(000) 00000-00-00
AMENDMENT 10
EFFECTIVE MARCH 8, 2005
TO THE
AUTOMATIC AND FACULTATIVE YEARLY RENEWABLE TERM REINSURANCE AGREEMENT
EFFECTIVE MARCH 1, 2004
BETWEEN
HARTFORD LIFE AND ANNUITY INSURANCE COMPANY ("CEDING COMPANY")
AND
RGA REINSURANCE COMPANY ("REINSURER")
("AGREEMENT")
WHEREAS, the Reinsurer agrees to extend coverage for the policy listed below on
a facultative basis, acknowledging the fact that said policy was issued on a
Plan of Insurance not covered under the Agreement.
NOW, THEREFORE, for good and valuable consideration, receipt of which is hereby
acknowledged, the Ceding Company and the Reinsurer hereby agree as follows:
1. The above recitals are true and accurate and are incorporated herein.
2. The policy listed below shall be reinsured on a Facultative Reinsurance
basis, under the terms of the Agreement.
INSURED POLICY NUMBER DATE OF BIRTH PLAN FACE AMT REINSURED AMT TABLE
---------------------------------------------------------------------------------------------------------
3. The reference above to a specific policy is for purposes of description
only; such reference shall not create any relationship between the
policyholder, beneficiary or insured of that policy and the Reinsurer, and
such references shall not create any rights in any party other than the
Ceding Company and the Reinsurer.
LS Excess Treaty -- Effective 3/01/2004
Between HLAIC and RGA
Amendment # 10 -- Effective 3/8/2005
1
(000) 00000-00-00
4. This Amendment represents an exception to the Agreement. The Reinsurer's
acceptance should not be viewed as a precedent in the event future cases
should arise as a result of similar circumstances.
5. Except as herein amended, all other terms and conditions of the Agreement
shall remain unchanged.
In witness of the foregoing, the Ceding Company and the Reinsurer have, by their
respective officers, executed this Amendment in duplicate on the dates indicated
below, with an effective date of March 8, 2005.
RGA REINSURANCE COMPANY
By: /s/ Xxxxx Xxxxx Attest: /s/ Xxxxx X. Xxxxxx
---------------------------------------- ----------------------------------------
Name: Xxxxx Xxxxx Name: Xxxxx X. Xxxxxx
Title: Vice President, Business Development Title: Vice President and Actuary
Date: 6/11/12 Date: 6/11/2012
HARTFORD LIFE AND ANNUITY INSURANCE COMPANY
By: /s/ Xxxx Xxxxxxx Attest: /s/ Xxxxx X. Xxxxxx
---------------------------------------- ----------------------------------------
Name: Xxxx Xxxxxxx Name: Xxxxx X. Xxxxxx
Title: Assistant Vice President and Actuary Title: Vice President and Actuary
Date: June 18, 2012 Date: 6/25/2012
LS Excess Treaty -- Effective 3/01/2004
Between HLAIC and RGA
Amendment # 10 -- Effective 3/8/2005
2
