarterly

        0.280
	 
  
	  	 
 
	      Monthly

      0.087
	 
  
	  				  				  			

  

			
	Page 7 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 15 Year Term - $250,000 - $499,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.39	 	  	 	0.75	 	  	 	1.38	 	  	 	1.84	 	  	 	0.33	 	  	 	0.61	 	  	 	1.05	 	  	 	1.27	 
	 19
	  	 	0.39	 	  	 	0.75	 	  	 	1.38	 	  	 	1.85	 	  	 	0.33	 	  	 	0.61	 	  	 	1.05	 	  	 	1.27	 
	 20
	  	 	0.39	 	  	 	0.75	 	  	 	1.38	 	  	 	1.85	 	  	 	0.33	 	  	 	0.61	 	  	 	1.05	 	  	 	1.27	 
	 21
	  	 	0.39	 	  	 	0.75	 	  	 	1.39	 	  	 	1.86	 	  	 	0.33	 	  	 	0.61	 	  	 	1.06	 	  	 	1.28	 
	 22
	  	 	0.39	 	  	 	0.75	 	  	 	1.41	 	  	 	1.86	 	  	 	0.33	 	  	 	0.61	 	  	 	1.06	 	  	 	1.28	 
	 23
	  	 	0.39	 	  	 	0.75	 	  	 	1.42	 	  	 	1.87	 	  	 	0.33	 	  	 	0.61	 	  	 	1 07	 	  	 	1.29	 
	 24
	  	 	0.39	 	  	 	0.75	 	  	 	1.43	 	  	 	1.88	 	  	 	0.33	 	  	 	0.61	 	  	 	1.07	 	  	 	1.30	 
	 25
	  	 	0.39	 	  	 	0.75	 	  	 	1.45	 	  	 	1.89	 	  	 	0.33	 	  	 	0.61	 	  	 	1.08	 	  	 	1.31	 
	 26
	  	 	0.39	 	  	 	0.76	 	  	 	1.46	 	  	 	1.91	 	  	 	0.33	 	  	 	0.61	 	  	 	1.09	 	  	 	1.34	 
	 27
	  	 	0.39	 	  	 	0.77	 	  	 	1.47	 	  	 	1.93	 	  	 	0.33	 	  	 	0.61	 	  	 	1.09	 	  	 	1.38	 
	 28
	  	 	0.39	 	  	 	0.78	 	  	 	1.49	 	  	 	1.95	 	  	 	0.33	 	  	 	0.62	 	  	 	1.10	 	  	 	1.41	 
	 29
	  	 	0.39	 	  	 	0.79	 	  	 	1.51	 	  	 	1.98	 	  	 	0.33	 	  	 	0.62	 	  	 	1.11	 	  	 	1.46	 
	 30
	  	 	0.39	 	  	 	0.81	 	  	 	1.53	 	  	 	2.01	 	  	 	0.33	 	  	 	0.62	 	  	 	1.12	 	  	 	1.50	 
	 31
	  	 	0.40	 	  	 	0.82	 	  	 	1.55	 	  	 	2.05	 	  	 	0.33	 	  	 	0.63	 	  	 	1.15	 	  	 	1.54	 
	 32
	  	 	0.41	 	  	 	0.83	 	  	 	1.56	 	  	 	2.09	 	  	 	0.34	 	  	 	0.65	 	  	 	1.18	 	  	 	1.58	 
	 33
	  	 	0.42	 	  	 	0.85	 	  	 	1.58	 	  	 	2.14	 	  	 	0.35	 	  	 	0.66	 	  	 	1.21	 	  	 	1.63	 
	 34
	  	 	0.44	 	  	 	0.86	 	  	 	1.61	 	  	 	2.20	 	  	 	0.35	 	  	 	0.68	 	  	 	1.25	 	  	 	1.68	 
	 35
	  	 	0.45	 	  	 	0.88	 	  	 	1.63	 	  	 	2.26	 	  	 	0.36	 	  	 	0.70	 	  	 	1.29	 	  	 	1.74	 
	 36
	  	 	0.48	 	  	 	0.93	 	  	 	1.73	 	  	 	2.43	 	  	 	0.38	 	  	 	0.75	 	  	 	1.37	 	  	 	1.86	 
	 37
	  	 	0.51	 	  	 	0.98	 	  	 	1.84	 	  	 	2.61	 	  	 	0.41	 	  	 	0.80	 	  	 	1.46	 	  	 	2.00	 
	 38
	  	 	0.54	 	  	 	1.03	 	  	 	1.96	 	  	 	2.82	 	  	 	0.43	 	  	 	0.86	 	  	 	1.56	 	  	 	2.15	 
	 39
	  	 	0.58	 	  	 	1.10	 	  	 	2.09	 	  	 	3.04	 	  	 	0.46	 	  	 	0.93	 	  	 	1.67	 	  	 	2.32	 
	 40
	  	 	0.62	 	  	 	1.17	 	  	 	2.24	 	  	 	3.30	 	  	 	0.50	 	  	 	1.01	 	  	 	1.80	 	  	 	2.52	 
	 41
	  	 	0.68	 	  	 	1.28	 	  	 	2.50	 	  	 	3.62	 	  	 	0.56	 	  	 	1.09	 	  	 	1.96	 	  	 	2.74	 
	 42
	  	 	0.75	 	  	 	1.41	 	  	 	2.80	 	  	 	3.97	 	  	 	0.62	 	  	 	1.17	 	  	 	2.14	 	  	 	2.99	 
	 43
	  	 	0.83	 	  	 	1.55	 	  	 	3.12	 	  	 	4.35	 	  	 	0.69	 	  	 	1.27	 	  	 	2.33	 	  	 	3.26	 
	 44
	  	 	0.91	 	  	 	1.70	 	  	 	3.46	 	  	 	4.76	 	  	 	0.77	 	  	 	1.38	 	  	 	2.55	 	  	 	3.56	 
	 45
	  	 	1.00	 	  	 	1.87	 	  	 	3.82	 	  	 	5.20	 	  	 	0.86	 	  	 	1.50	 	  	 	2.78	 	  	 	3.89	 
	 46
	  	 	1.11	 	  	 	2.01	 	  	 	4.16	 	  	 	5.61	 	  	 	0.94	 	  	 	1.61	 	  	 	3.03	 	  	 	4.25	 
	 47
	  	 	1.22	 	  	 	2.17	 	  	 	4.54	 	  	 	6.05	 	  	 	1.03	 	  	 	1.72	 	  	 	3.30	 	  	 	4.63	 
	 48
	  	 	1.36	 	  	 	2.35	 	  	 	4.96	 	  	 	6.55	 	  	 	1.12	 	  	 	1.85	 	  	 	3.59	 	  	 	5.05	 
	 49
	  	 	1.51	 	  	 	2.56	 	  	 	5.43	 	  	 	7.12	 	  	 	1.22	 	  	 	1.98	 	  	 	3.90	 	  	 	5.49	 
	 50
	  	 	1.68	 	  	 	2.79	 	  	 	5.96	 	  	 	7.75	 	  	 	1.33	 	  	 	2.13	 	  	 	4.23	 	  	 	5.96	 
	 51
	  	 	1.86	 	  	 	3.09	 	  	 	6.64	 	  	 	8.62	 	  	 	1.43	 	  	 	2.30	 	  	 	4.60	 	  	 	6.50	 
	 52
	  	 	2.07	 	  	 	3.41	 	  	 	7.37	 	  	 	9.56	 	  	 	1.54	 	  	 	2.48	 	  	 	4.99	 	  	 	7.08	 
	 53
	  	 	2.29	 	  	 	3.77	 	  	 	8.16	 	  	 	10.57	 	  	 	1.66	 	  	 	2.67	 	  	 	5.40	 	  	 	7.69	 
	 54
	  	 	2.53	 	  	 	4.16	 	  	 	9.00	 	  	 	11.64	 	  	 	1.78	 	  	 	2.88	 	  	 	5.84	 	  	 	8.34	 
	 55
	  	 	2.79	 	  	 	4.58	 	  	 	9.88	 	  	 	12.77	 	  	 	1.92	 	  	 	3.10	 	  	 	6.31	 	  	 	9.03	 
	 56
	  	 	3.09	 	  	 	5.06	 	  	 	10.61	 	  	 	13.78	 	  	 	2.13	 	  	 	3.50	 	  	 	6.90	 	  	 	9.74	 
	 57
	  	 	3.42	 	  	 	5.59	 	  	 	11.38	 	  	 	14.85	 	  	 	2.35	 	  	 	3.94	 	  	 	7.53	 	  	 	10.51	 
	 58
	  	 	3.79	 	  	 	6.18	 	  	 	12.21	 	  	 	16.00	 	  	 	2.59	 	  	 	4.42	 	  	 	8.21	 	  	 	11.33	 
	 59
	  	 	4.19	 	  	 	6.82	 	  	 	13.12	 	  	 	17.26	 	  	 	2.85	 	  	 	4.94	 	  	 	8.94	 	  	 	12.22	 
	 60
	  	 	4.64	 	  	 	7.54	 	  	 	14.10	 	  	 	18.62	 	  	 	3.14	 	  	 	5.50	 	  	 	9.73	 	  	 	13.18	 
	 61
	  	 	5.28	 	  	 	8.48	 	  	 	15.96	 	  	 	20.48	 	  	 	3.49	 	  	 	6.11	 	  	 	10.57	 	  	 	14.47	 
	 62
	  	 	5.98	 	  	 	9.50	 	  	 	17.95	 	  	 	22.47	 	  	 	3.87	 	  	 	6.77	 	  	 	11.49	 	  	 	15.86	 
	 63
	  	 	6.74	 	  	 	10.62	 	  	 	20.07	 	  	 	24.59	 	  	 	4.28	 	  	 	7.50	 	  	 	12.46	 	  	 	17.35	 
	 64
	  	 	7.57	 	  	 	11.84	 	  	 	22.32	 	  	 	26.85	 	  	 	4.74	 	  	 	8.30	 	  	 	13.51	 	  	 	18.95	 
	 65
	  	 	8.48	 	  	 	13.18	 	  	 	24.73	 	  	 	29.26	 	  	 	5.24	 	  	 	9.18	 	  	 	14.65	 	  	 	20.69	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	     Quarterly
      0.280
	 
  
	  	 
 
	      Monthly

      0.087
	 
  
	  				  				  			

  

			
	Page 8 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 15 Year Term - $500,000 - $999,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.39	 	  	 	0.70	 	  	 	1.37	 	  	 	1.83	 	  	 	0.33	 	  	 	0.59	 	  	 	1.04	 	  	 	1.26	 
	 19
	  	 	0.39	 	  	 	0.70	 	  	 	1.37	 	  	 	1.84	 	  	 	0.33	 	  	 	0.59	 	  	 	1.04	 	  	 	1.26	 
	 20
	  	 	0.39	 	  	 	0.70	 	  	 	1.37	 	  	 	1.84	 	  	 	0.33	 	  	 	0.59	 	  	 	1.04	 	  	 	1.26	 
	 21
	  	 	0.39	 	  	 	0.70	 	  	 	1.37	 	  	 	1.85	 	  	 	0.33	 	  	 	0.59	 	  	 	1.05	 	  	 	1.27	 
	 22
	  	 	0.39	 	  	 	0.70	 	  	 	1.38	 	  	 	1.86	 	  	 	0.33	 	  	 	0.59	 	  	 	1.05	 	  	 	1.27	 
	 23
	  	 	0.39	 	  	 	0.70	 	  	 	1.38	 	  	 	1.87	 	  	 	0.33	 	  	 	0.59	 	  	 	1.06	 	  	 	1.28	 
	 24
	  	 	0.39	 	  	 	0.70	 	  	 	1.39	 	  	 	1.88	 	  	 	0.33	 	  	 	0.59	 	  	 	1.06	 	  	 	1.29	 
	 25
	  	 	0.39	 	  	 	0.70	 	  	 	1.39	 	  	 	1.89	 	  	 	0.33	 	  	 	0.59	 	  	 	1.07	 	  	 	1.30	 
	 26
	  	 	0.39	 	  	 	0.71	 	  	 	1.40	 	  	 	1.90	 	  	 	0.33	 	  	 	0.59	 	  	 	1.07	 	  	 	1.33	 
	 27
	  	 	0.39	 	  	 	0.72	 	  	 	1.41	 	  	 	1.92	 	  	 	0.33	 	  	 	0.59	 	  	 	1.07	 	  	 	1.37	 
	 28
	  	 	0.39	 	  	 	0.74	 	  	 	1.42	 	  	 	1.94	 	  	 	0.33	 	  	 	0.60	 	  	 	1.07	 	  	 	1.40	 
	 29
	  	 	0.39	 	  	 	0.76	 	  	 	1.44	 	  	 	1.96	 	  	 	0.33	 	  	 	0.60	 	  	 	1.07	 	  	 	1.45	 
	 30
	  	 	0.39	 	  	 	0.78	 	  	 	1.46	 	  	 	1.99	 	  	 	0.33	 	  	 	0.60	 	  	 	1.07	 	  	 	1.49	 
	 31
	  	 	0.40	 	  	 	0.79	 	  	 	1.49	 	  	 	2.03	 	  	 	0.33	 	  	 	0.61	 	  	 	1.10	 	  	 	1.52	 
	 32
	  	 	0.41	 	  	 	0.80	 	  	 	1.52	 	  	 	2.07	 	  	 	0.34	 	  	 	0.62	 	  	 	1.12	 	  	 	1.56	 
	 33
	  	 	0.42	 	  	 	0.81	 	  	 	1.55	 	  	 	2.12	 	  	 	0.35	 	  	 	0.63	 	  	 	1.15	 	  	 	1.60	 
	 34
	  	 	0.44	 	  	 	0.82	 	  	 	1.59	 	  	 	2.18	 	  	 	0.35	 	  	 	0.65	 	  	 	1.19	 	  	 	1.64	 
	 35
	  	 	0.45	 	  	 	0.83	 	  	 	1.63	 	  	 	2.24	 	  	 	0.36	 	  	 	0.66	 	  	 	1.23	 	  	 	1.69	 
	 36
	  	 	0.48	 	  	 	0.88	 	  	 	1.73	 	  	 	2.38	 	  	 	0.38	 	  	 	0.71	 	  	 	1.32	 	  	 	1.82	 
	 37
	  	 	0.50	 	  	 	0.93	 	  	 	1.84	 	  	 	2.53	 	  	 	0.41	 	  	 	0.76	 	  	 	1.42	 	  	 	1.96	 
	 38
	  	 	0.54	 	  	 	1.00	 	  	 	1.96	 	  	 	2.69	 	  	 	0.43	 	  	 	0.81	 	  	 	1.53	 	  	 	2.12	 
	 39
	  	 	0.57	 	  	 	1.06	 	  	 	2.09	 	  	 	2.88	 	  	 	0.46	 	  	 	0.88	 	  	 	1.66	 	  	 	2.30	 
	 40
	  	 	0.61	 	  	 	1.14	 	  	 	2.24	 	  	 	3.09	 	  	 	0.50	 	  	 	0.95	 	  	 	1.80	 	  	 	2.51	 
	 41
	  	 	0.67	 	  	 	1.24	 	  	 	2.45	 	  	 	3.44	 	  	 	0.55	 	  	 	1.01	 	  	 	1.96	 	  	 	2.72	 
	 42
	  	 	0.74	 	  	 	1.34	 	  	 	2.69	 	  	 	3.82	 	  	 	0.60	 	  	 	1.09	 	  	 	2.13	 	  	 	2.96	 
	 43
	  	 	0.82	 	  	 	1.46	 	  	 	2.94	 	  	 	4.25	 	  	 	0.67	 	  	 	1.17	 	  	 	2.33	 	  	 	3.23	 
	 44
	  	 	0.91	 	  	 	1.59	 	  	 	3.22	 	  	 	4.70	 	  	 	0.73	 	  	 	1.26	 	  	 	2.54	 	  	 	3.51	 
	 45
	  	 	1.00	 	  	 	1.73	 	  	 	3.51	 	  	 	5.18	 	  	 	0.81	 	  	 	1.36	 	  	 	2.77	 	  	 	3.83	 
	 46
	  	 	1.11	 	  	 	1.87	 	  	 	3.90	 	  	 	5.59	 	  	 	0.88	 	  	 	1.48	 	  	 	3.02	 	  	 	4.19	 
	 47
	  	 	1.22	 	  	 	2.03	 	  	 	4.33	 	  	 	6.04	 	  	 	0.96	 	  	 	1.62	 	  	 	3.29	 	  	 	4.58	 
	 48
	  	 	1.36	 	  	 	2.21	 	  	 	4.80	 	  	 	6.55	 	  	 	1.04	 	  	 	1.76	 	  	 	3.58	 	  	 	4.99	 
	 49
	  	 	1.51	 	  	 	2.41	 	  	 	5.34	 	  	 	7.11	 	  	 	1.13	 	  	 	1.91	 	  	 	3.89	 	  	 	5.44	 
	 50
	  	 	1.68	 	  	 	2.64	 	  	 	5.94	 	  	 	7.75	 	  	 	1.23	 	  	 	2.08	 	  	 	4.22	 	  	 	5.91	 
	 51
	  	 	1.86	 	  	 	2.93	 	  	 	6.62	 	  	 	8.61	 	  	 	1.34	 	  	 	2.25	 	  	 	4.59	 	  	 	6.45	 
	 52
	  	 	2.07	 	  	 	3.24	 	  	 	7.35	 	  	 	9.54	 	  	 	1.45	 	  	 	2.42	 	  	 	4.98	 	  	 	7.02	 
	 53
	  	 	2.29	 	  	 	3.59	 	  	 	8.14	 	  	 	10.54	 	  	 	1.57	 	  	 	2.61	 	  	 	5.39	 	  	 	7.62	 
	 54
	  	 	2.53	 	  	 	3.96	 	  	 	8.97	 	  	 	11.60	 	  	 	1.71	 	  	 	2.82	 	  	 	5.83	 	  	 	8.26	 
	 55
	  	 	2.79	 	  	 	4.37	 	  	 	9.85	 	  	 	12.71	 	  	 	1.85	 	  	 	3.04	 	  	 	6.30	 	  	 	8.94	 
	 56
	  	 	3.06	 	  	 	4.81	 	  	 	10.58	 	  	 	13.71	 	  	 	2.06	 	  	 	3.41	 	  	 	6.85	 	  	 	9.65	 
	 57
	  	 	3.36	 	  	 	5.29	 	  	 	11.36	 	  	 	14.77	 	  	 	2.29	 	  	 	3.80	 	  	 	7.43	 	  	 	10.41	 
	 58
	  	 	3.68	 	  	 	5.82	 	  	 	12.19	 	  	 	15.91	 	  	 	2.54	 	  	 	4.23	 	  	 	8.07	 	  	 	11.22	 
	 59
	  	 	4.05	 	  	 	6.41	 	  	 	13.10	 	  	 	17.15	 	  	 	2.81	 	  	 	4.70	 	  	 	8.75	 	  	 	12.10	 
	 60
	  	 	4.45	 	  	 	7.06	 	  	 	14.09	 	  	 	18.50	 	  	 	3.11	 	  	 	5.21	 	  	 	9.48	 	  	 	13.05	 
	 61
	  	 	5.09	 	  	 	8.06	 	  	 	15.95	 	  	 	20.37	 	  	 	3.46	 	  	 	5.85	 	  	 	10.34	 	  	 	14.33	 
	 62
	  	 	5.79	 	  	 	9.15	 	  	 	17.93	 	  	 	22.37	 	  	 	3.83	 	  	 	6.55	 	  	 	11.27	 	  	 	15.71	 
	 63
	  	 	6.56	 	  	 	10.33	 	  	 	20.04	 	  	 	24.50	 	  	 	4.25	 	  	 	7.32	 	  	 	12.27	 	  	 	17.19	 
	 64
	  	 	7.39	 	  	 	11.63	 	  	 	22.29	 	  	 	26.77	 	  	 	4.70	 	  	 	8.16	 	  	 	13.35	 	  	 	18.78	 
	 65
	  	 	8.31	 	  	 	13.05	 	  	 	24.70	 	  	 	29.20	 	  	 	5.20	 	  	 	9.08	 	  	 	14.51	 	  	 	20.50	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	     Quarterly
      0.280
	 
  
	  	 
 
	      Monthly

      0.087
	 
  
	  				  				  			

  

			
	Page 9 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 15 Year Term - $1,000,000 and over Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.36	 	  	 	0.65	 	  	 	1.19	 	  	 	1.70	 	  	 	0.30	 	  	 	0.57	 	  	 	0.89	 	  	 	1.23	 
	 19
	  	 	0.36	 	  	 	0.65	 	  	 	1.19	 	  	 	1.71	 	  	 	0.30	 	  	 	0.57	 	  	 	0.89	 	  	 	1.23	 
	 20
	  	 	0.36	 	  	 	0.65	 	  	 	1.19	 	  	 	1.71	 	  	 	0.30	 	  	 	0.57	 	  	 	0.89	 	  	 	1.23	 
	 21
	  	 	0.36	 	  	 	0.65	 	  	 	1.19	 	  	 	1.72	 	  	 	0.30	 	  	 	0.57	 	  	 	0.90	 	  	 	1.23	 
	 22
	  	 	0.36	 	  	 	0.65	 	  	 	1.19	 	  	 	1.73	 	  	 	0.30	 	  	 	0.57	 	  	 	0.90	 	  	 	1.23	 
	 23
	  	 	0.36	 	  	 	0.65	 	  	 	1.19	 	  	 	1.74	 	  	 	0.30	 	  	 	0.57	 	  	 	0.91	 	  	 	1.24	 
	 24
	  	 	0.36	 	  	 	0.66	 	  	 	1.19	 	  	 	1.75	 	  	 	0.30	 	  	 	0.57	 	  	 	0.92	 	  	 	1.24	 
	 25
	  	 	0.36	 	  	 	0.66	 	  	 	1.19	 	  	 	1.76	 	  	 	0.30	 	  	 	0.57	 	  	 	0.93	 	  	 	1.24	 
	 26
	  	 	0.36	 	  	 	0.66	 	  	 	1.21	 	  	 	1.77	 	  	 	0.30	 	  	 	0.57	 	  	 	0.94	 	  	 	1.26	 
	 27
	  	 	0.36	 	  	 	0.66	 	  	 	1.23	 	  	 	1.78	 	  	 	0.30	 	  	 	0.58	 	  	 	0.96	 	  	 	1.28	 
	 28
	  	 	0.36	 	  	 	0.66	 	  	 	1.26	 	  	 	1.79	 	  	 	0.30	 	  	 	0.58	 	  	 	0.97	 	  	 	1.30	 
	 29
	  	 	0.36	 	  	 	0.67	 	  	 	1.29	 	  	 	1.80	 	  	 	0.30	 	  	 	0.59	 	  	 	0.99	 	  	 	1.32	 
	 30
	  	 	0.36	 	  	 	0.67	 	  	 	1.33	 	  	 	1.82	 	  	 	0.30	 	  	 	0.59	 	  	 	1.01	 	  	 	1.34	 
	 31
	  	 	0.37	 	  	 	0.68	 	  	 	1.35	 	  	 	1.85	 	  	 	0.30	 	  	 	0.59	 	  	 	1.03	 	  	 	1.39	 
	 32
	  	 	0.38	 	  	 	0.69	 	  	 	1.37	 	  	 	1.89	 	  	 	0.31	 	  	 	0.59	 	  	 	1.05	 	  	 	1.45	 
	 33
	  	 	0.39	 	  	 	0.71	 	  	 	1.40	 	  	 	1.93	 	  	 	0.31	 	  	 	0.60	 	  	 	1.07	 	  	 	1.51	 
	 34
	  	 	0.40	 	  	 	0.72	 	  	 	1.43	 	  	 	1.98	 	  	 	0.32	 	  	 	0.60	 	  	 	1.09	 	  	 	1.59	 
	 35
	  	 	0.41	 	  	 	0.74	 	  	 	1.46	 	  	 	2.03	 	  	 	0.32	 	  	 	0.60	 	  	 	1.12	 	  	 	1.67	 
	 36
	  	 	0.44	 	  	 	0.79	 	  	 	1.57	 	  	 	2.18	 	  	 	0.34	 	  	 	0.64	 	  	 	1.22	 	  	 	1.78	 
	 37
	  	 	0.46	 	  	 	0.85	 	  	 	1.69	 	  	 	2.34	 	  	 	0.37	 	  	 	0.69	 	  	 	1.34	 	  	 	1.90	 
	 38
	  	 	0.50	 	  	 	0.92	 	  	 	1.82	 	  	 	2.53	 	  	 	0.40	 	  	 	0.75	 	  	 	1.47	 	  	 	2.04	 
	 39
	  	 	0.53	 	  	 	1.00	 	  	 	1.97	 	  	 	2.73	 	  	 	0.43	 	  	 	0.81	 	  	 	1.61	 	  	 	2.20	 
	 40
	  	 	0.57	 	  	 	1.08	 	  	 	2.14	 	  	 	2.96	 	  	 	0.47	 	  	 	0.88	 	  	 	1.78	 	  	 	2.38	 
	 41
	  	 	0.64	 	  	 	1.18	 	  	 	2.36	 	  	 	3.32	 	  	 	0.52	 	  	 	0.95	 	  	 	1.93	 	  	 	2.60	 
	 42
	  	 	0.71	 	  	 	1.29	 	  	 	2.61	 	  	 	3.72	 	  	 	0.58	 	  	 	1.03	 	  	 	2.09	 	  	 	2.84	 
	 43
	  	 	0.79	 	  	 	1.42	 	  	 	2.88	 	  	 	4.16	 	  	 	0.64	 	  	 	1.12	 	  	 	2.27	 	  	 	3.10	 
	 44
	  	 	0.88	 	  	 	1.55	 	  	 	3.17	 	  	 	4.62	 	  	 	0.71	 	  	 	1.22	 	  	 	2.47	 	  	 	3.39	 
	 45
	  	 	0.98	 	  	 	1.70	 	  	 	3.48	 	  	 	5.12	 	  	 	0.79	 	  	 	1.33	 	  	 	2.69	 	  	 	3.71	 
	 46
	  	 	1.08	 	  	 	1.84	 	  	 	3.83	 	  	 	5.52	 	  	 	0.85	 	  	 	1.44	 	  	 	2.93	 	  	 	4.05	 
	 47
	  	 	1.19	 	  	 	2.00	 	  	 	4.21	 	  	 	5.96	 	  	 	0.91	 	  	 	1.55	 	  	 	3.20	 	  	 	4.41	 
	 48
	  	 	1.32	 	  	 	2.18	 	  	 	4.63	 	  	 	6.44	 	  	 	0.98	 	  	 	1.68	 	  	 	3.48	 	  	 	4.81	 
	 49
	  	 	1.47	 	  	 	2.38	 	  	 	5.10	 	  	 	6.99	 	  	 	1.05	 	  	 	1.81	 	  	 	3.79	 	  	 	5.23	 
	 50
	  	 	1.63	 	  	 	2.61	 	  	 	5.64	 	  	 	7.61	 	  	 	1.13	 	  	 	1.96	 	  	 	4.11	 	  	 	5.67	 
	 51
	  	 	1.81	 	  	 	2.86	 	  	 	6.25	 	  	 	8.34	 	  	 	1.23	 	  	 	2.11	 	  	 	4.45	 	  	 	6.07	 
	 52
	  	 	2.02	 	  	 	3.15	 	  	 	6.91	 	  	 	9.14	 	  	 	1.34	 	  	 	2.28	 	  	 	4.80	 	  	 	6.48	 
	 53
	  	 	2.24	 	  	 	3.45	 	  	 	7.62	 	  	 	10.00	 	  	 	1.46	 	  	 	2.45	 	  	 	5.18	 	  	 	6.93	 
	 54
	  	 	2.48	 	  	 	3.79	 	  	 	8.37	 	  	 	10.91	 	  	 	1.58	 	  	 	2.64	 	  	 	5.58	 	  	 	7.40	 
	 55
	  	 	2.74	 	  	 	4.15	 	  	 	9.16	 	  	 	11.86	 	  	 	1.72	 	  	 	2.85	 	  	 	6.01	 	  	 	7.90	 
	 56
	  	 	3.01	 	  	 	4.62	 	  	 	9.83	 	  	 	12.84	 	  	 	1.93	 	  	 	3.23	 	  	 	6.55	 	  	 	8.76	 
	 57
	  	 	3.30	 	  	 	5.12	 	  	 	10.54	 	  	 	13.88	 	  	 	2.15	 	  	 	3.65	 	  	 	7.14	 	  	 	9.68	 
	 58
	  	 	3.63	 	  	 	5.68	 	  	 	11.31	 	  	 	15.01	 	  	 	2.40	 	  	 	4.10	 	  	 	7.76	 	  	 	10.68	 
	 59
	  	 	3.99	 	  	 	6.30	 	  	 	12.15	 	  	 	16.23	 	  	 	2.66	 	  	 	4.59	 	  	 	8.44	 	  	 	11.73	 
	 60
	  	 	4.39	 	  	 	6.99	 	  	 	13.05	 	  	 	17.56	 	  	 	2.95	 	  	 	5.12	 	  	 	9.17	 	  	 	12.88	 
	 61
	  	 	5.02	 	  	 	7.98	 	  	 	14.70	 	  	 	19.48	 	  	 	3.26	 	  	 	5.64	 	  	 	10.01	 	  	 	13.87	 
	 62
	  	 	5.70	 	  	 	9.06	 	  	 	16.45	 	  	 	21.53	 	  	 	3.60	 	  	 	6.20	 	  	 	10.93	 	  	 	14.93	 
	 63
	  	 	6.44	 	  	 	10.23	 	  	 	18.33	 	  	 	23.71	 	  	 	3.97	 	  	 	6.82	 	  	 	11.90	 	  	 	16.07	 
	 64
	  	 	7.26	 	  	 	11.51	 	  	 	20.32	 	  	 	26.03	 	  	 	4.38	 	  	 	7.50	 	  	 	12.95	 	  	 	17.30	 
	 65
	  	 	8.15	 	  	 	12.92	 	  	 	22.45	 	  	 	28.52	 	  	 	4.83	 	  	 	8.24	 	  	 	14.09	 	  	 	18.62	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	    Quarterly
     0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 10 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 20 Year Term - Under $100,000 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual Policy
Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.99	 	  	 	1.54	 	  	 	2.94	 	  	 	3.69	 	  	 	0.89	 	  	 	1.32	 	  	 	2.29	 	  	 	2.65	 
	 19
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	3.70	 	  	 	0.89	 	  	 	1.32	 	  	 	2.29	 	  	 	2.65	 
	 20
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	3.70	 	  	 	0.89	 	  	 	1.32	 	  	 	2.29	 	  	 	2.65	 
	 21
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	3.71	 	  	 	0.89	 	  	 	1.32	 	  	 	2.30	 	  	 	2.65	 
	 22
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	3.74	 	  	 	0.89	 	  	 	1.32	 	  	 	2.30	 	  	 	2.65	 
	 23
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	3.79	 	  	 	0.89	 	  	 	1.34	 	  	 	2.31	 	  	 	2.65	 
	 24
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	3.81	 	  	 	0.89	 	  	 	1.34	 	  	 	2.33	 	  	 	2.65	 
	 25
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	3.84	 	  	 	0.89	 	  	 	1.34	 	  	 	2.34	 	  	 	2.65	 
	 26
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	3.93	 	  	 	0.89	 	  	 	1.34	 	  	 	2.40	 	  	 	2.72	 
	 27
	  	 	0.99	 	  	 	1.54	 	  	 	2.96	 	  	 	4.02	 	  	 	0.90	 	  	 	1.34	 	  	 	2.45	 	  	 	2.82	 
	 28
	  	 	0.99	 	  	 	1.55	 	  	 	2.96	 	  	 	4.10	 	  	 	0.90	 	  	 	1.34	 	  	 	2.54	 	  	 	2.93	 
	 29
	  	 	0.99	 	  	 	1.55	 	  	 	2.96	 	  	 	4.23	 	  	 	0.92	 	  	 	1.34	 	  	 	2.60	 	  	 	3.05	 
	 30
	  	 	0.99	 	  	 	1.55	 	  	 	2.96	 	  	 	4.36	 	  	 	0.92	 	  	 	1.34	 	  	 	2.69	 	  	 	3.15	 
	 31
	  	 	1.00	 	  	 	1.58	 	  	 	3.07	 	  	 	4.46	 	  	 	0.94	 	  	 	1.39	 	  	 	2.76	 	  	 	3.25	 
	 32
	  	 	1.03	 	  	 	1.59	 	  	 	3.20	 	  	 	4.46	 	  	 	0.96	 	  	 	1.45	 	  	 	2.86	 	  	 	3.37	 
	 33
	  	 	1.04	 	  	 	1.62	 	  	 	3.35	 	  	 	4.48	 	  	 	0.99	 	  	 	1.51	 	  	 	2.96	 	  	 	3.51	 
	 34
	  	 	1.07	 	  	 	1.65	 	  	 	3.52	 	  	 	4.48	 	  	 	1.03	 	  	 	1.58	 	  	 	3.00	 	  	 	3.65	 
	 35
	  	 	1.10	 	  	 	1.69	 	  	 	3.70	 	  	 	4.48	 	  	 	1.06	 	  	 	1.66	 	  	 	3.04	 	  	 	3.80	 
	 36
	  	 	1.17	 	  	 	1.82	 	  	 	3.79	 	  	 	4.90	 	  	 	1.10	 	  	 	1.72	 	  	 	3.20	 	  	 	4.01	 
	 37
	  	 	1.24	 	  	 	1.96	 	  	 	3.89	 	  	 	5.37	 	  	 	1.14	 	  	 	1.77	 	  	 	3.40	 	  	 	4.25	 
	 38
	  	 	1.32	 	  	 	2.11	 	  	 	4.00	 	  	 	5.82	 	  	 	1.20	 	  	 	1.85	 	  	 	3.65	 	  	 	4.51	 
	 39
	  	 	1.42	 	  	 	2.28	 	  	 	4.13	 	  	 	6.32	 	  	 	1.25	 	  	 	1.93	 	  	 	3.89	 	  	 	4.80	 
	 40
	  	 	1.52	 	  	 	2.46	 	  	 	4.25	 	  	 	6.90	 	  	 	1.31	 	  	 	2.01	 	  	 	4.15	 	  	 	5.11	 
	 41
	  	 	1.65	 	  	 	2.68	 	  	 	4.73	 	  	 	7.57	 	  	 	1.41	 	  	 	2.15	 	  	 	4.49	 	  	 	5.68	 
	 42
	  	 	1.80	 	  	 	2.90	 	  	 	5.27	 	  	 	8.32	 	  	 	1.54	 	  	 	2.30	 	  	 	4.85	 	  	 	6.30	 
	 43
	  	 	1.97	 	  	 	3.17	 	  	 	5.86	 	  	 	9.17	 	  	 	1.66	 	  	 	2.46	 	  	 	5.24	 	  	 	6.96	 
	 44
	  	 	2.15	 	  	 	3.45	 	  	 	6.49	 	  	 	10.11	 	  	 	1.79	 	  	 	2.63	 	  	 	5.66	 	  	 	7.63	 
	 45
	  	 	2.35	 	  	 	3.77	 	  	 	7.20	 	  	 	11.09	 	  	 	1.94	 	  	 	2.83	 	  	 	6.13	 	  	 	8.25	 
	 46
	  	 	2.62	 	  	 	4.08	 	  	 	8.20	 	  	 	11.99	 	  	 	2.11	 	  	 	3.07	 	  	 	6.55	 	  	 	8.99	 
	 47
	  	 	2.90	 	  	 	4.42	 	  	 	9.28	 	  	 	12.90	 	  	 	2.31	 	  	 	3.32	 	  	 	7.00	 	  	 	9.54	 
	 48
	  	 	3.21	 	  	 	4.79	 	  	 	10.44	 	  	 	13.89	 	  	 	2.51	 	  	 	3.61	 	  	 	7.49	 	  	 	10.14	 
	 49
	  	 	3.56	 	  	 	5.18	 	  	 	11.69	 	  	 	14.96	 	  	 	2.73	 	  	 	3.90	 	  	 	8.01	 	  	 	10.77	 
	 50
	  	 	3.94	 	  	 	5.63	 	  	 	13.04	 	  	 	16.11	 	  	 	2.97	 	  	 	4.23	 	  	 	8.56	 	  	 	11.45	 
	 51
	  	 	4.25	 	  	 	6.25	 	  	 	14.21	 	  	 	17.32	 	  	 	3.20	 	  	 	4.62	 	  	 	9.42	 	  	 	12.39	 
	 52
	  	 	4.59	 	  	 	6.93	 	  	 	15.46	 	  	 	18.62	 	  	 	3.44	 	  	 	5.04	 	  	 	10.35	 	  	 	13.41	 
	 53
	  	 	4.96	 	  	 	7.69	 	  	 	16.83	 	  	 	20.04	 	  	 	3.69	 	  	 	5.51	 	  	 	11.34	 	  	 	14.36	 
	 54
	  	 	5.37	 	  	 	8.52	 	  	 	18.30	 	  	 	21.55	 	  	 	3.97	 	  	 	6.00	 	  	 	12.41	 	  	 	15.31	 
	 55
	  	 	5.82	 	  	 	9.42	 	  	 	19.86	 	  	 	23.17	 	  	 	4.28	 	  	 	6.55	 	  	 	13.54	 	  	 	16.29	 
	 56
	  	 	6.73	 	  	 	10.59	 	  	 	21.83	 	  	 	25.04	 	  	 	4.76	 	  	 	7.85	 	  	 	14.10	 	  	 	16.92	 
	 57
	  	 	7.72	 	  	 	11.87	 	  	 	23.93	 	  	 	27.03	 	  	 	5.28	 	  	 	9.24	 	  	 	14.49	 	  	 	17.61	 
	 58
	  	 	8.79	 	  	 	13.27	 	  	 	26.17	 	  	 	29.15	 	  	 	5.86	 	  	 	10.76	 	  	 	14.87	 	  	 	18.42	 
	 59
	  	 	9.99	 	  	 	14.82	 	  	 	28.61	 	  	 	31.46	 	  	 	6.46	 	  	 	12.41	 	  	 	15.03	 	  	 	19.34	 
	 60
	  	 	11.30	 	  	 	16.51	 	  	 	31.25	 	  	 	33.97	 	  	 	7.14	 	  	 	14.20	 	  	 	16.01	 	  	 	20.68	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	     Quarterly
      0.280
	 
  
	  	 
 
	     Monthly
      0.087
	 
  
	  				  				  			

  

			
	Page 11 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 20 Year Term - $100,000 - $249,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.70	 	  	 	1.09	 	  	 	2.09	 	  	 	3.14	 	  	 	0.63	 	  	 	0.94	 	  	 	1.75	 	  	 	2.06	 
	 19
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.14	 	  	 	0.63	 	  	 	0.94	 	  	 	1.76	 	  	 	2.07	 
	 20
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.15	 	  	 	0.63	 	  	 	0.94	 	  	 	1.76	 	  	 	2.07	 
	 21
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.15	 	  	 	0.63	 	  	 	0.94	 	  	 	1.76	 	  	 	2.07	 
	 22
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.15	 	  	 	0.63	 	  	 	0.94	 	  	 	1.76	 	  	 	2.08	 
	 23
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.16	 	  	 	0.63	 	  	 	0.95	 	  	 	1.76	 	  	 	2.08	 
	 24
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.16	 	  	 	0.63	 	  	 	0.95	 	  	 	1.76	 	  	 	2.09	 
	 25
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.16	 	  	 	0.63	 	  	 	0.95	 	  	 	1.76	 	  	 	2.09	 
	 26
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.16	 	  	 	0.63	 	  	 	0.95	 	  	 	1.80	 	  	 	2.11	 
	 27
	  	 	0.70	 	  	 	1.09	 	  	 	2.10	 	  	 	3.16	 	  	 	0.64	 	  	 	0.95	 	  	 	1.85	 	  	 	2.14	 
	 28
	  	 	0.70	 	  	 	1.10	 	  	 	2.10	 	  	 	3.17	 	  	 	0.64	 	  	 	0.95	 	  	 	1.90	 	  	 	2.17	 
	 29
	  	 	0.70	 	  	 	1.10	 	  	 	2.10	 	  	 	3.17	 	  	 	0.65	 	  	 	0.95	 	  	 	1.96	 	  	 	2.20	 
	 30
	  	 	0.70	 	  	 	1.10	 	  	 	2.10	 	  	 	3.17	 	  	 	0.65	 	  	 	0.95	 	  	 	2.03	 	  	 	2.24	 
	 31
	  	 	0.71	 	  	 	1.12	 	  	 	2.18	 	  	 	3.17	 	  	 	0.67	 	  	 	0.99	 	  	 	2.05	 	  	 	2.31	 
	 32
	  	 	0.73	 	  	 	1.13	 	  	 	2.27	 	  	 	3.17	 	  	 	0.68	 	  	 	1.03	 	  	 	2.07	 	  	 	2.39	 
	 33
	  	 	0.74	 	  	 	1.15	 	  	 	2.38	 	  	 	3.18	 	  	 	0.70	 	  	 	1.07	 	  	 	2.10	 	  	 	2.49	 
	 34
	  	 	0.76	 	  	 	1.17	 	  	 	2.50	 	  	 	3.18	 	  	 	0.73	 	  	 	1.12	 	  	 	2.13	 	  	 	2.59	 
	 35
	  	 	0.78	 	  	 	1.20	 	  	 	2.63	 	  	 	3.18	 	  	 	0.75	 	  	 	1.18	 	  	 	2.16	 	  	 	2.70	 
	 36
	  	 	0.83	 	  	 	1.29	 	  	 	2.69	 	  	 	3.48	 	  	 	0.78	 	  	 	1.22	 	  	 	2.29	 	  	 	2.85	 
	 37
	  	 	0.88	 	  	 	1.39	 	  	 	2.76	 	  	 	3.81	 	  	 	0.81	 	  	 	1.26	 	  	 	2.43	 	  	 	3.02	 
	 38
	  	 	0.94	 	  	 	1.50	 	  	 	2.84	 	  	 	4.17	 	  	 	0.85	 	  	 	1.31	 	  	 	2.59	 	  	 	3.20	 
	 39
	  	 	1.01	 	  	 	1.62	 	  	 	2.93	 	  	 	4.57	 	  	 	0.89	 	  	 	1.37	 	  	 	2.76	 	  	 	3.41	 
	 40
	  	 	1.08	 	  	 	1.75	 	  	 	3.02	 	  	 	5.00	 	  	 	0.93	 	  	 	1.43	 	  	 	2.95	 	  	 	3.63	 
	 41
	  	 	1.17	 	  	 	1.90	 	  	 	3.36	 	  	 	5.48	 	  	 	1.00	 	  	 	1.53	 	  	 	3.19	 	  	 	4.03	 
	 42
	  	 	1.28	 	  	 	2.06	 	  	 	3.74	 	  	 	6.00	 	  	 	1.09	 	  	 	1.63	 	  	 	3.44	 	  	 	4.47	 
	 43
	  	 	1.40	 	  	 	2.25	 	  	 	4.16	 	  	 	6.58	 	  	 	1.18	 	  	 	1.75	 	  	 	3.72	 	  	 	4.94	 
	 44
	  	 	1.53	 	  	 	2.45	 	  	 	4.61	 	  	 	7.21	 	  	 	1.27	 	  	 	1.87	 	  	 	4.02	 	  	 	5.46	 
	 45
	  	 	1.67	 	  	 	2.68	 	  	 	5.11	 	  	 	7.90	 	  	 	1.38	 	  	 	2.01	 	  	 	4.35	 	  	 	6.01	 
	 46
	  	 	1.86	 	  	 	2.90	 	  	 	5.82	 	  	 	8.51	 	  	 	1.50	 	  	 	2.18	 	  	 	4.65	 	  	 	6.38	 
	 47
	  	 	2.06	 	  	 	3.14	 	  	 	6.59	 	  	 	9.16	 	  	 	1.64	 	  	 	2.36	 	  	 	4.97	 	  	 	6.77	 
	 48
	  	 	2.28	 	  	 	3.40	 	  	 	7.41	 	  	 	9.86	 	  	 	1.78	 	  	 	2.56	 	  	 	5.32	 	  	 	7.20	 
	 49
	  	 	2.53	 	  	 	3.68	 	  	 	8.30	 	  	 	10.62	 	  	 	1.94	 	  	 	2.77	 	  	 	5.69	 	  	 	7.65	 
	 50
	  	 	2.80	 	  	 	4.00	 	  	 	9.26	 	  	 	11.44	 	  	 	2.11	 	  	 	3.00	 	  	 	6.08	 	  	 	8.13	 
	 51
	  	 	3.02	 	  	 	4.44	 	  	 	10.09	 	  	 	12.30	 	  	 	2.27	 	  	 	3.26	 	  	 	6.69	 	  	 	8.80	 
	 52
	  	 	3.26	 	  	 	4.92	 	  	 	10.98	 	  	 	13.22	 	  	 	2.44	 	  	 	3.58	 	  	 	7.35	 	  	 	9.52	 
	 53
	  	 	3.52	 	  	 	5.46	 	  	 	11.95	 	  	 	14.23	 	  	 	2.62	 	  	 	3.91	 	  	 	8.05	 	  	 	10.28	 
	 54
	  	 	3.81	 	  	 	6.05	 	  	 	12.99	 	  	 	15.30	 	  	 	2.82	 	  	 	4.26	 	  	 	8.81	 	  	 	11.10	 
	 55
	  	 	4.13	 	  	 	6.69	 	  	 	14.10	 	  	 	16.45	 	  	 	3.04	 	  	 	4.65	 	  	 	9.61	 	  	 	11.98	 
	 56
	  	 	4.78	 	  	 	7.52	 	  	 	15.50	 	  	 	17.78	 	  	 	3.38	 	  	 	5.57	 	  	 	10.37		  	 	13.09	 
	 57
	  	 	5.48	 	  	 	8.43	 	  	 	16.99	 	  	 	19.19	 	  	 	3.75	 	  	 	6.56	 	  	 	11.19	 	  	 	14.27	 
	 58
	  	 	6.24	 	  	 	9.42	 	  	 	18.58	 	  	 	20.70	 	  	 	4.16	 	  	 	7.64	 	  	 	12.06	 	  	 	15.53	 
	 59
	  	 	7.09	 	  	 	10.52	 	  	 	20.31	 	  	 	22.34	 	  	 	4.59	 	  	 	8.81	 	  	 	12.98	 	  	 	16.88	 
	 60
	  	 	8.02	 	  	 	11.72	 	  	 	22.19	 	  	 	24.12	 	  	 	5.07	 	  	 	10.08	 	  	 	13.97	 	  	 	18.31	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  		  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  		  	 	—  	 	  	 	—  	 	  	 	—  	
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	    Quarterly
     0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 12 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 20 Year Term - $250,000 - $499,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.53	 	  	 	0.85	 	  	 	1.62	 	  	 	2.13	 	  	 	0.39	 	  	 	0.65	 	  	 	1.23	 	  	 	1.46	 
	 19
	  	 	0.53	 	  	 	0.85	 	  	 	1.63	 	  	 	2.14	 	  	 	0.39	 	  	 	0.65	 	  	 	1.23	 	  	 	1.46	 
	 20
	  	 	0.53	 	  	 	0.85	 	  	 	1.63	 	  	 	2.14	 	  	 	0.39	 	  	 	0.65	 	  	 	1.23	 	  	 	1.46	 
	 21
	  	 	0.53	 	  	 	0.85	 	  	 	1.66	 	  	 	2.15	 	  	 	0.39	 	  	 	0.65	 	  	 	1.24	 	  	 	1.46	 
	 22
	  	 	0.53	 	  	 	0.85	 	  	 	1.70	 	  	 	2.17	 	  	 	0.39	 	  	 	0.65	 	  	 	1.24	 	  	 	1.46	 
	 23
	  	 	0.53	 	  	 	0.85	 	  	 	1.74	 	  	 	2.19	 	  	 	0.39	 	  	 	0.65	 	  	 	1.25	 	  	 	1.46	 
	 24
	  	 	0.53	 	  	 	0.85	 	  	 	1.79	 	  	 	2.21	 	  	 	0.39	 	  	 	0.65	 	  	 	1.26	 	  	 	1.46	 
	 25
	  	 	0.53	 	  	 	0.85	 	  	 	1.84	 	  	 	2.23	 	  	 	0.39	 	  	 	0.65	 	  	 	1.27	 	  	 	1.46	 
	 26
	  	 	0.53	 	  	 	0.85	 	  	 	1.86	 	  	 	2.28	 	  	 	0.39	 	  	 	0.65	 	  	 	1.30	 	  	 	1.50	 
	 27
	  	 	0.53	 	  	 	0.86	 	  	 	1.88	 	  	 	2.33	 	  	 	0.40	 	  	 	0.66	 	  	 	1.33	 	  	 	1.55	 
	 28
	  	 	0.54	 	  	 	0.87	 	  	 	1.90	 	  	 	2.39	 	  	 	0.40	 	  	 	0.66	 	  	 	1.37	 	  	 	1.61	 
	 29
	  	 	0.54	 	  	 	0.87	 	  	 	1.92	 	  	 	2.46	 	  	 	0.41	 	  	 	0.67	 	  	 	1.41	 	  	 	1.67	 
	 30
	  	 	0.54	 	  	 	0.88	 	  	 	1.95	 	  	 	2.53	 	  	 	0.41	 	  	 	0.67	 	  	 	1.45	 	  	 	1.74	 
	 31
	  	 	0.55	 	  	 	0.90	 	  	 	1.96	 	  	 	2.59	 	  	 	0.43	 	  	 	0.70	 	  	 	1.49	 	  	 	1.83	 
	 32
	  	 	0.56	 	  	 	0.93	 	  	 	1.98	 	  	 	2.65	 	  	 	0.45	 	  	 	0.73	 	  	 	1.54	 	  	 	1.93	 
	 33
	  	 	0.57	 	  	 	0.96	 	  	 	1.99	 	  	 	2.72	 	  	 	0.47	 	  	 	0.77	 	  	 	1.59	 	  	 	2.04	 
	 34
	  	 	0.58	 	  	 	0.99	 	  	 	2.01	 	  	 	2.80	 	  	 	0.49	 	  	 	0.81	 	  	 	1.65	 	  	 	2.17	 
	 35
	  	 	0.59	 	  	 	1.03	 	  	 	2.03	 	  	 	2.89	 	  	 	0.52	 	  	 	0.85	 	  	 	1.72	 	  	 	2.31	 
	 36
	  	 	0.63	 	  	 	1.09	 	  	 	2.18	 	  	 	3.11	 	  	 	0.55	 	  	 	0.90	 	  	 	1.82	 	  	 	2.43	 
	 37
	  	 	0.68	 	  	 	1.16	 	  	 	2.34	 	  	 	3.35	 	  	 	0.58	 	  	 	0.96	 	  	 	1.94	 	  	 	2.57	 
	 38
	  	 	0.74	 	  	 	1.24	 	  	 	2.53	 	  	 	3.63	 	  	 	0.62	 	  	 	1.02	 	  	 	2.06	 	  	 	2.72	 
	 39
	  	 	0.79	 	  	 	1.33	 	  	 	2.72	 	  	 	3.92	 	  	 	0.66	 	  	 	1.08	 	  	 	2.20	 	  	 	2.89	 
	 40
	  	 	0.86	 	  	 	1.42	 	  	 	2.94	 	  	 	4.24	 	  	 	0.71	 	  	 	1.16	 	  	 	2.35	 	  	 	3.07	 
	 41
	  	 	0.95	 	  	 	1.55	 	  	 	3.28	 	  	 	4.71	 	  	 	0.77	 	  	 	1.25	 	  	 	2.59	 	  	 	3.37	 
	 42
	  	 	1.04	 	  	 	1.70	 	  	 	3.65	 	  	 	5.22	 	  	 	0.85	 	  	 	1.35	 	  	 	2.85	 	  	 	3.69	 
	 43
	  	 	1.15	 	  	 	1.86	 	  	 	4.06	 	  	 	5.78	 	  	 	0.92	 	  	 	1.46	 	  	 	3.13	 	  	 	4.05	 
	 44
	  	 	1.27	 	  	 	2.04	 	  	 	4.51	 	  	 	6.40	 	  	 	1.01	 	  	 	1.57	 	  	 	3.43	 	  	 	4.43	 
	 45
	  	 	1.40	 	  	 	2.24	 	  	 	5.00	 	  	 	7.07	 	  	 	1.10	 	  	 	1.70	 	  	 	3.76	 	  	 	4.84	 
	 46
	  	 	1.53	 	  	 	2.45	 	  	 	5.47	 	  	 	7.63	 	  	 	1.20	 	  	 	1.86	 	  	 	4.05	 	  	 	5.25	 
	 47
	  	 	1.67	 	  	 	2.67	 	  	 	5.97	 	  	 	8.22	 	  	 	1.31	 	  	 	2.04	 	  	 	4.36	 	  	 	5.68	 
	 48
	  	 	1.82	 	  	 	2.92	 	  	 	6.51	 	  	 	8.86	 	  	 	1.43	 	  	 	2.22	 	  	 	4.70	 	  	 	6.15	 
	 49
	  	 	1.99	 	  	 	3.19	 	  	 	7.10	 	  	 	9.55	 	  	 	1.56	 	  	 	2.43	 	  	 	5.06	 	  	 	6.65	 
	 50
	  	 	2.18	 	  	 	3.49	 	  	 	7.73	 	  	 	10.30	 	  	 	1.70	 	  	 	2.65	 	  	 	5.44	 	  	 	7.18	 
	 51
	  	 	2.40	 	  	 	3.93	 	  	 	8.42	 	  	 	11.07	 	  	 	1.87	 	  	 	2.86	 	  	 	5.93	 	  	 	7.74	 
	 52
	  	 	2.65	 	  	 	4.41	 	  	 	9.17	 	  	 	11.90	 	  	 	2.05	 	  	 	3.10	 	  	 	6.45	 	  	 	8.35	 
	 53
	  	 	2.92	 	  	 	4.94	 	  	 	9.98	 	  	 	12.79	 	  	 	2.25	 	  	 	3.35	 	  	 	7.01	 	  	 	8.99	 
	 54
	  	 	3.22	 	  	 	5.53	 	  	 	10.85	 	  	 	13.76	 	  	 	2.47	 	  	 	3.62	 	  	 	7.61	 	  	 	9.68	 
	 55
	  	 	3.55	 	  	 	6.17	 	  	 	11.77	 	  	 	14.78	 	  	 	2.70	 	  	 	3.92	 	  	 	8.25	 	  	 	10.42	 
	 56
	  	 	4.08	 	  	 	6.82	 	  	 	12.89	 	  	 	16.03	 	  	 	2.97	 	  	 	4.44	 	  	 	8.99	 	  	 	11.46	 
	 57
	  	 	4.65	 	  	 	7.52	 	  	 	14.08	 	  	 	17.35	 	  	 	3.27	 	  	 	5.01	 	  	 	9.78	 	  	 	12.57	 
	 58
	  	 	5.28	 	  	 	8.28	 	  	 	15.35	 	  	 	18.77	 	  	 	3.59	 	  	 	5.62	 	  	 	10.62	 	  	 	13.75	 
	 59
	  	 	5.98	 	  	 	9.13	 	  	 	16.74	 	  	 	20.31	 	  	 	3.93	 	  	 	6.29	 	  	 	11.52	 	  	 	15.01	 
	 60
	  	 	6.74	 	  	 	10.06	 	  	 	18.24	 	  	 	21.98	 	  	 	4.31	 	  	 	7.01	 	  	 	12.48	 	  	 	16.35	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	    Quarterly
     0.280
	 
  
	  	 
 
	        Monthly

        0.087
	 
  
	  				  				  			

  

			
	Page 13 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 20 Year Term - $500,000 - $999,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.53	 	  	 	0.84	 	  	 	1.61	 	  	 	2.11	 	  	 	0.38	 	  	 	0.64	 	  	 	1.23	 	  	 	1.45	 
	 19
	  	 	0.53	 	  	 	0.84	 	  	 	1.62	 	  	 	2.12	 	  	 	0.38	 	  	 	0.64	 	  	 	1.23	 	  	 	1.45	 
	 20
	  	 	0.53	 	  	 	0.84	 	  	 	1.62	 	  	 	2.12	 	  	 	0.38	 	  	 	0.64	 	  	 	1.23	 	  	 	1.45	 
	 21
	  	 	0.53	 	  	 	0.84	 	  	 	1.65	 	  	 	2.13	 	  	 	0.38	 	  	 	0.64	 	  	 	1.24	 	  	 	1.45	 
	 22
	  	 	0.53	 	  	 	0.84	 	  	 	1.69	 	  	 	2.15	 	  	 	0.38	 	  	 	0.64	 	  	 	1.24	 	  	 	1.45	 
	 23
	  	 	0.53	 	  	 	0.84	 	  	 	1.73	 	  	 	2.17	 	  	 	0.38	 	  	 	0.64	 	  	 	1.25	 	  	 	1.45	 
	 24
	  	 	0.53	 	  	 	0.84	 	  	 	1.77	 	  	 	2.19	 	  	 	0.38	 	  	 	0.64	 	  	 	1.26	 	  	 	1.45	 
	 25
	  	 	0.53	 	  	 	0.84	 	  	 	1.82	 	  	 	2.21	 	  	 	0.38	 	  	 	0.64	 	  	 	1.27	 	  	 	1.45	 
	 26
	  	 	0.53	 	  	 	0.84	 	  	 	1.84	 	  	 	2.26	 	  	 	0.38	 	  	 	0.64	 	  	 	1.30	 	  	 	1.49	 
	 27
	  	 	0.53	 	  	 	0.85	 	  	 	1.86	 	  	 	2.31	 	  	 	0.39	 	  	 	0.65	 	  	 	1.33	 	  	 	1.54	 
	 28
	  	 	0.54	 	  	 	0.86	 	  	 	1.88	 	  	 	2.37	 	  	 	0.39	 	  	 	0.65	 	  	 	1.36	 	  	 	1.60	 
	 29
	  	 	0.54	 	  	 	0.86	 	  	 	1.90	 	  	 	2.43	 	  	 	0.40	 	  	 	0.66	 	  	 	1.40	 	  	 	1.66	 
	 30
	  	 	0.54	 	  	 	0.87	 	  	 	1.93	 	  	 	2.50	 	  	 	0.40	 	  	 	0.66	 	  	 	1.44	 	  	 	1.73	 
	 31
	  	 	0.55	 	  	 	0.88	 	  	 	1.94	 	  	 	2.56	 	  	 	0.41	 	  	 	0.69	 	  	 	1.48	 	  	 	1.82	 
	 32
	  	 	0.55	 	  	 	0.89	 	  	 	1.96	 	  	 	2.62	 	  	 	0.43	 	  	 	0.72	 	  	 	1.53	 	  	 	1.92	 
	 33
	  	 	0.56	 	  	 	0.91	 	  	 	1.98	 	  	 	2.69	 	  	 	0.45	 	  	 	0.76	 	  	 	1.58	 	  	 	2.03	 
	 34
	  	 	0.57	 	  	 	0.92	 	  	 	2.00	 	  	 	2.77	 	  	 	0.47	 	  	 	0.80	 	  	 	1.64	 	  	 	2.15	 
	 35
	  	 	0.58	 	  	 	0.94	 	  	 	2.02	 	  	 	2.86	 	  	 	0.49	 	  	 	0.84	 	  	 	1.71	 	  	 	2.29	 
	 36
	  	 	0.62	 	  	 	1.01	 	  	 	2.17	 	  	 	3.08	 	  	 	0.52	 	  	 	0.89	 	  	 	1.81	 	  	 	2.41	 
	 37
	  	 	0.67	 	  	 	1.08	 	  	 	2.34	 	  	 	3.33	 	  	 	0.55	 	  	 	0.95	 	  	 	1.91	 	  	 	2.54	 
	 38
	  	 	0.73	 	  	 	1.17	 	  	 	2.52	 	  	 	3.61	 	  	 	0.59	 	  	 	1.01	 	  	 	2.03	 	  	 	2.69	 
	 39
	  	 	0.78	 	  	 	1.26	 	  	 	2.72	 	  	 	3.91	 	  	 	0.63	 	  	 	1.08	 	  	 	2.16	 	  	 	2.85	 
	 40
	  	 	0.85	 	  	 	1.36	 	  	 	2.94	 	  	 	4.24	 	  	 	0.67	 	  	 	1.16	 	  	 	2.30	 	  	 	3.03	 
	 41
	  	 	0.94	 	  	 	1.50	 	  	 	3.28	 	  	 	4.71	 	  	 	0.73	 	  	 	1.25	 	  	 	2.51	 	  	 	3.33	 
	 42
	  	 	1.03	 	  	 	1.65	 	  	 	3.65	 	  	 	5.22	 	  	 	0.81	 	  	 	1.35	 	  	 	2.74	 	  	 	3.66	 
	 43
	  	 	1.14	 	  	 	1.82	 	  	 	4.06	 	  	 	5.78	 	  	 	0.88	 	  	 	1.46	 	  	 	2.99	 	  	 	4.02	 
	 44
	  	 	1.26	 	  	 	2.02	 	  	 	4.50	 	  	 	6.40	 	  	 	0.97	 	  	 	1.57	 	  	 	3.26	 	  	 	4.40	 
	 45
	  	 	1.39	 	  	 	2.23	 	  	 	4.99	 	  	 	7.07	 	  	 	1.06	 	  	 	1.70	 	  	 	3.55	 	  	 	4.82	 
	 46
	  	 	1.52	 	  	 	2.42	 	  	 	5.44	 	  	 	7.63	 	  	 	1.15	 	  	 	1.86	 	  	 	3.88	 	  	 	5.15	 
	 47
	  	 	1.66	 	  	 	2.63	 	  	 	5.93	 	  	 	8.22	 	  	 	1.26	 	  	 	2.03	 	  	 	4.23	 	  	 	5.51	 
	 48
	  	 	1.82	 	  	 	2.87	 	  	 	6.45	 	  	 	8.86	 	  	 	1.37	 	  	 	2.22	 	  	 	4.60	 	  	 	5.89	 
	 49
	  	 	1.99	 	  	 	3.12	 	  	 	7.01	 	  	 	9.55	 	  	 	1.49	 	  	 	2.42	 	  	 	5.00	 	  	 	6.30	 
	 50
	  	 	2.18	 	  	 	3.40	 	  	 	7.62	 	  	 	10.30	 	  	 	1.62	 	  	 	2.64	 	  	 	5.43	 	  	 	6.73	 
	 51
	  	 	2.39	 	  	 	3.80	 	  	 	8.33	 	  	 	11.07	 	  	 	1.76	 	  	 	2.85	 	  	 	5.90	 	  	 	7.28	 
	 52
	  	 	2.62	 	  	 	4.25	 	  	 	9.10	 	  	 	11.90	 	  	 	1.91	 	  	 	3.08	 	  	 	6.40	 	  	 	7.88	 
	 53
	  	 	2.87	 	  	 	4.74	 	  	 	9.93	 	  	 	12.79	 	  	 	2.07	 	  	 	3.33	 	  	 	6.94	 	  	 	8.51	 
	 54
	  	 	3.15	 	  	 	5.28	 	  	 	10.82	 	  	 	13.76	 	  	 	2.25	 	  	 	3.61	 	  	 	7.51	 	  	 	9.19	 
	 55
	  	 	3.46	 	  	 	5.87	 	  	 	11.77	 	  	 	14.78	 	  	 	2.44	 	  	 	3.90	 	  	 	8.13	 	  	 	9.92	 
	 56
	  	 	3.86	 	  	 	6.53	 	  	 	12.89	 	  	 	16.03	 	  	 	2.73	 	  	 	4.43	 	  	 	8.89	 	  	 	11.04	 
	 57
	  	 	4.30	 	  	 	7.24	 	  	 	14.08	 	  	 	17.35	 	  	 	3.05	 	  	 	4.99	 	  	 	9.70	 	  	 	12.24	 
	 58
	  	 	4.77	 	  	 	8.02	 	  	 	15.35	 	  	 	18.77	 	  	 	3.39	 	  	 	5.61	 	  	 	10.56	 	  	 	13.51	 
	 59
	  	 	5.30	 	  	 	8.87	 	  	 	16.73	 	  	 	20.31	 	  	 	3.76	 	  	 	6.28	 	  	 	11.49	 	  	 	14.87	 
	 60
	  	 	5.88	 	  	 	9.82	 	  	 	18.23	 	  	 	21.98	 	  	 	4.17	 	  	 	7.01	 	  	 	12.47	 	  	 	16.32	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 14 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 20 Year Term - $1,000,000 and over Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.51	 	  	 	0.80	 	  	 	1.57	 	  	 	2.05	 	  	 	0.36	 	  	 	0.60	 	  	 	1.19	 	  	 	1.39	 
	 19
	  	 	0.51	 	  	 	0.80	 	  	 	1.58	 	  	 	2.06	 	  	 	0.36	 	  	 	0.60	 	  	 	1.19	 	  	 	1.39	 
	 20
	  	 	0.51	 	  	 	0.80	 	  	 	1.58	 	  	 	2.06	 	  	 	0.36	 	  	 	0.60	 	  	 	1.19	 	  	 	1.39	 
	 21
	  	 	0.51	 	  	 	0.80	 	  	 	1.58	 	  	 	2.06	 	  	 	0.36	 	  	 	0.60	 	  	 	1.19	 	  	 	1.39	 
	 22
	  	 	0.51	 	  	 	0.80	 	  	 	1.58	 	  	 	2.06	 	  	 	0.36	 	  	 	0.60	 	  	 	1.19	 	  	 	1.39	 
	 23
	  	 	0.51	 	  	 	0.80	 	  	 	1.58	 	  	 	2.06	 	  	 	0.36	 	  	 	0.60	 	  	 	1.19	 	  	 	1.40	 
	 24
	  	 	0.51	 	  	 	0.81	 	  	 	1.58	 	  	 	2.06	 	  	 	0.36	 	  	 	0.60	 	  	 	1.19	 	  	 	1.40	 
	 25
	  	 	0.51	 	  	 	0.81	 	  	 	1.58	 	  	 	2.06	 	  	 	0.36	 	  	 	0.60	 	  	 	1.19	 	  	 	1.40	 
	 26
	  	 	0.51	 	  	 	0.82	 	  	 	1.59	 	  	 	2.08	 	  	 	0.36	 	  	 	0.61	 	  	 	1.20	 	  	 	1.42	 
	 27
	  	 	0.51	 	  	 	0.83	 	  	 	1.60	 	  	 	2.10	 	  	 	0.37	 	  	 	0.61	 	  	 	1.21	 	  	 	1.45	 
	 28
	  	 	0.51	 	  	 	0.84	 	  	 	1.62	 	  	 	2.13	 	  	 	0.37	 	  	 	0.62	 	  	 	1.23	 	  	 	1.47	 
	 29
	  	 	0.51	 	  	 	0.85	 	  	 	1.63	 	  	 	2.15	 	  	 	0.38	 	  	 	0.63	 	  	 	1.24	 	  	 	1.51	 
	 30
	  	 	0.51	 	  	 	0.87	 	  	 	1.65	 	  	 	2.18	 	  	 	0.38	 	  	 	0.64	 	  	 	1.26	 	  	 	1.54	 
	 31
	  	 	0.52	 	  	 	0.88	 	  	 	1.69	 	  	 	2.26	 	  	 	0.39	 	  	 	0.67	 	  	 	1.31	 	  	 	1.64	 
	 32
	  	 	0.53	 	  	 	0.89	 	  	 	1.74	 	  	 	2.36	 	  	 	0.41	 	  	 	0.70	 	  	 	1.36	 	  	 	1.75	 
	 33
	  	 	0.54	 	  	 	0.90	 	  	 	1.80	 	  	 	2.47	 	  	 	0.42	 	  	 	0.73	 	  	 	1.42	 	  	 	1.87	 
	 34
	  	 	0.55	 	  	 	0.91	 	  	 	1.86	 	  	 	2.59	 	  	 	0.44	 	  	 	0.77	 	  	 	1.49	 	  	 	2.01	 
	 35
	  	 	0.56	 	  	 	0.93	 	  	 	1.93	 	  	 	2.73	 	  	 	0.46	 	  	 	0.81	 	  	 	1.56	 	  	 	2.16	 
	 36
	  	 	0.60	 	  	 	0.99	 	  	 	2.07	 	  	 	2.94	 	  	 	0.49	 	  	 	0.86	 	  	 	1.67	 	  	 	2.30	 
	 37
	  	 	0.64	 	  	 	1.07	 	  	 	2.22	 	  	 	3.18	 	  	 	0.52	 	  	 	0.92	 	  	 	1.79	 	  	 	2.46	 
	 38
	  	 	0.69	 	  	 	1.15	 	  	 	2.39	 	  	 	3.44	 	  	 	0.56	 	  	 	0.98	 	  	 	1.93	 	  	 	2.63	 
	 39
	  	 	0.74	 	  	 	1.24	 	  	 	2.57	 	  	 	3.72	 	  	 	0.60	 	  	 	1.05	 	  	 	2.08	 	  	 	2.81	 
	 40
	  	 	0.80	 	  	 	1.34	 	  	 	2.77	 	  	 	4.03	 	  	 	0.65	 	  	 	1.13	 	  	 	2.24	 	  	 	3.02	 
	 41
	  	 	0.89	 	  	 	1.48	 	  	 	3.13	 	  	 	4.45	 	  	 	0.71	 	  	 	1.21	 	  	 	2.44	 	  	 	3.32	 
	 42
	  	 	0.98	 	  	 	1.63	 	  	 	3.52	 	  	 	4.91	 	  	 	0.78	 	  	 	1.30	 	  	 	2.66	 	  	 	3.64	 
	 43
	  	 	1.09	 	  	 	1.80	 	  	 	3.95	 	  	 	5.42	 	  	 	0.85	 	  	 	1.40	 	  	 	2.90	 	  	 	4.00	 
	 44
	  	 	1.22	 	  	 	1.99	 	  	 	4.43	 	  	 	5.98	 	  	 	0.93	 	  	 	1.51	 	  	 	3.15	 	  	 	4.38	 
	 45
	  	 	1.35	 	  	 	2.20	 	  	 	4.94	 	  	 	6.59	 	  	 	1.02	 	  	 	1.63	 	  	 	3.43	 	  	 	4.79	 
	 46
	  	 	1.47	 	  	 	2.38	 	  	 	5.39	 	  	 	7.14	 	  	 	1.10	 	  	 	1.79	 	  	 	3.77	 	  	 	5.12	 
	 47
	  	 	1.60	 	  	 	2.58	 	  	 	5.88	 	  	 	7.74	 	  	 	1.20	 	  	 	1.96	 	  	 	4.13	 	  	 	5.48	 
	 48
	  	 	1.75	 	  	 	2.80	 	  	 	6.40	 	  	 	8.37	 	  	 	1.30	 	  	 	2.15	 	  	 	4.52	 	  	 	5.86	 
	 49
	  	 	1.91	 	  	 	3.04	 	  	 	6.97	 	  	 	9.06	 	  	 	1.40	 	  	 	2.35	 	  	 	4.93	 	  	 	6.27	 
	 50
	  	 	2.08	 	  	 	3.30	 	  	 	7.58	 	  	 	9.81	 	  	 	1.52	 	  	 	2.57	 	  	 	5.37	 	  	 	6.70	 
	 51
	  	 	2.29	 	  	 	3.70	 	  	 	8.24	 	  	 	10.60	 	  	 	1.66	 	  	 	2.79	 	  	 	5.79	 	  	 	7.22	 
	 52
	  	 	2.53	 	  	 	4.13	 	  	 	8.96	 	  	 	11.44	 	  	 	1.82	 	  	 	3.02	 	  	 	6.24	 	  	 	7.78	 
	 53
	  	 	2.78	 	  	 	4.62	 	  	 	9.73	 	  	 	12.36	 	  	 	1.98	 	  	 	3.28	 	  	 	6.72	 	  	 	8.38	 
	 54
	  	 	3.07	 	  	 	5.15	 	  	 	10.56	 	  	 	13.34	 	  	 	2.16	 	  	 	3.55	 	  	 	7.23	 	  	 	9.02	 
	 55
	  	 	3.38	 	  	 	5.73	 	  	 	11.44	 	  	 	14.39	 	  	 	2.36	 	  	 	3.85	 	  	 	7.78	 	  	 	9.71	 
	 56
	  	 	3.76	 	  	 	6.34	 	  	 	12.45	 	  	 	15.70	 	  	 	2.63	 	  	 	4.31	 	  	 	8.60	 	  	 	10.63	 
	 57
	  	 	4.18	 	  	 	7.00	 	  	 	13.53	 	  	 	17.09	 	  	 	2.93	 	  	 	4.81	 	  	 	9.46	 	  	 	11.61	 
	 58
	  	 	4.64	 	  	 	7.72	 	  	 	14.49	 	  	 	18.58	 	  	 	3.25	 	  	 	5.35	 	  	 	10.39	 	  	 	12.65	 
	 59
	  	 	5.14	 	  	 	8.51	 	  	 	15.94	 	  	 	20.20	 	  	 	3.60	 	  	 	5.93	 	  	 	11.38	 	  	 	13.77	 
	 60
	  	 	5.70	 	  	 	9.39	 	  	 	17.30	 	  	 	21.95	 	  	 	3.98	 	  	 	6.57	 	  	 	12.43	 	  	 	14.96	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 15 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 30 Year Term - Under $100,000 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual Policy
Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	1.75	 	  	 	2.38	 	  	 	4.04	 	  	 	5.08	 	  	 	1.24	 	  	 	1.77	 	  	 	3.35	 	  	 	3.94	 
	 19
	  	 	1.75	 	  	 	2.39	 	  	 	4.04	 	  	 	5.08	 	  	 	1.24	 	  	 	1.77	 	  	 	3.37	 	  	 	4.00	 
	 20
	  	 	1.75	 	  	 	2.39	 	  	 	4.05	 	  	 	5.08	 	  	 	1.24	 	  	 	1.77	 	  	 	3.37	 	  	 	4.08	 
	 21
	  	 	1.75	 	  	 	2.39	 	  	 	4.05	 	  	 	5.08	 	  	 	1.24	 	  	 	1.77	 	  	 	3.37	 	  	 	4.12	 
	 22
	  	 	1.75	 	  	 	2.39	 	  	 	4.05	 	  	 	5.08	 	  	 	1.24	 	  	 	1.77	 	  	 	3.37	 	  	 	4.13	 
	 23
	  	 	1.76	 	  	 	2.41	 	  	 	4.08	 	  	 	5.08	 	  	 	1.25	 	  	 	1.79	 	  	 	3.38	 	  	 	4.14	 
	 24
	  	 	1.76	 	  	 	2.41	 	  	 	4.08	 	  	 	5.08	 	  	 	1.25	 	  	 	1.79	 	  	 	3.38	 	  	 	4.15	 
	 25
	  	 	1.76	 	  	 	2.41	 	  	 	4.08	 	  	 	5.08	 	  	 	1.25	 	  	 	1.79	 	  	 	3.38	 	  	 	4.17	 
	 26
	  	 	1.77	 	  	 	2.44	 	  	 	4.17	 	  	 	5.15	 	  	 	1.27	 	  	 	1.82	 	  	 	3.44	 	  	 	4.25	 
	 27
	  	 	1.79	 	  	 	2.45	 	  	 	4.27	 	  	 	5.24	 	  	 	1.28	 	  	 	1.85	 	  	 	3.51	 	  	 	4.34	 
	 28
	  	 	1.80	 	  	 	2.48	 	  	 	4.37	 	  	 	5.34	 	  	 	1.30	 	  	 	1.89	 	  	 	3.59	 	  	 	4.46	 
	 29
	  	 	1.82	 	  	 	2.52	 	  	 	4.49	 	  	 	5.45	 	  	 	1.32	 	  	 	1.93	 	  	 	3.68	 	  	 	4.57	 
	 30
	  	 	1.83	 	  	 	2.55	 	  	 	4.61	 	  	 	5.57	 	  	 	1.34	 	  	 	1.97	 	  	 	3.76	 	  	 	4.70	 
	 31
	  	 	1.85	 	  	 	2.59	 	  	 	4.80	 	  	 	5.75	 	  	 	1.35	 	  	 	2.01	 	  	 	3.86	 	  	 	4.85	 
	 32
	  	 	1.87	 	  	 	2.63	 	  	 	5.00	 	  	 	5.94	 	  	 	1.37	 	  	 	2.07	 	  	 	3.96	 	  	 	5.00	 
	 33
	  	 	1.89	 	  	 	2.69	 	  	 	5.23	 	  	 	6.17	 	  	 	1.39	 	  	 	2.11	 	  	 	4.07	 	  	 	5.20	 
	 34
	  	 	1.92	 	  	 	2.75	 	  	 	5.46	 	  	 	6.41	 	  	 	1.41	 	  	 	2.18	 	  	 	4.20	 	  	 	5.39	 
	 35
	  	 	1.94	 	  	 	2.82	 	  	 	5.73	 	  	 	6.67	 	  	 	1.44	 	  	 	2.24	 	  	 	4.32	 	  	 	5.60	 
	 36
	  	 	2.00	 	  	 	3.00	 	  	 	5.80	 	  	 	6.75	 	  	 	1.54	 	  	 	2.44	 	  	 	4.68	 	  	 	5.68	 
	 37
	  	 	2.06	 	  	 	3.18	 	  	 	6.30	 	  	 	7.16	 	  	 	1.63	 	  	 	2.63	 	  	 	5.04	 	  	 	6.07	 
	 38
	  	 	2.13	 	  	 	3.41	 	  	 	6.54	 	  	 	7.64	 	  	 	1.75	 	  	 	2.86	 	  	 	5.25	 	  	 	6.59	 
	 39
	  	 	2.20	 	  	 	3.63	 	  	 	6.99	 	  	 	8.18	 	  	 	1.87	 	  	 	3.11	 	  	 	5.41	 	  	 	7.15	 
	 40
	  	 	2.27	 	  	 	3.89	 	  	 	7.52	 	  	 	8.79	 	  	 	2.00	 	  	 	3.38	 	  	 	5.63	 	  	 	7.47	 
	 41
	  	 	2.62	 	  	 	4.34	 	  	 	8.12	 	  	 	9.47	 	  	 	2.17	 	  	 	3.68	 	  	 	5.85	 	  	 	7.90	 
	 42
	  	 	3.00	 	  	 	4.85	 	  	 	8.78	 	  	 	10.23	 	  	 	2.37	 	  	 	3.99	 	  	 	6.15	 	  	 	8.41	 
	 43
	  	 	3.42	 	  	 	5.38	 	  	 	9.48	 	  	 	11.05	 	  	 	2.56	 	  	 	4.34	 	  	 	6.81	 	  	 	9.06	 
	 44
	  	 	3.89	 	  	 	5.99	 	  	 	10.15	 	  	 	11.93	 	  	 	2.80	 	  	 	4.72	 	  	 	7.66	 	  	 	9.79	 
	 45
	  	 	4.39	 	  	 	6.63	 	  	 	10.97	 	  	 	12.85	 	  	 	3.04	 	  	 	5.13	 	  	 	8.39	 	  	 	10.59	 
	 46
	  	 	4.89	 	  	 	7.45	 	  	 	—  	 	  	 	—  	 	  	 	3.49	 	  	 	5.66	 	  	 	—  	 	  	 	—  	 
	 47
	  	 	5.42	 	  	 	8.34	 	  	 	—  	 	  	 	—  	 	  	 	3.97	 	  	 	6.25	 	  	 	—  	 	  	 	—  	 
	 48
	  	 	6.00	 	  	 	9.30	 	  	 	—  	 	  	 	—  	 	  	 	4.51	 	  	 	6.84	 	  	 	—  	 	  	 	—  	 
	 49
	  	 	6.63	 	  	 	10.25	 	  	 	—  	 	  	 	—  	 	  	 	5.07	 	  	 	7.34	 	  	 	—  	 	  	 	—  	 
	 50
	  	 	7.32	 	  	 	11.06	 	  	 	—  	 	  	 	—  	 	  	 	5.69	 	  	 	7.88	 	  	 	—  	 	  	 	—  	 
	 51
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 52
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 53
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 54
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 55
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 56
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 57
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 58
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 59
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 60
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 16 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 30 Year Term - $100,000 - $249,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	1.24	 	  	 	1.69	 	  	 	3.03	 	  	 	4.30	 	  	 	0.88	 	  	 	1.26	 	  	 	2.38	 	  	 	3.13	 
	 19
	  	 	1.24	 	  	 	1.70	 	  	 	3.03	 	  	 	4.31	 	  	 	0.88	 	  	 	1.26	 	  	 	2.39	 	  	 	3.13	 
	 20
	  	 	1.24	 	  	 	1.70	 	  	 	3.04	 	  	 	4.32	 	  	 	0.88	 	  	 	1.26	 	  	 	2.39	 	  	 	3.14	 
	 21
	  	 	1.24	 	  	 	1.70	 	  	 	3.04	 	  	 	4.32	 	  	 	0.88	 	  	 	1.26	 	  	 	2.39	 	  	 	3.14	 
	 22
	  	 	1.24	 	  	 	1.70	 	  	 	3.04	 	  	 	4.32	 	  	 	0.88	 	  	 	1.26	 	  	 	2.39	 	  	 	3.14	 
	 23
	  	 	1.25	 	  	 	1.71	 	  	 	3.05	 	  	 	4.33	 	  	 	0.89	 	  	 	1.27	 	  	 	2.40	 	  	 	3.15	 
	 24
	  	 	1.25	 	  	 	1.71	 	  	 	3.05	 	  	 	4.33	 	  	 	0.89	 	  	 	1.27	 	  	 	2.40	 	  	 	3.15	 
	 25
	  	 	1.25	 	  	 	1.71	 	  	 	3.05	 	  	 	4.33	 	  	 	0.89	 	  	 	1.27	 	  	 	2.40	 	  	 	3.15	 
	 26
	  	 	1.26	 	  	 	1.73	 	  	 	3.10	 	  	 	4.36	 	  	 	0.90	 	  	 	1.29	 	  	 	2.44	 	  	 	3.18	 
	 27
	  	 	1.27	 	  	 	1.74	 	  	 	3.15	 	  	 	4.40	 	  	 	0.91	 	  	 	1.31	 	  	 	2.49	 	  	 	3.22	 
	 28
	  	 	1.28	 	  	 	1.76	 	  	 	3.21	 	  	 	4.44	 	  	 	0.92	 	  	 	1.34	 	  	 	2.55	 	  	 	3.26	 
	 29
	  	 	1.29	 	  	 	1.79	 	  	 	3.27	 	  	 	4.48	 	  	 	0.94	 	  	 	1.37	 	  	 	2.61	 	  	 	3.30	 
	 30
	  	 	1.30	 	  	 	1.81	 	  	 	3.34	 	  	 	4.53	 	  	 	0.95	 	  	 	1.40	 	  	 	2.67	 	  	 	3.35	 
	 31
	  	 	1.31	 	  	 	1.84	 	  	 	3.48	 	  	 	4.66	 	  	 	0.96	 	  	 	1.43	 	  	 	2.74	 	  	 	3.48	 
	 32
	  	 	1.33	 	  	 	1.87	 	  	 	3.63	 	  	 	4.81	 	  	 	0.97	 	  	 	1.47	 	  	 	2.81	 	  	 	3.61	 
	 33
	  	 	1.34	 	  	 	1.91	 	  	 	3.80	 	  	 	4.97	 	  	 	0.99	 	  	 	1.50	 	  	 	2.89	 	  	 	3.76	 
	 34
	  	 	1.36	 	  	 	1.95	 	  	 	3.98	 	  	 	5.15	 	  	 	1.00	 	  	 	1.55	 	  	 	2.98	 	  	 	3.92	 
	 35
	  	 	1.38	 	  	 	2.00	 	  	 	4.19	 	  	 	5.35	 	  	 	1.02	 	  	 	1.59	 	  	 	3.07	 	  	 	4.09	 
	 36
	  	 	1.42	 	  	 	2.13	 	  	 	4.57	 	  	 	5.88	 	  	 	1.09	 	  	 	1.73	 	  	 	3.32	 	  	 	4.38	 
	 37
	  	 	1.46	 	  	 	2.26	 	  	 	4.97	 	  	 	6.42	 	  	 	1.16	 	  	 	1.87	 	  	 	3.58	 	  	 	4.70	 
	 38
	  	 	1.51	 	  	 	2.42	 	  	 	5.41	 	  	 	7.01	 	  	 	1.24	 	  	 	2.03	 	  	 	3.87	 	  	 	5.04	 
	 39
	  	 	1.56	 	  	 	2.58	 	  	 	5.88	 	  	 	7.65	 	  	 	1.33	 	  	 	2.21	 	  	 	4.18	 	  	 	5.41	 
	 40
	  	 	1.61	 	  	 	2.76	 	  	 	6.36	 	  	 	8.33	 	  	 	1.42	 	  	 	2.40	 	  	 	4.51	 	  	 	5.81	 
	 41
	  	 	1.86	 	  	 	3.08	 	  	 	7.08	 	  	 	9.00	 	  	 	1.54	 	  	 	2.61	 	  	 	4.95	 	  	 	6.34	 
	 42
	  	 	2.13	 	  	 	3.44	 	  	 	7.83	 	  	 	9.72	 	  	 	1.68	 	  	 	2.83	 	  	 	5.43	 	  	 	6.91	 
	 43
	  	 	2.43	 	  	 	3.82	 	  	 	8.64	 	  	 	10.50	 	  	 	1.82	 	  	 	3.08	 	  	 	5.95	 	  	 	7.53	 
	 44
	  	 	2.76	 	  	 	4.25	 	  	 	9.50	 	  	 	11.33	 	  	 	1.99	 	  	 	3.35	 	  	 	6.52	 	  	 	8.19	 
	 45
	  	 	3.12	 	  	 	4.71	 	  	 	10.42	 	  	 	12.21	 	  	 	2.16	 	  	 	3.64	 	  	 	7.12	 	  	 	8.91	 
	 46
	  	 	3.47	 	  	 	5.29	 	  	 	—  	 	  	 	—  	 	  	 	2.48	 	  	 	4.02	 	  	 	—  	 	  	 	—  	 
	 47
	  	 	3.85	 	  	 	5.92	 	  	 	—  	 	  	 	—  	 	  	 	2.82	 	  	 	4.44	 	  	 	—  	 	  	 	—  	 
	 48
	  	 	4.26	 	  	 	6.60	 	  	 	—  	 	  	 	—  	 	  	 	3.20	 	  	 	4.89	 	  	 	—  	 	  	 	—  	 
	 49
	  	 	4.71	 	  	 	7.35	 	  	 	—  	 	  	 	—  	 	  	 	3.60	 	  	 	5.38	 	  	 	—  	 	  	 	—  	 
	 50
	  	 	5.20	 	  	 	8.18	 	  	 	—  	 	  	 	—  	 	  	 	4.04	 	  	 	5.91	 	  	 	—  	 	  	 	—  	 
	 51
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 52
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 53
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 54
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 55
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 56
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 57
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 58
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 59
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 60
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 17 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 30 Year Term - $250,000 - $499,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.84	 	  	 	1.41	 	  	 	2.58	 	  	 	3.54	 	  	 	0.57	 	  	 	1.02	 	  	 	1.89	 	  	 	2.63	 
	 19
	  	 	0.84	 	  	 	1.41	 	  	 	2.58	 	  	 	3.55	 	  	 	0.57	 	  	 	1.02	 	  	 	1.90	 	  	 	2.63	 
	 20
	  	 	0.84	 	  	 	1.41	 	  	 	2.59	 	  	 	3.56	 	  	 	0.57	 	  	 	1.02	 	  	 	1.90	 	  	 	2.64	 
	 21
	  	 	0.84	 	  	 	1.41	 	  	 	2.59	 	  	 	3.56	 	  	 	0.57	 	  	 	1.02	 	  	 	1.90	 	  	 	2.64	 
	 22
	  	 	0.84	 	  	 	1.41	 	  	 	2.59	 	  	 	3.56	 	  	 	0.57	 	  	 	1.02	 	  	 	1.90	 	  	 	2.64	 
	 23
	  	 	0.85	 	  	 	1.42	 	  	 	2.60	 	  	 	3.57	 	  	 	0.58	 	  	 	1.03	 	  	 	1.91	 	  	 	2.65	 
	 24
	  	 	0.85	 	  	 	1.42	 	  	 	2.60	 	  	 	3.57	 	  	 	0.58	 	  	 	1.03	 	  	 	1.91	 	  	 	2.65	 
	 25
	  	 	0.85	 	  	 	1.42	 	  	 	2.60	 	  	 	3.57	 	  	 	0.58	 	  	 	1.03	 	  	 	1.91	 	  	 	2.65	 
	 26
	  	 	0.85	 	  	 	1.42	 	  	 	2.63	 	  	 	3.63	 	  	 	0.60	 	  	 	1.04	 	  	 	1.96	 	  	 	2.70	 
	 27
	  	 	0.86	 	  	 	1.42	 	  	 	2.67	 	  	 	3.70	 	  	 	0.61	 	  	 	1.06	 	  	 	2.01	 	  	 	2.76	 
	 28
	  	 	0.86	 	  	 	1.43	 	  	 	2.71	 	  	 	3.78	 	  	 	0.63	 	  	 	1.08	 	  	 	2.06	 	  	 	2.83	 
	 29
	  	 	0.87	 	  	 	1.43	 	  	 	2.76	 	  	 	3.87	 	  	 	0.66	 	  	 	1.10	 	  	 	2.12	 	  	 	2.90	 
	 30
	  	 	0.87	 	  	 	1.43	 	  	 	2.81	 	  	 	3.96	 	  	 	0.68	 	  	 	1.12	 	  	 	2.19	 	  	 	2.98	 
	 31
	  	 	0.88	 	  	 	1.47	 	  	 	2.89	 	  	 	4.10	 	  	 	0.70	 	  	 	1.15	 	  	 	2.27	 	  	 	3.08	 
	 32
	  	 	0.89	 	  	 	1.51	 	  	 	2.97	 	  	 	4.26	 	  	 	0.72	 	  	 	1.18	 	  	 	2.35	 	  	 	3.18	 
	 33
	  	 	0.91	 	  	 	1.56	 	  	 	3.07	 	  	 	4.44	 	  	 	0.74	 	  	 	1.22	 	  	 	2.44	 	  	 	3.30	 
	 34
	  	 	0.92	 	  	 	1.62	 	  	 	3.17	 	  	 	4.63	 	  	 	0.76	 	  	 	1.26	 	  	 	2.54	 	  	 	3.42	 
	 35
	  	 	0.94	 	  	 	1.68	 	  	 	3.29	 	  	 	4.85	 	  	 	0.79	 	  	 	1.30	 	  	 	2.65	 	  	 	3.55	 
	 36
	  	 	1.02	 	  	 	1.82	 	  	 	3.62	 	  	 	5.25	 	  	 	0.84	 	  	 	1.39	 	  	 	2.84	 	  	 	3.85	 
	 37
	  	 	1.12	 	  	 	1.98	 	  	 	3.98	 	  	 	5.68	 	  	 	0.90	 	  	 	1.50	 	  	 	3.05	 	  	 	4.17	 
	 38
	  	 	1.22	 	  	 	2.16	 	  	 	4.36	 	  	 	6.15	 	  	 	0.96	 	  	 	1.61	 	  	 	3.28	 	  	 	4.51	 
	 39
	  	 	1.33	 	  	 	2.34	 	  	 	4.77	 	  	 	6.65	 	  	 	1.03	 	  	 	1.73	 	  	 	3.52	 	  	 	4.88	 
	 40
	  	 	1.45	 	  	 	2.55	 	  	 	5.21	 	  	 	7.18	 	  	 	1.10	 	  	 	1.86	 	  	 	3.78	 	  	 	5.28	 
	 41
	  	 	1.62	 	  	 	2.79	 	  	 	5.81	 	  	 	7.84	 	  	 	1.22	 	  	 	2.02	 	  	 	4.21	 	  	 	5.72	 
	 42
	  	 	1.81	 	  	 	3.05	 	  	 	6.45	 	  	 	8.55	 	  	 	1.35	 	  	 	2.19	 	  	 	4.67	 	  	 	6.20	 
	 43
	  	 	2.02	 	  	 	3.33	 	  	 	7.13	 	  	 	9.31	 	  	 	1.49	 	  	 	2.37	 	  	 	5.18	 	  	 	6.72	 
	 44
	  	 	2.25	 	  	 	3.64	 	  	 	7.87	 	  	 	10.12	 	  	 	1.65	 	  	 	2.58	 	  	 	5.72	 	  	 	7.28	 
	 45
	  	 	2.50	 	  	 	3.98	 	  	 	8.65	 	  	 	10.98	 	  	 	1.82	 	  	 	2.80	 	  	 	6.30	 	  	 	7.88	 
	 46
	  	 	2.75	 	  	 	4.41	 	  	 	—  	 	  	 	—  	 	  	 	1.98	 	  	 	3.19	 	  	 	—  	 	  	 	—  	 
	 47
	  	 	3.01	 	  	 	4.88	 	  	 	—  	 	  	 	—  	 	  	 	2.16	 	  	 	3.62	 	  	 	—  	 	  	 	—  	 
	 48
	  	 	3.30	 	  	 	5.39	 	  	 	—  	 	  	 	—  	 	  	 	2.35	 	  	 	4.09	 	  	 	—  	 	  	 	—  	 
	 49
	  	 	3.62	 	  	 	5.95	 	  	 	—  	 	  	 	—  	 	  	 	2.56	 	  	 	4.59	 	  	 	—  	 	  	 	—  	 
	 50
	  	 	3.97	 	  	 	6.57	 	  	 	—  	 	  	 	—  	 	  	 	2.78	 	  	 	5.13	 	  	 	—  	 	  	 	—  	 
	 51
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 52
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 53
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 54
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 55
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 56
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 57
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 58
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 59
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 60
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	Quarterly
 0.280
	 
  
	  	 
 
	    Monthly
     0.087
	 
  
	  				  				  			

  

			
	Page 18 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 30 Year Term - $500,000 - $999,999 Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.83	 	  	 	1.41	 	  	 	2.49	 	  	 	3.53	 	  	 	0.56	 	  	 	1.01	 	  	 	1.89	 	  	 	2.62	 
	 19
	  	 	0.83	 	  	 	1.41	 	  	 	2.50	 	  	 	3.54	 	  	 	0.56	 	  	 	1.01	 	  	 	1.90	 	  	 	2.62	 
	 20
	  	 	0.83	 	  	 	1.41	 	  	 	2.50	 	  	 	3.55	 	  	 	0.56	 	  	 	1.01	 	  	 	1.90	 	  	 	2.63	 
	 21
	  	 	0.83	 	  	 	1.41	 	  	 	2.50	 	  	 	3.55	 	  	 	0.56	 	  	 	1.01	 	  	 	1.90	 	  	 	2.63	 
	 22
	  	 	0.83	 	  	 	1.41	 	  	 	2.50	 	  	 	3.55	 	  	 	0.56	 	  	 	1.01	 	  	 	1.90	 	  	 	2.63	 
	 23
	  	 	0.84	 	  	 	1.42	 	  	 	2.51	 	  	 	3.56	 	  	 	0.57	 	  	 	1.02	 	  	 	1.91	 	  	 	2.64	 
	 24
	  	 	0.84	 	  	 	1.42	 	  	 	2.51	 	  	 	3.56	 	  	 	0.57	 	  	 	1.02	 	  	 	1.91	 	  	 	2.64	 
	 25
	  	 	0.84	 	  	 	1.42	 	  	 	2.51	 	  	 	3.56	 	  	 	0.57	 	  	 	1.02	 	  	 	1.91	 	  	 	2.64	 
	 26
	  	 	0.84	 	  	 	1.42	 	  	 	2.52	 	  	 	3.62	 	  	 	0.59	 	  	 	1.04	 	  	 	1.96	 	  	 	2.69	 
	 27
	  	 	0.85	 	  	 	1.42	 	  	 	2.53	 	  	 	3.69	 	  	 	0.60	 	  	 	1.05	 	  	 	2.01	 	  	 	2.75	 
	 28
	  	 	0.86	 	  	 	1.43	 	  	 	2.54	 	  	 	3.77	 	  	 	0.62	 	  	 	1.07	 	  	 	2.06	 	  	 	2.81	 
	 29
	  	 	0.86	 	  	 	1.43	 	  	 	2.55	 	  	 	3.86	 	  	 	0.65	 	  	 	1.10	 	  	 	2.12	 	  	 	2.88	 
	 30
	  	 	0.87	 	  	 	1.43	 	  	 	2.56	 	  	 	3.95	 	  	 	0.67	 	  	 	1.12	 	  	 	2.19	 	  	 	2.96	 
	 31
	  	 	0.88	 	  	 	1.46	 	  	 	2.68	 	  	 	4.09	 	  	 	0.69	 	  	 	1.15	 	  	 	2.27	 	  	 	3.06	 
	 32
	  	 	0.89	 	  	 	1.50	 	  	 	2.81	 	  	 	4.25	 	  	 	0.70	 	  	 	1.18	 	  	 	2.35	 	  	 	3.17	 
	 33
	  	 	0.91	 	  	 	1.55	 	  	 	2.95	 	  	 	4.42	 	  	 	0.72	 	  	 	1.22	 	  	 	2.44	 	  	 	3.28	 
	 34
	  	 	0.92	 	  	 	1.60	 	  	 	3.11	 	  	 	4.62	 	  	 	0.74	 	  	 	1.26	 	  	 	2.54	 	  	 	3.41	 
	 35
	  	 	0.94	 	  	 	1.65	 	  	 	3.29	 	  	 	4.83	 	  	 	0.76	 	  	 	1.30	 	  	 	2.64	 	  	 	3.54	 
	 36
	  	 	1.02	 	  	 	1.80	 	  	 	3.62	 	  	 	5.23	 	  	 	0.82	 	  	 	1.39	 	  	 	2.83	 	  	 	3.83	 
	 37
	  	 	1.11	 	  	 	1.96	 	  	 	3.98	 	  	 	5.66	 	  	 	0.88	 	  	 	1.49	 	  	 	3.04	 	  	 	4.15	 
	 38
	  	 	1.21	 	  	 	2.14	 	  	 	4.36	 	  	 	6.13	 	  	 	0.94	 	  	 	1.60	 	  	 	3.27	 	  	 	4.49	 
	 39
	  	 	1.32	 	  	 	2.33	 	  	 	4.77	 	  	 	6.63	 	  	 	1.01	 	  	 	1.71	 	  	 	3.51	 	  	 	4.85	 
	 40
	  	 	1.44	 	  	 	2.54	 	  	 	5.21	 	  	 	7.16	 	  	 	1.09	 	  	 	1.84	 	  	 	3.77	 	  	 	5.25	 
	 41
	  	 	1.61	 	  	 	2.78	 	  	 	5.81	 	  	 	7.82	 	  	 	1.19	 	  	 	1.99	 	  	 	4.20	 	  	 	5.69	 
	 42
	  	 	1.79	 	  	 	3.03	 	  	 	6.44	 	  	 	8.53	 	  	 	1.30	 	  	 	2.16	 	  	 	4.66	 	  	 	6.17	 
	 43
	  	 	1.99	 	  	 	3.31	 	  	 	7.13	 	  	 	9.29	 	  	 	1.41	 	  	 	2.35	 	  	 	5.17	 	  	 	6.69	 
	 44
	  	 	2.21	 	  	 	3.62	 	  	 	7.86	 	  	 	10.11	 	  	 	1.54	 	  	 	2.55	 	  	 	5.71	 	  	 	7.25	 
	 45
	  	 	2.45	 	  	 	3.96	 	  	 	8.64	 	  	 	10.97	 	  	 	1.68	 	  	 	2.77	 	  	 	6.29	 	  	 	7.85	 
	 46
	  	 	2.69	 	  	 	4.39	 	  	 	—  	 	  	 	—  	 	  	 	1.86	 	  	 	3.12	 	  	 	—  	 	  	 	—  	 
	 47
	  	 	2.96	 	  	 	4.85	 	  	 	—  	 	  	 	—  	 	  	 	2.06	 	  	 	3.49	 	  	 	—  	 	  	 	—  	 
	 48
	  	 	3.24	 	  	 	5.35	 	  	 	—  	 	  	 	—  	 	  	 	2.27	 	  	 	3.90	 	  	 	—  	 	  	 	—  	 
	 49
	  	 	3.56	 	  	 	5.90	 	  	 	—  	 	  	 	—  	 	  	 	2.50	 	  	 	4.34	 	  	 	—  	 	  	 	—  	 
	 50
	  	 	3.90	 	  	 	6.51	 	  	 	—  	 	  	 	—  	 	  	 	2.75	 	  	 	4.82	 	  	 	—  	 	  	 	—  	 
	 51
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 52
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 53
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 54
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 55
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 56
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 57
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 58
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 59
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 60
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	    Quarterly
     0.280
	 
  
	  	 
 
	        Monthly

        0.087
	 
  
	  				  				  			

  

			
	Page 19 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates 
 Policy
Form F4200 - 30 Year Term - $1,000,000 and over Face Amount Band 
 Guaranteed Initial Level Premium Rates Per $1,000 - $65 Annual
Policy Fee 
  

																																	
	 Issue
Age
	  	Male	 	  	Female	 
	  	Non-Nicotine	 	  	Nicotine	 	  	Non-Nicotine	 	  	Nicotine	 
	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 	  	Pref	 	  	Std	 
	 18
	  	 	0.82	 	  	 	1.40	 	  	 	2.43	 	  	 	3.35	 	  	 	0.55	 	  	 	1.00	 	  	 	1.83	 	  	 	2.47	 
	 19
	  	 	0.82	 	  	 	1.40	 	  	 	2.44	 	  	 	3.35	 	  	 	0.55	 	  	 	1.00	 	  	 	1.84	 	  	 	2.48	 
	 20
	  	 	0.82	 	  	 	1.40	 	  	 	2.44	 	  	 	3.36	 	  	 	0.55	 	  	 	1.00	 	  	 	1.84	 	  	 	2.48	 
	 21
	  	 	0.82	 	  	 	1.40	 	  	 	2.44	 	  	 	3.36	 	  	 	0.55	 	  	 	1.00	 	  	 	1.84	 	  	 	2.48	 
	 22
	  	 	0.82	 	  	 	1.40	 	  	 	2.44	 	  	 	3.36	 	  	 	0.55	 	  	 	1.00	 	  	 	1.84	 	  	 	2.48	 
	 23
	  	 	0.83	 	  	 	1.41	 	  	 	2.45	 	  	 	3.37	 	  	 	0.56	 	  	 	1.01	 	  	 	1.85	 	  	 	2.49	 
	 24
	  	 	0.83	 	  	 	1.41	 	  	 	2.45	 	  	 	3.37	 	  	 	0.56	 	  	 	1.01	 	  	 	1.85	 	  	 	2.49	 
	 25
	  	 	0.83	 	  	 	1.41	 	  	 	2.45	 	  	 	3.37	 	  	 	0.56	 	  	 	1.01	 	  	 	1.85	 	  	 	2.49	 
	 26
	  	 	0.83	 	  	 	1.41	 	  	 	2.46	 	  	 	3.44	 	  	 	0.58	 	  	 	1.03	 	  	 	1.88	 	  	 	2.56	 
	 27
	  	 	0.83	 	  	 	1.41	 	  	 	2.47	 	  	 	3.52	 	  	 	0.60	 	  	 	1.05	 	  	 	1.91	 	  	 	2.64	 
	 28
	  	 	0.84	 	  	 	1.42	 	  	 	2.48	 	  	 	3.61	 	  	 	0.62	 	  	 	1.07	 	  	 	1.95	 	  	 	2.72	 
	 29
	  	 	0.84	 	  	 	1.42	 	  	 	2.49	 	  	 	3.70	 	  	 	0.64	 	  	 	1.09	 	  	 	1.99	 	  	 	2.82	 
	 30
	  	 	0.84	 	  	 	1.42	 	  	 	2.50	 	  	 	3.81	 	  	 	0.67	 	  	 	1.12	 	  	 	2.03	 	  	 	2.92	 
	 31
	  	 	0.85	 	  	 	1.44	 	  	 	2.62	 	  	 	3.94	 	  	 	0.68	 	  	 	1.14	 	  	 	2.10	 	  	 	3.01	 
	 32
	  	 	0.86	 	  	 	1.47	 	  	 	2.76	 	  	 	4.08	 	  	 	0.68	 	  	 	1.17	 	  	 	2.19	 	  	 	3.11	 
	 33
	  	 	0.87	 	  	 	1.50	 	  	 	2.91	 	  	 	4.23	 	  	 	0.69	 	  	 	1.20	 	  	 	2.27	 	  	 	3.21	 
	 34
	  	 	0.89	 	  	 	1.53	 	  	 	3.08	 	  	 	4.41	 	  	 	0.70	 	  	 	1.23	 	  	 	2.37	 	  	 	3.33	 
	 35
	  	 	0.90	 	  	 	1.57	 	  	 	3.27	 	  	 	4.60	 	  	 	0.71	 	  	 	1.26	 	  	 	2.47	 	  	 	3.45	 
	 36
	  	 	0.98	 	  	 	1.70	 	  	 	3.59	 	  	 	5.02	 	  	 	0.76	 	  	 	1.36	 	  	 	2.67	 	  	 	3.74	 
	 37
	  	 	1.07	 	  	 	1.84	 	  	 	3.93	 	  	 	5.48	 	  	 	0.82	 	  	 	1.46	 	  	 	2.89	 	  	 	4.06	 
	 38
	  	 	1.17	 	  	 	2.00	 	  	 	4.30	 	  	 	5.98	 	  	 	0.89	 	  	 	1.58	 	  	 	3.12	 	  	 	4.40	 
	 39
	  	 	1.27	 	  	 	2.17	 	  	 	4.70	 	  	 	6.51	 	  	 	0.95	 	  	 	1.70	 	  	 	3.37	 	  	 	4.77	 
	 40
	  	 	1.39	 	  	 	2.36	 	  	 	5.12	 	  	 	7.07	 	  	 	1.03	 	  	 	1.84	 	  	 	3.64	 	  	 	5.17	 
	 41
	  	 	1.53	 	  	 	2.59	 	  	 	5.73	 	  	 	7.75	 	  	 	1.13	 	  	 	1.99	 	  	 	4.00	 	  	 	5.56	 
	 42
	  	 	1.69	 	  	 	2.84	 	  	 	6.38	 	  	 	8.47	 	  	 	1.25	 	  	 	2.15	 	  	 	4.39	 	  	 	5.98	 
	 43
	  	 	1.86	 	  	 	3.11	 	  	 	7.08	 	  	 	9.25	 	  	 	1.37	 	  	 	2.32	 	  	 	4.82	 	  	 	6.43	 
	 44
	  	 	2.05	 	  	 	3.41	 	  	 	7.83	 	  	 	10.08	 	  	 	1.51	 	  	 	2.51	 	  	 	5.28	 	  	 	6.92	 
	 45
	  	 	2.25	 	  	 	3.74	 	  	 	8.63	 	  	 	10.96	 	  	 	1.66	 	  	 	2.72	 	  	 	5.77	 	  	 	7.45	 
	 46
	  	 	2.52	 	  	 	4.14	 	  	 	—  	 	  	 	—  	 	  	 	1.81	 	  	 	3.04	 	  	 	—  	 	  	 	—  	 
	 47
	  	 	2.81	 	  	 	4.58	 	  	 	—  	 	  	 	—  	 	  	 	1.97	 	  	 	3.38	 	  	 	—  	 	  	 	—  	 
	 48
	  	 	3.13	 	  	 	5.05	 	  	 	—  	 	  	 	—  	 	  	 	2.15	 	  	 	3.76	 	  	 	—  	 	  	 	—  	 
	 49
	  	 	3.48	 	  	 	5.57	 	  	 	—  	 	  	 	—  	 	  	 	2.34	 	  	 	4.16	 	  	 	—  	 	  	 	—  	 
	 50
	  	 	3.86	 	  	 	6.14	 	  	 	—  	 	  	 	—  	 	  	 	2.54	 	  	 	4.60	 	  	 	—  	 	  	 	—  	 
	 51
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 52
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 53
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 54
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 55
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 56
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 57
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 58
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 59
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 60
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 61
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 62
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 63
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 64
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 65
	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 	  	 	—  	 
	 Semi-Annual

0.520
	  

 
	  	 
 
	    Quarterly
     0.280
	 
  
	  	 
 
	        Monthly

        0.087
	 
  
	  				  				  			

  

			
	Page 20 of 22	 	Version 12-1-2011

 Fidelity Life Association, A Legal Reserve Life Insurance Company 

Hybrid Term Rates (all states except WA) 

Policy Form F4200 - Annual Renewal Term Rates After Initial Level Term Period - All Face Amounts 

Guaranteed Annual Renewable Term Rates Per $1,000 - $65 Annual Policy Fee 

 

																	
	 Attained
Age
	  	Non-nicotine	 	  	Nicotine	 
	  	Male	 	  	Female	 	  	Male	 	  	Female	 
	 20
	  	 	2.38	 	  	 	1.13	 	  	 	3.18	 	  	 	1.45	 
	 21
	  	 	2.38	 	  	 	1.15	 	  	 	3.33	 	  	 	1.53	 
	 22
	  	 	2.38	 	  	 	1.20	 	  	 	3.50	 	  	 	1.63	 
	 23
	  	 	2.40	 	  	 	1.20	 	  	 	3.65	 	  	 	1.68	 
	 24
	  	 	2.43	 	  	 	1.25	 	  	 	3.85	 	  	 	1.80	 
	 25
	  	 	2.45	 	  	 	1.25	 	  	 	4.08	 	  	 	1.93	 
	 26
	  	 	2.55	 	  	 	1.33	 	  	 	4.28	 	  	 	2.03	 
	 27
	  	 	2.68	 	  	 	1.43	 	  	 	4.53	 	  	 	2.18	 
	 28
	  	 	2.63	 	  	 	1.45	 	  	 	4.55	 	  	 	2.30	 
	 29
	  	 	2.58	 	  	 	1.55	 	  	 	4.53	 	  	 	2.48	 
	 30
	  	 	2.55	 	  	 	1.60	 	  	 	4.50	 	  	 	2.58	 
	 31
	  	 	2.53	 	  	 	1.70	 	  	 	4.50	 	  	 	2.80	 
	 32
	  	 	2.53	 	  	 	1.80	 	  	 	4.55	 	  	 	2.98	 
	 33
	  	 	2.60	 	  	 	1.90	 	  	 	4.68	 	  	 	3.20	 
	 34
	  	 	2.65	 	  	 	2.05	 	  	 	4.85	 	  	 	3.48	 
	 35
	  	 	2.73	 	  	 	2.23	 	  	 	5.00	 	  	 	3.83	 
	 36
	  	 	2.88	 	  	 	2.38	 	  	 	5.28	 	  	 	4.13	 
	 37
	  	 	3.00	 	  	 	2.58	 	  	 	5.58	 	  	 	4.48	 
	 38
	  	 	3.23	 	  	 	2.68	 	  	 	6.00	 	  	 	4.70	 
	 39
	  	 	3.43	 	  	 	2.83	 	  	 	6.43	 	  	 	5.00	 
	 40
	  	 	3.65	 	  	 	3.00	 	  	 	6.93	 	  	 	5.30	 
	 41
	  	 	3.95	 	  	 	3.18	 	  	 	7.58	 	  	 	5.65	 
	 42
	  	 	4.33	 	  	 	3.38	 	  	 	8.33	 	  	 	6.08	 
	 43
	  	 	4.75	 	  	 	3.63	 	  	 	9.23	 	  	 	6.58	 
	 44
	  	 	5.25	 	  	 	3.93	 	  	 	10.30	 	  	 	7.15	 
	 45
	  	 	5.83	 	  	 	4.28	 	  	 	11.43	 	  	 	7.83	 
	 46
	  	 	6.38	 	  	 	4.68	 	  	 	12.48	 	  	 	8.58	 
	 47
	  	 	6.98	 	  	 	5.18	 	  	 	13.65	 	  	 	9.53	 
	 48
	  	 	7.33	 	  	 	5.73	 	  	 	14.30	 	  	 	10.70	 
	 49
	  	 	7.73	 	  	 	6.33	 	  	 	15.05	 	  	 	12.03	 
	 50
	  	 	8.30	 	  	 	7.03	 	  	 	16.13	 	  	 	13.48	 
	 51
	  	 	8.98	 	  	 	7.80	 	  	 	17.40	 	  	 	15.05	 
	 52
	  	 	9.90	 	  	 	8.68	 	  	 	19.15	 	  	 	16.78	 
	 53
	  	 	10.90	 	  	 	9.63	 	  	 	21.13	 	  	 	18.60	 
	 54
	  	 	12.18	 	  	 	10.63	 	  	 	23.60	 	  	 	20.60	 
	 55
	  	 	13.75	 	  	 	11.70	 	  	 	26.40	 	  	 	22.70	 
	 56
	  	 	15.35	 	  	 	12.95	 	  	 	29.25	 	  	 	24.95	 
	 57
	  	 	17.08	 	  	 	14.25	 	  	 	32.28	 	  	 	27.35	 
	 58
	  	 	18.55	 	  	 	15.65	 	  	 	34.65	 	  	 	29.68	 
	 59
	  	 	20.25	 	  	 	17.05	 	  	 	37.40	 	  	 	32.25	 

																	
	 Attained
Age
	  	Non-nicotine	 	  	Nicotine	 
	  	Male	 	  	Female	 	  	Male	 	  	Female	 
	 60
	  	 	22.30	 	  	 	18.50	 	  	 	40.73	 	  	 	34.93	 
	 61
	  	 	24.80	 	  	 	20.08	 	  	 	44.85	 	  	 	37.70	 
	 62
	  	 	27.85	 	  	 	21.80	 	  	 	49.83	 	  	 	40.83	 
	 63
	  	 	31.28	 	  	 	23.58	 	  	 	55.35	 	  	 	43.95	 
	 64
	  	 	34.88	 	  	 	25.50	 	  	 	61.00	 	  	 	47.25	 
	 65
	  	 	38.68	 	  	 	27.63	 	  	 	66.58	 	  	 	50.85	 
	 66
	  	 	42.53	 	  	 	29.98	 	  	 	71.95	 	  	 	54.68	 
	 67
	  	 	46.43	 	  	 	32.55	 	  	 	77.18	 	  	 	58.98	 
	 68
	  	 	50.63	 	  	 	35.43	 	  	 	82.68	 	  	 	63.70	 
	 69
	  	 	54.98	 	  	 	38.58	 	  	 	88.13	 	  	 	68.83	 
	 70
	  	 	60.25	 	  	 	42.05	 	  	 	94.73	 	  	 	74.55	 
	 71
	  	 	66.15	 	  	 	46.05	 	  	 	101.95	 	  	 	81.08	 
	 72
	  	 	73.90	 	  	 	50.53	 	  	 	111.78	 	  	 	88.28	 
	 73
	  	 	82.08	 	  	 	55.38	 	  	 	121.65	 	  	 	96.03	 
	 74
	  	 	90.68	 	  	 	60.70	 	  	 	131.63	 	  	 	104.53	 
	 75
	  	 	100.08	 	  	 	66.60	 	  	 	143.23	 	  	 	113.08	 
	 76
	  	 	110.33	 	  	 	73.08	 	  	 	155.58	 	  	 	122.40	 
	 77
	  	 	122.23	 	  	 	80.20	 	  	 	169.85	 	  	 	132.43	 
	 78
	  	 	136.13	 	  	 	88.08	 	  	 	186.35	 	  	 	143.23	 
	 79
	  	 	152.18	 	  	 	96.58	 	  	 	205.13	 	  	 	154.90	 
	 80
	  	 	169.68	 	  	 	106.08	 	  	 	225.18	 	  	 	167.48	 
	 81
	  	 	189.60	 	  	 	118.98	 	  	 	247.63	 	  	 	185.18	 
	 82
	  	 	210.35	 	  	 	133.53	 	  	 	270.28	 	  	 	204.40	 
	 83
	  	 	232.73	 	  	 	148.03	 	  	 	294.03	 	  	 	223.13	 
	 84
	  	 	257.50	 	  	 	164.05	 	  	 	319.85	 	  	 	243.25	 
	 85
	  	 	285.18	 	  	 	182.10	 	  	 	350.23	 	  	 	263.53	 
	 86
	  	 	315.85	 	  	 	198.48	 	  	 	383.48	 	  	 	280.43	 
	 87
	  	 	349.35	 	  	 	223.13	 	  	 	419.23	 	  	 	307.23	 
	 88
	  	 	385.25	 	  	 	248.88	 	  	 	456.80	 	  	 	333.98	 
	 89
	  	 	423.13	 	  	 	276.33	 	  	 	495.68	 	  	 	360.88	 
	 90
	  	 	462.65	 	  	 	301.63	 	  	 	535.33	 	  	 	382.63	 
	 91
	  	 	499.83	 	  	 	314.43	 	  	 	571.08	 	  	 	387.35	 
	 92
	  	 	538.58	 	  	 	339.60	 	  	 	607.55	 	  	 	406.65	 
	 93
	  	 	579.45	 	  	 	376.95	 	  	 	645.25	 	  	 	437.75	 
	 94
	  	 	622.63	 	  	 	424.10	 	  	 	684.35	 	  	 	477.43	 

 
 

  

													
	 	  	Semi-Annual	 	  	Quarterly	 	  	Monthly	 
	 Modal Factors:
	  	 	0.520	 	  	 	0.280	 	  	 	0.087	 

  

			
	Page 21 of 22	 	Version 12-1-2011

 Hybrid Term Allowances 

  
 39 

 10 Year Term - MED 
  

																	
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-10	  	55	  	53	  	49	  	29	  	7
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-10	  	53	  	51	  	35	  	17	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-10	  	41	  	21	  	11	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-10	  	13	  	6	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-10	  	55	  	48	  	38	  	23	  	17
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-10	  	40	  	40	  	21	  	14	  	10
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-10	  	23	  	13	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-10	  	57	  	48	  	38	  	14	  	8
	 Standard Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-10	  	57	  	38	  	21	  	4	  	14
	 Standard Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-10	  	42	  	19	  	11	  	4	  	8
	 Standard Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-10	  	21	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	6	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-10	  	54	  	43	  	27	  	14	  	14
	 Standard Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-10	  	41	  	25	  	13	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-10	  	21	  	11	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-10	  	63	  	46	  	31	  	15	  	6
	 Preferred Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-10	  	55	  	35	  	21	  	8	  	4
	 Preferred Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-10	  	53	  	28	  	17	  	15	  	8
	 Preferred Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-10	  	31	  	18	  	6	  	4	  	4
	 Preferred Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Preferred Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100

  
 Page 1 of 16 

 10 Year Term - MED 
  

																	
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Preferred Nicotine
	  	Male	  	Band 1	  	2-10	  	40	  	40	  	16	  	11	  	8
	 Preferred Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-10	  	37	  	22	  	4	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	6	  	5	  	6
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-10	  	25	  	13	  	4	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-10	  	11	  	4	  	4	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-10	  	57	  	35	  	26	  	19	  	9
	 Standard Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	9
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-10	  	52	  	22	  	17	  	12	  	9
	 Standard Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-10	  	37	  	15	  	14	  	11	  	9
	 Standard Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-10	  	21	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-10	  	41	  	23	  	16	  	7	  	7
	 Standard Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-10	  	30	  	13	  	8	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 2	  	11+	  	6	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-10	  	18	  	7	  	7	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-10	  	9	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 Page 2 of 16 

 10 Year Term - NMD 
  

																	
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	69	  	20	  	64	  	42	  	57
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	54	  	54	  	55	  	47	  	48
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	29	  	30	  	35	  	29	  	30
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	16	  	17	  	28	  	23	  	33
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	5	  	6	  	28	  	30	  	30
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	58	  	60	  	57	  	44	  	44
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	36	  	35	  	37	  	33	  	33
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	6	  	 6
	  	13	  	7	  	7
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	6	  	6	  	6	  	6	  	6
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	6	  	6	  	6	  	6	  	 6

	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	 75
	  	70	  	66	  	57	  	54
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	 64
	  	 60
	  	56	  	44	  	44
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	43	  	44	  	42	  	 38
	  	30
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	36	  	33	  	37	  	25	  	26
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	28	  	 35
	  	34	  	34	  	38
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	50	  	55	  	54	  	42	  	39
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	 46
	  	41	  	43	  	33	  	 32

	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	24	  	28	  	24	  	17	  	17
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	15	  	29	  	18	  	12	  	12
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	7	  	6	  	8	  	6	  	6
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	66	  	63	  	60	  	51	  	48
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	 67
	  	53	  	52	  	38	  	48
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	 50
	  	39	  	42	  	24	  	29
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	58	  	38	  	38	  	22	  	23
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	53	  	35	  	45	  	34	  	28
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	55	  	51	  	53	  	34	  	30
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	 50
	  	38	  	41	  	28	  	23
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	 36
	  	 16
	  	24	  	12	  	11
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	 33
	  	14	  	22	  	7	  	7
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	31	  	18	  	18	  	6	  	6
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-10	  	68	  	67	  	52	  	42	  	31
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5

  
 Page 3 of 16 

 10 Year Term - NMD 
  

																	
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-10	  	46	  	45	  	45	  	32	  	25
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-10	  	56	  	38	  	41	  	28	  	18
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-10	  	45	  	34	  	38	  	16	  	12
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-10	  	 38
	  	26	  	38	  	12	  	9
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-10	  	55	  	48	  	42	  	34	  	22
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-10	  	42	  	 31
	  	21	  	6	  	6
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-10	  	24	  	11	  	6	  	6	  	6
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-10	  	58	  	6	  	6	  	6	  	6
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-10	  	21	  	6	  	6	  	6	  	6
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-10	  	62	  	42	  	38	  	30	  	18
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-10	  	47	  	33	  	33	  	24	  	29
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-10	  	42	  	36	  	27	  	14	  	9
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-10	  	 37
	  	26	  	17	  	18	  	6
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-10	  	34	  	22	  	14	  	8	  	8
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-10	  	46	  	39	  	34	  	23	  	13
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-10	  	40	  	30	  	 26
	  	6	  	6
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-10	  	27	  	56	  	8	  	6	  	6
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-10	  	26	  	6	  	6	  	6	  	6
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-10	  	14	  	6	  	6	  	6	  	6
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-10	  	45	  	 28
	  	26	  	24	  	54
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-10	  	47	  	27	  	24	  	19	  	11
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-10	  	 43
	  	29	  	14	  	7	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-10	  	41	  	20	  	14	  	6	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-10	  	36	  	18	  	8	  	4	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-10	  	36	  	28	  	25	  	11	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-10	  	36	  	15	  	9	  	5	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-10	  	36	  	6	  	6	  	6	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-10	  	18	  	6	  	6	  	6	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-10	  	11	  	6	  	6	  	6	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 Page 4 of 16 

 15 Year Term - MED 
  

																	
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-15	  	61	  	55	  	44	  	21	  	7
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-15	  	57	  	49	  	32	  	9	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-15	  	54	  	28	  	11	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-15	  	44	  	13	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-15	  	4	  	4	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-15	  	62	  	52	  	36	  	25	  	22
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-15	  	56	  	40	  	23	  	16	  	13
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-15	  	36	  	18	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-15	  	26	  	7	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-15	  	4	  	4	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-15	  	62	  	46	  	32	  	12	  	11
	 Standard Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-15	  	62	  	34	  	18	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-15	  	51	  	20	  	9	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-15	  	46	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-15	  	31	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-15	  	57	  	37	  	29	  	13	  	13
	 Standard Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-15	  	47	  	22	  	15	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-15	  	33	  	12	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-15	  	22	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-15	  	4	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-15	  	57	  	47	  	31	  	19	  	4
	 Preferred Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-15	  	54	  	41	  	23	  	13	  	12
	 Preferred Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-15	  	49	  	27	  	14	  	11	  	9
	 Preferred Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-15	  	46	  	21	  	12	  	9	  	6
	 Preferred Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-15	  	4	  	4	  	4	  	4	  	4
	 Preferred Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100

  
 Page 5 of 16 

 15 Year Term - MED 
  

																	
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Preferred Nicotine
	  	Male	  	Band 1	  	2-15	  	58	  	43	  	25	  	20	  	17
	 Preferred Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-15	  	51	  	33	  	16	  	14	  	12
	 Preferred Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-15	  	39	  	21	  	12	  	11	  	11
	 Preferred Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-15	  	34	  	18	  	6	  	6	  	6
	 Preferred Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-15	  	4	  	4	  	4	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-15	  	62	  	43	  	27	  	16	  	4
	 Standard Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-15	  	56	  	31	  	20	  	8	  	6
	 Standard Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-15	  	43	  	18	  	17	  	16	  	13
	 Standard Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-15	  	39	  	13	  	13	  	13	  	13
	 Standard Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-15	  	4	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-15	  	51	  	33	  	22	  	17	  	16
	 Standard Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-15	  	43	  	25	  	16	  	11	  	11
	 Standard Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-15	  	32	  	6	  	13	  	13	  	13
	 Standard Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-15	  	28	  	6	  	6	  	6	  	6
	 Standard Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-10	  	4	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 Page 6 of 16 

 15 Year Term - NMD 
  

																	
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	70	  	61	  	60	  	46	  	42
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	60	  	54	  	56	  	45	  	45
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	42	  	33	  	38	  	29	  	21
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-15	  	32	  	33	  	38	  	28	  	29
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	24	  	24	  	33	  	34	  	39
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	60	  	57	  	52	  	47	  	47
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	42	  	40	  	44	  	45	  	45
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	17	  	12	  	13	  	28	  	28
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	6	  	6	  	11	  	23	  	23
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	6	  	6	  	14	  	22	  	22
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	 68
	  	61	  	55	  	43	  	41
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	61	  	61	  	55	  	44	  	44
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	53	  	44	  	44	  	30	  	35
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-15	  	47	  	38	  	32	  	21	  	27
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	46	  	61	  	53	  	45	  	41
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	58	  	53	  	50	  	42	  	42
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	47	  	43	  	45	  	42	  	42
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	33	  	23	  	31	  	30	  	38
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	22	  	18	  	23	  	26	  	28
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	20	  	20	  	28	  	22	  	22
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	61	  	47	  	44	  	33	  	35
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	61	  	51	  	51	  	38	  	41
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	60	  	42	  	42	  	25	  	30
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-15	  	41	  	32	  	35	  	22	  	23
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	51	  	48	  	53	  	44	  	38
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	49	  	39	  	40	  	34	  	35
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	45	  	37	  	 43
	  	37	  	 38

	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	41	  	28	  	30	  	36	  	29
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	34	  	20	  	30	  	28	  	24
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	34	  	30	  	32	  	19	  	30
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-15	  	64	  	54	  	41	  	26	  	6
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5

  
 Page 7 of 16 

 15 Year Term - MED 
  

																	
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-15	  	57	  	48	  	41	  	23	  	22
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-15	  	45	  	36	  	37	  	35	  	22
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-15	  	48	  	34	  	42	  	34	  	29
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-15	  	43	  	33	  	40	  	31	  	38
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-15	  	57	  	44	  	36	  	32	  	32
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-15	  	60	  	33	  	36	  	28	  	28
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-15	  	34	  	35	  	29	  	15	  	15
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-15	  	28	  	12	  	19	  	14	  	14
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-15	  	24	  	6	  	17	  	7	  	7
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-15	  	54	  	44	  	34	  	18	  	6
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-15	  	52	  	43	  	55	  	13	  	13
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-15	  	44	  	34	  	34	  	24	  	16
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-15	  	42	  	32	  	32	  	32	  	17
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-15	  	40	  	35	  	35	  	24	  	23
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-15	  	47	  	35	  	28	  	22	  	20
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-15	  	44	  	36	  	26	  	13	  	6
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-15	  	33	  	15	  	17	  	6	  	6
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-15	  	21	  	14	  	14	  	6	  	6
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-15	  	27	  	13	  	13	  	6	  	6
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-15	  	48	  	35	  	23	  	6	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-15	  	42	  	35	  	25	  	6	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-15	  	40	  	30	  	27	  	17	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-15	  	47	  	34	  	33	  	24	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-15	  	48	  	35	  	32	  	29	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-15	  	48	  	54	  	20	  	13	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-15	  	42	  	34	  	35	  	6	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-15	  	33	  	15	  	16	  	6	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-15	  	30	  	11	  	13	  	6	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-15	  	30	  	22	  	11	  	6	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 Page 8 of 16 

 20 Year Term - MED 
  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	
18-29
	  	
30-39
	  	 40-49
	  	
50-60

	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-20	  	59	  	50	  	32	  	13
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-20	  	55	  	37	  	13	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-20	  	42	  	16	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-20	  	13	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-20	  	4	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-20	  	51	  	51	  	26	  	13
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-20	  	46	  	26	  	7	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	6	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-20	  	23	  	7	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-20	  	4	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-20	  	4	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-20	  	57	  	41	  	17	  	6
	 Standard Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-20	  	43	  	21	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-20	  	22	  	6	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-20	  	11	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-20	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-20	  	51	  	31	  	15	  	9
	 Standard Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-20	  	33	  	9	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-20	  	13	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-20	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-20	  	4	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-20	  	61	  	48	  	30	  	23
	 Preferred Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-20	  	51	  	33	  	25	  	12
	 Preferred Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-20	  	45	  	27	  	11	  	8
	 Preferred Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-20	  	25	  	13	  	4	  	4

  
 Page 9 of 16 

 20 Year Term - MED 
  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-60

	 Preferred Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-20	  	4	  	4	  	4	  	4
	 Preferred Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-20	  	56	  	42	  	17	  	15
	 Preferred Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-20	  	43	  	26	  	6	  	6
	 Preferred Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	6	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-20	  	37	  	13	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-20	  	23	  	7	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-20	  	4	  	4	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-20	  	54	  	33	  	21	  	11
	 Standard Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-20	  	46	  	22	  	13	  	7
	 Standard Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-20	  	33	  	11	  	4	  	4
	 Standard Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-20	  	13	  	4	  	4	  	4
	 Standard Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-20	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-20	  	46	  	46	  	16	  	12
	 Standard Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-20	  	42	  	4	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-20	  	23	  	4	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-20	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-20	  	4	  	4	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 Page 10 of 16 

 20 Year Term - NMD 
  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	
18-29
	  	
30-39
	  	
40-49
	  	
50-60

	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	 2-20
	  	70	  	65	  	53	  	40
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	 2-20
	  	60	  	60	  	54	  	44
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	 2-20
	  	47	  	40	  	36	  	32
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	 2-20
	  	28	  	30	  	37	  	34
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	 2-20
	  	33	  	33	  	41	  	40
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	 2-20
	  	62	  	56	  	45	  	38
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	 2-20
	  	47	  	43	  	42	  	33
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	 2-20
	  	28	  	16	  	24	  	24
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	 2-20
	  	10	  	6	  	10	  	22
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	 2-20
	  	16	  	8	  	30	  	28
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	 2-20
	  	68	  	60	  	47	  	33
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	 2-20
	  	53	  	60	  	52	  	42
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	 2-20
	  	33	  	45	  	34	  	28
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	 2-20
	  	45	  	39	  	38	  	26
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	 2-20
	  	48	  	46	  	47	  	43
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	 2-20
	  	58	  	46	  	43	  	29
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	 2-20
	  	40	  	44	  	48	  	54
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	 2-20
	  	38	  	23	  	28	  	28
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	 2-20
	  	23	  	17	  	25	  	25
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	 1
	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	 2-20
	  	33	  	26	  	38	  	35
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	 2-20
	  	60	  	43	  	36	  	29
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	 2-20
	  	60	  	55	  	45	  	34
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	 2-20
	  	53	  	41	  	35	  	24
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	 2-20
	  	57	  	40	  	34	  	25
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	 2-20
	  	60	  	57	  	48	  	42
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	 2-20
	  	42	  	25	  	34	  	24
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	 2-20
	  	45	  	29	  	42	  	33
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	 2-20
	  	42	  	26	  	26	  	29
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	 2-20
	  	40	  	12	  	25	  	27
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	 1
	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	 2-20
	  	47	  	33	  	42	  	25
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	 21+
	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	 1
	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	 2-20
	  	43	  	48	  	34	  	23
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	 21+
	  	5	  	5	  	5	  	 5

  
 Page 11 of 16 

 20 Year Term - ILLEGIBLE 
  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	
18-29
	  	
30-39
	  	
40-49
	  	
50-60

	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-20	  	59	  	45	  	42	  	29
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-20	  	51	  	41	  	41	  	50
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-20	  	51	  	40	  	43	  	28
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-20	  	49	  	38	  	41	  	33
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-20	  	54	  	41	  	24	  	24
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-20	  	49	  	37	  	32	  	31
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-20	  	38	  	15	  	25	  	24
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-20	  	35	  	12	  	24	  	23
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-20	  	32	  	13	  	29	  	21
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-20	  	53	  	35	  	24	  	12
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-20	  	52	  	29	  	25	  	15
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-20	  	43	  	37	  	12	  	19
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-20	  	42	  	25	  	35	  	26
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-20	  	42	  	17	  	32	  	59
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-20	  	46	  	25	  	25	  	15
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-20	  	45	  	26	  	26	  	19
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-20	  	34	  	14	  	14	  	14
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-20	  	31	  	17	  	14	  	11
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-20	  	29	  	19	  	17	  	10
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-20	  	44	  	25	  	23	  	6
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-20	  	47	  	25	  	21	  	10
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-20	  	44	  	27	  	25	  	11
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-20	  	46	  	25	  	21	  	10
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-20	  	46	  	25	  	21	  	12
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-20	  	36	  	13	  	15	  	11
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-20	  	44	  	14	  	14	  	4
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-20	  	28	  	15	  	13	  	4
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-20	  	25	  	14	  	11	  	4
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-20	  	23	  	15	  	14	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 Page 12 of 16 

 30 Year Term - MED 
  

													
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-30	  	61	  	44	  	25
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-30	  	56	  	32	  	11
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-30	  	45	  	13	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-30	  	9	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-30	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-30	  	59	  	44	  	25
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-30	  	57	  	32	  	11
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-30	  	41	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-30	  	9	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-30	  	4	  	4	  	4
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-30	  	59	  	33	  	19
	 Standard Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-30	  	55	  	17	  	11
	 Standard Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-30	  	43	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-30	  	9	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-30	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-30	  	54	  	29	  	19
	 Standard Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-30	  	47	  	15	  	11
	 Standard Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-30	  	37	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-30	  	9	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-30	  	4	  	4	  	4
	 Standard Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-30	  	62	  	40	  	25
	 Preferred Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-30	  	59	  	33	  	24

  
 Page 13 of 16 

 30 Year Term - MED 
  

													
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Preferred Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-30	  	53	  	28	  	22
	 Preferred Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-30	  	21	  	18	  	16
	 Preferred Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-30	  	13	  	4	  	4
	 Preferred Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-30	  	56	  	38	  	23
	 Preferred Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-30	  	52	  	33	  	22
	 Preferred Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-30	  	49	  	25	  	21
	 Preferred Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-30	  	21	  	13	  	11
	 Preferred Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-30	  	13	  	4	  	4
	 Preferred Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-30	  	59	  	34	  	23
	 Standard Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-30	  	53	  	25	  	22
	 Standard Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-30	  	49	  	21	  	19
	 Standard Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-30	  	21	  	14	  	12
	 Standard Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-30	  	13	  	4	  	4
	 Standard Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-30	  	51	  	21	  	16
	 Standard Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-30	  	47	  	19	  	17
	 Standard Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-30	  	45	  	15	  	12
	 Standard Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-30	  	21	  	9	  	6
	 Standard Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-30	  	9	  	4	  	4
	 Standard Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5

  
 Page 14 of 16 

 30 Year Term - NMD 
  

													
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	71	  	50	  	46
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	66	  	56	  	42
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	52	  	47	  	47
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	51	  	47	  	49
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	45	  	40	  	46
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	66	  	54	  	45
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	55	  	45	  	42
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	41	  	31	  	36
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	36	  	26	  	30
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	36	  	25	  	22
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	47	  	53	  	47
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	64	  	55	  	53
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	55	  	52	  	49
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	63	  	55	  	53
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	55	  	51	  	55
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	60	  	45	  	45
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	54	  	43	  	48
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	50	  	45	  	36
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	47	  	36	  	44
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	50	  	43	  	40
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	50	  	44	  	43
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	62	  	51	  	52
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	61	  	52	  	46
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	65	  	56	  	54
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	65	  	58	  	53
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	54	  	39	  	43
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	51	  	40	  	43
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	53	  	44	  	42
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	52	  	43	  	47
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	58	  	46	  	44
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-30	  	52	  	47	  	27
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5

  
 Page 15 of 16 

 30 Year Term - MMD 
  

													
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-30	  	53	  	36	  	36
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-30	  	49	  	34	  	33
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-30	  	47	  	32	  	
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-30	  	43	  	30	  	29
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-30	  	53	  	29	  	26
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-30	  	45	  	30	  	25
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-30	  	37	  	26	  	18
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-30	  	33	  	15	  	12
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-30	  	22	  	14	  	12
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-30	  	53	  	44	  	35
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-30	  	53	  	36	  	30
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-30	  	50	  	31	  	28
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-30	  	46	  	33	  	28
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-30	  	48	  	33	  	30
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-30	  	50	  	34	  	28
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-30	  	47	  	30	  	22
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-30	  	37	  	22	  	17
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-30	  	25	  	20	  	54
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-30	  	17	  	6	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-30	  	57	  	38	  	35
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-30	  	40	  	21	  	29
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-30	  	48	  	30	  	29
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-30	  	47	  	29	  	27
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-30	  	49	  	22	  	30
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-30	  	42	  	31	  	27
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-30	  	43	  	27	  	20
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-30	  	35	  	30	  	15
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-30	  	33	  	19	  	14
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-30	  	16	  	6	  	6
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5

  
 Page 16 of 16 

 EXHIBIT F 

UNDERWRITING GUIDELINES AND NOTIFICATION 

(To Be Inserted) 

  
 40 

 

 

 Introducing Hybrid Life 

From Fidelity Life Association 
 The Only Way to Obtain
High Face Amount, 
 Low Cost Term Insurance Right Away! 

 

 As an agent, you know that today’s customer is seeking a good value for their premium dollar. High face
amount, low cost term insurance is a popular option for this reason. Unfortunately, the typical life insurance company can take up to 12 weeks (or even longer) to issue a high face amount policy at a reasonable cost. Potential customers often drop
out of the process and never become policyholders due to the lengthy, invasive medical underwriting process. This creates inefficiency and lost opportunity for the agent. 

Alternatively, some companies issues coverage quickly, but either limit the total amount of coverage that can be purchased, or change a very high premium
– or both. This increases the chance that the policyholder will lapse their coverage once a higher face amount, lower premium product is found. Up until now, there has simply been no company that is issuing high face amount, low cost term life
insurance quickly. 
 Changing the Way Life Insurance is Sold 

Fidelity Life Association has developed Hybrid Life, a patent pending life insurance product designed to solve this problem. Only available from Fidelity Life,
Hybrid Life provides a blend of level term “all cause” life insurance and an accidental death benefit through a convenient, quick non-medical underwriting process. In fact, most policies can be
issued in 24 hours or less. 
 With Hybrid Life, the customer has up to six months to complete the optional medical underwriting process. Based on the
customer’s medical underwriting results, the company will increase the “all cause” portion (up to 100%) and reduce the accidental death portion proportionally. If a customer’s medical underwriting results do not allow for any
improvement in policy benefits, the initial blend of coverage remains in force as originally issued. 
 Hybrid Life allows coverage to be put in force very
quickly while giving the customer the option to complete medical underwriting at their convenience in order to maximize policy benefits. This directly improves the number of cases the agent can place, which drives up profitability per agent. In
addition, Hybrid Life’s competitive premium rates and high coverage limits increase the chance that once a policy is in force, it stays in force.

 Experience the Hybrid Life Difference 

Hybrid Life offers several distinct advantages for both the agent and customer alike. Unlike other companies who may issue temporary insurance agreements or
conditional receipts, Hybrid Life is unconditional coverage that can be kept in force for the length of the term period chosen and beyond (up to age 95). 

With typical medically underwritten products available elsewhere, the customer must take the medical exam immediately before even temporary or conditional
coverage can be issued. In contrast, Hybrid Life allows the customer up to six months to undergo a medical exam. This not only allows for convenient scheduling, it also allows the customer to improve health issues such as weight, cholesterol or
blood pressure which may ultimately allow for a more favorable blend of benefits. 
 These unique features make for a product that fits the needs of most
customers seeking high face amount, low cost term life insurance coverage. This adds up to a product that has been proven to increase agent placement and profitability. 

Continue reading to learn more about how Hybrid Life can benefit you and your customers. Most importantly, begin offering Hybrid Life today! 

 
 

 
 Established 1896 

Innovation Is Our Policy® 

Fidelity Life Association, 
 A Legal Reserve Life Insurance
Company 
 8700 W. Bryn Mawr Ave., Ste. 9005, Chicago, IL 60611 

www.FidelityLife.com 

 

 
 

 
 Hybrid Life Product Features 
  

	 	•	 	10, 15, 20 and 30-year term life insurance 

  

	 	•	 	Blender coverage providing an initial All Cause Death Benefit and Accidental Death Benefit 

  

	 	•	 	Initial blend of coverage is issued after the customer is approved through a non-medical, 24-to-48 hour under-writing process.

  

	 	•	 	Option to undergo medical underwriting within the first six months of the policy’s issue date to potentially qualify for an improved blend of policy benefits. 

 

	 	•	 	All Cause Death Benefit is renewable on a level premium basis through the initial term period, and on an annual renewable term (ART) basis up to age 95. 

 

	 	•	 	The Accident Death Benefit expires after the initial term period. 

 Issue Ages by Term Period 

 

					
	 Term Period
	  	
Non-Nicotine
	  	 Nicotine

	10-year	  	18-65	  	18-65
	15-year	  	18-65	  	18-65
	20-year	  	18-60	  	18-60
	30-year	  	18-50*	  	18-45†

  

	* 	 Issue limit—Age 50: $50,000 to $900,000 

	† 	 Issue limits—Age 18 - 44: $50,000 to $690,000; Age 45:
$50,000 to $640,000 

 Issue Limits 
  

					
	 Issue Age
	  	 Minimum
	  	 Maximum

	18-65	  	$50,000	  	$1,000,000

  

	* 	 Issue limits for Non-Nicotine user
10-year term—Age 50: $50,000 to $900,000; Nicotine user 30-year term— Age 18-44: $50,000 to $640,000; Age 45: $50,000
to $640,000 

	† 	 The total combined account of coverage available with all FLA products is $1,000,000. 

Age Basis 
 This product is age nearest, rather than age
last birthday. 
 Conversion 
 This product is non-convertible 
 Premium Bands 
  

	1)	 $50,000 - $99,999 

 

	2)	 $100,000 -$249,999 

 

	3)	 $250,000 - $499,999 

 

	4)	 $500,000 - $999,999 

 

	5)	 $1,000,000

 

 
 Established 1896 
 Innovation
Is Our Policy® 
 Table of Contents 

 

					
	 Product Introduction
	  	 	Inside front cover	 
		
	 Product Features
	  	 	1	 
		
	 Hybrid Life Sample
	  	 	2	 
		
	 The Underwriting Approach
	  	 	3	 
		
	 Initial Non-Medical Criteria
	  	 	4	 
		
	 Hybrid Life Medically Underwritten Premium Class
	  	 	6	 
		
	 Hybrid Life Build Chart
	  	 	7	 
		
	 Prescription & Miscellaneous Quoting Criteria
	  	 	8	 
		
	 Financial Justification
	  	 	8	 
		
	 Foreign Travel
	  	 	10	 
		
	 Hybrid Life Billing Information
	  	 	11	 
		
	 Hybrid Life Sales Business
	  	 	11	 
		
	 General Business Standards
	  	 	12	 
		
	 Home Office Contacts
	  	 	12	 

 Premium Classes (Non-Med) 

 

	 	•	 	Three non-medical premium classes are offered, Tier 1, Tier 2 and Tier 3. 

  

	 	•	 	The premium paid for Tier 1 is equivalent to the premium charged for the Preferred, medically underwritten premium class assuming 100% all cause coverage. 

 

	 	•	 	The premium paid for Tier 2 is equivalent to the premium charged for the Standard, medically underwritten premium class assuming 100% all cause coverage. 

 

	 	•	 	The premium paid for Tier 3 is equivalent to the premium charged for a Table D, medically underwritten premium class assuming 100% all cause coverage. 

Premium Classes (Medical) 
  

	 	•	 	Preferred 

  

	 	•	 	Preferred Nicotine 

  

	 	•	 	Standard 

  

	 	•	 	Standard Nicotine 

 Substandard Ratings (Medical) 

Ratings through Table H are allowed. In addition to Flat Extra’s up to $7.50.

 

  
 1 

 Hybrid Life 

from Fidelity Life Association 
 Hybrid Life Example: 35
year-old male, $500,000, 20-year term 
 Annual Policy Fee: $65

  

																																									
	 Initial
Non-Medical
Premium Class
	  	Equivalent
Medical
Premium	 	  	Initial
All Cause
Benefit	 	  	Initial
All
Cause
%	 	  	Initial
ADB
Benefit	 	  	Initial
ADB
%	 	  	Premium Class
After Medical
Underwriting	 	  	New All
Cause
Benefit	 	  	New
All
Cause
%	 	 	New
ADB
Benefit	 	  	New
ADB
%	 
	 Tier 1
	  				  				  				  				  				  				  				  				 				  			
	 ILLEGIBLE
	  

	 ILLEGIBLE
	  

	 Tier 2
	  				  				  				  				  				  				  				  				 				  			
	 ILLEGIBLE
	  

	 ILLEGIBLE
	  

	 Tier 3
	  				  				  				  				  				  				  				  				 				  			
	 ILLEGIBLE
	  

	 ILLEGIBLE
	  
	  	 	Table E	 	  	$	250,000	 	  	 	50	% 	 	$	250,000	 	  	 	50	% 
	 ILLEGIBLE
	  
	  	 	Table F	 	  	$	225,000	 	  	 	45	% 	 	$	275,000	 	  	 	55	% 
	 ILLEGIBLE
	  
	  	 	Table G	 	  	$	200,000	 	  	 	40	% 	 	$	300,000	 	  	 	60	% 
	 ILLEGIBLE
	  
	  	 	Table H	 	  	$	175,000	 	  	 	35	% 	 	$	325,000	 	  	 	65	% 
	 ILLEGIBLE
	  

	 ILLEGIBLE
	  
	  	 	Table E	 	  	$	325,000	 	  	 	65	% 	 	$	175,000	 	  	 	35	% 
	 ILLEGIBLE
	  
	  	 	Table F	 	  	$	300,000	 	  	 	60	% 	 	$	200,000	 	  	 	40	% 
	 ILLEGIBLE
	  
	  	 	Table G	 	  	$	275,000	 	  	 	55	% 	 	$	225,000	 	  	 	45	% 
	 ILLEGIBLE
	  
	  	 	ILLEGIBLE	 	  	$	250,000	 	  	 	50	% 	 	$	250,000	 	  	 	50	% 

 Rate and splits remain at non-medical level if customer chooses to NOT to undergo
Medical underwriting or if rated below the last medical premium class listed under each tier. 
  

	*	 Any form of tobacco or nicotine product, including Cigarettes, electronic Cigarettes, cigars, pipes, chewing
tobacco, Snuff, nicoltine patches or nicotine gum. 

  
 2 

			
	 

	  	 

 Established 1896
 Innovation Is
Our Policy®

 The Underwriting Approach 

Does your client qualify for Non-Medical Hybrid Life? 

1. Client must be a U.S. citizen or have a permanent resident status (a green card) and have a valid Social Security Number. 

2. My Client lives and works in the United States. 
 3. My
Client (older than 55 years) has seen his/her personal physician within the past 5 years. 
 Conditions NOT Acceptable at All—Do NOT Submit
(within the last 10 years unless otherwise stated) 

 

 Alcohol/Drug dependence within 5 years or currently elevated liver function tests 

ALS (Lou Gherig’s Disease) 
 Alzheimers, Dementia or Memory
Impairment 
 Anemia other than Iron Deficiency 
 Aneurysm
(Aortic or Brain) 
 Angina 
 Atrial Fibrillation 

Arrhythmia 
 Autism 

Blockage or narrowing of the arteries 
 Cancer/Malanoma (other
than Basal or Squamous Cell) 
 Cardiac Bypass or Stent Placement 

Cardiomyopathy 
 Cerebal Palsy 

Congestive Heart Disease 
 COPD/Emphysema-Severe 

COPD/Sarcoldosis (pulmonary) 
 COPD with tobacco use 

Crohn’s Disease/Ulcerative Colitis-less than 2 years since last symptoms 

Cystic Fibrosis

 Defibrillator or Pacemaker 

Diabetes with Cerebral/Cardio Vascular Disease 
 Down’s
Syndrome 
 Hepatitis-other than A 
 HIV/AIDS 

Kidney Disorder including renal failure or dialysis 
 Leukemia

 Liver Disease 
 Lupus (SLE) 

Malignant Neoplasm/Lymphoma 
 Mentally Challenged 

Mental Ilness—Bi-Polar, Schizophrenia or Psychosis 

Mitral Valve Prolapse with Treatment 
 Muscular Dystrophy 

Multiple Sclerosis 
 Pancreatitis 

Parkinson’s Disease 
 Seizures-Grand Mal/Partial/Focal-with
only Moderate control 
 Stroke (CVA) or Multiple TIAs 

Transplant Recipients 
 Vascular Disease-other than mild with no
surgery 

 

  
 APS Ordering Requirements 

 

							
	 Price Amount
	  	Ages
	ILLEGIBLE	  	18-40	  	41-50	  	51-65
	 To $250,000
	  	IC	  	IC	  	6 months*
	 $250,000-$500,000
	  	IC	  	6 months*	  	1 year*
	 $500,000-$1,000,000
	  	IC	  	1 year*	  	2 year*

 IC-Individual Consideration 

 

	*	 If the ILLEGIBLE insured has seen a doctor within this timeframe, an APS will be ordered.

 Age & Amount Medical Underwriting Requirements 

 

											
	 	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	Less than 50K	  	N/A	  	N/A	  	N/A	  	N/A	  	Paramed, Blood/HOS
	$50,000-$249,999	  	 Paramed, Blood/HOS
	  	 Paramed, Blood/HOS
	  	 Paramed, Blood/HOS
	  	 Paramed, Blood/HOS
	  	 Paramed, Blood/HOS

	$250,000-$499,999	  	Paramed, Blood/HOS	  	Paramed, Blood/HOS	  	Paramed, Blood/HOS	  	Paramed, Blood/HOS	  	Paramed, Blood/HOS/EKG
	$500,000-$999,999	  	 Paramed, Blood/HOS
	  	 Paramed, Blood/HOS
	  	 Paramed, Blood/HOS
	  	 Paramed, Blood/HOS/EKG
	  	 Paramed, Blood/HOS/EKG

	$1,000,000+	  	Paramed, Blood/HOS	  	Paramed, Blood/HOS	  	Paramed, Bld/HOS/EKG	  	MD Exam, Blood/HOS/ EKG, Inspection	  	MD Exam, Blood/HOS/ EKG, Inspection/APS

  
 3 

 Hybrid Life 

from Fidelity Life Association 
 Initial Non-Medical Tier Criteria 
  

									
	 Medical History
	  	 Tier 1
	  	 Tier 2
	  	 Tier 3
	  	 Additional Clarifications

	ADD & ADHD	  	NO	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Anemla—Iron Deficiency	  	YES	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Arthritis, Osteoarthritis, etc.	  	YES	  	YES	  	YES	  	
					
	Arthritis, Rheumatoid or Psoriatic	  	NO	  	YES (mild)	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Asthma w/tobacco use (MILD only)	  	NO	  	NO	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	CAD—Mild Insufficiency/Stenosis/Regarg	  	NO	  	NO	  	NO	  	
					
	CAD—Angioplasty, Stent	  	NO	  	NO	  	NO	  	
					
	CAD—Heart Murrnuz Grade I-II (treatment)	  	NO	  	YES	  	YES	  	
					
	CAD—Myocardial Infarction	  	NO	  	NO	  	YES (IC)	  	45+ yrs, after 6 months, mild (1-3 vessels, less than 40% blockage), no bypass, no tobacco, normal BP & Cholesterol and regular cardiac follow up with no progression of CAD
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Cerebral Palsy	  	NO	  	NO	  	NO	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Colon Polyps (bengin)	  	YES	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	Mild-minimal or no symptoms or no tobacco use
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Corhn’s-mild/mod & 2 yrs with no symptoms	  	NO	  	YES	  	YES	  	No steroids in past 2 years
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Diabetes I or Insulim Dependent	  	NO	  	NO	  	YES	  	
					
	Diabetes I or Insulim Dependent w/tobacco use	  	NO	  	NO	  	NO	  	
					
	Diabetes II w/good control (AIC) 40+ years	  	NO	  	NO	  	YES	  	Control—based on A1C and other impirments
					
	Diabetes II w/good control below age 40	  	NO	  	NO	  	YES	  	
					
	Diabetes II w/tobacco use	  	NO	  	NO	  	YES	  	
					
	Diabetes II w/proteinuria or complications	  	NO	  	NO	  	YES	  	
					
	Diabetes, Gestational	  	NO	  	YES	  	YES	  	
					
	Diabetes & Sleep Apnea, Neuropathy or DI	  	NO	  	NO	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLEE
					
	Family History–more than 1 death from	  	NO	  	YES	  	YES	  	CAD/Cancer or Diabetes in parens or sibiling prior to age 60
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE

  
 4 

			
	

	  	 

 Established 1896
 Innovation Is
Our Policy

 Initial Non-Medical Tier Criteria (continued) 

 

									
	 Medical History
	  	Tier 1	  	Tier 2	  	Tier 3	  	 Additional Clarifications

	GERD—with or without treatment	  	YES	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	Hapatities A (fully recovererd)	  	YES	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	YES	  	YES	  	YES	  	
					
	ILLEGIBLE	  	NO	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	YES	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	Lupus	  	NO	  	NO	  	NO	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	NO	  	YES	  	YES	  	
					
	ILLEGIBLE	  	NO	  	NO	  	NO	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	NO	  	YES	  	YES	  	NO treatment or no episodes in last 3 years
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	NO	  	NO	  	NO	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	
					
	Sleep Apnea—mild and under control	  	NO	  	YES	  	YES	  	Mild—AI 5-20 and RDI 10-30
					
	Sleep Apnea—moderate/sever	  	NO	  	NO	  	YES	  	Moderate—AI 21-40 and RDI 31-50
					
	Sleep Apnea—w/tobacco use or rated build	  	NO	  	NO	  	YES	  	
					
	Tobacco—no use with 12-24 months	  	NO	  	YES	  	YES	  	
					
	vascular Disease (DVT), mild, no suegery	  	NO	  	YES	  	YES	  	If last treatment was over 6 months ago & no complications
					
	Weight Loss Surgery w/no complications	  	NO	  	YES	  	YES	  	

  
 5 

 Hybrid Life 

from Fidelity Life Association 
 Hybrid Life Medically
Underwritten Premium Class Criteria 
  

							
	 	  	Preferred	  	Standard	  	Table D
	Non Nicotine Use	  	24+ Months	  	12 Months	  	Yes
				
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
				
	Cholesterol Max2	  	240 w/ratio 6.0	  	300 w/ratio 8.0	  	350 w/ratio 10.5
				
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
				
	BP/Female	  	140/90	  	155/92	  	See BP Guides
				
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
				
	Moving Violations2	  	No more than
2 in last 5
years.	  	No more than
3 in the last 2
years.	  	Yes
				
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
				
	US Residency	  	2 years with
permanent
resident status.	  	Must have
permanent
resident status.	  	Must have
permanent
resident status.
				
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
				
	Foreign Travel1 (Under-developed, unstable or hazardous areas)	  	None in next 2
years.	  	Yes	  	Yes

  

	1 	 When ILLEGIBLE are over 250, disregard elevated Chol/HDL ratios over 6.0 

	2 	 Flat Extras allowed ILLEGIBLE, ILLEGIBLE, Driving History, Foreign Travel & Occupations.

	3 	 Foreign Travel - Do not ask in the state of Florida. Residences of the states of California, ILLEGIBLE,
ILLEGIBLE, ILLEGIBLE, ILLEGIBLE, ILLEGIBLE, ILLEGIBLE, New Jersey, New York, ILLEGIBLE & Washington cannot have adverse actions taken for future travel. 

  
 6 

					
	

	  	 

	  	 
	  	 Established 1896
 Innovation Is Our Policy®
	  	 
	  	 
	Hybrid Life Non-Medical Build Chart*	  	 	  	 

  

									
	 	  	Minimum	  	Maximum Tier 1	  	Maximum Tier 2	  	Maximum Tier 3
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 4’ 6”
	  	RTU	  	RTU	  	RTU	  	RTU
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 4’ 8”
	  	83	  	150	  	179	  	202
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 4’ 10”
	  	90	  	160	  	191	  	215
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 5’ 0”
	  	96	  	170	  	205	  	230
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 5’ 2”
	  	102	  	180	  	219	  	246
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 5’ 4”
	  	109	  	192	  	233	  	262
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 5’ 6”
	  	116	  	204	  	248	  	279
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 5’ 8”
	  	123	  	216	  	263	  	296
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 5’ 10”
	  	130	  	229	  	279	  	314
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 6’ 0”
	  	138	  	243	  	295	  	332
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 6’ 2”
	  	146	  	256	  	312	  	351
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 6’ 4”
	  	154	  	270	  	329	  	370
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 6’ 6”
	  	162	  	285	  	346	  	389
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 6’ 8”
	  	170	  	300	  	364	  	410
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 6’ 10”
	  	179	  	318	  	383	  	430
					
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 7’ 0”
	  	RTU	  	RTU	  	RTU	  	RTU

 RTU—Refer to Underwriting 

  
 7 

 Hybrid Life 

from Fidelity Life Association 

Prescription & Miscellaneous Quoting Criteria 
  

									
	 Medications*
	  	Tier 1	  	Tier 2	  	Tier 3	  	 Notes

	2 Blood Pressure & 1 Cholesterol	  	NO	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	3 Blood Pressure or 3 Cholesterol	  	NO	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	 1 Anxiety/Depression, 1 Blood Pressure & 1 Cholesterol
	  	NO	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	1 Anxiety/Depression & 1 Sleeping Aide	  	NO	  	YES	  	YES	  	
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Blood Thinner (Coumadin)	  	NO	  	YES (IC)	  	YES	  	Depends on details
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
					
	Narcotic Pain (daily)	  	NO	  	YES	  	YES	  	Depends on medication and duration
					
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE

  

	*	 All of these combinations are Individual Consideration depending on the impairments prescribed for.

  

							
	 Miscellaneous
	  	Tier 1	  	Tier 2	  	Tier 3
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
				
	 No DUI or 3 violations in past 2 years
	  	NO	  	YES	  	YES
				
	 Non-valid Drivers License w/reasonable
explanation**
	  	YES	  	YES	  	YES
				
	 ILLEGIBLE
	  	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
				
	 After 5 years, not on probation
	  	YES	  	YES	  	YES
				
	 Within 5 years
	  	NO	  	NO	  	NO
				
	 Currently on probation
	  	NO	  	NO	  	NO

  

	**	 Reasonable-no suspended or revoked Drivers License

  

													
	 Driving History Flat Extras
	 
	 ILLEGIBLE
	  	 	ILLEGIBLE	 	  	 	ILLEGIBLE	 	  	 	ILLEGIBLE	 
				
	 0-6 points
	  	 	7-9 points	 	  	 	10-11 points	 	  	 	Over 12 points	 
				
	 0 debits/Standard
	  	 	$1.00-$3.50	 	  	 	$5.00-$7.50	 	  	 	†	 

  

	†	 We accept up to $7.50 per $1,000 flat extras for driving history. 

If Driver’s License from state other than resident state, okay to accept with explanation at Tier 1, 2 or 3. 

Non-Valid Driver’s License for the following reasons are IC (Individual Consideration): 

Child Support 
 No Insurance 

Never had a License 
 Just Moved

 Parking Tickets 
 Expired Tag
or License 
 Court Costs or No Show 

Emission Testing 

  
 8 

  

			
	

	  	 

 Established 1896

Innovation Is Our Policy®

 Financial Justification 

 

 Financial Justification of the amount of life insurance requested is an important consideration. While large
business or estate planning cases can present both special and complex challenges, personal insurance remains straight forward. 
 Please use the following
factors for determining the amount of personal insurance available to applicants. 
  

					
	 Age
	  	Earned
Income Factor	  	Unearned
Income Factor
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE
	ILLEGIBLE	  	ILLEGIBLE	  	ILLEGIBLE

 For example, someone aged 35 earning $40,000 per year would be eligible for total coverage (all sources) of $1,000,000 (40,000
x 25). 
 Earned income includes all the taxable income and pensions and other wages obtained through employment. 

For our calculations, SSI benefits, disability pension benefits, welfare or other city, state or federal assistance benefits are considered unearned income.

 Exceptions: 
  

	1.	 Except in rare cases, the minimum face amount, in the absence of other coverage, may be allowed regardless of
income. 

  

	2.	 Rounding should be done to the next $10,000. For example, if someone qualifies for $102,000 of coverage we
would allow $110,000. 

 As always, underwriter discretion (allowing more or less coverage) may be applied provided documented
justification is properly added to the file using an “exception” note.

 Family Income 

An unemployed spouse may have an amount equal to that in force (or applied for) on the employed spouse up to $300,000. For amounts over that, the unemployed
spouse is usually limited to 50% of the amount in force (applied for) on the employed spouse. Homemakers are OK without an interview up to the maximum for age providing the spouse or children are the primary beneficiaries. 

Student Coverage 
 Our general guidelines are a maximum of
$100,000 on high school and trade school students, a maximum of $200,000 for college students and a maximum of $300,000 for post-graduate students (Masters, PhD, Law School or Medical school). 

Military 
 Military personnel are evaluated based on what
they do, not their rank/grade. We do not offer coverage to combat specialists, members of combat teams, hazardous military occupations and recruits or enlisted Grades 1 through 4. 

Military risks serving in, or alerted for service in areas of conflict or potential conflict are not acceptable. 

Aviation exclusions are only available to Air National Guard or reserve pilots. All exclusions must be witnessed by the beneficiary. 

All military applicants are subject to an underwriting interview.

 

  
 9 

 Hybrid life 

form Fidelity Life Association 
 Foreign Travel 

 

 The factors that affect consideration of applicants who plan foreign travel can change very quickly. These
guidelines are not a substitute for common sense. The current political, environmental, military, criminal and health factors for each country or area where travel is contemplated must be considered. 

Always check the State Department Web site (www.travel.state.gov) for any travel warnings. If present, coverage is not available. 

NOTE: While a small number of states do not allow underwriting action based on hazardous foreign travel, this does not apply to foreign residence. The travel
question on the application MUST be answered in all cases. 
 The following guidelines apply to U.S. citizens traveling abroad. Permanent Residents (green
card holders) will be considered only if proposed travel is to low risk areas. 
 Foregin Travel Defined 

 

	a.	 Vacation travel is a single trip of 30 days or less. 

 

	b.	 Business travel totaling not more then 90 days per year and not more than four weeks at a time.

  

	c.	 Longer periods of travel (4-6 months) will be classified as Foreign
Residence and rated appropriately. 

 Occupations 

Where business travel is indicated and the occupation does not appear to be appropriate (e.g., janitor) a clear explanation will be required. 

Travel by Missionaries (and related religious activities), Diplomats, Journalists, Archeologists, Geologists, Volunteer and foreign Aid workers will not be
considered. Military and U.S. State Department personnel may be considered on an individual basis.

 Vacation 

Travel to resort destinations is usually considered at best class. The same holds true for cruise ships which have ports of call in areas of moderate concern.

 Visits to “family” should not be considered as true vacation travel and should be handled strictly in accordance with the area classification.

 The standard requirement for our business is that the proposed Insured must be a U.S. citizen living in the United States or a permanent Resident (green
card holder) living in the United States. 
 In some cases, a U.S. citizen living outside the United States on a temporary basis might be considered if they
are residing in a low risk country. The temporary residency must be for a period of 90 days or less. Where a longer period of time is anticipated or where the total amount of time living outside the United States will exceed 4 months per year, we
will underwrite on a case by case basis. 
 Temporary Residents 

Applicants who are in the United States on the basis of a temporary visa will not be considered.

 

  
 10 

			
	

	  	 

 Established 1896

Innovation Is Our Policy®

 
 Hybrid Life Billing Information 

Hybrid Life is available for quoting exclusively through Fidelity Life’s proprietary Rapid App system. 

Billing Modes 
  

			
	Annual	  	Direct, Credit Card or EFT
	Semi-Annual	  	Direct, Credit Card or EFT
	Quarterly	  	Direct, Credit Card or EFT
	Monthly	  	Credit Card or EFT

 The credit card payment option may not be available in all
states. 
 Modal Factors 
  

			
	 Annual
	  	1.00
	 Semi-Annual
	  	  .52
	 Quarterly
	  	  .28
	 Monthly
	  	  .087

 Hybrid Life Follow-up Schedule 

In the event the customer does not schedule their paramed exam, the company initiates the following process to remind the customer to schedule the exam. 

 

			
	 Timing
	  	 Activity Scheduled

	30 days post-issue	  	E-mail reminder (call if no e-mail available)
		
	60 days post-issue	  	Regular mail reminder letter
		
	90 days post-issue	  	E-mail reminder (call if no e-mail available)
		
	120 days post-issue	  	Regular mail reminder letter
		
	150 days post-issue	  	Regular mail reminder letter
		
	165 days post-issue	  	Final reminder phone call
		
	180 days post-issue	  	Final reminder letter

 

 

  
 11 

 Hybrid Life 

from Fidelity Life Association 

 

 General Business Standards 

Fidelity Life Association complies with all federal and state regulations. Each person transacting business with Fidelity Life Association is expected to be
familiar with the regulations of the state in which they do business and to act within both the letter and the spirit of the law. 
 Home Office Contacts

 Policyowner Service and Commissions 
 Toll-free (800) 369-3990 
 New Business and Appointments 

Toll-free (888) 440-1540 

Underwriting and Risk Assessment 
 Toll-free (866) 947-8739 
 Switchboard (630) 522-0392 

General E-mail 
  

			
	New Business	  	newbus@FidelityLife.com
	Policyowner Services	  	pos@FidelityLife.com
	Agency/Marketing	  	agency@FidelityLife.com

 New Business 
  

			
	Phone:	  	(888) 440-1540
	Fax:	  	(866) 947-8730 (New Applications)
	Fax:	  	(866) 947-8735 (Requirements)

 Mail and Courier 
 Mailing
Address 
 Fidelity Life Association 
 P.O. Box 5030 

Des Plaines, IL 60017 
 Courier Address 

Fidelity Life Association 
 8700 W. Bryn Mawr Ave., Ste. 900S 

Chicago, IL 60631

 Underwriting Contacts 

Underwriting at Fidelity Life is completed by a combination of home office staff and outside underwriting groups. We recognize that producers have a need to
contact an underwriter for any number of reasons and encourage you to do so. Our success, like yours, depends on being able to put profitable business on the books. 

Need to speak to an underwriter? Call: (866) 947-8739 This toll-free number searches the underwriting group and finds
an available underwriter here at the home office. 
 Underwriting Case Status: (888) 440-1540 

You may receive communication from underwriters who are not listed below. Feel free to deal with these other underwriters on a case by case basis. General
questions or situations of concern should, however, be addressed to the following: 
 Doug Coe, Chief Underwriter 

(224) 265-9726 

doug.coe@FidelityLife.com 

Fran Gramberg, Underwriting Administration 

(224) 265-9759 

fran.gramberg@FidelityLife.com 

Jeannine Duplessis, Underwriting Manager 

(224) 265-9757 

jeannine.duplessis@FidelityLife.com 

Danny Kidd, Underwriting Consultant 

(224) 265-9755 

danny.kidd@FidelityLife.com 

Mary Peifer, Underwriting Consultant 

(224) 265-9758 

mary.peifer@FidelityLife.com 

Tracy Morin, Underwriter 

(224) 265-9716 

tracy.morin@FidelityLife.com 
 Other Contact
Information 
  

			
	Underwriting E-Fax	  	(866) 947-8734
		
	General Underwriting E-Mail	  	und@FidelityLife.com
		
	Fidelity Life Website	  	www.FidelityLife.com

 
 

  
 12 

 Innovation Designed Around You 

With an A. {Excellent} rating from A.M. Best,* Fidelity Life Association offers financial strength and security. As an innovator, we provide the kind of
flexibility and quickness-to-market that keeps you ahead of the curve in taking advantage of opportunities for success. 

 

	*	 Total access to key decision-makers. 

 

	*	 The ability to create custom life solutions for your customers. 

 

	*	 Unique Web-based application and underwriting process—among the
most convenient in the industry. 

 To learn more about Hybrid Life from Fidelity Life Association, call us at (866) 710-1013. 

 
 

 
  Established 1896 

 Innovation Is Our Policy* 

 Fidelity Life Association, 

 A Legal Reserve Life Insurance Company 

 www.FidelityLife.com 
  

					
	M4200 January 2012	  		  	

 

 
 Established
1896                                         
   
  
 

 
 Fidelity Life Association 

8700 W. Bryn Mawr Avenue, #900S 

Chicago, IL 60631 
 The guide is a
work in progress and not a substitute for common sense. 
 The underwriter must exercise good judgment and prudent risk selection skills in
every case. 

 Hybrid Life Underwriting Guide 1/2012 

Fidelity Life Association 
  

Hybrid Life is level death benefit term life insurance renewable to age 95. It offers guaranteed level premium periods of 10, 15, 20 and 30 years. After the
level premium period, rates increase each year through age 94. Coverage is a blend of level term insurance (All Cause) with an Accidental Death Benefit (ADB). This benefit is embedded into the base plan. Hybrid Life includes a provision whereby the
customer may undergo medical underwriting for evaluation within six months of the policy issued date. Based on the results of medical underwriting we may modify the blend of coverage originally issued by increasing the All Cause percentage and
reducing or eliminating the Accidental Death Benefit. 
 Issue Ages 

(Age nearest birthday) 
  

			                        		                        
	Term	  	Non-Nic.	  	Nicotine
	10 yr	  	18-65	  	18-65
	15 yr	  	18-65	  	18-65
	20 yr	  	18-60	  	18-60
	30 yr	  	18-50	  	18-45

 Min / Max Face Amounts: 

Ages 18 - 65 

$50,000 - $1,000,000 
  

	 	*	 For 30 year term, nicotine classes 

 

					
	 Ages 18-44
	 	Minimum $50,000	 	Maximum $690,000
	 Age 45
	 	Minimum $50,000	 	Maximum $640,000

 Face Amount Limits 

The total combined amount of coverage available with all FLA products is $1,000,000 

Premium Classes (Non-Med): 
  

	 	•	 	 Three non-medical premium classes are offered (i.e. Tiers 1, 2 or 3).
Tiers 2 and 3 are designed to accommodate substandard risks through Table 8 (H). 

  

	 	•	 	 The premium paid for Tier 1 is equivalent to the premium charged for the Preferred, medically
underwritten premium class assuming 100% all cause coverage. 

  

	 	•	 	 The premium paid for Tier 2 is equivalent to the premium charged for the Standard, medically
underwritten premium class assuming 100% all cause coverage. 

  

	 	•	 	 The premium paid for Tier 3 is equivalent to the premium charged for a Table 4, medically
underwritten premium class assuming 100% all cause coverage. 

  
 Page 2 of 24 

 Hybrid Life Underwriting Guide 1/2012 

Fidelity Life Association 
  

Non-Medical Premium Classes: 

Tier 1 

Non-Nicotine 

Nicotine 
 Tier 2 

Non-Nicotine 

Nicotine 
 Tier 3 

Non-Nicotine 

Nicotine 
 Medical Premium Classes: 

Preferred Non-Nicotine 

Standard Non-Nicotine 

Preferred Nicotine 
 Standard
Nicotine 
 Substandard Ratings (Medical): 

Ratings through Table 8 (H) are allowed 

Flat extra’s through $7.50 per $1,000 

Premium Rate Bands by Face Amount: 
 Premium Bands 

 

	 	1)	 $50,000 - $99,999 

 

	 	2)	 $100,000 - $249,999 

  

	 	3)	 $250,000 - $499,999 

  

	 	4)	 $500,000 - $999,999 

  

	 	5)	 $1,000,000 

Expiry Age – 95 
 Policy Fee (non-commissionable)            $65.00 
 Conversion:

 This product is non-convertible. However, requests for conversion will be honored as though the policy is
convertible to a permanent plan of insurance offered by the company for such purpose. The last conversion date is the earlier of 1 year prior to the expiration of the initial term period or prior to the insured’s attained age 65. 

  
 Page 3 of 24 

 Hybrid Life Underwriting Guide 1/2012 

Fidelity Life Association 
  

Age/Amount Medical Requirements: 
 (as of 5/15/09)

  

											
	 	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-59
	  	 60-65

	 Less than 50K
	  	N/A	  	N/A	  	N/A	  	N/A	  	Paramed Blood/HOS
	 $50,000 - $249,999
	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Blood/HOS
	 $250,000 - $499,999
	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Blood/HOS/EKG
	 $500,000 - $999,999
	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Bld/HOS/EKG	  	Paramed Bld/HOS/EKG
	 $1,000,000+
	  	Paramed Blood/HOS	  	Paramed Blood/HOS	  	Paramed Bld/HOS/EKG	  	 MD Exam Bld/HOS/EKG

Inspection
	  	 MD Exam Bld/HOS/EKG

Inspection/APS

 APS Ordering Requirements: 
  

									
	 AGES FACE AMOUNT
	 	 	  	 18-40
	  	 41-50
	  	 51-65

	 To $250,000
	 		  	IC	  	IC	  	6 months
	 $250,00 - $500,000
	 		  	IC	  	6 months	  	1 year
	 $500,001-$1,000,000
	 		  	IC	  	1 year	  	2 years
	 $1,000,001-$2,000,000
	 		  	6 months	  	2 years	  	3 years

 While we need to keep the number of APS requests to a minimum, the prudent evaluation of the risk means that there are cases
where an APS is mandatory. The underwriter has the task of walking a fine line between the two extremes. As with all guidelines, common sense (including underwriter intuition) makes the exception. 

In addition to underwriter discretion, an APS should be ordered using the above “check-up or routine exam”
chart. Also, where the medical history includes; Diabetes I, CAD, cancer, emphysema/COPD, brain disorders, alcohol/drug abuse and major depression or anxiety. 

For all other medical history or laboratory results, please see the FLA Impairment Guide, Hannover Manual or the Hybrid Medical Guide. 

  
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Fidelity Life Association 
  

Hybrid Medical 
 Premium
Class Criteria 
 For all other medical history or laboratory results, please see the Fidelity Manuals and /or the
Hannover(ASCENT) manual. 
  

							
	 	  	 Preferred
	  	 Standard
	  	 Table D

	 Non-Nicotine Use
	  	24 Months	  	12 Months	  	Yes
	 Nicotine Rates
	  	Yes	  	Yes	  	Yes
	 Cholesterol Max*
	  	240 w/ratio 6.0	  	300 w/ratio 8.0	  	350 w/ratio 10.5
	 BP/Male
	  	140/90	  	155/92	  	See BP Guides
	 BP/Female
	  	140/90	  	155/92	  	See BP Guides
	 Family History
	  	One death from CAD, Cancer or Diabetes in parent or sibling prior to age 60.	  	 More than one death
 from CAD,
Cancer or Diabetes in parent or sibling prior to age 60.
	  	More than one death from CAD, Cancer or Diabetes in parent or sibling prior to age 60.
	 Moving Violations**
	  	No more than 2 in last 5 years.	  	No more than 3 in last 2 years	  	Yes
	 DUI
	  	None in past 5 years.	  	None in past 2 years.	  	Yes
	 US Residency
	  	2 years with permanent resident status.	  	Must have permanent resident status.	  	Must have permanent resident status
	 Hazardous Occupation or Avocation**
	  	None in past 2 years and none planned.	  	Yes	  	Yes
	 Foreign Travel (Under-developed, unstable or hazardous areas)
	  	None in next 2 years.	  	Yes	  	Yes

  

	•	 *When triglycerides are over 250, disregard elevated Chol/HDL ratios over 6.0

	•	 **Flat extras are allowed on Aviation, Avocations, Driving History, Travel & Occupations

	•	 Foreign Travel - Do not ask in the state of Florida. Residents of the states of California, Colorado,
Connecticut, Georgia, Illinois, Massachusetts, Missouri, New York, New Jersey, Tennessee and Washington cannot have adverse actions taken for future travel. 

  
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Fidelity Life Association 
  

Underwriting Workflow 
 Electronic Application 1045E

 Age nearest birthday 
 Medical Underwriting 

Agent is able to quote Tier 1, 2 or 3 on a non-medical basis and up to Table 8 (H) on a medical basis 

Age/Face Medical Requirements 
 APS Ordering Guidelines 

The medical underwriting has no bearing on the initial face amount. If the Insured is declined or rated beyond a certain Table rating, the initial face amount
stays intact. The all-cause death benefit will never be reduced regardless of the outcome of the medical underwriting.* Upon completion of medical underwriting, the policy’s mix of coverage will be
adjusted based upon the rate class for which the client is approved. 
  

	*	 The only exception is if we uncover something as the result of medical underwriting that indicates the Insured
misrepresented themselves on the initial application. 

 Hybrid Life & Hybrid Medical Life Workflow 

1045E application loaded into the system 

Verified in New Business 

Forwarded to UW Queue for Underwriter – Hybrid Non-Medical 

Underwrite using Tier 1, 2 or 3 guidelines 

Final Decision – Approve/Close/Decline 

If approved, input “Approved Tier 1, 2 or 3” with the date and UW initials 

In the system input Preferred for Tier I, Standard for Tier 2 & Rated for Tier 3 

If approved other than applied (a higher Tier), approve w/modifications 

Please add reason why approved at a different premium class. 

This will generate a “Should we Issue?” requirement for the agent 

An amendment or endorsement is not required for Non-Medical cases if approved at a higher Tier. 

If closed or declined, please be specific. If due to MIB, add category (cardiac, labs, respiratory, etc.) 

Issue & Activate 
 An
automatic letter is sent to the Insured about scheduling their Exam or the agent has ordered at the point of sale (E Financial only). 
 The
Insured has up to 12 months to contact New Business for the exam. 
 New Business will reopen the case, change plan to Hybrid Medical which
automatically orders an appropriate age/amount Paramed requirement and transmits to Portamedic. 

  
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Fidelity Life Association 
  

The case is moved back to the UW Queue, reflecting the previous Tier approval, status changed to Pending Requirements Outstanding and a
“hold” icon

 is displayed. 
 If the original data bureau requirements (MIB/MVR/Rx) are over 90 days old, please re-order and review. 
 FLA does accept medical exams and lab results from other carriers if completed
within 90 days and the tests are identical to FLA’s. We always reserve the right to request our own exam and labs. It is the agent’s responsibility to obtain both parts. 

Once the exam is completed, Heritage sends the exam package to FLA electronically. The status is automatically changed to Pending Requirements
Received and a “high priority” icon

 is displayed. A report will be forwarded to the Underwriters on a daily basis of exams received that day. (24 hour turnaround) 

There is no review of these requirements until the UW reviews them! 

It is up to the UW to make sure all appropriate requirements are attached, all questions are answered and all signatures and dates are
completed. If all the above is verified, only then can the UW mark it as Reviewed. 
 If any of the above is
NOT there, the UW must make a note in the file, email NB as to what is missing and then mark as Partially Received.* This will automatically trigger the file to be added to the New Business (NB) follow-up report. NB reviews the report daily and notifies Portamedic by e-mail of the missing requirements. Once Portamedic has verified the
e-mail, they add an automatic note to the file. The icon on the file will then change to “hold”

.. 
 *After marking the file Partially Received, the UW must Save & Exit.

 if this step is missed, none of the above will happen. 

Once NB has notified Portamedic there is a two day wait. If the missing requirements are not received in 2 days, NB calls Portamedic which
will trigger another automatic note on the file, as to the status of the requirement. (NB will make their own note, just in case). This procedure continues until the requirement is received. Once the requirement is received, the case in the UW queue
will show the “high priority” icon

 which starts the whole process Over again. 
 If repeat labs need to be ordered, New Business will use the
Portamedic website, bring up the Insured’s order and directly email the branch with what is required. Additional specimens need to be ordered through NB, send email with what is needed and NB will reopen the Paramed requirement. Please check
with Home Office before ordering “repeat” specimens. 

  
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Fidelity Life Association 
  

If additional requirements are needed (APS, Insp., etc.), the UW will email Home Office with specifics for Tracy to send the request. The UW
will add the APS requirement on FLAPs to include the Physician’s name. Please use the specific requirement, i.e. APS Medical, APS Age/Amount & APS PIL. 

Do not forget to hit Save & Exit so the

 icon does not show. 
 APS’ are received through Home Office and will be forwarded to the file. 

A daily report will be sent to the UWs working the case. (48 hour turnaround) 

Once approved the UW will input on the Plan Underwriting Screen the approved rate class under the originally approved Tier. 

Tier 1 – Preferred 

Tier 2 – Standard 

Tier 3 – Table D, E, F, G & H 

If approved at a rate class not available in the original Tier, click “No Improvement” on the Plan Underwriting Screen. If the rate
class is over Table H, please add “Uninsurable”. 
 On the Final Decision Screen give details in the Field Message Comments with
the actual approved rate class. Be specific – build of 5’4” 280 lbs, cholesterol of 275 or medical history from APS. 

Add your Internal Comments and click “Submit”. The top portion of this page is already completed for you, there is no need to change
anything. 
 The approvals should be input in both the Field Message and Internal Comments on the Final Decision screen. The agent and New
Business will need to understand both the 1st and 2nd approval notes. 

At issue, New Business will calculate the “All Cause” face amount and ADB split for the approved rate class. If questions, they will
contact the agent via email. 
 A new “Policy Schedule Page” will be sent to the Insured upon issue. 

Amendments cannot be added to Hybrid Medical cases, if one is needed, either endorse or note the system depending on the significance of the
information. 
 If the Insured misrepresented themselves, notify Home Office to process a rescission. 

On the Final Decision screen, input Field Message Comments, Letter & Internal Comments, The top portion of the page is already
completed for you. 

  
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Fidelity Life Association 
  

If a Hybrid Medical is either “No Improvement” or “Uninsurable” the initial policy 

stays intact unless the Insured misrepresented themselves. 

Closed – once Portamedic closes their handling, New Business will automatically be notified and will contact the Insured and try and
reschedule the exam. If unsuccessful, the case will be sent back to the Completed Queue as an “active” Hybrid Non-Medical case. The UW is not responsible for closing out these files. 

Declined – if the Hybrid Medical is a “No Improvement” or “Uninsurable” and the Insured did not misrepresent
themselves the case will be sent back to the Completed Queue as an “active” Hybrid Non-Medical case. The UW will just need to input the Field Message, Internal Comments and Letter #3A. 

Rescissions – if the Insured misrepresented themselves on the original application, the H.O. Underwriter will process a rescission. This
will happen in the case of positive cotinine* on our lab results or medical history that is obtained via the exam or APS which was not admitted on the original application and is an outright decline. The UW would input “No Improvement” on
the case and complete the same process as above. Notify Home Office if you encounter this. 
 Flat Extras 

If the case requires a flat extra for foreign travel, avocation, aviation or driving history and all else okay then Tier 1 plus the flat extra. 

You can add a flat extra on a case that is already a Tier 2 or 3, i.e. Diabetes or Sleep Apnea, etc. 

  
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Fidelity Life Association 
  

Rapid Underwriting System 

(RUS) Workflow 
 Log into system each
morning 
 Pop Up Box when a case is available 

Click on case 
 Advise agent via
“Contact Agent” you are reviewing the file 
 SS Check, MIB, MVR and Rx run automatically 

Review Tabs – Insured, Beneficiary, Coverage, Applicant/Owner and 3rd Party Review Application
(Click button on upper right side of screen) - Pay attention to Additional Comments of the application for details, which might not require a phone interview. 

Interview Needed/Interview Not Completed 

Attempt to call while reviewing case 

Add initial review of case under Underwriter Notes (Note Pad Icon) 

When attempt not successful, add details under Agent Notes (provide your reason for the UI) 

Send a final chat to agent- “Sending the case to Standard Processing to await the UI” 

Click on “Underwriting Decision” 

Click “Needs Review” (will send case to FLAPPs) 

Add additional details under New Business Notes 

Click “Make Decision” 

Interview not Needed/Interview Completed 

Add review of underwriting material under Underwriter Notes (Note Pad Icon) 

If a decision can be made, send final chat to agent with that decision Click on “Underwriting Decision” 

Click option; Approved as Applied, Issue w/Endors., Decline, etc. 

Add final decision under Agent Notes (provide specific details for higher Tier offer). 

Add issue or decline instructions under New Business Notes including the Letter # 

Click “Make Decision” 

NOTE: Once you “Make a Decision” you can no longer “chat” with the agent via RUS. If you would like to communicate w/the
agent you can e-mail or call them via the “Contact Agent” information listed on RUS. 

  
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Case now sent via Standard Processing to FLAPPs 

If case (“Needs Review”) is still pending for outstanding requirements – New Business will copy and paste the notes from RUS and
email the assigned RUS Underwriter when the case is in UW Queue 
 If case has final decision – file will automatically be sent to the
Issue Queue 
 REMINDERS: 
 It is very important that
you select “Needs Review” if you are sending a case to Standard Processing. This plan type is the only way that New Business knows to copy/paste the notes for you. If you select another option, the case will not show up on her report and
might be subject to another TPU UW taking the ease and underwriting it a second time. New Business does have access (as do all of the New Business reps) to RUS and copying/pasting the notes into an e-mail to
her is no longer necessary. 
 If you send a case to Standard Processing and you do not see that it has made it to FLAPPS, please send an e-mail to New Business and cc Underwriting at und@fidelitylife.com. They will investigate why the case has not been moved along to Underwriting in FLAPPS. We will also monitor those rare cases to make sure
they are moving along. This has occurred before and we have had to manually push the case through. 
 If a case has been sent to Standard Processing to
await an UI and the person calls you right back, you can still access your case on RUS. It might be in transition to FLAPPS (so not yet on that system). You can view all notes, requirements, application etc. on RUS even if you are not the assigned
UW. You have to log into RUS as “Reviewer” and look up the case by name or policy number. 
 Note: Cases that go through Standard Processing might
take several hours to show up on FLAPPS. 

  
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Fidelity Life Association 
  

COMMON AVIATION SITUATIONS 
  

 

			
	 Commercial Aviation
	  	
	 Major scheduled airline pilots and crew members*
	  	Rating or Best Possible Class
	 At least one base in U.S. or Canada
	  	Select
	 Others
	  	2.50 per $1,000
		
	 Nonscheduled commercial pilots and crew members flying well-maintained company-owned multi-engine
planes on company business*
	  	Standard
		
	 Nonscheduled airline pilots and crew members flying
multi-engine
	  	
	 Commercial passenger and cargo planes
	  	
	 Based in the U.S. or Canada
	  	Select
	 Others
	  	3.00 per $1,000 and up. IC
		
	 Nonscheduled single engine pilots and crew members
	  	IC
		
	 Traffic reporting
	  	Standard
	
	 Private Aviation

	 Private pilots flying factory built fixed wing aircraft
	  	
	 Student pilots or less than 75 hr solo experience 75–400 hr solo experience
	  	2.50 per $1,000
	 Flying up to 200 hr per yr
	  	Standard
	 Flying over 200 hr per yr
	  	2.50 per $1,000
	 Over 400 hr solo experience
	  	
	 Flying up to 300 hr per yr
	  	Standard
	 Flying over 300 hr per yr
	  	2.50 per $1,000
		
	 Helicopters
	  	IC
		
	 Homebuilt aircraft
	  	Decline
		
	 Glider Pilots
	  	
	 Student pilots or less than 25 hr solo experience
	  	2.50 per $1,000
	 At least 25 hr solo experience
	  	Standard
		
	 Ultralites
	  	Decline

  

	*	 lf the airline is not one of the major airlines; American, United etc. and they are based in rural areas,
please investigate to make sure the airline does not participate in any aerial fire fighting. If they do, please complete an Interview and question the Insured to see if they are involved in activity. 

  
 Page 12 of 24 

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Fidelity Life Association 
  

FOREIGN TRAVEL 
  

The factors that affect consideration of applicants who plan foreign travel can change very quickly. These guidelines are not a substitute for common sense.
The current political, environmental, military, criminal and health factors for each country or area where travel is contemplated must be considered. 

Always check the Reinsurer’s Guide for current criteria. The State Department web site (www.travel.state.gov/travel warnings) is also a good
source for any travel warnings. If present, coverage is not available. 
 The following guidelines apply to U.S. citizens traveling abroad. Permanent
Residents (Green Card holders) will be considered only if proposed travel is to A+ or A areas only. 
 Foreign Travel Defined: 

 

	 	a.	 A single trip for vacation of 30 days or less. 

 

	 	b.	 Business travel totaling not more than 90 days per year and not more than four weeks at a time.

  

	 	c.	 Longer periods of travel (4-6 months) should be classified as Foreign
Residence and rated appropriately. Use your judgement, depending on where traveling. 

 Occupations: 

Where business travel is indicated and the occupation does not appear to be appropriate (i.e.: janitor) an explanation should be requested.

 Travel by Missionaries (and related religious activities), Diplomats, Journalists, Archeologists, Geologists, Volunteer and Foreign Aid
workers will not be considered. Military and US State Department personnel may be considered on an individual basis. 
 Vacation: 

Travel to resort destinations is usually considered at best class. The same holds true for cruise ships which have ports of call in
areas of moderate concern. 
 Visits to “family” should not be considered as true vacation travel and should be handled strictly in
accordance with the area classification. 
 Country Classifications 

The underwriter needs to begin by checking the appropriate reinsurance guide to determine the acceptability of any country or area. 

Beyond that, however, the underwriter is expected to be aware of and/or to carefully check available resources for current hazards related to
travel plans for each applicant. 

  
 Page 13 of 24 

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Fidelity Life Association 
  

Country Guide 
  

															
	 Rating Key:
	  				  				  	
	A+	 	-	 	 Preferred
	  	 	A	 	  	 	-	 	  	Standard
	B	 	-	 	 $1.50/1000
	  	 	C	 	  	 	-	 	  	$3/1000
	D	 	-	 	 $5/1000
	  	 	E	 	  	 	-	 	  	Minimum of $7.50/1000
	U	 	-	 	 Uninsurable
	  				  				  	

 Subject to change without notice. 

 

							
	 Country
	  	Rating	  	Congo, Republic of	  	U
	 Afghanistan
	  	U	  	Cook Islands	  	C
	 Albania
	  	U	  	Costa Rica	  	A
	 Algeria
	  	U	  	Croatia	  	U
	 Andorra
	  	A+	  	Cuba	  	U
	 Angola
	  	U	  	Curacao	  	A
	 Anguilla
	  	A	  	Cyprus	  	C
	 Antigua
	  	A	  	Czech Republic	  	B
	 Argentina
	  	A	  	Denmark	  	A+
	 Armenia
	  	U	  	Djibouti	  	U
	 Aruba
	  	A	  	Dominica	  	B
	 Australia
	  	A+	  	Dominican Republic	  	B
	 Austria
	  	A+	  	Ecuador	  	A
	 Azerbaijan
	  	U	  	Egypt	  	U
	 Bahamas
	  	A	  	El Salvador	  	D
	 Bahrain
	  	U	  	England	  	A+
	 Bangladesh
	  	U	  	Equatorial Guinea	  	U
	 Barbados
	  	A	  	Eritrea	  	U
	 Barbuda
	  	A	  	Estonia	  	D
	 Belarus
	  	U	  	Ethiopia	  	U
	 Belgium
	  	A+	  	Fiji	  	C
	 Belize
	  	A	  	Finland	  	A+
	 Benin
	  	U	  	France	  	A+
	 Bermuda
	  	A+	  	French Guiana	  	D
	 Bhutan
	  	U	  	French Polynesia	  	C
	 Bolivia
	  	U	  	Gabon	  	U
	 Bosnia Herzegovina
	  	U	  	Gambia	  	U
	 Botswana
	  	U	  	Georgia	  	U
	 Brazil
	  	A	  	Germany	  	A+
	 Brunel
	  	A	  	Ghana	  	U
	 Bulgaria
	  	E	  	Gibraltar	  	A
	 Burkino Faso
	  	U	  	Greece	  	A
	 Burundi
	  	U	  	Greenland	  	A+
	 Caicos Islands
	  	A	  	Grenada	  	A
	 Cambodia
	  	U	  	Grenadines	  	A
	 Cameroon
	  	U	  	Guadeloupe	  	A
	 Canada
	  	A+	  	Guam	  	A
	 Canary Islands
	  	A+	  	Guatemala	  	D
	 Cape Verde Islands
	  	A	  	Guinea	  	U
	 Cayman Islands
	  	A	  	Guinea-Bissau	  	U
	 Central African Republic
	  	U	  	Guyana	  	U
	 Chad
	  	U	  	Haiti	  	U
	 Chile
	  	A	  	Honduras	  	C
	 China
	  	D***	  	Hong Kong	  	A
	 Colombia
	  	U	  	Hungary	  	B
	 Comoros
	  	U	  	Iceland	  	A+
	 Congo, Democratic Republic
	  	U	  	India	  	D****

  
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Fidelity Life Association 
  

							
	 Indonesia
	  	E	  	Niger	  	U
	 Iran
	  	U	  	Nigeria	  	U
	 Iraq
	  	U	  	Nive	  	U
	 Ireland
	  	A+	  	Northern Marianas	  	A
	 Israel
	  	U	  	Norway	  	A+
	 Italy
	  	A+	  	Oman	  	U
	 Ivory Coast
	  	U	  	Pakistan	  	U
	 Jamaica
	  	A	  	Palao	  	U
	 Japan
	  	A+	  	Panama	  	B
	 Jordan
	  	U	  	Paraguay	  	B
	 Kazakhstan
	  	U	  	Peru	  	C
	 Kenya
	  	U	  	Philippines	  	U*
	 Kiribati
	  	U	  	Poland	  	B
	 Korea, North
	  	U	  	Portugal	  	A+
	 Korea, South
	  	A	  	Puerto Rico	  	A
	 Kuwait
	  	U	  	Qatar	  	U
	 Kyrgystan
	  	U	  	Romania	  	E
	 Laos
	  	U	  	Russia	  	U*
	 Latvia
	  	C	  	Rwanda	  	U
	 Lebanon
	  	U	  	Samoa	  	B
	 Lesotho
	  	U	  	San Marino	  	A+
	 Liberia
	  	U	  	Sao Tome and Principe	  	U
	 Libya
	  	U	  	Saudi Arabia	  	U
	 Liechtenstein
	  	A+	  	Scotland	  	A+
	 Lithuania
	  	C	  	Senegal	  	U
	 Luxembourg
	  	A+	  	Serbia	  	U
	 Macau
	  	B	  	Seychelles	  	B
	 Macedonia
	  	U	  	Sierra Leone	  	U
	 Madagascar
	  	U	  	Singapore	  	A
	 Madeira
	  	B	  	Slovak Republic	  	B
	 Malawi
	  	U	  	Slovenia	  	U
	 Malaysia
	  	B	  	Solomon Islands	  	U
	 Maldives
	  	E	  	Somalia	  	U
	 Mali
	  	U	  	South Africa	  	D
	 Malta
	  	A	  	Spain	  	A+
	 Marshall Islands
	  	D	  	Sri Lanka	  	U
	 Martinique
	  	A	  	St. Barthelemey	  	B
	 Mauritania
	  	U	  	St. John	  	A
	 Mauritius
	  	C	  	St. Kitts	  	A
	 Mexico
	  	A	  	St. Lucia	  	A
	 Micronesia
	  	C	  	St. Martin	  	A
	 Monaco
	  	A+	  	St. Nevis	  	A
	 Mongolia
	  	U	  	St. Thomas	  	A
	 Monserrat
	  	B	  	St. Vincent	  	A
	 Montenegro
	  	U	  	Sudan	  	U
	 Morocco
	  	U	  	Surinam	  	E
	 Mozambique
	  	U	  	Swaziland	  	U
	 Myanmar (Burma)
	  	U	  	Sweden	  	A+
	 Namibia
	  	U	  	Switzerland	  	A+
	 Nauru
	  	E	  	Syria	  	U
	 Nepal
	  	U	  	Taiwan	  	A
	 Netherlands (Holland)
	  	A+	  	Tajikistan	  	U
	 Netherlands Antilles
	  	A	  	Tanzania	  	U
	 New Caledonia
	  	B	  	Thailand	  	U**
	 New Guinea
	  	D	  	Tibet	  	U
	 New Zealand
	  	A+	  	Tobago	  	A
	 Nicaragua
	  	D	  	Togo	  	U

  
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Fidelity Life Association 
  

 

					
	 Tokelau
	  	U	  	
	 Tonga

Trinidad
	  	 U
 A
	  	 NOTE: Flat extras up to $7.50/1,000 are allowed for Hybrid Life. (i.e. STD with the flat extra must be added
to the Plan Underwriting Screen if a flat extra applies.)
  

Flat extras over $7.50/$1,000 will be declined for Hybrid Life.

	 Tunisia
	  	U
	 Turkey
	  	U
	 Turkmenistan
	  	U
	 Turks
	  	A
	 Tuvala
	  	U
	 Uganda
	  	U
	 Ukraine
	  	E
	 United Arab Emirates
	  	U
	 United Kingdom
	  	A+
	 United States
	  	A
	 Uruguay
	  	A
	 US - Protectorates, etc.
	  	A
	 Uzbekistan
	  	U
	 Vanuatu
	  	C
	 Vatican City
	  	A	  	
	 Venezuela (all other locations)
	  	E	  	
	 Venezuela (to a major city by
	  		  	
	 Venezuelan Nationals only)
	  	A*	  	
	 Vietnam
	  	U	  	
	 Virgin Islands
	  	A	  	
	 Wales
	  	A+	  	
	 Western Sahara
	  	U	  	
	 Yemen
	  	U	  	
	 Yugoslavia
	  	U	  	
	 Zambia
	  	U	  	
	 Zimbabwe
	  	U	  	

  

	•	 	 Philippines: Luzon and major cities will be considered on an individual case basis. 

 

	•	 	  

	 	**	 Thailand: Bangkok will be a ”D”. 

	 	***	 China: Major cities – 

Beijing, Guangzhou, Hangzhou, Shanghai and Shenzhen will be a “C”. 

 

	•	 	 **** India: Travel to Mumbai, Calcutta, Hyderabad, New Delhi, and Bangalore will be a “D”, all other
locations in India are a decline. 

  

	•	 	 Russia: St. Petersburg and Moscow may qualify for an “E” classification subject to
consideration. Both cities will be limited to a maximum face amount of $1 million. 

 Rating Key: 

 

					
	A+	  	-	  	Preferred
	A	  	-	  	Standard
	B	  	-	  	$1.50/1000
	C	  	-	  	$3/1000
	D	  	-	  	$5/1000
	E	  	-	  	Minimum of $7.50/1000
	U	  	-	  	Uninsurable

  
 Page 16 of 24 

 STATE LAWS & FOREIGN TRAVEL 

Several states have enacted legislation prohibiting the use of information regarding planned foreign travel in the evaluation of the risk. Effective
immediately, travel information developed on any application in the following states should not be used as a basis for adverse action. 

California 
 Colorado 

Connecticut 
 Florida 

Georgia 
 Illinois 

Maryland 
 Massachusetts 

Missouri 
 New Jersey 

New York 
 Tennessee 

Washington 
 If the underwriter is aware of
foreign travel plans which would otherwise be of concern, a note should be added to the file indicating that their travel information is being ignored in accordance with state statute. 

Exclusions: Politicians, Public Figures, Missionaries, Government Leaders, Elected Officials, Journalists, Judicial Policy, Trade Union Officials, Military
Personnel, Prominent Individuals, Former Elected Officials and close family members of the Politicians. 
 The prohibition against the use of travel plans
in the underwriting process does not apply to foreign residence, only foreign travel. For this reason, the travel question, as it currently exists on our applications must be answered. The question includes a reference to foreign residence
and this information must be provided. 
 Travel over 4-6 months is considered foreign residency and should be rated accordingly. 

  

 Hybrid Life Underwriting Guide 1/2012 

 
 FOREIGN NATIONALS 

 
 The standard requirement for our business is that the
Proposed Insured must be a US citizen, living in the United States or, a Permanent Resident (green card holder) living in the United States. Canadians and European citizens must have a green card to qualify. 

In some cases, a US citizen living outside the United States on a temporary basis might be considered if they are residing in a low risk country. The
temporary residency must be for a period of 90 days or less. Where a longer period of time is anticipated or where the total amount of time living outside the United States will exceed 4 months per year, the case, if consideration is warranted, must
be referred to our reinsurer on a facultative basis. 
 Temporary Residents 

In general, applicants living in the United States on a basis of a visa cannot be considered. For fully examined business, applicants (and
family members living with them) residing in the United States on H1B visas and who are from a low risk country can be considered on an individual basis. 

If there is any question whatsoever regarding the applicant’s status, the underwriter should feel free to investigate without apology.

 SSN Check 
 When the SSN is checked, the date of
issue must make sense compared to the DOB of the applicant and or their resident status. 
 Citizenship: 

INS regulations state that in order to be eligible for citizenship the applicant; 

 

	 	1.	 Must have been a permanent resident for at least 5 years. 

or 
  

	 	2.	 Must have been married to a US citizen for at least 3 years. 

or 
  

	 	3.	 Must have served in the US military for at least 1 year. 

Immigrants whose SSN was issued outside these guidelines and who claim to be citizens will be investigated. 

  
 Page 18 of 24 

 Hybrid Life Underwriting Guide 1/2012 

 
 MVR 

Mortality associated with an adverse driving record is significant. Where multiple infractions exist the underwriter should consider adding additional debits
to those shown. 
  

																					
	 Points Chart
	 
	
Violation1
	  	Points for Each Incident from Date of Violation2	 
	 	  	0-1 year	 	  	1-2 years	 	  	2-3 years	 	  	3-4 years	 	  	4-5 years	 
	 DUI (single incident)
	  	 	12	 	  	 	8	 	  	 	6	 	  	 	4	 	  	 	2	 
	 License suspended or revoked
	  	 	8	 	  	 	8	 	  	 	6	 	  	 	4	 	  	 	2	 
	 Reckless or negligent Driving
	  	 	7	 	  	 	5	 	  	 	3	 	  	 	2	 	  	 	1	 
	 Major accident (at fault/injury)
	  	 	5	 	  	 	4	 	  	 	2	 	  	 	1	 	  	 	0	 
	 Speeding = 15 mph over maximum posted limit or > 85 mph
	  	 	4	 	  	 	3	 	  	 	2	 	  	 	1	 	  	 	0	 
	 Speeding <15 mph over maximum posted limit or unspecified
	  	 	2	 	  	 	1	 	  	 	1	 	  	 	0	 	  	 	0	 
	 Other moving violations (i.e., careless driving, Improper turn, disregarding traffic device, lane
violation, failure to yield, minor accident)
	  	 	2	 	  	 	1	 	  	 	1	 	  	 	0	 	  	 	0	 

  

	1 	 The underwriter should view the MVR as reflecting the most favorable information about the client’s
driving habits. If there are any discrepancies with Information on the application, inspection report or APS, further investigation may be needed to obtain an accurate picture. In assessing the accident risk, it is important to consider not only the
motor vehicle record but the entire profile, including any habits criticism, avocations, indication of immaturity, instability or risk-taking behavior, as well as medical impairments. 

	2 	 It may be appropriate to combine points if the applicant is charged with more than one violation per incident
(e.g., speeding and an accident). 

  

			
	 Rating Chart

	 Total Points
	  	
Annual Extra Premium/$1,000 of Face Amount

	 0-6
	  	+0
	 7-9
	  	$2.50/M - $3.50/M
	 10-11
	  	$5.00/M - $6.00/M
	 12-13
	  	$7.50/M -  $10.00/M
	 14 or more
	  	Decline

  

			
	 Modifying Factors

	 Multiple DUIs, revocations or suspensions; license not currently valid due to multiple moving
violations
	  	Decline
	 Criticism regarding habits, avocations, maturity (lack of), instability, risk-taking behavior or
medical impairments
	  	IC
	 Motorcycle violations
	  	Use higher rating
	 Over age 70
	  	Use higher rating
	 Multiple violations within 2 years, OR driving in a high risk state (Alabama, Arizona, Arkansas,
Kentucky, Mississippi, Montana, Nevada, New Mexico, Oklahoma and South Carolina), OR male gender, OR under age 25
	  	Use higher rating

 Multiple suspensions do not apply to non-moving violations (child
support, emissions, etc.) 
 No DUI within 1 year! 

  
 Page 19 of 24 

 Hybrid Life Underwriting Guide 1/2012 

 
 MVR RATING SCHEDULE 

 
 Driving Rating 

 

	 	a.	 If MPH unknown, assume 15–29 over limit. 

 

	 	b.	 When ticketed for more than one violation at the same time, assign only the highest point.

  

	 	c.	 Option riders to increase coverage, ADB and WP Riders are not available when ratable. 

MVR Rating Schedule 
  

									
	 	 	Total Rating Points	  	 	  	Life	 	 
		 	 0-6 points

0 dbts
	  		  	Tier 1, 2 or 3	 	
		 	 7-9 points

$1.00 - $3.50 FE
	  		  	Tier 1, 2 or 3	 	
		 	 10-11 points

$5.00 - $6.00 FE
	  		  	Tier 1, 2 or 3	 	
		 	 12 points

$7.50 FE
	  		  	Tier 1, 2 or 3	 	
		 	 Over 12 points
	  		  	Decline*	 	

  

	*	 We accept up to $7.50 per $1,000 flat extras for driving history 

  
 Page 20 of 21 

 Hybrid Life Underwriting Guide 1/2012 

 
 DRIVER’S LICENSE STATUS 

One of the key elements in the Hybrid Life process is the information obtained from the client’s Motor Vehicle Record. Without this information our
assessment is incomplete. If the driver’s license is from a state other than the residence state, it will require an interview to as to why. We will accept a driver’s license from a state other than a residence state if a clean MVR form
the Driver’s License state. 
 We will accept a Hybrid application even if the Proposed Insured cannot provide a valid U.S. driver’s license, but
can provide a state ID number. 
 NOTE: This restriction does not apply to our Graded Death Benefit products. 

Where the license is currently “not valid”: 
  

					
	DUI or Reckless Driving	  	Decline	  	
	Tickets	  	Decline	  	
	Financial Responsibility	  	Decline	  	
	Revoked	  	Decline	  	
	Reason Unknown	  	Decline	  	
			
	Expired Tag or License	  	Eligible**	  	
	Child Support	  	Eligible**	  	
	No Insurance	  	Eligible**	  	
	Court Costs or No Show	  	Eligible**	  	
	Emission Testing	  	Eligible**	  	

  

	**	 If reasonable explanation, Individual Consideration. 

  
 Page 21 of 24 

 Hybrid Life Underwriting Guide 1/2012 

 
 MVR Reports 

Moving vs Non-Moving Violations 

Moving Violation – traffic violation committed by a moving vehicle 

Non-Moving Violation – related to a car that is not in motion 

Moving Violations 
 Speeding 

Accidents 
 Improper Passing 

Reckless/Careless Driving 

Driving while license expired, suspended or revoked 

Driving in wrong direction 

Improper Lane Usage 
 Following to
closely 
 Driving too fast for conditions 

Red Light or Stop Sign violation 

Cell Phone Use (if illegal in that city/state) 

No Seat Belt 
 No Child Restraint

 Non-Moving Violations 

No Insurance 
 Expired Tag 

Parking Violations 
 Faulty
Equipment or Illegal Vehicle Modifications 

  
 Page 22 of 24 

 Hybrid Life Underwriting Guide 1/2012 

 
  
 Financial
Underwriting 
 Please use the following factors for determining the amount of personal insurance available to applicants. 

 

									
	 Age
	  	Earned Income
(Taxable Income/Wages*)
Factor	 	  	Unearned Income
(DI, Pension, SSI, etc.)
Factor	 
	 20 - 30
	  	 	30	 	  	 	3	 
	 31 - 40
	  	 	25	 	  	 	3	 
	 41 - 50
	  	 	20	 	  	 	3	 
	 51 - 65
	  	 	15	 	  	 	3	 

 As always, underwriter discretion (allowing more or less coverage) may be applied provided documented justification is
properly added to the file using an “exception” note. 
  

	*	 Also Includes deferred compensation and other employee benefits that will cease upon the Insured’s
death. 

     Examples: Government and/or Teacher pensions 

Insurable Interest 
 Owners and beneficiaries need to make
sense. The owner should usually be the insured, spouse or employer. The beneficiary should have a reasonable relationship with the insured and appropriate financial/emotional loss upon the insured’s death. We need to conduct an underwriting
interview on questionable cases. 
 Family Income 
 An
unemployed spouse may have an amount equal to that in force (or applied for) on the employed spouse up to $300,000. For amounts over that, the unemployed spouse is usually limited to 50% of the amount in force (applied for) on the employed spouse.
Homemakers are okay without an interview at 50% of the amount the working spouse has in force, providing the spouse or children are primary beneficiaries. 

Occupations 
 The occupation in general should be
questioned if listed as retired and under age 55, self-employed, independent contractor, consultant or sales with no company name listed and/or unemployed. Full-time professional athletes or entertainers are not acceptable for this product. 

Student Coverage 
 Our general guideline is $100,000 on
High School Students-Trade School Students, $200,000 for College-University Students and $300,000 for Post Graduate Students (Masters, Ph.D. Medical School or Law School). We do have exceptions to this guideline. 

Military** 
 Military personnel are evaluated based on
what they do not their rank/grade. We do not offer coverage to combat specialists, members of combat teams, hazardous military occupations and recruits or enlisted Grades 1 though 4. 

Military risks serving in, or alerted for service in areas of conflict or potential conflict are not acceptable. 

**Please interview all military occupations! 

  
 Page 23 of 24 

 Hybrid Life Underwriting Guide 1/2012 

 
  

Attachments 
 Current Build Chart

 Quoting Chart 
 Unacceptable
Impairments 
 Misc. & Pharmacy 

  
 Page 24 of 24 

																					
	 Height
	  	Minimum	 	  	Maximum
Select	 	  	Maximum
Standard
(T1-T2)	 	  	Maximum
T3-T4	 	  	Maximum
T5 T8	 
	 4’ 9
	  	 	76	 	  	 	153	 	  	 	176	 	  	 	185	 	  	 	208	 
	 4’ 10
	  	 	79	 	  	 	158	 	  	 	182	 	  	 	191	 	  	 	215	 
	 4’ 11
	  	 	82	 	  	 	163	 	  	 	188	 	  	 	198	 	  	 	223	 
	 5’ 0
	  	 	84	 	  	 	169	 	  	 	195	 	  	 	205	 	  	 	230	 
	 5’ 1
	  	 	87	 	  	 	175	 	  	 	201	 	  	 	212	 	  	 	238	 
	 5’ 2
	  	 	90	 	  	 	180	 	  	 	208	 	  	 	219	 	  	 	246	 
	 5’ 3
	  	 	93	 	  	 	186	 	  	 	215	 	  	 	226	 	  	 	254	 
	 5’ 4
	  	 	96	 	  	 	192	 	  	 	221	 	  	 	233	 	  	 	262	 
	 5’ 5
	  	 	99	 	  	 	198	 	  	 	228	 	  	 	240	 	  	 	270	 
	 5’ 6
	  	 	102	 	  	 	204	 	  	 	235	 	  	 	248	 	  	 	279	 
	 5’ 7
	  	 	105	 	  	 	211	 	  	 	243	 	  	 	255	 	  	 	287	 
	 5’ 8
	  	 	109	 	  	 	217	 	  	 	250	 	  	 	263	 	  	 	296	 
	 5’ 9
	  	 	112	 	  	 	223	 	  	 	257	 	  	 	271	 	  	 	305	 
	 5’ 10
	  	 	115	 	  	 	230	 	  	 	265	 	  	 	279	 	  	 	314	 
	 5’ 11
	  	 	118	 	  	 	237	 	  	 	272	 	  	 	287	 	  	 	323	 
	 6’ 0
	  	 	122	 	  	 	243	 	  	 	280	 	  	 	295	 	  	 	332	 
	 6’ 1
	  	 	125	 	  	 	250	 	  	 	288	 	  	 	303	 	  	 	341	 
	 6’ 2
	  	 	129	 	  	 	257	 	  	 	296	 	  	 	312	 	  	 	351	 
	 6’ 3
	  	 	132	 	  	 	264	 	  	 	304	 	  	 	320	 	  	 	360	 
	 6’ 4
	  	 	136	 	  	 	271	 	  	 	312	 	  	 	329	 	  	 	370	 
	 6’ 5
	  	 	139	 	  	 	278	 	  	 	320	 	  	 	337	 	  	 	380	 
	 6’ 6
	  	 	143	 	  	 	286	 	  	 	329	 	  	 	346	 	  	 	389	 
	 6’ 7
	  	 	146	 	  	 	293	 	  	 	337	 	  	 	355	 	  	 	399	 
	 6’ 8
	  	 	150	 	  	 	300	 	  	 	346	 	  	 	364	 	  	 	410	 
	 6’ 9
	  	 	159	 	  	 	308	 	  	 	355	 	  	 	373	 	  	 	420	 
	 6’ 10
	  	 	163	 	  	 	316	 	  	 	363	 	  	 	383	 	  	 	430	 
		  				  	  
	  
	 	  	  
	  
	 	  	  
	  
	 	  	  
	  
	 
	 BMI
	  				  	 	33	 	  	 	38	 	  	 	40	 	  	 	45	 

 BMI over 45 will be declined. 

Using the Hybrid terminology, it reduces to: 
  

																	
	 Height
	  	Minimum	 	  	Maximum
Tier 1	 	  	Maximum
Tier 2	 	  	Maximum
Tier 3	 
	 4’ 8
	  	 	73	 	  	 	170	 	  	 	179	 	  	 	202	 
	 4’ 9
	  	 	76	 	  	 	176	 	  	 	185	 	  	 	208	 
	 4’ 10
	  	 	79	 	  	 	182	 	  	 	191	 	  	 	215	 
	 4’ 11
	  	 	82	 	  	 	188	 	  	 	198	 	  	 	223	 
	 5’ 0
	  	 	84	 	  	 	195	 	  	 	205	 	  	 	230	 
	 5’ 1
	  	 	87	 	  	 	201	 	  	 	212	 	  	 	238	 
	 5’ 2
	  	 	90	 	  	 	208	 	  	 	219	 	  	 	246	 
	 5’ 3
	  	 	93	 	  	 	215	 	  	 	226	 	  	 	254	 
	 5’ 4
	  	 	96	 	  	 	221	 	  	 	233	 	  	 	262	 
	 5’ 5
	  	 	99	 	  	 	228	 	  	 	240	 	  	 	270	 
	 5’ 6
	  	 	102	 	  	 	235	 	  	 	248	 	  	 	279	 
	 5’ 7
	  	 	105	 	  	 	243	 	  	 	255	 	  	 	287	 
	 5’ 8
	  	 	109	 	  	 	250	 	  	 	263	 	  	 	296	 
	 5’ 9
	  	 	112	 	  	 	257	 	  	 	271	 	  	 	305	 

																	
	 5’ 10
	  	 	115	 	  	 	265	 	  	 	279	 	  	 	314	 
	 5’ 11
	  	 	118	 	  	 	272	 	  	 	287	 	  	 	323	 
	 6’ 0
	  	 	122	 	  	 	280	 	  	 	295	 	  	 	332	 
	 6’ 1
	  	 	125	 	  	 	288	 	  	 	303	 	  	 	341	 
	 6’ 2
	  	 	129	 	  	 	296	 	  	 	312	 	  	 	351	 
	 6’ 3
	  	 	132	 	  	 	304	 	  	 	320	 	  	 	360	 
	 6’ 4
	  	 	136	 	  	 	312	 	  	 	329	 	  	 	370	 
	 6’ 5
	  	 	139	 	  	 	320	 	  	 	337	 	  	 	380	 
	 6’ 6
	  	 	143	 	  	 	329	 	  	 	346	 	  	 	389	 
	 6’ 7
	  	 	146	 	  	 	337	 	  	 	355	 	  	 	399	 
	 6’ 8
	  	 	150	 	  	 	346	 	  	 	364	 	  	 	410	 
	 6’ 9
	  	 	159	 	  	 	355	 	  	 	373	 	  	 	420	 
	 6’10
	  	 	163	 	  	 	363	 	  	 	383	 	  	 	430	 

 AMENDMENT I 

TO THE REINSURANCE AGREEMENT 

between 
 FIDELITY LIFE
ASSOCIATION 
 (the “Company”) 

and 
 HANNOVER LIFE REASSURANCE
COMPANY OF AMERICA 
 (the “Reinsurer”) 

This Amendment is to be attached to and made a part of the Automatic Coinsurance Reinsurance Agreement which became effective on January 1, 2012. All
provisions of the Reinsurance Agreement not in conflict with the provisions of this Amendment shall remain unchanged. 
 The Amendment shall add the
following: 
 Exhibit E - Hybrid Term Allowances, for new business issued on or after January 20, 2014 (includes back dated and forward dated policies with
issue dates January 20, 2014 and later). 
 Exhibit F - The use of the Company’s updated underwriting guidelines, Hybrid Life Underwriting Guide
08/2013. 
 In witness of the above, this Amendment is signed in duplicate at the dates and places indicated with an effective date of
January 20, 2014. 
  

									
	FIDELITY LIFE ASSOCIATION	 		 	
	Chicago, Illinois	 		 	
					
	By:	 	 /s/ James Harkensee
	 		 	By:	 	 /s/ Daniel Cotter

	Title:	 	President, COO	 		 	Title:	 	Vice President GC, Secretary
	Date:	 	3/12/2014	 		 	Date:	 	3/13/14

  

									
	 HANNOVER LIFE REASSURANCE COMPANY OF AMERICA

Orlando, Florida 

					
	By:	 	UNDICIPHERABLE	 		 	By:	 	UNDICIPHERABLE
	Title:	 	 AVP, Marketing
	 		 	Title:	 	 VP

	Date:	 	3/14/14	 		 	Date:	 	3/14/14

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

 EXHIBIT E 

Hybrid Term Allowances 
  

			
	10 Year Term - MED	  	1/20/2014

  

																			
	 Class
	  	Gender	  	Band	 	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Preferred Non-nicotine
	  	Female	  	 	Band 1	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	 	Band 1	 	  	2-10	  	62.3	  	59.4	  	54.9	  	32.1	  	7.8
	 Preferred Non-nicotine
	  	Female	  	 	Band 1	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	 	Band 2	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	 	Band 2	 	  	2-10	  	60	  	57.1	  	39.2	  	18.8	  	4.4
	 Preferred Non-nicotine
	  	Female	  	 	Band 2	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	 	Band 3	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	 	Band 3	 	  	2-10	  	46.4	  	23.5	  	12.3	  	4.4	  	4.4
	 Preferred Non-nicotine
	  	Female	  	 	Band 3	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	 	Band 4	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	 	Band 4	 	  	2-10	  	14.7	  	6.7	  	4.5	  	4.4	  	4.4
	 Preferred Non-nicotine
	  	Female	  	 	Band 4	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	 	Band 5	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	 	Band 5	 	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Preferred Non-nicotine
	  	Female	  	 	Band 5	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	 	Band 1	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	 	Band 1	 	  	2-10	  	62.3	  	54.9	  	40.3	  	25.5	  	18.8
	 Preferred Non-nicotine
	  	Male	  	 	Band 1	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	 	Band 2	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	 	Band 2	 	  	2-10	  	53.2	  	44.8	  	23.5	  	15.5	  	11.1
	 Preferred Non-nicotine
	  	Male	  	 	Band 2	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	 	Band 3	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	 	Band 3	 	  	2-10	  	26	  	14.6	  	4.5	  	4.4	  	4.4
	 Preferred Non-nicotine
	  	Male	  	 	Band 3	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	 	Band 4	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	 	Band 4	 	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Preferred non-nicotine
	  	Male	  	 	Band 4	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	 	Band 5	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	 	Band 5	 	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Preferred Non-nicotine
	  	Male	  	 	Band 5	 	  	11+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	10 Year Term - MED	 	1/20/2014

  

																			
	 Class
	  	Gender	  	Band	 	  	Duration	  	18 -29	  	30-39	  	40-49	  	50-59	  	60-65
	 Standard Non-nicotine
	  	Female	  	 	Band 1	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	 	Band 1	 	  	2-10	  	64.5	  	51.5	  	40.3	  	15.5	  	8.9
	 Standard Non-nicotine
	  	Female	  	 	Band 1	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	 	Band 2	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	 	Band 2	 	  	2-10	  	64.5	  	40.3	  	23.5	  	4.4	  	15.5
	 Standard Non-nicotine
	  	Female	  	 	Band 2	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	 	Band 3	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	 	Band 3	 	  	2-10	  	47.5	  	21.3	  	12.3	  	4.4	  	8.9
	 Standard Non-nicotine
	  	Female	  	 	Band 3	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	 	Band 4	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	 	Band 4	 	  	2-10	  	23.8	  	4.5	  	4.5	  	4.4	  	4.4
	 Standard Non-nicotine
	  	Female	  	 	Band 4	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	 	Band 5	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	 	Band 5	 	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Standard Non-nicotine
	  	Female	  	 	Band 5	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	 	Band 1	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	 	Band 1	 	  	2-10	  	61.1	  	48.2	  	30.2	  	15.5	  	15.5
	 Standard Non-nicotine
	  	Male	  	 	Band 1	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	 	Band 2	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	 	Band 2	 	  	2-10	  	46.4	  	28	  	14.6	  	5.5	  	5.5
	 Standard Non-nicotine
	  	Male	  	 	Band 2	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	 	Band 3	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	 	Band 3	 	  	2-10	  	23.8	  	12.3	  	4.5	  	4.4	  	4.4
	 Standard Non-nicotine
	  	Male	  	 	Band 3	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	 	Band 4	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	 	Band 4	 	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Standard Non-nicotine
	  	Male	  	 	Band 4	 	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	 	Band 5	 	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	 	Band 5	 	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Standard Non-nicotine
	  	Male	  	 	Band 5	 	  	11+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	10 Year Term - MED	  	1/20/2014

  

																	
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-10	  	71.3	  	51.5	  	34.7	  	16.6	  	6.6
	 Preferred Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-10	  	62.3	  	39.2	  	23.5	  	10	  	4.4
	 Preferred Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-10	  	60	  	31.4	  	19	  	16.6	  	6.6
	 Preferred Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-10	  	35.1	  	20.2	  	6.7	  	4.4	  	4.4
	 Preferred Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Preferred Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-10	  	55.5	  	44.8	  	17.9	  	12.2	  	8.9
	 Preferred Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-10	  	41.9	  	24.6	  	4.5	  	4.4	  	4.4
	 Preferred Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-10	  	28.3	  	14.6	  	4.5	  	4.4	  	4.4
	 Preferred Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-10	  	12.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Preferred Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Preferred Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-10	  	64.5	  	39.2	  	29.1	  	21.1	  	10
	 Standard Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-10	  	58.9	  	24.6	  	19	  	13.3	  	10
	 Standard Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-10	  	41.9	  	16.8	  	15.7	  	12.2	  	10
	 Standard Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-10	  	23.8	  	4.5	  	4.5	  	4.4	  	4.4
	 Standard Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Standard Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	10 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 1/20/2014

	 Class
	  	Gender	  	Band 	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-10	  	46.4	  	25.8	  	17.9	  	7.8	  	7.8
	 Standard Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-10	  	34	  	14.6	  	9	  	4.4	  	4.4
	 Standard Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-10	  	20.4	  	7.8	  	7.8	  	4.4	  	4.4
	 Standard Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-10	  	10.2	  	4.5	  	4.5	  	4.4	  	4.4
	 Standard Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-10	  	4.5	  	4.5	  	4.5	  	4.4	  	4.4
	 Standard Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
									
	10 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	72	  	72.8	  	70.7	  	64.2	  	59.1
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	56.4	  	56.2	  	57.2	  	48.7	  	47.7
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	30.3	  	31.2	  	36.4	  	29	  	33.2
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	15.7	  	17.7	  	29.1	  	23.8	  	23.8
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	6.3	  	6.2	  	29.1	  	31.1	  	31.1
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	10 Year Term - NMD	  	 1/20/2014

									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	60.6	  	62.4	  	59.3	  	45.6	  	45.6
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	36.5	  	36.4	  	38.5	  	34.2	  	34.2
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	6.3	  	6.2	  	13.5	  	7.3	  	7.3
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	6.3	  	6.2	  	6.2	  	6.2	  	6.2
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	6.3	  	6.2	  	6.2	  	6.2	  	6.2
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	73.1	  	72.8	  	68.6	  	59.1	  	55.9
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	63.7	  	59.3	  	58.2	  	45.6	  	45.6
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	44.9	  	41.6	  	43.7	  	31.1	  	31.1
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	37.6	  	34.3	  	38.5	  	26.9	  	26.9
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	29.2	  	26	  	40.6	  	35.2	  	34.2
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	61.6	  	61.4	  	60.3	  	43.4	  	40.4
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	48	  	42.6	  	44.7	  	34.2	  	33.2
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	25.1	  	20.8	  	25	  	17.6	  	17.6
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	15.7	  	10.4	  	18.7	  	12.4	  	12.4
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	7.3	  	6.2	  	8.3	  	6.2	  	6.2
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	10 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	68.9	  	65.5	  	62.4	  	52.8	  	49.7
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	69.9	  	55.1	  	54.1	  	39.4	  	41.4
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	59.5	  	40.6	  	43.7	  	24.9	  	26.9
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	57.4	  	39.5	  	39.5	  	22.8	  	23.8
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	55.3	  	36.4	  	46.8	  	35.2	  	29
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	57.4	  	53	  	55.1	  	35.2	  	31.1
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	55.3	  	37.4	  	42.6	  	29	  	23.8
	 Tier 3 Non-nicotine
	  	Male	  	Bend 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	37.6	  	19.8	  	25	  	12.4	  	11.4
	 Tier 3 Non-nicotine
	  	Male	  	Bend 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	34.5	  	14.6	  	22.9	  	7.3	  	7.3
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	32.4	  	16.6	  	13.5	  	6.2	  	6.2
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	10 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	90-65
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-10	  	68.9	  	59.3	  	54.1	  	41.4	  	32.1
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-10	  	58.5	  	46.8	  	46.8	  	33.2	  	26.9
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-10	  	52.2	  	39.5	  	42.6	  	26.9	  	16.6
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-10	  	47	  	35.4	  	39.5	  	16.6	  	12.4
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Famale	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-10	  	36.5	  	27	  	39.5	  	12.4	  	9.3
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-10	  	57.4	  	49.9	  	43.7	  	35.2	  	22.8
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Mete	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-10	  	43.8	  	32.2	  	21.8	  	6.2	  	6.2
	 Tier 1 Nicotine
	  	Mate	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Mate	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-10	  	25.1	  	11.4	  	6.2	  	6.2	  	6.2
	 Tier 1 Nicotine
	  	Male	  	band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-10	  	18.8	  	6.2	  	6.2	  	6.2	  	6.2
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-10	  	21.9	  	6.2	  	6.2	  	6.2	  	6.2
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-10	  	54.3	  	43.7	  	39.5	  	31.1	  	18.6
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-10	  	49.1	  	38.5	  	38.4	  	24.9	  	20.7
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-10	  	43.8	  	34.3	  	28.1	  	14.5	  	9.3
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-10	  	38.6	  	27	  	17.7	  	10.4	  	6.2
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Bend 5	  	2-10	  	35.5	  	22.9	  	14.6	  	8.3	  	6.2
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	10 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-10	  	48	  	40.6	  	35.4	  	23.8	  	13.5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-10	  	41.8	  	31.2	  	20.8	  	6.2	  	6.2
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-10	  	28.2	  	16.6	  	8.3	  	6.2	  	6.2
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-10	  	20.9	  	9.4	  	6.2	  	6.2	  	6.2
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-10	  	14.6	  	6.2	  	6.2	  	6.2	  	6.2
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-10	  	47	  	29.1	  	27	  	24.9	  	14.5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-10	  	49.1	  	28.1	  	25	  	19.7	  	11.4
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-10	  	42.8	  	30.2	  	14.6	  	7.3	  	6.2
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-10	  	42.8	  	20.8	  	10.4	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-10	  	37.6	  	18.7	  	8.3	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-10	  	36.5	  	29.1	  	26	  	11.4	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-10	  	37.6	  	15.6	  	9.4	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-10	  	27.1	  	6.2	  	6.2	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-10	  	10.4	  	6.2	  	6.2	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-10	  	11.5	  	6.2	  	6.2	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	15 Year Term – MED	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-15	  	70.4	  	62.7	  	50.2	  	23.6	  	7.9
	 Preferred Non-nicotine
	  	Famale	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-15	  	65.8	  	55.9	  	36.5	  	10.1	  	4.5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-15	  	62.3	  	31.9	  	14.8	  	4.5	  	4.5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-15	  	50.8	  	14.8	  	4.6	  	4.5	  	4.5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Famale	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-15	  	4.6	  	4.6	  	4.6	  	4.5	  	4.5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-15	  	71.5	  	59.3	  	41	  	28.2	  	24.8
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-15	  	64.6	  	45.6	  	26.2	  	18	  	14.6
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-15	  	41.5	  	20.5	  	4.6	  	4.5	  	4.5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-15	  	30	  	8	  	4.6	  	4.5	  	4.5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-15	  	4.6	  	4.6	  	4.6	  	4.5	  	4.5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-15	  	71.5	  	52.4	  	36.5	  	13.5	  	12.4
	 Standard Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-15	  	71.5	  	38.8	  	20.5	  	4.5	  	4.5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-15	  	58.9	  	22.8	  	10.3	  	4.5	  	4.5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-15	  	51.9	  	9.1	  	4.6	  	4.5	  	4.5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-15	  	35.8	  	4.6	  	4.6	  	4.5	  	4.5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	15 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-15	  	65.8	  	42.2	  	33.1	  	14.6	  	14.6
	 Standard Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-15	  	54.2	  	25.1	  	17.1	  	4.5	  	4.5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-15	  	38.1	  	13.7	  	4.6	  	4.5	  	4.5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-15	  	25.4	  	4.6	  	4.6	  	4.5	  	4.5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-15	  	4.6	  	4.6	  	4.6	  	4.5	  	4.5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
								
	15 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-15	  	65.8	  	53.6	  	35.3	  	21.4	  	4.5
	 Preferred Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-15	  	62.3	  	46.7	  	26.2	  	14.6	  	13.5
	 Preferred Nicotine 
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-15	  	56.5	  	30.8	  	16	  	12.4	  	10.1
	 Preferred Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-15	  	53.1	  	23.9	  	13.7	  	10.1	  	6.8
	 Preferred Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-15	  	4.6	  	4.6	  	4.6	  	4.5	  	4.5
	 Preferred Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	15 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-15	  	66.9	  	49	  	28.5	  	22.5	  	19.1
	 Preferred Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-15	  	58.9	  	37.6	  	18.2	  	15.8	  	13.5
	 Preferred Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-15	  	45	  	23.9	  	13.7	  	12.4	  	12.4
	 Preferred Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-15	  	39.2	  	18.2	  	6.8	  	6.8	  	6.8
	 Preferred Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-15	  	4.6	  	4.6	  	4.6	  	4.5	  	4.5
	 Preferred Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-15	  	71.5	  	49	  	30.8	  	18	  	4.5
	 Standard Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-15	  	63.5	  	35.3	  	22.8	  	10.1	  	6.8
	 Standard Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-15	  	49.6	  	20.5	  	19.4	  	18	  	14.6
	 Standard Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2.15	  	45	  	14.8	  	14.8	  	14.6	  	14.6
	 Standard Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-15	  	4.6	  	4.6	  	4.6	  	4.5	  	4.5
	 Standard Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-15	  	58.9	  	37.6	  	25.1	  	19.1	  	18
	 Standard Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-15	  	49.6	  	28.5	  	18.2	  	12.4	  	12.4
	 Standard Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-15	  	36.9	  	6.8	  	14.8	  	14.6	  	14.6
	 Standard Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-15	  	32.3	  	6.8	  	6.8	  	6.8	  	6.8
	 Standard Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-15	  	4.6	  	4.6	  	4.6	  	4.5	  	4.5
	 Standard Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	15 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	l	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	73.1	  	69.7	  	62.4	  	47.7	  	43.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	62.6	  	60.3	  	58.2	  	46.6	  	46.6
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	43.8	  	34.3	  	39.5	  	30	  	30
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-15	  	33.4	  	22.9	  	31.2	  	25.9	  	25.9
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Bend 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	25.1	  	25	  	40.6	  	40.4	  	40.4
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	62.6	  	59.3	  	54.1	  	48.7	  	48.7
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	43.8	  	43.7	  	45.8	  	46.6	  	46.6
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	17.7	  	12.5	  	17.7	  	26.9	  	26.9
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	6.3	  	6.2	  	11.4	  	23.8	  	23.8
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	6.3	  	6.2	  	14.6	  	22.8	  	22.68
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	71	  	63.4	  	57.2	  	44.5	  	42.5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	63.7	  	59.3	  	57.2	  	45.6	  	45.6
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	55.3	  	45.8	  	45.8	  	31.1	  	31.1
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-15	  	49.1	  	37.4	  	38.5	  	28	  	28
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	45.9	  	42.6	  	52	  	46.6	  	42.5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	15 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	60.6	  	55.1	  	52	  	43.5	  	43.5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	49.1	  	44.7	  	47.8	  	43.5	  	43.5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	36.5	  	28.1	  	32.2	  	31.1	  	31.1
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	27.1	  	18.7	  	23.9	  	26.9	  	26.9
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	20.9	  	20.8	  	30.2	  	22.8	  	22.8
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	63.7	  	48.9	  	45.8	  	34.2	  	36.3
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	63.7	  	53	  	53	  	39.4	  	42.5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	62.6	  	43.7	  	43.7	  	25.9	  	28
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Bend 4	  	2-15	  	62.6	  	38.5	  	36.4	  	22.8	  	23.8
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	61.6	  	51	  	55.1	  	45.6	  	39.4
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	51.2	  	40.6	  	41.6	  	35.2	  	38.3
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	47	  	38.5	  	44.7	  	38.3	  	39.4
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	42.8	  	27	  	31.2	  	26.9	  	28
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	37.6	  	20.8	  	23.9	  	23.8	  	24.9
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	35.5	  	31.2	  	33.3	  	19.7	  	20.7
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	15 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-15	  	66.8	  	56.2	  	44.7	  	26.9	  	6.2
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Bend 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-15	  	59.5	  	49.9	  	42.6	  	23.8	  	22.8
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-15	  	51.2	  	37.4	  	38.5	  	26.9	  	23.8
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-15	  	50.1	  	37.4	  	43.7	  	35.2	  	22.8
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-15	  	44.9	  	31.2	  	41.6	  	32.1	  	31.1
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-15	  	59.5	  	45.8	  	37.4	  	33.2	  	33.2
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-15	  	52.2	  	34.3	  	37.4	  	26.9	  	26.9
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-15	  	35.5	  	16.6	  	27	  	15.5	  	15.5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-15	  	29.2	  	12.5	  	19.8	  	14.5	  	14.5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	00	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-15	  	25.1	  	9.4	  	17.7	  	7.3	  	7.3
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-15	  	60.6	  	45.8	  	35.4	  	18.6	  	6.2
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-15	  	54.3	  	44.7	  	33.3	  	13.5	  	13.5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-15	  	45.9	  	35.4	  	35.4	  	24.9	  	19.7
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-15	  	43.8	  	38.5	  	38.5	  	33.2	  	17.6
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-15	  	41.8	  	36.4	  	36.4	  	24.9	  	23.8
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

																	
	15 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	1/20/2014
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-15	  	49.1	  	38.5	  	29.1	  	22.8	  	20.7
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-15	  	45.9	  	37.4	  	27	  	17.6	  	8.3
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-15	  	33.4	  	17.7	  	17.7	  	6.2	  	6.2
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-15	  	29.2	  	14.6	  	14.6	  	6.2	  	6.2
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-15	  	28.2	  	13.5	  	13.5	  	6.2	  	6.2
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-15	  	50.1	  	34.3	  	23.9	  	7.3	  	6.2
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-15	  	51.2	  	36.4	  	26	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-15	  	48	  	31.2	  	28.1	  	17.6	  	8.3
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-15	  	49.1	  	35.4	  	34.3	  	26.9	  	6.2
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-15	  	51.2	  	36.4	  	34.3	  	20.7	  	13.5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-15	  	41.8	  	27	  	20.8	  	13.5	  	8.3
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-15	  	43.8	  	31.2	  	20.8	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-15	  	34.5	  	16.6	  	15.6	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-15	  	31.3	  	11.4	  	13.5	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-15	  	31.3	  	12.5	  	11.4	  	6.2	  	6.2
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 20 Year Term - MED
	  	1/20/2014

  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-60

	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-20	  	76.5	  	63.8	  	41.3	  	17.2
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-20	  	71.4	  	47.5	  	17.5	  	6.1
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-20	  	54.8	  	21.3	  	6.3	  	6.1
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-20	  	16.6	  	5	  	5	  	4.9
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-20	  	77.8	  	63.8	  	32.5	  	15.9
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-20	  	58.7	  	32.5	  	8.8	  	4.9
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-20	  	29.3	  	8.8	  	5	  	4.9
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-20	  	72.7	  	51.3	  	21.3	  	7.4
	 Standard Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-20	  	54.8	  	26.3	  	5	  	4.9
	 Standard Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-20	  	28.1	  	7.5	  	5	  	4.9
	 Standard Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-20	  	14	  	5	  	5	  	4.9
	 Standard Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Standard Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 20 Year Term - MED 
	  	1/20/2014

  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40 -49
	  	 50-60

	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-20	  	65	  	38.8	  	18.8	  	11
	 Standard Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-20	  	42.1	  	11.3	  	5	  	4.9
	 Standard Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-20	  	16.6	  	5	  	5	  	4.9
	 Standard Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Standard Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Standard Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  

			
	 20 Year Term - MED 
	  	1/20/2014

  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-60

	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-20	  	77.8	  	60	  	37.5	  	28.2
	 Preferred Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-20	  	65	  	41.3	  	31.3	  	14.7
	 Preferred Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-20	  	57.4	  	33.8	  	13.8	  	9.8
	 Preferred Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-20	  	33.2	  	16.3	  	5	  	4.9
	 Preferred Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-20	  	5-1	  	5	  	5	  	4.9
	 Preferred Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 20 Year Term - MED 
	  	1/20/2014

  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-60

	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-20	  	71.4	  	52.5	  	21.3	  	18.4
	 Preferred Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-20	  	54.8	  	32.5	  	7.5	  	7.4
	 Preferred Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-20	  	47.2	  	16.3	  	5	  	4.9
	 Preferred Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-20	  	29.3	  	8.8	  	5	  	4.9
	 Preferred Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Preferred Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-20	  	68.9	  	41.3	  	26.3	  	13.5
	 Standard Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2 	  	2-20	  	58.7	  	27.5	  	16.3	  	8.6
	 Standard Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-20	  	42.1	  	13.8	  	5	  	4.9
	 Standard Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-20	  	16.6	  	5	  	5	  	4.9
	 Standard Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Standard Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-20	  	58.7	  	22.5	  	20	  	14.7
	 Standard Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-20	  	53.6	  	5	  	5	  	4.9
	 Standard Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-20	  	29.3	  	5	  	5	  	4.9
	 Standard Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Standard Nicotine
	  	Male 	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-20	  	5.1	  	5	  	5	  	4.9
	 Standard Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 20 Year Term - NMD 
	  	1/20/2014

  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-60

	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-20	  	75.4	  	69.6	  	56.7	  	42.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-20	  	66.8	  	64.2	  	57.8	  	46.8
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-20	  	50.6	  	42.8	  	39.6	  	34
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-20	  	40.9	  	32.1	  	33.2	  	25.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-20	  	35.5	  	35.3	  	43.9	  	42.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-20	  	66.8	  	59.9	  	48.2	  	29.8
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-20	  	50.6	  	46	  	44.9	  	35.1
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-20	  	30.2	  	17.1	  	25.7	  	25.5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-20	  	20.5	  	6.4	  	20.3	  	23.4
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-20	  	16.2	  	8.6	  	32.1	  	29.8
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1 	  	2-20	  	73.2	  	64.2	  	50.3	  	39.3
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-20	  	67.9	  	64.2	  	55.6	  	44.6
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-20	  	57.1	  	48.2	  	40.7	  	29.8
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-20	  	52.8	  	41.7	  	37.5	  	27.6
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-20	  	51.7	  	49.2	  	50.3	  	45.7
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 20 Year Term - NMD 
	  	1/20/2014

  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-60

	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-20	  	62.5	  	52.4	  	46	  	30.8
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-20	  	52.8	  	47.1	  	46	  	36.1
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-20	  	40.9	  	30	  	30	  	29.8
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-20	  	35.5	  	18.2	  	26.8	  	26.6
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-20	  	35.5	  	27.8	  	40.7	  	37.2
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-20	  	64.6	  	52.4	  	38.5	  	30.8
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-20	  	67.9	  	58.9	  	49.2	  	40.4
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-20	  	63.5	  	43.9	  	37.5	  	25.5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-20	  	61.4	  	42.8	  	36.4	  	24.4
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-20	  	64.6	  	54.6	  	51.4	  	44.6
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-20	  	50.6	  	37.5	  	36.4	  	25.5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-20	  	49.5	  	41.7	  	42.8	  	31.9
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-20	  	45.2	  	27.8	  	27.8	  	30.8
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-20	  	43.1	  	18.2	  	26.8	  	28.7
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male 	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-20	  	50.6	  	35.3	  	44.9	  	37.2
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 20 Year Term - NMD 
	  	1/20/2014

  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-60

	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-20	  	67.9	  	51.4	  	38.5	  	24.4
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-20	  	63.5	  	51.4	  	44.9	  	30.8
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-20	  	54.9	  	43.9	  	43.9	  	31.9
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-20	  	54.9	  	46	  	46	  	38.3
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-20	  	52.8	  	40.7	  	43.9	  	35.1
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-20	  	58.2	  	43.9	  	25.7	  	25.5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-20	  	52.8	  	39.6	  	34.2	  	33
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-20	  	40.9	  	17.1	  	27.8	  	25.5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-20	  	37.7	  	12.8	  	25.7	  	24.4
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-20	  	34.5	  	13.9	  	31	  	22.3
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-20	  	57.1	  	38.5	  	30	  	12.8
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-20	  	56	  	41.7	  	37.5	  	17
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-20	  	46.3	  	39.6	  	34.2	  	20.2
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-20	  	45.2	  	40.7	  	40.7	  	27.6
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female 	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-20	  	45.2	  	39.6	  	39.6	  	24.4
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 20 Year Term - NMD
	  	1/20/2014

  

															
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-49
	  	 50-60

	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-20	  	49.5	  	26.8	  	26.8	  	15.9
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-20	  	48.5	  	30	  	27.8	  	20.2
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-20	  	36.6	  	19.3	  	19.3	  	14.9
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-20	  	33.4	  	18.2	  	15	  	13.8
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-20	  	31.2	  	20.3	  	18.2	  	10.6
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-20	  	47.4	  	26.8	  	24.8	  	6.4
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-20	  	50.6	  	27.8	  	22.5	  	10.6
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-20	  	47.4	  	28.9	  	21.4	  	11.7
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-20	  	49.5	  	27.8	  	22.5	  	13.8
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-20	  	49.5	  	27.8	  	22.5	  	12.8
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-20	  	38.8	  	13.9	  	17.1	  	11.7
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-20	  	47.4	  	15	  	15	  	9.6
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-20	  	30.2	  	17.1	  	13.9	  	6.4
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-20	  	26.9	  	15	  	11.8	  	6.4
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-20	  	24.8	  	16.1	  	15	  	6.4
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 30 Year Term -MED
	  	1/20/2014

  

													
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-50

	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-30	  	81.1	  	57.2	  	32.5
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-30	  	74.5	  	41.6	  	14.3
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-30	  	59.9	  	16.9	  	5.2
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-30	  	12	  	5.2	  	5.2
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-30	  	5.3	  	5.2	  	5.2
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-30	  	78.5	  	57.2	  	32.5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-30	  	75.8	  	41.6	  	14.3
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-30	  	54.5	  	5.2	  	5.2
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-30	  	12	  	5.2	  	5.2
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-30	  	5.3	  	5.2	  	5.2
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-30	  	78.5	  	42.9	  	24.7
	 Standard Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-30	  	73.2	  	22.1	  	14.3
	 Standard Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-30	  	57.2	  	5.2	  	5.2
	 Standard Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Nun-nicotine
	  	Female	  	Band 4	  	2-30	  	12	  	5.2	  	5.2
	 Standard Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-30	  	5.3	  	5.2	  	5.2
	 Standard Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 30 Year Term - MED
	  	1/20/2014

  

													
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-50

	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-30	  	71.8	  	37.7	  	24.7
	 Standard Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-30	  	62.5	  	19.5	  	14.3
	 Standard Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-30	  	49.2	  	5.2	  	5.2
	 Standard Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-30	  	12	  	5.2	  	5.2
	 Standard Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-30	  	5.3	  	5.2	  	5.2
	 Standard Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5

  

			
	 30 Year Term - MED
	  	1/20/2014

  

													
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-50

	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-30	  	82.5	  	52	  	32.5
	 Preferred Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-30	  	78.5	  	42.9	  	31.2
	 Preferred Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-30	  	70.5	  	36.4	  	28.6
	 Preferred Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-30	  	27.9	  	23.4	  	20.8
	 Preferred Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-30	  	17.3	  	5.2	  	5.2
	 Preferred Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-30	  	74.5	  	49.4	  	29.9
	 Preferred Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-30	  	69.2	  	42.9	  	28.6
	 Preferred Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-30	  	65.2	  	32.5	  	27.3
	 Preferred Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-30	  	27.9	  	16.9	  	14.3
	 Preferred Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-30	  	17.3	  	5.2	  	5.2

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 30 Year Term - MED
	  	1/20/2014

  

													
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-50

	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-30	  	78.5	  	44.2	  	29.9
	 Standard Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-30	  	70.5	  	32.5	  	28.6
	 Standard Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-30	  	65.2	  	27.3	  	24.7
	 Standard Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-30	  	27.9	  	18.2	  	15.6
	 Standard Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-30	  	17.3	  	5.2	  	5.2
	 Standard Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-30	  	67.8	  	27.3	  	20.8
	 Standard Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-30	  	62.5	  	24.7	  	22.1
	 Standard Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-30	  	59.9	  	19.5	  	15.6
	 Standard Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-30	  	27.9	  	11.7	  	7.8
	 Standard Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-30	  	12	  	5.2	  	5.2
	 Standard Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 30 Year Term - NMD
	  	1/20/2014

  

													
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-50

	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	76.5	  	63.1	  	49.2
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	71.1	  	59.9	  	52.4
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	56	  	50.3	  	50.3
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	54.9	  	50.3	  	52.4
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	48.5	  	42.8	  	49.2
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	71.1	  	57.8	  	48.2
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	59.2	  	48.2	  	44.9
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	44.2	  	33.2	  	38.5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	38.8	  	26.8	  	41.7
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	38.8	  	26.8	  	34.2
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	72.2	  	56.7	  	50.3
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	68.9	  	58.9	  	56.7
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	63.5	  	55.6	  	52.4
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	64.6	  	58.9	  	56.7
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	62.5	  	54.6	  	54.6
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 30 Year Term - NMD
	  	1/20/2014

  

													
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-50

	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	64.6	  	51.4	  	48.2
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	58.2	  	46	  	46
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	53.9	  	46	  	41.7
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	50.6	  	41.7	  	47.1
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	53.9	  	42.8	  	42.8
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	63.5	  	47.1	  	46
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	66.8	  	54.6	  	55.6
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	65.7	  	55.6	  	52.4
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	70	  	59.9	  	57.8
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	70	  	58.9	  	56.7
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	58.2	  	41.7	  	46
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	54.9	  	42.8	  	46
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	57.1	  	47.1	  	44.9
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	56	  	46	  	50.3
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	62.5	  	49.2	  	47.1
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 30 Year Term - NMD
	  	1/20/2014

  

													
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-50

	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-30	  	66.8	  	50.3	  	39.6
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-30	  	57.1	  	38.5	  	38.5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-30	  	52.8	  	36.4	  	35.3
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	31 +	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-30	  	50.6	  	34.2	  	34.2
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female 	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-30	  	50.6	  	32.1	  	31
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-30	  	57.1	  	31	  	30
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-30	  	49.5	  	32.1	  	31
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-30	  	39.8	  	21.4	  	19.3
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-30	  	35.5	  	16.1	  	12.8
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-30	  	23.7	  	15	  	12.8
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-30	  	62.5	  	47.1	  	37.5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-30	  	57.1	  	37.5	  	32.1
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-30	  	53.9	  	33.2	  	30
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-30	  	51.7	  	33.2	  	30
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-30	  	51.7	  	35.3	  	32.1
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

			
	 30 Year Term - NMD
	  	1/20/2014

  

													
	 Class
	  	 Gender
	  	 Band
	  	 Duration
	  	 18-29
	  	 30-39
	  	 40-50

	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-30	  	53.9	  	36.4	  	30
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-30	  	50.6	  	32.1	  	23.5
	 Tar 2 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-30	  	39.8	  	23.5	  	18.2
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-30	  	37.7	  	21.4	  	15
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-30	  	18.3	  	6.4	  	6.4
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-30	  	54.9	  	40.7	  	37.5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-30	  	52.8	  	33.2	  	31
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-30	  	51.7	  	32.1	  	30
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-30	  	50.6	  	31	  	28.9
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-30	  	52.8	  	34.2	  	32.1
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-30	  	45.2	  	33.2	  	28.9
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-30	  	46.3	  	28.9	  	21.4
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male 	  	Band 3	  	2-30	  	37.7	  	21.4	  	17.1
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-30	  	35.5	  	20.3	  	15
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-30	  	17.2	  	6.4	  	6.4
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

 EXHIBIT F 

UNDERWRITING GUIDELINES 
 The Company and
the Reinsurer agree that Initial Nonmedical underwriting shall be in accordance with Company’s current underwriting guidelines, the Hybrid Life Underwriting Guide, 08/2013, using the Reinsurer’s MERICA systems for obtaining and
interpreting third party data. For Medically-underwritten policies, full underwriting shall take place in accordance with the Company’s current underwriting guidelines. 

  
 AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

 AMENDMENT II 

TO THE REINSURANCE AGREEMENT 

between 
 FIDELITY LIFE
ASSOCIATION 
 (the “Company”) 

and 
 HANNOVER LIFE REASSURANCE
COMPANY OF AMERICA 
 (the “Reinsurer”) 

This Amendment is to be attached to and made a part of the Automatic Coinsurance Reinsurance Agreement which became effective on January 1, 2012. All
provisions of the Reinsurance Agreement not in conflict with the provisions of this Amendment shall remain unchanged. 
 This Amendment shall add the
following: 
 Exhibit E - Hybrid Term Allowances, for new business issued on or after January 1, 2015 (includes back dated and forward dated policies with
issue dates January 1, 2015 and later). 
 In witness of the above, this Amendment is signed in duplicate at the dates and places indicated with an
effective date of January 1, 2015. 
  

					
	Hannover Life Reassurance Company of America	 		 	Fidelity Life Association
	Orlando, Florida	 		 	Chicago, Illinois
			
	10/27/15	 		 	10/19/2015
	Date	 		 	Date
	UNDICIPHERABLE	 		 	 /s/ James Harkensee

	By	 		 	By
	UNDICIPHERABLE	 		 	 James Harkensee

	Print Name	 		 	Print Name
	 AVP, Marketing
	 		 	President + COO
	Title	 		 	Title
	 /s/ Suzanne Downey
	 		 	 /s/ Gregory J Roemelt

	By	 		 	By
	 Suzanne Downey
	 		 	 Gregory J Roemelt

	Print Name	 		 	Print Name
	VP	 		 	 Chief Actuary

	Title	 		 	Title

  
 2 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT I 

 EXHIBIT E 

Hybrid Term Allowances 
  

																	
	10 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-10	  	66	  	63.4	  	59.3	  	37.5	  	12.8
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-10	  	63.9	  	61.3	  	45.1	  	24.2	  	9.4
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-10	  	51.6	  	31	  	20.9	  	9.8	  	9.4
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-10	  	20.1	  	12.1	  	9.9	  	9.8	  	9.4
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-10	  	9.5	  	9.5	  	9.5	  	9.4	  	9.4
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-10	  	66	  	Illegible	  	46.1	  	30.9	  	23.7
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-10	  	57.8	  	50.2	  	31	  	21	  	16.1
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-10	  	33.2	  	22.9	  	13.8	  	9.8	  	9.4
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-10	  	Illegible	  	Illegible	  	Illegible	  	9.8	  	9.4
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-10	  	9.5	  	9.5	  	9.5	  	9.4	  	9.4
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-10	  	68	  	56.2	  	46.1	  	21	  	13.8
	 Standard Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-10	  	68	  	46.1	  	31	  	9.8	  	20.5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-10	  	52.6	  	29	  	20.9	  	9.8	  	13.8
	 Standard Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-10	  	29.2	  	9.9	  	9.9	  	9.8	  	9.4
	 Standard Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-10	  	9.5	  	9.5	  	9.5	  	9.4	  	9.4
	 Standard Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 3 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	10 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-10	  	64.9	  	53.3	  	37	  	21	  	20.5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-10	  	51.6	  	35	  	22.9	  	11	  	10.5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-10	  	31.2	  	20.9	  	13.8	  	9.8	  	9.4
	 Standard Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-10	  	9.9	  	9.9	  	9.9	  	9.8	  	9.4
	 Standard Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-10	  	9.5	  	9.5	  	9.5	  	9.4	  	9.4
	 Standard Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-10	  	74.1	  	56.2	  	41.1	  	22	  	11.6
	 Preferred Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-10	  	66	  	45.1	  	31	  	15.5	  	9.4
	 Preferred Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-10	  	63.9	  	38.1	  	Illegible	  	22	  	11.6
	 Preferred Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-10	  	40.5	  	25.6	  	12.1	  	9.8	  	9.4
	 Preferred Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-10	  	9.5	  	9.5	  	9.5	  	9.4	  	9.4
	 Preferred Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-10	  	59.8	  	50.2	  	25.9	  	17.6	  	13.8
	 Preferred Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-10	  	47.6	  	32	  	13.8	  	9.8	  	9.4
	 Preferred Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-10	  	35.3	  	22.9	  	13.8	  	9.8	  	9.4
	 Preferred Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-10	  	17.9	  	9.9	  	9.9	  	9.8	  	9.4
	 Preferred Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-10	  	9.5	  	9.5	  	9.5	  	9.4	  	9.4
	 Preferred Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-10	  	68	  	45.1	  	36	  	26.6	  	15
	 Standard Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-10	  	62.9	  	32	  	26.9	  	18.8	  	15
	 Standard Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5

  
 4 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	10 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-10	  	47.6	  	24.9	  	23.9	  	17.6	  	15
	 Standard Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-10	  	29.2	  	9.9	  	9.9	  	9.8	  	9.4
	 Standard Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-10	  	9.5	  	9.5	  	9.5	  	9.4	  	9.4
	 Standard Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-10	  	51.6	  	33	  	25.9	  	13.3	  	12.8
	 Standard Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-10	  	40.4	  	22.9	  	17.9	  	9.8	  	9.4
	 Standard Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-10	  	28.2	  	16.8	  	16.8	  	9.8	  	9.4
	 Standard Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-10	  	15.6	  	9.9	  	9.9	  	9.8	  	9.4
	 Standard Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-10	  	9.5	  	9.5	  	9.5	  	9.4	  	9.4
	 Standard Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
									
	10 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	80.05	  	72.45	  	76.25	  	70.5	  	65
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	80.05	  	72.45	  	65.8	  	61.5	  	58
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	80.05	  	47.75	  	49.65	  	48.5	  	50
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	76.5	  	39.5	  	46.5	  	45.5	  	49
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	55	  	7	  	48	  	52	  	58
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	78.15	  	76.25	  	63.9	  	49.5	  	51
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	78.15	  	55.35	  	44.9	  	46.5	  	53
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	16.4	  	6.9	  	17.35	  	20.5	  	41
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5

  
 5 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	10 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	2.5	  	2.5	  	10.5	  	18.5	  	40
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	2	  	2	  	2	  	19	  	40
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	72.45	  	74.35	  	64.85	  	56.5	  	61
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	73.4	  	64.85	  	57.25	  	48.5	  	61
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	64.85	  	56.3	  	50.6	  	40.5	  	54
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	62.5	  	54.5	  	47.5	  	38.5	  	54
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	58	  	52	  	50	  	45	  	54
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	52.5	  	52.5	  	49.65	  	35.5	  	45
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	54.4	  	40.15	  	39.2	  	35.5	  	48
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	43	  	30.65	  	25.9	  	24.5	  	42
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	39.5	  	26.5	  	22.5	  	20.5	  	40
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	34	  	27	  	18	  	17	  	39
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-10	  	81.95	  	81.95	  	69.6	  	61.5	  	66
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-10	  	71.5	  	71.5	  	62.95	  	54.5	  	67
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-10	  	62	  	62	  	56.3	  	47.5	  	60
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-10	  	61.5	  	61.5	  	54.5	  	46.5	  	59
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-10	  	61	  	61	  	59	  	53	  	60
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 6 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	10 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-10	  	81.95	  	71.5	  	62.95	  	42.5	  	51
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-10	  	81.95	  	63.9	  	55.35	  	47.5	  	55
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-10	  	81.95	  	54.4	  	43	  	36.5	  	49
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-10	  	77.5	  	52.5	  	41.5	  	32.5	  	47
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-10	  	77	  	60	  	38	  	29	  	47
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-10	  	71.5	  	70.55	  	60.1	  	51.5	  	48
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-10	  	71.5	  	63.9	  	58.2	  	53.5	  	52
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-10	  	71.5	  	63.9	  	61.05	  	53.5	  	49
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-10	  	70.5	  	62.5	  	60.5	  	45.5	  	47
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-10	  	70	  	53	  	56	  	38	  	41
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-10	  	74.35	  	62	  	44.9	  	41.5	  	30
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-10	  	67.7	  	54.4	  	23.05	  	13.5	  	17
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-10	  	53.45	  	38.25	  	9.75	  	2.5	  	11
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-10	  	51.5	  	35.5	  	8.5	  	2.5	  	11
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-10	  	45	  	30	  	10	  	2	  	14
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-10	  	64.85	  	60.1	  	53.45	  	48.5	  	48
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-10	  	63.9	  	56.3	  	53.45	  	51.5	  	55
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-10	  	61.05	  	57.25	  	58.2	  	42.5	  	49
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5

  
 7 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	10 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-10	  	59.5	  	53.5	  	58.5	  	41.5	  	45
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-10	  	55	  	50	  	53	  	31	  	36
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	11+	  	Illegible	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-10	  	53.45	  	44.9	  	38.25	  	31.5	  	28
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-10	  	51.55	  	43	  	23.05	  	4.5	  	16
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-10	  	45.85	  	31.6	  	18.3	  	2.5	  	12
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-10	  	43.5	  	29.5	  	12.5	  	2.5	  	12
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-10	  	41	  	23	  	12	  	2	  	11
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-10	  	78.15	  	56.3	  	51.55	  	50.8	  	49
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-10	  	80.05	  	55.35	  	54.4	  	54.5	  	57
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-10	  	77.2	  	57.25	  	61.05	  	44.5	  	51
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-10	  	77.5	  	53.5	  	61.5	  	44.5	  	46
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-10	  	69	  	49	  	56	  	33	  	37
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-10	  	64.85	  	46.8	  	42.05	  	34.5	  	29
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-10	  	63.9	  	46.8	  	24.95	  	5.5	  	17
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-10	  	52.5	  	29.7	  	20.2	  	2.5	  	13
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-10	  	52.5	  	28.5	  	13.5	  	2.5	  	13
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	11+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-10	  	45	  	18	  	13	  	2	  	12
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	11+	  	5	  	5	  	5	  	5	  	5

  
 8 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	15 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-15	  	73.3	  	66.3	  	55.1	  	29	  	12.9
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-15	  	69.1	  	60.2	  	42.7	  	15.5	  	9.5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-15	  	66	  	38.5	  	23.1	  	9.9	  	9.5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-15	  	56.1	  	20.2	  	10	  	9.9	  	9.5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-15	  	9.6	  	9.6	  	9.6	  	9.5	  	9.5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-15	  	74.3	  	63.3	  	46.8	  	33.6	  	29.7
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-15	  	68.1	  	50.9	  	33.4	  	23.4	  	19.5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-15	  	47.2	  	28.3	  	13.9	  	9.9	  	9.5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-15	  	35.4	  	13.5	  	10	  	9.9	  	9.5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-15	  	9.6	  	9.6	  	9.6	  	9.5	  	9.5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-15	  	74.3	  	57	  	42.7	  	19	  	17.4
	 Standard Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-15	  	74.3	  	44.8	  	28.3	  	9.9	  	9.5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-15	  	62.9	  	30.3	  	19	  	9.9	  	9.5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-15	  	57.3	  	14.6	  	10	  	9.9	  	9.5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-15	  	40.7	  	9.6	  	9.6	  	9.5	  	9.5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-15	  	69.1	  	47.8	  	39.8	  	20	  	19.5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-15	  	58.7	  	32.4	  	25.2	  	9.9	  	9.5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5

  
 9 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	15 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-15	  	44.1	  	22.1	  	13.9	  	9.9	  	9.5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-15	  	30.8	  	10	  	10	  	9.9	  	9.5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-15	  	9.6	  	9.6	  	9.6	  	9.5	  	9.5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-15	  	69.1	  	58.1	  	41.6	  	26.9	  	9.5
	 Preferred Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-15	  	66	  	51.9	  	33.4	  	20	  	18.5
	 Preferred Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-15	  	60.7	  	37.5	  	24.2	  	17.8	  	15.1
	 Preferred Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-15	  	58.5	  	29.3	  	19.2	  	15.5	  	11.7
	 Preferred Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-15	  	9.6	  	9.6	  	9.6	  	9.5	  	9.5
	 Preferred Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-15	  	70.1	  	54	  	35.5	  	27.9	  	24.1
	 Preferred Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-15	  	62.9	  	43.7	  	26.2	  	21.2	  	18.5
	 Preferred Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-15	  	50.4	  	31.3	  	22.1	  	17.8	  	17.4
	 Preferred Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-15	  	44.6	  	23.6	  	12.2	  	12.2	  	11.7
	 Preferred Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-15	  	9.6	  	9.6	  	9.6	  	9.5	  	9.5
	 Preferred Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-15	  	74.3	  	54	  	37.5	  	23.4	  	9.5
	 Standard Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-15	  	67.1	  	41.6	  	30.3	  	15.5	  	11.7
	 Standard Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-15	  	54.5	  	28.3	  	27.3	  	23.4	  	19.5
	 Standard Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-15	  	50.4	  	20.2	  	20.2	  	20	  	19.5
	 Standard Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-15	  	9.6	  	9.8	  	9.6	  	9.5	  	9.5
	 Standard Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 10 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	15 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-15	  	62.9	  	43.7	  	32.4	  	24.6	  	23
	 Standard Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-15	  	54.5	  	36.6	  	26.2	  	17.8	  	17.4
	 Standard Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-15	  	43.1	  	15.9	  	23.1	  	20	  	19.5
	 Standard Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-15	  	37.7	  	12.2	  	12.2	  	12.2	  	11.7
	 Standard Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-15	  	9.6	  	9.6	  	9.6	  	9.5	  	9.5
	 Standard Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
									
	15 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	78.15	  	78.15	  	64.85	  	51.5	  	51
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	78.15	  	69.6	  	60.1	  	52.5	  	58
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	78.15	  	39.2	  	43	  	42.5	  	48
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-15	  	75.6	  	29.5	  	36.5	  	38.5	  	47
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	62	  	36	  	55	  	56	  	52
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	80.06	  	67.7	  	52.5	  	51.5	  	57
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	64.85	  	48.7	  	46.8	  	55.5	  	58
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	6.9	  	6.9	  	11.65	  	38.5	  	52
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	2.5	  	2.5	  	7.5	  	37.5	  	50
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	2	  	2	  	23	  	38	  	51
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	75.3	  	66.8	  	53.45	  	41.5	  	51
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	71.5	  	61.05	  	52.5	  	46.5	  	65
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5

  
 11 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	15 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	71.5	  	53.45	  	45.85	  	39.5	  	58
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-15	  	69.5	  	49.5	  	40.5	  	37.5	  	58
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	65	  	56	  	56	  	56	  	61
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	60.1	  	48.7	  	39.2	  	37.5	  	58
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	56.3	  	42.05	  	39.2	  	43.5	  	59
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	54.4	  	35.4	  	27.8	  	35.5	  	55
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	50.5	  	30.5	  	21.5	  	32.5	  	55
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	45	  	35	  	31	  	31	  	56
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-15	  	71.5	  	71.5	  	57.25	  	46.5	  	53
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-15	  	70.55	  	70.55	  	60.1	  	53.5	  	68
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-15	  	59.15	  	59.15	  	51.55	  	45.5	  	62
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-15	  	53.5	  	53.5	  	45.5	  	42.5	  	61
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-15	  	66	  	66	  	64	  	61	  	64
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-15	  	78.15	  	62	  	50.6	  	46.5	  	62
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-15	  	77.2	  	61.05	  	55.35	  	54.5	  	64
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-15	  	80.05	  	50.6	  	42.05	  	46.5	  	61
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-15	  	78.5	  	45.5	  	36.5	  	43.5	  	60
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-15	  	71	  	61	  	48	  	41	  	61
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  
 12 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	15 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-15	  	81.95	  	72.45	  	55.35	  	41.5	  	23
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-15	  	81.95	  	66.75	  	51.55	  	42.5	  	45
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-15	  	77.2	  	57.25	  	50.6	  	49.5	  	50
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-15	  	79.5	  	58.5	  	57.5	  	56.5	  	49
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-15	  	68	  	49	  	52	  	51	  	54
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-15	  	78.15	  	62.95	  	43	  	40.5	  	44
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-15	  	72.45	  	54.4	  	40.15	  	36.5	  	41
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-15	  	59.15	  	39.2	  	29.7	  	26.5	  	33
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-15	  	53.5	  	34.5	  	21.5	  	24.5	  	33
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-15	  	38	  	32	  	22	  	21	  	28
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-15	  	75.3	  	62	  	44.9	  	31.5	  	25
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-15	  	70.55	  	57.25	  	43	  	33.5	  	46
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-15	  	65.8	  	50.6	  	47.75	  	47.5	  	54
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-15	  	67.5	  	53.5	  	53.5	  	54.5	  	53
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-15	  	60	  	50	  	49	  	45	  	55
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-15	  	61.05	  	45.85	  	32.55	  	28.5	  	35
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-15	  	56.3	  	42.05	  	31.6	  	25.5	  	33
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-15	  	48.7	  	27.8	  	25.9	  	17.5	  	30
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5

  
 13 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

																	
	15 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 	  	 
									
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-59	  	60-65
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-15	  	45.5	  	23.5	  	24.5	  	16.5	  	29
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-15	  	41	  	23	  	25	  	13	  	30
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-15	  	76.25	  	53.45	  	36.35	  	26.5	  	21
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-15	  	73.4	  	51.55	  	38.25	  	32.5	  	46
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-15	  	68.65	  	45.85	  	46.8	  	48.5	  	54
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-15	  	72.5	  	51.5	  	54.5	  	55.5	  	54
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-15	  	64	  	48	  	50	  	47	  	55
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-15	  	62.95	  	40.15	  	28.75	  	28.5	  	35
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-15	  	60.1	  	40.15	  	31.6	  	26.5	  	33
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-15	  	48.7	  	20.2	  	26.85	  	19.5	  	31
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-15	  	47.5	  	17.5	  	26.5	  	18.5	  	30
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	16+	  	5	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-15	  	39	  	18	  	28	  	15	  	31
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	16+	  	5	  	5	  	5	  	5	  	5

  

															
	20 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 
								
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-60
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-20	  	78.8	  	67.3	  	47	  	22.7
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-20	  	74.2	  	52.6	  	25.5	  	11.6
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-20	  	59.2	  	29	  	15.4	  	11.6
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-20	  	22	  	10.5	  	10.5	  	10.3
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-20	  	10.1	  	10	  	10	  	9.8
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 14 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

															
	20 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 
								
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-60
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-20	  	80	  	67.3	  	39.1	  	21.3
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-20	  	62.7	  	39.1	  	17.7	  	10.3
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-20	  	36.2	  	17.7	  	14.3	  	10.3
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-20	  	10.6	  	10.5	  	10.5	  	10.3
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-20	  	10.1	  	10	  	10	  	9.8
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-20	  	75.4	  	56	  	29	  	12.9
	 Standard Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-20	  	59.2	  	33.5	  	14.3	  	10.3
	 Standard Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-20	  	35.1	  	16.5	  	14.3	  	10.3
	 Standard Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-20	  	19.4	  	10.5	  	10.5	  	10.3
	 Standard Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-20	  	10.1	  	10	  	10	  	9.8
	 Standard Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-20	  	68.4	  	44.8	  	26.7	  	16.5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-20	  	47.7	  	19.9	  	14.3	  	10.3
	 Standard Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-20	  	24.7	  	14.3	  	14.3	  	10.3
	 Standard Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-20	  	10.6	  	10.5	  	10.5	  	10.3
	 Standard Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-20	  	10.1	  	10	  	10	  	9.8
	 Standard Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-20	  	80	  	63.9	  	43.6	  	33.6
	 Preferred Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-20	  	68.4	  	47	  	38	  	20.1
	 Preferred Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-20	  	61.6	  	40.3	  	22.2	  	15.3
	 Preferred Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5

  
 15 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

															
	20 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 	  	 
								
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-60
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-20	  	38.6	  	21.7	  	10.5	  	10.3
	 Preferred Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-20	  	10.1	  	10	  	10	  	9.8
	 Preferred Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-20	  	74.2	  	57.1	  	29	  	23.8
	 Preferred Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-20	  	59.2	  	39.1	  	16.5	  	12.9
	 Preferred Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-20	  	52.3	  	24.5	  	14.3	  	10.3
	 Preferred Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-20	  	34.7	  	14.2	  	10.5	  	10.3
	 Preferred Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-20	  	10.1	  	10	  	10	  	9.8
	 Preferred Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-20	  	71.9	  	47	  	33.5	  	19
	 Standard Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-20	  	62.7	  	34.6	  	24.5	  	14
	 Standard Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-20	  	47.7	  	22.2	  	14.3	  	10.3
	 Standard Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-20	  	22	  	10.5	  	10.5	  	10.3
	 Standard Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-20	  	10.1	  	10	  	10	  	9.8
	 Standard Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-20	  	62.7	  	30.1	  	27.8	  	20.1
	 Standard Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-20	  	58.1	  	14.3	  	14.3	  	10.3
	 Standard Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-20	  	36.2	  	14.3	  	14.3	  	10.3
	 Standard Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-20	  	10.6	  	10.5	  	10.5	  	10.3
	 Standard Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-20	  	10.1	  	10	  	10	  	9.8
	 Standard Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  
 16 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

															
	20 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 
								
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-60
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-20	  	73.4	  	75.3	  	57.25	  	45.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-20	  	73.4	  	68.65	  	52.5	  	48.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-20	  	73.4	  	44.9	  	36.35	  	41.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-20	  	70.5	  	34.5	  	32.5	  	34.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-20	  	68	  	44	  	48	  	51
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-20	  	78.15	  	63.9	  	43.95	  	32.5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-20	  	66.75	  	48.7	  	38.25	  	37.5
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-20	  	47.75	  	9.75	  	17.35	  	33.5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-20	  	39.5	  	2.5	  	15.5	  	30.5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-20	  	30	  	8	  	40	  	42
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-20	  	72.45	  	64.85	  	45.85	  	37.5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-20	  	69.6	  	62	  	44.9	  	44.5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-20	  	65.8	  	50.6	  	36.35	  	35.5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-20	  	63.5	  	47.5	  	35.5	  	34.5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-20	  	64	  	54	  	47	  	51
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-20	  	58.2	  	44.9	  	32.55	  	27.5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-20	  	54.4	  	40.15	  	33.5	  	35.5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-20	  	52.5	  	32.55	  	23.05	  	37.5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5

  
 17 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

															
	20 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 
								
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-60
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-20	  	49.5	  	26.5	  	20.5	  	34.5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-20	  	50	  	33	  	38	  	43
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-20	  	81.95	  	68.65	  	46.8	  	39.5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-20	  	81.95	  	68.65	  	50.6	  	49.5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-20	  	81.95	  	51.55	  	39.2	  	40.5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-20	  	80.5	  	48.5	  	37.5	  	38.5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-20	  	80	  	61	  	54	  	56
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-20	  	74.35	  	54.4	  	40.15	  	31.5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-20	  	73.4	  	58.35	  	46.8	  	44.5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-20	  	74.35	  	40.15	  	32.55	  	46.5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-20	  	72.5	  	32.5	  	31.5	  	43.5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-20	  	74	  	52	  	54	  	52
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-20	  	81.95	  	65.8	  	46.8	  	36.5
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-20	  	80.05	  	62	  	46.8	  	43.5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-20	  	73.4	  	55.35	  	49.65	  	48.5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-20	  	75.5	  	58.5	  	52.5	  	53.5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-20	  	67	  	51	  	48	  	49
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-20	  	72.45	  	56.3	  	27.8	  	35.5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5

  
 18 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

															
	20 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 
								
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-60
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-20	  	67.7	  	52.5	  	29.7	  	38.5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-20	  	55.35	  	28.75	  	22.1	  	31.5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-20	  	52.5	  	23.5	  	20.5	  	30.5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-20	  	39	  	24	  	29	  	30
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-20	  	70.55	  	54.4	  	38.25	  	24.5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-20	  	69.6	  	51.55	  	43	  	35.5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-20	  	62	  	48.7	  	43	  	41.5
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-20	  	63.5	  	53.5	  	49.5	  	46.5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-20	  	56	  	47	  	46	  	42
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-20	  	58.2	  	34.45	  	27.8	  	21.5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-20	  	58.2	  	31.6	  	33.5	  	25.5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-20	  	44.9	  	19.25	  	23.05	  	22.5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-20	  	41.5	  	15.5	  	22.5	  	22.5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-20	  	35	  	17	  	26	  	22
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-20	  	67.7	  	43	  	30.65	  	19.5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-20	  	69.6	  	44.9	  	40.15	  	34.5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-20	  	62	  	44.9	  	42.05	  	42.5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-20	  	66.5	  	51.5	  	50.5	  	47.5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	21+	  	5	  	5	  	5	  	5

  
 19 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

															
	20 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 	  	 
								
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-49	  	50-60
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-20	  	58	  	46	  	47	  	43
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-20	  	55.35	  	21.15	  	23.05	  	20.5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-20	  	61.05	  	24.95	  	33.5	  	26.5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-20	  	41.1	  	10.7	  	24	  	25.5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-20	  	38.5	  	8.5	  	24.5	  	24.5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	21+	  	5	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-20	  	30	  	12	  	29	  	25
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	21+	  	5	  	5	  	5	  	5

  

													
	30 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 
							
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	2-30	  	82.9	  	61.4	  	39.1
	 Preferred Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	2-30	  	77	  	47.3	  	22.7
	 Preferred Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	2-30	  	63.8	  	25	  	14.4
	 Preferred Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	2-30	  	17.4	  	10.7	  	10.7
	 Preferred Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	2-30	  	10.3	  	10.2	  	10.2
	 Preferred Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	2-30	  	80.6	  	61.4	  	39.1
	 Preferred Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	2-30	  	78.2	  	47.3	  	22.7
	 Preferred Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	2-30	  	58.9	  	14.4	  	14.4
	 Preferred Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	2-30	  	17.4	  	10.7	  	10.7
	 Preferred Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	2-30	  	10.3	  	10.2	  	10.2
	 Preferred Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 1	  	2-30	  	80.6	  	48.5	  	32
	 Standard Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5

  
 20 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

													
	30 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 
							
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Standard Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 2	  	2-30	  	75.8	  	29.7	  	22.7
	 Standard Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 3	  	2-30	  	61.4	  	14.4	  	14.4
	 Standard Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 4	  	2-30	  	17.4	  	10.7	  	10.7
	 Standard Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Female	  	Band 5	  	2-30	  	10.3	  	10.2	  	10.2
	 Standard Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 1	  	2-30	  	74.5	  	43.8	  	32
	 Standard Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 2	  	2-30	  	66.2	  	27.3	  	22.7
	 Standard Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 3	  	2-30	  	54.2	  	14.4	  	14.4
	 Standard Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 4	  	2-30	  	17.4	  	10.7	  	10.7
	 Standard Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Non-nicotine
	  	Male	  	Band 5	  	2-30	  	10.3	  	10.2	  	10.2
	 Standard Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 1	  	2-30	  	84.2	  	56.7	  	39.1
	 Preferred Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 2	  	2-30	  	80.6	  	48.5	  	37.9
	 Preferred Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 3	  	2-30	  	73.4	  	42.6	  	35.6
	 Preferred Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 4	  	2-30	  	33.3	  	28.8	  	26.2
	 Preferred Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Female	  	Band 5	  	2-30	  	22.3	  	10.2	  	10.2
	 Preferred Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 1	  	2-30	  	77	  	54.3	  	36.7
	 Preferred Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 2	  	2-30	  	72.2	  	48.5	  	35.6
	 Preferred Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 3	  	2-30	  	68.6	  	39.1	  	34.4
	 Preferred Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Preferred Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 4	  	2-30	  	33.3	  	22.3	  	19.7
	 Preferred Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5

  
 21 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

													
	30 Year Term - MED	  	 	  	 	  	 	  	 	  	 	  	 
							
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Preferred Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Preferred Nicotine
	  	Male	  	Band 5	  	2-30	  	22.3	  	10.2	  	10.2
	 Preferred Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 1	  	2-30	  	80.6	  	49.6	  	36.7
	 Standard Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 2	  	2-30	  	73.4	  	39.1	  	35.6
	 Standard Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 3	  	2-30	  	68.6	  	34.4	  	32
	 Standard Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 4	  	2-30	  	33.3	  	23.6	  	21.1
	 Standard Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Female	  	Band 5	  	2-30	  	22.3	  	10.2	  	10.2
	 Standard Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 1	  	2-30	  	70.9	  	34.4	  	28.5
	 Standard Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 2	  	2-30	  	66.2	  	32	  	29.7
	 Standard Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 3	  	2-30	  	63.8	  	27.3	  	23.8
	 Standard Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 4	  	2-30	  	33.3	  	17.2	  	13.3
	 Standard Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Standard Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Standard Nicotine
	  	Male	  	Band 5	  	2-30	  	17	  	10.2	  	10.2
	 Standard Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
							
	30 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 
							
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	78.15	  	66.75	  	52.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	78.15	  	55.35	  	45.85
	 Tier 1 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	67.7	  	45.85	  	45.85
	 Tier 1 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	69.5	  	49.5	  	50.5
	 Tier 1 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	64	  	41	  	47
	 Tier 1 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	78.15	  	60.1	  	48.7
	 Tier 1 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5

  
 22 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

													
	30 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 
							
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	68.65	  	43.95	  	39.2
	 Tier 1 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	56.3	  	25.9	  	34.45
	 Tier 1 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	52.5	  	21.5	  	41.5
	 Tier 1 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	51	  	25	  	34
	 Tier 1 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	70.55	  	58.2	  	49.65
	 Tier 2 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	65.8	  	53.45	  	48.7
	 Tier 2 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	64.85	  	51.55	  	46.8
	 Tier 2 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	65.5	  	54.5	  	51.5
	 Tier 2 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	63	  	52	  	50
	 Tier 2 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	58.2	  	43	  	39.2
	 Tier 2 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	53.45	  	36.35	  	34.45
	 Tier 2 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	53.45	  	37.3	  	35.4
	 Tier 2 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	51.5	  	34.5	  	39.5
	 Tier 2 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	52	  	37	  	37
	 Tier 2 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	2-30	  	79.1	  	58.2	  	50.55
	 Tier 3 Non-nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	2-30	  	76.25	  	54.4	  	51.55
	 Tier 3 Non-nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	2-30	  	75.3	  	53.45	  	50.6
	 Tier 3 Non-nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	2-30	  	78.5	  	59.5	  	57.5
	 Tier 3 Non-nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5

  
 23 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

													
	30 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 
							
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	2-30	  	75	  	58	  	55
	 Tier 3 Non-nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	2-30	  	71.5	  	49.65	  	46.8
	 Tier 3 Non-nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	2-30	  	65.8	  	41.1	  	43
	 Tier 3 Non-nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	2-30	  	69.6	  	47.75	  	44.9
	 Tier 3 Non-nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	2-30	  	68.5	  	45.5	  	52.5
	 Tier 3 Non-nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	2-30	  	70	  	51	  	49
	 Tier 3 Non-nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	2-30	  	81.95	  	62.95	  	48.7
	 Tier 1 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	2-30	  	71.5	  	44.9	  	39.2
	 Tier 1 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	2-30	  	63.9	  	36.35	  	37.3
	 Tier 1 Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	2-30	  	61.5	  	33.5	  	36.5
	 Tier 1 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	2-30	  	57	  	31	  	34
	 Tier 1 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	2-30	  	72.45	  	58.2	  	41.1
	 Tier 1 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	2-30	  	59.15	  	40.15	  	29.7
	 Tier 1 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	2-30	  	44.9	  	15.45	  	16.4
	 Tier 1 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	2-30	  	40.5	  	12.5	  	15.5
	 Tier 1 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	2-30	  	33	  	14	  	14
	 Tier 1 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	2-30	  	73.4	  	54.4	  	42.05
	 Tier 2 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	2-30	  	63.9	  	37.3	  	32.55
	 Tier 2 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5

  
 24 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT II 

													
	30 Year Term - NMD	  	 	  	 	  	 	  	 	  	 	  	 
							
	 Class
	  	Gender	  	Band	  	Duration	  	18-29	  	30-39	  	40-50
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	2-30	  	59.15	  	32.55	  	31.6
	 Tier 2 Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	2-30	  	56.5	  	30.5	  	31.5
	 Tier 2 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	2-30	  	52	  	31	  	31
	 Tier 2 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	2-30	  	60.1	  	38.25	  	28.75
	 Tier 2 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	2-30	  	51.55	  	23.05	  	20.2
	 Tier 2 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	2-30	  	40.15	  	11.65	  	13.55
	 Tier 2 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	2-30	  	37.5	  	8.5	  	13.5
	 Tier 2 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	2-30	  	32	  	8	  	12
	 Tier 2 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	2-30	  	71.5	  	47.75	  	39.2
	 Tier 3 Nicotine
	  	Female	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	2-30	  	62	  	30.65	  	32.55
	 Tier 3 Nicotine
	  	Female	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	2-30	  	58.2	  	26.85	  	33.5
	 Tier 3 Nicotine
	  	Female	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	2-30	  	57.5	  	26.5	  	32.5
	 Tier 3 Nicotine
	  	Female	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	2-30	  	52	  	28	  	33
	 Tier 3 Nicotine
	  	Female	  	Band 5	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	2-30	  	58.2	  	32.55	  	27.8
	 Tier 3 Nicotine
	  	Male	  	Band 1	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	2-30	  	50.6	  	18.3	  	22.1
	 Tier 3 Nicotine
	  	Male	  	Band 2	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	2-30	  	36.35	  	6.9	  	17.35
	 Tier 3 Nicotine
	  	Male	  	Band 3	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	2-30	  	35.5	  	4.5	  	16.5
	 Tier 3 Nicotine
	  	Male	  	Band 4	  	31+	  	5	  	5	  	5
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	1	  	100	  	100	  	100
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	2-30	  	28	  	5	  	16
	 Tier 3 Nicotine
	  	Male	  	Band 5	  	31+	  	5	  	5	  	5

  
 25 

AUTOMATIC COINSURANCE 

HA-FKLA-07/HA3351 
 AMENDMENT IIEX-10.6

 Exhibit 10.6 

INDEMNITY REINSURANCE AGREEMENT 

(COMBINED BLOCK) 
 by
and between 
 FIDELITY LIFE ASSOCIATION (“REINSURER”) 

and 

COMBINED INSURANCE COMPANY OF AMERICA
(“COMPANY”) 
 Effective as of Coinsurance Effective Date 

  
 1 

 INDEMNITY REINSURANCE AGREEMENT 

THIS INDEMNITY REINSURANCE AGREEMENT (the “Agreement”), effective as of the Coinsurance Effective Date, is made and entered into by
and between Combined Insurance Company of America, an Illinois domiciled life, accident and health insurance company (“Company”) and Fidelity Life Association, an Illinois domiciled accident and health insurance company
(“Reinsurer”). 
 ARTICLE I 

Definitions 

“Active Certificates” means certificates under the Policies that have not lapsed, for which the Certificateholder is actively paying
premium according to the Certificate’s payment schedule. 
 “Additional Collateral” shall have the meaning as set forth in
Section 3.2. 
 “Affiliate” means, as applied to any Person, any other Person directly or indirectly controlling, controlled
by or under common control with that Person. For the purposes of this definition, “control” (including with correlative meanings, the terms “controlling”, “controlled by”, and “under common control with”) as
applied to any Person, means the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of that Person, whether through ownership of voting securities or by contract or otherwise. 

“Applicable Law” means all applicable federal laws and regulations, Illinois state law, ordinance or code, or any rules,
regulations, administrative interpretations or orders issued by the Governmental Authority pursuant to any of the foregoing, and any order, writ, injunction, directive, judgment or decree of a court of competent jurisdiction applicable to the
parties hereto. 
 “Business Day” means any day other than Saturday, Sunday or a day on which banking institutions in the State of
Illinois are permitted or obligated by Applicable Law to be closed. 
 “Certificateholder” means an insured who has been issued a
certificate under a Policy, and who has been identified as the member of the Policyholder organization to which a Policy has been issued. 

“Change of Control” means the acquisition, directly or indirectly, of more than (i) ten percent (10%) of the voting capital
stock of, or of any Person that owns or controls, directly or indirectly, Reinsurer, or (ii) a majority ownership of Reinsurer, in either case of (i) or (ii), by any Person that was or is not an Affiliate of Reinsurer as of the Coinsurance
Effective Date. 

  
 1 

 “Code” means the Internal Revenue Code of 1986, as amended, and the rules and
regulations thereunder. 
 “Coinsurance Effective Date” means April 1, 2013, or a date agreed to by Company and Reinsurer, if
sooner. 
 “Confidential Information” shall have the meaning set forth in Section 12.1 

“Extra-Contractual Obligations” means liabilities not covered under the Policies or any other provision of this Agreement, but which
arise from the business covered hereunder, such liabilities arising because of, but not limited to, the following: failure by Company to settle within the Policy limit, or by reason of alleged or actual negligence, fraud or bad faith in claims
handling or in rejecting an offer of settlement or in the preparation of the defense or in the trial of any action against its insured or reinsured or in the preparation or prosecution of an appeal consequent upon such action. Extra-Contractual
Obligations do not include any loss incurred due to a final legal adjudication of fraud of a member of the Board of Directors or a duly elected Corporate officer of Company acting individually or collectively or in collusion with any individual,
corporation or any other organization or party involved in the presentation, defense or settlement of any claim covered hereunder. 

“GAAP” means United States generally accepted accounting principles as in effect from time to time. 

“Governmental Authority” means the Illinois Insurance Department. 

“Illinois SAP” means the statutory accounting principles and procedures applicable under Applicable Law and the rules, regulations
and practices prescribed or permitted by the Governmental Authority relating thereto. 
 “Interim Coverage” means the coverage
provided by a Certificate between the date applied for by the proposed Certificateholder and the Certificate Effective Date, as approved by the underwriting and enrollment conditions applicable to that Certificate, 

“Loss Expense” means all costs incurred by Company in the investigation, adjustment, appraisal, defense or settlements of all
claims, alleged claims, or suits, including appeals, under or related to the Policies reinsured hereunder, including legal fees, expenses of determining coverage under a Policy (including declaratory judgment expenses), subrogation, salvage and
recovery expenses, both prejudgment and post-judgment interest, and any award of costs by a court of competent jurisdiction, excluding, however, office expenses and salaries of officials and employees of Company not classified as loss adjusters.

  
 2 

 “Loss In Excess of Policy Limits” means any amount payable in excess of the Policy
limit for reasons including alleged or actual negligence, fraud or bad faith in failing to settle or rejecting a settlement within the Policy limit, in preparation of the defense, in the trial of any action involving the insured or Company, or in
the preparation or prosecution of an appeal consequent upon such action. Loss in Excess of Policy Limits extends only to amounts that would have been covered had the limit of liability of the Policy been adequate. Loss In Excess of Policy Limits
does not include any loss incurred due to a final legal adjudication of fraud of a member of the Board of Directors or a duly elected corporate officer of Company acting individually or collectively or in collusion with any individual, corporation
or any other organization or party involved in the presentation, defense or settlement of any claim covered hereunder. 
 “Notice of
Change of Control” shall have the meaning set forth in Section 3.5. 
 “Paid Up Certificates” means certificates under
the Policies that have lapsed and have converted to a paid up status based on available Policy values. 
 “Person” means any
natural person, corporation, joint stock corporation, general partnership, limited partnership, limited liability company or partnership, proprietorship, other business organization, trust, union, association or Governmental Authority. 

“Policies” (each a “Policy”) means the group lifetime benefit term life insurance policies together with all related
binders, slips, enrollment forms and certificates (including applications therefor and all supplements, endorsements, riders and ancillary agreements in connection therewith) that have been issued or delivered by Company in any state, territory,
district or commonwealth of the United States (collectively “the U.S.”) at any time on or after the Coinsurance Effective Date. 

“Policy Liabilities” means any and all gross liabilities and obligations arising out of or relating to the Policies, including
claims arising during Interim Coverage, Extra-contractual Obligations, Loss In Excess of Policy Limits and Loss Expense; provided, however, Policy Liabilities shall not include any Premium-related Taxes (as defined below in
“Premium-related Taxes Allowances”) and fees, and any assessments and similar charges in connection with Company’s participation in any guaranty association(s). 

“Policyholder” means with respect to each Policy, The U.S. employer, group, association or other organization which has been issued
a Policy. 
 ‘‘Premiums” or ‘‘Premium” means premiums, considerations, deposits and similar receipts with
respect to the Policies including return premiums as a result of surrenders, cancellations, lapses, and rescissions, 

“Premium-related Taxes Allowance” means the provision for the payment of premium taxes, assessments and fees on the Policies
coinsured hereunder as of the Coinsurance Effective Date, which Reinsurer allows Company in an amount equal to 2.25% of the Premium ceded hereunder. 

  
 3 

 “Producers” mean all brokers, agents, general agents, captive employed agents,
producers, third party administrators or other Persons who marketed, produced or serviced the Policies and are entitled to receive Commissions from Company. 

“Producer Commissions” means all commissions, expense allowances, benefit credits, service fees, payments and other fees and
compensation paid to Producers for the sale or service of Polities. 
 “Reinsurance Premium” shall have the meaning set forth in
Section 4.1. 
 “Reserves” means the sum of all reserves and liabilities required to be maintained by Company for the
Politics including, without limitation, active life, incurred but not reported, claim and unearned premium reserves, in each case calculated: (a) consistent with the reserve requirements, statutory accounting rules, regulations, practices and
actuarial principles applicable to Company under Applicable Law; and (b) in accordance with a methodology agreed upon by both Company and Reinsurer and consistent with Illinois SAP, sound actuarial principles and any valuation bases and methods
of determining, reserves as provided in the Forms of Policies; provided, however, that Company makes no representations or warranties with respect to the adequacy of reserves under or related to the Policies. 

“Tax” or “Taxes” means any and all United States and foreign, federal, state, municipal or local net or gross income,
gross receipts, net proceeds, sales, use, ad valorem, value added, transfer, franchise, recapture, withholding, payroll, employment, excise, premium-related taxes and foes, property, alternative or add-on
minimum, environmental, retaliatory or other taxes, assessments, duties, fees, levies or other governmental charges of any nature whatsoever, but shall not include any assessments or other charges of guaranty funds or similar organizations. 

“TPA Fees” means all fees payable by Company to the third party administrator to be attached as Exhibit A. 

“U.S, Trust Agreement” shall have the meaning set forth in Section 3.1 and shall be in the form set forth as Exhibit B.

 ARTICLE II 

Coinsurance of the Policy Liabilities 

2.1 Coinsurance. Subject to the terms and conditions of this Agreement and as of the Coinsurance Effective Date, Company hereby cedes
on a coinsurance basis to Reinsurer and Reinsurer hereby agrees to indemnity reinsure fifty percent (50%) of the Policy Liabilities. The coinsurance provided for hereunder shall be effective as of the Coinsurance Effective Date. 

  
 4 

 2.2 Parties to Coinsurance. Article II of this Agreement provides only for indemnity
reinsurance solely between Company and Reinsurer and the acceptance of reinsurance under this Article II shall not create any right or legal relationship between Reinsurer and any Policyholder or any other Person under a Policy. 

2.3 Policy Changes or Reductions. Material changes in the provisions and conditions of a Policy, except for those to Policy rates,
Policy interest rates, mortality charges and other variable Policy provisions (“Non-Guaranteed Policy Elements”), a corresponding change in this Agreement and any appropriate Policy Liabilities’
adjustments shall be made consistent with the terms of any Policy or prevailing underwriting practices, and at all times, in accordance with Applicable Law. If the benefit amount of a Policy is reduced or increased, whether as required by Applicable
Law or otherwise, the amount reinsured by Reinsurer hereunder shall be automatically reduced or increased accordingly. Company will review the Policy experience with Reinsurer annually to determine if any changes to the Non-Guaranteed Policy Elements are necessary. Any dispute regarding the necessity of a Non-Guaranteed Policy Element shall be subject to Mini Dispute Resolution procedure
under Section 11.2. 
 2.4 Termination of Coinsurance. Coinsurance under this Article II will continue hereunder without
reduction until such time as Company chooses to terminate Such coverage in Company’s sole discretion. Notwithstanding the foregoing, coinsurance under this Article II shall terminate in the following circumstances: 

(a) In the event any Policy, is forfeited or surrendered and/or no further benefits are payable thereunder; in such event the coinsurance of
such Policy Liabilities shall automatically terminate; or 
 (b) Upon the occurrence of a Ratings Reduction or Rating Withdrawal under
Section 3.3 in Company’s sole discretion; in such event, commutation of the Policies also shall be in Company’s sole discretion. 

2.5 Maintenance of Reserves. From and after the Coinsurance Effective Date, Reinsurer shall establish and maintain as a liability on
its statutory financial statements, Reserves with respect to the Policy Liabilities calculated in a manner consistent with: (a) the Reserve requirements, statutory accounting rules, regulations, practices and actuarial principles applicable to
Company under Applicable Law; and (b) in accordance with a methodology agreed upon by both Company and Reinsurer and consistent with Illinois SAP, sound actuarial principles and any valuation bases and methods of determining Reserves as
provided in the forms of Policies. The Reinsurer shall provide Company, not less than annually, with copies of all actuarial opinions and actuarial memoranda and all Reserve evaluations pertaining to the Reserves, Including, without limitation, any
actuarial opinions and Reserve evaluations performed by independent actuaries, auditors or other outside consultants. 

  
 5 

 2.6 Reserve Credits. Reinsurer shall, at all times during the term of this Agreement,
maintain all licenses, authorizations or otherwise take any and all reasonable action necessary under the Applicable Law in which the Policies are outstanding to ensure that Company shall be permitted to take full Reserve credit on its statutory
financial statements with respect to the indemnity reinsurance by Reinsurer under this Article II of the Policy Liabilities. 
 ARTICLE
III 
 Trust Agreement 

3.1 Trust Funding. Reinsurer, as grantor, Company, as beneficiary, and a mutually acceptable trustee, shall enter into a trust
agreement in the form set forth as Exhibit B to secure Reinsurer’s obligations to Company under this Agreement for as long as there remain Policies coinsured hereunder (the “U.S. Trust Agreement”). The Reinsurance Premium
payable hereunder by Company to Reinsurer shall be deposited into the trust account established under the U.S. Trust Agreement such that the amount in the trust account equals, at all times while there are Policies coinsured pursuant to this Article
II, one hundred and ten percent (110%) of Reinsurer’s share of Company’s Policy Liabilities, based on Company’s GAAP accounting basis. The Reinsurer shall have the exclusive right and authority to direct the investments under the U.S.
Trust Agreement, subject to the requirements contained therein. 
 3.2 Negative Rating Outlook. If Reinsurer’s A.M. Best rating
outlook becomes negative, the Percentage specified in Section 3.1 shall increase by ten percent (10%) of the then-outstanding Policy Liabilities coinsured hereunder (the “Additional Collateral”) such that Company is, at all times
thererafter, collateralized to an amount equal to one hundred and twenty percent (120%) of the then-outstanding Policy Liabilities coinsured hereunder. Provided however, that if Reinsurer’s RBC ratio remains at or above the seven hundred and
fifty percent (750%) of company action level, the funding percentage specified in Section 3.1 shall increase by five percent (5%) of then-outstanding Policy Liabilities coinsured hereunder such that Company is, at all times thereafter,
collateralized to an amount equal to one hundred and fifteen percent (115%) of the then-outstanding Policy Liabilities coinsured hereunder. For the avoidance of doubt, the Additional Collateral required herein shall be in addition to the U.S. Trust
Agreement required under Section 3.1, and may be provided in one of the following forms, as accepted by Company: 
 (i) Evergreen letter
of credit from a financial institution acceptable, at all times, to Company; or 
 (ii) Deposit of acceptable assets in the trust account
established under the U.S. Trust Agreement. 
 3.3 Rating Reduction or Rating Withdrawal. In the event that Reinsurer is downgraded
to below A- by A.M. Best, or the rating of Reinsurer is withdrawn for any reason, the funding percentage specified in Section 3.1 shall increase by fifteen percent (15%) of the then-outstanding Policy
Liabilities coinsured hereunder (the “Additional 

  
 6 

 
Collateral”) such that Company is, at all times thererafter, collateralized to an amount equal to one hundred and twenty five percent (125%) of the then-outstanding Policy Liabilities
coinsured hereunder. In addition, Company shall have the right, but not the obligation, to commute and recapture the Policies in accordance with the procedure set forth in Section 3.4 below. Company shall provide Reinsurer notice of its intent
to exercise one of the options set forth above within thirty (30) days of the notice of downgrade or withdrawal. Further, Company shall provide Reinsurer with five (5) Business Days notice of which option it intends to exercise from the
options set forth above 
 3.4 Recapture Procedure. The commutation value for the Reinsurance Agreement shall be based on the
reinsured portion of Policies and calculated as the sum of 1l0% of the unamortized balance of excess first year Producer Commissions. TPA Fees, and expense allowances, less policy reserves on inforce policies as of the date of the commutation (the
“Commutation Price”). The unamortized first year expense shall be calculated based on experienced lapse rates up to the commutation date, and pricing lapse rates thereafter, unless agreed otherwise. Following Company’s submission of
the Commutation Price to the Reinsurer, Reinsurer shall have five (5) Business Days from such date to agree to the Commutation Price. If the Commutation Price is positive, Company shall pay such amount to Reinsurer. If the Commutation Price is
negative, Reinsurer shall pay such amount to Company. Such payment shall be completed via wire transfer (wire transfer instructions to be provided within one (1) Business Day of the date Company receives confirmation of Reinsurer’s
agreement of the Commutation Price). 
 In the event Reinsurer does not agree upon the Commutation Price within five (5) Business Days
of Company’s submission of the Commutation Price, it shall provide the Company its calculation of the Commutation Price within thirty (30) days of Company’s submission of the Commutation Price to Reinsurer. Company and Reinsurer shall
then have 30 days from the Company’s original submission date to agree upon the final Commutation Price. If the parties cannot mutually agree upon the Commutation Price, Company and Reinsurer shall appoint a mutually agreed actuarial firm to
determine the Commutation Price. The cost of the actuarial review shall be shared equally; provided, however, that if the review is conducted in connection with a dispute arising out of this Agreement, a panel established pursuant to
Section 11.1 hereof shall have the discretion to allocate such costs between the parties. If the parties are unable to agree to an actuarial firm within ten (10) days, Towers Watson shall act as the appointed firm, If Towers Watson is
unable or unwilling to perform this function for any reason, Milliman USA shall be the appointed firm. The appointed actuarial firm shall advise in writing. (by a method that produces verification of receipt) of its opinion of the appropriate
Commutation Price within 30 days of its appointment. This Commutation Price shall then be binding as between Company and Reinsurer. Reinsurer shall have five (5) Business Days from the receipt of the appointed actuarial firm’s written
valuation of the Commutation Price to pay the Commutation Price to Company via wire transfer (wire transfer instructions to be provided within one (1) Business Day of the date Company receives the Commutation Price). 

  
 7 

 Company shall not be required to release any funds held in the trust account established
under the U.S. Trust Agreement or as Additional Collateral, until it has (x) received full payment of the finally determined Commutation Price and (y) confirmed that Reinsurer has paid its share of any fees and costs related to this
process, including the cost, if any, associated with any jointly appointed actuarial firm. 
 3.5 Change in Control. In the event of
a proposed Change of Control on or after the Coinsurance Effective Date, Reinsurer shall provide Company with at least thirty (30) days prior written notice of the Change of Control (“Notice of Change of Control”). In the event that
the Change in Control triggers a rating downgrade of the Reinsurer, the provisions of sections 3.2 and 3.3 shall apply. 
 Section 3.6
Ratings Upgrade. In the event that Reinsurer a) receives a ratings downgrade and subsequently receives a ratings upgrade to A- or higher, or b) receives a negative outlook, and subsequently maintains
the A- rating and the ratings outlook returns to neutral or positive, the provisions of Section 3.2 or 3.3 shall no longer apply, and any Additional collateral in the U.S. Trust Account will be released
by the Company. 
 Section 3.7 Trust Provisions. This Article III and the obligations established herein shall survive the
expiration or termination of this Agreement for as long as there remain Policy Liabilities under the Policies. 
 ARTICLE IV 

Reinsurance Premium 

4.1 Reinsurance Premium Payment. 

(a) In consideration of Reinsurer’s coinsurance of the Policy Liabilities, Company shall pay to Reinsurer consideration equal to the:

 (i) Total of all Premiums, with respect to the Policies, multiplied by the Coinsurance Percentage (50%); less 

(ii) Total of Policy Liabilities paid by Company during the period from and after the Coinsurance Effective Date, multiplied by
the Coinsurance Percentage; less 
 (iii) For premiums payable for the
1st twenty (20) years of coverage, a Ceding Allowance as defined in 4.2, applied to 4.1(a)(i) as appropriate; less 

(iv) For premiums paid for the 21st and later years of coverage, Producer
Commissions and TPA Maintenance Fees paid by Company, multiplied by the Coinsurance Percentage, and Reinsurer’s share of the National Benefit Parter’s (NBP) Producer bonuses paid by Company; and less 

  
 8 

 (v) Premium-related Taxes Allowance, applied to 4.1(a)(i). Company may
adjust this Allowance upon demonstration that the applicable state premium tax rates for the Policies have increased, from the later of inception or the last such measurement, such that the blended premium tax rate has increased to the greater of
two and one-half percent (2.5%) or twenty five one-hundreths of a percent (.25%) more than the current allowance. Such change shall be implemented in the second monthly
quarterly cash settlement following notice and satisfactory demonstration thereof to the Reinsurer. 
 The consideration set forth under
items (i) through (v) above, referred to as the “Reinsurance Premium.” 
 (b) No later than fifteen (15) days following
the end of each month, positive cash flow will result in payment of the Reinsurance Premium by Company in cash in immediately available funds to the trust account established under the U.S. Trust Agreement plus any additional funds required to reach
the minimum balance required under the U.S. Trust Agreement, or if quarterly cash flow from the Policies is negative, Reinsurer shall make payment to Company. 

4.2 Ceding Allowance. Company shall be entitled to a Ceding Allowance of thirty six and twenty five hundredths percent (36.25%) of
premium for the Policies, inclusive of all Policy and associated rider premium and fees, but exclusive of the Premium-related Taxes Allowance, for Policy premiums payable for each policy’s first 20 years of coverage, and three percent (3%) for
Premiums payable for the twenty first (21st) and later years of coverage. The Ceding Allowance shall be credited to Company as a reduction in the Reinsurance Premium in accordance with
Section 4.1, above. 
 4.3 Reports. On a quarterly basis following from and after the Coinsurance Effective Date, Company shall
provide Reinsurer, in an electronic format such as EXCEL no later than the tenth business day following the close of each month, with the following informational report: 
  

	 	(i)	 Premiums collected during the period; 

 

	 	(ii)	 Ceding Allowances, as applicable; 

 

	 	(iii)	 Producer Commissions and TPA Fees paid during the period; 

 

	 	(iv)	 Policy Liabilities paid by Company, including but not limited to all losses and loss expenses paid;

  

	 	(v)	 Pending claims, including accelerated and extension of benefits long term care claims; 

 

	 	(vi)	 Claim Reserves, computed on a statutory basis, including reserves on acceleration and extension of benefits
long term care claims; 

  

	 	(vii)	 An estimate of incurred but not reported claims, including acceleration and extension of benefits long term
care claims; 

  

	 	(viii)	 Total Policy Reserves ceded on a statutory basis to Reinsurer; 

 

	 	(ix)	 Premiums due and unpaid at the end of the reporting period; and 

 

	 	(x)	 Premiums paid in advance at the end of the reporting period. 

  
 9 

 ARTICLE V 

Administration and Books and Records 

5.1 Reporting Obligations. Company and Reinsurer will cooperate with each other in good faith to develop a mutually acceptable format
for any and all reports that may be required by Company for financial statement preparation or any other reasonable business purpose, including any ad hoc reports that may be required by Company or Reinsurer. 

ARTICLE VI 
 Other
Covenants and Undertakings 
 6.1 Fees and Expenses. Except as otherwise specifically provided herein, each party shall pay
all costs incurred by it for legal, actuarial and other services used in connection with this Agreement. 
 6.2 Arm’s Length
Agreement. This Agreement is entered into at arm’s length without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. It shall not be construed against either party hereto. 

ARTICLE VII 

Representations and Warranties of Company 

Company hereby represents and warrants to Reinsurer as follows: 

7.1 Organization and Standing of Company. Company is a corporation duly organized, validly existing and in good standing under the laws
of the State of Illinois and has all requisite power and authority to carry on the business and operation of Company as now being and as heretofore conducted. 

7.2 Authorization. Company has all requisite corporate power and authority to enter into this Agreement, and to perform its obligations
hereunder subject to receipt of any approvals and consents described herein. The execution and delivery by Company of this Agreement and the performance by Company of its obligations hereunder have been duly authorized and will be a valid and
binding obligation of Company, enforceable against it in accordance with its terms, except as enforceability may be limited by bankruptcy, insolvency, moratorium or other similar laws affecting creditors rights generally or by the principles
governing the availability of equitable remedies, 
 7.3 No Conflict or Violation. The execution, delivery and performance of this
Agreement will not: (a) violate any provision of the Articles or Certificate of Incorporation, By-laws or other organizational document of Company; (b) violate, conflict with or result in the breach
of any of the terms of, result in any modification of, 

  
 10 

 give any counterpart the right to terminate, or constitute a default under, any contract or other agreement
to which Company is a party; (c) violate any order, judgment, injunction, award or decree of the Governmental Authority body against, or binding upon, or any agreement with, or condition imposed by, the Governmental Authority binding upon
Company; or (d) subject to the receipt of any required approvals and consents, violate Applicable Law. 
 7.4 Actions and
Proceedings. There are no outstanding orders, decrees or judgments by or with the Governmental Authority, or arbitration tribunal which, individually or in the aggregate, have or could reasonably be expected to have a material adverse effect on
the Policies. There are no actions, suits or claims or legal, administrative or arbitration proceedings pending or, to the best knowledge of Company, threatened against or involving Company, or any of its directors, officers, employees, properties
or assets in connection with the Policies which, individually or in the aggregate, have or could reasonably be expected to have a material adverse effect on the Policies. 

7.5 Consents and Approvals. Notwithstanding any filing required under Illinois law or regulation, the execution, delivery and
performance of this Agreement does not require Company to obtain any consent, approval or action from, or make any filing with or give any notice to, any Person under any Applicable Law. Company shall be responsible for making any required
filings with the Illinois Insurance Department and obtain all necessary approvals of this Agreement. 
 7.6 Financial Statements.
Prior to the Coinsurance Effective Date, Company has made available to Reinsurer true, correct and complete copies of: (a) the Annual Statement of Company as filed with the Governmental Authority for the years ended December 31, 2009, 2010
and 2011; and (b) the Quarterly Statement of Company as filed with the Governmental Authority for the quarters ended March 31, 2012 and June 30, 2012. Each such Annual Statement and Quarterly Statement complied in all material
respects with Applicable Law when so filed. No material deficiencies have been asserted by the Governmental Authority with respect to any Annual Statement or any Quarterly Statement referred to in (a) and (b) of this Section 7.6. 

7.7 Brokers and Finders. Company has not employed any broker or finder or incurred any liability for any brokerage fees, commissions or
finders’ fees in connection with the transactions contemplated by this Agreement. 
 7.8 Licensing. Company is duly licensed to
underwrite the same type of insurance provided under the Policies in the State of Illinois where the Policies were issued or Policyholders or certificate-holders reside. 

7.9 U.S. Tax Status. Company is subject to U.S. taxation under either the provisions of Subchapter L of Chapter 1 or Subpart F of Part
III of Subchapter N of Chapter 1 of the Code. 

  
 11 

 7.10 Survival. All representations and warranties of Company contained in this
Agreement will be true, accurate and complete at the time of the Coinsurance Effective Date and will survive the Coinsurance Effective Date. 

ARTICLE VIII 

Representations and Warranties of Reinsurer 

Reinsurer hereby represents and warrants to Company as follows: 

8.1 Organization and Standing of Reinsurer. Reinsurer is a corporation duly organized, validly existing and in good standing under the
laws of the State of Illinois and has all requisite power and authority to carry cut the business and operation of Reinsurer as now being and as heretofore conducted. 

8.2 Authorization. Reinsurer has all requisite corporate power and authority to enter into this Agreement, and to perform its
obligations hereunder subject to receipt of any approvals and consents described herein. The execution and delivery by Reinsurer of this Agreement and the performance by Reinsurer of its obligations hereunder have been duly authorized and will be a
valid and binding obligation of Reinsurer, enforceable against it in accordance with its terms, except as enforceability may be limited by bankruptcy, insolvency, moratorium or other similar laws affecting creditors rights generally or by the
principles governing the availability of equitable remedies. 
 8.3 No Conflict or Violation. The execution, delivery and performance
of this Agreement will not; (a) violate any provision of the Articles or Certificate of Incorporation, By-laws or other organizational document of Reinsurer; (b) violate, conflict with or result in
the breach of any of the terms of, result in any modification of, give any counterpart the right to terminate, or constitute a default under, any contract or other agreement to which Reinsurer is a party; (c) violate any order, judgment,
injunction, award or decree of the Governmental Authority against, or binding upon, or any agreement with, or condition imposed by, the Governmental Authority binding upon Reinsurer; or (d) subject to the receipt of any required approvals and
consents, violate Applicable Law. 
 8.4 Actions and Proceedings. There arc no outstanding orders, decrees or judgments by or with
the Governmental Authority, or arbitration tribunal which, individually or in the aggregate, have or could reasonably be expected to have a material adverse effect on Reinsurer. There are no actions, suits or claims or legal, administrative or
arbitration proceedings pending or, to the best knowledge of Reinsurer, threatened against or involving Reinsurer, or any of its directors, officers, employees, properties or assets which, individually or in the aggregate, have or could reasonably
be expected to have a material adverse effect on Reinsurer. 

  
 12 

 8.5 Consents and Approvals. The execution, delivery and performance of this Agreement
does not require Reinsurer to obtain any consent, approval or action from, or make any filing with or give any notice to, any Person under any Applicable Law. 

8.6 Financial Statements. 

(a) Prior to the Coinsurance Effective Date, Reinsurer has made available to Company true, correct and complete copies its (i) 2011 Management
Discussion and Analysis (MD&A), (ii) 2011 Accident and Sickness Summary, and (iii) 2010 and 2011 A&M Best Reports. Each such Statement complied in all material respects with Applicable Law when so tiled and was timely filed with the
Governmental Authority. No material deficiencies have been asserted by any Government Authority with respect to any Statement referred to in (i) and (ii ) of this Section 8.6(a). 

(b) Prior to the date hereof, Reinsurer has made available to Company true, correct and complete copies of (i) the audited balance sheet
as of December 31, 2011 and the related statement of income for the twelve months then ended, and (ii) the unaudited balance sheet as of June 30, 2012 and the related statements of income and cash flows for the nine months then ended;
or the information described in Section 8.6(a). Such financial statements were prepared in accordance with SAP and present fairly in all material respects the financial position as of the dates indicated and the results of its operations for
the periods then ended. 
 8.7 Brokers and Finders. Reinsurer has not employed any broker or finder or incurred any liability for any
brokerage fees, commissions or finders’ fees in connection with the transactions contemplated by this Agreement. 
 8.8
Licensing. Reinsurer is duly licensed to underwrite and reinsure the same type of insurance provided under the Policies in the Slate of Illinois where the Policies were issued or Policyholders or certificate-holders reside. 

8.9 U.S. Tax status. Reinsurer is subject to U.S. taxation under the provisions of Subchapter L of Chapter 1 of the Code. 

8.10 Survival. All representations and warranties of Reinsurer contained in this Agreement will be true, accurate and complete at the
time of the Coinsurance Effective Date and will survive the Coinsurance Effective Date. 

  
 13 

 ARTICLE IX 

Conditions Precedent to Coinsurance Effective Date 

9.1. Company’s Conditions Precedent. The obligation of Company to cede the Policy Liabilities as contemplated by Article II
hereunder as of the Coinsurance Effective Date is subject to the satisfaction or, at Company’s sole option, waiver of, the following conditions as of the Coinsurance Effective Date: 

(a) (i) The representations and warranties of Reinsurer contained in this Agreement shall be true and correct in all material respects (but
without regard to any materiality or material adverse effect qualifications contained in any specific representation or warranty), except that any such representations and warranties that are given as of a particular date and which relate solely to
a particular date or period shall be true and correct in all material respects as of such date or period, and 
 (ii) Reinsurer shall have
performed and complied in all material respects with all covenants and agreements required by this Agreement to be performed or complied with by Reinsurer on or prior to the Coinsurance Effective Date, and (iii) the parties shall have
established the U.S. Trust Agreement. 
 (b) There shall not have been any action taken by the Governmental Authority prohibiting or making
illegal the transactions contemplated by this Agreement. 
 (c) No action, suit or proceeding shall have been instituted and be continuing
or be threatened in writing by the Governmental Authority or any other Parson or entity to restrain, modify or prevent the carrying out of the transactions contemplated hereby, or to seek damages in connection with such transactions, that has or is
reasonably likely to have a material adverse effect on the Policies or the business, property, prospects, results of operations or financial condition of Company. 

9.2. Reinsurer’s Conditions Precedent. The obligation of Reinsurer to coinsure the Policy Liabilities as contemplated by
Article II hereunder as of the Coinsurance Effective Date is subject to the satisfaction or, at Reinsurer’s sole option, waiver of, the following conditions prior to the Coinsurance Effective Date: 

(a) (i) The representations and warranties of Company contained in this Agreement shall be true and correct in all material respects (but
without regard to any materiality or material adverse effect qualifications contained in any specific representation or warranty), except that any such representations and warranties that are given as of a particular date and which relate solely to
a particular date or period shall be true and correct in all material respects as of such date or period, and 
 (ii) Company shall have
performed and complied in all material respects with all covenants and agreements required by this Agreement to be performed or complied with by Company on or prior to the Coinsurance Effective Date. 

(b) There shall not have been any action taken by the Governmental Authority prohibiting or making illegal the transactions contemplated by
this Agreement. 
 (c) No action, suit or proceeding shall have been instituted and be continuing or be threatened in writing by the
Governmental Authority or any other Person or entity to restrain, modify or prevent the carrying out of the transactions contemplated hereby, or to seek damages in connection with such transactions, that has or is reasonably likely to have a
material adverse effect on the Policies or the business, property prospects, results of operations or financial condition of Reinsurer. 

  
 14 

 ARTICLE X 

Insolvency 
 10.1
Insolvency. Reinsurer hereby agrees that, as to all reinsurance made, ceded, renewed or otherwise becoming effective hereunder, the reinsurance shall be payable by Reinsurer on the basis of the liability of Company with respect to the Policy
Liabilities, without diminution because of the insolvency of Company, directly to Company or to its liquidator, receiver or other statutory successor immediately upon demand. It is agreed that in the event of Company’s insolvency, the
liquidator, receiver or statutory successor of Company shall give prompt written notice to Reinsurer of the pendency or submission of a claim filed in the insolvency proceeding under the Policies. During the pendency of such claim, Reinsurer may
investigate such claim and interpose, at its own expense, in the proceeding where such claim is to be adjudicated any defense(s) available to Company or its receiver. The expense thus incurred by Reinsurer is chargeable against Company as a part of
the expense of liquidation to the extent of a proportionate share of the benefit which may accrue to Company solely as a result of the defense undertaken by Reinsurer. 

ARTICLE XI 

Arbitration and Mini Dispute Resolution 

11.1 Disputes Subject to Arbitration. 

(a) Except for any disputes regarding the calculation of the Reinsurance Premium, in the event of any dispute or difference of opinion arising
hereafter with respect to this Agreement or any dispute hereunder, it is hereby mutually agreed upon by the parties that such dispute or difference of opinion shall be submitted to mandatory and binding arbitration. One arbiter shall be chosen by
Company, the other by Reinsurer, and an umpire shall be chosen by the two arbiters before they enter upon arbitration. The arbiters and the umpire shall all be active or retired disinterested executive officers of life, accident and health insurance
or reinsurance companies that write the type of business that is the subject matter of this Agreement. In the event that either party shall fail to choose an arbiter within thirty (30) days following a written request by the other party to do
so, the requesting party’s arbiter may choose a second arbiter, and the two (2) arbiters shall, in turn, choose an umpire before entering upon arbitration. If the two arbiters fail to agree upon the selection of an umpire within thirty
(30) days following their appointment, the American Arbitration Association shall be named to appoint the umpire. 

  
 15 

 (b) Each party shall present its case to the arbiters within thirty (30) days following
the date of appointment of the umpire. No discovery shall be permitted. The decision of the arbiters shall be final and binding on both parties. In the event that the arbiters fail to reach an agreement the umpire shall cast the deciding vote, which
shall be final and binding upon both parties. Judgment upon the final decision of the arbiters may be entered in any court of competent jurisdiction. Each party shall bear the expense of one (1) arbiter and shall jointly and equally bear with
the other the expense of the umpire and of the arbitration. 
 (c) Any arbitration proceeding shall take place at a location mutually agreed
upon by the parties to this Agreement. If the parties to this Agreement fail to agree upon a location, such arbitration proceedings shall take place in Chicago, Illinois. 

11.2 Disputes Subject to Mini Dispute Resolution. With respect to disputes regarding the calculation of the Reinsurance Premium, the
parties’ sole method for resolving such disputes shall be the procedure set forth under this Section 11.2. If the respective parties at Company and Reinsurer responsible for preparing and reviewing the Reinsurance Premium under
Section 4.1(b) are unable to reach agreement within five (5) Business Days after provision of the Reinsurance Premium calculation under 4.1(b), the matter shall be referred to the respective Chief Financial Officers of the parties. The Chief
Financial Officers shall meet and confer within five (5) Business Days of having the dispute referred to them, and shall use commercially reasonable efforts to come to a resolution of the dispute. If the Chief Financial Officers still are unable to
reach agreement as to the Reinsurance Premium within such five (5) Business Day period, the dispute shall be sent to a mutually agreed upon third party financial consultant for final resolution. The parties shall use their respective commercially
reasonable best efforts to ensure that such third party financial consultant resolves the dispute within ten (10) Business Days and the decision of such third party financial consultant shall be final and binding the parties. The cost of the
third party financial consultant shall be borne equally by the parties. All payments of disputed amounts shall be paid with Interest. If the Chief Financial Officers of the parties are unable to mutually agree on a third party financial consultant,
the parties shall refer the dispute to the arbitration provision set forth under Section 11.1 above. 
 ARTICLE XII 

Privacy and Canfidentiality 
 12.1
Privacy. Reinsurer recognizes that, in the performance of its obligations under this Agreement, it may obtain from Company and other sources personal or privileged information about individuals collected or received in connection with
insurance transactions. Each party agrees to maintain the confidentiality of such information in accordance with all Applicable Laws and not to re-dlsclose such information further without the
individual’s written authorization unless such disclosure is otherwise permitted by Applicable Law. The Parties will not disclose such information to any other unrelated parties without the required written consent, except; as necessary for
retrocession purposes, as requested by external auditors, as required by court order, or as required or allowed by law or regulation. 

  
 16 

 12.2 Confidentiality. 

(a) The parties agree that, other than as contemplated by this Agreement and to the extent permitted or required to implement the transactions
contemplated by this Agreement, the parties will keep confidential and will not use or disclose the other party’s Confidential Information (as defined below) and the terms and conditions of this Agreement, including, without limitation, the
exhibits and schedules hereto, except as otherwise required by Applicable Law or as may be agreed in writing by the parties hereto. 
 (b)
“Confidential Information” means all documents and information concerning one party or any of its Affiliates or a Policyholder furnished to the other party or such other party’s Affiliates or representatives in connection with this
Agreement or the transactions contemplate hereby, except that Confidential Information shall not include information which: (i) at the time of disclosure or thereafter is generally available to and known by the public other than by way of a
wrongful disclosure by a party hereto or by any representative of a party hereto; (ii) was available on a nonconfidential basis from a source other than the parties hereto or their representatives, provided that such source is not and was not
bound by a confidentiality agreement with a party hereto; or (iii) was independently developed without violating any obligations under this Agreement and without the use of any Confidential Information. 

(c) The parties acknowledge and agree that Reinsurer may, in accordance with Applicable Law, use all Confidential Information regarding a
Policyholder, Certificateholder, the Policy Liabilities or the Policies in order to perform the Administrative Services under the Services Agreement. 

ARTICLE XIII 

Miscellancous 
 13.1
Co-operation. The parties hereto shall cooperate with each other and, individually or collectively, shall take such further action and execute such further documents as may be reasonably necessary to effectuate the purposes of this Agreement.

 13.2 Errors. Inadvertent delays, errors or omissions made in connection with this Agreement by any party shall not relieve either
party from any liability or duty which would have attached had such delay, error or omission not occurred, provided that such delay, error or omission shall have been rectified as soon as possible after discovery. 

13.3 Assignment. This Agreement, shall not be assigned by operation of law or otherwise by any party hereto without the prior written
approval of the other party. Subject to the foregoing, the rights and obligations of the parties under this Agreement shall inure to the benefit of and be binding upon the parties hereto and their respective transferees, successors and assigns. 

  
 17 

 13.4 Audit. Reinsurer reserves the right to audit all records related to the business
ceded, including premiums, case underwriting, claims and other matters. Reinsurer can use its employees or contractors to perform such audits. All such audits will be performed during the Company’s regular working hours, as arranged with the
reinsurer. Reinsurer will bear all costs of the audits. 
 13.5 Notices. Any and all notices or other communications required or
permitted under this Agreement shall be in writing and shall be provided by any method that produces a written receipt or written evidence of its sending and of its receipt by the recipient to the persons and at the addresses, facsimile numbers or e-mail addresses set forth below: 
 If to Company: 

Combined Insurance Company of America 
 1000 N. Milwaukee Avenue

 Glenview, Illinois 60025 
 Attn: Chris Martin, President,
Worksite Solutions 
 Telephone No. (847) 953-8128 
 Fax No.
(847) 953-8100 
 E-Mail: Chris.J.Martin@combined.com 

With a copy to: 
 Combined Insurance Company of America 

1000 N. Milwaukee Avenue 
 Glenview, Illinois 60025 

Attn: Chad Hclin 
 Telephone No. (847) 953-8114 
 Fax NO. (847) 953-1556 

E-Mail: Chad.Helin@combined.com 

If to Reinsurer: 
 Fidelity Life Association 

Fidelity Life Association 
 8700 W. Bryn Mawr Ave. Suite 900S

 Chicago, Illinois 60631 
 Attn: Jim Harkensee 

Telephone No. (312) 379 2927 
 Fax # 866 375 8175 

E-Mail jim.harkensee@fidelitylifc.com 

  
 18 

 With a copy to: 

Fidelity Life Association 
 8700 W. Bryn Mawr Ave. Suite 900S

 Chicago, Illinois 60631 
 Attn: Jim Harkensee 

Telephone No. (312) 379 2927 
 Fax # 866 375 8175 

E-Mail Jim.Harkensee@fidelitylife.com 

Notice shall be deemed received on the first Business Day following actual receipt. Either party may change the names or addresses where notice is to be given
by providing notice to the other party of such change in accordance with this section. 
 13.6 Entire Contract. This Agreement is the
entire contract between the parties hereto, and supersedes all prior oral discussions and written agreements between the parties with respect to the subject matter hereof. 

13.7 Non-Waiver. Except as otherwise specified herein, no act, delay, omission or course of
dealing by or between the parties in this Agreement shall constitute a waiver of any right or remedy under this Agreement. No waiver, change, modification or discharge, in whole or in part, of any provision of this Agreement shall be effective
unless made in writing and signed by a duly authorized officer of the party agreeing to said waiver, change, modification or discharge. The waiver of any right or remedy under this Agreement shall not constitute a continuing waiver, nor a waiver of
any other right or remedy, unless expressly provided in a writing to the contrary. 
 13.8 Amendment. This Agreement may be modified
or amended only by a writing duly executed by authorized officers of the parties hereto. 
 13.9 Counterparts. This Agreement may be
executed simultaneously in any number of counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. 

13.10 Governing Law. This Agreement shall be governed by, construed and enforced in accordance with the laws of the State of Illinois,
without regard to principles of conflict of laws of any jurisdiction. 
 13.11 Severability. If any portion of this Agreement shall
be determined by any court of competent jurisdiction to be unenforceable, the unenforceable term or provision shall be stricken or interpreted in such manner as may be necessary to permit it to be enforceable, and the remaining portions of this
Agreement shall be enforced in accordance with their respective terms. 

  
 19 

 13.12 No Third Party Beneficiaries. No Person not a party to this Agreement shall
have any benefit under this Agreement nor have any third-party beneficiary rights under this Agreement. 
 13.13 U.S. Dollars. Any
monetary amount described in this Agreement, including any schedules hereto, shall mean United States Dollars. 
 13.14 Public
Announcements. At all times, Company and Reinsurer will each consult with the other before issuing or making any reports, statements or releases to the public with respect to this Agreement or the transactions contemplated hereby and will use
good faith efforts to obtain the other party’s approval of the form, content and timing of any public report, statement or release to be made solely on behalf of a party. If Company and Reinsurer are unable to agree upon or approve the form,
content and timing of any such public report, statement or release and such report, statement or release is, in the opinion of legal counsel to the party, required by Applicable Law or by legal disclosure requirements, then such party may make or
issue the legally required report, statement or release and shall provide to the other party a copy of such report, statement or release along with the opinion of legal counsel permitting such release. For the avoidance of doubt, the release by a
party of its publicly available financial statements shall not be subject to this Section 13.14. 
 13.15 No Prejudice. The
parties agree that this Agreement has been jointly negotiated and drafted by the parties hereto and that the terms hereof shall not be construed in favor of or against any party on account of its participation in such negotiations and drafting. 

13.16 Set-Off. Any debts, amounts due or credits between the parties arising under this
agreement are deemed mutual debts or credits, as the case may be, and shall be netted or set off, as the case may be, and only the balance remaining shall be allowed or paid hereunder 

  
 20 

 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to executed by
their duly authorized officers as of the Execution Date written below. 
  

			
	FIDELITY LIFE ASSOCIATION
		
	By:	 	/s/ Jim Harkensee
	Name:	 	Jim Harkensee
	Title:	 	President & COO
	Date:	 	8/27/2013

  

			
	COMBINED INSURANCE COMPANY OF AMERICA
		
	By:	 	/s/ Chris Martin
	Name:	 	Chris Martin
	Title:	 	President, Combined Worksite Solutions
	Date:	 	8-21-13

  
 21 

 Exhibit A 

Administrative Services Agreement 

(To Be Attached) 

  
 22 

 Exhibit B 

Form Of U.S. Trust Agreement 

(To Be Attached) 

  
 23

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