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					                                              STATE OF COLORADO
DEPARTMENT OF REGULATORY AGENCIES
Tambor Williams
Executive Director

DIVISION OF INSURANCE
David F. Rivera
                                                                                                      ________________
Commissioner of Insurance
                                                                                                      Bill Owens
1560 Broadway, Suite 850
                                                                                                      Governor
Denver, Colorado 80202




                                                   BULLETIN 10-05

                                 Requirements for the Filing of Rates and Forms
                                     for Life, Accident and Health Carriers

                                                                                               Issued: October 26, 2005
                                                                                         Re-issued: November 10, 2005

I.         Background and Purpose

The purpose of this bulletin is to provide carriers with comprehensive guidance on filing life, accident and
health rates (includes rating rules or plans, i.e. experience rating) and forms. If you are a multi-line company
involved in property and casualty insurance, please refer to the ―Requirements for the Filing of Rates and
Forms for Property and Casualty Carriers.‖ This bulletin replaces in its entirety bulletin 01-04. Following
these guidelines and checklists will eliminate incomplete or unsupported rate and form filings, while providing
greater protection to Colorado consumers. These checklists are to assist the carriers in preparing the filings;
please do not send the checklists with the filings.

The following checklists are provided for your information:

           Credit Life, Accident and Health Insurance Form Certification Filings
           Credit Life, Accident and Health Insurance Rate Filings
           Excess Loss Insurance for Self-Insured Employer Health Benefit Plans under ERISA
           Health Form Certification Filings
           Health Rate Filings
           Health Reasonable Modification Filings
           Medicare Supplement Form Filings
           Medicare Supplement Rate Filings
           Prepaid Dental Form Filings
           Preneed Funeral Contract Certification Filings

This bulletin provides a standardized format for the certification of accident and health forms as prescribed
in Colorado Regulation 1-1-6 for each Listing of New Policy Forms or Annual Report of Policy Forms.
Additionally, the submission of a complete and supported filing should reduce costs to the insurance
industry, Colorado consumers, and the Division of Insurance (DOI). The DOI has made reasonable efforts
to ensure that all information made available in this bulletin is current, complete and accurate. The DOI
does not warrant or represent that this information is current, complete and accurate.

All information is subject to change and the electronic version is available at the DOI web site
(http://www.dora.state.co.us/insurance), which may be more current than the published, paper version.


                              “The Mission of the Division of Insurance is Consumer Protection.”
     General Number: (303) 894-7499 / Consumer Complaints: (303) 894-7490 / Toll Free 1-800-930-3745 / FAX: (303) 894-7455
           Producer Licensing/Promissor: 1-800-275-8247 / V/TDD for the Deaf or Hearing Impaired: (303) 894-7880
                                           http://www.dora.state.co.us/insurance
Colorado insurance statutes and regulations require the filing and/or approval of insurance rates and
applicable supporting documentation concurrent with or prior to distribution, release to producers, collection
of premium, advertising, or any other use of the rate. Forms may not be distributed, released to producers,
advertised or used in any other manner prior to the 31-day waiting period or, if required by law, prior
approval. Additional Colorado insurance statutes and regulations require the filing or approval of forms or
form certifications. Companies are failing to use the most current revision of the forms and filing transmittal
form, or have failed to include a transmittal form or other forms with their filings. This bulletin gives
guidance on usage of the correct version of these forms.

Bulletins are the Division’s interpretations of existing insurance law or general statements of Division
policy. Bulletins themselves establish neither binding norms nor finally determine issues or rights.

II.     Applicability and Scope

Companies, for the purposes of this bulletin, include all property and casualty carriers (authorized to write
life and health insurance); life and health carriers; non-profit hospital, medical-surgical, and health service
corporations; health maintenance organizations (HMOs) and limited service licensed provider networks
(LSLPNs). This bulletin does not require filings not otherwise required by statute or regulation, and it does
not expand the authority of any regulations to include additional lines, such as life insurance.

III.    Division Position

All Filings

All companies shall submit a separate and fully completed filing transmittal sheet (the NAIC Uniform
Transmittal Form may be used) with each rate or form filing for each company (this includes form filings
made using the Annual Certification code). A copy of this document, including an example and code list, is
attached and available on the internet at http://www.dora.state.co.us/insurance.

Each company should maintain records of the type and kind reasonably necessary to support: its methods of
operation; its experience; and data, statistics, or information collected or used by the company in connection
with rates, rating plans, rating systems, classifications, rating schedules, minimum premiums, policy fees,
rating rules, and underwriting rules. The availability of these records is necessary to enable the DOI to
determine whether every rate, rating plan, and rate system made or used by the company complies with
Colorado insurance laws and regulations. Given this requirement, the duplicate filing, stamped by the DOI
and returned to the company, is a necessary record that should be maintained by the company. These records
may be requested as part of an investigation of an insurance complaint, a rate investigation, a desk audit or a
market conduct examination.

Companies must submit all filings in duplicate with a self-addressed, postage-paid envelope large enough to
accommodate the return filing. The duplicate filing will be returned to the company in order to acknowledge
filings received by the DOI, and it must contain a copy of the cover letter and all appropriate filing forms,
such as Form HR-1, certifications of compliance and form listings. If a duplicate copy, postage-paid
envelope of a sufficient size to accommodate the filing or minimum supporting documentation is not
received, the filing will be returned as incomplete.

Preparation of Documents: Documents must be prepared so that oversize documents are reduced to a
maximum size of 8 ½ by 14 inches. If track feed paper is used, the feed edges must be removed. We will
not accept permanently bound documents. Smaller documents should be mounted and taped onto an 8 ½ by
11 inch piece of paper or copied onto an 8 ½ by 11 inch piece of paper. Additionally, all documents
must be printed on white paper with black ink. Please remove all shading from the documents prior to
submitting them to the Division. Please remove ALL staples from the Division’s copy of the filing.




REVISED October 2005                                                                                2
Multiple Company Filings: Each company’s filing within the group of filings should be separate and contain
all of the required filing forms and supporting documentation for that company. Please do not include filing
forms for any other company in the filing.

If reproduced, all DOI filing forms should be typed in a font size no smaller than 10 points.

Carriers may submit filings or filing information to the Colorado DOI in two manners:

         The DOI is currently accepting rate and form filings via SERFF (Submission of Electronic Rate and
          Form Filings). SERFF reduces the amount of paper being used and, by eliminating the mail time,
          provides for a quicker response from the DOI. Companies are encouraged to utilize SERFF as a
          means to efficiently submit their filings.
         Companies may make rate and form filings by submitting them in paper.

In the future, other forms of electronic submission may become available.

Rate Filings

In accordance with Colorado statues and regulations, carriers must submit rate filings with the required
supporting documentation. The minimum required supporting documentation for any rate filing is
documented in Colorado regulations. This bulletin contains the following forms for use in conjunction with
these regulations:

        Form HR-1                                     Colorado Regulation 4-2-11
        Filing Transmittal Sheet                      Colorado Regulation 4-2-11

Health carriers must submit a fully completed Form HR-1. A separate rate filing and Form HR-1 form must
be filed for each type of health coverage. A separate rate filing and Form HR-1 is required for each major
line of business (e.g. large group, small group, individual, etc.). Each filing must be submitted as a separate
document with proper supporting documentation attached to each. Only one Form HR-1 should be submitted
with each rate filing. Form HR-1 is attached to this bulletin, along with instructions for completing it, and
reproduction by carriers is authorized and encouraged. The form is also available on the Internet at:
www.dora.state.co.us/Insurance.

Additionally, for health rate filings, supporting documentation equivalent to the following is required:
(Please review Regulation 4-2-11(6)(F) for a listing of all requirements.)

   Projections of the loss ratio, with and without any rate adjustment(s).
   All other supporting information necessary to develop or support the rate change.
   A complete description as to how the rate increase was calculated, including all underlying assumptions
    with appropriate justification.
   For Medicare supplement policies and any other policies basing the increase on aggregate data, a
    complete description as to how the increase was allocated over the individual policy forms.
   For Medicare supplement policies, a loss ratio analysis by policy duration over all experience years, i.e.,
    the historic loss ratio for each of the plan’s durations. These loss ratios should be compared to the
    expected loss ratio for each duration of the plan. If this ratio is not greater than or equal to 100% for the
    majority of the plan durations, the filing must clearly justify the need for any increase.

For Medicare supplement policies: please note that Colorado Regulation 4-3-1 was revised effective
December 1, 2005. Please review the regulation to ensure that all filings made are in compliance with
Sections 13 and 14 of the regulation. In particular, filings will be returned to the company as incomplete if
they do not include an analysis of the loss ratio by policy duration, for each plan, and a comparison of the
actual to expected loss ratio by plan and in aggregate.

REVISED October 2005                                                                                 3
Form and Form Certification Filings

Filings requiring a company submission listing policy forms, per Regulation 1-1-6, do not require submittal
of any actual policy forms.

All carriers and other organizations authorized to conduct business in Colorado which provide health
coverage, credit life/health insurance and/or preneed funeral contracts are required to fully execute and file
with each Listing of New Policy Forms or Annual Report of policy forms the following certification forms:

     Colorado Health Coverage Certification Form for Listing of New Policy Forms ( FORM HEALTH): This
      form must accompany all Listings of New Policy Forms of health insurance forms, subscription
      certificates, membership certificates, or other evidences of coverage.
     Colorado Health Coverage Certification Form for Annual Reports (FORM HEALTH ANNUAL):
      This form must accompany all Annual Reports of health insurance forms, subscription certificates,
      membership certificates, or other evidences of coverage. Please use Product Category 849A on the filing
      transmittal form.
     Colorado Credit Insurance Policy Certification Form for Annual Reports and Listings of New Policy
      Forms (FORM CI): This form must accompany all Listings of New Policy Forms or Annual Reports of
      policy forms of credit insurance forms. Please use Product Category 862 on the filing transmittal form.
     Colorado Preneed Certification Form for Annual Reports and Listings of New Contracts ( FORM PN):
      This form must accompany all Listings of New Policy Forms or Annual Reports of preneed funeral
      contracts. Please use Product Category 877 on the filing transmittal form.
     Colorado Excess Loss Insurance for Self-Insured Employer Benefit Plans under ERISA Certification
      Form (FORM EXCESS LOSS): This form must accompany submission of the actual forms.

Each of these forms is attached to this bulletin and available on the internet at:
http://www.dora.state.co.us/insurance. Reproduction by carriers is authorized and encouraged for any forms
included in this bulletin.

PLEASE NOTE: Company officers must sign the certification forms and it must be an original signature
(electronic signatures are not acceptable unless provided through a signature verification provider such as
VeriSign). If the individual signing the certification is other than the president, vice president, assistant vice
president, corporate secretary, assistant corporate secretary, CEO, CFO, COO, general counsel, or an actuary
who is also a corporate officer, please include documentation that shows that this individual has been
appointed as an officer of your organization by the Board of Directors. This documentation should be
submitted with each filing.

IV.      For More Information

If you have questions concerning this bulletin, please contact:

Colorado Division of Insurance
Rates and Forms Section
1560 Broadway, Suite 850
Denver, CO 80202
Tel. 303-894-7499

This bulletin and its forms are available on the Colorado DOI Internet website, at:
http://www.dora.state.co.us/insurance




REVISED October 2005                                                                                 4
                                     TABLE OF CONTENTS

Filing Forms                                                                                Page
Number
Filing Transmittal Form                                                                              8
FORM HR-1, Colorado Health Rate Filing Form                                                         16
FORM HEALTH, Colorado Health Coverage Certification Form for Listing of New
                                                                                                    18
Policy Forms
FORM HEALTH ANNUAL, Colorado Health Coverage Certification Form for Annual
                                                                                                    19
Reports
FORM CI, Colorado Credit Insurance Policy Certification Form for Annual Reports and
Listings of New Policy Forms                                                                        21
FORM PN, Colorado Preneed Certification Form for Annual Reports and Listings of
                                                                                                    23
New Contracts

FORM EXCESS LOSS, Colorado Excess Loss Insurance for Self-Insured Employer
                                                                                                    28
Benefit Plans under ERISA Certification Form

Checklists/Instructions                                                                    Page Number

A.   Instructions for Completing the Filing Transmittal Form                                         7
B.   Health Rate Filing Checklist                                                                    8
C.   Credit Insurance Rate Filing Checklist                                                         11
D.   Medicare Supplement Rate Filing Checklist                                                      12
E.   Instructions for Completing Form HR-1 (all coverages except Credit Life, Accident &            14
     Health)
F.   Instructions for Completing Form HR-1 for Credit Life, Accident & Health                       15
G.   Health Form Certification Filing Checklist                                                     17
H.   Credit Insurance Form Certification Filing Checklist                                           20
I.   Preneed Funeral Contract Certification Filing Checklist                                        22
J.   Prepaid Dental Form Filing Checklist                                                           24
K.   Medicare Supplement Form Filing Checklist                                                      25
L.   Reasonable Modification Notification Filing Checklist                                          26

M. Excess Loss Insurance for Self-Insured Employer Benefit Plans under ERISA                        27
   Certification Filing Checklist

N.   Filing Transmittal Form State Specific Code Listing                                            29

REVISED October 2005                                                                          5
O.   Uniform Life, Accident & Health, Annuity and Credit Coding Matrix       30




REVISED October 2005                                                     6
                  INSTRUCTIONS FOR COMPLETING THE FILING TRANSMITTAL FORM

                   PLEASE DO NOT SEND THESE INSTRUCTIONS IN WITH THE FILING.

It is imperative that our form be utilized and not altered in any way on another computer system. Our data
entry system is keyed to read this form as is, with all appropriate blocks completed.

A separate transmittal form should be completed for each company and for each type of filing. Combined form and
rate filings are not acceptable.

The filing transmittal form is an integral part of the process of preparing the carrier’s filings for the imaging of
documents. This coding is critical to our ability to report and/or publish accurate statistical data regarding the
insurance industry.

Name of Company: This should be the name of the company for which the filing is being made; note that group
filings are not permitted in Colorado.

Company DOI Number: This is the number assigned to the company by the Colorado DOI (not the five-digit NAIC
number). If you do not know your DOI Number, it can be obtained directly from the Division, either by phone or by
accessing the Division’s Internet website. Title agencies: Please use ―AGENT‖ in this field.

The following example will explain the reason for each of the categories of codes. If you are filing a document that
qualifies under more than one Filing code, use as many codes as needed (up to 7, which is 21 characters). Carriers
and consumers utilize this information, and every code will assist them in retrieving the appropriate information they
are seeking. The codes can be found at the end of this bulletin.

EXAMPLE (this is an example only, note that not all Primary Filing” codes are H16G, nor are all “Sub-Type
Filing Codes” codes H16G.002C, nor are all “State Specific Codes” 616):

                                                                                  FILING TYPE
                                                                           (Please Check Only ONE)***
                           PRIMARY FILING CODE                            Form
              H        1      6  G                                        Rate                 
                                                                          Rule
                                                                          Rate and Rule
                           SUB-TYPE FILING CODE                           Loss Cost
              H        1      6   G.    0   0   2                C        Annual Filing
                                                                          Other/Letter


                                               STATE SPECIFIC CODES
                       6   1   6
                                               (UP TO 21 CHARACTERS)

*** Rate/Rule filings cannot be combined with Form filings. Combining filings and/or checking more than
    one box may result in the entire filing being returned.

H16G               =           Identifies this filing as a Group Health – Major Medical filing
H16G.002C          =           Identifies this filing as a Large Group Only - Other filing
                  =           Identifies the filing type as a Rate filing.
616                =           Identifies the filing as a Multi-state Association (616) filing.
                               [Use as many codes as necessary for proper identification (up to 7 codes, which is 21 characters).]

If you have any questions or concerns regarding this filing transmittal form, please contact the DOI for assistance.

Please Note: The NAIC Uniform Transmittal form may be used in place of this transmittal and must include
Colorado’s product category and product codes. However, all other filing forms are required as appropriate for
the type of filing being submitted.



REVISED October 2005                                                                                            7
                                              COLORADO DOI

                                      FILING TRANSMITTAL FORM

                          ONE FORM PER COMPANY PER LINE OF BUSINESS


                        _____________________________________________________
                                        NAME OF COMPANY


 COMPANY DOI NUMBER (not the NAIC number; see instructions):



                       ______________________________________________________
                                          NAME OF FILING

__________________________                                             __________________________
 DATE FILING PREPARED                                                        FILING DATE**

** Note filing date means the date the filing is RECEIVED at the DOI. Please allow 7-10 days for mailing.

                          _________________________________________________
                                     COMPANY FILING NUMBER


                                                                           FILING TYPE
                                                                    (Please Check Only ONE)***
                       PRIMARY FILING CODE                          Form
                                                                    Rate
                                                                    Rule
                                                                    Rate and Rule
                       SUB-TYPE FILING CODE                         Loss Cost
                                                                    Annual Filing
                                                                    Other/Letter


                                         STATE SPECIFIC CODES



*** Rate/Rule filings cannot be combined with Form filings. Combining filings and/or checking more than
    one box may result in the entire filing being returned.


                    DOI Received Date:      ________________________________


                    DOI Filing Number:      ________________________________




                                           (FOR DOI USE ONLY)
                                     STATE OF COLORADO
                           COMPANY CHECKLIST FOR HEALTH RATE FILINGS
                                  REQUIRED ITEMS FOR A COMPLETE FILING

            Required                                   Information                             Statutory/Regulation/
                                                                                                  Information Cite
    Filing Transmittal Form       Submit one for each company and for each type of          Colorado Regulation 4-2-11
                                  filing. A form filing cannot be combined with a rate       (5)(B)(1)
                                  filing; they must be separate.                            Colorado Bulletin 10-05
    Cover Letter                     Brief summary of the rate filing                      Division Policy
                                     Helps identify what companies and lines of
                                      insurance are being filed
                                     One copy for each company and/or filing
    Form HR-1                        Must accompany all submissions                        Colorado Regulation 4-2-11
                                     Effective dates must not be retroactive. If            (5)(B)(1)
                                      resubmitting, filing and effective date must be
                                      current date
                                     Only one HR-1 should be submitted with each filing    Colorado Bulletin 10-05
    Actuarial Certification       Should be signed and dated by a qualified actuary         Colorado Regulation 4-2-11
                                  stating that the rates are “not excessive, inadequate      (5)(B)(2)
                                  or unfairly discriminatory”.
    Actuarial Memorandum          Actuarial Memorandum must contain a description of        Colorado Regulation 4-2-11
    items:                        the items in the left column:                              (6)(A)
     Summary of the               Must summarize the reasons for the rate filing, the     Colorado Regulation 4-2-11
        reasons for the rate          marketing methods(s), premium classifications, and     (6)(B)
        filing                        product descriptions
     Rating Period                Must clearly identify the period for which the rates    Colorado Regulation 4-2-11
                                      will be effective                                      (6)(C)
       Effect of Underwriting     Must describe the extent to which the product will      Colorado Regulation 4-2-11
        on the Rates                  be underwritten. The separate effects of specific      (6)(D)
                                      types of underwriting should be identified.
                                   Describe the extent to which the rate changes are
       Effect of Law Changes         due to changes in law or regulation                   Colorado Regulation 4-2-11
        on the Rates               Must include a chart indicating the rate changes        (6)(E)
       Rate History                  implemented for the 3 years preceding the date of     Colorado Regulation 4-2-11
                                      the filing and the cumulative effect, on renewal       (6)(F)
                                      rates, of all rate changes in the past year
                                   Must describe the effect of coordination of benefits
       Coordination of               on rates                                              Colorado Regulation 4-2-11
        Benefits                   Must adequately support the reasonableness of the        (6)(G)
       Relation of Benefits to       projected benefits to the projected earned            Colorado Regulation 4-2-11
        Premium                       premiums (at least three alternatives are offered)     (6)(H)
                                   Must identify the amount or percentage of the
       Profit Provision              provision for profit and contingencies and how this   Colorado Regulation 4-2-11
                                      provision is included in the final rate               (6)(I)
                                   Must describe completely how the rate increase
       Description of the            was determined. Support for all underlying rate       Colorado Regulation 4-2-11
        calculation of the            assumptions and a discussion of the Colorado          (6)(J) & (6)(K)
        increase                      credibility requirement should be included.



          REVISED October 2005                                                                            8
Health Rate Filing Requirements                                                                                   page 2

            Required                                     Information                             Statutory/Regulation/
                                                                                                    Information Cite
                                         (Actuarial Memorandum Requirements continued)
       Data Description             Should include Colorado experience for the past 3        Colorado Regulation 4-2-11
                                      years and any additional supplement experience.          (6)(L)
                                      Rate changes should be based upon as much
                                      Colorado data as possible. The experience should
                                      include data within at least 6 months of the date of
                                      the filing
       Side-by-Side                 Must contain a side-by-side comparison comparing         Colorado Regulation 4-2-11
        Comparison                    the old rating factor, the new factor, and the            (6)(M)
                                      percentage change for each rating factor that has
                                      been changed
       Loss Ratio Projections       Must project the loss ratio for the rating period both   Colorado Regulation 4-2-11
                                      with and without the requested increase                   (6)(N)
       Description of Other         Must clearly display all other rating factors and        Colorado Regulation 4-2-11
        Rating Factors                definitions including the area factors, gender            (6)(O)
                                      factors, etc.
    Duplicate Copy and            To be stamped and returned for the company's records         Colorado Regulation 4-2-11
    Postage-paid Return           to document filing (The copy should be separate from          (5)(A)(4)
    Envelope                      the original.)                                               Colorado Bulletin 10-05
    Additional requirements for the following lines of business:
    Individual                  Specific Individual Rate Filing Requirements                   Colorado Regulation 4-2-11
                                                                                               (7)(A)
    Small Group                   Specific Small Group Rate Filing Requirements                Colorado Regulation 4-2-11
                                                                                               (7)(B)
                                                                                               Colorado Regulation 4-6-7
    Large Group                   Specific Large Group Rate Filing Requirements                Colorado Regulation 4-2-11
                                                                                               (7)(C)
    Medicare Supplement           Specific Medicare Supplement Rate Filing                     Colorado Regulation 4-2-11
                                  Requirements                                                 (7)(D)
    Long-Term Care                Specific Long-Term Care Rate Filing Requirements             Colorado Regulation 4-2-11
                                  Please include:                                              (7)(E)
                                     Demonstrate that investment income has been
                                      considered in the development of the rate;               Colorado Bulletin 10-05
                                     Provide the expected loss ratios for both the
                                      experience period and the projection period;
                                     Provide the ratio of the actual loss ratio to the
                                      expected loss ratio for each year of the life of the
                                      policy on both a durational and calendar year basis;
                                      and
                                     Provide a discussion as to how the original pricing
                                      assumptions have changed historically, and how
                                      the assumptions for the future period compare to
                                      the original pricing assumptions and the current
                                      rating assumptions.
    Disability Income             Specific Disability Income Rate Filing Requirements          Colorado Regulation 4-2-11
                                                                                               (7)(F)

          REVISED October 2005                                                                              9
    HMO                          Specific HMO Rate Filing Requirements        Colorado Regulation 4-2-11
                                                                              (7)(G)
            Required                                Information                  Statutory/Regulation/
                                                                                     Information Cite
    LSLPN                        Specific LSLPN Rate Filing Requirements      Colorado Regulation 4-2-11
                                                                              (7)(H)

                           PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING




          REVISED October 2005                                                             10
                                            STATE OF COLORADO

              COMPANY CHECKLIST FOR CREDIT INSURANCE RATE FILINGS
                                 REQUIRED ITEMS FOR A COMPLETE FILING

        Required                                Information                                 Statutory/Regulation/
                                                                                               Information Cite
    Filing Transmittal   Submit one for each company and for each type of              Colorado Bulletin 10-05
    Form                 filing. A form filing cannot be combined with a rate
                         filing; they must be separate.

    Cover Letter            Brief summary of the rate filing                          Division Policy
                            Helps identify what companies and lines of
                             insurance are being filed
                            One copy for each company

    Form HR-1               Must accompany all submissions                            Colorado Bulletin 10-05
                            Effective dates must not be retroactive. If
                             resubmitting, filing and effective date must be
                             current.
                              Colorado Bulletin 10-05 has specific
                                 instructions for Credit entities

    Actuarial                All credit rate filings must credibly demonstrate that   §10-10-109(2), C.R.S.
    Memorandum                a proposed rate will produce a loss ratio of at least    Colorado Regulation 4-9-2(12)(B)
                              40%.
                                                                                       Colorado Regulation 4-9-2
                             Experience of earned premiums, incurred losses            (12)(D)(1)
                              and calculated loss ratios for the prior three years,
                              or all available experience, if less than three (3)
                              years. Rates and rating data must be based on
                              Colorado data to the extent that it is credible.
                                                                                       Colorado Regulation 4-9-2
                             Target or expected loss ratio                             (12)(D)(2)
                                                                                       Colorado Regulation 4-9-2
                             Quantification of any benefit changes                     (12)(D)(3)
                                                                                       Colorado Regulation 4-9-2
                             Rate development                                          (12)(D)(4)
                                                                                       Colorado Regulation 4-9-2
                             Analysis of credibility, and use of collateral data       (12)(D)(5)
                              such as company experience in other states for
                              similar policies, industry experience, mortality
                              tables or morbidity tables
                                                                                       Colorado Regulation 4-9-2
                             Demonstrate compliance with loss ratio standard           (12)(D)(6)

                                                                                       Colorado Regulation 4-9-2
                             Certification by a qualified actuary                      (12)(D)(6)

    Duplicate Copy       To be stamped and returned for the company's records          Colorado Bulletin 10-05
    and Postage-paid     to document filing (The copy should be separate from
    Return Envelope      the original.)

                             PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING

        REVISED October 2005                                                                                11
                                                              STATE OF COLORADO

                                             ALL MEDICARE SUPPLEMENT RATE FILINGS

                                                        REQUIRED ITEMS FOR COMPLETE FILING

           Required                                                Information                                               Regulation cite
    Filing Transmittal Form   Submit one for each company and for each type of filing. A form filing cannot be        Colorado Regulation 4-2-11
                              combined with a rate filing; they must be separate.                                      (5)(A)(1)
                                                                                                                      Colorado Bulletin 10-05

    Form HR-1                 One fully completed form must accompany each filing.                                    Colorado Regulation 4-2-11
                                                                                                                       (5)(B)(1)
                                                                                                                      Colorado Bulletin 10-05

    Actuarial Certification   Should be signed and dated by a qualified actuary. Must include the following:          Colorado Regulation 4-3-1
                                  To the best of my knowledge and judgment, the following are true with respect      (14)(H)
                                     to this Medicare Supplement rate filing:
                                      The assumptions present my best judgment as to the expected value for
                                         each assumption and are consistent with the Company’s business plan at
                                         the time of the filing;
                                      The anticipated lifetime loss ratio, future loss ratios, and third year loss
                                         ratios all equal or exceed the applicable required loss ratio in Colorado;
                                      The filed rates maintain the proper relationship between policies which
                                         were originally filed with differing rating methodologies;
                                      The filing was prepared based on current standards of practice as
                                         promulgated by the Actuarial Standards Board, including the data quality
                                         standard of practice;
                                      The filing is in compliance with applicable Colorado laws and regulations;
                                         and
                                      The rates are reasonable in relationship to benefits.

    Actuarial Memorandum      Must contain all of the following items:
    1 All items required in   Please see Checklist for Health Rate Filings.                                           Colorado Regulation 4-2-11
       Regulation 4-2-11                                                                                               (6)
    2 Discussion of the       Must discuss the credibility of the underlying data affected by the proposed rate       Colorado Regulation 4-3-1
       Credibility of the     change and MUST reference the Colorado credibility requirement of 2,000 lives and        (14)(I)
       Underlying Data        2,000 claims.
    REVISED October 2005                                                                           12
Actuarial Memorandum (continued)
3 Discussion of the     Must discuss how the underlying data was aggregated in order to meet the Colorado            Colorado Regulation 4-3-1
   Aggregation of the   credibility standard and MUST reference the Colorado requirements for data                    (14)(I)
   Underlying Data      aggregation.
4 Actual to Expected    Must include a listing(s) of the actual and expected loss ratios, by issue year and over     Colorado Regulation 4-3-1
   Loss Ratio Analysis  all issue years, by policy duration, and a comparison of these two ratios. Each listing       (14)(G)(1) and (2)
                        should include a total line identifying the actual and expected loss ratio for that period
                        and a comparison of these two ratios. [This analysis should be provided over the
                        aggregated data set(s).]
5 Third-year            Must demonstrate that the loss ratio for policies in the third duration, and each            Colorado Regulation 4-3-1
   requirement          subsequent duration, is greater than or equal to 65% for Individual Policies and 75%          (14)(G)(3)
                        for Group Policies. [This analysis should be provided over the aggregated data set(s).]
6 Historical Loss Ratio Must demonstrate that the historical loss ratio requirement for Standardized Forms           Colorado Regulation 4-3-1,
   Requirement          and the historical loss ratio requirements for Pre-Standardized Forms have been met.          (13)(A)(2) –
                        [This analysis should be provided over the aggregated data set(s).]                                Standardized Forms
                                                                                                                      (13)(A)(5)(a) and (b) –
                                                                                                                            Pre-Standardized
                                                                                                                     Forms
7   Future Period Loss     The memorandum must demonstrate that the future period loss ratio requirement will        Colorado Regulation 4-3-1,
    Ratio Requirement      be met. [This analysis should be provided over the aggregated data set(s).]                (13)(A)(3) –
                                                                                                                            Standardized Forms
                                                                                                                      (13)(A)(5)(c) –
                                                                                                                            Pre-Standardized
                                                                                                                     Forms
8   Lifetime Loss Ratio    The memorandum must demonstrate that the lifetime loss ratio requirement will be          Colorado Regulation 4-3-1,
    Requirement            met. [This analysis should be provided over the aggregated data set(s).]                   (13)(A)(1) –
                                                                                                                            Standardized Forms
                                                                                                                      (13)(A)(5)(d) –
                                                                                                                            Pre-Standardized
                                                                                                                     Forms

Duplicate Copy and         To be stamped and returned for the company's records to document filing                   Colorado Bulletin 10-05
Postage-paid Return        (The copy should be separate from the original.)
Envelope

                                            PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING




REVISED October 2005                                                                            13
                            Instructions for completing Colorado HR-1 Form
                 (for ALL coverages EXCEPT Credit Life, Accident & Health Insurance)
                     PLEASE DO NOT SEND THESE INSTRUCTIONS IN WITH THE FILING.
NOTE: ANY FRACTIONS SHOULD BE ROUNDED TO TWO DECIMAL POINTS.
Item                Instructions
 1, 2, 3, 4, 5      Self-explanatory.
 6                  How services are provided or reimbursed (one selection per HR-1 form).
 7                  Individual, Small or Large Group. One selection per HR-1 form; however, if filing rates for a
                    non-health benefit plan product that is being marketed to all size groups, please mark the ―Large
                    Group‖ checkbox.
 8                  Describe the health benefits provided.
 9                  Reason(s) for this filing.
 10                 A. List all policy form(s) affected by this rate filing, beginning with the major forms and continuing
                       on a separate sheet if necessary.
                    B. Please indicate if these policy forms are ―closed‖ blocks of business, i.e., are no longer being marketed.
 11                 Describe the benefits provided.
 Please Note: For items 12-17, only one entry per line is acceptable.
*12                 Specify the number of Colorado covered lives affected by this rate change.
*13                 These items are for the rating period. Please check the appropriate rating period box in A. If this
                    period is a quarter, the percentages should be calculated on a quarterly basis. Percentages should
                    reflect the average change over all policy forms affected.
                    A. The percentage increase, decrease or no change (renewal business only) without trend, for the
                        rating period.
                    B. The trend assumption for the rating period.
                    C. Total rate change percentage requested (A+B).
                        Note: 13C should lie between the maximum and minimum defined in 13 D. and E.
                    D. Indicate the highest rate change for the rating period that can affect a specific policyholder.
                    E. Indicate the lowest rate change for the rating period that can affect a specific policyholder.
*14                 Please provide the average change in the rate from one year ago (one year prior to the proposed
                    effective date) to the proposed effective date indicated in item 17.

*15                 A. The annualized trend assumption used in the previous rating period.
                    B. The current annualized assumption being used

*16                 Provide the estimated annual Colorado written premium dollar amount for this product showing
                    amounts for both before and after this filing.
 17                 The expected loss ratio for the rating period after the rate change being filed has been implemented.
                    New products only: the anticipated lifetime loss ratio.
 18                 Proposed prospective effective date for the new rates or methodology change, etc.
*19                 List the effective date and percentage change of the last rate change for affected policy form(s).
 20, 21             Check the appropriate blocks for source and length of statistical experience (need 3 years Colorado
                    and nationwide experience, if available). If this is a new benefit plan, completely describe the
                    experience used as the basis for the determination of the rates.
 22                 If this is a small group health benefit plan filing, indicate the unique index rate as of the effective date
                    listed in item 17. If the company is filing for more than one index rate (to be used in sequence, over a
                    period of not more than 12 months), the only index rate listed should be the first one that will be effective.

* THESE ITEMS SHOULD NOT BE COMPLETED FOR NEW PRODUCTS OR FOR NEW PLAN DESIGN ONLY FILINGS
REVISED October 2005                                                                                                14
                            Instructions for completing Colorado Form HR1 for
                          CREDIT LIFE, ACCIDENT & HEALTH INSURANCE

                  PLEASE DO NOT SEND THESE INSTRUCTIONS IN WITH THE FILING.

NOTE: ANY FRACTIONS SHOULD BE ROUNDED TO TWO DECIMAL POINTS.

Item             Instructions

 1, 2, 3, 4, 5   Self-Explanatory.
 6               N/A
 7               Individual, Small or Large Group. One selection per HR-1 form; however, if filing rates for a
                 product that is being marketed to all size groups, please mark the ―Large Group‖ checkbox.
 8               Describe the benefits provided.
 9               Reason(s) for this filing.
 10              A. List all policy form(s) affected by this rate filing, beginning with the major forms and continuing
                    on a separate sheet if necessary.
                 B. N/A
 11              Describe the benefits provided for riders and endorsements only.
 Please Note: For items 12-17, only one entry per line is acceptable.
*12              Specify the number of Colorado covered lives affected by this rate change.
*13              These items are for the rating period. Please check the appropriate rating period box in A. If this
                 period is a quarter, the percentages should be calculated on a quarterly basis. Percentages should
                 reflect the average change over all policy forms affected.
                 A. The percentage increase, decrease or no change (renewal business only) without trend, for the
                     rating period.
                 B. The trend assumption for the rating period.
                 C. Total rate change percentage requested (A+B).
                     Note: 13C should lie between the maximum and minimum defined in 13 D. and E.
                 D. Indicate the highest rate change for the rating period that can affect a specific policyholder.
                 E. Indicate the lowest rate change for the rating period that can affect a specific policyholder.

*14              Please provide the average change in the rate from one year ago (one year prior to the proposed
                 effective date) to the proposed effective date indicated in item 17.

*15              A. The annualized trend assumption used in the previous rating period.
                 B. The current annualized assumption being used

*16              Provide the estimated annual Colorado written premium dollar amount for this product showing
                 amounts for both before and after this filing.
 17              The expected loss ratio for the rating period after the rate change being filed has been implemented.
                 New products only: the anticipated lifetime loss ratio.
 18              Proposed prospective effective date for the new rates or methodology change, etc.
*19              List the effective date and percentage change of the last rate change for affected policy form(s).
 20, 21          Check the appropriate blocks for source and length of statistical experience (need 3 years Colorado
                 and nationwide experience, if available). If this is a new benefit plan, completely describe the
                 experience used as the basis for the determination of the rates.
 22              N/A
* THESE ITEMS SHOULD NOT BE COMPLETED FOR NEW PRODUCTS OR FOR NEW PLAN DESIGN ONLY FILINGS

REVISED October 2005                                                                                            15
                      FORM HR-1         COLORADO HEALTH RATE FILING FORM

1.   COMPANY NAME:
2.   PERSON RESPONSIBLE FOR FILING:
3.   TITLE: __________________________________________           TELEPHONE #: ______________________
4.   ADDRESS OF
     RESPONSIBLE PERSON:
5.   EMAIL ADDRESS:      ________________________________________________________________________
6.   TYPE OF COVERAGE:       ‫ڤ‬HMO        ‫ڤ‬PPO       ‫ ڤ‬INDEMNITY       ‫ڤ‬PREPAID DENTAL          ‫ڤ‬LSLPN
7.   SUB CATEGORY:        INDIVIDUAL            LARGE GROUP            SMALL GROUP(1-50)
8.   DESCRIPTION (DISABILITY, MAJOR MEDICAL, LTC, ETC. Also describe all methodology changes.):
______________________________________________________________________________________________
9.   REASON FOR FILING:
        INCREASE IN BENEFITS?                                        Yes   No
        REDUCTION IN BENEFITS?                                       Yes   No
        CHANGE NEEDED TO MEET PROJECTED LOSSES?                      Yes   No
        TREND ONLY?                                                  Yes   No
        CHANGE IN RATING METHODOLOGY?                                Yes   No
        NEW PRODUCT (initial offering as opposed to rate revision)?  Yes   No
        OTHER?                                                       Yes   No
        (PLEASE SPECIFY) ____________________________________________________________________

 10. A. POLICY FORM(S) AFFECTED:
     B. CLOSED BLOCK(S)?  YES  NO
 11. IF RIDER OR ENDORSEMENT, TYPE OF BENEFITS?
*12. NUMBER OF COLORADO COVERED LIVES:

*13. A. RATE CHANGE WITHOUT TREND: (Rating Period:  Annual  Semi-annual  Quarterly) ____________%
     B. UNDERLYING TREND ASSUMPTION FOR THE RATING PERIOD:                               ____________%
     C. TOTAL RATE CHANGE REQUESTED (A+B):                                               ____________%
        NOTE: 13 C should lie between the maximum and the minimum defined in 13 D and E.
     D. WHAT IS THE MAXIMUM RATE CHANGE THAT CAN AFFECT A POLICYHOLDER? __________ %
     E. WHAT IS THE MINIMUM RATE CHANGE THAT CAN AFFECT A POLICYHOLDER? __________ %

*14. AVERAGE CHANGE IN RATES FROM ONE YEAR PRIOR TO EFFECTIVE DATE: ____________ %

*15. A. PRIOR UNDERLYING ANNUALIZED TREND ASSUMPTION (If applicable):                      ____________%
     B. CURRENT UNDERLYING ANNUALIZED TREND ASSUMPTION (If applicable):                    ____________%

*16. A. ANNUAL COLORADO WRITTEN PREMIUM BEFORE CHANGE(S):                  $________________
     B. ANNUAL COLORADO WRITTEN PREMIUM AFTER CHANGE(S) [(13C*16A) + 16A]: $________________

 17. WHAT IS THE ANTICIPATED/PROJECTED LOSS RATIO FOR THE RATING PERIOD?                     ____________ %

 18. PROPOSED EFFECTIVE DATE (Please see instructions): ___________________________________________

*19. DATE/PERCENT OF LAST RATE CHANGE FOR AFFECTED POLICY FORM(S): ____/____/____ ______%

 20. EXPERIENCE PROVIDED:  National                Colorado     Other (Specify)   ___________________

 21. EXPERIENCE PROVIDED:  0-2 YRS (new plan only)               3-4 YRS        5 OR MORE YEARS
 22. Small group filings only: UNIQUE SINGLE INDEX RATE (effective for all small group plans) $ ___________
* THESE ITEMS SHOULD NOT BE COMPLETED FOR NEW PRODUCTS OR FOR NEW PLAN DESIGN ONLY FILINGS
REVISED October 2005                                                               16
                                           STATE OF COLORADO
                                   COMPANY CHECKLIST FOR
                               HEALTH FORM CERTIFICATION FILINGS
                                  REQUIRED ITEMS FOR A COMPLETE FILING

             Required                                  Information                            Statutory/Regulation/
                                                                                                 Information Cite
    Filing Transmittal Form          Submit one for each company and for each              Colorado Bulletin 10-05
                                     type of filing. A form filing cannot be
                                     combined with a rate filing; they must be
                                     separate.

    Cover Letter                        Brief summary of the form filing                  Division Policy
                                        Helps identify what companies and lines
                                         of insurance are being filed
                                        One copy for each company

    Certification of Compliance         The exact wording of the certification            §10-16-107.2(1) and (2),
                                         must be used.                                      C.R.S.
                                        It must contain an original signature of a        Colorado Regulation 1-1-6
                                         company officer (President, vice
                                         president, corporate secretary, assistant
                                         corporate secretary, CEO, CFO, COO,               Colorado Bulletin 10-05
                                         general counsel, or an actuary who is a           Exhibits:
                                         company officer).
                                        If it is not signed by one of the                 New Policy Forms:
                                         individuals listed above, documentation           (FORM HEALTH)
                                         showing that the individual signing the
                                                                                           Annual Report of Forms:
                                         certification has been appointed by the
                                                                                           (FORM HEALTH ANNUAL)
                                         Board of Directors as a company officer
                                         must accompany each filing.

    Listing of New Form(s)           Must be a separate document which lists:              §10-16-107.2(1) and (2),
                                      Line of insurance (e.g., individual health,          C.R.S.
              OR                        large group, dental, etc.)                         Colorado Regulation 1-1-6
                                      Form Numbers                                        Colorado Bulletin 10-05
    Annual Report of Forms            Form Titles
                                      Must have an Effective Date for Use in
                                        Colorado that is at least 31 days after
                                        the date of filing (new forms only).
                                         **Note filing date means the date the filing is
                                         RECEIVED at the DOI. Please allow 7-10 days
                                         for mailing.
                                        Do not send actual forms
                                        Annual reports to be filed prior to
                                         December 31 of each year

    Duplicate Copy and Postage-      To be stamped and returned for the company's          Colorado Bulletin 10-05
    paid Return Envelope             records to document filing (The copy should
                                     be separate from the original.)
                              PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING
        REVISED October 2005                                                                                 17
                                                  FORM HEALTH


                          COLORADO HEALTH COVERAGE CERTIFICATION FORM
                                FOR LISTING OF NEW POLICY FORMS


I, THE UNDERSIGNED OFFICER OF ___________________________________________________________
                                          (Name of Entity)

        AM KNOWLEDGEABLE OF HEALTH COVERAGES;

        HAVE CAREFULLY REVIEWED THE CONTENTS OF THE POLICY FORMS, APPLICATIONS,
        SUBSCRIPTION CERTIFICATES, MEMBERSHIP CERTIFICATES OR OTHER EVIDENCES OF
        HEALTH CARE COVERAGE IDENTIFIED ON THE ATTACHED LISTING OF NEW FORMS WHICH IS
        HEREBY FILED WITH THE COLORADO COMMISSIONER OF INSURANCE;

        HAVE READ AND UNDERSTAND EACH OF THE APPLICABLE COLORADO LAWS, RULES,
        REGULATIONS, AND BULLETINS;

        HAVE REVIEWED, SIGNED AND PLACED ON FILE AT THE COMPANY’S OFFICES THE HEALTH
        COVERAGE COMPLIANCE GUIDE;

        AM AWARE OF THE PENALTIES WHICH MAY BE ENFORCED FOR CERTIFICATION OF A
        NONCOMPLYING FORM; AND

        CERTIFY, TO THE BEST OF MY GOOD FAITH, KNOWLEDGE AND BELIEF, THAT THE POLICY
        FORMS, APPLICATIONS, SUBSCRIPTION CERTIFICATES, MEMBERSHIP CERTIFICATES OR
        OTHER EVIDENCES OF HEALTH CARE COVERAGE IDENTIFIED ON THE LISTING OF NEW
        POLICY FORMS, FILED WITH THIS CERTIFICATION, PROVIDE ALL REQUIRED BENEFITS AND
        ARE IN FULL COMPLIANCE WITH ALL COLORADO INSURANCE LAWS, RULES AND
        REGULATIONS.




     (Original Signature of Officer*)                                               (Title of Officer*)




        (Printed Name of Officer*)                                                        (Date)




*   If the individual signing the certification is other than the president, vice president, assistant vice president,
    corporate secretary, assistant corporate secretary, CEO, CFO, COO, general counsel, or an actuary that is also a
    corporate officer, documentation must be included that shows that this individual has been appointed as an officer
    of the organization by the Board of Directors.




REVISED October 2005                                                                                          18
                                             FORM HEALTH ANNUAL


                          COLORADO HEALTH COVERAGE CERTIFICATION FORM
                                      FOR ANNUAL REPORTS


I, THE UNDERSIGNED OFFICER OF ___________________________________________________________
                                            (Name of Entity)

        AM KNOWLEDGEABLE OF HEALTH COVERAGES;

        HAVE CAREFULLY REVIEWED THE CONTENTS OF THE POLICY FORMS, APPLICATIONS,
        SUBSCRIPTION CERTIFICATES, MEMBERSHIP CERTIFICATES OR OTHER EVIDENCES OF
        HEALTH CARE COVERAGE IDENTIFIED ON THE ATTACHED ANNUAL REPORT WHICH IS
        HEREBY FILED WITH THE COLORADO COMMISSIONER OF INSURANCE;

        HAVE READ AND UNDERSTAND EACH OF THE APPLICABLE COLORADO LAWS, RULES,
        REGULATIONS, AND BULLETINS;

        AM AWARE OF THE PENALTIES WHICH MAY BE ENFORCED FOR CERTIFICATION OF A
        NONCOMPLYING FORM; AND

        CERTIFY THAT THE POLICY FORMS, APPLICATIONS, SUBSCRIPTION CERTIFICATES,
        MEMBERSHIP CERTIFICATES OR OTHER EVIDENCES OF HEALTH CARE COVERAGE
        IDENTIFIED ON THE LISTING OF NEW POLICY FORMS OR ANNUAL REPORT FILED WITH THIS
        CERTIFICATION, PROVIDE ALL REQUIRED BENEFITS AND ARE IN FULL COMPLIANCE WITH
        ALL COLORADO INSURANCE LAWS, RULES AND REGULATIONS.




     (Original Signature of Officer*)                                               (Title of Officer*)




        (Printed Name of Officer*)                                                        (Date)




*   If the individual signing the certification is other than the president, vice president, assistant vice president,
    corporate secretary, assistant corporate secretary, CEO, CFO, COO, general counsel, or an actuary that is also a
    corporate officer, documentation must be included that shows that this individual has been appointed as an officer
    of the organization by the Board of Directors.




REVISED October 2005                                                                                          19
                                           STATE OF COLORADO
                                COMPANY CHECKLIST FOR
                      CREDIT INSURANCE FORM CERTIFICATION FILINGS
                                  REQUIRED ITEMS FOR A COMPLETE FILING
              Required                                 Information                          Statutory/Regulation/
                                                                                                Information Cite
    Filing Transmittal Form          Submit one for each company and for each            Colorado Bulletin 10-05
                                     type of filing. A form filing cannot be combined
                                     with a rate filing; they must be separate.

    Cover Letter                        Brief summary of the form filing                Division Policy
                                        Helps identify what companies and lines of
                                         insurance are being filed
                                        One copy for each company

    Certification of Compliance         The exact wording of the certification must     §10-10-109(1), C.R.S.
                                         be used.
                                        It must contain an original signature of a      Colorado Regulation 4-9-2
                                         company officer (President, vice president,      (11)(A)(1) and (B)
                                         corporate secretary, assistant corporate
                                         secretary, CEO, CFO, COO, general
                                         counsel, or an actuary who is a company         Colorado Bulletin 10-05
                                         officer).                                       Exhibits:
                                        If it is not signed by one of the individuals
                                         listed above, documentation showing that        FORM CI
                                         the individual signing the certification has
                                         been appointed by the Board of Directors
                                         as a company officer must accompany
                                         each filing.

    Listing of New Form(s)           Submit as a separate document. This listing         §10-10-109(3)(a) and (b),
                                     should not be on a cover letter or included with     C.R.S.
              OR                     anything else in the submission. It should
                                     include:                                            Colorado Regulation 4-9-2
    Annual Report of Forms            Line of insurance (e.g., group credit              (11)(A)(1) and (2)
                                         disability, etc.)
                                      Form Numbers
                                      Form Titles
                                      Description of new policy form(s).
                                      Must have an Effective Date for Use in
                                         Colorado that is at least 31 days after
                                         the date of filing (new forms only). **Note
                                         filing date means the date the filing is
                                         RECEIVED at the DOI. Please allow 7-10 days
                                         for mailing.
                                        Do not send actual forms
                                        Annual reports to be filed prior to July 1 of
                                         each year

    Duplicate Copy and Postage-      To be stamped and returned for the company's        Colorado Bulletin 10-05
    paid Return Envelope             records to document filing (The copy should
                                     be separate from the original.)

                   PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING
        REVISED October 2005                                                                               20
                                                      FORM CI


                              COLORADO CREDIT INSURANCE POLICY
                                      CERTIFICATION FORM
                      FOR ANNUAL REPORTS AND LISTINGS OF NEW POLICY FORMS


I, THE UNDERSIGNED OFFICER OF ______________________________________________________
                                                   (Name of Entity)

        AM KNOWLEDGEABLE OF CREDIT INSURANCE;

        HAVE CAREFULLY REVIEWED THE CONTENTS OF THE POLICY FORMS IDENTIFIED ON THE
        ATTACHED LISTING OF NEW POLICY FORMS OR ANNUAL REPORT WHICH IS HEREBY FILED
        WITH THE COLORADO COMMISSIONER OF INSURANCE;

        HAVE READ AND UNDERSTAND EACH OF THE APPLICABLE COLORADO LAWS, RULES,
        REGULATIONS, AND BULLETINS;

        AM AWARE OF THE PENALTIES WHICH MAY BE ENFORCED FOR CERTIFICATION OF A
        NONCOMPLYING FORM; AND

        CERTIFY THAT THE POLICY FORMS IDENTIFIED ON THE LISTING OF NEW POLICY FORMS OR
        ANNUAL REPORT, FILED WITH THIS CERTIFICATION, ARE IN FULL COMPLIANCE WITH ALL
        RELEVANT COLORADO INSURANCE LAWS, RULES AND REGULATIONS.




     (Original Signature of Officer*)                                               (Title of Officer*)




        (Printed Name of Officer*)                                                        (Date)




*   If the individual signing the certification is other than the president, vice president, assistant vice president,
    corporate secretary, assistant corporate secretary, CEO, CFO, COO, general counsel, or an actuary that is also a
    corporate officer, documentation must be included that shows that this individual has been appointed as an officer
    of the organization by the Board of Directors.




REVISED October 2005                                                                                          21
                                          STATE OF COLORADO

                              COMPANY CHECKLIST FOR
                   PRENEED FUNERAL CONTRACT CERTIFICATION FILINGS

                                  REQUIRED ITEMS FOR A COMPLETE FILING

             Required                                Information                         Statutory/Regulation/
                                                                                            Information Cite
    Filing Transmittal Form          Submit one for each company.                     Colorado Bulletin 10-05

    Cover Letter                        Brief summary of the form filing             Division Policy
                                        Helps identify what companies and lines
                                         of insurance are being filed
                                        One copy for each company

    Certification of Compliance         The exact wording of the certification       §10-15-105(1)(b)(II) and (III),
                                         must be used.                                 C.R.S.
    (To be used with                    It must contain an original signature of a
    manuscripted and prototype           company officer (President, vice
    preneed contracts)                   president, corporate secretary, assistant
                                         corporate secretary, CEO, CFO, COO,          Colorado Bulletin 10-05
                                         general counsel, or an actuary who is a      Exhibits:
                                         company officer).
                                        If it is not signed by one of the            FORM PN
                                         individuals listed above, documentation
                                         showing that the individual signing the
                                         certification has been appointed by the
                                         Board of Directors as a company officer
                                         must accompany each filing.

    Listing of New Form(s)           Must be a separate document which lists:         §10-15-105(1)(b)(II) and (III),
                                      Line of insurance                               C.R.S.
            OR                        Form Numbers
                                      Form Titles                                    Colorado Regulation 1-1-6
    Annual Report of Forms            Do not send actual forms
                                      Annual reports to be filed prior to July 1     Colorado Bulletin 10-05
                                        of each year

    Duplicate Copy and Postage-      To be stamped and returned for the company's     Colorado Bulletin 10-05
    paid Return Envelope             records to document filing
                                     (The copy should be separate from the
                                     original.)

                              PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING




        REVISED October 2005                                                                            22
                                                     FORM PN


                                       COLORADO PRENEED
                                       CERTIFICATION FORM
                        FOR ANNUAL REPORTS AND LISTINGS OF NEW CONTRACTS


I, THE UNDERSIGNED OFFICER OF ____________________________________________________________
                                                  (Name of Entity)

        AM KNOWLEDGEABLE OF PRENEED FUNERAL CONTRACTS;

        HAVE CAREFULLY REVIEWED THE CONTENTS OF THE CONTRACTS IDENTIFIED ON THE
        ATTACHED LISTING OF NEW CONTRACTS OR ANNUAL REPORT WHICH IS HEREBY FILED
        WITH THE COLORADO COMMISSIONER OF INSURANCE;

        HAVE READ AND UNDERSTAND EACH OF THE APPLICABLE COLORADO LAWS, RULES,
        REGULATIONS, AND BULLETINS;

        AM AWARE OF THE PENALTIES WHICH MAY BE ENFORCED FOR CERTIFICATION OF A
        NONCOMPLYING CONTRACT; AND

        CERTIFY THAT THE CONTRACTS IDENTIFIED ON THE LISTING OF NEW CONTRACTS OR
        ANNUAL REPORT, FILED WITH THIS CERTIFICATION, ARE IN FULL COMPLIANCE WITH ALL
        RELEVANT COLORADO INSURANCE LAWS, RULES AND REGULATIONS.




     (Original Signature of Officer*)                                               (Title of Officer*)




        (Printed Name of Officer*)                                                        (Date)




*   If the individual signing the certification is other than the president, vice president, assistant vice president,
    corporate secretary, assistant corporate secretary, CEO, CFO, COO, general counsel, or an actuary that is also a
    corporate officer, documentation must be included that shows that this individual has been appointed as an officer
    of the organization by the Board of Directors.




REVISED October 2005                                                                                          23
                                          STATE OF COLORADO

                                     COMPANY CHECKLIST FOR
                                   PREPAID DENTAL FORM FILINGS

                                 REQUIRED ITEMS FOR A COMPLETE FILING


             Required                               Information                        Statutory/Regulation/
                                                                                          Information Cite
    Filing Transmittal Form          Submit one for each company and for each       Colorado Bulletin 10-05
                                     type of filing. A form filing cannot be
                                     combined with a rate filing; they must be
                                     separate.

    Cover Letter                        Brief summary of the form filing           Division Policy
                                        Helps identify what companies and lines
                                         of insurance are being filed
                                        One copy for each company

    All prepaid dental forms         Forms must be submitted on 8 ½ x 11 white      §10-16-107(4)(d), C.R.S.
    (enrollee coverage or            paper.
    amendment, advertising
    and/or sales material) are
    prior approval and must be
    submitted for review.

    Duplicate Copy and Postage-      To be stamped and returned for the company's   Colorado Bulletin 10-05
    paid Return Envelope             records to document filing
                                     (The copy should be separate from the
                                     original.)

                              PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING




        REVISED October 2005                                                                          24
                                          STATE OF COLORADO

                                    COMPANY CHECKLIST FOR
                               MEDICARE SUPPLEMENT FORM FILINGS

                                 REQUIRED ITEMS FOR A COMPLETE FILING


             Required                               Information                        Statutory/Regulation/
                                                                                          Information Cite
    Filing Transmittal Form          Submit one for each company and for each       Colorado Bulletin 10-05
                                     type of filing. A form filing cannot be
                                     combined with a rate filing; they must be
                                     separate.

    Cover Letter                        Brief summary of the form filing           Division Policy
                                        Helps identify what companies and lines
                                         of insurance are being filed
                                        One copy for each company

    All Medicare supplement          Forms must be submitted on 8 ½ x 11 white      §10-18-108, C.R.S.
    forms are prior approval and     paper.                                         Colorado Regulation 4-3-1
    must be submitted for review.
    Advertisements must be filed
    prior to or concurrent with
    use.

    Duplicate Copy and Postage-      To be stamped and returned for the company's   Colorado Bulletin 10-05
    paid Return Envelope             records to document filing
                                     (The copy should be separate from the
                                     original.)

                              PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING




        REVISED October 2005                                                                          25
                                        STATE OF COLORADO

                              COMPANY CHECKLIST FOR
                    REASONABLE MODIFICATIONS NOTIFICATION FILINGS
                                       [Section 10-16-201.5(8), C.R.S.]

                                REQUIRED ITEMS FOR A COMPLETE FILING

             Required                              Information                          Statutory/Regulation/
                                                                                           Information Cite
    Filing Transmittal Form        Submit one for each company and for each          Colorado Bulletin 10-05
                                   type of filing. A form filing cannot be
                                   combined with a rate filing; they must be
                                   separate.

    Cover Letter                      Brief summary of the form filing              Division Policy
                                      Helps identify what companies and lines
                                       of insurance are being filed
                                      One copy for each company

    Side-by-Side Comparison        A chart, table or spreadsheet that provides a     Division Policy
                                   comparison of the current benefits and the        §10-1-203, C.R.S.
                                   modified benefits

    Rating Impact                  An attachment that provides an explanation        Division Policy
                                   of the impact the benefit modifications will      §10-1-203, C.R.S.
                                   have on the renewal rates

                                   Please note: If the policyholder notification     Colorado Regulation 4-2-11
                                   will include a quote of rates different than
                                   those on file with the Division, a complete
                                   rate filing must be done concurrent with their
                                   use in the policyholder notification.

    Policyholder Notification      A copy of the notification that will be sent to   Division Policy
                                   the policyholder at least 90 days prior to the    §10-1-203, C.R.S.
                                   renewal date. The notification should             §10-16-201.5(8), C.R.S.
                                   provide a clear explanation of all
                                   modifications being made, a clear
                                   explanation of the policyholder’s right to
                                   purchase any other plan being offered in the
                                   same market and how additional information
                                   regarding those plans may be obtained.

    Duplicate Copy and Postage-    To be stamped and returned for the company's      Colorado Bulletin 10-05
    paid Return Envelope           records to document filing
                                   (The copy should be separate from the
                                   original.)

                      PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING


        REVISED October 2005                                                                           26
                               COMPANY CHECKLIST FOR
                       EXCESS LOSS INSURANCE FOR SELF-INSURED
                      EMPLOYER HEALTH BENEFIT PLANS UNDER ERISA
                             CERTIFICATION/FORM FILINGS

                                  REQUIRED ITEMS FOR A COMPLETE FILING


                Required                               Information                      Statutory/Regulation/
                                                                                            Information Cite
    Filing Transmittal Form             One for each company and line of business     Colorado Bulletin 10-05

    Cover Letter                           Brief summary of the form filing          Division Policy
                                           Helps identify what companies and lines
                                            of insurance are being filed
                                           One copy for each company
    Certification of Compliance            Must have company name                    §10-16-119, C.R.S.,
                                           Must have original signature by           Colorado Regulation 1-1-6
                                            company officer                           Colorado Bulletin 10-05
                                           Must have current date                    Exhibits:
                                                                                      FORM EXCESS LOSS
    All policy forms must be               Forms must be submitted on 8 ½ x 11       §10-16-119, C.R.S.
    submitted with the certification        white copies                              Colorado Regulation 1-1-6
    form.                                  Must have a current edition date          Colorado Bulletin 10-05

    Duplicate Copy and Postage-paid     To be stamped and returned for the            Colorado Bulletin 10-05
    Return Envelope                     company's records to document filing
                                        (The copy should be separate from the
                                        original.)


                              PLEASE DO NOT SEND THIS CHECKLIST IN WITH THE FILING




        REVISED October 2005                                                                       27
                                               FORM EXCESS LOSS


                         COLORADO EXCESS LOSS INSURANCE FOR SELF-INSURED
                               EMPLOYER BENEFIT PLANS UNDER ERISA
                                      CERTIFICATION FORM


I, THE UNDERSIGNED OFFICER OF ___________________________________________________________
                                            (Name of Entity)

        AM KNOWLEDGEABLE OF EXCESS LOSS INSURANCE FOR SELF-INSURED EMPLOYER
        BENEFIT PLANS UNDER ERISA;

        HAVE CAREFULLY REVIEWED THE CONTENTS OF THE POLICY FORMS ATTACHED TO
        THIS CERTIFICATION;

        WHICH IS HEREBY FILED WITH THE COLORADO COMMISSIONER OF INSURANCE;

        HAVE READ AND UNDERSTAND EACH OF THE APPLICABLE COLORADO LAWS, RULES,
        REGULATIONS, AND BULLETINS;

        AM AWARE OF THE PENALTIES WHICH MAY BE ENFORCED FOR CERTIFICATION OF A
        NONCOMPLYING FORM; AND

        CERTIFY, TO THE BEST OF MY KNOWLEDGE THAT THE POLICY FORMS ATTACHED AND
        FILED WITH THIS CERTIFICATION, ARE IN FULL COMPLIANCE WITH ALL COLORADO
        INSURANCE LAWS, RULES AND REGULATIONS.




     (Original Signature of Officer*)                                               (Title of Officer*)




        (Printed Name of Officer*)                                                        (Date)




*   If the individual signing the certification is other than the president, vice president, assistant vice president,
    corporate secretary, assistant corporate secretary, CEO, CFO, COO, general counsel, or an actuary that is also a
    corporate officer, documentation must be included that shows that this individual has been appointed as an officer
    of the organization by the Board of Directors.




REVISED October 2005                                                                                          28
                                   STATE OF COLORADO
                       Filing Transmittal Form State Specific Code Listing

                         Please do not include this listing with the filing

                         411   Withdraw a specific filing or product
                         412   Withdraw from a specific line of business
                         616   Multi State Association
                         627   Point of Service
                         630   Business Group of One Report
                         633   Small Group Rate Cert (4-2-11)
                         642   Annual Health Rate Cert (4-2-11)
                         646   LTC Rescission Report
                         650   Mandate Exception
                         651   Bona Fide Association
                         700   Large Group
                         701   Small Group
                         703   Medsup Annual Report
                         704   Medsup Refund Calculation
                         706   Lapse Report
                         710   Preneed Trust Manuscript
                         711   Preneed Insurance Manuscript
                         712   Preneed Trust Prototype
                         713   Preneed Insurance Prototype
                         715   Medsup Dup Policy Report
                         721   Life Illustration - Annual Cert
                         722   Life Illustration - Actuary Appt
                         726   Credit A&H
                         727   Credit Dismemberment
                         730   Group Medsup Under Age 65
                         735   Individual Medsup Under Age 65
                         737   Medicare Select Plan K
                         738   Medicare Select Plan L
                         739   Combined Medsup Filing Multiple Plans
                         805   Name Change
                         849   Annual Forms Certification




REVISED October 2005                                                          29
               Uniform Life, Accident & Health, Annuity and Credit Coding Matrix
                                 (Revised by the NAIC on 1/1/05)
                    FOR THE MOST CURRENT LISTING PLEASE VISIT: HTTP://WWW.NAIC.ORG/

                               PLEASE DO NOT INCLUDE THIS LISTING WITH THE FILING



             TOI                            SUB-TOI                                    DESCRIPTION


                                                                An arrangement whereby an annuitant is guaranteed to receive a
                             Annuities                          series of payments commencing either immediately or at some
                                                                future date.
A01 Annuities – Assumption        A01.000 Annuities –           An insurance certificate issued on an existing insurance contract
Agreement                         Assumption Agreement          indicating that another insurer has assumed all of the risk under
                                                                the contract from the ceding insurance company.
A02G Group Annuities –                                          An annuity contract that provides an accumulation based on
Deferred Non-variable                                           funds that accumulate based on a guaranteed crediting interest
                                                                rate or additional interest rate. This annuity contract provides
                                                                for the initiation of payments at some designated future date.
                                  A02G.001 Fixed Premium        An annuity where premium payments are fixed.
                                  A02G.002 Flexible Premium     The premium payments are flexible.
                                  A02G.003 Single Premium       Purchase by the payment of one lump sum.
                                  A02G.004 Modified Single      Purchased by payment of a lump sum and additional payments
                                  Premium                       during the first 12 months.
                                  A02G.005 Limited Flexible     The premium payments are specified for a designated time
                                  Premium                       frame, i.e. 5 years.
A02I Individual Annuities-                                      An annuity contract that provides an accumulation based on
Deferred Non-Variable                                           funds that accumulate based on a guaranteed crediting interest
                                                                rate or additional interest rate. This annuity contract provides
                                                                for the initiation of payments at some designated future date.
                                  A02I.001 Fixed Premium        An annuity where premium payments are fixed.
                                  A02I.002 Flexible Premium     The premium payments are flexible.
                                  A02I.003 Single Premium       Purchase by the payment of one lump sum.
                                  A02I.004 Modified Single      Purchased by payment of a lump sum and additional payments
                                  Premium                       during the first 12 months.
                                  A02I.005 Limited Flexible     The premium payment are specified for a designated time
                                  Premium                       frame, i.e. 5 years.
A02.1G Group Annuities –                                        An annuity contract that provides an accumulation based on
Deferred Non-Variable and                                       both (1) funds that accumulate based on a guaranteed crediting
Variable                                                        interest rates or additional interest rate applied to designated
                                                                considerations, and (2) funds where the accumulation vary in
                                                                accordance with the rate of return of the underlying investment
                                                                portfolio selected by the policyholder. The contract provides
                                                                for the initiation of payments at some designated future date.
                                  A02.1G.001 Fixed Premium      An annuity where premium payments are fixed.
                                  A02.1G.002 Flexible Premium   The premium payments are flexible.
                                  A02.1G.003 Single Premium     Purchase by the payment of one lump sum.
                                  A02.1G.004 Modified Single    Purchased by payment of a lump sum and additional payments
                                  Premium                       during the first 12 months.
                                  A02.1G.005 Limited Flexible   The premium payments are specified for a designated time
                                  Premium                       frame, i.e. 5 years.




       REVISED October 2005                                                                                    30
             TOI                         SUB-TOI                                       DESCRIPTION


A02.1I Individual Annuities-                                   An annuity contract that provides an accumulation based on
Deferred Non-Variable and                                      both (1) funds that accumulate based on a guaranteed crediting
Variable                                                       interest rates or additional interest rate applied to designated
                                                               considerations, and (2) funds where the accumulation vary in
                                                               accordance with the rate of return of the underlying investment
                                                               portfolio selected by the policyholder. The contract provides
                                                               for the initiation of payments at some designated future date.
                               A02.1I.001 Fixed Premium        An annuity where premium payments are fixed.
                               A02.1I.002 Flexible Premium     The premium payments are flexible.
                               A02.1I.003 Single Premium       Purchase by the payment of one lump sum.
                               A02.1I.004 Modified Single      Purchased by payment of a lump sum and additional payments
                               Premium                         during the first 12 months.
                               A02.1I.005 Limited Flexible     The premium payments are specified for a designated time
                               Premium                         frame, i.e. 5 years.
A03G Group Annuities –                                         An annuity contract that provides an accumulation based fund
Deferred Variable                                              where the accumulation varies in accordance with the rate of
                                                               return of the underlying investment portfolio selected by the
                                                               policyholder. Must include at least one option to have the
                                                               accumulation vary in accordance with the rate of return of the
                                                               underlying investment portfolio selected by the policyholder
                                                               and may include at least one option to have the series of
                                                               payments vary in accordance with the rate of return of the
                                                               underlying investment portfolio selected by the policyholder.
                                                               This annuity contract provides for the initiation of payments at
                                                               some designated future date.
                               A03G.001 Fixed Premium          An annuity where premium payments are fixed.
                               A03G.002 Flexible Premium       Premium payments are flexible.
                               A03G.003 Single Premium         Purchase by the payment of one lump sum.
                               A03G.004 Modified Single        Purchased by payment of a lump sum and additional payments
                               Premium                         during the first 12 months.
                               A03G.005 Limited Flexible       The premium payment are specified for a designated time
                               Premium                         frame, i.e. 5 years.
A03I Individual Annuities –                                    An annuity contract that provides an accumulation based fund
Deferred Variable                                              where the accumulation varies in accordance with the rate of
                                                               return of the underlying investment portfolio selected by the
                                                               policyholder. Must include at least one option to have the
                                                               accumulation vary in accordance with the rate of return of the
                                                               underlying investment portfolio selected by the policyholder
                                                               and may include at least one option to have the series of
                                                               payments vary in accordance with the rate of return of the
                                                               underlying investment portfolio selected by the policyholder.
                                                               This annuity contract provides for the initiation of payments at
                                                               some designated future date.
                               A03I.001 Fixed Premium          An annuity where premium payments are fixed.
                               A03I.002 Flexible Premium       Premium payments are flexible.
                               A03I.003 Single Premium         Purchase by the payment of one lump sum.
                               A03I.004 Modified Single        Purchased by payment of a lump sum and additional payments
                               Premium                         during the first 12 months.
                               A03I.005 Limited Flexible       The premium payment are specified for a designated time
                               Premium                         frame, i.e. 5 years.
A05G Group Annuities –         A05.000 Annuities – Immediate   An annuity contract that provides for the fixed payment of the
Immediate Non-Variable         Non-variable                    annuity at the end of the first interval of payment after purchase.
                                                               The interval may vary, however the annuity payouts must begin
                                                               within 13 months.
       REVISED October 2005                                                                                     31
             TOI                         SUB-TOI                                        DESCRIPTION


A05I Individual Annuities-     A05I.000 Annuities – Immediate   An annuity contract that provides for the fixed payment of the
Immediate Non-Variable         Non-variable                     annuity at the end of the first interval of payment after purchase.
                                                                The interval may vary, however the annuity payouts must begin
                                                                within 13 months.
A06G Group Annuities –         A06G.000 Annuities –             An annuity contract that provides for the first payment of the
Immediate Variable             Immediate Variable               annuity at the end of the fixed interval of payment after
                                                                purchase. The interval may vary, however the annuity payouts
                                                                must begin within 13 months. The amount varies with the value
                                                                of equities (separate account) purchased as investments by the
                                                                insurance companies.
A06I Individual Annuities –    A06I.000 Annuities – Immediate   An annuity contract that provides for the first payment of the
Immediate Variable             Variable                         annuity at the end of the fixed interval of payment after
                                                                purchase. The interval may vary, however the annuity payouts
                                                                must begin within 13 months. The amount varies with the value
                                                                of equities (separate account) purchased as investments by the
                                                                insurance companies.
A06.1G Group Annuities –       A06.1G.000 Annuities –           An annuity contract that provides an accumulation based on
Immediate Non-Variable and     Immediate Non-Variable and       both (1) funds that accumulate based on a guaranteed crediting
Variable                       Variable                         interest rates or additional interest rate applied to designated
                                                                considerations, and (2) funds where the accumulation vary in
                                                                accordance with the rate of return of the underlying investment
                                                                portfolio selected by the policyholder. The contract provides for
                                                                the initiation of payments at some interval that may vary,
                                                                however the annuity payouts must begin within 13 months
A06.1I Individual Annuities-   A06.1I.000 Annuities –           An annuity contract that provides an accumulation based on
Immediate Non-Variable and     Immediate Variable and Non-      both (1) funds that accumulate based on a guaranteed crediting
Variable                       Variable                         interest rates or additional interest rate applied to designated
                                                                considerations, and (2) funds where the accumulation vary in
                                                                accordance with the rate of return of the underlying investment
                                                                portfolio selected by the policyholder. The contract provides for
                                                                the initiation of payments at some interval that may vary,
                                                                however the annuity payouts must begin within 13 months.
A07G Group Annuities –                                          Contracts with certain noteworthy attributes.
                               A07G.001 Equity Indexed          A fixed annuity that earns interest or provides benefits that are
                                                                linked to an external reference or equity index, subject to a
                                                                minimum guarantee.
                               A07G.002 Modified Guaranteed     An annuity that contains a provision that adjusts the value of
                                                                withdrawn funds based on a formula in the contract. The
                                                                formula reflects market value adjustments.
A07I Individual Annuities –                                     Contracts with certain noteworthy attributes.
Special
                               A07I.001 Equity Indexed          A fixed annuity that earns interest or provides benefits that are
                                                                linked to an external reference or equity index, subject to a
                                                                minimum guarantee.
                               A07I.002 Modified Guaranteed     An annuity that contains a provision that adjusts the value of
                                                                withdrawn funds based on a formula in the contract. The
                                                                formula reflects market value adjustments.
A08G Group Annuities –                                          Annuity contracts or portions thereof where the Insurer
Unallocated                                                     purchases an annuity for the retirees.
                               A08G.001 Funding Agreement       Contracts that guarantee principal and interest for a specified
                                                                period of time and do not include the option to purchase
                                                                immediate annuities that depend on the survival of the
                                                                annuitant.

       REVISED October 2005                                                                                     32
             TOI                             SUB-TOI                                      DESCRIPTION


                                   A08G.002 GIC                   Contracts that guarantee principal and interest for a specified
                                                                  period of time and include the option to purchase immediate
                                                                  annuities that depend on the survival of the annuitant.
                                   A08G.003 Deposit               Annuity contracts that typically provide for an unallocated fund
                                   Administration                 accumulation for active lives out of which immediate annuities
                                                                  are purchased for individuals at retirement and deferred
                                                                  annuities are purchased for terminated employees with vested
                                                                  benefits.
A10 Annuities – Other           A10.000 Annuities – Other         Not specifically described above.
           Continuing Care Retirement Communities
CC01G Group Continuing Care                                       Continuing Care Retirement Communities are senior housing
Retirement Communities                                            arrangements that in addition to housing include some provision
                                                                  for skilled nursing care.
                                   CC01G.000 CCRC – Type A        Type A communities are also referred to as Life Care
                                                                  Communities. There is no increase in the required monthly fee
                                                                  when the resident enters the skilled nursing facility.
                                   CC02G.000 CCRC – Type B        Type B communities are those that don’t meet the definition of
                                                                  Type A or Type C. They may involve some combination of full
                                                                  skilled nursing home benefits, but only for a limited period of
                                                                  time and/or an increase in the monthly fee when the resident
                                                                  enters the skilled nursing facility but not up to full market rates.
                                   CC03G.000 CCRC – Type C        Type C communities guarantee access to a skilled nursing home
                                                                  bed but the residents pays the full market rate.
                                   CC04G.000 CCRC – Other         Not specifically described above.
CC01I Individual Continuing        CC01I.000 CCRC – Type A        Type A communities are also referred to as Life Care
Care Retirement Communities                                       Communities. There is no increase in the required monthly fee
                                                                  when the resident enters the skilled nursing facility.
                                   CC02I.000 CCRC – Type B        Type B communities are those that don’t meet the definition of
                                                                  Type A or Type C. They may involve some combination of full
                                                                  skilled nursing home benefits, but only for a limited period of
                                                                  time and/or an increase in the monthly fee when the resident
                                                                  enters the skilled nursing facility but not up to full market rates.
                                   CC03I.000 CCRC – Type C        Type C communities guarantee access to a skilled nursing home
                                                                  bed but the residents pays the full market rate.
                                   CC04I.000 CCRC – Other         Not specifically described above.
                                                                  Coverage on a debtor in favor of a creditor to pay off or reduce
                               Credit                             the balance due on a loan/credit transaction in the event of a
                                                                  covered loss.
CR01 Credit – Assumption           CR01.000 Credit – Assumption   An insurance certificate issued on an existing insurance contract
Agreement                          Agreement                      indicating that another insurer has assumed all of the risk under
                                                                  the contract from the ceding insurance company.
CR02 G Group Credit – Credit                                      Makes monthly loan/credit transaction payments to the creditor
Disability                                                        upon the disablement of an insured debtor.




       REVISED October 2005                                                                                        33
             TOI                             SUB-TOI                                     DESCRIPTION


                                   CR02G.001 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                   Open-End                      balance owed on a open-end loan/credit transaction or revolving
                                                                 charge account (i. e. the loan/credit transaction does not have a
                                                                 fixed termination date). Actual premium amounts decline along
                                                                 with the declining outstanding balance from month to month.
                                                                 Premium charges track accordingly. The outstanding balance
                                                                 may increase from time to time when an additional advance is
                                                                 taken on a line of credit or additional credit card charges are
                                                                 made by the insured; monthly premium charges will track
                                                                 accordingly. The debtor is charged monthly for coverage on a
                                                                 loan/credit transaction that allows for the debtor (subject to
                                                                 credit limits) to increase the indebtedness upon demand.
                                   CR02G.002 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                   Closed-End                    balance owed on a closed-end loan/credit transaction (i.e. the
                                                                 loan/credit transaction has a fixed termination date). Premium
                                                                 amounts are determined based on the declining outstanding
                                                                 balance. Premiums can be charged on a declining monthly basis
                                                                 or level monthly basis. The debtor is charged monthly for
                                                                 coverage on a loan/credit transaction that does not allows for
                                                                 the debtor (subject to credit limits) to increase the indebtedness
                                                                 upon demand.
                                   CR02G.003 Single Premium      The debtor is charged by a single premium for this insurance
                                                                 protection.
                                   CR02G.004 Full Term           Coverage for the entire term of the loan/credit transaction.
                                   CR02G.005 Critical Period     Disability benefits are limited to a specific number of months or
                                                                 for the remaining term of the loan/credit transaction, if less.
                                   CR02G.006 Truncated           Coverage for a term less than the term of the loan/credit
                                                                 transaction.
                                   CR02G.007 Other               Not specifically described above.
CR02I Individual Credit – Credit                                 Makes monthly loan/credit transaction payments to the creditor
Disability                                                       upon the disablement of an insured debtor.
                                   CR02I.001 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                   Open-End                      balance owed on a open-end loan/credit transaction or revolving
                                                                 charge account (i. e. the loan/credit transaction does not have a
                                                                 fixed termination date). Actual premium amounts decline along
                                                                 with the declining outstanding balance from month to month.
                                                                 Premium charges track accordingly. The outstanding balance
                                                                 may increase from time to time when an additional advance is
                                                                 taken on a line of credit or additional credit card charges are
                                                                 made by the insured; monthly premium charges will track
                                                                 accordingly. The debtor is charged monthly for coverage on a
                                                                 loan/credit transaction that allows for the debtor (subject to
                                                                 credit limits) to increase the indebtedness upon demand.
                                   CR02I.002 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                   Closed-End                    balance owed on a closed-end loan/credit transaction (i.e. the
                                                                 loan/credit transaction has a fixed termination date). Premium
                                                                 amounts are determined based on the declining outstanding
                                                                 balance. Premiums can be charged on a declining monthly basis
                                                                 or level monthly basis. The debtor is charged monthly for
                                                                 coverage on a loan/credit transaction that does not allows for
                                                                 the debtor (subject to credit limits) to increase the indebtedness
                                                                 upon demand.
                                   CR02I.003 Single Premium      The debtor is charged by a single premium for this insurance
                                                                 protection.
       REVISED October 2005                                                                                      34
            TOI                            SUB-TOI                                    DESCRIPTION


                                CR02I.004 Full Term           Coverage for the entire term of the loan/credit transaction.
                                CR02I.005 Critical Period     Disability benefits are limited to a specific number of months or
                                                              for the remaining term of the loan/credit transaction, if less.
                                CR02I.006 Truncated           Coverage for a term less than the term of the loan/credit
                                                              transaction.
                                CR02I.007 Other               Not specifically described above.
CR03G Group Credit - FMLA                                     Makes loan/credit transaction payments to the creditor when the
                                                              debtor is on unpaid leave from his/her job under the Family and
                                                              Medical Leave Act (FMLA)
                                CR03G.001 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                Open-End                      balance owed on a open-end loan/credit transaction or revolving
                                                              charge account (i. e. the loan/credit transaction does not have a
                                                              fixed termination date). Actual premium amounts decline along
                                                              with the declining outstanding balance from month to month.
                                                              Premium charges track accordingly. The outstanding balance
                                                              may increase from time to time when an additional advance is
                                                              taken on a line of credit or additional credit card charges are
                                                              made by the insured; monthly premium charges will track
                                                              accordingly. The debtor is charged monthly for coverage on a
                                                              loan/credit transaction that allows for the debtor (subject to
                                                              credit limits) to increase the indebtedness upon demand.
                                CR03G.002 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                Closed-End                    balance owed on a closed-end loan/credit transaction (i.e. the
                                                              loan/credit transaction has a fixed termination date). Premium
                                                              amounts are determined based on the declining outstanding
                                                              balance. Premiums can be charged on a declining monthly basis
                                                              or level monthly basis. The debtor is charged monthly for
                                                              coverage on a loan/credit transaction that does not allows for
                                                              the debtor (subject to credit limits) to increase the indebtedness
                                                              upon demand.
                                CR03G.003 Single Premium      The debtor is charged by a single premium for this insurance
                                                              protection.
CR03I Individual Credit -FMLA                                 Makes loan/credit transaction payments to the creditor when the
                                                              debtor is on unpaid leave from his/her job under the Family and
                                                              Medical Leave Act (FMLA)
                                CR03I.001 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                Open-End                      balance owed on a open-end loan/credit transaction or revolving
                                                              charge account (i. e. the loan/credit transaction does not have a
                                                              fixed termination date). Actual premium amounts decline along
                                                              with the declining outstanding balance from month to month.
                                                              Premium charges track accordingly. The outstanding balance
                                                              may increase from time to time when an additional advance is
                                                              taken on a line of credit or additional credit card charges are
                                                              made by the insured; monthly premium charges will track
                                                              accordingly. The debtor is charged monthly for coverage on a
                                                              loan/credit transaction that allows for the debtor (subject to
                                                              credit limits) to increase the indebtedness upon demand.




       REVISED October 2005                                                                                   35
              TOI                         SUB-TOI                                      DESCRIPTION


                                 CR03I.002 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                 Closed-End                    balance owed on a closed-end loan/credit transaction (i.e. the
                                                               loan/credit transaction has a fixed termination date). Premium
                                                               amounts are determined based on the declining outstanding
                                                               balance. Premiums can be charged on a declining monthly basis
                                                               or level monthly basis. The debtor is charged monthly for
                                                               coverage on a loan/credit transaction that does not allows for
                                                               the debtor (subject to credit limits) to increase the indebtedness
                                                               upon demand.
                                 CR03I.003 Single Premium      The debtor is charged by a single premium for this insurance
                                                               protection.
CR04G Group Credit - Life                                      Contracts sold in connection with loan/credit transactions or
                                                               other credit transactions, which do not exceed a stated duration
                                                               and/or amount and provide insurance protection against death.
                                 CR04G.001 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                 Open-End                      balance owed on a open-end loan/credit transaction or revolving
                                                               charge account (i. e. the loan/credit transaction does not have a
                                                               fixed termination date). Actual premium amounts decline along
                                                               with the declining outstanding balance from month to month.
                                                               Premium charges track accordingly. The outstanding balance
                                                               may increase from time to time when an additional advance is
                                                               taken on a line of credit or additional credit card charges are
                                                               made by the insured; monthly premium charges will track
                                                               accordingly. The debtor is charged monthly for coverage on a
                                                               loan/credit transaction that allows for the debtor (subject to
                                                               credit limits) to increase the indebtedness upon demand.
                                 CR04G.002 Monthly Premium –   A fixed rate is applied each month to the declining outstanding
                                 Closed-End                    balance owed on a closed-end loan/credit transaction (i.e. the
                                                               loan/credit transaction has a fixed termination date). Premium
                                                               amounts are determined based on the declining outstanding
                                                               balance. Premiums can be charged on a declining monthly basis
                                                               or level monthly basis. The debtor is charged monthly for
                                                               coverage on a loan/credit transaction that does not allows for
                                                               the debtor (subject to credit limits) to increase the indebtedness
                                                               upon demand.
                                 CR04G.003 Single Premium      The debtor is charged by a single premium for this insurance
                                                               protection.
                                 CR04G.004 Gross               Coverage for the total amount payable on the loan/credit
                                                               transaction (the net indebtedness plus the scheduled interest
                                                               charges).
                                 CR04G.005 Net                 Coverage for the scheduled or actual unpaid principal amount
                                                               of the loan/credit transaction.
                                 CR04G.006 Truncated           Coverage for a term less than the term of the loan/credit
                                                               transaction.
CR04I Individual Credit - Life                                 Contracts sold in connection with loan/credit transactions or
                                                               other credit transactions, which do not exceed a stated duration
                                                               and/or amount and provide insurance protection against death.




        REVISED October 2005                                                                                   36
             TOI                        SUB-TOI                                       DESCRIPTION


                              CR04I.001 Monthly Premium –     A fixed rate is applied each month to the declining outstanding
                              Open-End                        balance owed on a open-end loan/credit transaction or revolving
                                                              charge account (i. e. the loan/credit transaction does not have a
                                                              fixed termination date). Actual premium amounts decline along
                                                              with the declining outstanding balance from month to month.
                                                              Premium charges track accordingly. The outstanding balance
                                                              may increase from time to time when an additional advance is
                                                              taken on a line of credit or additional credit card charges are
                                                              made by the insured; monthly premium charges will track
                                                              accordingly. The debtor is charged monthly for coverage on a
                                                              loan/credit transaction that allows for the debtor (subject to
                                                              credit limits) to increase the indebtedness upon demand.
                              CR04I.002 Monthly Premium –     A fixed rate is applied each month to the declining outstanding
                              Closed-End                      balance owed on a closed-end loan/credit transaction (i.e. the
                                                              loan/credit transaction has a fixed termination date). Premium
                                                              amounts are determined based on the declining outstanding
                                                              balance. Premiums can be charged on a declining monthly basis
                                                              or level monthly basis. The debtor is charged monthly for
                                                              coverage on a loan/credit transaction that does not allows for
                                                              the debtor (subject to credit limits) to increase the indebtedness
                                                              upon demand.
                              CR04I.003 Single Premium        The debtor is charged by a single premium for this insurance
                                                              protection.
                              CR04I.004 Gross                 Coverage for the total amount payable on the loan/credit
                                                              transaction (the net indebtedness plus the scheduled interest
                                                              charges).
                              CR04I.005 Net                   Coverage for the scheduled or actual unpaid principal amount
                                                              of the loan/credit transaction.
                              CR04I.006 Truncated             Coverage for a term less than the term of the loan/credit
                                                              transaction.
CR05 Credit – Property                                        This section is for use where credit personal property is handled
                                                              by the life and/or health section of the state insurance
                                                              department. Under CR05.002 through CR05.004 credit
                                                              insurance may be either ―single interest‖ or ―dual interest‖.
                                                              Single interest means insurance that protects only the creditor’s
                                                              interest in the collateral securing a debtor’s credit transaction.
                                                              Dual interest (also commonly referred to as ―limited dual
                                                              interest‖) means insurance that protects the creditor’s and the
                                                              debtor’s interest in the collateral securing the debtor’s credit
                                                              transaction.
                              CR05.002 Creditor-Placed Home   Single interest or dual interest credit insurance purchased
                                                              unilaterally by the creditor, who is the named insured,
                                                              subsequent to the date of the credit transaction, providing
                                                              coverage against loss to property that would either impair a
                                                              creditor’s interest or adversely affect the value of collateral on
                                                              homes, mobile homes, and other real estate.
                              CR05.003 Creditor-Placed Auto   Single interest or dual interest credit insurance that is purchased
                                                              unilaterally by the creditor, who is the named insured,
                                                              subsequent to the date of the credit transaction, providing
                                                              coverage against loss to property that would either impair a
                                                              creditor’s interest or adversely affect the value of collateral on
                                                              automobiles, boats, or other vehicles.



       REVISED October 2005                                                                                   37
             TOI                          SUB-TOI                                      DESCRIPTION


                                CR05.004 Personal Property     Single interest or dual interest credit insurance (where collateral
                                                               is not a motor vehicle, mobile home, or real estate) that covers
                                                               perils to goods purchased or used as collateral and that concerns
                                                               a creditor’s interest in the purchased goods or pledged collateral
                                                               either in whole or in part; or covers perils to goods purchased in
                                                               connection with an open-end credit transaction.
                                CR05.005 Credit Family Leave   Credit insurance that provides a monthly or lump sum benefit
                                                               during an unpaid leave of absence from employment resulting
                                                               from specified causes, such as illness of a close relative,
                                                               adoption or birth of a child.
                                CR05.006 Personal Gap          Credit insurance that insures the excess of the outstanding
                                Insurance                      indebtedness over the primary property insurance benefits in the
                                                               event of a total loss to a collateral asset.
                                CR05.007 Other                 Not specifically described above.
CR06 Credit – Involuntary                                      This section is for use where credit unemployment is handled
Unemployment                                                   by the life and/or health section of the state insurance
                                                               department. This coverage makes loan/credit transaction
                                                               payments to the creditor when the debtor becomes involuntarily
                                                               unemployed.
                                CR06.001 Monthly Premium –     ―Open-end credit‖ means credit extended by a creditor by an
                                Open-End                       agreement that is a line of credit loan/credit transaction, a
                                                               revolving charge plan, or any other open-end self-replenishing
                                                               credit arrangement between the creditor and a customer that
                                                               may be drawn upon from time to time by the customer without
                                                               renegotiating the lending agreement. The customer may repay
                                                               the full outstanding balance at any time, or a specified
                                                               minimum portion of the indebtedness.
                                CR06.002 Monthly Premium –     "Closed-end credit" means a credit agreement on which
                                Closed-End                     payments are due in equal monthly installments for a fixed
                                                               term.
                                CR06.003 Single Premium        ―Single premium‖ means the purchase of insurance by the
                                                               payment of one lump sum on the date coverage begins.
CR07 Credit – Other             CR07.000 Credit - Other        Not specifically described above.
                                                               Accident & health contracts provide benefits for losses resulting
                            Health
                                                               from accident, sickness or medical condition.
H01 Health – Assumption         H01.000 Health – Assumption    An insurance certificate issued on an existing insurance contract
Agreement                       Agreement                      indicating that another insurer has assumed all of the risk under
                                                               the contract from the ceding insurance company.
H02G Group Health – Accident    H02G.000 Health – Accident     An insurance contract that provides coverage, singly or in
Only                            Only                           combination, for death, dismemberment, disability, or hospital
                                                               and medical care caused by or necessitated as a result of
                                                               accident or specified kinds of accident.
H02I Individual Health –        H02I.000 Health – Accident     An insurance contract that provides coverage, singly or in
Accident Only                   Only                           combination, for death, dismemberment, disability, or hospital
                                                               and medical care caused by or necessitated as a result of
                                                               accident or specified kinds of accident.
H03G Group Health –             H03G.000 Health – Accidental   An insurance contract that pays a stated benefit in the event of
Accidental Death &              Death & Dismemberment          death and/or dismemberment caused by accident or specified
Dismemberment                                                  kinds of accidents.
H03I Individual Health –        H03I.000 Health – Accidental   An insurance contract that pays a stated benefit in the event of
Accidental Death &              Death & Dismemberment          death and/or dismemberment caused by accident or specified
Dismemberment                                                  kinds of accidents.
H04 Health – Blanket            H04.000 Health – Blanket       A health insurance contract that covers all of a class of persons
Accident/Sickness               Accident/Sickness              not individually identified in the contract.
       REVISED October 2005                                                                                    38
              TOI                             SUB-TOI                                    DESCRIPTION


                                   H04.001 Student               A health insurance contract that covers a class of students not
                                                                 individually identified in the contract.
H05 Health – Champus/Tricare       H05.000 Health –              Civilian Health and Medical Program of the Uniformed
Supplement                         Champus/Tricare Supplement    Services (Champus). A private health plan that provides
                                                                 beneficiaries eligible for Champus with supplemental health
                                                                 care coverage.
H06 Health – Conversion            H06.000 Health – Conversion   Guarantees an insured whose coverage is ending for specified
                                                                 reasons a right to purchase a policy without presenting evidence
                                                                 of insurability.
H07G Group Health – Specified                                    Pays benefits for the diagnosis and treatment of a specifically
Disease – Limited Benefit                                        named disease or diseases. Benefits can be paid as expense
                                                                 incurred, per diem, or a principle sum.
                                   H07G.001 Critical Illness     Benefits can be paid as expense incurred, per diem, or as a
                                                                 principle sum.
                                   H07G.002 Dread Disease        Pays benefits for the diagnosis and treatment of a specifically
                                                                 named disease or diseases. Benefits can be paid on as expense
                                                                 incurred, per diem, or a principle sum.
                                   H07G.002A Dread Disease –     Provides benefits for losses resulting from cancer and its
                                   Cancer Only                   associated diagnosis and treatments. Pays benefits for the
                                                                 diagnosis and treatment of a specifically named disease or
                                                                 diseases. Benefits can be paid as expense incurred, per diem, or
                                                                 a principle sum.
                                   H07G.003 HIV Indemnity        Provides benefits for losses resulting from occupational
                                                                 exposure and infection of the Human Immunodeficiency Virus.
                                                                 Benefits often include some form of occupational income
                                                                 replacement. Benefits can be paid as expense incurred, per
                                                                 diem, or a principle sum.
H07I Individual Health –                                         Pays benefits for the diagnosis and treatment of a specifically
Specified Disease – Limited                                      named disease or diseases. Benefits can be paid as expense
Benefit                                                          incurred, per diem, or a principle sum.
                                   H07I.001 Critical Illness     Benefits can be paid as expense incurred, per diem, or as a
                                                                 principle sum.
                                   H07I.002 Dread Disease        Pays benefits for the diagnosis and treatment of a specifically
                                                                 named disease or diseases. Benefits can be paid on as expense
                                                                 incurred, per diem, or a principle sum.
                                   H07I.002A Dread Disease –     Provides benefits for losses resulting from cancer and its
                                   Cancer Only                   associated diagnosis and treatments. Pays benefits for the
                                                                 diagnosis and treatment of a specifically named disease or
                                                                 diseases. Benefits can be paid as expense incurred, per diem, or
                                                                 a principle sum.
                                   H07I.003 HIV Indemnity        Provides benefits for losses resulting from occupational
                                                                 exposure and infection of the Human Immunodeficiency Virus.
                                                                 Benefits often include some form of occupational income
                                                                 replacement. Benefits can be paid as expense incurred, per
                                                                 diem, or a principle sum.
H08G Group Health – Intensive      H08G.000 Health – Intensive   Provides a daily benefit for confinement in a qualified intensive
Care – Limited Benefit             Care – Limited Benefit        care unit of a certified hospital. Benefits are specific to services
                                                                 delivered by the staff of a hospital intensive care unit. Benefits
                                                                 not to exceed a stated dollar amount per day.
H08I Individual Health –           H08I.000 Health – Intensive   Provides a daily benefit for confinement in a qualified intensive
Intensive Care – Limited Benefit   Care – Limited Benefit        care unit of a certified hospital. Benefits are specific to services
                                                                 delivered by the staff of a hospital intensive care unit. Benefits
                                                                 not to exceed a stated dollar amount per day.

       REVISED October 2005                                                                                       39
             TOI                             SUB-TOI                                      DESCRIPTION


H09G Group Health – Organ &       H09G.000 Health – Organ &        Provides benefits for services incurred as a result of human
Tissue Transplant – Limited       Tissue Transplant – Limited      and/or non-human organ transplant. Benefits are specific to the
Benefit                           Benefit                          delivery of care associated with the covered organ or tissue
                                                                   transplant. Benefits not to exceed a stated dollar amount per
                                                                   day.
H09I Individual Health – Organ    H09I.000 Health – Organ &        Provides benefits for services incurred as a result of human
& Tissue Transplant – Limited     Tissue Transplant – Limited      and/or non-human organ transplant. Benefits are specific to the
Benefit                           Benefit                          delivery of care associated with the covered organ or tissue
                                                                   transplant. Benefits not to exceed a stated dollar amount per
                                                                   day.
H10G Group Health - Dental        H10G.000 Health - Dental         Insurance that provides benefits for routine dental examinations,
                                                                   preventive dental work and dental procedures needed to treat
                                                                   tooth decay and diseases of the teeth and jaw.
H10I Individual Health - Dental   H10I.000 Health - Dental         Insurance that provides benefits for routine dental examinations,
                                                                   preventive dental work and dental procedures needed to treat
                                                                   tooth decay and diseases of the teeth and jaw.
H11G Group Health – Disability                                     A policy designed to compensate insured individuals for a
Income                                                             portion of the income they lose because of a disabling injury or
                                                                   illness.
                                  H11G.001 Business Overhead       A policy designed to compensate insured individuals by paying
                                  Expense                          a benefit to replace income/revenue lost because of a disabling
                                                                   injury or sickness where the lost income/revenue paid business
                                                                   overhead expenses.
                                  H11G.002 Short Term              Disability income insurance that provides a benefit for a short
                                                                   disability. Group short-term disability usually specifies a
                                                                   maximum benefit period of less than one year.
                                  H11G.003 Long Term               The group disability maximum benefit period commonly
                                                                   extends to retirement or age 70.Group long-term disability
                                                                   usually specifies a maximum benefit period of at least one year.
                                  H11G.004 Other                   Not specifically described above.
                                  H11G.005 Combined Short          Disability income insurance that provides a benefit for both
                                  Term and Long Term               short term and long term disability.
H11I Individual Health –                                           A policy designed to compensate insured individuals for a
Disability Income                                                  portion of the income they lose because of a disabling injury or
                                                                   illness.
                                  H11I.001 Business Overhead       A policy designed to compensate insured individuals by paying
                                  Expense —Unrelated to            a benefit to replace income/revenue lost because of a disabling
                                  marketing with employer or       injury or illness where the lost income/revenue paid business
                                  association groups               overhead expenses.
                                  H11I.002 Short Term—             Disability income insurance that provides a benefit for a short
                                  Unrelated to marketing with      disability. Individual short-term disability insurance features a
                                  employer or association groups   maximum benefit period of from six months to 5 years.
                                  H11I.003 Long Term—              In individual long term disability income insurance, the
                                  Unrelated to marketing with      maximum benefit period is always greater than 5 years,
                                  employer or association groups   commonly extending to age 65 or for the insured’s lifetime.
                                  H11I.004 Other                   Not specifically described in other H11I categories.
                                  H11I.005 Business Overhead       A policy designed to compensate insured individuals by paying
                                  Expense —Related to marketing    a benefit to replace income/revenue lost because of a disabling
                                  with employer or association     injury or illness where the lost income/revenue paid business
                                  groups                           overhead expenses. The coverage is issued based upon some
                                                                   type of employer or association involvement.



       REVISED October 2005                                                                                       40
             TOI                          SUB-TOI                                      DESCRIPTION


                                H11I.006 Short Term—Related     Disability income insurance that provides a benefit for a short
                                to marketing with employer or   disability. Individual short-term disability insurance features a
                                association groups              maximum benefit period of from six months to 5 years. The
                                                                coverage is issued based upon some type of employer or
                                                                association involvement.
                                H11I.007 Long Term—Related      In individual long term disability income insurance, the
                                to marketing with employer or   maximum benefit period is always greater than 5 years,
                                association groups              commonly extending to age 65 or for the insured’s lifetime. The
                                                                coverage is issued based upon some type of employer or
                                                                association involvement.
                                H11I.008 Combined Short Term    Individual disability income insurance that provides for a
                                and Long Term—Unrelated to      maximum benefit period as short as six months up to the
                                marketing with employer or      insured’s lifetime, depending on the option chosen by the
                                association groups              insured, but all maximum benefit periods are offered through
                                                                the same policy.
                                H11I.009 Combined Short Term    Individual disability income insurance that provides for a
                                and Long Term—Related to        maximum benefit period as short as six months up to the
                                marketing with employer or      insured’s lifetime, depending on the option chosen by the
                                association groups              insured, but all maximum benefit periods are offered through
                                                                the same policy. The coverage is issued based upon some type
                                                                of employer or association involvement.
H12 Health – Excess/Stop Loss                                   This type of insurance may be extended to either a health plan
                                                                or a self-insured employer plan. Its purpose is to insure against
                                                                the risk that any one claim will exceed a specific dollar amount
                                                                or that an entire plan's losses will exceed a specific amount.
                                H12.001 Accident & Sickness     Accident is a form of insurance against loss from an unforeseen
                                                                mishap that results in bodily injury to the insured. Sickness
                                                                refers to those insurance contracts that guard against losses
                                                                associated with the illness and disease of the insured.
                                H12.002 Managed Care            A system of health care delivery where the primary goal is to
                                                                deliver value by giving people access to high quality, cost-
                                                                effective health care through monitoring and recommending
                                                                utilization of services, and overseeing costs of services.
                                H12.003 Provider                Any individual or group of individuals that provides a health
                                                                care services. A provider may be, but is not limited to, a
                                                                physician, hospital, group medical practice, nurse, nursing
                                                                home or a pharmacy.
                                H12.004 Self-Funded Health      An insurance contract that covers an employer’s exposure to
                                Plan                            losses incurred under a self-funded health plan.
H13G Group Health – Short                                       Coverage that provides medical and other services to insured’s
Term Care                                                       who need constant care in their own home or in a nursing
                                                                facility for periods of less than one year.
                                H13G.001 Home Health Care       Coverage that provides medical and non--medical services
                                                                provided to ill, disabled or infirm persons in their residences.
                                H13G.002 Nursing Home           Coverage provided in a facility setting for health related
                                                                services for the purpose of supporting frail, impaired elderly or
                                                                other disabled adults who require continued care and attention.
                                H13G.003 Adult Day Care         Coverage provided for individuals of social and health related
                                                                services provided during the day in a community group setting
                                                                for the purpose of supporting frail, impaired elderly or other
                                                                disabled adults who benefit from care in a group setting outside
                                                                the home.


       REVISED October 2005                                                                                    41
             TOI                            SUB-TOI                                   DESCRIPTION


H13I Individual Health – Short                                Coverage that provides medical and other services to insured’s
Term Care                                                     who need constant care in their own home or in a nursing
                                                              facility for periods of less than one year.
                                 H13I.001 Home Health Care    Coverage that provides medical and non--medical services
                                                              provided to ill, disabled or infirm persons in their residences.
                                 H13I.002 Nursing Home        Coverage provided in a facility setting for health related
                                                              services for the purpose of supporting frail, impaired elderly or
                                                              other disabled adults who require continued care and attention.
                                 H13I.003 Adult Day Care      Coverage provided for individuals of social and health related
                                                              services provided during the day in a community group setting
                                                              for the purpose of supporting frail, impaired elderly or other
                                                              disabled adults who benefit from care in a group setting outside
                                                              the home.
H14G Group Health - Hospital     H14G.000 Health - Hospital   An insurance contract that pays a fixed dollar amount without
Indemnity                        Indemnity                    regard to the actual expense incurred for each day the covered
                                                              person is confined to the hospital as a result of injury, sickness,
                                                              and/or medical condition..
H14I Individual Health -         H14I.000 Health - Hospital   An insurance contract that pays a fixed dollar amount without
Hospital Indemnity               Indemnity                    regard to the actual expense incurred for each day the covered
                                                              person is confined to the hospital as a result of injury, sickness,
                                                              and/or medical condition..
H15G Group Health –                                           An insurance contract that provides coverage to or reimburses
Hospital/Surgical/Medical                                     the covered person for hospital, surgical, and/or medical
Expense                                                       expense incurred as a result of injury, sickness, and/or medical
                                                              condition.
                                 H15G.001 Any Size Group      A hospital/surgical/medical expense contract that may be issued
                                                              to any size group.
                                 H15G.002 Large Group Only    A hospital/surgical/medical expense contract that may be issued
                                                              only to ―large groups‖ as that term is defined in the state in
                                                              which the contract will be delivered.
                                 H15G.003 Small Group Only    A hospital/surgical/medical expense contract that may be issued
                                                              only to ―small groups‖ as that term is defined in the state in
                                                              which the contract will be delivered.
H15I Individual Health –         H15I.001 Health –            An insurance contract that provides coverage to or reimburses
Hospital/Surgical/Medical        Hospital/Surgical/Medical    the covered person for hospital, surgical, and/or medical
Expense                          Expense                      expense incurred as a result of injury, sickness, and/or medical
                                                              condition.
H16G Group Health – Major                                     A hospital/surgical/medical expense contract that provides
Medical                                                       comprehensive benefits as defined in the state in which the
                                                              contract will be delivered.
                                 H16G.001A Any Size Group –   A major medical contract that may be issued to any size group.
                                 PPO                          A plan that provides incentives to enrollees to use plan
                                                              providers, but still provides lesser coverage if the enrollee
                                                              chooses a non-plan provider.
                                 H16G.001B Any Size Group –   A major medical contract that may be issued to any size group.
                                 POS                          A combination of traditional indemnity health insurance and an
                                                              HMO under which an enrollee is able to select the type of
                                                              coverage at the time a service is needed.
                                 H16G.001C Any Size Group -   A major medical contract that may be issued to any size group.
                                 Other                        Not specifically described above.
                                                              A major medical contract that may be issued only to ―large
                                                              groups‖ as that term is defined in the state in which the contract
                                                              will be delivered.

       REVISED October 2005                                                                                   42
    TOI                         SUB-TOI                                       DESCRIPTION


                       H16G.002A Large Group Only –   A major medical contract that may be issued only to ―large
                       PPO                            groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. A plan that provides incentives to enrollees to
                                                      use plan providers, but still provides lesser coverage if the
                                                      enrollee chooses a non-plan provider.
                       H16G.002B Large Group Only -   A major medical contract that may be issued only to ―large
                       POS                            groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. A combination of traditional indemnity health
                                                      insurance and an HMO under which an enrollee is able to select
                                                      the type of coverage at the time a service is needed.
                       H16G.002C Large Group Only -   A major medical contract that may be issued only to ―large
                       Other                          groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. Not specifically described above.
                                                      A major medical contract that may be issued only to ―small
                                                      groups‖ as that term is defined in the state in which the contract
                                                      will be delivered.
                       H16G.003A Small Group Only -   A major medical contract that may be issued only to ―small
                       PPO                            groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. A combination of traditional indemnity health
                                                      insurance and an HMO under which an enrollee is able to select
                                                      the type of coverage at the time a service is needed.
                       H16G.003B Small Group Only –   A major medical contract that may be issued only to ―small
                       PPO Basic                      groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. A basic plan that provides incentives to
                                                      enrollees to use plan providers, but still provides lesser
                                                      coverage if the enrollee chooses a non-plan provider.
                       H16G.003C Small Group Only –   A major medical contract that may be issued only to ―small
                       PPO Standard                   groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. A standard plan that provides incentives to
                                                      enrollees to use plan providers, but still provides lesser
                                                      coverage if the enrollee chooses a non-plan provider.
                       H16G.003D Small Group Only –   A major medical contract that may be issued only to ―small
                       POS                            groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. A combination of traditional indemnity heath
                                                      insurance and an HMO under which an enrollee is able to select
                                                      the type of coverage at the time a service is needed.
                       H16G.003E Small Group Only –   A major medical contract that may be issued only to ―small
                       POS Basic                      groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. One of the benefit plans that must be offered
                                                      in most states in the small group market. The specifications
                                                      vary from state to state but the basic plan generally has lower
                                                      benefits than the other state mandated plan: the standard benefit
                                                      plan.
                       H16G.003F Small Group Only –   A major medical contract that may be issued only to ―small
                       POS Standard                   groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. One of the benefit plans that must be offered
                                                      in most states in the small group market. The specifications
                                                      vary from state to state but the standard plan generally has
                                                      higher benefits than the other state mandated plan: the basic
                                                      benefit plan.
                       H16G.003G Small Group Only -   A major medical contract that may be issued only to ―small
                       Other                          groups‖ as that term is defined in the state in which the contract
                                                      will be delivered. Not specifically described above.

REVISED October 2005                                                                                  43
              TOI                            SUB-TOI                                       DESCRIPTION


                                  H16G.004 Short Term              A major medical policy or plan designed to provide coverage
                                                                   during a "gap" in coverage. Short term policies generally have
                                                                   pre-existing condition exclusions and are not renewable.
H16I Individual Health – Major                                     A major medical contract that may be issued only to
Medical                                                            ―individuals‖ as that term is defined in the state in which the
                                                                   contract will be delivered.
                                  H16I.005A Individual –           A plan that provides incentives to enrollees to use plan
                                  Preferred Provider (PPO)         providers, but still provides lesser coverage if the enrollee
                                                                   chooses a non-plan provider.
                                  H16I.005B Individual – Point-    A combination of traditional indemnity health insurance and an
                                  of-Service (POS)                 HMO under which an enrollee is able to select the type of
                                                                   coverage at the time a service is needed.
                                  H16I.005C Individual - Other     Not specifically described above.
                                  H16I.004 Short Term              A major medical policy or plan designed to provide coverage
                                                                   during a "gap" in coverage. Short term policies generally have
                                                                   pre-existing condition exclusions and are not renewable.
H17G Group Health –               H17G.000 Health – Prescription   Prescription drug plan that covers the cost of drugs (except
Prescription Drug                 Drug                             those dispensed in a hospital or in an extended care facility) that
                                                                   are required by either state or federal law to be dispensed by
                                                                   prescription. Drugs for which prescriptions are not required by
                                                                   law may be covered.
H17I Individual Health –          H17I.000 Health – Prescription   Prescription drug plan that covers the cost of drugs (except
Prescription Drug                 Drug                             those dispensed in a hospital or in an extended care facility) that
                                                                   are required by either state or federal law to be dispensed by
                                                                   prescription. Drugs for which prescriptions are not required by
                                                                   law may be covered.
H18G Group Health - Sickness      H18G.000 Health - Sickness       Limited benefit expense policies. Provides benefits for sickness
                                                                   only. Benefits not to exceed a stated dollar amount per day.
H18I Individual Health -          H18I.000 Health - Sickness       Limited benefit expense policies. Provides benefits for sickness
Sickness                                                           only. Benefits not to exceed a stated dollar amount per day.
H19I Individual Health - Travel   H19I.000 Health - Travel         Limited benefit expense policies. Provides benefits for loss
                                                                   incurred while traveling generally outside a 100-mile radius of
                                                                   the US borders. *May extend to domestic as well as foreign
                                                                   travel. May provide both sickness and injury benefits. May
                                                                   include loss of baggage benefits. May include air transportation
                                                                   services for emergencies. Benefits not to exceed a stated dollar
                                                                   amount per day, per month or trip duration. (*Subject to
                                                                   applicable state limitations.)
H19G Group Health - Travel        H19G.000 Health - Travel         Limited benefit expense policies. Provides benefits for loss
                                                                   incurred while traveling generally outside a 100-mile radius of
                                                                   the US borders. *May extend to domestic as well as foreign
                                                                   travel. May provide both sickness and injury benefits. May
                                                                   include loss of baggage benefits. May include air transportation
                                                                   services for emergencies. Benefits not to exceed a stated dollar
                                                                   amount per day, per month or trip duration. (*Subject to
                                                                   applicable state limitations.)
H20G Group Health – Vision        H20G.000 Health – Vision         Limited benefit expense policies. Provides benefits for eye care
                                                                   and eye care accessories. Generally provides a stated dollar
                                                                   amount per annual eye examination. Benefits often include a
                                                                   stated dollar amount for glasses and contacts. May include
                                                                   surgical benefits for injury or sickness associated with the eye.




       REVISED October 2005                                                                                        44
             TOI                            SUB-TOI                                     DESCRIPTION


H20I Individual Health – Vision   H20I.000 Health – Vision      Limited benefit expense policies. Provides benefits for eye care
                                                                and eye care accessories. Generally provides a stated dollar
                                                                amount per annual eye examination. Benefits often include a
                                                                stated dollar amount for glasses and contacts. May include
                                                                surgical benefits for injury or sickness associated with the eye.
H21 Health - Other                H21.000 Health - Other        Not specifically described above.
                                                                A form of health insurance combining a range of coverages in a
                                                                group basis. These coverages are offered on a prepaid basis to
                     Health Maintenance (HMO)
                                                                plan members. Members generally must use contracted medical
                                                                service providers.
HOrg01 Health Organizations –     HOrg01.000 Health             An insurance certificate issued on an existing insurance contract
Assumption Agreement              Organizations – Assumption    indicating that another insurer has assumed all of the risk under
                                  Agreement                     the contract from the ceding insurance company.
HOrg02G Group Health                                            A plan under which an enrollee pays a membership fixed fee in
Organizations – Health                                          advance in return for a wide range of comprehensive health care
Maintenance (HMO)                                               services with the HMO’s approved providers in a designated
                                                                service area.
                                  HOrg02G.001 Conversion        Guarantees an insured whose coverage is ending for specified
                                                                reasons a right to purchase a policy without presenting evidence
                                                                of insurability.
                                                                Coverage may be issued to any size group.
                                  HOrg02G.002A Any Size Group   Coverage may be issued to any size group. A plan that provides
                                  - PPO                         incentives to enrollees to use plan providers, but still provides
                                                                lesser coverage if the enrollee chooses a non-plan provider.
                                  HOrg02G.002B Any Size         Coverage may be issued to any size group. A combination of
                                  Group - POS                   traditional indemnity health insurance and an HMO under
                                                                which an enrollee is able to select the type of coverage at the
                                                                time a service is needed.
                                                                Coverage may be issued only to ―large groups‖ as that term is
                                                                defined in the state in which the contract will be delivered.
                                  HOrg02G.003A Large Group      Coverage may be issued only to ―large groups‖ as that term is
                                  Only - PPO                    defined in the state in which the contract will be delivered. A
                                                                plan that provides incentives to enrollees to use plan providers,
                                                                but still provides lesser coverage if the enrollee chooses a non-
                                                                plan provider.
                                  HOrg02G.003B Large Group      Coverage may be issued only to ―large groups‖ as that term is
                                  Only - POS                    defined in the state in which the contract will be delivered. A
                                                                combination of traditional indemnity health insurance and an
                                                                HMO under which an enrollee is able to select the type of
                                                                coverage at the time a service is needed.
                                                                Coverage may be issued only to ―small groups‖ as that term is
                                                                defined in the state in which the contract will be delivered.
                                  HOrg02G.004A Small Group      Coverage may be issued only to ―small groups‖ as that term is
                                  Only – PPO Basic              defined in the state in which the contract will be delivered. A
                                                                PPO basic plan that provides incentives to enrollees to use plan
                                                                providers, but still provides lesser coverage if the enrollee
                                                                chooses a non-plan provider.
                                  HOrg02G.004B Small Group      Coverage may be issued only to ―small groups‖ as that term is
                                  Only – PPO Standard           defined in the state in which the contract will be delivered. A
                                                                PPO standard plan that provides incentives to enrollees to use
                                                                plan providers, but still provides lesser coverage if the enrollee
                                                                chooses a non-plan provider.


       REVISED October 2005                                                                                     45
             TOI                         SUB-TOI                                        DESCRIPTION


                              HOrg02G.004C Small Group          Coverage may be issued only to ―small groups‖ as that term is
                              Only – POS Basic                  defined in the state in which the contract will be delivered. A
                                                                POS basic plan that provides incentives to enrollees to use plan
                                                                providers, but still provides lesser coverage if the enrollee
                                                                chooses a non-plan provider.
                              HOrg02G.004D Small Group          Coverage may be issued only to ―small groups‖ as that term is
                              Only – POS Standard               defined in the state in which the contract will be delivered. A
                                                                POS standard plan which would provide incentives to enrollees
                                                                to use plan providers, but still provides lesser coverage if the
                                                                enrollee chooses a non-plan provider.
                              HOrg02G.004E Small Group          Coverage may be issued only to ―small groups‖ as that term is
                              Only – Other                      defined in the state in which the contract will be delivered. Not
                                                                specifically described above.
HOrg02I Individual Health
                                                                Coverage may be issued only to ―individuals‖ as that term is
Organizations - Health
                                                                defined in the state in which the contract will be delivered.
Maintenance (HMO)
                              HOrg02I.005A Individual –         A plan that provides incentives to enrollees to use plan
                              Preferred Provider (PPO)          providers, but still provides lesser coverage if the enrollee
                                                                chooses a non-plan provider.
                              HOrg02I.005B Individual –         A combination of traditional indemnity health insurance and an
                              Point-of-Service (POS)            HMO under which an enrollee is able to select the type of
                                                                coverage at the time a service is needed.
                              HOrg02I.005C Individual –
                                                                Not specifically described above.
                              Other
HOrg03 Health - Other         HOrg03.000 Health - Other         Not specifically described above.
                                                                An insurance contract that provides a specified benefit amount
Life
                                                                to a named beneficiary upon the death of the insured.
L01 Life - Assumption         L01.000 Life – Assumption         An insurance certificate issued on an existing insurance contract
Agreement                     Agreement                         indicating that another insurer has assumed all of the risk under
                                                                the contract from the ceding insurance company.
L02G Group Life - Endowment   L02G.000 Life – Endowment         Insurance that pays the same benefit amount should the insured
                                                                die during the term of the contract, or if the insured survives to
                                                                the end of the specified coverage term or age.
                              L02G.001 Single Life -            Endowment on a single insured that requires payment of a
                              Fixed/Indeterminate Premium       specified modal premium of a fixed amount or where the
                                                                premium is dependent on factors that may be changed by the
                                                                insurer but not to go beyond a guaranteed maximum for the
                                                                certificate to remain in force.
                              L02G.002 Single Life - Single     Endowment on a single insured where the insured pays only one
                              Premium                           specified premium amount at the time the certificate is issued.
                              L02G.101 Joint (First to Die) -   Endowment on more than one insured where the benefit is
                              Fixed/Indeterminate Premium       payable on first death that requires a premium to be paid by a
                                                                specified modal premium of a fixed amount or where the
                                                                premium is dependent on factors that may be changed by the
                                                                insurer, but not to go beyond a guaranteed maximum for the
                                                                certificate to remain in force.
                              L02G.102 Joint (First to Die) -   Endowment on more than one insured where the benefit is
                              Single Premium                    payable on the first death and the insured pays only one
                                                                specified premium amount at the time the certificate is issued.




       REVISED October 2005                                                                                     46
              TOI                           SUB-TOI                                        DESCRIPTION


                                 L02G.201 Joint (Last Survivor) -   Endowment on more than one insured where the benefit is
                                 Fixed/Indeterminate Premium        payable on the last death that requires payment of a specified
                                                                    modal premium of a fixed amount or where the premium is
                                                                    dependent on factors that may be changed by the insurer, but
                                                                    not to go beyond a guaranteed maximum for the certificate to
                                                                    remain in force.
                                 L02G.202 Joint (Last Survivor) -   Endowment on more than one insured where the benefit is
                                 Single Premium                     payable on the last death and the insured pays only one
                                                                    specified premium amount at the time the certificate is issued.
L02I Individual Life –           L02I.000 Life – Endowment          An insurance contract that pays the same benefit amount should
Endowment                                                           the insured die during the term of the contract or if the insured
                                                                    survives to the end of the specified policy term or age.
                                 L02I.001 Single Life -             Endowment on a single insured that requires payment of a
                                 Fixed/Indeterminate Premium        specified modal of premium of a fixed amount or where the
                                                                    premium is dependent on factors that may be changed by the
                                                                    insurer, but not to go beyond a guaranteed maximum for the
                                                                    policy to remain in force.
                                 L02I.002 Single Life - Single      Endowment on a single insured where the insured pays only one
                                 Premium                            specified premium amount at the time the policy is issued.
                                 L02I.101 Joint (First to Die) -    Endowment on more than one insured where the benefit is
                                 Fixed/Indeterminate Premium        payable on the first death that requires payment of a specified
                                                                    modal premium of a fixed amount or where the premium is
                                                                    dependent on factors that may be changed by the insurer, but
                                                                    not to go beyond a guaranteed maximum for the policy to
                                                                    remain in force.
                                 L02I.102 Joint (First to Die) -    Endowment on a single insured where the insured pays only one
                                 Single Premium                     specified premium amount at the time the policy is issued.
                                 L02I.201 Joint (Last Survivor) -   Endowment on more than one insured where the benefit is
                                 Fixed/Indeterminate Premium        payable on the last death that requires payment of a specified
                                                                    modal premium of a fixed amount or where the premium is
                                                                    dependent on factors that may be changed by the insurer, but
                                                                    not to go beyond a guaranteed maximum for the policy to
                                                                    remain in force.
                                 L02I.202 Joint (Last Survivor) -   Endowment on more than one insured where benefit is payable
                                 Single Premium                     on last death where the insured pays only one specified
                                                                    premium amount at the time the policy is issued.
L03G Group Life - Special        L03G.000 Group Life - Special      Contracts with certain noteworthy attributes (not otherwise
                                                                    covered).
L03I Individual Life - Special   L03I.000 Individual Life -         Contracts with certain noteworthy attributes (not otherwise
                                 Special                            covered).
L04G Group Life – Term                                              Life insurance where the policy provides protection only for a
                                                                    specified period of time.
                                 L04G.003 Single Life - Single      Term on a single insured where the insured pays only one
                                 Premium                            specified premium amount at the time the coverage is issued.
                                 L04G.004 Joint (First to Die) -    Term on more than one insured where the benefit is payable on
                                 Single Premium                     the first death and there is only one specified premium amount
                                                                    paid at the time the coverage is issued.
                                 L04G.005 Joint (Last Survivor) -   Term on more than one insured where the benefit is payable on
                                 Single Premium                     last death and the insured pays only one specified premium
                                                                    amount at the time the coverage is issued.




        REVISED October 2005                                                                                       47
    TOI                           SUB-TOI                                       DESCRIPTION


                       L04G.103 Renewable - Single       Term on a single insured that requires the insured to pay a
                       Life - Fixed/Indeterminate        specified modal premium where the premium is either a fixed
                       Premium                           amount or dependent on factors that may be changed by the
                                                         insurer, but not to go beyond a guaranteed maximum for the
                                                         coverage to remain in force.
                       L04G.104 Renewable - Joint        Term on more than one insured where the benefit is payable on
                       (First to Die) -                  first death and the insured pays a specified modal premium that
                       Fixed/Indeterminate Premium       is a fixed amount or where the premium is dependent on factors
                                                         that may be changed by the insurer, but not to go beyond a
                                                         guaranteed maximum for the coverage to remain in force.
                       L04G.105 Renewable - Joint        Term on more than one insured where the benefit is payable on
                       (Last Survivor) -                 last death and the insured pays a specified modal premium that
                       Fixed/Indeterminate Premium       is a fixed amount or where the premium is dependent on factors
                                                         that may be changed by the insurer, but not to go beyond a
                                                         guaranteed maximum for the coverage to remain in force.
                       L04G.203 Specified Age or         Term on a single insured that requires the payment of a
                       Duration - Single Premium -       specified single premium where the coverage remains in force
                       Single Life                       to a specified age or for a specified duration.
                       L04G.204 Specified Age or         Term on more than one life that requires the payment of a
                       Duration - Single Premium -       specified single premium where the death benefit is paid on the
                       Joint (First to Die)              first death and the coverage remains in force to a specified age
                                                         or for a specified duration.
                       L04G.205 Specified Age or         Term on more than one life that requires the payment of a
                       Duration - Single Premium -       specified single premium where the death benefit is paid on the
                       Joint (Last Survivor)             last death and the coverage remains in force to a specified age
                                                         or for a specified duration.
                       L04G.213 Specified Age or         Term on a single insured that requires the payment of a
                       Duration - Fixed/Indeterminate    specified modal premium where the premium is either a fixed
                       Premium - Single Life             amount or dependent on factors that may be changed by the
                                                         policy owner, but not to go beyond a guaranteed maximum for
                                                         the policy to remain in force. The coverage remains in force to
                                                         a specified age or for a specified duration.
                       L04G.214 Specified Age or         Term on more than one life that requires the payment of a
                       Duration - Fixed/Indeterminate    specified modal premium where the premium is either a fixed
                       Premium - Joint (First to Die)    amount or dependent on factors that may be changed by the
                                                         policy owner, but not to go beyond a guaranteed maximum for
                                                         the policy to remain in force. The death benefit is paid on the
                                                         first death and the coverage remains in force to a specified age
                                                         or for a specified duration.
                       L04G.215 Specified Age or         Term on more than one life that requires the payment of a
                       Duration - Fixed/Indeterminate    specified modal premium where the premium is either a fixed
                       Premium - Joint (Last Survivor)   amount or dependent on factors that may be changed by the
                                                         policy owner, but not to go beyond a guaranteed maximum for
                                                         the policy to remain in force. The death benefit is paid on the
                                                         last death and the coverage remains in force to a specified age
                                                         or for a specified duration.
                       L04G.303 Decreasing - Single      Term on a single insured in which the death benefit reduces
                       Life - Single Premium             monthly or annually similar to a mortgage schedule. and only
                                                         one specified premium amount is paid at the time the coverage
                                                         is issued.
                       L04G.304 Decreasing - Joint       Term on more than one insured where the benefit is payable on
                       (First to Die) - Single Premium   first death and the death benefit reduces monthly or annually
                                                         similar to a mortgage schedule and only one specified premium
                                                         amount is paid at the time the coverage is issued.
REVISED October 2005                                                                                   48
             TOI                          SUB-TOI                                        DESCRIPTION


                              L04G.305 Decreasing - Joint        Term on more than one insured where the benefit is payable on
                              (Last Survivor) - Single           last death and the death benefit reduces monthly or annually
                              Premium                            similar to a mortgage schedule and only one specified premium
                                                                 amount is paid at the time the coverage is issued.
                              L04G.313 Decreasing - Single       Term on a single insured that requires the insured to pay a
                              Life - Fixed/Indeterminate         specified modal premium where the premium is either a fixed
                              Premium                            amount or dependent on factors that may be changed by the
                                                                 insurer, but not to go beyond a guaranteed maximum for the
                                                                 coverage to remain in force. The death benefit reduces monthly
                                                                 or annually similar to a mortgage schedule
                              L04G.314 Decreasing - Joint        Term on more than one insured where the benefit is payable on
                              (First to Die) -                   the first death and the insured pays a specified modal premium
                              Fixed/Indeterminate Premium        of a fixed amount or where the premium is dependent on factors
                                                                 that may be changed by the insurer, but not to go beyond a
                                                                 guaranteed maximum for the coverage to remain in force. The
                                                                 death benefit reduces monthly or annually similar to a mortgage
                                                                 schedule.
                              L04G.315 Decreasing - Joint        Term on more than one insured where the benefit is payable on
                              (Last Survivor) -                  last death and the insured pays a specified modal premium of a
                              Fixed/Indeterminate Premium        fixed amount or where the premium is dependent on factors that
                                                                 may be changed by the insurer, but not to go beyond a
                                                                 guaranteed maximum for the coverage to remain in force. The
                                                                 death benefit reduces monthly or annually similar to a mortgage
                                                                 schedule.
                              L04G.403 Deposit Term - Single     Term on a single insured where there is an additional premium
                              Life                               paid at issue that provides an endowment at the end of the initial
                                                                 term period.
                              L04G.404 Deposit Term - Joint      Term on more than one insured where the death benefit is
                              (First to Die)                     payable on the first death, and where there is an additional
                                                                 premium paid at issue that provides an endowment at the end of
                                                                 the initial term period.
                              L04G.405 Deposit Term - Joint      Term on more than one insured where the death benefit is
                              (Last Survivor)                    payable on the last death, and where there is an additional
                                                                 premium paid at issue that provides an endowment at the end of
                                                                 the initial term period.
                              L04G.500 Other                     Not specifically described above.
L04I Individual Life – Term                                      Life insurance where the policy provides protection only for a
                                                                 specified period of time.
                              L04I.003 Single Life - Single      Term on a single insured in which the insured pays only one
                              Premium                            specified premium amount at the time the policy is issued.
                              L04I.004 Joint (First to Die) -    Term on more than one insured where the benefit is payable on
                              Single Premium                     first death where only one specified premium amount is paid at
                                                                 the time the policy is issued.
                              L04I.005 Joint (Last Survivor) -   Term on more than one insured where the benefit is payable on
                              Single Premium                     the last death and the insured pays only one specified premium
                                                                 amount at the time the policy is issued.
                              L04I.103 Renewable - Single        Term on a single insured that requires the insured to pay a
                              Life - Fixed/Indeterminate         specified modal premium where the premium is either a fixed
                              Premium                            amount or dependent on factors that may be changed by the
                                                                 insurer, but not to go beyond a guaranteed maximum for the
                                                                 policy to remain in force.




       REVISED October 2005                                                                                      49
    TOI                           SUB-TOI                                       DESCRIPTION


                       L04I.104 Renewable - Joint        Term on more than one insured where the benefit is payable on
                       (First to Die) - Fixed            first death and the insured pays a specified modal premium of a
                       Premium/Indeterminate             fixed amount or where the premium is dependent on factors that
                       Premium                           may be changed by the insurer, but not to go beyond a
                                                         guaranteed maximum for the policy to remain in force.
                       L04I.105 Renewable - Joint        Term on more than one insured where the benefit is payable on
                       (Last Survivor) - Fixed           the last death and the insured pays a specified modal premium
                       Premium/Indeterminate             of a fixed amount or where the premium is dependent on factors
                       Premium                           that may be changed by the insurer, but not to go beyond a
                                                         guaranteed maximum for the policy to remain in force.
                       L04I.203 Specified Age or         Term on a single insured that requires the payment of a
                       Duration - Single Premium -       specified single premium where the policy remains in force to a
                       Single Life                       specified age or for a specified duration.
                       L04I.204 Specified Age or         Term on more than one life that requires the payment of a
                       Duration - Single Premium -       specified single premium where the death benefit is paid on the
                       Joint (First to Die)              first death and the policy remains in force to a specified age or
                                                         for a specified duration.
                       L04I.205 Specified Age or         Term on more than one life that requires the payment of a
                       Duration - Single Premium -       specified single premium where the death benefit is paid on the
                       Joint (Last Survivor)             last death and the policy remains in force to a specified age or
                                                         for a specified duration.
                       L04I.213 Specified Age or         Term on a single insured that requires the payment of a
                       Duration - Fixed/Indeterminate    specified modal premium where the premium is either a fixed
                       Premium - Single Life             amount or dependent on factors that may be changed by the
                                                         policy owner, but not to go beyond a guaranteed maximum for
                                                         the policy to remain in force. The policy remains in force to a
                                                         specified age or for a specified duration.
                       L04I.214 Specified Age or         Term on more than one life that requires the payment of a
                       Duration - Fixed/Indeterminate    specified modal premium where the premium is either a fixed
                       Premium - Joint (First to Die)    amount or dependent on factors that may be changed by the
                                                         policy owner, but not to go beyond a guaranteed maximum for
                                                         the policy to remain in force. The death benefit is paid on the
                                                         first death and the policy remains in force to a specified age or
                                                         for a specified duration.
                       L04I.215 Specified Age or         Term on more than one life that requires the payment of a
                       Duration - Fixed/Indeterminate    specified modal premium where the premium is either a fixed
                       Premium - Joint (Last Survivor)   amount or dependent on factors that may be changed by the
                                                         policy owner, but not to go beyond a guaranteed maximum for
                                                         the policy to remain in force. The death benefit is paid on the
                                                         last death and the policy remains in force to a specified age or
                                                         for a specified duration.
                       L04I.303 Decreasing -Single       Term on a single insured where the death benefit reduces
                       Life - Single Premium             monthly or annually similar to a mortgage schedule and only
                                                         one specified premium amount is paid at the time the policy is
                                                         issued.
                       L04I.304 Decreasing - Joint       Term on more than one insured where the benefit is payable on
                       (First to Die) - Single Premium   the first death and the death benefit reduces monthly or annually
                                                         similar to a mortgage schedule and only one specified premium
                                                         amount is paid at the time the policy is issued.
                       L04I.305 Decreasing - Joint       Term on more than one insured where the benefit is payable on
                       (Last Survivor) - Single          the last death and the death benefit reduces monthly or annually
                       Premium                           similar to a mortgage schedule and only one specified premium
                                                         amount is paid at the time the policy is issued.

REVISED October 2005                                                                                    50
             TOI                         SUB-TOI                                        DESCRIPTION


                              L04I.313 Decreasing - Single      Term on a single insured that requires the insured to pay a
                              Life - Fixed/Indeterminate        specified modal premium where the premium is either a fixed
                              Premium                           amount or dependent on factors that may be changed by the
                                                                insurer, but not to go beyond a guaranteed maximum for the
                                                                policy to remain in force. Death benefit reduces monthly or
                                                                annually similar to a mortgage schedule.
                              L04I.314 Decreasing - Joint       Term on more than one insured where the benefit is payable on
                              (First to Die) -                  the first death and the insured pays a specified modal premium
                              Fixed/Indeterminate Premium       of a fixed amount or where the premium is dependent on factors
                                                                that may be changed by the insurer, but not to go beyond a
                                                                guaranteed maximum for the policy to remain in force. The
                                                                death benefit reduces monthly or annually similar to a mortgage
                                                                schedule.
                              L04I.315 Decreasing - Joint       Term on more than one insured where the benefit is payable on
                              (Last Survivor) -                 the last death where the insured pays a specified modal
                              Fixed/Indeterminate Premium       premium of a fixed amount or where the premium is dependent
                                                                on factors that may be changed by the insurer, but not to go
                                                                beyond a guaranteed maximum for the policy to remain in
                                                                force. The death benefit reduces monthly or annually similar to
                                                                a mortgage schedule.
                              L04I.403 Deposit Term - Single    Term on a single insured where there is an additional premium
                              Life                              paid at issue that provides an endowment at the end of the initial
                                                                term period.
                              L04I.404 Deposit Term - Joint     Term on more than one insured where the death benefit is
                              (First to Die)                    payable on the first death and where there is an additional
                                                                premium paid at issue that provides an endowment at the end of
                                                                the initial term period.
                              L04I.405 Deposit Term - Joint     Term on more than one insured where the death benefit is
                              (Last Survivor)                   payable on the last death and where there is an additional
                                                                premium paid at issue that provides an endowment at the end of
                                                                the initial term period.
                              L04I.500 Other                    Not specifically described above.
L06G Group Life - Variable                                      Life insurance whose face value and/or duration varies
                                                                depending upon the value of underlying securities.
                              L06G.001 Single Life - Fixed      Variable life insurance on a single insured requiring the insured
                              Premium                           to pay a specified modal premium for the coverage to remain in
                                                                force.
                              L06G.002 Single Life - Flexible   Variable life insurance on a single insured that allows the
                              Premium                           insured to vary the modal premium that is paid or to skip a
                                                                payment, so long as the account value is sufficient to keep the
                                                                coverage in force.
                              L06G.003 Single Life - Single     Variable life insurance on a single insured in which the insurer
                              Premium                           pays only one specified premium amount at the time the
                                                                coverage is issued.
                              L06G.004 Single Life - Modified   Variable life insurance on a single insured that allows the
                              Single Premium                    insured to pay one specified premium amount at the time the
                                                                coverage is issued and optional subsequent premiums subject to
                                                                the federal guideline premium limits.
                              L06G.101 Joint (First to Die) -   Variable life insurance on more than one insured where the
                              Fixed Premium                     benefit is payable on the first death and that requires the insured
                                                                to pay a specified modal premium for the coverage to remain in
                                                                force.


       REVISED October 2005                                                                                     51
              TOI                             SUB-TOI                                        DESCRIPTION


                                  L06G.102 Joint (First to Die) -    Variable life insurance on more than one insured where the
                                  Flexible Premium                   benefit is payable on the first death that allows the insured to
                                                                     vary the modal premium that is paid or to skip a payment, so
                                                                     long as the account value is sufficient to keep the coverage in
                                                                     force.
                                  L06G.103 Joint (First to Die) -    Variable life insurance on more than one insured where the
                                  Single Premium                     benefit is payable on the first death and the insured pays only
                                                                     one specified premium amount at the time the coverage is
                                                                     issued.
                                  L06G.104 Joint (First to Die) -    Variable life insurance on more than one insured where the
                                  Modified Single Premium            benefit is payable on the first death that allows the insured to
                                                                     pay one specified premium amount at the time the coverage is
                                                                     issued and optional subsequent premiums subject to the federal
                                                                     guideline premium limits.
                                  L06G.201 Joint (Last Survivor) -   Variable life insurance on more than one insured where the
                                  Fixed Premium                      benefit is payable on the last death that requires the insured to
                                                                     pay a specified modal premium for the coverage to remain in
                                                                     force.
                                  L06G.202 Joint (Last Survivor) -   Variable life insurance on more than one insured where the
                                  Flexible Premium                   benefit is payable on the last death that allows the insured to
                                                                     vary the modal premium that is paid or to skip a payment, so
                                                                     long as the account value is sufficient to keep the coverage in
                                                                     force.
                                  L06G.203 Joint (Last Survivor) -   Variable life insurance on more than one insured where the
                                  Single Premium                     benefit is payable on the last death where the insured pays only
                                                                     one specified premium amount at the time the coverage is
                                                                     issued.
                                  L06G.204 Joint (Last Survivor) -   Variable life insurance on more than one insured where the
                                  Modified Single Premium            benefit is payable on the last death that allows the insured to
                                                                     pay one specified premium amount at the time the coverage is
                                                                     issued and optional subsequent premiums subject to the federal
                                                                     guideline premium limits.
L06I Individual Life - Variable                                      Life insurance whose face value and/or duration varies
                                                                     depending upon the value of underlying securities.
                                  L06I.001 Single Life - Fixed       Life insurance requiring the insured to pay a specified modal
                                  Premium                            premium for the policy to remain in force.
                                  L06I.002 Single Life - Flexible    Life insurance that allows the insured to vary the modal
                                  Premium                            premium that is paid or to skip a payment, so long as the policy
                                                                     value is sufficient to keep the policy in force.
                                  L06I.003 Single Life - Single      Life insurance in which the insured would pay only one
                                  Premium                            specified premium amount at the time the policy is issued.
                                  L06I.004 Single Life - Modified    Variable life insurance on a single insured that allows the
                                  Single Premium                     insured to pay one specified premium amount at the time the
                                                                     policy is issued and optional subsequent premiums subject to
                                                                     the federal guideline premium limits.
                                  L06I.101 Joint (First to Die) -    Variable life insurance on more than one insured where the
                                  Fixed Premium                      benefit is payable on the first death that requires the insured to
                                                                     pay a specified modal premium for the policy to remain in
                                                                     force.
                                  L06I.102 Joint (First to Die) -    Variable life insurance on more than one insured where the
                                  Flexible Premium                   benefit is payable on the first death that allows the insured to
                                                                     vary the modal premium that is paid or to skip a payment, so
                                                                     long as the policy value is sufficient to keep the policy in force.

        REVISED October 2005                                                                                         52
            TOI                           SUB-TOI                                        DESCRIPTION


                              L06I.103 Joint (First to Die) -    Variable life insurance on more than one insured where the
                              Single Premium                     benefit is payable on the first death where the insured pays only
                                                                 one specified premium amount at the time the policy is issued.
                              L06I.104 Joint (First to Die) -    Variable life insurance on more than one insured where the
                              Modified Single Premium            benefit is payable on the first death that allows the insured to
                                                                 pay one specified premium amount at the time the policy is
                                                                 issued and optional subsequent premiums subject to the federal
                                                                 guideline premium limits.
                              L06I.201 Joint (Last Survivor) -   Variable life insurance on more than one insured where the
                              Fixed Premium                      benefit is payable on the last death that requires the insured to
                                                                 pay a specified modal premium for the policy to remain in
                                                                 force.
                              L06I.202 Joint (Last Survivor) -   Variable life insurance on more than one insured where the
                              Flexible Premium                   benefit is payable on the last death that allows the insured to
                                                                 vary the modal premium that is paid or to skip a payment, so
                                                                 long as the policy value is sufficient to keep the policy in force.
                              L06I.203 Joint (Last Survivor) -   Variable life insurance on more than one insured where the
                              Single Premium                     benefit is payable on the last death where the insured pays only
                                                                 one specified premium amount at the time the policy is issued.
                              L06I.204 Joint (Last Survivor) -   Variable life insurance on more than one insured where the
                              Modified Single Premium            benefit is payable on the last death that allows the insured to
                                                                 pay one specified premium amount at the time the policy is
                                                                 issued and optional subsequent premiums subject to the federal
                                                                 guideline premium limits.
L07G Group Life - Whole                                          Life insurance that may be kept in force for a person’s entire
                                                                 life and that pays a benefit upon the person’s death, whenever
                                                                 that may be.
                              L07G.101 Fixed/Indeterminate       Whole life on a single insured that requires a premium to be
                              Premium - Single Life              paid by a specified modal premium of a fixed amount or where
                                                                 the premium is dependent on factors that may be changed by
                                                                 the insurer, but not to go beyond a guaranteed maximum for the
                                                                 certificate to remain in force.
                              L07G.102 - Fixed/Indeterminate     Whole life on more than one insured where the benefit is
                              Premium - Joint (First to Die)     payable on first death that requires payment of a specified
                                                                 modal premium of a fixed amount or where the premium is
                                                                 dependent on factors that may be changed by the insurer, but
                                                                 not to go beyond a guaranteed maximum for the certificate to
                                                                 remain in force.
                              L07G.103 - Fixed/Indeterminate     Whole life on more than one insured where the benefit is
                              Premium -Joint (Last Survivor)     payable on last death that requires payment of a specified modal
                                                                 premium of a fixed amount or where the premium is dependent
                                                                 on factors that may be changed by the insurer, but not to go
                                                                 beyond a guaranteed maximum for the certificate to remain in
                                                                 force.
                              L07G.104 Fixed/Indeterminate       Whole life on a single insured used to fund funeral expense or
                              Premium - Single Life - Funeral    preneed funeral coverage that requires payment of a specified
                              Expense                            modal premium of a fixed amount or where the premium is
                                                                 dependent on factors that may be changed by the insurer, but
                                                                 not to go beyond a guaranteed maximum for the certificate to
                                                                 remain in force.
                              L07G.111 Single Premium -          Whole life insurance with a guaranteed single premium and
                              Single Life                        benefits on one insured.



       REVISED October 2005                                                                                      53
    TOI                           SUB-TOI                                        DESCRIPTION


                       L07G.112 Single Premium -          Whole life insurance on more than one insured with a
                       Joint (First to Die)               guaranteed single premium and benefits, with the death benefit
                                                          payable upon the first death.
                       L07G.113 Single Premium -Joint     Whole life insurance on more than one insured with a
                       (Last Survivor)                    guaranteed single premium and benefits, with the death benefit
                                                          payable upon the last death.
                       L07G.114 Single Premium -          Whole life insurance on more than one insured with a
                       Single Life - Funeral Expense      guaranteed single premium and benefits, used to fund funeral
                                                          expense or a preneed funeral contract.
                       L07G.121 Graded Premium -          Whole life insurance on more than one insured with a
                       Single Life                        guaranteed graded premium and benefits.
                       L07G.122 Graded Premium -          Whole life insurance on more than one insured with a
                       Joint (First to Die)               guaranteed graded premium and benefits, with the death benefit
                                                          payable upon the first death.
                       L07G.123 Graded Premium -          Whole life insurance on more than one insured with a
                       Joint (Last Survivor)              guaranteed graded premium and benefits, with the death benefit
                                                          payable upon the last death.
                       L07G.201 Early Duration
                                                          Whole life insurance with a guaranteed level premium and
                       Reduced Benefit - Level
                                                          benefits reduced during the early durations.
                       Premium - Any Policy Design
                       L07G.202 Early Duration
                                                          Whole life insurance with a guaranteed level premium and
                       Reduced Benefit - Level
                                                          benefits reduced during the early durations and used to fund
                       Premium - Any Policy Design -
                                                          funeral expense or preneed funeral contracts.
                       Funeral Expense
                       L07G.211 Early Duration
                                                          Whole life insurance with a single premium and benefits
                       Reduced Benefit - Single
                                                          reduced during the early durations.
                       Premium - Any Policy Design
                       L07G.212 Early Duration
                                                          Whole life insurance with a single premium and benefits
                       Reduced Benefit - Single
                                                          reduced during the early durations used to fund funeral expense
                       Premium - Any Policy Design -
                                                          or preneed funeral contracts.
                       Funeral Expense
                       L07G.301 Current Assumption -      Whole life insurance on a single insured with a fixed premium
                       Fixed Premium - Single Life        where the certificate value is not guaranteed due to the
                                                          company’s right to change interest, expense and/or mortality
                                                          assumptions.     The policy or certificate holder may pay
                                                          additional premiums.
                       L07G.302 Current Assumption -      Whole life insurance on more than one insured with a fixed
                       Fixed Premium - Joint (First to    premium where the certificate value is dependent on the
                       Die)                               company’s right to change interest, expense and/or mortality
                                                          assumptions, with the death benefit payable upon the first death.
                                                          The policy or certificate holder may pay additional premiums.
                       L07G.303 Current Assumption -      Whole life insurance on more than one insured with a fixed
                       Fixed Premium - Joint (Last        premium where the certificate value is dependent on the
                       Survivor)                          company’s right to change interest, expense and/or mortality
                                                          assumptions, with the death benefit payable upon the last death.
                                                          The policy or certificate holder may pay additional premiums.
                       L07G.311 Current Assumption -      Whole life insurance on a single insured with a single premium
                       Single Premium - Single Life       where the certificate value is dependent on the company’s right
                                                          to change interest, expense and/or mortality assumptions.
                       L07G.312 Current Assumption -      Whole life insurance on more than one insured with a single
                       Single Premium - Joint (First to   premium where the certificate value is dependent on the
                       Die)                               company’s right to change interest, expense and/or mortality
                                                          assumptions, with the death benefit payable upon first death.

REVISED October 2005                                                                                     54
    TOI                           SUB-TOI                                         DESCRIPTION


                       L07G.313 Current Assumption -      Whole life insurance on more than one insured with a single
                       Single Premium -Joint (Last        premium where the certificate value is dependent on the
                       Survivor)                          company’s right to change interest, expense and/or mortality
                                                          assumptions, with the death benefit payable upon the last death.
                       L07G.321 Current Assumption -      Whole life insurance on a single insured where premium and
                       Indeterminate Premium - Single     certificate value are dependent on the company’s right to
                       Life                               change interest, expense and/or mortality assumptions. The
                                                          policy or certificate holder may pay additional premiums.
                       L07G.322 Current Assumption -      Whole life insurance on more than one insured where premium
                       Indeterminate Premium - Joint      and certificate value are dependent on the company’s right to
                       (First to Die)                     change interest, expense and/or mortality assumptions, with the
                                                          death benefit payable upon the first death. The policy or
                                                          certificate holder may pay additional premiums.
                       L07G.323 Current Assumption -      Whole life insurance on more than one insured where premium
                       Indeterminate Premium -Joint       and certificate value are dependent on the company’s right to
                       (Last Survivor)                    change interest, expense and/or mortality assumptions, with the
                                                          death benefit payable upon the last death. The policy or
                                                          certificate holder may pay additional premiums.
                       L07G.401 Adjustable - Current      Whole life insurance on a single insured where the insured may
                       Assumption - Indeterminate         change the plan of insurance or the death benefit and where
                       Premium - Single Life              premium and certificate value are dependent on the company’s
                                                          right to change interest, expense and/or mortality assumptions.
                                                          The policy or certificate holder may pay additional premiums.
                       L07G.402 Adjustable - Current      Whole life insurance on a single insured where the insured may
                       Assumption - Indeterminate         change the plan of insurance or the death benefit and where
                       Premium - Joint (First to Die)     premium and certificate value are dependent on the company’s
                                                          right to change interest, expense and/or mortality assumptions,
                                                          with the death benefit payable upon the first death. The policy
                                                          or certificate holder may pay additional premiums.
                       L07G.403 Adjustable - Current      Whole life insurance on a single insured where the insured may
                       Assumption - Indeterminate         change the plan of insurance or the death benefit and where
                       Premium -Joint (Last Survivor)     premium and certificate value are dependent on the company’s
                                                          right to change interest, expense and/or mortality assumptions,
                                                          with the death benefit payable upon the last death. The policy or
                                                          certificate holder may pay additional premiums.
                       L07G.501 External Index- Level     Whole life insurance on a single insured with level premium
                       Premium - Single Life              where certificate values are linked to an external or equity
                                                          index.
                       L07G.502 External Index -          Whole life insurance on more than one insured with level
                       Level Premium - Joint (First to    premium where certificate values are linked to an external or
                       Die)                               equity index, with the death benefit payable upon the first death.
                       L07G.503 External Index -          Whole life insurance on more than one insured with level
                       Level Premium - Joint (Last        premium where certificate values are linked to an external or
                       Survivor)                          equity index, with the death benefit payable upon the last death.
                       L07G.511 External Index -          Whole life insurance on one insured with a single premium
                       Single Premium - Single Life       where certificate values are linked to an external or equity
                                                          index.
                       L07G.512 External Index -          Whole life insurance on more than one insured with level
                       Single Premium - Joint (First to   premium and where certificate values are linked to an external
                       Die)                               or equity index, with the death benefit payable upon the first
                                                          death.




REVISED October 2005                                                                                      55
             TOI                          SUB-TOI                                       DESCRIPTION


                               L07G.513 External Index -         Whole life insurance on more than one insured with level
                               Single Premium - Joint (Last      premium and where certificate values are linked to an external
                               Survivor)                         or equity index, with the death benefit payable upon the last
                                                                 death.
L07I Individual Life - Whole                                     Life insurance that may be kept in force for a person’s entire
                                                                 life and that pays a benefit upon the person’s death, whenever
                                                                 that may be.
                               L07I.101 Fixed/Indeterminate      Whole life on a single insured that requires payment of a
                               Premium - Single Life             specified modal premium that is a fixed amount or where the
                                                                 premium is dependent on factors that may be changed by the
                                                                 insurer, but not to go beyond a guaranteed maximum for the
                                                                 policy to remain in force.
                               L07I.102 Fixed/Indeterminate      Whole life on more than one insured where the benefit is
                               Premium - Joint (First to Die)    payable on first death that requires payment of a specified
                                                                 modal premium that is a fixed amount or where the premium is
                                                                 dependent on factors that may be changed by the insurer, but
                                                                 not to go beyond a guaranteed maximum for the certificate to
                                                                 remain in force.
                               L07I.103 Fixed/Indeterminate      Whole life on more than one insured where the benefit is
                               Premium - Joint (Last Survivor)   payable on last death that requires payment of a specified modal
                                                                 premium that is a fixed amount or where the premium is
                                                                 dependent on factors that may be changed by the insurer, but
                                                                 not to go beyond a guaranteed maximum for the certificate to
                                                                 remain in force.
                               L07I.104 Fixed/Indeterminate      Whole life insurance on one insured with guaranteed level
                               Premium - Single Life - Funeral   premium and benefits used to fund funeral expense or preneed
                               Expense                           funeral contract.
                               L07I.111 Single Premium -         Whole life insurance on one insured with guaranteed single
                               Single Life                       premium and benefits.
                               L07I.112 Single Premium -         Whole life insurance on more than one insured with guaranteed
                               Joint (First to Die)              single premium and benefits, with the death benefit payable
                                                                 upon the first death.
                               L07I.113 Single Premium -Joint    Whole life insurance on more than one insured with guaranteed
                               (Last Survivor)                   single premium and benefits, with the death benefit payable
                                                                 upon the last death.
                               L07I.114 Single Premium -         Whole life insurance on one insured with guaranteed single
                               Single Life - Funeral Expense     premium and benefits used to fund funeral expense or preneed
                                                                 funeral contract.
                               L07I.121 Graded Premium -         Whole life insurance on one insured with guaranteed graded
                               Single Life                       premium and benefits.
                               L07I.122 Graded Premium -         Whole life insurance on more than one insured with guaranteed
                               Joint (First to Die)              graded premium and benefits, with the death benefit payable
                                                                 upon the first death.
                               L07I.123 Graded Premium -Joint    Whole life insurance on more than one insured with guaranteed
                               (Last Survivor)                   graded premium and benefits, with the death benefit payable
                                                                 upon the last death.
                               L07I.124 Graded Premium -
                                                                 Life insurance that is term to age X and then converts to whole
                               Jumping Juvenile (Term to Age
                                                                 life.
                               X, Whole Life Thereafter)
                               L07I.201 Early Duration
                                                                 Whole life insurance with guaranteed level premium and
                               Reduced Benefit - Level
                                                                 benefits reduced during the early durations.
                               Premium - Any Policy Design


       REVISED October 2005                                                                                    56
    TOI                           SUB-TOI                                        DESCRIPTION


                       L07I.202 Early Duration
                                                          Whole life insurance with guaranteed level premium and
                       Reduced Benefit - Level
                                                          benefits reduced during the early durations, used to fund funeral
                       Premium - Any Policy Design -
                                                          expense or a preneed funeral contract.
                       Funeral Expense
                       L07I.211 Early Duration
                                                          Whole life insurance with single premium and benefits reduced
                       Reduced Benefit - Single
                                                          during the early durations.
                       Premium - Any Policy Design
                       L07I.212 Early Duration
                                                          Whole life insurance with single premium and benefits reduced
                       Reduced Benefit - Single
                                                          during the early durations used to fund funeral expense or a
                       Premium - Any Policy Design -
                                                          preneed funeral contract.
                       Funeral Expense
                       L07I.301 Current Assumption -      Whole life insurance on a single insured with a fixed premium
                       Fixed Premium - Single Life        where policy value is not guaranteed due to company’s right to
                                                          change interest, expense and/or mortality assumptions. The
                                                          policy owner may pay additional premiums.
                       L07I.302 Current Assumption -      Whole life insurance on more than one insured with a fixed
                       Fixed Premium - Joint (First to    premium where the policy value is dependent on the company’s
                       Die)                               right to change interest, expense and/or mortality assumptions,
                                                          with the death benefit payable upon the first death. The policy
                                                          owner may pay additional premiums.
                       L07I.303 Current Assumption -      Whole life insurance on more than one insured with a fixed
                       Fixed Premium - Joint (Last        premium where the policy value is dependent on the company’s
                       Survivor)                          right to change interest, expense and/or mortality assumptions,
                                                          with the death benefit payable upon the last death. The policy
                                                          owner may pay additional premiums.
                       L07I.311 Current Assumption -      Whole life insurance on a single insured with a single premium
                       Single Premium - Single Life       where the policy value is dependent on the company’s right to
                                                          change interest, expense and/or mortality assumptions.
                       L07I.312 Current Assumption -      Whole life insurance on more than one insured with a single
                       Single Premium - Joint (First to   premium where the policy value is dependent on the company’s
                       Die)                               right to change interest, expense and/or mortality assumptions,
                                                          with the death benefit payable upon the first death.
                       L07I.313 Current Assumption -      Whole life insurance on more than one insured with a single
                       Single Premium -Joint (Last        premium where the policy value is dependent on the company’s
                       Survivor)                          right to change interest, expense and/or mortality assumptions,
                                                          with the death benefit payable upon the last death.
                       L07I.321 Current Assumption -      Whole life insurance on a single insured where premium and
                       Indeterminate Premium - Single     policy value are dependent on the company’s right to change
                       Life                               interest, expense and/or mortality assumptions. The policy
                                                          owner may pay additional premiums.
                       L07I.322 Current Assumption -      Whole life insurance on more than one insured where premium
                       Indeterminate Premium - Joint      and policy value are dependent upon the company’s right to
                       (First to Die)                     change interest, expense and/or mortality assumptions, with the
                                                          death benefit payable upon the first death. The policy owner
                                                          may pay additional premiums.
                       L07I.323 Current Assumption -      Whole life insurance on more than one insured where premium
                       Indeterminate Premium -Joint       and policy value are dependent upon the company’s right to
                       (Last Survivor)                    change interest, expense and/or mortality assumptions, with the
                                                          death benefit payable upon the last death. The policy owner
                                                          may pay additional premiums.




REVISED October 2005                                                                                     57
             TOI                         SUB-TOI                                         DESCRIPTION


                              L07I.401 Adjustable - Current      Whole life insurance on a single insured where the insured may
                              Assumption - Indeterminate         change the plan of insurance or the death benefit and where
                              Premium - Single Life              premium and policy value are dependent on the company’s
                                                                 right to change interest, expense and/or mortality assumptions.
                                                                 The policy owner may pay additional premiums.
                              L07I.402 Adjustable - Current      Whole life insurance on more than one insured where the
                              Assumption - Indeterminate         insured may change the plan of insurance or the death benefit
                              Premium - Joint (First to Die)     and where premium and policy value are dependent on the
                                                                 company’s right to change interest, expense and/or mortality
                                                                 assumptions, with the death benefit payable upon the first death.
                                                                 The policy owner may pay additional premiums.
                              L07I.403 Adjustable - Current      Whole life insurance on more than one insured where the
                              Assumption - Indeterminate         insured may change the plan of insurance or the death benefit
                              Premium -Joint (Last Survivor)     and where premium and policy value are dependent on the
                                                                 company’s right to change interest, expense and/or mortality
                                                                 assumptions, with the death benefit payable upon the last death.
                                                                 The policy owner may pay additional premiums.
                              L07I.501 External Index - Level    Whole life insurance with level premium where policy values
                              Premium                            are linked to an external or equity index.
                              L07I.502 External Index - Level    Whole life insurance on more than one insured with level
                              Premium - Joint (First to Die)     premium where policy values are linked to an external or equity
                                                                 index, with the death benefit payable upon the first death.
                              L07I.503 External Index - Level    Whole life insurance on more than one insured with level
                              Premium - Joint (Last Survivor)    premium where policy values are linked to an external or equity
                                                                 index, with the death benefit payable upon the last death.
                              L07I.511 External Index - Single   Whole life insurance with a single premium where policy
                              Premium                            values are linked to an external or equity index.
                              L07I.512 External Index - Single   Whole life insurance on more than one insured with level
                              Premium - Joint (First to Die)     premium where policy values are linked to an external or equity
                                                                 index, with the death benefit payable upon the first death.
                              L07I.513 External Index - Single   Whole life insurance on more than one insured with level
                              Premium - Joint (Last Survivor)    premium where policy values are linked to an external or equity
                                                                 index, with the death benefit payable upon the last death.
L08 Life - Other              L08.000 Life - Other               Not specifically described above.
L09G Group Life - Flexible                                       A group life insurance that provides a face amount that is
Premium Adjustable Life                                          adjustable to the certificate holder and allows the certificate
                                                                 holder to vary the modal premium that is paid or to skip a
                                                                 payment so long as the certificate value is sufficient to keep the
                                                                 certificate in force, and under which separately identified
                                                                 interest credits (other than in connection with dividend
                                                                 accumulation, premium deposit funds or other supplementary
                                                                 accounts) and mortality and expense charges are made to
                                                                 individual certificates while providing minimum guaranteed
                                                                 values.
                              L09G.001 Single Life               A flexible premium adjustable life policy where the certificate
                                                                 insures one life.
                              L09G.002 Joint (Last Survivor)     A flexible premium adjustable life policy where the certificate
                                                                 insures more than one life and will pay the specified death
                                                                 benefit upon the last death.
                              L09G.003 Joint (First to Die)      A flexible premium adjustable life policy where the certificate
                                                                 insures more than one life and will pay the specified death
                                                                 benefit upon the first death.


       REVISED October 2005                                                                                      58
              TOI                            SUB-TOI                                       DESCRIPTION


                                  L09G.101 External Indexed -      A flexible premium adjustable life policy where the certificate
                                  Single Life                      insures one life and earns interest or provides benefits that are
                                                                   linked to an external or equity index.
                                  L09G.102 External Indexed -      A flexible premium adjustable life policy where the certificate
                                  Joint (First to Die)             earns interest or provides benefits that are linked to an external
                                                                   or equity index. The certificate insures more than one life and
                                                                   will pay the specified death benefit upon the first death.
                                  L09G.103 External Indexed -      A flexible premium adjustable life policy where the certificate
                                  Joint (Last Survivor)            earns interest or provides benefits that are linked to an external
                                                                   or equity index. The certificate insures more than one life and
                                                                   will pay the specified death benefit upon the last death.
L09I Individual Life - Flexible                                    Life insurance that provides a face amount that is adjustable to
Premium Adjustable Life                                            the policyholder and allows the policyholder to vary the modal
                                                                   premium that is paid or to skip a payment so long as the account
                                                                   value is sufficient to keep the coverage in force, and under
                                                                   which separately identified interest credits (other than in
                                                                   connection with dividend accumulation, premium deposit funds
                                                                   or other supplementary accounts) and mortality and expense
                                                                   charges are made to a policy that provides minimum
                                                                   nonforfeiture values.
                                  L09I.001 Single Life             A flexible premium adjustable life policy where the policy
                                                                   insures one life.
                                  L09I.002 Joint (Last Survivor)   A flexible premium adjustable life policy where the policy
                                                                   insures more than one life and will pay the specified death
                                                                   benefit upon the last death.
                                  L09I.003 Joint (First to Die)    A flexible premium adjustable life policy where the policy
                                                                   insures more than one life and will pay the specified death
                                                                   benefit upon the first death.
                                  L09I.101 External Indexed -      A flexible premium adjustable life policy that insures one life
                                  Single Life                      and earns interest or provides benefits that are linked to an
                                                                   external or equity index.
                                  L09I.102 External Indexed -      A flexible premium adjustable life policy that earns interest or
                                  Joint (First to Die)             provides benefits that are linked to an external or equity index.
                                                                   The policy insures more than one life and will pay the specified
                                                                   death benefit upon the first death.
                                  L09I.103 External Indexed -      A flexible premium adjustable life policy that earns interest or
                                  Joint (Last Survivor)            provides benefits that are linked to an external or equity index.
                                                                   The policy insures more than one life and will pay the specified
                                                                   death benefit upon the last death.
                                                                   Coverage that includes long term care, nursing home, and home
                         Long Term Care
                                                                   care contracts that provide reimbursement for these services.
LTC01 Long Term Care –            LTC01.000 Long Term Care –       An insurance certificate issued on an existing insurance contract
Assumption Agreement              Assumption Agreement             indicating that another insurer has assumed all of the risk under
                                                                   the contract from the ceding insurance company.
LTC02G Group Long Term Care                                        Coverage that provides coverage for non-institutional care
– Home Health Care Only                                            provided in a person’s own home or in an adult day care setting.
                                  LTC02G.001 Qualified             A home health care only policy that meets the federal IRS
                                                                   requirements to qualify for a tax deduction.
                                  LTC02G.002 Non Qualified         A home health care only policy that does not meet the federal
                                                                   IRS requirements.
                                  LTC02G.003 Other                 Not specifically described above.
LTC02I Individual Long Term                                        Coverage that provides coverage for non-institutional care
Care – Home Health Care Only                                       provided in a person’s own home or in an adult day care setting.

        REVISED October 2005                                                                                       59
            TOI                          SUB-TOI                                 DESCRIPTION


                               LTC02I.001 Qualified       A home health care only policy that meets the federal IRS
                                                          requirements to qualify for a tax deduction.
                               LTC02I.002 Non Qualified   A home health care only policy that does not meet the federal
                                                          IRS requirements.
                               LTC02I.003 Other           Not specifically described above.
LTC03G Group Long Term Care                               Coverage that provides reimbursement for the following long
                                                          term care services: nursing home care, assisted living care,
                                                          home health care and adult day care.
                               LTC03G.001 Qualified       A long term care policy that meets the federal IRS requirements
                                                          to qualify for a tax deduction.
                               LTC03G.002 Non Qualified   A long term care policy that does not meet the federal IRS
                                                          requirements to qualify for a tax deduction.
                               LTC03G.003 Other           Not specifically described above.
LTC03I Individual Long Term                               Coverage that provides reimbursement for the following long
Care                                                      term care services: nursing home care, assisted living care,
                                                          home health care and adult day care.
                               LTC03I.001 Qualified       A long term care policy that meets the federal IRS requirements
                                                          to qualify for a tax deduction.
                               LTC03I.002 Non Qualified   A long term care policy that does not meet the federal IRS
                                                          requirements to qualify for a tax deduction.
                               LTC03I.003 Other           Not specifically described above.
LTC04G Group Long Term Care                               A policy or rider that provides coverage only while a
– Nursing Home                                            policyholder is confined to a nursing home and meets the policy
                                                          requirements for coverage.
                               LTC04G.001 Qualified       Nursing home policies that would meet the federal IRS
                                                          requirements to qualify for a tax deduction.
                               LTC04G.002 Non Qualified   Nursing home policies that do not meet the federal IRS
                                                          requirements to qualify for a tax deduction.
                               LTC04G.003 Other           Not specifically described above.
LTC04I Individual Long Term                               A policy or rider that provides coverage only while a
Care – Nursing Home                                       policyholder is confined to a nursing home and meets the policy
                                                          requirements for coverage.
                               LTC04I.001 Qualified       Nursing home policies that would meet the federal IRS
                                                          requirements to qualify for a tax deduction.
                               LTC04I.002 Non Qualified   Nursing home policies that do not meet the federal IRS
                                                          requirements to qualify for a tax deduction.
                               LTC04I.003 Other           Not specifically described above.
LTC05G Group Long Term Care
                                                          A policy or rider that would includes coverage for both
– Nursing Home & Home Health
                                                          institutional nursing home and home health care.
Care
                               LTC05G.001 Qualified       Nursing home and home health care policies that would meet
                                                          the federal IRS requirements to qualify for a tax deduction.
                               LTC05G.002 Non Qualified   Nursing home and home health care policies that do not meet
                                                          the federal IRS requirements to qualify for a tax deduction.
                               LTC05G.003 Other           Not specifically described above.
LTC05I Individual Long Term
                                                          A policy or rider that would includes coverage for both
Care – Nursing Home & Home
                                                          institutional nursing home and home health care.
Health Care
                               LTC05I.001 Qualified       Nursing home and home health care policies that would meet
                                                          the federal IRS requirements to qualify for a tax deduction.
                               LTC05I.002 Non Qualified   Nursing home and home health care policies that do not meet
                                                          the federal IRS requirements to qualify for a tax deduction.
                               LTC05I.003 Other           Not specifically described above.

       REVISED October 2005                                                                             60
             TOI                           SUB-TOI                                      DESCRIPTION


LTC05.1G Group Assisted                                         A policy or rider that provides coverage only while a
Living Care                                                     policyholder is confined to an assisted living facility and meets
                                                                the policy requirements for coverage.
                                LTC05.1G.001 Qualified          Assisted living policies that would meet the federal IRS
                                                                requirements to qualify for a tax deduction.
                                LTC05.1G.002 Non Qualified      Assisted living policies that do not meet the federal IRS
                                                                requirements to qualify for a tax deduction.
                                LTC05.1G.003 Other              Not specifically described above.
LTC05.1I Individual Assisted                                    A policy or rider that provides coverage only while a
Living Care                                                     policyholder is confined to an assisted living facility and meets
                                                                the policy requirements for coverage.
                                LTC05.1I.001 Qualified          Assisted living policies that would meet the federal IRS
                                                                requirements to qualify for a tax deduction.
                                LTC05.1I.002 Non Qualified      Assisted living policies that do not meet the federal IRS
                                                                requirements to qualify for a tax deduction.
                                LTC05.1I.003 Other              Not specifically described above.
LTC05.2G Group Adult Day                                        A policy or rider that provides coverage only for adult day care
Care                                                            for an individual who meets the policy requirements for
                                                                coverage.
                                LTC05.2G.001 Qualified          Adult day care policies that would meet the federal IRS
                                                                requirements to qualify for a tax deduction.
                                LTC05.2G.002 Non Qualified      Adult day care policies that do not meet the federal IRS
                                                                requirements to qualify for a tax deduction.
                                LTC05.2G.003 Other              Not specifically described above.
LTC05.2I Individual Adult Day                                   A policy or rider that provides coverage only for adult day care
Care                                                            for an individual who meets the policy requirements for
                                                                coverage.
                                LTC05.2I.001 Qualified          Adult day care policies that would meet the federal IRS
                                                                requirements to qualify for a tax deduction.
                                LTC05.2I.002 Non Qualified      Adult day care policies that do not meet the federal IRS
                                                                requirements to qualify for a tax deduction.
                                LTC05.2I.003 Other              Not specifically described above.
LTC06 Long Term Care - Other    LTC06.000 Long Term Care -      Not specifically described above or a combination of two or
                                Other                           more, but less than four products.
                                                                Insurance coverage sold on a individual or group basis to help
                                                                fill the "gaps" in the protections granted by the federal Medicare
                                                                program. This is strictly supplemental coverage and cannot
                     Medicare Supplement                        duplicate any benefits provided by Medicare. It is structured to
                                                                pay part or all of Medicare's deductibles and co-payments. It
                                                                may also cover some services and expenses not covered by
                                                                Medicare. Also known as "Medigap" insurance.
MS01 Medicare Supplement –      MS01.000 Medicare Supplement    An insurance certificate issued on an existing insurance contract
Assumption Agreement            – Assumption Agreement          indicating that another insurer has assumed all of the risk under
                                                                the contract from the ceding insurance company.
MS02G Group Medicare            MS02G.000 Medicare              A plan issued prior to required federal standardization of
Supplement – Pre-Standardized   Supplement – Pre-Standardized   Medicare supplement policy forms and rates.
MS02I Individual Medicare       MS02I.000 Medicare              A plan issued prior to required federal standardization of
Supplement – Pre-Standardized   Supplement – Pre-Standardized   Medicare supplement policy forms and rates.
MS03G Group Medicare            MS03G.000 Medicare              A contract between a Medicare beneficiary and an insurer that
Supplement – Medicare +         Supplement – Medicare +         has contracted with the federal government to provide both
Choice                          Choice                          Medicare and Medigap type services to beneficiaries.



       REVISED October 2005                                                                                     61
             TOI                         SUB-TOI                                DESCRIPTION


MS03I Individual Medicare      MS03I.000 Medicare         A contract between a Medicare beneficiary and an insurer that
Supplement – Medicare +        Supplement – Medicare +    has contracted with the federal government to provide both
Choice                         Choice                     Medicare and Medigap type services to beneficiaries.
MS04G Group Medicare                                      A type of Medigap plan under which a policyholder generally
Supplement – Medicare Select                              must use specific hospitals and, in some cases, doctors are to
                                                          receive full Medigap benefits.
                               MS04G.001 Plan A           Basic benefits: blood after first 3 pints; Part A hospital
                                                          coinsurance; Part B medical expense coinsurance.
                               MS04G.002 Plan B           Basic benefits plus Part A deductible.
                               MS04G.003 Plan C           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Part B deductible, and also Foreign Travel
                                                          Emergency.
                               MS04G.004 Plan D           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Foreign Travel Emergency, and also At-home
                                                          Recovery.
                               MS04G.005 Plan E           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, preventative Care, and also Foreign Travel
                                                          Emergency.
                               MS04G.006 Plan F (Basic)   Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Part B deductible, Part B Excess100%, and also
                                                          Foreign Travel Emergency.
                               MS04G.007 Plan F (High)    High deductible option.
                               MS04G.008 Plan G           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Part B Excess80%, At-home Recovery, Foreign
                                                          Travel Emergency, and At-home Recovery.
                               MS04G.009 Plan H           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Foreign Travel Emergency, and also Basic Drugs.
                               MS04G.010 Plan I           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Part B Excess100%, Foreign Travel Emergency,
                                                          At-home Recovery, and also Basic Drugs.
                               MS04G.011 Plan J (Basic)   Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Part B deductible, Extended Drugs, Part B
                                                          Excess100%, Foreign Travel Emergency, Preventive Care,
                                                          and also At-home Recovery.
                               MS04G.012 Plan J (High)    High deductible option.
MS04I Individual Medicare                                 A type of Medigap plan under which a policyholder generally
Supplement – Medicare Select                              must use specific hospitals and, in some cases, doctors are to
                                                          receive full Medigap benefits.
                               MS04I.001 Plan A           Basic benefits: blood after first 3 pints; Part A hospital
                                                          coinsurance; Part B medical expense coinsurance.
                               MS04I.002 Plan B           Basic benefits plus Part A deductible.
                               MS04I.003 Plan C           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Part B deductible, and also Foreign Travel
                                                          Emergency.
                               MS04I.004 Plan D           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Foreign Travel Emergency, and also At-home
                                                          Recovery.
                               MS04I.005 Plan E           Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, preventative Care, and also Foreign Travel
                                                          Emergency.
                               MS04I.006 Plan F (Basic)   Basic benefits plus skilled nursing coinsurance, Part A
                                                          deductible, Part B deductible, Part B Excess100%, and also
                                                          Foreign Travel Emergency.

       REVISED October 2005                                                                            62
             TOI                        SUB-TOI                               DESCRIPTION


                              MS04I.007 Plan F (High)    High deductible option.
                              MS04I.008 Plan G           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B Excess80%, At-home Recovery, Foreign
                                                         Travel Emergency, and At-home Recovery.
                              MS04I.009 Plan H           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Foreign Travel Emergency, and also Basic Drugs.
                              MS04I.010 Plan I           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B Excess100%, Foreign Travel Emergency,
                                                         At-home Recovery, and also Basic Drugs.
                              MS04I.011 Plan J (Basic)   Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B deductible, Extended Drugs, Part B
                                                         Excess100%, Foreign Travel Emergency, Preventive Care,
                                                         and also At-home Recovery.
                              MS04I.012 Plan J (High)    High deductible option.
MS05G Group Medicare                                     A Medigap policy under which a policyholder may obtain
Supplement – Standard Plans                              services from any provider of care.
                              MS05G.001 Plan A           Basic benefits: blood after first 3 pints; Part A hospital
                                                         coinsurance; Part B medical expense coinsurance.
                              MS05G.002 Plan B           Basic benefits plus Part A deductible.
                              MS05G.003 Plan C           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B deductible, and also Foreign Travel
                                                         Emergency.
                              MS05G.004 Plan D           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Foreign Travel Emergency, and also At-home
                                                         Recovery.
                              MS05G.005 Plan E           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Preventive Care, and also Foreign Travel
                                                         Emergency.
                              MS05G.006 Plan F (Basic)   Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B deductible, Part B Excess100%, & Foreign
                                                         Travel Emergency.
                              MS05G.007 Plan F (High)    High deductible option.
                              MS05G.008 Plan G           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B Excess80%; At-home Recovery, and also
                                                         Foreign Travel Emergency.
                              MS05G.009 Plan H           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Foreign Travel Emergency, and also Basic Drugs.
                              MS05G.010 Plan I           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B Excess100%, Foreign Travel Emergency,
                                                         At-home Recovery, and also Basic Drugs.
                              MS05G.011 Plan J (Basic)   Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B deductible, Part B Excess100%, Foreign
                                                         Travel Emergency, Preventive Care, At-home Recovery, and
                                                         also Extended Drugs.
                              MS05G.012 Plan J (High)    High deductible option.
MS05I Individual Medicare                                A Medigap policy under which a policyholder may obtain
Supplement – Standard Plans                              services from any provider of care.
                              MS05I.001 Plan A           Basic benefits: blood after first 3 pints; Part A hospital
                                                         coinsurance; Part B medical expense coinsurance.
                              MS05I.002 Plan B           Basic benefits plus Part A deductible.
                              MS05I.003 Plan C           Basic benefits plus skilled nursing coinsurance, Part A
                                                         deductible, Part B deductible, and also Foreign Travel
                                                         Emergency.
       REVISED October 2005                                                                         63
             TOI                            SUB-TOI                                      DESCRIPTION


                                  MS05I.004 Plan D                Basic benefits plus skilled nursing coinsurance, Part A
                                                                  deductible, Foreign Travel Emergency, and also At-home
                                                                  Recovery.
                                  MS05I.005 Plan E                Basic benefits plus skilled nursing coinsurance, Part A
                                                                  deductible, Preventive Care, and also Foreign Travel
                                                                  Emergency.
                                  MS05I.006 Plan F (Basic)        Basic benefits plus skilled nursing coinsurance, Part A
                                                                  deductible, Part B deductible, Part B Excess100%, & Foreign
                                                                  Travel Emergency.
                                  MS05I.007 Plan F (High)         High deductible option.
                                  MS05I.008 Plan G                Basic benefits plus skilled nursing coinsurance, Part A
                                                                  deductible, Part B Excess80%; At-home Recovery, and also
                                                                  Foreign Travel Emergency.
                                  MS05I.009 Plan H                Basic benefits plus skilled nursing coinsurance, Part A
                                                                  deductible, Foreign Travel Emergency, and also Basic Drugs.
                                  MS05I.010 Plan I                Basic benefits plus skilled nursing coinsurance, Part A
                                                                  deductible, Part B Excess100%, Foreign Travel Emergency,
                                                                  At-home Recovery, and also Basic Drugs.
                                  MS05I.011 Plan J (Basic)        Basic benefits plus skilled nursing coinsurance, Part A
                                                                  deductible, Part B deductible, Part B Excess100%, Foreign
                                                                  Travel Emergency, Preventive Care, At-home Recovery, and
                                                                  also Extended Drugs.
                                  MS05I.012 Plan J (High)         High deductible option.
MS06 Medicare Supplement -        MS06.000 Medicare Supplement
                                                                  Not specifically described above.
Other                             - Other
                                                                  Filings that may be submitted for both life and health insurance
                            Multi-Line
                                                                  in one form such as an application.
ML01 Multi-Line – Assumption      ML01.000 Multi-Line –           An insurance certificate issued on an existing insurance contract
Agreement                         Assumption Agreement            indicating that another insurer has assumed all of the risk under
                                                                  the contract from the ceding insurance company.
ML02 Multi-Line - Other           ML02.000 Multi-Line - Other     Not specifically described above.
Viatical Settlements
VS01 Viatical Settlements         VS01.000 Viatical Settlements   Contracts or agreements in which a buyer agrees to purchase all
                                                                  or a part of a life insurance policy.




       REVISED October 2005                                                                                      64

				
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