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Filing at a Glance Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania TOI: LTC03I Individual Long Term Care Sub-TOI: LTC03I.003 Other Filing Type: Rate - M.U. (Medically underwritten) Date Submitted: 11/02/2017 SERFF Tr Num: IASL-131253463 SERFF Status: Assigned State Tr Num: IASL-131253463 State Status: Received Review in Progress Co Tr Num: JN LTC RI Implementation Date Requested: 01/01/2018 Author(s): Jaime Marchese Reviewer(s): Jim Laverty (primary) Disposition Date: Disposition Status: Implementation Date: State Filing Description: Proposed 25% increase on 27 policyholders of Jackson National's individual LTC forms LTC 1/98 PA and QLTC 1/98 PA. SERFF Tracking #: IASL-131253463 State Tracking #: IASL-131253463 Company Tracking #: JN LTC RI State: Pennsylvania Filing Company: Jackson National Life Insurance Company TOI/Sub-TOI: LTC03I Individual Long Term Care/LTC03I.003 Other Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing Project Name/Number: / PDF Pipeline for SERFF Tracking Number IASL-131253463 Generated 11/02/2017 01:13 PM

Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

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Page 1: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

Filing at a Glance

Company: Jackson National Life Insurance Company

Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing

State: Pennsylvania

TOI: LTC03I Individual Long Term Care

Sub-TOI: LTC03I.003 Other

Filing Type: Rate - M.U. (Medically underwritten)

Date Submitted: 11/02/2017

SERFF Tr Num: IASL-131253463

SERFF Status: Assigned

State Tr Num: IASL-131253463

State Status: Received Review in Progress

Co Tr Num: JN LTC RI

ImplementationDate Requested:

01/01/2018

Author(s): Jaime Marchese

Reviewer(s): Jim Laverty (primary)

Disposition Date:

Disposition Status:

Implementation Date:

State Filing Description:

Proposed 25% increase on 27 policyholders of Jackson National's individual LTC forms LTC 1/98 PA and QLTC 1/98 PA.

SERFF Tracking #: IASL-131253463 State Tracking #: IASL-131253463 Company Tracking #: JN LTC RI

State: Pennsylvania Filing Company: Jackson National Life Insurance Company

TOI/Sub-TOI: LTC03I Individual Long Term Care/LTC03I.003 Other

Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing

Project Name/Number: /

PDF Pipeline for SERFF Tracking Number IASL-131253463 Generated 11/02/2017 01:13 PM

Page 2: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

General Information

Company and Contact

Filing Fees

Project Name: Status of Filing in Domicile: Not Filed

Project Number: Date Approved in Domicile:

Requested Filing Mode: Review & Approval Domicile Status Comments:

Explanation for Combination/Other: Market Type: Individual

Submission Type: New Submission Individual Market Type:

Overall Rate Impact: 25% Filing Status Changed: 11/02/2017

State Status Changed: 11/02/2017

Deemer Date: Created By: Jaime Marchese

Submitted By: Jaime Marchese Corresponding Filing Tracking Number:

State TOI: LTC03I Individual Long Term Care

Filing Description:

Jackson National Life Insurance Company Long Term Care Rate Increase Filing

Form Numbers: LTC 1/98 PA; QLTC 1/98 PA

Rate Increase Amount: 25.0%

This filing applies to all of the Company's Long Term Care and Home Health Care policy forms and all attached riders,originally issued by Southwestern Life Insurance Company ("SWL"). Effective December 28, 2006, SWL merged with and intoValley Forge Life Insurance Company ("Valley Forge"). In 2007, Valley Forge changed its name to Reassure America LifeInsurance Company (“Reassure America”). Effective December 31, 2012, Reassure America merged with and into JacksonNational Life Insurance Company (the “Company”).

Filing Contact InformationJaime Marchese, Compliance Analyst [email protected]

17757 US HWY 19 North, Suite660

Clearwater, FL 33764-6598

877-777-2443 [Phone] 2425 [Ext]

727-373-4539 [FAX]

Filing Company Information(This filing was made by a third party - insuranceadministrativesolutions)

Jackson National Life InsuranceCompany

1 Corporate Way

Lansing, MI 48951

(517) 367-4370 ext. [Phone]

CoCode: 65056

Group Code: 918

Group Name:

FEIN Number: 38-1659835

State of Domicile: Michigan

Company Type:

State ID Number:

Fee Required? No

Retaliatory? No

Fee Explanation:

SERFF Tracking #: IASL-131253463 State Tracking #: IASL-131253463 Company Tracking #: JN LTC RI

State: Pennsylvania Filing Company: Jackson National Life Insurance Company

TOI/Sub-TOI: LTC03I Individual Long Term Care/LTC03I.003 Other

Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing

Project Name/Number: /

PDF Pipeline for SERFF Tracking Number IASL-131253463 Generated 11/02/2017 01:13 PM

Page 3: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

Rate Information Rate data applies to filing.

Filing Method: SERFF

Rate Change Type: Increase

Overall Percentage of Last Rate Revision: 20.000%

Effective Date of Last Rate Revision: 04/01/2015

Filing Method of Last Filing: SERFF

Company Rate Information

Company

Name:

Overall %

Indicated

Change:

Overall %

Rate

Impact:

Written Premium

Change for

this Program:

Number of Policy

Holders Affected

for this Program:

Written

Premium for

this Program:

Maximum %

Change

(where req'd):

Minimum %

Change

(where req'd):Jackson National LifeInsurance Company

25.000% 25.000% $18,328 27 $73,310 25.000% 25.000%

SERFF Tracking #: IASL-131253463 State Tracking #: IASL-131253463 Company Tracking #: JN LTC RI

State: Pennsylvania Filing Company: Jackson National Life Insurance Company

TOI/Sub-TOI: LTC03I Individual Long Term Care/LTC03I.003 Other

Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing

Project Name/Number: /

PDF Pipeline for SERFF Tracking Number IASL-131253463 Generated 11/02/2017 01:13 PM

Page 4: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

Rate/Rule Schedule

Item

No.

Schedule

Item

Status

Document Name

Affected Form Numbers

(Separated with commas) Rate Action Rate Action Information Attachments

1 PA Rates LTC 1/98 PA, QLTC 1/98 PA Revised Previous State Filing Number:IASL-129777603Percent Rate Change Request:25

PA Rates.pdf,

SERFF Tracking #: IASL-131253463 State Tracking #: IASL-131253463 Company Tracking #: JN LTC RI

State: Pennsylvania Filing Company: Jackson National Life Insurance Company

TOI/Sub-TOI: LTC03I Individual Long Term Care/LTC03I.003 Other

Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing

Project Name/Number: /

PDF Pipeline for SERFF Tracking Number IASL-131253463 Generated 11/02/2017 01:13 PM

Page 5: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 23.88 20.90 17.93 14.94

51 26.86 23.88 20.90 17.93

52 26.86 23.88 20.90 17.93

53 29.85 26.86 23.88 20.90

54 32.84 29.85 26.86 23.88

55 32.84 29.85 26.86 23.88

56 35.83 32.84 29.85 26.86

57 38.80 35.83 29.85 26.86

58 41.78 38.80 32.84 29.85

59 44.78 41.78 35.83 32.84

60 44.78 41.78 35.83 32.84

61 47.78 44.78 38.80 35.83

62 50.75 47.78 41.78 38.80

63 53.73 50.75 44.78 41.78

64 56.71 53.73 44.78 41.78

65 59.70 56.71 47.78 44.78

66 65.68 59.70 50.75 47.78

67 71.63 65.68 53.73 50.75

68 77.61 71.63 59.70 53.73

69 83.58 77.61 65.68 56.71

70 89.55 83.58 71.63 62.68

71 98.50 89.55 77.61 68.65

72 107.45 98.50 83.58 74.63

73 116.41 107.45 89.55 80.58

74 125.38 116.41 95.53 86.56

75 137.30 125.38 104.48 95.53

76 149.25 137.30 113.41 104.48

77 161.18 149.25 122.38 113.41

78 173.10 161.18 134.33 122.38

79 185.08 173.10 146.25 131.33

80 199.98 185.08 158.20 140.28

81 214.93 197.00 167.15 149.25

82 232.80 208.94 176.10 158.20

83 247.73 220.88 185.08 167.15

84 262.65 232.80 194.03 176.10

85 274.60 244.75 202.95 185.08

86 286.55 253.73 211.90 194.03

87 298.49 262.65 220.88 199.98

88 310.41 271.60 226.85 205.95

89 319.38 280.56 232.80 211.90

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

JACKSON NATIONAL LIFE INSURANCE COMPANY

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

1 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

AVAILABLE

NOT

PENNSYLVANIA Page 1 of 42OCTOBER 2017

Page 6: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 41.78 38.80 32.84 29.85 32.84 29.85 26.86 23.88

51 44.78 41.78 32.84 29.85 32.84 29.85 26.86 23.88

52 47.78 44.78 35.83 32.84 35.83 32.84 29.85 26.86

53 50.75 47.78 38.80 35.83 38.80 35.83 32.84 29.85

54 56.71 50.75 41.78 38.80 41.78 38.80 32.84 29.85

55 62.68 56.71 47.78 41.78 44.78 41.78 35.83 32.84

56 68.65 62.68 53.73 47.78 47.78 44.78 38.80 35.83

57 74.63 68.65 59.70 53.73 50.75 47.78 41.78 38.80

58 83.58 74.63 65.68 59.70 53.73 50.75 41.78 38.80

59 92.53 83.58 71.63 65.68 56.71 53.73 44.78 41.78

60 101.48 92.53 77.61 71.63 59.70 56.71 47.78 41.78

61 110.43 101.48 86.56 77.61 62.68 59.70 50.75 44.78

62 122.38 110.43 95.53 83.58 65.68 62.68 53.73 47.78

63 134.33 122.38 104.48 92.53 68.65 65.68 56.71 50.75

64 149.25 134.33 113.41 101.48 71.63 68.65 59.70 53.73

65 164.18 149.25 125.38 113.41 77.61 71.63 62.68 56.71

66 182.05 167.15 140.28 125.38 83.58 77.61 65.68 59.70

67 202.95 185.08 158.20 140.28 89.55 83.58 68.65 62.68

68 226.85 205.95 176.10 158.20 95.53 89.55 74.63 65.68

69 253.73 229.83 197.00 176.10 101.48 95.53 80.58 71.63

70 283.58 256.70 217.89 197.00 110.43 101.48 86.56 77.61

71 316.40 286.55 244.75 220.88 119.40 107.45 92.53 83.58

72 352.20 319.38 271.60 244.75 128.35 116.41 98.50 89.55

73 391.00 355.20 301.45 271.60 137.30 125.38 107.45 95.53

74 432.80 394.00 334.30 301.45 146.25 134.33 116.41 101.48

75 480.54 435.78 370.11 334.30 155.23 146.25 125.38 110.43

76 531.29 483.54 408.91 367.13 167.15 158.20 134.33 119.40

77 585.03 534.29 450.70 402.95 179.09 170.13 143.26 128.35

78 641.73 588.00 492.50 441.74 191.03 182.05 152.23 137.30

79 704.40 641.73 537.25 483.54 205.95 194.03 161.18 146.25

80 770.05 698.43 588.00 528.30 220.88 205.95 173.10 155.23

81 838.71 761.13 638.73 576.06 235.80 217.89 185.08 164.18

82 910.36 826.79 689.48 620.84 250.73 229.83 194.03 173.10

83 973.04 880.53 737.24 662.63 265.65 241.75 202.95 182.05

84 1,029.75 931.26 782.03 701.43 280.56 253.73 211.90 191.03

85 1,083.48 978.99 823.80 740.23 295.50 262.65 220.88 199.98

86 1,134.21 1,026.76 862.60 776.04 307.43 271.60 229.83 205.95

87 1,184.95 1,071.54 898.41 808.86 319.38 280.56 235.80 211.90

88 1,232.71 1,116.31 934.23 841.71 331.30 289.53 241.75 217.89

89 1,280.46 1,158.09 970.05 874.53 340.26 298.49 247.73 223.88

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

JACKSON NATIONAL LIFE INSURANCE COMPANY

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

2 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 2 of 42OCTOBER 2017

Page 7: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 53.73 47.78 38.80 35.83 44.78 41.78 38.80 35.83

51 56.71 50.75 41.78 38.80 47.78 44.78 38.80 35.83

52 59.70 53.73 44.78 41.78 50.75 47.78 41.78 35.83

53 65.68 59.70 50.75 44.78 53.73 50.75 44.78 38.80

54 71.63 65.68 56.71 50.75 56.71 53.73 47.78 41.78

55 77.61 71.63 62.68 56.71 62.68 56.71 50.75 44.78

56 86.56 77.61 68.65 62.68 65.68 59.70 53.73 47.78

57 95.53 86.56 74.63 68.65 68.65 62.68 56.71 50.75

58 104.48 95.53 83.58 74.63 71.63 65.68 59.70 53.73

59 113.41 104.48 92.53 80.58 77.61 71.63 62.68 56.71

60 125.38 113.41 101.48 89.55 80.58 74.63 65.68 59.70

61 137.30 125.38 110.43 98.50 83.58 77.61 68.65 62.68

62 152.23 137.30 119.40 107.45 86.56 80.58 71.63 65.68

63 167.15 152.23 131.33 119.40 92.53 86.56 74.63 68.65

64 185.08 167.15 143.26 131.33 98.50 92.53 77.61 71.63

65 205.95 185.08 158.20 143.26 104.48 98.50 83.58 74.63

66 229.83 205.95 176.10 158.20 110.43 104.48 89.55 77.61

67 256.70 229.83 197.00 176.10 116.41 110.43 95.53 83.58

68 286.55 256.70 220.88 197.00 125.38 116.41 101.48 89.55

69 319.38 286.55 244.75 220.88 134.33 122.38 107.45 95.53

70 355.20 319.38 271.60 247.73 143.26 131.33 113.41 101.48

71 394.00 358.18 304.45 274.60 152.23 140.28 119.40 107.45

72 438.75 399.96 340.26 304.45 161.18 149.25 128.35 113.41

73 489.51 444.74 379.06 337.28 170.13 158.20 137.30 122.38

74 543.23 495.48 420.85 376.08 182.05 170.13 146.25 131.33

75 602.93 549.18 465.63 417.88 194.03 182.05 155.23 140.28

76 665.61 605.91 513.38 462.65 205.95 194.03 164.18 149.25

77 734.25 668.58 564.14 510.39 220.88 205.95 176.10 158.20

78 808.86 734.25 617.85 558.15 235.80 220.88 188.05 167.15

79 886.49 805.89 677.54 608.88 253.73 235.80 199.98 179.09

80 970.05 880.53 740.23 665.61 271.60 250.73 211.90 191.03

81 1,059.60 961.11 802.90 725.31 289.53 265.65 223.88 202.95

82 1,152.14 1,044.66 868.56 782.03 307.43 283.58 235.80 214.93

83 1,232.71 1,116.31 925.28 832.75 325.35 298.49 247.73 226.85

84 1,301.35 1,178.99 976.03 877.51 340.26 310.41 259.68 235.80

85 1,364.04 1,235.69 1,023.78 919.30 355.20 322.35 271.60 244.75

86 1,420.75 1,289.43 1,068.54 961.11 367.13 334.30 280.56 253.73

87 1,477.48 1,340.16 1,113.31 999.90 379.06 346.23 289.53 262.65

88 1,531.19 1,387.94 1,152.14 1,035.70 391.00 355.20 298.49 268.64

89 1,581.91 1,432.70 1,187.94 1,068.54 399.96 364.15 304.45 274.60

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

3 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 3 of 42OCTOBER 2017

Page 8: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 56.71 50.75 44.78 41.78 62.68 56.71 50.75 44.78

51 62.68 56.71 47.78 44.78 62.68 59.70 53.73 47.78

52 68.65 62.68 53.73 47.78 65.68 62.68 53.73 50.75

53 77.61 71.63 59.70 53.73 71.63 65.68 56.71 50.75

54 86.56 77.61 65.68 59.70 74.63 71.63 59.70 53.73

55 95.53 83.58 74.63 65.68 77.61 74.63 62.68 56.71

56 104.48 92.53 83.58 71.63 80.58 77.61 65.68 59.70

57 113.41 101.48 92.53 80.58 86.56 83.58 71.63 62.68

58 122.38 110.43 101.48 89.55 89.55 86.56 74.63 65.68

59 134.33 122.38 110.43 98.50 95.53 92.53 77.61 68.65

60 146.25 134.33 119.40 107.45 101.48 95.53 80.58 74.63

61 161.18 146.25 128.35 116.41 107.45 101.48 86.56 77.61

62 176.10 161.18 140.28 125.38 113.41 104.48 89.55 80.58

63 194.03 179.09 152.23 137.30 119.40 110.43 95.53 86.56

64 211.90 197.00 167.15 149.25 125.38 116.41 101.48 89.55

65 232.80 214.93 185.08 164.18 131.33 122.38 104.48 95.53

66 259.68 238.79 205.95 182.05 137.30 128.35 110.43 101.48

67 289.53 265.65 226.85 205.95 146.25 137.30 116.41 107.45

68 325.35 298.49 253.73 229.83 155.23 143.26 125.38 113.41

69 364.15 334.30 283.58 256.70 164.18 152.23 131.33 119.40

70 405.93 373.10 316.40 283.58 173.10 158.20 137.30 125.38

71 453.70 414.90 352.20 316.40 182.05 167.15 146.25 131.33

72 507.40 462.65 391.00 352.20 194.03 179.09 155.23 140.28

73 564.14 516.38 435.78 394.00 205.95 188.05 164.18 149.25

74 626.80 573.08 483.54 435.78 217.89 199.98 176.10 158.20

75 695.46 635.76 534.29 483.54 229.83 214.93 185.08 167.15

76 770.05 701.43 590.99 534.29 244.75 226.85 197.00 179.09

77 850.68 773.05 650.69 588.00 262.65 244.75 211.90 191.03

78 934.23 850.68 713.35 644.71 280.56 259.68 226.85 202.95

79 1,026.76 934.23 782.03 704.40 298.49 277.58 241.75 214.93

80 1,122.29 1,020.81 853.65 767.09 319.38 295.50 256.70 229.83

81 1,226.75 1,113.31 928.26 835.74 340.26 316.40 271.60 244.75

82 1,334.19 1,208.84 1,008.84 907.36 364.15 337.28 289.53 262.65

83 1,423.74 1,286.43 1,074.51 967.06 382.04 352.20 304.45 274.60

84 1,498.36 1,355.09 1,131.24 1,017.81 396.98 367.13 316.40 283.58

85 1,564.03 1,414.78 1,178.99 1,059.60 411.89 382.04 328.33 295.50

86 1,626.70 1,471.49 1,223.76 1,098.39 426.83 394.00 337.28 304.45

87 1,683.43 1,522.23 1,265.54 1,137.20 438.75 405.93 349.23 313.43

88 1,734.15 1,569.99 1,304.34 1,173.01 450.70 414.90 355.20 322.35

89 1,784.90 1,611.76 1,340.16 1,205.84 459.66 423.85 364.15 328.33

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

4 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 4 of 42OCTOBER 2017

Page 9: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 65.68 59.70 53.73 47.78 71.63 65.68 59.70 53.73

51 71.63 65.68 56.71 50.75 74.63 68.65 62.68 56.71

52 77.61 71.63 59.70 53.73 80.58 74.63 65.68 59.70

53 83.58 77.61 65.68 59.70 86.56 80.58 71.63 62.68

54 92.53 83.58 71.63 65.68 89.55 83.58 74.63 65.68

55 101.48 92.53 80.58 71.63 95.53 89.55 80.58 71.63

56 110.43 101.48 89.55 77.61 101.48 95.53 83.58 74.63

57 122.38 113.41 98.50 86.56 104.48 98.50 86.56 77.61

58 134.33 125.38 107.45 95.53 110.43 104.48 92.53 80.58

59 146.25 137.30 116.41 104.48 116.41 110.43 95.53 83.58

60 161.18 149.25 125.38 113.41 122.38 113.41 98.50 86.56

61 176.10 164.18 137.30 125.38 128.35 119.40 104.48 92.53

62 194.03 179.09 152.23 137.30 134.33 125.38 107.45 95.53

63 211.90 197.00 167.15 149.25 140.28 131.33 113.41 101.48

64 232.80 214.93 185.08 164.18 146.25 137.30 119.40 107.45

65 256.70 235.80 202.95 182.05 152.23 143.26 125.38 113.41

66 286.55 262.65 223.88 202.95 161.18 149.25 131.33 119.40

67 319.38 292.50 250.73 223.88 170.13 158.20 137.30 125.38

68 358.18 328.33 280.56 250.73 179.09 167.15 146.25 131.33

69 399.96 364.15 310.41 280.56 188.05 176.10 155.23 137.30

70 444.74 405.93 346.23 310.41 199.98 185.08 164.18 146.25

71 495.48 453.70 385.05 346.23 211.90 194.03 173.10 155.23

72 555.18 507.40 429.81 388.03 223.88 205.95 182.05 164.18

73 617.85 564.14 477.55 429.81 238.79 220.88 191.03 173.10

74 686.50 626.80 528.30 477.55 253.73 235.80 202.95 182.05

75 761.13 692.48 585.03 528.30 268.64 250.73 214.93 194.03

76 841.71 767.09 644.71 582.05 286.55 265.65 229.83 205.95

77 928.26 844.68 710.38 638.73 304.45 283.58 244.75 220.88

78 1,020.81 928.26 779.01 701.43 325.35 304.45 262.65 235.80

79 1,119.30 1,017.81 853.65 767.09 346.23 325.35 280.56 253.73

80 1,226.75 1,113.31 931.26 838.71 370.11 346.23 301.45 271.60

81 1,337.18 1,211.83 1,014.81 913.34 396.98 370.11 322.35 292.50

82 1,456.56 1,316.26 1,101.39 990.96 423.85 394.00 343.26 310.41

83 1,552.08 1,405.81 1,173.01 1,056.61 444.74 414.90 361.15 325.35

84 1,629.69 1,477.48 1,232.71 1,110.33 462.65 429.81 376.08 337.28

85 1,698.35 1,537.18 1,283.46 1,155.10 477.55 444.74 388.03 349.23

86 1,761.01 1,590.89 1,328.24 1,196.90 492.50 459.66 399.96 361.15

87 1,814.73 1,641.61 1,370.01 1,232.71 507.40 471.59 411.89 370.11

88 1,865.49 1,686.40 1,405.81 1,265.54 519.36 483.54 420.85 379.06

89 1,910.25 1,728.20 1,441.64 1,295.39 528.30 492.50 429.81 385.05

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

5 Year Benefit Period - without Inflation Rider

Home Health Care RiderBase Nursing Home Policy

PENNSYLVANIA Page 5 of 42OCTOBER 2017

Page 10: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 74.63 71.63 62.68 56.71 77.61 74.63 65.68 59.70

51 80.58 74.63 65.68 59.70 83.58 80.58 71.63 65.68

52 86.56 80.58 68.65 62.68 89.55 83.58 74.63 68.65

53 95.53 86.56 74.63 68.65 95.53 89.55 80.58 74.63

54 104.48 95.53 83.58 74.63 101.48 95.53 83.58 77.61

55 113.41 104.48 92.53 80.58 107.45 101.48 89.55 80.58

56 125.38 116.41 101.48 89.55 113.41 104.48 92.53 83.58

57 137.30 128.35 110.43 98.50 119.40 110.43 98.50 89.55

58 149.25 140.28 119.40 107.45 125.38 116.41 101.48 92.53

59 164.18 152.23 128.35 116.41 131.33 122.38 107.45 98.50

60 179.09 164.18 140.28 128.35 134.33 125.38 110.43 101.48

61 197.00 179.09 152.23 140.28 140.28 131.33 116.41 104.48

62 214.93 197.00 167.15 152.23 146.25 137.30 119.40 107.45

63 235.80 217.89 185.08 167.15 152.23 143.26 125.38 113.41

64 256.70 238.79 202.95 182.05 158.20 149.25 128.35 116.41

65 283.58 259.68 220.88 199.98 164.18 155.23 134.33 122.38

66 313.43 286.55 244.75 220.88 170.13 161.18 140.28 128.35

67 349.23 319.38 274.60 244.75 179.09 167.15 146.25 134.33

68 391.00 358.18 304.45 274.60 191.03 176.10 155.23 140.28

69 435.78 396.98 337.28 304.45 202.95 188.05 164.18 149.25

70 483.54 441.74 376.08 337.28 214.93 199.98 173.10 158.20

71 537.25 492.50 417.88 376.08 226.85 211.90 185.08 167.15

72 599.94 549.18 465.63 417.88 241.75 223.88 197.00 176.10

73 668.58 608.88 516.38 462.65 256.70 235.80 208.94 188.05

74 740.23 674.56 570.09 513.38 271.60 250.73 220.88 199.98

75 817.83 746.19 629.79 567.10 286.55 265.65 232.80 211.90

76 904.38 823.80 692.48 623.83 304.45 280.56 247.73 223.88

77 993.93 904.38 761.13 683.53 325.35 298.49 265.65 238.79

78 1,092.44 993.93 832.75 749.16 349.23 319.38 283.58 256.70

79 1,196.90 1,086.46 910.36 817.83 373.10 343.26 304.45 274.60

80 1,307.33 1,187.94 990.96 892.45 399.96 370.11 325.35 292.50

81 1,426.71 1,292.41 1,077.50 970.05 429.81 399.96 349.23 313.43

82 1,549.11 1,402.85 1,167.05 1,050.66 462.65 432.80 376.08 337.28

83 1,653.58 1,498.36 1,244.64 1,119.30 489.51 459.66 396.98 355.20

84 1,737.14 1,572.98 1,304.34 1,173.01 510.39 477.55 408.91 367.13

85 1,808.78 1,632.66 1,355.09 1,217.79 525.33 489.51 420.85 379.06

86 1,868.48 1,686.40 1,399.86 1,259.58 540.24 501.44 432.80 391.00

87 1,919.23 1,734.15 1,441.64 1,295.39 552.20 513.38 444.74 402.95

88 1,966.96 1,778.93 1,477.48 1,328.24 564.14 525.33 456.68 411.89

89 2,011.73 1,820.71 1,510.29 1,358.09 573.08 534.29 465.63 420.85

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

8 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 6 of 42OCTOBER 2017

Page 11: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Day 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 83.58 77.61 68.65 59.70 83.58 77.61 71.63 62.68

51 89.55 83.58 71.63 62.68 89.55 83.58 74.63 65.68

52 98.50 89.55 77.61 68.65 95.53 89.55 80.58 71.63

53 107.45 98.50 83.58 74.63 101.48 95.53 86.56 77.61

54 116.41 107.45 92.53 80.58 107.45 101.48 92.53 83.58

55 128.35 116.41 101.48 89.55 113.41 107.45 98.50 89.55

56 140.28 128.35 110.43 98.50 119.40 113.41 101.48 92.53

57 152.23 140.28 119.40 107.45 125.38 119.40 107.45 98.50

58 167.15 152.23 131.33 116.41 131.33 125.38 110.43 101.48

59 182.05 167.15 143.26 128.35 137.30 131.33 116.41 104.48

60 197.00 182.05 155.23 140.28 143.26 137.30 119.40 107.45

61 214.93 197.00 167.15 152.23 149.25 143.26 125.38 113.41

62 235.80 214.93 182.05 164.18 155.23 149.25 128.35 116.41

63 256.70 235.80 199.98 179.09 161.18 155.23 134.33 122.38

64 280.56 256.70 220.88 197.00 167.15 161.18 137.30 125.38

65 307.43 280.56 241.75 214.93 173.10 167.15 143.26 128.35

66 340.26 310.41 265.65 238.79 179.09 173.10 149.25 134.33

67 379.06 346.23 295.50 265.65 188.05 179.09 155.23 140.28

68 420.85 385.05 328.33 295.50 199.98 185.08 164.18 149.25

69 468.60 429.81 364.15 328.33 211.90 194.03 173.10 158.20

70 519.36 477.55 402.95 364.15 226.85 205.95 185.08 167.15

71 579.03 528.30 447.70 402.95 241.75 220.88 197.00 176.10

72 644.71 588.00 498.45 447.70 256.70 235.80 208.94 188.05

73 716.35 653.68 552.20 495.48 274.60 250.73 220.88 199.98

74 790.98 722.33 608.88 549.18 289.53 265.65 232.80 211.90

75 874.53 796.94 671.58 602.93 307.43 280.56 247.73 223.88

76 964.08 877.51 737.24 662.63 325.35 301.45 265.65 238.79

77 1,059.60 964.08 808.86 728.28 346.23 322.35 283.58 253.73

78 1,164.06 1,056.61 883.50 796.94 373.10 349.23 304.45 271.60

79 1,274.49 1,155.10 964.08 871.56 399.96 376.08 325.35 292.50

80 1,387.94 1,259.58 1,050.66 946.18 429.81 405.93 349.23 316.40

81 1,513.28 1,370.01 1,140.18 1,026.76 462.65 435.78 376.08 340.26

82 1,641.61 1,486.41 1,232.71 1,110.33 498.45 465.63 405.93 364.15

83 1,749.09 1,584.91 1,310.31 1,178.99 525.33 489.51 426.83 382.04

84 1,838.63 1,659.54 1,373.00 1,232.71 546.21 510.39 447.70 396.98

85 1,913.23 1,722.21 1,423.74 1,280.46 564.14 528.30 462.65 411.89

86 1,975.93 1,775.94 1,468.51 1,322.26 579.03 543.23 474.59 423.85

87 2,026.66 1,826.69 1,510.29 1,358.09 593.98 558.15 486.53 435.78

88 2,071.43 1,871.45 1,546.10 1,390.90 605.91 570.09 495.48 444.74

89 2,113.20 1,910.25 1,578.95 1,420.75 617.85 582.05 504.44 453.70

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

JACKSON NATIONAL LIFE INSURANCE COMPANY

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Lifetime Benefit Period - without Inflation Rider

Preferred Risk Rate Class

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 7 of 42OCTOBER 2017

Page 12: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 53.73 47.78 38.80 32.84

51 56.71 50.75 41.78 35.83

52 59.70 53.73 44.78 38.80

53 62.68 56.71 47.78 41.78

54 65.68 59.70 50.75 44.78

55 68.65 62.68 53.73 47.78

56 71.63 65.68 56.71 50.75

57 74.63 68.65 59.70 53.73

58 77.61 71.63 62.68 56.71

59 80.58 74.63 65.68 59.70

60 83.58 77.61 68.65 65.68

61 89.55 83.58 71.63 68.65

62 95.53 89.55 77.61 71.63

63 101.48 92.53 80.58 74.63

64 107.45 98.50 83.58 77.61

65 113.41 104.48 86.56 80.58

66 119.40 107.45 89.55 86.56

67 125.38 113.41 95.53 89.55

68 131.33 122.38 101.48 92.53

69 137.30 131.33 110.43 95.53

70 149.25 140.28 119.40 101.48

71 161.18 149.25 128.35 110.43

72 173.10 158.20 137.30 119.40

73 185.08 170.13 146.25 128.35

74 197.00 182.05 155.23 137.30

75 208.94 194.03 164.18 146.25

76 220.88 205.95 173.10 158.20

77 235.80 217.89 182.05 170.13

78 250.73 232.80 194.03 182.05

79 265.65 247.73 205.95 191.03

80 283.58 262.65 217.89 199.98

81 301.45 277.58 229.83 208.94

82 322.35 289.53 244.75 217.89

83 337.28 301.45 253.73 226.85

84 349.23 313.43 262.65 235.80

85 361.15 325.35 271.60 244.75

86 373.10 334.30 280.56 253.73

87 385.05 340.26 286.55 259.68

88 394.00 346.23 292.50 265.65

89 402.95 352.20 298.49 271.60

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

Non-Tax Qualified Long Term Care Policy and Riders

JACKSON NATIONAL LIFE INSURANCE COMPANY

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

1 Year Benefit Period - with Compound Inflation Rider

Base Nursing Home Policy Home Health Care Rider

AVAILABLE

NOT

PENNSYLVANIA Page 8 of 42OCTOBER 2017

Page 13: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Day 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 122.38 110.43 95.53 86.56 68.65 62.68 56.71 50.75

51 125.38 113.41 98.50 89.55 71.63 65.68 59.70 53.73

52 131.33 119.40 101.48 92.53 74.63 68.65 62.68 56.71

53 140.28 128.35 104.48 95.53 77.61 71.63 65.68 59.70

54 149.25 137.30 110.43 101.48 83.58 77.61 68.65 62.68

55 161.18 146.25 122.38 110.43 89.55 83.58 71.63 65.68

56 173.10 155.23 134.33 119.40 95.53 89.55 74.63 68.65

57 185.08 167.15 146.25 128.35 98.50 92.53 77.61 71.63

58 199.98 179.09 158.20 137.30 104.48 98.50 80.58 74.63

59 214.93 194.03 170.13 146.25 107.45 101.48 86.56 77.61

60 229.83 208.94 182.05 158.20 113.41 107.45 89.55 80.58

61 244.75 223.88 194.03 170.13 116.41 113.41 95.53 83.58

62 262.65 238.79 205.95 182.05 122.38 116.41 101.48 89.55

63 280.56 253.73 217.89 194.03 128.35 122.38 104.48 92.53

64 301.45 271.60 232.80 205.95 134.33 125.38 110.43 98.50

65 322.35 292.50 250.73 220.88 140.28 131.33 113.41 104.48

66 349.23 319.38 271.60 238.79 146.25 137.30 116.41 107.45

67 379.06 346.23 295.50 262.65 155.23 143.26 122.38 110.43

68 411.89 373.10 319.38 286.55 164.18 152.23 128.35 113.41

69 447.70 405.93 346.23 313.43 173.10 161.18 134.33 119.40

70 486.53 441.74 376.08 340.26 182.05 170.13 143.26 125.38

71 531.29 480.54 408.91 370.11 194.03 179.09 152.23 134.33

72 576.06 522.35 444.74 399.96 205.95 188.05 161.18 143.26

73 623.83 567.10 480.54 432.80 217.89 199.98 170.13 152.23

74 671.58 611.88 519.36 468.60 229.83 211.90 179.09 161.18

75 725.31 659.63 558.15 504.44 241.75 223.88 188.05 170.13

76 785.01 713.35 602.93 543.23 253.73 235.80 197.00 179.09

77 844.68 767.09 647.69 582.05 265.65 247.73 208.94 191.03

78 904.38 823.80 692.48 620.84 280.56 262.65 220.88 202.95

79 967.06 880.53 740.23 662.63 295.50 277.58 232.80 211.90

80 1,032.74 940.21 787.98 707.39 313.43 292.50 244.75 220.88

81 1,104.36 1,002.89 841.71 758.13 331.30 307.43 256.70 229.83

82 1,178.99 1,071.54 892.45 802.90 346.23 319.38 268.64 238.79

83 1,238.69 1,122.29 940.21 844.68 361.15 331.30 277.58 247.73

84 1,289.43 1,167.05 978.99 877.51 376.08 340.26 286.55 256.70

85 1,334.19 1,205.84 1,014.81 910.36 391.00 349.23 292.50 262.65

86 1,373.00 1,241.68 1,044.66 940.21 402.95 358.18 298.49 268.64

87 1,408.81 1,274.49 1,068.54 964.08 411.89 364.15 304.45 274.60

88 1,441.64 1,304.34 1,092.44 984.98 420.85 370.11 310.41 280.56

89 1,471.49 1,331.20 1,116.31 1,005.88 429.81 376.08 316.40 286.55

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Non-Tax Qualified Long Term Care Policy and Riders

Preferred Risk Rate Class

2 Year Benefit Period - with Compound Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 9 of 42OCTOBER 2017

Page 14: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 155.23 137.30 113.41 104.48 92.53 86.56 77.61 68.65

51 161.18 143.26 119.40 110.43 98.50 92.53 80.58 71.63

52 170.13 152.23 128.35 116.41 104.48 98.50 86.56 74.63

53 179.09 161.18 137.30 125.38 110.43 104.48 92.53 77.61

54 188.05 173.10 149.25 134.33 116.41 107.45 95.53 83.58

55 199.98 185.08 161.18 143.26 122.38 113.41 101.48 89.55

56 214.93 197.00 173.10 155.23 128.35 116.41 104.48 95.53

57 229.83 211.90 185.08 167.15 134.33 122.38 110.43 98.50

58 247.73 226.85 199.98 179.09 140.28 128.35 116.41 104.48

59 265.65 241.75 214.93 191.03 146.25 134.33 119.40 107.45

60 283.58 259.68 229.83 202.95 152.23 140.28 125.38 113.41

61 304.45 277.58 244.75 217.89 158.20 146.25 131.33 116.41

62 325.35 295.50 259.68 232.80 164.18 152.23 137.30 122.38

63 349.23 316.40 274.60 247.73 173.10 158.20 143.26 128.35

64 373.10 337.28 289.53 265.65 182.05 167.15 149.25 131.33

65 402.95 364.15 310.41 283.58 191.03 176.10 155.23 137.30

66 438.75 394.00 337.28 304.45 199.98 185.08 161.18 143.26

67 477.55 429.81 367.13 328.33 208.94 194.03 167.15 149.25

68 519.36 465.63 399.96 358.18 217.89 202.95 173.10 155.23

69 564.14 507.40 432.80 391.00 226.85 211.90 179.09 161.18

70 611.88 549.18 471.59 426.83 235.80 220.88 185.08 167.15

71 662.63 599.94 510.39 462.65 247.73 229.83 194.03 173.10

72 719.33 653.68 555.18 498.45 259.68 238.79 205.95 182.05

73 779.01 710.38 602.93 537.25 271.60 250.73 217.89 191.03

74 841.71 770.05 653.68 582.05 286.55 265.65 229.83 202.95

75 910.36 829.75 704.40 629.79 301.45 280.56 241.75 214.93

76 982.00 895.44 758.13 680.53 316.40 295.50 253.73 226.85

77 1,059.60 964.08 814.83 731.28 331.30 310.41 265.65 238.79

78 1,140.18 1,032.74 871.56 785.01 349.23 325.35 277.58 250.73

79 1,220.78 1,107.35 931.26 838.71 367.13 340.26 289.53 262.65

80 1,307.33 1,184.95 990.96 895.44 385.05 355.20 301.45 274.60

81 1,396.86 1,265.54 1,056.61 955.13 405.93 373.10 313.43 286.55

82 1,492.40 1,352.11 1,125.25 1,011.84 426.83 391.00 325.35 298.49

83 1,569.99 1,420.75 1,178.99 1,059.60 444.74 405.93 337.28 310.41

84 1,629.69 1,477.48 1,220.78 1,098.39 459.66 417.88 349.23 319.38

85 1,677.44 1,522.23 1,259.58 1,131.24 471.59 429.81 361.15 325.35

86 1,719.24 1,561.04 1,292.41 1,164.06 480.54 438.75 370.11 331.30

87 1,758.05 1,593.88 1,322.26 1,190.93 489.51 447.70 376.08 337.28

88 1,790.86 1,623.73 1,349.13 1,211.83 498.45 453.70 382.04 343.26

89 1,820.71 1,647.61 1,367.01 1,229.73 504.44 459.66 388.03 349.23

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

3 Year Benefit Period - with Compound Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 10 of 42OCTOBER 2017

Page 15: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 164.18 146.25 131.33 119.40 128.35 119.40 107.45 95.53

51 179.09 158.20 140.28 128.35 134.33 125.38 110.43 98.50

52 194.03 173.10 149.25 137.30 140.28 128.35 113.41 101.48

53 208.94 188.05 161.18 146.25 146.25 134.33 116.41 104.48

54 223.88 202.95 173.10 158.20 149.25 140.28 119.40 107.45

55 238.79 217.89 188.05 170.13 155.23 146.25 125.38 113.41

56 256.70 232.80 202.95 182.05 161.18 152.23 131.33 116.41

57 274.60 247.73 217.89 197.00 167.15 158.20 137.30 122.38

58 292.50 265.65 232.80 211.90 173.10 164.18 143.26 125.38

59 313.43 283.58 247.73 226.85 182.05 170.13 149.25 131.33

60 334.30 304.45 265.65 241.75 191.03 179.09 155.23 137.30

61 355.20 325.35 283.58 256.70 202.95 188.05 161.18 143.26

62 379.06 346.23 301.45 271.60 211.90 197.00 167.15 149.25

63 402.95 370.11 319.38 286.55 220.88 205.95 176.10 158.20

64 429.81 394.00 340.26 304.45 229.83 214.93 182.05 164.18

65 459.66 423.85 364.15 325.35 238.79 223.88 188.05 173.10

66 495.48 456.68 394.00 352.20 247.73 229.83 194.03 182.05

67 540.24 495.48 423.85 385.05 256.70 238.79 202.95 188.05

68 590.99 543.23 459.66 417.88 265.65 244.75 211.90 194.03

69 644.71 590.99 501.44 453.70 274.60 253.73 220.88 199.98

70 701.43 641.73 543.23 489.51 283.58 262.65 229.83 205.95

71 764.10 695.46 590.99 531.29 295.50 271.60 238.79 214.93

72 829.75 758.13 641.73 576.06 310.41 283.58 250.73 226.85

73 898.41 823.80 695.46 626.80 325.35 298.49 262.65 238.79

74 973.04 889.45 749.16 677.54 340.26 313.43 277.58 250.73

75 1,050.66 961.11 805.89 731.28 358.18 331.30 289.53 262.65

76 1,137.20 1,035.70 871.56 787.98 376.08 349.23 304.45 274.60

77 1,226.75 1,113.31 937.21 847.66 394.00 367.13 319.38 286.55

78 1,316.26 1,196.90 1,005.88 907.36 411.89 385.05 334.30 298.49

79 1,411.79 1,280.46 1,074.51 967.06 432.80 402.95 349.23 310.41

80 1,510.29 1,370.01 1,146.14 1,029.75 453.70 423.85 364.15 325.35

81 1,614.75 1,465.51 1,223.76 1,101.39 477.55 444.74 382.04 343.26

82 1,728.20 1,567.00 1,307.33 1,175.99 504.44 465.63 399.96 364.15

83 1,811.75 1,638.65 1,367.01 1,232.71 522.35 480.54 414.90 376.08

84 1,874.43 1,695.35 1,414.78 1,274.49 534.29 495.48 426.83 385.05

85 1,925.19 1,740.13 1,450.60 1,304.34 546.21 507.40 435.78 394.00

86 1,969.95 1,781.90 1,480.44 1,328.24 558.15 516.38 441.74 399.96

87 2,002.78 1,811.75 1,504.33 1,352.11 567.10 522.35 447.70 405.93

88 2,029.65 1,835.64 1,525.21 1,373.00 576.06 528.30 453.70 411.89

89 2,053.51 1,853.54 1,540.14 1,387.94 582.05 534.29 459.66 417.88

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

4 Year Benefit Period - with Compound Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 11 of 42OCTOBER 2017

Page 16: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 191.03 173.10 152.23 137.30 149.25 137.30 125.38 113.41

51 202.95 185.08 161.18 143.26 158.20 143.26 131.33 116.41

52 214.93 197.00 170.13 152.23 167.15 152.23 137.30 122.38

53 229.83 208.94 179.09 161.18 176.10 158.20 143.26 128.35

54 244.75 223.88 191.03 173.10 182.05 167.15 149.25 134.33

55 259.68 238.79 205.95 185.08 191.03 176.10 158.20 140.28

56 277.58 256.70 220.88 197.00 199.98 185.08 164.18 146.25

57 298.49 277.58 238.79 211.90 205.95 194.03 170.13 152.23

58 319.38 298.49 256.70 229.83 214.93 202.95 176.10 158.20

59 343.26 319.38 274.60 244.75 223.88 208.94 182.05 164.18

60 367.13 340.26 292.50 259.68 232.80 214.93 188.05 170.13

61 391.00 361.15 310.41 277.58 241.75 223.88 194.03 176.10

62 414.90 385.05 328.33 295.50 250.73 232.80 199.98 182.05

63 441.74 408.91 349.23 313.43 259.68 241.75 208.94 188.05

64 471.59 435.78 373.10 334.30 268.64 250.73 217.89 197.00

65 507.40 465.63 396.98 358.18 277.58 259.68 226.85 205.95

66 549.18 501.44 426.83 388.03 286.55 268.64 232.80 211.90

67 596.95 546.21 465.63 420.85 295.50 277.58 241.75 217.89

68 650.69 593.98 507.40 456.68 304.45 286.55 250.73 223.88

69 707.39 644.71 549.18 495.48 316.40 295.50 259.68 229.83

70 767.09 698.43 596.95 537.25 328.33 304.45 268.64 238.79

71 832.75 761.13 647.69 582.05 343.26 316.40 280.56 250.73

72 907.36 829.75 704.40 632.78 361.15 331.30 292.50 262.65

73 984.98 898.41 761.13 686.50 379.06 349.23 304.45 274.60

74 1,065.55 970.05 820.83 740.23 396.98 367.13 319.38 286.55

75 1,149.15 1,047.65 883.50 796.94 417.88 388.03 334.30 301.45

76 1,241.68 1,131.24 952.15 859.60 438.75 408.91 352.20 316.40

77 1,337.18 1,217.79 1,023.78 922.30 459.66 429.81 370.11 331.30

78 1,435.66 1,307.33 1,095.40 987.96 480.54 450.70 388.03 349.23

79 1,537.18 1,399.86 1,170.03 1,053.63 501.44 471.59 405.93 367.13

80 1,644.60 1,495.36 1,250.63 1,125.25 525.33 492.50 426.83 385.05

81 1,761.01 1,596.85 1,337.18 1,202.86 555.18 519.36 450.70 408.91

82 1,886.39 1,704.30 1,426.71 1,283.46 585.03 546.21 474.59 429.81

83 1,975.93 1,790.86 1,492.40 1,346.11 605.91 567.10 492.50 444.74

84 2,041.58 1,850.56 1,543.13 1,390.90 623.83 579.03 507.40 453.70

85 2,089.35 1,892.34 1,578.95 1,420.75 635.76 590.99 516.38 462.65

86 2,131.13 1,925.19 1,608.80 1,447.64 647.69 602.93 525.33 471.59

87 2,157.99 1,952.04 1,629.69 1,465.51 656.65 611.88 534.29 477.55

88 2,181.85 1,972.93 1,644.60 1,480.44 662.63 617.85 540.24 483.54

89 2,196.80 1,987.86 1,659.54 1,495.36 668.58 623.83 546.21 489.51

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

5 Year Benefit Period - with Compound Inflation Rider

Preferred Risk Rate Class

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 12 of 42OCTOBER 2017

Page 17: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 220.88 208.94 179.09 164.18 164.18 155.23 137.30 125.38

51 229.83 214.93 185.08 170.13 173.10 164.18 146.25 134.33

52 241.75 223.88 194.03 176.10 182.05 173.10 152.23 140.28

53 256.70 235.80 205.95 185.08 191.03 182.05 161.18 149.25

54 274.60 250.73 220.88 197.00 199.98 191.03 167.15 155.23

55 292.50 268.64 235.80 208.94 208.94 199.98 176.10 161.18

56 313.43 289.53 250.73 223.88 217.89 205.95 182.05 167.15

57 334.30 310.41 265.65 238.79 226.85 214.93 191.03 173.10

58 358.18 331.30 283.58 253.73 235.80 223.88 197.00 179.09

59 382.04 352.20 301.45 271.60 244.75 232.80 202.95 185.08

60 408.91 373.10 319.38 292.50 253.73 238.79 208.94 191.03

61 435.78 396.98 340.26 310.41 262.65 247.73 217.89 197.00

62 462.65 423.85 361.15 328.33 271.60 256.70 223.88 202.95

63 489.51 450.70 385.05 349.23 280.56 265.65 229.83 208.94

64 519.36 480.54 408.91 370.11 289.53 274.60 235.80 214.93

65 555.18 513.38 435.78 394.00 298.49 280.56 244.75 223.88

66 599.94 549.18 468.60 423.85 307.43 289.53 250.73 229.83

67 650.69 593.98 510.39 459.66 316.40 298.49 256.70 235.80

68 710.38 644.71 552.20 498.45 328.33 307.43 265.65 241.75

69 770.05 701.43 596.95 537.25 340.26 316.40 274.60 250.73

70 832.75 761.13 647.69 582.05 352.20 328.33 286.55 259.68

71 901.41 826.79 701.43 629.79 367.13 343.26 301.45 271.60

72 982.00 898.41 761.13 683.53 385.05 358.18 316.40 283.58

73 1,065.55 970.05 820.83 737.24 405.93 376.08 331.30 298.49

74 1,149.15 1,047.65 883.50 796.94 426.83 394.00 349.23 313.43

75 1,238.69 1,128.24 952.15 856.64 447.70 411.89 364.15 328.33

76 1,334.19 1,214.79 1,020.81 919.30 468.60 429.81 382.04 343.26

77 1,432.70 1,304.34 1,095.40 984.98 492.50 447.70 399.96 361.15

78 1,537.18 1,396.86 1,173.01 1,053.63 516.38 471.59 417.88 379.06

79 1,644.60 1,492.40 1,250.63 1,122.29 540.24 498.45 438.75 396.98

80 1,758.05 1,593.88 1,331.20 1,196.90 567.10 528.30 462.65 414.90

81 1,880.40 1,701.31 1,420.75 1,277.48 602.93 561.14 489.51 438.75

82 2,005.78 1,817.73 1,510.29 1,361.05 638.73 596.95 519.36 465.63

83 2,104.28 1,907.26 1,584.91 1,426.71 668.58 623.83 540.24 483.54

84 2,175.90 1,969.95 1,632.66 1,468.51 686.50 641.73 552.20 495.48

85 2,226.65 2,008.74 1,668.50 1,498.36 698.43 650.69 561.14 504.44

86 2,262.45 2,041.58 1,695.35 1,525.21 707.39 659.63 570.09 513.38

87 2,283.36 2,062.48 1,716.25 1,540.14 713.35 665.61 576.06 519.36

88 2,301.25 2,080.38 1,728.20 1,552.08 719.33 671.58 582.05 525.33

89 2,316.20 2,095.33 1,740.13 1,564.03 725.31 677.54 588.00 531.29

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

8 Year Benefit Period - with Compund Inflation Rider

Preferred Risk Rate Class

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 13 of 42OCTOBER 2017

Page 18: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 241.75 226.85 197.00 173.10 179.09 167.15 149.25 131.33

51 256.70 238.79 205.95 179.09 188.05 176.10 158.20 137.30

52 271.60 250.73 214.93 188.05 197.00 185.08 167.15 146.25

53 289.53 265.65 226.85 199.98 205.95 194.03 176.10 155.23

54 310.41 283.58 241.75 211.90 214.93 202.95 185.08 164.18

55 331.30 301.45 259.68 229.83 226.85 211.90 194.03 173.10

56 352.20 322.35 277.58 247.73 235.80 220.88 199.98 182.05

57 376.08 343.26 295.50 265.65 244.75 229.83 205.95 191.03

58 399.96 364.15 313.43 283.58 253.73 238.79 211.90 197.00

59 423.85 388.03 331.30 301.45 262.65 247.73 217.89 202.95

60 447.70 411.89 349.23 319.38 271.60 256.70 223.88 208.94

61 477.55 435.78 370.11 337.28 280.56 265.65 232.80 214.93

62 507.40 462.65 391.00 355.20 289.53 274.60 238.79 220.88

63 537.25 489.51 417.88 376.08 298.49 283.58 244.75 226.85

64 567.10 519.36 444.74 399.96 307.43 292.50 250.73 232.80

65 602.93 552.20 474.59 423.85 316.40 301.45 259.68 238.79

66 650.69 593.98 510.39 456.68 325.35 310.41 265.65 244.75

67 704.40 644.71 552.20 495.48 334.30 319.38 271.60 250.73

68 764.10 698.43 596.95 537.25 343.26 328.33 280.56 256.70

69 826.79 758.13 644.71 579.03 355.20 337.28 289.53 265.65

70 895.44 820.83 695.46 626.80 373.10 346.23 304.45 274.60

71 973.04 886.49 752.18 677.54 391.00 358.18 319.38 286.55

72 1,053.63 961.11 814.83 731.28 411.89 376.08 337.28 301.45

73 1,140.18 1,041.69 880.53 790.98 432.80 396.98 352.20 319.38

74 1,226.75 1,122.29 946.18 850.68 456.68 417.88 367.13 334.30

75 1,322.26 1,205.84 1,014.81 913.34 480.54 438.75 385.05 349.23

76 1,423.74 1,295.39 1,089.45 978.99 504.44 459.66 405.93 367.13

77 1,528.21 1,390.90 1,167.05 1,050.66 528.30 483.54 426.83 382.04

78 1,638.65 1,486.41 1,244.64 1,122.29 552.20 513.38 447.70 399.96

79 1,749.09 1,587.91 1,325.24 1,193.91 579.03 543.23 471.59 423.85

80 1,865.49 1,692.36 1,408.81 1,268.54 608.88 576.06 498.45 450.70

81 1,993.81 1,805.79 1,501.34 1,352.11 647.69 611.88 528.30 477.55

82 2,125.18 1,925.19 1,596.85 1,438.66 689.48 644.71 558.15 504.44

83 2,226.65 2,017.71 1,668.50 1,501.34 716.35 668.58 582.05 522.35

84 2,301.25 2,077.40 1,719.24 1,543.13 734.25 686.50 602.93 534.29

85 2,355.00 2,119.19 1,752.06 1,575.95 749.16 701.43 614.88 546.21

86 2,390.80 2,149.03 1,775.94 1,599.84 758.13 713.35 623.83 555.18

87 2,411.69 2,172.90 1,796.84 1,614.75 767.09 722.33 629.79 561.14

88 2,426.63 2,187.84 1,811.75 1,626.70 773.05 728.28 635.76 567.10

89 2,441.54 2,202.75 1,826.69 1,638.65 779.01 734.25 641.73 573.08

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

Lifetime Benefit Period - with Compund Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 14 of 42OCTOBER 2017

Page 19: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 41.78 38.80 32.84 26.86

51 44.78 41.78 35.83 29.85

52 47.78 44.78 38.80 32.84

53 50.75 47.78 41.78 35.83

54 53.73 50.75 44.78 38.80

55 56.71 53.73 47.78 41.78

56 59.70 56.71 50.75 44.78

57 62.68 59.70 53.73 47.78

58 65.68 62.68 56.71 50.75

59 68.65 65.68 59.70 53.73

60 71.63 68.65 62.68 56.71

61 77.61 71.63 65.68 59.70

62 83.58 77.61 68.65 62.68

63 89.55 80.58 71.63 65.68

64 95.53 86.56 74.63 68.65

65 101.48 89.55 77.61 71.63

66 107.45 95.53 80.58 74.63

67 113.41 101.48 83.58 77.61

68 119.40 110.43 89.55 83.58

69 125.38 119.40 98.50 86.56

70 134.33 128.35 107.45 92.53

71 146.25 137.30 116.41 101.48

72 158.20 146.25 125.38 110.43

73 170.13 158.20 134.33 119.40

74 182.05 167.15 143.26 125.38

75 194.03 179.09 152.23 134.33

76 205.95 191.03 161.18 146.25

77 220.88 202.95 170.13 158.20

78 235.80 217.89 182.05 170.13

79 250.73 232.80 194.03 179.09

80 268.64 247.73 205.95 188.05

81 283.58 262.65 217.89 197.00

82 304.45 274.60 232.80 205.95

83 319.38 286.55 241.75 214.93

84 331.30 298.49 250.73 223.88

85 343.26 310.41 259.68 232.80

86 355.20 319.38 268.64 241.75

87 367.13 325.35 274.60 247.73

88 376.08 331.30 280.56 253.73

89 385.05 337.28 286.55 259.68

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

1 Year Benefit Period - with Simple Inflation Rider

AVAILABLE

NOT

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 15 of 42OCTOBER 2017

Page 20: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 83.58 74.63 62.68 56.71 56.71 50.75 44.78 38.80

51 89.55 77.61 65.68 59.70 59.70 53.73 47.78 41.78

52 95.53 83.58 68.65 62.68 62.68 56.71 50.75 44.78

53 101.48 89.55 74.63 68.65 65.68 59.70 53.73 47.78

54 107.45 98.50 80.58 74.63 68.65 62.68 56.71 50.75

55 116.41 107.45 89.55 80.58 74.63 68.65 59.70 53.73

56 128.35 116.41 98.50 86.56 77.61 74.63 62.68 56.71

57 140.28 125.38 107.45 95.53 83.58 77.61 65.68 59.70

58 152.23 137.30 119.40 107.45 86.56 83.58 68.65 62.68

59 167.15 149.25 131.33 116.41 89.55 86.56 74.63 65.68

60 179.09 164.18 140.28 128.35 95.53 89.55 77.61 68.65

61 197.00 179.09 152.23 137.30 98.50 95.53 83.58 71.63

62 214.93 194.03 167.15 146.25 104.48 98.50 86.56 77.61

63 229.83 208.94 176.10 158.20 110.43 104.48 89.55 80.58

64 250.73 226.85 194.03 170.13 116.41 107.45 95.53 86.56

65 271.60 247.73 211.90 185.08 122.38 116.41 98.50 89.55

66 298.49 274.60 232.80 205.95 128.35 122.38 104.48 95.53

67 328.33 298.49 256.70 226.85 140.28 128.35 110.43 98.50

68 361.15 328.33 280.56 250.73 146.25 137.30 113.41 101.48

69 396.98 361.15 310.41 280.56 155.23 146.25 119.40 107.45

70 438.75 396.98 337.28 304.45 164.18 155.23 128.35 113.41

71 480.54 435.78 370.11 334.30 176.10 164.18 137.30 122.38

72 528.30 477.55 405.93 364.15 188.05 173.10 146.25 131.33

73 576.06 525.33 444.74 399.96 199.98 185.08 158.20 140.28

74 623.83 567.10 480.54 435.78 211.90 197.00 164.18 149.25

75 674.56 614.88 519.36 471.59 223.88 208.94 173.10 158.20

76 734.25 668.58 564.14 510.39 235.80 217.89 182.05 167.15

77 790.98 722.33 608.88 546.21 247.73 229.83 194.03 179.09

78 850.68 779.01 653.68 585.03 262.65 244.75 205.95 191.03

79 916.34 832.75 701.43 626.80 277.58 259.68 217.89 199.98

80 978.99 892.45 746.19 671.58 295.50 274.60 229.83 208.94

81 1,050.66 955.13 799.90 722.33 313.43 289.53 241.75 217.89

82 1,125.25 1,023.78 850.68 767.09 328.33 301.45 253.73 226.85

83 1,187.94 1,074.51 901.41 808.86 343.26 313.43 262.65 235.80

84 1,238.69 1,122.29 940.21 841.71 358.18 322.35 271.60 244.75

85 1,286.43 1,161.09 978.99 877.51 373.10 331.30 277.58 250.73

86 1,325.24 1,196.90 1,005.88 907.36 385.05 340.26 283.58 256.70

87 1,364.04 1,232.71 1,032.74 931.26 394.00 346.23 289.53 262.65

88 1,399.86 1,268.54 1,062.59 958.11 402.95 352.20 295.50 268.64

89 1,432.70 1,295.39 1,086.46 978.99 411.89 361.15 301.45 274.60

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

2 Year Benefit Period - with Simple Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 16 of 42OCTOBER 2017

Page 21: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 104.48 92.53 77.61 71.63 74.63 68.65 62.68 56.71

51 110.43 98.50 83.58 77.61 80.58 74.63 65.68 59.70

52 119.40 107.45 89.55 83.58 83.58 80.58 71.63 62.68

53 128.35 116.41 95.53 89.55 92.53 86.56 74.63 65.68

54 137.30 125.38 107.45 95.53 98.50 89.55 80.58 68.65

55 146.25 137.30 119.40 104.48 104.48 92.53 83.58 74.63

56 161.18 146.25 128.35 116.41 110.43 98.50 86.56 80.58

57 173.10 161.18 137.30 125.38 113.41 101.48 92.53 83.58

58 188.05 173.10 152.23 137.30 119.40 107.45 98.50 86.56

59 205.95 188.05 167.15 149.25 125.38 113.41 101.48 89.55

60 223.88 205.95 179.09 161.18 131.33 119.40 107.45 95.53

61 241.75 223.88 194.03 176.10 137.30 125.38 113.41 98.50

62 262.65 238.79 208.94 188.05 140.28 131.33 119.40 104.48

63 286.55 259.68 223.88 202.95 149.25 137.30 125.38 110.43

64 310.41 277.58 241.75 217.89 158.20 146.25 131.33 116.41

65 340.26 304.45 262.65 235.80 167.15 152.23 137.30 122.38

66 373.10 334.30 289.53 259.68 179.09 164.18 143.26 125.38

67 411.89 373.10 319.38 283.58 185.08 173.10 149.25 131.33

68 456.68 408.91 352.20 313.43 194.03 182.05 155.23 137.30

69 498.45 447.70 385.05 349.23 202.95 191.03 161.18 146.25

70 549.18 492.50 420.85 382.04 214.93 199.98 170.13 152.23

71 599.94 543.23 459.66 417.88 226.85 208.94 179.09 158.20

72 656.65 596.95 507.40 456.68 238.79 217.89 188.05 167.15

73 719.33 656.65 555.18 498.45 250.73 229.83 199.98 176.10

74 782.03 716.35 605.91 540.24 265.65 244.75 211.90 188.05

75 850.68 776.04 656.65 588.00 280.56 259.68 223.88 199.98

76 919.30 835.74 707.39 635.76 295.50 274.60 235.80 211.90

77 993.93 904.38 764.10 686.50 310.41 289.53 247.73 223.88

78 1,074.51 973.04 820.83 740.23 328.33 304.45 259.68 235.80

79 1,152.14 1,047.65 880.53 790.98 346.23 319.38 271.60 247.73

80 1,241.68 1,125.25 940.21 850.68 361.15 334.30 283.58 259.68

81 1,328.24 1,202.86 1,005.88 910.36 382.04 352.20 295.50 271.60

82 1,423.74 1,292.41 1,074.51 967.06 402.95 370.11 307.43 283.58

83 1,504.33 1,361.05 1,128.24 1,014.81 420.85 385.05 319.38 295.50

84 1,564.03 1,417.79 1,173.01 1,056.61 435.78 396.98 331.30 304.45

85 1,614.75 1,465.51 1,211.83 1,089.45 447.70 408.91 343.26 310.41

86 1,659.54 1,507.33 1,247.63 1,125.25 456.68 417.88 352.20 316.40

87 1,701.31 1,543.13 1,280.46 1,155.10 468.60 426.83 358.18 322.35

88 1,740.13 1,578.95 1,307.33 1,175.99 477.55 432.80 364.15 328.33

89 1,772.94 1,602.83 1,331.20 1,196.90 483.54 438.75 370.11 334.30

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

3 Year Benefit Period - with Simple Inflation Rider

Home Health Care RiderBase Nursing Home Policy

PENNSYLVANIA Page 17 of 42OCTOBER 2017

Page 22: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 113.41 98.50 89.55 83.58 104.48 95.53 86.56 77.61

51 125.38 110.43 98.50 89.55 110.43 101.48 89.55 80.58

52 134.33 122.38 107.45 98.50 116.41 104.48 92.53 83.58

53 149.25 134.33 116.41 104.48 122.38 110.43 95.53 86.56

54 164.18 146.25 125.38 113.41 125.38 116.41 101.48 89.55

55 176.10 158.20 137.30 122.38 131.33 122.38 104.48 92.53

56 194.03 170.13 152.23 134.33 137.30 128.35 110.43 98.50

57 208.94 185.08 164.18 149.25 143.26 134.33 116.41 101.48

58 223.88 202.95 179.09 161.18 149.25 140.28 122.38 107.45

59 241.75 220.88 194.03 176.10 155.23 146.25 125.38 110.43

60 262.65 238.79 208.94 191.03 164.18 155.23 131.33 116.41

61 283.58 259.68 223.88 202.95 176.10 161.18 137.30 122.38

62 304.45 280.56 241.75 217.89 182.05 170.13 143.26 128.35

63 328.33 301.45 259.68 232.80 191.03 179.09 152.23 137.30

64 355.20 325.35 280.56 250.73 199.98 188.05 158.20 143.26

65 385.05 355.20 307.43 271.60 208.94 197.00 164.18 152.23

66 420.85 388.03 334.30 298.49 220.88 202.95 173.10 161.18

67 465.63 426.83 367.13 331.30 229.83 214.93 182.05 167.15

68 516.38 474.59 402.95 367.13 238.79 220.88 191.03 173.10

69 570.09 522.35 441.74 399.96 250.73 229.83 199.98 179.09

70 623.83 573.08 486.53 435.78 259.68 238.79 208.94 188.05

71 689.48 629.79 531.29 477.55 271.60 250.73 217.89 197.00

72 755.16 689.48 585.03 525.33 286.55 262.65 229.83 208.94

73 826.79 758.13 641.73 579.03 298.49 274.60 241.75 220.88

74 904.38 826.79 698.43 626.80 313.43 289.53 256.70 232.80

75 978.99 898.41 752.18 680.53 334.30 307.43 268.64 244.75

76 1,065.55 970.05 814.83 737.24 349.23 325.35 283.58 256.70

77 1,152.14 1,047.65 877.51 793.95 367.13 343.26 298.49 268.64

78 1,241.68 1,128.24 946.18 853.65 385.05 361.15 313.43 280.56

79 1,334.19 1,211.83 1,017.81 916.34 405.93 379.06 328.33 292.50

80 1,432.70 1,298.39 1,086.46 978.99 426.83 399.96 343.26 304.45

81 1,537.18 1,393.89 1,167.05 1,047.65 447.70 417.88 358.18 322.35

82 1,650.59 1,495.36 1,247.63 1,122.29 477.55 438.75 376.08 343.26

83 1,734.15 1,567.00 1,310.31 1,178.99 495.48 453.70 394.00 355.20

84 1,796.84 1,626.70 1,358.09 1,223.76 507.40 468.60 405.93 364.15

85 1,853.54 1,674.45 1,396.86 1,256.58 519.36 483.54 414.90 376.08

86 1,901.30 1,719.24 1,429.71 1,283.46 531.29 492.50 420.85 382.04

87 1,940.10 1,752.06 1,456.56 1,310.31 540.24 498.45 426.83 388.03

88 1,969.95 1,784.90 1,480.44 1,334.19 552.20 504.44 432.80 394.00

89 1,999.80 1,805.79 1,501.34 1,352.11 558.15 510.39 438.75 399.96

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

4 Year Benefit Period - with Simple Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 18 of 42OCTOBER 2017

Page 23: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 131.33 116.41 104.48 92.53 122.38 110.43 101.48 92.53

51 143.26 128.35 110.43 98.50 128.35 116.41 107.45 95.53

52 152.23 140.28 119.40 107.45 137.30 125.38 113.41 101.48

53 164.18 149.25 125.38 116.41 146.25 131.33 119.40 107.45

54 176.10 158.20 137.30 125.38 152.23 140.28 125.38 113.41

55 191.03 173.10 149.25 134.33 161.18 149.25 134.33 119.40

56 205.95 188.05 164.18 146.25 170.13 158.20 140.28 122.38

57 223.88 205.95 179.09 161.18 176.10 164.18 146.25 128.35

58 241.75 226.85 194.03 176.10 185.08 173.10 152.23 134.33

59 262.65 244.75 208.94 188.05 191.03 179.09 155.23 140.28

60 286.55 265.65 226.85 202.95 199.98 185.08 161.18 146.25

61 307.43 286.55 244.75 217.89 208.94 194.03 167.15 152.23

62 331.30 310.41 262.65 235.80 214.93 202.95 173.10 158.20

63 358.18 334.30 283.58 253.73 223.88 208.94 179.09 164.18

64 388.03 358.18 307.43 274.60 232.80 217.89 191.03 173.10

65 423.85 388.03 331.30 301.45 241.75 226.85 199.98 182.05

66 465.63 426.83 361.15 328.33 250.73 238.79 208.94 188.05

67 510.39 468.60 399.96 361.15 262.65 247.73 214.93 194.03

68 567.10 519.36 441.74 396.98 274.60 259.68 223.88 202.95

69 623.83 567.10 483.54 435.78 286.55 268.64 235.80 208.94

70 680.53 620.84 528.30 477.55 298.49 277.58 247.73 217.89

71 749.16 683.53 582.05 522.35 313.43 289.53 256.70 226.85

72 823.80 755.16 638.73 576.06 331.30 304.45 268.64 241.75

73 907.36 826.79 698.43 629.79 352.20 322.35 280.56 253.73

74 984.98 898.41 761.13 686.50 370.11 340.26 295.50 265.65

75 1,071.54 976.03 823.80 743.20 388.03 361.15 310.41 280.56

76 1,161.09 1,059.60 889.45 802.90 408.91 382.04 328.33 295.50

77 1,253.61 1,143.16 961.11 865.59 429.81 402.95 346.23 310.41

78 1,355.09 1,229.73 1,032.74 928.26 450.70 423.85 364.15 328.33

79 1,453.59 1,322.26 1,107.35 996.91 471.59 441.74 382.04 343.26

80 1,561.04 1,420.75 1,184.95 1,068.54 495.48 462.65 399.96 361.15

81 1,677.44 1,519.26 1,271.53 1,146.14 525.33 489.51 423.85 385.05

82 1,802.79 1,626.70 1,361.05 1,223.76 552.20 516.38 447.70 405.93

83 1,892.34 1,713.25 1,429.71 1,289.43 573.08 537.25 465.63 420.85

84 1,958.01 1,775.94 1,480.44 1,334.19 590.99 549.18 480.54 429.81

85 2,011.73 1,823.70 1,519.26 1,370.01 602.93 561.14 489.51 438.75

86 2,056.51 1,859.53 1,555.06 1,396.86 614.88 573.08 501.44 447.70

87 2,089.35 1,889.38 1,575.95 1,420.75 626.80 585.03 510.39 456.68

88 2,119.19 1,916.24 1,596.85 1,435.66 632.78 590.99 516.38 462.65

89 2,140.08 1,934.13 1,614.75 1,453.59 638.73 596.95 522.35 468.60

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

5 Year Benefit Period - with Simple Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 19 of 42OCTOBER 2017

Page 24: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 152.23 140.28 122.38 113.41 134.33 125.38 110.43 101.48

51 161.18 149.25 128.35 116.41 143.26 134.33 119.40 110.43

52 170.13 158.20 134.33 122.38 152.23 140.28 125.38 116.41

53 182.05 167.15 146.25 131.33 161.18 152.23 134.33 125.38

54 199.98 179.09 158.20 140.28 170.13 161.18 140.28 131.33

55 211.90 194.03 173.10 152.23 176.10 170.13 149.25 137.30

56 232.80 214.93 185.08 164.18 185.08 176.10 155.23 143.26

57 250.73 235.80 199.98 179.09 194.03 182.05 161.18 149.25

58 271.60 253.73 214.93 194.03 199.98 191.03 167.15 152.23

59 292.50 271.60 229.83 208.94 208.94 199.98 173.10 158.20

60 319.38 289.53 247.73 226.85 217.89 205.95 179.09 164.18

61 343.26 313.43 268.64 244.75 226.85 211.90 188.05 170.13

62 370.11 340.26 289.53 262.65 235.80 220.88 194.03 176.10

63 396.98 364.15 313.43 283.58 244.75 229.83 199.98 182.05

64 426.83 394.00 334.30 304.45 253.73 241.75 205.95 188.05

65 462.65 426.83 361.15 328.33 262.65 247.73 217.89 197.00

66 507.40 462.65 396.98 358.18 271.60 256.70 223.88 205.95

67 555.18 510.39 438.75 394.00 283.58 265.65 229.83 211.90

68 614.88 561.14 480.54 432.80 295.50 274.60 238.79 217.89

69 677.54 614.88 522.35 471.59 307.43 286.55 247.73 226.85

70 737.24 677.54 573.08 516.38 319.38 301.45 259.68 235.80

71 811.86 743.20 629.79 567.10 337.28 313.43 277.58 247.73

72 892.45 814.83 689.48 620.84 355.20 328.33 289.53 259.68

73 976.03 889.45 752.18 674.56 376.08 346.23 307.43 277.58

74 1,062.59 967.06 817.83 737.24 396.98 364.15 322.35 289.53

75 1,152.14 1,050.66 886.49 796.94 414.90 382.04 337.28 304.45

76 1,250.63 1,137.20 955.13 859.60 435.78 399.96 355.20 319.38

77 1,346.11 1,223.76 1,029.75 922.30 459.66 417.88 373.10 337.28

78 1,447.64 1,316.26 1,104.36 993.93 483.54 441.74 391.00 355.20

79 1,555.06 1,411.79 1,181.99 1,062.59 507.40 468.60 411.89 373.10

80 1,668.50 1,513.28 1,262.56 1,134.21 534.29 498.45 438.75 391.00

81 1,787.88 1,620.74 1,352.11 1,214.79 570.09 528.30 459.66 414.90

82 1,913.23 1,734.15 1,441.64 1,298.39 602.93 564.14 489.51 438.75

83 2,011.73 1,826.69 1,519.26 1,364.04 632.78 590.99 510.39 456.68

84 2,089.35 1,889.38 1,567.00 1,411.79 650.69 608.88 522.35 468.60

85 2,143.05 1,931.15 1,605.80 1,444.63 662.63 620.84 534.29 480.54

86 2,181.85 1,969.95 1,635.65 1,471.49 674.56 629.79 543.23 489.51

87 2,208.73 1,996.81 1,662.51 1,492.40 683.53 635.76 552.20 495.48

88 2,235.60 2,020.70 1,677.44 1,507.33 689.48 641.73 558.15 504.44

89 2,253.51 2,038.59 1,695.35 1,522.23 695.46 650.69 564.14 510.39

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

8 Year Benefit Period - with Simple Inflation Rider

Home Health Care RiderBase Nursing Home Policy

PENNSYLVANIA Page 20 of 42OCTOBER 2017

Page 25: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 164.18 155.23 134.33 116.41 146.25 134.33 122.38 107.45

51 179.09 164.18 143.26 125.38 152.23 143.26 128.35 113.41

52 191.03 173.10 149.25 134.33 161.18 152.23 140.28 122.38

53 202.95 188.05 158.20 143.26 173.10 161.18 146.25 131.33

54 223.88 202.95 170.13 152.23 182.05 170.13 155.23 140.28

55 241.75 217.89 188.05 164.18 191.03 179.09 164.18 149.25

56 259.68 235.80 205.95 182.05 199.98 188.05 170.13 155.23

57 280.56 256.70 220.88 197.00 208.94 197.00 176.10 164.18

58 301.45 277.58 238.79 214.93 217.89 205.95 182.05 170.13

59 322.35 298.49 253.73 229.83 223.88 214.93 188.05 173.10

60 346.23 322.35 271.60 247.73 232.80 223.88 194.03 179.09

61 376.08 343.26 292.50 265.65 241.75 229.83 199.98 185.08

62 405.93 370.11 313.43 283.58 250.73 238.79 205.95 191.03

63 435.78 396.98 337.28 304.45 262.65 247.73 211.90 197.00

64 465.63 426.83 367.13 328.33 271.60 256.70 217.89 202.95

65 501.44 459.66 396.98 352.20 277.58 265.65 229.83 208.94

66 549.18 501.44 429.81 385.05 286.55 274.60 235.80 214.93

67 602.93 549.18 471.59 423.85 298.49 283.58 241.75 220.88

68 662.63 605.91 516.38 465.63 307.43 292.50 253.73 229.83

69 725.31 665.61 564.14 507.40 319.38 301.45 262.65 238.79

70 793.95 728.28 614.88 555.18 337.28 310.41 277.58 250.73

71 871.56 793.95 677.54 605.91 358.18 325.35 292.50 265.65

72 955.13 871.56 740.23 665.61 379.06 343.26 310.41 277.58

73 1,044.66 952.15 805.89 725.31 399.96 367.13 322.35 295.50

74 1,137.20 1,035.70 874.53 787.98 420.85 385.05 337.28 310.41

75 1,232.71 1,122.29 943.19 850.68 444.74 405.93 355.20 322.35

76 1,331.20 1,211.83 1,020.81 916.34 468.60 426.83 376.08 340.26

77 1,432.70 1,307.33 1,095.40 984.98 492.50 450.70 396.98 355.20

78 1,543.13 1,399.86 1,173.01 1,056.61 516.38 480.54 417.88 373.10

79 1,653.58 1,501.34 1,253.61 1,128.24 543.23 510.39 441.74 396.98

80 1,769.98 1,605.80 1,337.18 1,202.86 576.06 543.23 468.60 423.85

81 1,898.31 1,719.24 1,429.71 1,286.43 611.88 576.06 495.48 447.70

82 2,029.65 1,838.63 1,522.23 1,373.00 650.69 608.88 525.33 474.59

83 2,131.13 1,931.15 1,596.85 1,435.66 677.54 632.78 552.20 495.48

84 2,208.73 1,993.81 1,647.61 1,483.44 698.43 650.69 573.08 507.40

85 2,265.45 2,038.59 1,686.40 1,516.25 713.35 668.58 585.03 519.36

86 2,307.23 2,074.43 1,716.25 1,546.10 722.33 677.54 593.98 531.29

87 2,334.09 2,104.28 1,740.13 1,564.03 731.28 689.48 599.94 537.25

88 2,355.00 2,125.18 1,758.05 1,578.95 737.24 695.46 605.91 543.23

89 2,375.88 2,146.05 1,778.93 1,593.88 746.19 704.40 611.88 549.18

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 1.01 to add the Prescription Drug Rider

Apply a factor of 1.10 to add the Modification of Benefit Qualification Rider

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Non-Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

Lifetime Benefit Period - with Simple Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 21 of 42OCTOBER 2017

Page 26: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 23.88 20.90 17.93 14.94

51 26.86 23.88 20.90 17.93

52 26.86 23.88 20.90 17.93

53 29.85 26.86 23.88 20.90

54 32.84 29.85 26.86 23.88

55 32.84 29.85 26.86 23.88

56 35.83 32.84 29.85 26.86

57 38.80 35.83 29.85 26.86

58 41.78 38.80 32.84 29.85

59 44.78 41.78 35.83 32.84

60 44.78 41.78 35.83 32.84

61 47.78 44.78 38.80 35.83

62 50.75 47.78 41.78 38.80

63 53.73 50.75 44.78 41.78

64 56.71 53.73 44.78 41.78

65 59.70 56.71 47.78 44.78

66 65.68 59.70 50.75 47.78

67 71.63 65.68 53.73 50.75

68 77.61 71.63 59.70 53.73

69 83.58 77.61 65.68 56.71

70 89.55 83.58 71.63 62.68

71 98.50 89.55 77.61 68.65

72 107.45 98.50 83.58 74.63

73 116.41 107.45 89.55 80.58

74 125.38 116.41 95.53 86.56

75 137.30 125.38 104.48 95.53

76 149.25 137.30 113.41 104.48

77 161.18 149.25 122.38 113.41

78 173.10 161.18 134.33 122.38

79 185.08 173.10 146.25 131.33

80 199.98 185.08 158.20 140.28

81 214.93 197.00 167.15 149.25

82 232.80 208.94 176.10 158.20

83 247.73 220.88 185.08 167.15

84 262.65 232.80 194.03 176.10

85 274.60 244.75 202.95 185.08

86 286.55 253.73 211.90 194.03

87 298.49 262.65 220.88 199.98

88 310.41 271.60 226.85 205.95

89 319.38 280.56 232.80 211.90

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

JACKSON NATIONAL LIFE INSURANCE COMPANY

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

1 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

AVAILABLE

NOT

PENNSYLVANIA Page 22 of 42OCTOBER 2017

Page 27: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 41.78 38.80 32.84 29.85 32.84 29.85 26.86 23.88

51 44.78 41.78 32.84 29.85 32.84 29.85 26.86 23.88

52 47.78 44.78 35.83 32.84 35.83 32.84 29.85 26.86

53 50.75 47.78 38.80 35.83 38.80 35.83 32.84 29.85

54 56.71 50.75 41.78 38.80 41.78 38.80 32.84 29.85

55 62.68 56.71 47.78 41.78 44.78 41.78 35.83 32.84

56 68.65 62.68 53.73 47.78 47.78 44.78 38.80 35.83

57 74.63 68.65 59.70 53.73 50.75 47.78 41.78 38.80

58 83.58 74.63 65.68 59.70 53.73 50.75 41.78 38.80

59 92.53 83.58 71.63 65.68 56.71 53.73 44.78 41.78

60 101.48 92.53 77.61 71.63 59.70 56.71 47.78 41.78

61 110.43 101.48 86.56 77.61 62.68 59.70 50.75 44.78

62 122.38 110.43 95.53 83.58 65.68 62.68 53.73 47.78

63 134.33 122.38 104.48 92.53 68.65 65.68 56.71 50.75

64 149.25 134.33 113.41 101.48 71.63 68.65 59.70 53.73

65 164.18 149.25 125.38 113.41 77.61 71.63 62.68 56.71

66 182.05 167.15 140.28 125.38 83.58 77.61 65.68 59.70

67 202.95 185.08 158.20 140.28 89.55 83.58 68.65 62.68

68 226.85 205.95 176.10 158.20 95.53 89.55 74.63 65.68

69 253.73 229.83 197.00 176.10 101.48 95.53 80.58 71.63

70 283.58 256.70 217.89 197.00 110.43 101.48 86.56 77.61

71 316.40 286.55 244.75 220.88 119.40 107.45 92.53 83.58

72 352.20 319.38 271.60 244.75 128.35 116.41 98.50 89.55

73 391.00 355.20 301.45 271.60 137.30 125.38 107.45 95.53

74 432.80 394.00 334.30 301.45 146.25 134.33 116.41 101.48

75 480.54 435.78 370.11 334.30 155.23 146.25 125.38 110.43

76 531.29 483.54 408.91 367.13 167.15 158.20 134.33 119.40

77 585.03 534.29 450.70 402.95 179.09 170.13 143.26 128.35

78 641.73 588.00 492.50 441.74 191.03 182.05 152.23 137.30

79 704.40 641.73 537.25 483.54 205.95 194.03 161.18 146.25

80 770.05 698.43 588.00 528.30 220.88 205.95 173.10 155.23

81 838.71 761.13 638.73 576.06 235.80 217.89 185.08 164.18

82 910.36 826.79 689.48 620.84 250.73 229.83 194.03 173.10

83 973.04 880.53 737.24 662.63 265.65 241.75 202.95 182.05

84 1,029.75 931.26 782.03 701.43 280.56 253.73 211.90 191.03

85 1,083.48 978.99 823.80 740.23 295.50 262.65 220.88 199.98

86 1,134.21 1,026.76 862.60 776.04 307.43 271.60 229.83 205.95

87 1,184.95 1,071.54 898.41 808.86 319.38 280.56 235.80 211.90

88 1,232.71 1,116.31 934.23 841.71 331.30 289.53 241.75 217.89

89 1,280.46 1,158.09 970.05 874.53 340.26 298.49 247.73 223.88

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

JACKSON NATIONAL LIFE INSURANCE COMPANY

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

2 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 23 of 42OCTOBER 2017

Page 28: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 53.73 47.78 38.80 35.83 44.78 41.78 38.80 35.83

51 56.71 50.75 41.78 38.80 47.78 44.78 38.80 35.83

52 59.70 53.73 44.78 41.78 50.75 47.78 41.78 35.83

53 65.68 59.70 50.75 44.78 53.73 50.75 44.78 38.80

54 71.63 65.68 56.71 50.75 56.71 53.73 47.78 41.78

55 77.61 71.63 62.68 56.71 62.68 56.71 50.75 44.78

56 86.56 77.61 68.65 62.68 65.68 59.70 53.73 47.78

57 95.53 86.56 74.63 68.65 68.65 62.68 56.71 50.75

58 104.48 95.53 83.58 74.63 71.63 65.68 59.70 53.73

59 113.41 104.48 92.53 80.58 77.61 71.63 62.68 56.71

60 125.38 113.41 101.48 89.55 80.58 74.63 65.68 59.70

61 137.30 125.38 110.43 98.50 83.58 77.61 68.65 62.68

62 152.23 137.30 119.40 107.45 86.56 80.58 71.63 65.68

63 167.15 152.23 131.33 119.40 92.53 86.56 74.63 68.65

64 185.08 167.15 143.26 131.33 98.50 92.53 77.61 71.63

65 205.95 185.08 158.20 143.26 104.48 98.50 83.58 74.63

66 229.83 205.95 176.10 158.20 110.43 104.48 89.55 77.61

67 256.70 229.83 197.00 176.10 116.41 110.43 95.53 83.58

68 286.55 256.70 220.88 197.00 125.38 116.41 101.48 89.55

69 319.38 286.55 244.75 220.88 134.33 122.38 107.45 95.53

70 355.20 319.38 271.60 247.73 143.26 131.33 113.41 101.48

71 394.00 358.18 304.45 274.60 152.23 140.28 119.40 107.45

72 438.75 399.96 340.26 304.45 161.18 149.25 128.35 113.41

73 489.51 444.74 379.06 337.28 170.13 158.20 137.30 122.38

74 543.23 495.48 420.85 376.08 182.05 170.13 146.25 131.33

75 602.93 549.18 465.63 417.88 194.03 182.05 155.23 140.28

76 665.61 605.91 513.38 462.65 205.95 194.03 164.18 149.25

77 734.25 668.58 564.14 510.39 220.88 205.95 176.10 158.20

78 808.86 734.25 617.85 558.15 235.80 220.88 188.05 167.15

79 886.49 805.89 677.54 608.88 253.73 235.80 199.98 179.09

80 970.05 880.53 740.23 665.61 271.60 250.73 211.90 191.03

81 1,059.60 961.11 802.90 725.31 289.53 265.65 223.88 202.95

82 1,152.14 1,044.66 868.56 782.03 307.43 283.58 235.80 214.93

83 1,232.71 1,116.31 925.28 832.75 325.35 298.49 247.73 226.85

84 1,301.35 1,178.99 976.03 877.51 340.26 310.41 259.68 235.80

85 1,364.04 1,235.69 1,023.78 919.30 355.20 322.35 271.60 244.75

86 1,420.75 1,289.43 1,068.54 961.11 367.13 334.30 280.56 253.73

87 1,477.48 1,340.16 1,113.31 999.90 379.06 346.23 289.53 262.65

88 1,531.19 1,387.94 1,152.14 1,035.70 391.00 355.20 298.49 268.64

89 1,581.91 1,432.70 1,187.94 1,068.54 399.96 364.15 304.45 274.60

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

3 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 24 of 42OCTOBER 2017

Page 29: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 56.71 50.75 44.78 41.78 62.68 56.71 50.75 44.78

51 62.68 56.71 47.78 44.78 62.68 59.70 53.73 47.78

52 68.65 62.68 53.73 47.78 65.68 62.68 53.73 50.75

53 77.61 71.63 59.70 53.73 71.63 65.68 56.71 50.75

54 86.56 77.61 65.68 59.70 74.63 71.63 59.70 53.73

55 95.53 83.58 74.63 65.68 77.61 74.63 62.68 56.71

56 104.48 92.53 83.58 71.63 80.58 77.61 65.68 59.70

57 113.41 101.48 92.53 80.58 86.56 83.58 71.63 62.68

58 122.38 110.43 101.48 89.55 89.55 86.56 74.63 65.68

59 134.33 122.38 110.43 98.50 95.53 92.53 77.61 68.65

60 146.25 134.33 119.40 107.45 101.48 95.53 80.58 74.63

61 161.18 146.25 128.35 116.41 107.45 101.48 86.56 77.61

62 176.10 161.18 140.28 125.38 113.41 104.48 89.55 80.58

63 194.03 179.09 152.23 137.30 119.40 110.43 95.53 86.56

64 211.90 197.00 167.15 149.25 125.38 116.41 101.48 89.55

65 232.80 214.93 185.08 164.18 131.33 122.38 104.48 95.53

66 259.68 238.79 205.95 182.05 137.30 128.35 110.43 101.48

67 289.53 265.65 226.85 205.95 146.25 137.30 116.41 107.45

68 325.35 298.49 253.73 229.83 155.23 143.26 125.38 113.41

69 364.15 334.30 283.58 256.70 164.18 152.23 131.33 119.40

70 405.93 373.10 316.40 283.58 173.10 158.20 137.30 125.38

71 453.70 414.90 352.20 316.40 182.05 167.15 146.25 131.33

72 507.40 462.65 391.00 352.20 194.03 179.09 155.23 140.28

73 564.14 516.38 435.78 394.00 205.95 188.05 164.18 149.25

74 626.80 573.08 483.54 435.78 217.89 199.98 176.10 158.20

75 695.46 635.76 534.29 483.54 229.83 214.93 185.08 167.15

76 770.05 701.43 590.99 534.29 244.75 226.85 197.00 179.09

77 850.68 773.05 650.69 588.00 262.65 244.75 211.90 191.03

78 934.23 850.68 713.35 644.71 280.56 259.68 226.85 202.95

79 1,026.76 934.23 782.03 704.40 298.49 277.58 241.75 214.93

80 1,122.29 1,020.81 853.65 767.09 319.38 295.50 256.70 229.83

81 1,226.75 1,113.31 928.26 835.74 340.26 316.40 271.60 244.75

82 1,334.19 1,208.84 1,008.84 907.36 364.15 337.28 289.53 262.65

83 1,423.74 1,286.43 1,074.51 967.06 382.04 352.20 304.45 274.60

84 1,498.36 1,355.09 1,131.24 1,017.81 396.98 367.13 316.40 283.58

85 1,564.03 1,414.78 1,178.99 1,059.60 411.89 382.04 328.33 295.50

86 1,626.70 1,471.49 1,223.76 1,098.39 426.83 394.00 337.28 304.45

87 1,683.43 1,522.23 1,265.54 1,137.20 438.75 405.93 349.23 313.43

88 1,734.15 1,569.99 1,304.34 1,173.01 450.70 414.90 355.20 322.35

89 1,784.90 1,611.76 1,340.16 1,205.84 459.66 423.85 364.15 328.33

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

4 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 25 of 42OCTOBER 2017

Page 30: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 65.68 59.70 53.73 47.78 71.63 65.68 59.70 53.73

51 71.63 65.68 56.71 50.75 74.63 68.65 62.68 56.71

52 77.61 71.63 59.70 53.73 80.58 74.63 65.68 59.70

53 83.58 77.61 65.68 59.70 86.56 80.58 71.63 62.68

54 92.53 83.58 71.63 65.68 89.55 83.58 74.63 65.68

55 101.48 92.53 80.58 71.63 95.53 89.55 80.58 71.63

56 110.43 101.48 89.55 77.61 101.48 95.53 83.58 74.63

57 122.38 113.41 98.50 86.56 104.48 98.50 86.56 77.61

58 134.33 125.38 107.45 95.53 110.43 104.48 92.53 80.58

59 146.25 137.30 116.41 104.48 116.41 110.43 95.53 83.58

60 161.18 149.25 125.38 113.41 122.38 113.41 98.50 86.56

61 176.10 164.18 137.30 125.38 128.35 119.40 104.48 92.53

62 194.03 179.09 152.23 137.30 134.33 125.38 107.45 95.53

63 211.90 197.00 167.15 149.25 140.28 131.33 113.41 101.48

64 232.80 214.93 185.08 164.18 146.25 137.30 119.40 107.45

65 256.70 235.80 202.95 182.05 152.23 143.26 125.38 113.41

66 286.55 262.65 223.88 202.95 161.18 149.25 131.33 119.40

67 319.38 292.50 250.73 223.88 170.13 158.20 137.30 125.38

68 358.18 328.33 280.56 250.73 179.09 167.15 146.25 131.33

69 399.96 364.15 310.41 280.56 188.05 176.10 155.23 137.30

70 444.74 405.93 346.23 310.41 199.98 185.08 164.18 146.25

71 495.48 453.70 385.05 346.23 211.90 194.03 173.10 155.23

72 555.18 507.40 429.81 388.03 223.88 205.95 182.05 164.18

73 617.85 564.14 477.55 429.81 238.79 220.88 191.03 173.10

74 686.50 626.80 528.30 477.55 253.73 235.80 202.95 182.05

75 761.13 692.48 585.03 528.30 268.64 250.73 214.93 194.03

76 841.71 767.09 644.71 582.05 286.55 265.65 229.83 205.95

77 928.26 844.68 710.38 638.73 304.45 283.58 244.75 220.88

78 1,020.81 928.26 779.01 701.43 325.35 304.45 262.65 235.80

79 1,119.30 1,017.81 853.65 767.09 346.23 325.35 280.56 253.73

80 1,226.75 1,113.31 931.26 838.71 370.11 346.23 301.45 271.60

81 1,337.18 1,211.83 1,014.81 913.34 396.98 370.11 322.35 292.50

82 1,456.56 1,316.26 1,101.39 990.96 423.85 394.00 343.26 310.41

83 1,552.08 1,405.81 1,173.01 1,056.61 444.74 414.90 361.15 325.35

84 1,629.69 1,477.48 1,232.71 1,110.33 462.65 429.81 376.08 337.28

85 1,698.35 1,537.18 1,283.46 1,155.10 477.55 444.74 388.03 349.23

86 1,761.01 1,590.89 1,328.24 1,196.90 492.50 459.66 399.96 361.15

87 1,814.73 1,641.61 1,370.01 1,232.71 507.40 471.59 411.89 370.11

88 1,865.49 1,686.40 1,405.81 1,265.54 519.36 483.54 420.85 379.06

89 1,910.25 1,728.20 1,441.64 1,295.39 528.30 492.50 429.81 385.05

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

5 Year Benefit Period - without Inflation Rider

Home Health Care RiderBase Nursing Home Policy

PENNSYLVANIA Page 26 of 42OCTOBER 2017

Page 31: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 74.63 71.63 62.68 56.71 77.61 74.63 65.68 59.70

51 80.58 74.63 65.68 59.70 83.58 80.58 71.63 65.68

52 86.56 80.58 68.65 62.68 89.55 83.58 74.63 68.65

53 95.53 86.56 74.63 68.65 95.53 89.55 80.58 74.63

54 104.48 95.53 83.58 74.63 101.48 95.53 83.58 77.61

55 113.41 104.48 92.53 80.58 107.45 101.48 89.55 80.58

56 125.38 116.41 101.48 89.55 113.41 104.48 92.53 83.58

57 137.30 128.35 110.43 98.50 119.40 110.43 98.50 89.55

58 149.25 140.28 119.40 107.45 125.38 116.41 101.48 92.53

59 164.18 152.23 128.35 116.41 131.33 122.38 107.45 98.50

60 179.09 164.18 140.28 128.35 134.33 125.38 110.43 101.48

61 197.00 179.09 152.23 140.28 140.28 131.33 116.41 104.48

62 214.93 197.00 167.15 152.23 146.25 137.30 119.40 107.45

63 235.80 217.89 185.08 167.15 152.23 143.26 125.38 113.41

64 256.70 238.79 202.95 182.05 158.20 149.25 128.35 116.41

65 283.58 259.68 220.88 199.98 164.18 155.23 134.33 122.38

66 313.43 286.55 244.75 220.88 170.13 161.18 140.28 128.35

67 349.23 319.38 274.60 244.75 179.09 167.15 146.25 134.33

68 391.00 358.18 304.45 274.60 191.03 176.10 155.23 140.28

69 435.78 396.98 337.28 304.45 202.95 188.05 164.18 149.25

70 483.54 441.74 376.08 337.28 214.93 199.98 173.10 158.20

71 537.25 492.50 417.88 376.08 226.85 211.90 185.08 167.15

72 599.94 549.18 465.63 417.88 241.75 223.88 197.00 176.10

73 668.58 608.88 516.38 462.65 256.70 235.80 208.94 188.05

74 740.23 674.56 570.09 513.38 271.60 250.73 220.88 199.98

75 817.83 746.19 629.79 567.10 286.55 265.65 232.80 211.90

76 904.38 823.80 692.48 623.83 304.45 280.56 247.73 223.88

77 993.93 904.38 761.13 683.53 325.35 298.49 265.65 238.79

78 1,092.44 993.93 832.75 749.16 349.23 319.38 283.58 256.70

79 1,196.90 1,086.46 910.36 817.83 373.10 343.26 304.45 274.60

80 1,307.33 1,187.94 990.96 892.45 399.96 370.11 325.35 292.50

81 1,426.71 1,292.41 1,077.50 970.05 429.81 399.96 349.23 313.43

82 1,549.11 1,402.85 1,167.05 1,050.66 462.65 432.80 376.08 337.28

83 1,653.58 1,498.36 1,244.64 1,119.30 489.51 459.66 396.98 355.20

84 1,737.14 1,572.98 1,304.34 1,173.01 510.39 477.55 408.91 367.13

85 1,808.78 1,632.66 1,355.09 1,217.79 525.33 489.51 420.85 379.06

86 1,868.48 1,686.40 1,399.86 1,259.58 540.24 501.44 432.80 391.00

87 1,919.23 1,734.15 1,441.64 1,295.39 552.20 513.38 444.74 402.95

88 1,966.96 1,778.93 1,477.48 1,328.24 564.14 525.33 456.68 411.89

89 2,011.73 1,820.71 1,510.29 1,358.09 573.08 534.29 465.63 420.85

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

8 Year Benefit Period - without Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 27 of 42OCTOBER 2017

Page 32: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Day 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 83.58 77.61 68.65 59.70 83.58 77.61 71.63 62.68

51 89.55 83.58 71.63 62.68 89.55 83.58 74.63 65.68

52 98.50 89.55 77.61 68.65 95.53 89.55 80.58 71.63

53 107.45 98.50 83.58 74.63 101.48 95.53 86.56 77.61

54 116.41 107.45 92.53 80.58 107.45 101.48 92.53 83.58

55 128.35 116.41 101.48 89.55 113.41 107.45 98.50 89.55

56 140.28 128.35 110.43 98.50 119.40 113.41 101.48 92.53

57 152.23 140.28 119.40 107.45 125.38 119.40 107.45 98.50

58 167.15 152.23 131.33 116.41 131.33 125.38 110.43 101.48

59 182.05 167.15 143.26 128.35 137.30 131.33 116.41 104.48

60 197.00 182.05 155.23 140.28 143.26 137.30 119.40 107.45

61 214.93 197.00 167.15 152.23 149.25 143.26 125.38 113.41

62 235.80 214.93 182.05 164.18 155.23 149.25 128.35 116.41

63 256.70 235.80 199.98 179.09 161.18 155.23 134.33 122.38

64 280.56 256.70 220.88 197.00 167.15 161.18 137.30 125.38

65 307.43 280.56 241.75 214.93 173.10 167.15 143.26 128.35

66 340.26 310.41 265.65 238.79 179.09 173.10 149.25 134.33

67 379.06 346.23 295.50 265.65 188.05 179.09 155.23 140.28

68 420.85 385.05 328.33 295.50 199.98 185.08 164.18 149.25

69 468.60 429.81 364.15 328.33 211.90 194.03 173.10 158.20

70 519.36 477.55 402.95 364.15 226.85 205.95 185.08 167.15

71 579.03 528.30 447.70 402.95 241.75 220.88 197.00 176.10

72 644.71 588.00 498.45 447.70 256.70 235.80 208.94 188.05

73 716.35 653.68 552.20 495.48 274.60 250.73 220.88 199.98

74 790.98 722.33 608.88 549.18 289.53 265.65 232.80 211.90

75 874.53 796.94 671.58 602.93 307.43 280.56 247.73 223.88

76 964.08 877.51 737.24 662.63 325.35 301.45 265.65 238.79

77 1,059.60 964.08 808.86 728.28 346.23 322.35 283.58 253.73

78 1,164.06 1,056.61 883.50 796.94 373.10 349.23 304.45 271.60

79 1,274.49 1,155.10 964.08 871.56 399.96 376.08 325.35 292.50

80 1,387.94 1,259.58 1,050.66 946.18 429.81 405.93 349.23 316.40

81 1,513.28 1,370.01 1,140.18 1,026.76 462.65 435.78 376.08 340.26

82 1,641.61 1,486.41 1,232.71 1,110.33 498.45 465.63 405.93 364.15

83 1,749.09 1,584.91 1,310.31 1,178.99 525.33 489.51 426.83 382.04

84 1,838.63 1,659.54 1,373.00 1,232.71 546.21 510.39 447.70 396.98

85 1,913.23 1,722.21 1,423.74 1,280.46 564.14 528.30 462.65 411.89

86 1,975.93 1,775.94 1,468.51 1,322.26 579.03 543.23 474.59 423.85

87 2,026.66 1,826.69 1,510.29 1,358.09 593.98 558.15 486.53 435.78

88 2,071.43 1,871.45 1,546.10 1,390.90 605.91 570.09 495.48 444.74

89 2,113.20 1,910.25 1,578.95 1,420.75 617.85 582.05 504.44 453.70

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

JACKSON NATIONAL LIFE INSURANCE COMPANY

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Lifetime Benefit Period - without Inflation Rider

Preferred Risk Rate Class

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 28 of 42OCTOBER 2017

Page 33: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 53.73 47.78 38.80 32.84

51 56.71 50.75 41.78 35.83

52 59.70 53.73 44.78 38.80

53 62.68 56.71 47.78 41.78

54 65.68 59.70 50.75 44.78

55 68.65 62.68 53.73 47.78

56 71.63 65.68 56.71 50.75

57 74.63 68.65 59.70 53.73

58 77.61 71.63 62.68 56.71

59 80.58 74.63 65.68 59.70

60 83.58 77.61 68.65 65.68

61 89.55 83.58 71.63 68.65

62 95.53 89.55 77.61 71.63

63 101.48 92.53 80.58 74.63

64 107.45 98.50 83.58 77.61

65 113.41 104.48 86.56 80.58

66 119.40 107.45 89.55 86.56

67 125.38 113.41 95.53 89.55

68 131.33 122.38 101.48 92.53

69 137.30 131.33 110.43 95.53

70 149.25 140.28 119.40 101.48

71 161.18 149.25 128.35 110.43

72 173.10 158.20 137.30 119.40

73 185.08 170.13 146.25 128.35

74 197.00 182.05 155.23 137.30

75 208.94 194.03 164.18 146.25

76 220.88 205.95 173.10 158.20

77 235.80 217.89 182.05 170.13

78 250.73 232.80 194.03 182.05

79 265.65 247.73 205.95 191.03

80 283.58 262.65 217.89 199.98

81 301.45 277.58 229.83 208.94

82 322.35 289.53 244.75 217.89

83 337.28 301.45 253.73 226.85

84 349.23 313.43 262.65 235.80

85 361.15 325.35 271.60 244.75

86 373.10 334.30 280.56 253.73

87 385.05 340.26 286.55 259.68

88 394.00 346.23 292.50 265.65

89 402.95 352.20 298.49 271.60

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

Tax Qualified Long Term Care Policy and Riders

JACKSON NATIONAL LIFE INSURANCE COMPANY

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

1 Year Benefit Period - with Compound Inflation Rider

Base Nursing Home Policy Home Health Care Rider

AVAILABLE

NOT

PENNSYLVANIA Page 29 of 42OCTOBER 2017

Page 34: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Day 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 122.38 110.43 95.53 86.56 68.65 62.68 56.71 50.75

51 125.38 113.41 98.50 89.55 71.63 65.68 59.70 53.73

52 131.33 119.40 101.48 92.53 74.63 68.65 62.68 56.71

53 140.28 128.35 104.48 95.53 77.61 71.63 65.68 59.70

54 149.25 137.30 110.43 101.48 83.58 77.61 68.65 62.68

55 161.18 146.25 122.38 110.43 89.55 83.58 71.63 65.68

56 173.10 155.23 134.33 119.40 95.53 89.55 74.63 68.65

57 185.08 167.15 146.25 128.35 98.50 92.53 77.61 71.63

58 199.98 179.09 158.20 137.30 104.48 98.50 80.58 74.63

59 214.93 194.03 170.13 146.25 107.45 101.48 86.56 77.61

60 229.83 208.94 182.05 158.20 113.41 107.45 89.55 80.58

61 244.75 223.88 194.03 170.13 116.41 113.41 95.53 83.58

62 262.65 238.79 205.95 182.05 122.38 116.41 101.48 89.55

63 280.56 253.73 217.89 194.03 128.35 122.38 104.48 92.53

64 301.45 271.60 232.80 205.95 134.33 125.38 110.43 98.50

65 322.35 292.50 250.73 220.88 140.28 131.33 113.41 104.48

66 349.23 319.38 271.60 238.79 146.25 137.30 116.41 107.45

67 379.06 346.23 295.50 262.65 155.23 143.26 122.38 110.43

68 411.89 373.10 319.38 286.55 164.18 152.23 128.35 113.41

69 447.70 405.93 346.23 313.43 173.10 161.18 134.33 119.40

70 486.53 441.74 376.08 340.26 182.05 170.13 143.26 125.38

71 531.29 480.54 408.91 370.11 194.03 179.09 152.23 134.33

72 576.06 522.35 444.74 399.96 205.95 188.05 161.18 143.26

73 623.83 567.10 480.54 432.80 217.89 199.98 170.13 152.23

74 671.58 611.88 519.36 468.60 229.83 211.90 179.09 161.18

75 725.31 659.63 558.15 504.44 241.75 223.88 188.05 170.13

76 785.01 713.35 602.93 543.23 253.73 235.80 197.00 179.09

77 844.68 767.09 647.69 582.05 265.65 247.73 208.94 191.03

78 904.38 823.80 692.48 620.84 280.56 262.65 220.88 202.95

79 967.06 880.53 740.23 662.63 295.50 277.58 232.80 211.90

80 1,032.74 940.21 787.98 707.39 313.43 292.50 244.75 220.88

81 1,104.36 1,002.89 841.71 758.13 331.30 307.43 256.70 229.83

82 1,178.99 1,071.54 892.45 802.90 346.23 319.38 268.64 238.79

83 1,238.69 1,122.29 940.21 844.68 361.15 331.30 277.58 247.73

84 1,289.43 1,167.05 978.99 877.51 376.08 340.26 286.55 256.70

85 1,334.19 1,205.84 1,014.81 910.36 391.00 349.23 292.50 262.65

86 1,373.00 1,241.68 1,044.66 940.21 402.95 358.18 298.49 268.64

87 1,408.81 1,274.49 1,068.54 964.08 411.89 364.15 304.45 274.60

88 1,441.64 1,304.34 1,092.44 984.98 420.85 370.11 310.41 280.56

89 1,471.49 1,331.20 1,116.31 1,005.88 429.81 376.08 316.40 286.55

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Tax Qualified Long Term Care Policy and Riders

Preferred Risk Rate Class

2 Year Benefit Period - with Compound Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 30 of 42OCTOBER 2017

Page 35: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 155.23 137.30 113.41 104.48 92.53 86.56 77.61 68.65

51 161.18 143.26 119.40 110.43 98.50 92.53 80.58 71.63

52 170.13 152.23 128.35 116.41 104.48 98.50 86.56 74.63

53 179.09 161.18 137.30 125.38 110.43 104.48 92.53 77.61

54 188.05 173.10 149.25 134.33 116.41 107.45 95.53 83.58

55 199.98 185.08 161.18 143.26 122.38 113.41 101.48 89.55

56 214.93 197.00 173.10 155.23 128.35 116.41 104.48 95.53

57 229.83 211.90 185.08 167.15 134.33 122.38 110.43 98.50

58 247.73 226.85 199.98 179.09 140.28 128.35 116.41 104.48

59 265.65 241.75 214.93 191.03 146.25 134.33 119.40 107.45

60 283.58 259.68 229.83 202.95 152.23 140.28 125.38 113.41

61 304.45 277.58 244.75 217.89 158.20 146.25 131.33 116.41

62 325.35 295.50 259.68 232.80 164.18 152.23 137.30 122.38

63 349.23 316.40 274.60 247.73 173.10 158.20 143.26 128.35

64 373.10 337.28 289.53 265.65 182.05 167.15 149.25 131.33

65 402.95 364.15 310.41 283.58 191.03 176.10 155.23 137.30

66 438.75 394.00 337.28 304.45 199.98 185.08 161.18 143.26

67 477.55 429.81 367.13 328.33 208.94 194.03 167.15 149.25

68 519.36 465.63 399.96 358.18 217.89 202.95 173.10 155.23

69 564.14 507.40 432.80 391.00 226.85 211.90 179.09 161.18

70 611.88 549.18 471.59 426.83 235.80 220.88 185.08 167.15

71 662.63 599.94 510.39 462.65 247.73 229.83 194.03 173.10

72 719.33 653.68 555.18 498.45 259.68 238.79 205.95 182.05

73 779.01 710.38 602.93 537.25 271.60 250.73 217.89 191.03

74 841.71 770.05 653.68 582.05 286.55 265.65 229.83 202.95

75 910.36 829.75 704.40 629.79 301.45 280.56 241.75 214.93

76 982.00 895.44 758.13 680.53 316.40 295.50 253.73 226.85

77 1,059.60 964.08 814.83 731.28 331.30 310.41 265.65 238.79

78 1,140.18 1,032.74 871.56 785.01 349.23 325.35 277.58 250.73

79 1,220.78 1,107.35 931.26 838.71 367.13 340.26 289.53 262.65

80 1,307.33 1,184.95 990.96 895.44 385.05 355.20 301.45 274.60

81 1,396.86 1,265.54 1,056.61 955.13 405.93 373.10 313.43 286.55

82 1,492.40 1,352.11 1,125.25 1,011.84 426.83 391.00 325.35 298.49

83 1,569.99 1,420.75 1,178.99 1,059.60 444.74 405.93 337.28 310.41

84 1,629.69 1,477.48 1,220.78 1,098.39 459.66 417.88 349.23 319.38

85 1,677.44 1,522.23 1,259.58 1,131.24 471.59 429.81 361.15 325.35

86 1,719.24 1,561.04 1,292.41 1,164.06 480.54 438.75 370.11 331.30

87 1,758.05 1,593.88 1,322.26 1,190.93 489.51 447.70 376.08 337.28

88 1,790.86 1,623.73 1,349.13 1,211.83 498.45 453.70 382.04 343.26

89 1,820.71 1,647.61 1,367.01 1,229.73 504.44 459.66 388.03 349.23

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

3 Year Benefit Period - with Compound Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 31 of 42OCTOBER 2017

Page 36: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 164.18 146.25 131.33 119.40 128.35 119.40 107.45 95.53

51 179.09 158.20 140.28 128.35 134.33 125.38 110.43 98.50

52 194.03 173.10 149.25 137.30 140.28 128.35 113.41 101.48

53 208.94 188.05 161.18 146.25 146.25 134.33 116.41 104.48

54 223.88 202.95 173.10 158.20 149.25 140.28 119.40 107.45

55 238.79 217.89 188.05 170.13 155.23 146.25 125.38 113.41

56 256.70 232.80 202.95 182.05 161.18 152.23 131.33 116.41

57 274.60 247.73 217.89 197.00 167.15 158.20 137.30 122.38

58 292.50 265.65 232.80 211.90 173.10 164.18 143.26 125.38

59 313.43 283.58 247.73 226.85 182.05 170.13 149.25 131.33

60 334.30 304.45 265.65 241.75 191.03 179.09 155.23 137.30

61 355.20 325.35 283.58 256.70 202.95 188.05 161.18 143.26

62 379.06 346.23 301.45 271.60 211.90 197.00 167.15 149.25

63 402.95 370.11 319.38 286.55 220.88 205.95 176.10 158.20

64 429.81 394.00 340.26 304.45 229.83 214.93 182.05 164.18

65 459.66 423.85 364.15 325.35 238.79 223.88 188.05 173.10

66 495.48 456.68 394.00 352.20 247.73 229.83 194.03 182.05

67 540.24 495.48 423.85 385.05 256.70 238.79 202.95 188.05

68 590.99 543.23 459.66 417.88 265.65 244.75 211.90 194.03

69 644.71 590.99 501.44 453.70 274.60 253.73 220.88 199.98

70 701.43 641.73 543.23 489.51 283.58 262.65 229.83 205.95

71 764.10 695.46 590.99 531.29 295.50 271.60 238.79 214.93

72 829.75 758.13 641.73 576.06 310.41 283.58 250.73 226.85

73 898.41 823.80 695.46 626.80 325.35 298.49 262.65 238.79

74 973.04 889.45 749.16 677.54 340.26 313.43 277.58 250.73

75 1,050.66 961.11 805.89 731.28 358.18 331.30 289.53 262.65

76 1,137.20 1,035.70 871.56 787.98 376.08 349.23 304.45 274.60

77 1,226.75 1,113.31 937.21 847.66 394.00 367.13 319.38 286.55

78 1,316.26 1,196.90 1,005.88 907.36 411.89 385.05 334.30 298.49

79 1,411.79 1,280.46 1,074.51 967.06 432.80 402.95 349.23 310.41

80 1,510.29 1,370.01 1,146.14 1,029.75 453.70 423.85 364.15 325.35

81 1,614.75 1,465.51 1,223.76 1,101.39 477.55 444.74 382.04 343.26

82 1,728.20 1,567.00 1,307.33 1,175.99 504.44 465.63 399.96 364.15

83 1,811.75 1,638.65 1,367.01 1,232.71 522.35 480.54 414.90 376.08

84 1,874.43 1,695.35 1,414.78 1,274.49 534.29 495.48 426.83 385.05

85 1,925.19 1,740.13 1,450.60 1,304.34 546.21 507.40 435.78 394.00

86 1,969.95 1,781.90 1,480.44 1,328.24 558.15 516.38 441.74 399.96

87 2,002.78 1,811.75 1,504.33 1,352.11 567.10 522.35 447.70 405.93

88 2,029.65 1,835.64 1,525.21 1,373.00 576.06 528.30 453.70 411.89

89 2,053.51 1,853.54 1,540.14 1,387.94 582.05 534.29 459.66 417.88

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

4 Year Benefit Period - with Compound Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 32 of 42OCTOBER 2017

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Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 191.03 173.10 152.23 137.30 149.25 137.30 125.38 113.41

51 202.95 185.08 161.18 143.26 158.20 143.26 131.33 116.41

52 214.93 197.00 170.13 152.23 167.15 152.23 137.30 122.38

53 229.83 208.94 179.09 161.18 176.10 158.20 143.26 128.35

54 244.75 223.88 191.03 173.10 182.05 167.15 149.25 134.33

55 259.68 238.79 205.95 185.08 191.03 176.10 158.20 140.28

56 277.58 256.70 220.88 197.00 199.98 185.08 164.18 146.25

57 298.49 277.58 238.79 211.90 205.95 194.03 170.13 152.23

58 319.38 298.49 256.70 229.83 214.93 202.95 176.10 158.20

59 343.26 319.38 274.60 244.75 223.88 208.94 182.05 164.18

60 367.13 340.26 292.50 259.68 232.80 214.93 188.05 170.13

61 391.00 361.15 310.41 277.58 241.75 223.88 194.03 176.10

62 414.90 385.05 328.33 295.50 250.73 232.80 199.98 182.05

63 441.74 408.91 349.23 313.43 259.68 241.75 208.94 188.05

64 471.59 435.78 373.10 334.30 268.64 250.73 217.89 197.00

65 507.40 465.63 396.98 358.18 277.58 259.68 226.85 205.95

66 549.18 501.44 426.83 388.03 286.55 268.64 232.80 211.90

67 596.95 546.21 465.63 420.85 295.50 277.58 241.75 217.89

68 650.69 593.98 507.40 456.68 304.45 286.55 250.73 223.88

69 707.39 644.71 549.18 495.48 316.40 295.50 259.68 229.83

70 767.09 698.43 596.95 537.25 328.33 304.45 268.64 238.79

71 832.75 761.13 647.69 582.05 343.26 316.40 280.56 250.73

72 907.36 829.75 704.40 632.78 361.15 331.30 292.50 262.65

73 984.98 898.41 761.13 686.50 379.06 349.23 304.45 274.60

74 1,065.55 970.05 820.83 740.23 396.98 367.13 319.38 286.55

75 1,149.15 1,047.65 883.50 796.94 417.88 388.03 334.30 301.45

76 1,241.68 1,131.24 952.15 859.60 438.75 408.91 352.20 316.40

77 1,337.18 1,217.79 1,023.78 922.30 459.66 429.81 370.11 331.30

78 1,435.66 1,307.33 1,095.40 987.96 480.54 450.70 388.03 349.23

79 1,537.18 1,399.86 1,170.03 1,053.63 501.44 471.59 405.93 367.13

80 1,644.60 1,495.36 1,250.63 1,125.25 525.33 492.50 426.83 385.05

81 1,761.01 1,596.85 1,337.18 1,202.86 555.18 519.36 450.70 408.91

82 1,886.39 1,704.30 1,426.71 1,283.46 585.03 546.21 474.59 429.81

83 1,975.93 1,790.86 1,492.40 1,346.11 605.91 567.10 492.50 444.74

84 2,041.58 1,850.56 1,543.13 1,390.90 623.83 579.03 507.40 453.70

85 2,089.35 1,892.34 1,578.95 1,420.75 635.76 590.99 516.38 462.65

86 2,131.13 1,925.19 1,608.80 1,447.64 647.69 602.93 525.33 471.59

87 2,157.99 1,952.04 1,629.69 1,465.51 656.65 611.88 534.29 477.55

88 2,181.85 1,972.93 1,644.60 1,480.44 662.63 617.85 540.24 483.54

89 2,196.80 1,987.86 1,659.54 1,495.36 668.58 623.83 546.21 489.51

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

5 Year Benefit Period - with Compound Inflation Rider

Preferred Risk Rate Class

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 33 of 42OCTOBER 2017

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Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 220.88 208.94 179.09 164.18 164.18 155.23 137.30 125.38

51 229.83 214.93 185.08 170.13 173.10 164.18 146.25 134.33

52 241.75 223.88 194.03 176.10 182.05 173.10 152.23 140.28

53 256.70 235.80 205.95 185.08 191.03 182.05 161.18 149.25

54 274.60 250.73 220.88 197.00 199.98 191.03 167.15 155.23

55 292.50 268.64 235.80 208.94 208.94 199.98 176.10 161.18

56 313.43 289.53 250.73 223.88 217.89 205.95 182.05 167.15

57 334.30 310.41 265.65 238.79 226.85 214.93 191.03 173.10

58 358.18 331.30 283.58 253.73 235.80 223.88 197.00 179.09

59 382.04 352.20 301.45 271.60 244.75 232.80 202.95 185.08

60 408.91 373.10 319.38 292.50 253.73 238.79 208.94 191.03

61 435.78 396.98 340.26 310.41 262.65 247.73 217.89 197.00

62 462.65 423.85 361.15 328.33 271.60 256.70 223.88 202.95

63 489.51 450.70 385.05 349.23 280.56 265.65 229.83 208.94

64 519.36 480.54 408.91 370.11 289.53 274.60 235.80 214.93

65 555.18 513.38 435.78 394.00 298.49 280.56 244.75 223.88

66 599.94 549.18 468.60 423.85 307.43 289.53 250.73 229.83

67 650.69 593.98 510.39 459.66 316.40 298.49 256.70 235.80

68 710.38 644.71 552.20 498.45 328.33 307.43 265.65 241.75

69 770.05 701.43 596.95 537.25 340.26 316.40 274.60 250.73

70 832.75 761.13 647.69 582.05 352.20 328.33 286.55 259.68

71 901.41 826.79 701.43 629.79 367.13 343.26 301.45 271.60

72 982.00 898.41 761.13 683.53 385.05 358.18 316.40 283.58

73 1,065.55 970.05 820.83 737.24 405.93 376.08 331.30 298.49

74 1,149.15 1,047.65 883.50 796.94 426.83 394.00 349.23 313.43

75 1,238.69 1,128.24 952.15 856.64 447.70 411.89 364.15 328.33

76 1,334.19 1,214.79 1,020.81 919.30 468.60 429.81 382.04 343.26

77 1,432.70 1,304.34 1,095.40 984.98 492.50 447.70 399.96 361.15

78 1,537.18 1,396.86 1,173.01 1,053.63 516.38 471.59 417.88 379.06

79 1,644.60 1,492.40 1,250.63 1,122.29 540.24 498.45 438.75 396.98

80 1,758.05 1,593.88 1,331.20 1,196.90 567.10 528.30 462.65 414.90

81 1,880.40 1,701.31 1,420.75 1,277.48 602.93 561.14 489.51 438.75

82 2,005.78 1,817.73 1,510.29 1,361.05 638.73 596.95 519.36 465.63

83 2,104.28 1,907.26 1,584.91 1,426.71 668.58 623.83 540.24 483.54

84 2,175.90 1,969.95 1,632.66 1,468.51 686.50 641.73 552.20 495.48

85 2,226.65 2,008.74 1,668.50 1,498.36 698.43 650.69 561.14 504.44

86 2,262.45 2,041.58 1,695.35 1,525.21 707.39 659.63 570.09 513.38

87 2,283.36 2,062.48 1,716.25 1,540.14 713.35 665.61 576.06 519.36

88 2,301.25 2,080.38 1,728.20 1,552.08 719.33 671.58 582.05 525.33

89 2,316.20 2,095.33 1,740.13 1,564.03 725.31 677.54 588.00 531.29

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

8 Year Benefit Period - with Compund Inflation Rider

Preferred Risk Rate Class

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 34 of 42OCTOBER 2017

Page 39: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 241.75 226.85 197.00 173.10 179.09 167.15 149.25 131.33

51 256.70 238.79 205.95 179.09 188.05 176.10 158.20 137.30

52 271.60 250.73 214.93 188.05 197.00 185.08 167.15 146.25

53 289.53 265.65 226.85 199.98 205.95 194.03 176.10 155.23

54 310.41 283.58 241.75 211.90 214.93 202.95 185.08 164.18

55 331.30 301.45 259.68 229.83 226.85 211.90 194.03 173.10

56 352.20 322.35 277.58 247.73 235.80 220.88 199.98 182.05

57 376.08 343.26 295.50 265.65 244.75 229.83 205.95 191.03

58 399.96 364.15 313.43 283.58 253.73 238.79 211.90 197.00

59 423.85 388.03 331.30 301.45 262.65 247.73 217.89 202.95

60 447.70 411.89 349.23 319.38 271.60 256.70 223.88 208.94

61 477.55 435.78 370.11 337.28 280.56 265.65 232.80 214.93

62 507.40 462.65 391.00 355.20 289.53 274.60 238.79 220.88

63 537.25 489.51 417.88 376.08 298.49 283.58 244.75 226.85

64 567.10 519.36 444.74 399.96 307.43 292.50 250.73 232.80

65 602.93 552.20 474.59 423.85 316.40 301.45 259.68 238.79

66 650.69 593.98 510.39 456.68 325.35 310.41 265.65 244.75

67 704.40 644.71 552.20 495.48 334.30 319.38 271.60 250.73

68 764.10 698.43 596.95 537.25 343.26 328.33 280.56 256.70

69 826.79 758.13 644.71 579.03 355.20 337.28 289.53 265.65

70 895.44 820.83 695.46 626.80 373.10 346.23 304.45 274.60

71 973.04 886.49 752.18 677.54 391.00 358.18 319.38 286.55

72 1,053.63 961.11 814.83 731.28 411.89 376.08 337.28 301.45

73 1,140.18 1,041.69 880.53 790.98 432.80 396.98 352.20 319.38

74 1,226.75 1,122.29 946.18 850.68 456.68 417.88 367.13 334.30

75 1,322.26 1,205.84 1,014.81 913.34 480.54 438.75 385.05 349.23

76 1,423.74 1,295.39 1,089.45 978.99 504.44 459.66 405.93 367.13

77 1,528.21 1,390.90 1,167.05 1,050.66 528.30 483.54 426.83 382.04

78 1,638.65 1,486.41 1,244.64 1,122.29 552.20 513.38 447.70 399.96

79 1,749.09 1,587.91 1,325.24 1,193.91 579.03 543.23 471.59 423.85

80 1,865.49 1,692.36 1,408.81 1,268.54 608.88 576.06 498.45 450.70

81 1,993.81 1,805.79 1,501.34 1,352.11 647.69 611.88 528.30 477.55

82 2,125.18 1,925.19 1,596.85 1,438.66 689.48 644.71 558.15 504.44

83 2,226.65 2,017.71 1,668.50 1,501.34 716.35 668.58 582.05 522.35

84 2,301.25 2,077.40 1,719.24 1,543.13 734.25 686.50 602.93 534.29

85 2,355.00 2,119.19 1,752.06 1,575.95 749.16 701.43 614.88 546.21

86 2,390.80 2,149.03 1,775.94 1,599.84 758.13 713.35 623.83 555.18

87 2,411.69 2,172.90 1,796.84 1,614.75 767.09 722.33 629.79 561.14

88 2,426.63 2,187.84 1,811.75 1,626.70 773.05 728.28 635.76 567.10

89 2,441.54 2,202.75 1,826.69 1,638.65 779.01 734.25 641.73 573.08

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

Lifetime Benefit Period - with Compund Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 35 of 42OCTOBER 2017

Page 40: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 41.78 38.80 32.84 26.86

51 44.78 41.78 35.83 29.85

52 47.78 44.78 38.80 32.84

53 50.75 47.78 41.78 35.83

54 53.73 50.75 44.78 38.80

55 56.71 53.73 47.78 41.78

56 59.70 56.71 50.75 44.78

57 62.68 59.70 53.73 47.78

58 65.68 62.68 56.71 50.75

59 68.65 65.68 59.70 53.73

60 71.63 68.65 62.68 56.71

61 77.61 71.63 65.68 59.70

62 83.58 77.61 68.65 62.68

63 89.55 80.58 71.63 65.68

64 95.53 86.56 74.63 68.65

65 101.48 89.55 77.61 71.63

66 107.45 95.53 80.58 74.63

67 113.41 101.48 83.58 77.61

68 119.40 110.43 89.55 83.58

69 125.38 119.40 98.50 86.56

70 134.33 128.35 107.45 92.53

71 146.25 137.30 116.41 101.48

72 158.20 146.25 125.38 110.43

73 170.13 158.20 134.33 119.40

74 182.05 167.15 143.26 125.38

75 194.03 179.09 152.23 134.33

76 205.95 191.03 161.18 146.25

77 220.88 202.95 170.13 158.20

78 235.80 217.89 182.05 170.13

79 250.73 232.80 194.03 179.09

80 268.64 247.73 205.95 188.05

81 283.58 262.65 217.89 197.00

82 304.45 274.60 232.80 205.95

83 319.38 286.55 241.75 214.93

84 331.30 298.49 250.73 223.88

85 343.26 310.41 259.68 232.80

86 355.20 319.38 268.64 241.75

87 367.13 325.35 274.60 247.73

88 376.08 331.30 280.56 253.73

89 385.05 337.28 286.55 259.68

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

1 Year Benefit Period - with Simple Inflation Rider

AVAILABLE

NOT

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 36 of 42OCTOBER 2017

Page 41: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 83.58 74.63 62.68 56.71 56.71 50.75 44.78 38.80

51 89.55 77.61 65.68 59.70 59.70 53.73 47.78 41.78

52 95.53 83.58 68.65 62.68 62.68 56.71 50.75 44.78

53 101.48 89.55 74.63 68.65 65.68 59.70 53.73 47.78

54 107.45 98.50 80.58 74.63 68.65 62.68 56.71 50.75

55 116.41 107.45 89.55 80.58 74.63 68.65 59.70 53.73

56 128.35 116.41 98.50 86.56 77.61 74.63 62.68 56.71

57 140.28 125.38 107.45 95.53 83.58 77.61 65.68 59.70

58 152.23 137.30 119.40 107.45 86.56 83.58 68.65 62.68

59 167.15 149.25 131.33 116.41 89.55 86.56 74.63 65.68

60 179.09 164.18 140.28 128.35 95.53 89.55 77.61 68.65

61 197.00 179.09 152.23 137.30 98.50 95.53 83.58 71.63

62 214.93 194.03 167.15 146.25 104.48 98.50 86.56 77.61

63 229.83 208.94 176.10 158.20 110.43 104.48 89.55 80.58

64 250.73 226.85 194.03 170.13 116.41 107.45 95.53 86.56

65 271.60 247.73 211.90 185.08 122.38 116.41 98.50 89.55

66 298.49 274.60 232.80 205.95 128.35 122.38 104.48 95.53

67 328.33 298.49 256.70 226.85 140.28 128.35 110.43 98.50

68 361.15 328.33 280.56 250.73 146.25 137.30 113.41 101.48

69 396.98 361.15 310.41 280.56 155.23 146.25 119.40 107.45

70 438.75 396.98 337.28 304.45 164.18 155.23 128.35 113.41

71 480.54 435.78 370.11 334.30 176.10 164.18 137.30 122.38

72 528.30 477.55 405.93 364.15 188.05 173.10 146.25 131.33

73 576.06 525.33 444.74 399.96 199.98 185.08 158.20 140.28

74 623.83 567.10 480.54 435.78 211.90 197.00 164.18 149.25

75 674.56 614.88 519.36 471.59 223.88 208.94 173.10 158.20

76 734.25 668.58 564.14 510.39 235.80 217.89 182.05 167.15

77 790.98 722.33 608.88 546.21 247.73 229.83 194.03 179.09

78 850.68 779.01 653.68 585.03 262.65 244.75 205.95 191.03

79 916.34 832.75 701.43 626.80 277.58 259.68 217.89 199.98

80 978.99 892.45 746.19 671.58 295.50 274.60 229.83 208.94

81 1,050.66 955.13 799.90 722.33 313.43 289.53 241.75 217.89

82 1,125.25 1,023.78 850.68 767.09 328.33 301.45 253.73 226.85

83 1,187.94 1,074.51 901.41 808.86 343.26 313.43 262.65 235.80

84 1,238.69 1,122.29 940.21 841.71 358.18 322.35 271.60 244.75

85 1,286.43 1,161.09 978.99 877.51 373.10 331.30 277.58 250.73

86 1,325.24 1,196.90 1,005.88 907.36 385.05 340.26 283.58 256.70

87 1,364.04 1,232.71 1,032.74 931.26 394.00 346.23 289.53 262.65

88 1,399.86 1,268.54 1,062.59 958.11 402.95 352.20 295.50 268.64

89 1,432.70 1,295.39 1,086.46 978.99 411.89 361.15 301.45 274.60

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

2 Year Benefit Period - with Simple Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 37 of 42OCTOBER 2017

Page 42: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 104.48 92.53 77.61 71.63 74.63 68.65 62.68 56.71

51 110.43 98.50 83.58 77.61 80.58 74.63 65.68 59.70

52 119.40 107.45 89.55 83.58 83.58 80.58 71.63 62.68

53 128.35 116.41 95.53 89.55 92.53 86.56 74.63 65.68

54 137.30 125.38 107.45 95.53 98.50 89.55 80.58 68.65

55 146.25 137.30 119.40 104.48 104.48 92.53 83.58 74.63

56 161.18 146.25 128.35 116.41 110.43 98.50 86.56 80.58

57 173.10 161.18 137.30 125.38 113.41 101.48 92.53 83.58

58 188.05 173.10 152.23 137.30 119.40 107.45 98.50 86.56

59 205.95 188.05 167.15 149.25 125.38 113.41 101.48 89.55

60 223.88 205.95 179.09 161.18 131.33 119.40 107.45 95.53

61 241.75 223.88 194.03 176.10 137.30 125.38 113.41 98.50

62 262.65 238.79 208.94 188.05 140.28 131.33 119.40 104.48

63 286.55 259.68 223.88 202.95 149.25 137.30 125.38 110.43

64 310.41 277.58 241.75 217.89 158.20 146.25 131.33 116.41

65 340.26 304.45 262.65 235.80 167.15 152.23 137.30 122.38

66 373.10 334.30 289.53 259.68 179.09 164.18 143.26 125.38

67 411.89 373.10 319.38 283.58 185.08 173.10 149.25 131.33

68 456.68 408.91 352.20 313.43 194.03 182.05 155.23 137.30

69 498.45 447.70 385.05 349.23 202.95 191.03 161.18 146.25

70 549.18 492.50 420.85 382.04 214.93 199.98 170.13 152.23

71 599.94 543.23 459.66 417.88 226.85 208.94 179.09 158.20

72 656.65 596.95 507.40 456.68 238.79 217.89 188.05 167.15

73 719.33 656.65 555.18 498.45 250.73 229.83 199.98 176.10

74 782.03 716.35 605.91 540.24 265.65 244.75 211.90 188.05

75 850.68 776.04 656.65 588.00 280.56 259.68 223.88 199.98

76 919.30 835.74 707.39 635.76 295.50 274.60 235.80 211.90

77 993.93 904.38 764.10 686.50 310.41 289.53 247.73 223.88

78 1,074.51 973.04 820.83 740.23 328.33 304.45 259.68 235.80

79 1,152.14 1,047.65 880.53 790.98 346.23 319.38 271.60 247.73

80 1,241.68 1,125.25 940.21 850.68 361.15 334.30 283.58 259.68

81 1,328.24 1,202.86 1,005.88 910.36 382.04 352.20 295.50 271.60

82 1,423.74 1,292.41 1,074.51 967.06 402.95 370.11 307.43 283.58

83 1,504.33 1,361.05 1,128.24 1,014.81 420.85 385.05 319.38 295.50

84 1,564.03 1,417.79 1,173.01 1,056.61 435.78 396.98 331.30 304.45

85 1,614.75 1,465.51 1,211.83 1,089.45 447.70 408.91 343.26 310.41

86 1,659.54 1,507.33 1,247.63 1,125.25 456.68 417.88 352.20 316.40

87 1,701.31 1,543.13 1,280.46 1,155.10 468.60 426.83 358.18 322.35

88 1,740.13 1,578.95 1,307.33 1,175.99 477.55 432.80 364.15 328.33

89 1,772.94 1,602.83 1,331.20 1,196.90 483.54 438.75 370.11 334.30

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

3 Year Benefit Period - with Simple Inflation Rider

Home Health Care RiderBase Nursing Home Policy

PENNSYLVANIA Page 38 of 42OCTOBER 2017

Page 43: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 113.41 98.50 89.55 83.58 104.48 95.53 86.56 77.61

51 125.38 110.43 98.50 89.55 110.43 101.48 89.55 80.58

52 134.33 122.38 107.45 98.50 116.41 104.48 92.53 83.58

53 149.25 134.33 116.41 104.48 122.38 110.43 95.53 86.56

54 164.18 146.25 125.38 113.41 125.38 116.41 101.48 89.55

55 176.10 158.20 137.30 122.38 131.33 122.38 104.48 92.53

56 194.03 170.13 152.23 134.33 137.30 128.35 110.43 98.50

57 208.94 185.08 164.18 149.25 143.26 134.33 116.41 101.48

58 223.88 202.95 179.09 161.18 149.25 140.28 122.38 107.45

59 241.75 220.88 194.03 176.10 155.23 146.25 125.38 110.43

60 262.65 238.79 208.94 191.03 164.18 155.23 131.33 116.41

61 283.58 259.68 223.88 202.95 176.10 161.18 137.30 122.38

62 304.45 280.56 241.75 217.89 182.05 170.13 143.26 128.35

63 328.33 301.45 259.68 232.80 191.03 179.09 152.23 137.30

64 355.20 325.35 280.56 250.73 199.98 188.05 158.20 143.26

65 385.05 355.20 307.43 271.60 208.94 197.00 164.18 152.23

66 420.85 388.03 334.30 298.49 220.88 202.95 173.10 161.18

67 465.63 426.83 367.13 331.30 229.83 214.93 182.05 167.15

68 516.38 474.59 402.95 367.13 238.79 220.88 191.03 173.10

69 570.09 522.35 441.74 399.96 250.73 229.83 199.98 179.09

70 623.83 573.08 486.53 435.78 259.68 238.79 208.94 188.05

71 689.48 629.79 531.29 477.55 271.60 250.73 217.89 197.00

72 755.16 689.48 585.03 525.33 286.55 262.65 229.83 208.94

73 826.79 758.13 641.73 579.03 298.49 274.60 241.75 220.88

74 904.38 826.79 698.43 626.80 313.43 289.53 256.70 232.80

75 978.99 898.41 752.18 680.53 334.30 307.43 268.64 244.75

76 1,065.55 970.05 814.83 737.24 349.23 325.35 283.58 256.70

77 1,152.14 1,047.65 877.51 793.95 367.13 343.26 298.49 268.64

78 1,241.68 1,128.24 946.18 853.65 385.05 361.15 313.43 280.56

79 1,334.19 1,211.83 1,017.81 916.34 405.93 379.06 328.33 292.50

80 1,432.70 1,298.39 1,086.46 978.99 426.83 399.96 343.26 304.45

81 1,537.18 1,393.89 1,167.05 1,047.65 447.70 417.88 358.18 322.35

82 1,650.59 1,495.36 1,247.63 1,122.29 477.55 438.75 376.08 343.26

83 1,734.15 1,567.00 1,310.31 1,178.99 495.48 453.70 394.00 355.20

84 1,796.84 1,626.70 1,358.09 1,223.76 507.40 468.60 405.93 364.15

85 1,853.54 1,674.45 1,396.86 1,256.58 519.36 483.54 414.90 376.08

86 1,901.30 1,719.24 1,429.71 1,283.46 531.29 492.50 420.85 382.04

87 1,940.10 1,752.06 1,456.56 1,310.31 540.24 498.45 426.83 388.03

88 1,969.95 1,784.90 1,480.44 1,334.19 552.20 504.44 432.80 394.00

89 1,999.80 1,805.79 1,501.34 1,352.11 558.15 510.39 438.75 399.96

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

4 Year Benefit Period - with Simple Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 39 of 42OCTOBER 2017

Page 44: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 131.33 116.41 104.48 92.53 122.38 110.43 101.48 92.53

51 143.26 128.35 110.43 98.50 128.35 116.41 107.45 95.53

52 152.23 140.28 119.40 107.45 137.30 125.38 113.41 101.48

53 164.18 149.25 125.38 116.41 146.25 131.33 119.40 107.45

54 176.10 158.20 137.30 125.38 152.23 140.28 125.38 113.41

55 191.03 173.10 149.25 134.33 161.18 149.25 134.33 119.40

56 205.95 188.05 164.18 146.25 170.13 158.20 140.28 122.38

57 223.88 205.95 179.09 161.18 176.10 164.18 146.25 128.35

58 241.75 226.85 194.03 176.10 185.08 173.10 152.23 134.33

59 262.65 244.75 208.94 188.05 191.03 179.09 155.23 140.28

60 286.55 265.65 226.85 202.95 199.98 185.08 161.18 146.25

61 307.43 286.55 244.75 217.89 208.94 194.03 167.15 152.23

62 331.30 310.41 262.65 235.80 214.93 202.95 173.10 158.20

63 358.18 334.30 283.58 253.73 223.88 208.94 179.09 164.18

64 388.03 358.18 307.43 274.60 232.80 217.89 191.03 173.10

65 423.85 388.03 331.30 301.45 241.75 226.85 199.98 182.05

66 465.63 426.83 361.15 328.33 250.73 238.79 208.94 188.05

67 510.39 468.60 399.96 361.15 262.65 247.73 214.93 194.03

68 567.10 519.36 441.74 396.98 274.60 259.68 223.88 202.95

69 623.83 567.10 483.54 435.78 286.55 268.64 235.80 208.94

70 680.53 620.84 528.30 477.55 298.49 277.58 247.73 217.89

71 749.16 683.53 582.05 522.35 313.43 289.53 256.70 226.85

72 823.80 755.16 638.73 576.06 331.30 304.45 268.64 241.75

73 907.36 826.79 698.43 629.79 352.20 322.35 280.56 253.73

74 984.98 898.41 761.13 686.50 370.11 340.26 295.50 265.65

75 1,071.54 976.03 823.80 743.20 388.03 361.15 310.41 280.56

76 1,161.09 1,059.60 889.45 802.90 408.91 382.04 328.33 295.50

77 1,253.61 1,143.16 961.11 865.59 429.81 402.95 346.23 310.41

78 1,355.09 1,229.73 1,032.74 928.26 450.70 423.85 364.15 328.33

79 1,453.59 1,322.26 1,107.35 996.91 471.59 441.74 382.04 343.26

80 1,561.04 1,420.75 1,184.95 1,068.54 495.48 462.65 399.96 361.15

81 1,677.44 1,519.26 1,271.53 1,146.14 525.33 489.51 423.85 385.05

82 1,802.79 1,626.70 1,361.05 1,223.76 552.20 516.38 447.70 405.93

83 1,892.34 1,713.25 1,429.71 1,289.43 573.08 537.25 465.63 420.85

84 1,958.01 1,775.94 1,480.44 1,334.19 590.99 549.18 480.54 429.81

85 2,011.73 1,823.70 1,519.26 1,370.01 602.93 561.14 489.51 438.75

86 2,056.51 1,859.53 1,555.06 1,396.86 614.88 573.08 501.44 447.70

87 2,089.35 1,889.38 1,575.95 1,420.75 626.80 585.03 510.39 456.68

88 2,119.19 1,916.24 1,596.85 1,435.66 632.78 590.99 516.38 462.65

89 2,140.08 1,934.13 1,614.75 1,453.59 638.73 596.95 522.35 468.60

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

5 Year Benefit Period - with Simple Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 40 of 42OCTOBER 2017

Page 45: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 152.23 140.28 122.38 113.41 134.33 125.38 110.43 101.48

51 161.18 149.25 128.35 116.41 143.26 134.33 119.40 110.43

52 170.13 158.20 134.33 122.38 152.23 140.28 125.38 116.41

53 182.05 167.15 146.25 131.33 161.18 152.23 134.33 125.38

54 199.98 179.09 158.20 140.28 170.13 161.18 140.28 131.33

55 211.90 194.03 173.10 152.23 176.10 170.13 149.25 137.30

56 232.80 214.93 185.08 164.18 185.08 176.10 155.23 143.26

57 250.73 235.80 199.98 179.09 194.03 182.05 161.18 149.25

58 271.60 253.73 214.93 194.03 199.98 191.03 167.15 152.23

59 292.50 271.60 229.83 208.94 208.94 199.98 173.10 158.20

60 319.38 289.53 247.73 226.85 217.89 205.95 179.09 164.18

61 343.26 313.43 268.64 244.75 226.85 211.90 188.05 170.13

62 370.11 340.26 289.53 262.65 235.80 220.88 194.03 176.10

63 396.98 364.15 313.43 283.58 244.75 229.83 199.98 182.05

64 426.83 394.00 334.30 304.45 253.73 241.75 205.95 188.05

65 462.65 426.83 361.15 328.33 262.65 247.73 217.89 197.00

66 507.40 462.65 396.98 358.18 271.60 256.70 223.88 205.95

67 555.18 510.39 438.75 394.00 283.58 265.65 229.83 211.90

68 614.88 561.14 480.54 432.80 295.50 274.60 238.79 217.89

69 677.54 614.88 522.35 471.59 307.43 286.55 247.73 226.85

70 737.24 677.54 573.08 516.38 319.38 301.45 259.68 235.80

71 811.86 743.20 629.79 567.10 337.28 313.43 277.58 247.73

72 892.45 814.83 689.48 620.84 355.20 328.33 289.53 259.68

73 976.03 889.45 752.18 674.56 376.08 346.23 307.43 277.58

74 1,062.59 967.06 817.83 737.24 396.98 364.15 322.35 289.53

75 1,152.14 1,050.66 886.49 796.94 414.90 382.04 337.28 304.45

76 1,250.63 1,137.20 955.13 859.60 435.78 399.96 355.20 319.38

77 1,346.11 1,223.76 1,029.75 922.30 459.66 417.88 373.10 337.28

78 1,447.64 1,316.26 1,104.36 993.93 483.54 441.74 391.00 355.20

79 1,555.06 1,411.79 1,181.99 1,062.59 507.40 468.60 411.89 373.10

80 1,668.50 1,513.28 1,262.56 1,134.21 534.29 498.45 438.75 391.00

81 1,787.88 1,620.74 1,352.11 1,214.79 570.09 528.30 459.66 414.90

82 1,913.23 1,734.15 1,441.64 1,298.39 602.93 564.14 489.51 438.75

83 2,011.73 1,826.69 1,519.26 1,364.04 632.78 590.99 510.39 456.68

84 2,089.35 1,889.38 1,567.00 1,411.79 650.69 608.88 522.35 468.60

85 2,143.05 1,931.15 1,605.80 1,444.63 662.63 620.84 534.29 480.54

86 2,181.85 1,969.95 1,635.65 1,471.49 674.56 629.79 543.23 489.51

87 2,208.73 1,996.81 1,662.51 1,492.40 683.53 635.76 552.20 495.48

88 2,235.60 2,020.70 1,677.44 1,507.33 689.48 641.73 558.15 504.44

89 2,253.51 2,038.59 1,695.35 1,522.23 695.46 650.69 564.14 510.39

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

8 Year Benefit Period - with Simple Inflation Rider

Home Health Care RiderBase Nursing Home Policy

PENNSYLVANIA Page 41 of 42OCTOBER 2017

Page 46: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

0 Day 20 Day 90 Day 180 Day 0 Visit 10 Visit 45 Visit 90 Visit

Issue Elimination Elimination Elimination Elimination Elimination Elimination Elimination Elimination

Age Period Period Period Period Period Period Period Period

50- 164.18 155.23 134.33 116.41 146.25 134.33 122.38 107.45

51 179.09 164.18 143.26 125.38 152.23 143.26 128.35 113.41

52 191.03 173.10 149.25 134.33 161.18 152.23 140.28 122.38

53 202.95 188.05 158.20 143.26 173.10 161.18 146.25 131.33

54 223.88 202.95 170.13 152.23 182.05 170.13 155.23 140.28

55 241.75 217.89 188.05 164.18 191.03 179.09 164.18 149.25

56 259.68 235.80 205.95 182.05 199.98 188.05 170.13 155.23

57 280.56 256.70 220.88 197.00 208.94 197.00 176.10 164.18

58 301.45 277.58 238.79 214.93 217.89 205.95 182.05 170.13

59 322.35 298.49 253.73 229.83 223.88 214.93 188.05 173.10

60 346.23 322.35 271.60 247.73 232.80 223.88 194.03 179.09

61 376.08 343.26 292.50 265.65 241.75 229.83 199.98 185.08

62 405.93 370.11 313.43 283.58 250.73 238.79 205.95 191.03

63 435.78 396.98 337.28 304.45 262.65 247.73 211.90 197.00

64 465.63 426.83 367.13 328.33 271.60 256.70 217.89 202.95

65 501.44 459.66 396.98 352.20 277.58 265.65 229.83 208.94

66 549.18 501.44 429.81 385.05 286.55 274.60 235.80 214.93

67 602.93 549.18 471.59 423.85 298.49 283.58 241.75 220.88

68 662.63 605.91 516.38 465.63 307.43 292.50 253.73 229.83

69 725.31 665.61 564.14 507.40 319.38 301.45 262.65 238.79

70 793.95 728.28 614.88 555.18 337.28 310.41 277.58 250.73

71 871.56 793.95 677.54 605.91 358.18 325.35 292.50 265.65

72 955.13 871.56 740.23 665.61 379.06 343.26 310.41 277.58

73 1,044.66 952.15 805.89 725.31 399.96 367.13 322.35 295.50

74 1,137.20 1,035.70 874.53 787.98 420.85 385.05 337.28 310.41

75 1,232.71 1,122.29 943.19 850.68 444.74 405.93 355.20 322.35

76 1,331.20 1,211.83 1,020.81 916.34 468.60 426.83 376.08 340.26

77 1,432.70 1,307.33 1,095.40 984.98 492.50 450.70 396.98 355.20

78 1,543.13 1,399.86 1,173.01 1,056.61 516.38 480.54 417.88 373.10

79 1,653.58 1,501.34 1,253.61 1,128.24 543.23 510.39 441.74 396.98

80 1,769.98 1,605.80 1,337.18 1,202.86 576.06 543.23 468.60 423.85

81 1,898.31 1,719.24 1,429.71 1,286.43 611.88 576.06 495.48 447.70

82 2,029.65 1,838.63 1,522.23 1,373.00 650.69 608.88 525.33 474.59

83 2,131.13 1,931.15 1,596.85 1,435.66 677.54 632.78 552.20 495.48

84 2,208.73 1,993.81 1,647.61 1,483.44 698.43 650.69 573.08 507.40

85 2,265.45 2,038.59 1,686.40 1,516.25 713.35 668.58 585.03 519.36

86 2,307.23 2,074.43 1,716.25 1,546.10 722.33 677.54 593.98 531.29

87 2,334.09 2,104.28 1,740.13 1,564.03 731.28 689.48 599.94 537.25

88 2,355.00 2,125.18 1,758.05 1,578.95 737.24 695.46 605.91 543.23

89 2,375.88 2,146.05 1,778.93 1,593.88 746.19 704.40 611.88 549.18

Notes:

Apply a factor of 1.00 for Preferred and 1.25 for Standard.

Apply a factor of 0.80 for married insureds or if two people residing together are both issued policies.

Apply a factor of 1.25 to add the Spousal Enrichment Benefit Rider.

Apply a factor of 1.20 to add the Non-Forfeiture Rider.

Apply a factor of 0.90 for Association Groups.

Modal Factors --- Annual: 1.0000, Semi-Annual: 0.5250, Quarterly: 0.2650, Monthly: 0.0875

ACTUARIAL JUSTIFICATION OF PREMIUM RATES

JACKSON NATIONAL LIFE INSURANCE COMPANY

Tax Qualified Long Term Care Policy and Riders

Exhibit E - Gross Annual Premiums per $10 Daily Benefit

Preferred Risk Rate Class

Lifetime Benefit Period - with Simple Inflation Rider

Base Nursing Home Policy Home Health Care Rider

PENNSYLVANIA Page 42 of 42OCTOBER 2017

Page 47: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

Supporting Document Schedules Satisfied - Item: Transmittal Letter (A&H)Comments:Attachment(s): PA cover letter.pdfItem Status:Status Date:

Bypassed - Item: Actuarial Certification (A&H)Bypass Reason: Filing LTC rate increase only.Attachment(s):Item Status:Status Date:

Satisfied - Item: Actuarial Memorandum and Explanatory Information (A&H)Comments:Attachment(s): PA Actuarial Justification.pdfItem Status:Status Date:

Bypassed - Item: Advertisements (A&H)Bypass Reason: Filing LTC rate increase only.Attachment(s):Item Status:Status Date:

Satisfied - Item: Authorization to File (A&H)Comments:Attachment(s): Third Party Authorization Letter.pdfItem Status:Status Date:

Bypassed - Item: Insert Page Explanation (A&H)Bypass Reason: Filing LTC rate increase only.Attachment(s):Item Status:Status Date:

SERFF Tracking #: IASL-131253463 State Tracking #: IASL-131253463 Company Tracking #: JN LTC RI

State: Pennsylvania Filing Company: Jackson National Life Insurance Company

TOI/Sub-TOI: LTC03I Individual Long Term Care/LTC03I.003 Other

Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing

Project Name/Number: /

PDF Pipeline for SERFF Tracking Number IASL-131253463 Generated 11/02/2017 01:13 PM

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Bypassed - Item: Rate Table (A&H)Bypass Reason: Filing LTC rate increase only.Attachment(s):Item Status:Status Date:

Bypassed - Item: Replacement Form with Highlighted Changes (A&H)Bypass Reason: Filing LTC rate increase only.Attachment(s):Item Status:Status Date:

Bypassed - Item: Reserve Calculation (A&H)Bypass Reason: Filing LTC rate increase only.Attachment(s):Item Status:Status Date:

Bypassed - Item: Variability Explanation (A&H)Bypass Reason: Filing LTC rate increase only.Attachment(s):Item Status:Status Date:

SERFF Tracking #: IASL-131253463 State Tracking #: IASL-131253463 Company Tracking #: JN LTC RI

State: Pennsylvania Filing Company: Jackson National Life Insurance Company

TOI/Sub-TOI: LTC03I Individual Long Term Care/LTC03I.003 Other

Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing

Project Name/Number: /

PDF Pipeline for SERFF Tracking Number IASL-131253463 Generated 11/02/2017 01:13 PM

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17757 US HWY 19 North, Suite 660 Clearwater, FL 33764-6598 www.IASadmin.com p: (727) 584-0007 f: (727) 373-4539

Insurance Administrative Solutions, L.L.C.

I N S U R A N C E A D M I N I S T R A T O R S

November 2, 2017 Commonwealth of Pennsylvania Department of Insurance 1326 Strawberry Square Harrisburg, PA 17120 Bureau of Accident & Health Insurance Office of Rate and Policy Regulation RE: NAIC NUMBER: 65056/JACKSON NATIONAL LIFE INSURANCE COMPANY

FEIN NUMBER: 38-1659835 SERFF TRACKING NUMBER: IASL-131253463

SUBMISSION RATE INCREASE FILING LONG TERM CARE AND HOME HEALTH CARE POLICIES FORM NUMBERS: LTC 1/98 PA; QLTC 1/98 PA Insurance Administrative Solutions, L.L.C. has been authorized to file the above captioned rate increase filing, on behalf of Jackson National Life Insurance Company. The Company is requesting a 25.0% rate increase for its Long Term Care and Home Health Care forms (form numbers: LTC 1/98 PA, QLTC 1/98 PA, and HHC 1/98 PA). This filing applies to all of the Company's Long Term Care and Home Health Care policy forms and all attached riders, originally issued by Southwestern Life Insurance Company ("SWL"). Effective December 28, 2006, SWL merged with and into Valley Forge Life Insurance Company ("Valley Forge"). In 2007, Valley Forge changed its name to Reassure America Life Insurance Company (“Reassure America”). Effective December 31, 2012, Reassure America merged with and into Jackson National Life Insurance Company (the “Company”). These policies are not actively being marketed and the rate increase will apply to inforce polices only. There is no filing fee in the Company’s domicile state of Michigan. We appreciate the Department’s time and consideration in the review of this filing for Jackson National Life Insurance Company. Sincerely,

Jaime Marchese, FLMI Compliance Lead 1-877-777-2443 ext. 2425 727-373-4539 (fax) E-mail: [email protected]

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Pennsylvania Page 1 of 3 October, 2017

Jackson National Life Insurance Company

ACTUARIAL JUSTIFICATION OF PREMIUM RATES Long Term Care and Home Health Care

Policies

1. PURPOSE OF FILING

This is a rate increase filing for existing Long Term Care and Home Health Care forms and attached riders. The purpose of this rate

filing is to demonstrate that the anticipated loss ratio of these forms meets the minimum requirements for this state. This rate

increase filing is not intended to be used for any other purpose.

2. SCOPE OF FILING

This filing applies to all of the Company's Long Term Care and Home Health Care policy forms and all attached riders, originally

issued by Southwestern Life Insurance Company ("SWL"). Effective December 28, 2006, SWL merged with and into Valley Forge Life

Insurance Company ("Valley Forge"). In 2007, Valley Forge changed its name to Reassure America Life Insurance Company

(“Reassure America”). Effective December 31, 2012, Reassure America merged with and into Jackson National Life Insurance

Company (the “Company”). These forms provide daily benefits for long term treatment in various settings when the insured meets

policy benefit qualification requirements. This form is individual, guaranteed renewable policy.

The included base policy forms are as follows:

LTC 1/98 PA

QLTC 1/98 PA

These policies are not actively being marketed, the rate increase will apply to inforce policies only.

The number of policyholders and annualized inforce premium as of 6/30/2017, as well as average premium before and after the

rate increase are shown in Exhibit A

3. REASON FOR RATE INCREASE REQUEST

The rate increase amount requested is 25% for the Company's Long Term Care and Home Health Care forms. The rate increase is

necessary because the emerging experience reveals actual morbidity and policy persistency that is higher than originally assumed in

product pricing. These products were priced to meet a 60% lifetime loss ratio. This 60% lifetime loss ratio is met over the life of the

contract. Attached is Exhibit B with the originally anticipated loss ratios by duration for these policy forms. This filing demonstrates

that actual past experience is exceeding these original pricing loss ratios. If this trend continues, the actual lifetime loss ratio will be

131.0%, versus a pricing loss ratio of 60%.

For projection purposes, the proposed effective date is January 1, 2018.

4. RATE INCREASE HISTORY

15% HHC and 10% LTC - Approved 11/2001

30% - Approved 09/2005

10% - Approved 01/2008

15% - Approved 07/2011

10% - Approved 01/2013

20% - Approved 01/2015

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Pennsylvania Page 2 of 3 October, 2017

5. PROJECTION ASSUMPTIONS

Interest – A 4.5% effective annual rate of interest has been assumed for accumulating historical experience and for discounting

projected future experience.

Persistency - For purposes of projecting future earned premium, persistency assumptions have been modified from the

original pricing expectations. Specifically, the mortality being used for the projections is 2008 VBT table. The lapse rates

used in the projections 1.5%.

The mortality assumptions have been modified from original pricing, as a company study shows that actual mortality to be

less than 50% of pricing. Pricing mortality was 110% in the first policy year, grading linearly to 130% over 20 years of the

1983 GAM tables, blended 40% male, 60% female. Industry mortality is running about 50% to the 1983 GAM mortality.

As noted above, these projections are using 2008 VBT mortality.

Morbidity - For purposes of projecting future incurred claims, pricing morbidity assumptions have been modified to reflect historic

experience from the past five years as seen in Exhibit C.

Rate increase - Projected future earned premiums assume the rate increase amounts as noted in 2) above will be fully effective in

2018.

6. MINIMUM REQUIRED LIFETIME LOSS RATIO

The minimum required lifetime loss ratio is 60%.

7. HISTORICAL EXPERIENCE

Nationwide Experience since inception through 2016 is shown in Exhibit C. The following summarizes the historical loss ratios:

Actual Expected Expected Expected

Earned Incurred Loss Earned Incurred Loss

Premiums Claims* Ratio Premium Claims Ratio A/E

$116,353,472 $116,234,427 99.9% $116,353,472 $100,411,840 86.3% 1.16

*Incurred Claims are calculated as Paid Claims plus Claim Reserves.

The Expected Loss Ratios above have been calculated by applying original filed loss ratios by duration to actual earned premiums by

duration.

8. PROJECTED FUTURE EXPERIENCE

Future experience which has been projected with the requested rate increase for 21 years using the assumptions described in section

5 is shown in Exhibit D. The following summarizes the anticipated future loss ratios:

Earned Premium Loss Ratio

Without With Incurred Without With

Increase Increase Claims Increase Increase

$16,702,783 $20,210,499 $58,034,824 347.5% 287.2%

Consistent with original filings, incurred claims do not include active life reserves.

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Pennsylvania Page 3 of 3 October, 2017

9. LIFETIME ANTICIPATED LOSS RATIO

The lifetime anticipated loss ratio is defined as the present value of the historical and projected future incurred claims divided by the

present value of the historical and projected future earned premiums. These values are summarized below:

Without Rate Increase With Rate Increase

Earned Incurred Loss Earned Incurred Loss

Premiums Claims Ratio Premiums Claims Ratio

Historical $116,353,472 $116,234,427 99.9% $116,353,472 $116,234,427 99.9%

Future $16,702,783 $58,034,824 347.5% $20,210,499 $58,034,824 287.2%

Lifetime $133,056,255 $174,269,251 131.0% $136,563,970 $174,269,251 127.6%

The above demonstrates that both the anticipated future loss ratio and the lifetime anticipated loss ratio are in compliance with the

minimum loss ratio requirements after the implementation of the rate increases of 25%.

10. ACTUARIAL CERTIFICATION

The rate certification submitted herein is in compliance with all applicable laws of this state, the rules of the Department of

Insurance, and Actuarial Standard of Practice Number 8, “Regulatory Filings for Rates and Financial Projections for Health Plans”, as

adopted by the Actuarial Standards Board, and the loss ratios of the policy forms affected by the rate certification meet the minimum

requirements of this state. In my opinion, the rates are not excessive or unfairly discriminatory.

Respectfully Submitted,

Sharon S. Goodman, ASA, MAAA

Consulting Actuary

Wakely Actuarial

Palm Harbor, Florida

Attachments:

Exhibit A: Inforce Policy Forms

Exhibit B: Annual Loss Ratios

Exhibit C: Historical Experience

Exhibit D: Lifetime Experience

Exhibit E: Revised Premium Rate Pages

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JACKSON NATIONAL LIFE INSURANCE COMPANY

2017 A&H Rate Increase

Average Annualized

Premiums

Before After

Annualized Rate Rate Rate

Premiums Inforce Increase Increase Increase

Nationwide

LTC 1/98 1,781,777 751 2,373 2,966 25.0%

QLTC 1/98 598,316 224 2,671 3,339 25.0%

HHC 1/98 441,053 295 1,495 1,869 25.0%

QHHC 1/98 3,703 2 1,852 2,314 25.0%

Total 2,824,849 1,272 2,221 2,776 25.0%

Pennsylvania

LTC 1/98 57,662 19 3,035 3,794 25.0%

QLTC 1/98 15,648 8 1,956 2,445 25.0%

HHC 1/98 0 0 0 0 25.0%

QHHC 1/98 0 0 0 0 25.0%

Total 73,310 27 2,715 3,394 25.0%

Exhibit A - Policies Inforce as of 6/30/2017 by Form

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2017 A&H Rate Increase 2004 A&H Rate Certification

LTC HHC

Policy Loss Loss

Year Ratio Ratio

1 19% 32%

2 28% 39%

3 38% 46%

4 49% 53%

5 58% 59%

6 65% 66%

7 73% 73%

8 81% 79%

9 90% 85%

10 99% 91%

11 133% 106%

12 146% 114%

13 159% 122%

14 173% 131%

15 189% 139%

16 205% 148%

17 223% 158%

18 242% 169%

19 263% 179%

20 286% 190%

21 310% 202%

22 336% 214%

23 365% 227%

24 397% 241%

25 431% 255%

26 468% 270%

27 508% 285%

28 553% 302%

29 601% 319%

30 654% 338%

31 710% 358%

32 772% 379%

33 840% 401%

34 915% 424%

35 995% 439%

36 1080% 476%

37 1168% 500%

38 1261% 524%

39 1359% 549%

40 1462% 573%

JACKSON NATIONAL LIFE INSURANCE COMPANY

Exhibit B - Originally Filed Anticipated Loss Ratios

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JACKSON NATIONAL LIFE INSURANCE COMPANY

2017 A&H Rate Increase

Long Term Care Policies

Exhibit C - Historical Experience

as of 6/30/2017

Nationwide Experience

Ending Expected Expected

Incurred Earned Paid Claim Incurred Actual Incurred Incurred A:E

Year Premium Claims Reserve Claims Loss Ratio Claims Loss Ratio Loss Ratio

1998 242,547 1,305 0 1,305 0.5% 55,317 22.8% 2.4%

1999 2,463,303 712,561 0 712,561 28.9% 618,849 25.1% 115.1%

2000 4,110,807 1,284,271 0 1,284,271 31.2% 1,197,273 29.1% 107.3%

2001 5,252,506 3,278,681 673,769 3,952,450 75.2% 1,808,853 34.4% 218.5%

2002 5,069,541 3,224,200 0 3,224,200 63.6% 2,225,393 43.9% 144.9%

2003 4,788,519 4,833,242 0 4,833,242 100.9% 2,506,633 52.3% 192.8%

2004 4,653,949 4,249,335 26,392 4,275,727 91.9% 2,813,711 60.5% 152.0%

2005 4,556,871 3,612,024 106,906 3,718,930 81.6% 3,104,925 68.1% 119.8%

2006 4,700,064 4,061,813 0 4,061,813 86.4% 3,543,003 75.4% 114.6%

2007 4,631,372 5,244,579 36,462 5,281,041 114.0% 3,857,957 83.3% 136.9%

2008 4,562,740 4,955,353 75,487 5,030,840 110.3% 4,259,423 93.4% 118.1%

2009 4,582,684 6,157,257 436,195 6,593,453 143.9% 5,010,972 109.3% 131.6%

2010 4,365,272 6,518,944 209,811 6,728,755 154.1% 5,491,908 125.8% 122.5%

2011 3,934,967 3,748,621 222,584 3,971,205 100.9% 5,578,556 141.8% 71.2%

2012 3,884,647 4,759,569 418,867 5,178,436 133.3% 5,995,357 154.3% 86.4%

2013 3,676,466 4,737,564 1,345,665 6,083,229 165.5% 6,180,973 168.1% 98.4%

2014 3,470,486 3,975,868 1,524,452 5,500,321 158.5% 6,342,504 182.8% 86.7%

2015 3,201,460 2,177,154 1,968,974 4,146,129 129.5% 6,395,297 199.8% 64.8%

2016 2,979,551 1,777,540 4,897,506 6,675,046 224.0% 6,471,795 217.2% 103.1%

Total 75,127,751 69,309,881 11,943,072 81,252,953 108.2% 73,458,699 97.8% 110.6%

Total w/4.5% Interest 116,353,472 xxx xxx 116,234,427 99.9% 100,411,840 86.3% 115.8%

Page 56: Filing at a Glance€¦ · Company: Jackson National Life Insurance Company Product Name: Jackson National Life Insurance Company Long Term Care Rate Increase Filing State: Pennsylvania

JACKSON NATIONAL LIFE INSURANCE COMPANY2017 A&H Rate Increase

Long Term Care and Home Health Care Policies

Exhibit D - Lifetime Experience (Nationwide)

All Products

Actual Actual Actual

Earned Rate Earned Paid Claim Incurred Loss

Year Premium Increase Premium Claims Reserves Claims Ratio

1998 242,547 242,547 1,305 0 1,305 0.5%

1999 2,463,303 2,463,303 712,561 0 712,561 28.9%

2000 4,110,807 4,110,807 1,284,271 0 1,284,271 31.2%

2001 5,252,506 5,252,506 3,278,681 673,769 3,952,450 75.2%

2002 5,069,541 5,069,541 3,224,200 0 3,224,200 63.6%

2003 4,788,519 4,788,519 4,833,242 0 4,833,242 100.9%

2004 4,653,949 4,653,949 4,249,335 26,392 4,275,727 91.9%

2005 4,556,871 4,556,871 3,612,024 106,906 3,718,930 81.6%

2006 4,700,064 4,700,064 4,061,813 0 4,061,813 86.4%

2007 4,631,372 4,631,372 5,244,579 36,462 5,281,041 114.0%

2008 4,562,740 4,562,740 4,955,353 75,487 5,030,840 110.3%

2009 4,582,684 4,582,684 6,157,257 436,195 6,593,453 143.9%

2010 4,365,272 4,365,272 6,518,944 209,811 6,728,755 154.1%

2011 3,934,967 3,934,967 3,748,621 222,584 3,971,205 100.9%

2012 3,884,647 3,884,647 4,759,569 418,867 5,178,436 133.3%

2013 3,676,466 3,676,466 4,737,564 1,345,665 6,083,229 165.5%

2014 3,470,486 3,470,486 3,975,868 1,524,452 5,500,321 158.5%

2015 3,201,460 3,201,460 2,177,154 1,968,974 4,146,129 129.5%

2016 2,979,551 2,979,551 1,777,540 4,897,506 6,675,046 224.0%

Total 75,127,751 75,127,751 69,309,881 11,943,072 81,252,953 108.2%

Acc @ 4.5% 116,353,472 116,353,472 xxx xxx 116,234,427 99.9%

Projected Projected

Earned Earned Projected Projected

Premium Rate Premium Incurred Loss

Year w/o Rate Increase Increase w/Rate Increase Claims Ratio

2017 2,731,376 0% 2,731,376 6,141,511 224.9%

2018 2,488,126 25% 3,110,158 6,077,806 195.4%

2019 2,234,345 0% 2,792,931 5,922,492 212.1%

2020 1,994,149 0% 2,492,687 5,732,797 230.0%

2021 1,768,644 0% 2,210,805 5,515,417 249.5%

2022 1,558,415 0% 1,948,019 5,275,791 270.8%

2023 1,363,866 0% 1,704,833 5,014,623 294.1%

2024 1,185,509 0% 1,481,886 4,733,763 319.4%

2025 1,023,716 0% 1,279,645 4,439,712 346.9%

2026 878,453 0% 1,098,067 4,140,314 377.1%

2027 749,172 0% 936,465 3,840,083 410.1%

2028 634,978 0% 793,723 3,540,872 446.1%

2029 534,930 0% 668,662 3,244,884 485.3%

2030 447,957 0% 559,946 2,955,771 527.9%

2031 372,874 0% 466,092 2,677,153 574.4%

2032 308,449 0% 385,561 2,410,696 625.2%

2033 253,529 0% 316,911 2,156,596 680.5%

2034 207,033 0% 258,791 1,914,685 739.9%

2035 167,936 0% 209,920 1,685,199 802.8%

2036 135,296 0% 169,120 1,469,584 869.0%

2037 108,247 0% 135,308 1,269,883 938.5%

Total 21,146,999 25,750,905 80,159,633 311.3%

Disc @ 4.5% 16,702,783 20,210,499 58,034,824 287.2%

Lifetime @ 4.5% 133,056,255 136,563,970 174,269,251 127.6%

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Sincerely,

Ha A. Goatley ice President — Legal

JACKSN® NATIONAL LIFE INSURANCE COMPANY

An Indirect Wholly Owned Subsidiary of Prudential plc London, England"

1 Corporate Way Lansing, MI 48951

Phone: 517/367-4370

Fax: 517/706-5517 [email protected]

Julia A. Goatley Senior Vice President - Insurance Legal

January 1, 2017

Ms. Darcey Shaffer, FLMI, ACS Director of Corporate Relations Insurance Administrative Solutions, L.L.C. 17757 US Hwy 19 N Ste 660 Clearwater, Florida 33764-6598

Re: Filing/Reporting Requirements

Dear Ms. Shaffer:

This letter authorizes Insurance Administrative Solutions, L.L.C. to file on behalf of Jackson National Life Insurance Company rate filings, forms and reports with the State Departments of Insurance.

The State Departments of Insurance may correspond directly with Insurance Administrative Solutions, L.L.C. regarding any questions they may have concerning the filings.

A copy of this letter is as valid as the original. This authorization will be valid for twelve months from the date of this letter.

" Not affiliated with Prudential Financial, Inc. of the United States of America Jackson National Life Insurance Company' (Home Office: Lansing, Michigan).

Distributed by Jackson National Life Distributors LLC.

XADV13606G IC 09/16 For representative use only. Not for public distribution.