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NAIC BLANKS (E) WORKING GROUP Blanks Agenda Item Submission Form DATE: 02/20/2014 CONTACT PERSON: TELEPHONE: EMAIL ADDRESS: ON BEHALF OF: Life Insurance and Annuities (A) Committee NAME: Julie Mix McPeak TITLE: Commissioner AFFILIATION: TN Dept of Commerce & Insurance ADDRESS: FOR NAIC USE ONLY Agenda Item # 2014-09BWG Year 2014 Changes to Existing Reporting [X ] New Reporting Requirement [ ] REVIEWED FOR ACCOUNTING PRACTICES AND PROCEDURES IMPACT No Impact [ X ] Modifies Required Disclosure [ DISPOSITION Davy Crockett Tower, 12 th Floor 500 James Robertson Pkwy. Nashville, TN 37243-0565 [ ] [ ] [ X ] [ ] [ ] [ ] [ ] ] Rejected For Public Comment Referred To Another NAIC Group Received For Public Comment Adopted Date Rejected Date Deferred Date Other (Specify) BLANK(S) TO WHICH PROPOSAL APPLIES [X ] [X ] ANNUAL STATEMENT INSTRUCTIONS [ [ ] ] [ X ] Life and Accident & Health [ ] Separate Accounts [ ] Other Specify [ ] [X ] QUARTERLY STATEMENT CROSSCHECKS Property/Casualty Fraternal [ [X ] [ ] ] BLANK Health Title Anticipated Effective Date: Annual 2014 IDENTIFICATION OF ITEM(S) TO CHANGE Modify the definition of contingent deferred annuities in the instructions for the Exhibit 5 Interrogatories. REASON, JUSTIFICATION FOR AND/OR BENEFIT OF CHANGE** The purpose of the proposal is to assist the Contingent Deferred Annuity (“CDA”) Working Group with its charge in evaluating the adequacy of existing laws and regulations as applied to CDAs, the working group determined that it would be useful to develop a uniform definition of CDAs for regulators, the industry and consumers. The CDA Working Group believes that this definition captures a CDA’s basic design structure. The definition was adopted by the Life Insurance and Annuities (A) Committee. NAIC STAFF COMMENTS Comment on Effective Reporting Date: Other Comments: ___________________________________________________________________________________________________ ** This section must be completed on all forms. Revised 6/13/2009 © 2014 National Association of Insurance Commissioners 115 ANNUAL STATEMENT INSTRUCTIONS – LIFE, FRATERNAL AND HEALTH (LIFE SUPPLEMENT) EXHIBIT 5 – INTERROGATORIES Detail Eliminated To Conserve Space Interrogatory 7 For purposes of this footnote disclosure, a synthetic GIC is defined as a contract or agreement in which the insurance entity guarantees specified payouts under the terms of an employee benefit plan from assets not owned by the insurance entity. Interrogatory 8 For purposes of this footnote disclosure, a Contingent Deferred Annuity is defined as an annuity contract that establishes a life insurer’s obligation to make periodic payments for the annuitant’s lifetime at the time designated investments, which are not owned or held by the insurer, are depleted to a contractually-defined amount due to contractually-permitted withdrawals, market performance, fees and/or other charges. Interrogatory 9 For purposes of this footnote disclosure, a Guaranteed Lifetime Income Benefit is defined as a fixed deferred annuity contract, agreement or rider in which the insurance entity guarantees specified payouts during the lifetime of the insured(s) regardless of the performance of a contractual account value that is used to determine cash surrender values and traditional withdrawal benefits. W:\QA\BlanksProposals\2014-09BWG.doc © 2014 National Association of Insurance Commissioners 116