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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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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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
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
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
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
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
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
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
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
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
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 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
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
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
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
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
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
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
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
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
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
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
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]
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
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.
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
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
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
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%
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%
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.