Survey of Nonparticipating Single-Premium Group Annuity Rates

OMB 1212-0030

Expiration date: 03/31/2012

NONPARTICIPATING NET SINGLE PREMIUM

GROUP ANNUITY RATE ILLUSTRATION

FOR

PLAN TERMINATION OR FAS 88 SETTLEMENT

Date of Illustration

Company Identification Code _________________________

Paperwork Reduction Act Notice

The PBGC has asked the ACLI to conduct this survey so that it can ensure that its actuarial assumptions are in line with those underlying private sector annuity prices. The PBGC uses this information to determine the actuarial present value of benefits under single-employer plans that terminate and under multi-employer plans that undergo a mass withdrawal of contributing employers. Your response is voluntary. The ACLI will not disclose to the PBGC the identity of the insurance company responding to this survey. The PBGC regards the information gathered through the survey as confidential under 5 U.S.C. section 552(b) and 29 CFR Part 4901.

Under the Paperwork Reduction Act, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. This collection of information has been approved by the Office of Management and Budget (OMB) under control number 1212-0030. The PBGC estimates that the average burden of responding to this survey is 30 minutes. Comments concerning the accuracy of this estimate or suggestions for reducing this burden may be sent to the Pension Benefit Guaranty Corporation, Office of the General Counsel, 1200 K Street, NW, Washington, DC 20005-4026.

/ / If you are temporarily withdrawn from the immediate annuity market at the Date of Illustration, please check this box.

(If you checked the above box, skip Part I below.)

/ / If you are temporarily withdrawn from the deferred annuity market at the Date of Illustration, please check this box.

(If you checked the above box, skip Part II below.)

(If you checked both of the above boxes, go directly to Part IV, Question 1.)

In completing Part I and Part II:

(a) Provide the net rate plan factors that reflect or are consistent with mortality and interest rate assumptions that underlie your company's quotation basis on actual bids on the above date. If you prefer, you may provide these assumptions explicitly. If you provide actuarial assumptions, please make sure that there is enough information for the PBGC to be able to fill out the tables in Parts I and II. In either event, the assumptions or the factors based on them should contain no specific expense loading or provisions for disabled lives.

(b) Assume an annuity contract for a plan termination or FAS 88 settlement on the date of illustration specified above. (See the enclosure for more details and background.)

PART I IMMEDIATE ANNUITY RATES

Exact Age (12)

of Annuitant $10 Monthly Life Annuity Due (120 a )

x

Male Female

45 ________

50 ________

55 ________

60 ________

62 ________

63 ________

65 ________

67 ________

70 ________

75 ________

80 ________

85 ________

PART II DEFERRED ANNUITY RATES

(12)

$10 Monthly Deferred Life Annuity (120 a )

y-x/ x

(without death benefit or surrender value)

Exact Age Deferred to Exact Age 60 Deferred to Exact Age 65

of Annuitant Male Female Male Female

20                                                                      

25                                                                      

30                                                                      

35                                                                      

40                                                                      

45                                                                      

50                                                                      

55                                                                      

60       xx              xx                                         

61       xx              xx                                         

62       xx               xx                                         

63       xx               xx                                         

64       xx               xx                                         

PART III

1. Please indicate the MINIMUM plan termination or FAS 88 settlement consideration per case that you are currently willing to accept on the basis illustrated.

a. / / Over $5 million

b. / / Over $2 million but not more than $5 million

c. / / Over $1 million but not more than $2 million

d. / / Over $500 thousand but not more than $1 million

e. / / Over $250 thousand but not more than $500 thousand

f. / / Not more than $250 thousand

2. Assuming the investment climate remains unchanged, please indicate the MAXIMUM amount of plan termination or FAS 88 settlement business (not necessarily in one transaction) that you would be willing to accept during the next quarter on the basis illustrated.

a. / / Over $100 million

b. / / Over $50 million but not more than $100 million

c. / / Over $25 million but not more than $50 million

d. / / Over $10 million but not more than $25 million

e. / / Over $2 million but not more than $10 million

f. / / Not more than $2 million

PART IV

1. Please indicate the TOTAL VOLUME of plan termination and FAS 88 settlement business that your company wrote during the quarter ending on the Date of Illustration.

a. / / Over $100 million

b. / / Over $50 million but not more than $100 million

c. / / Over $25 million but not more than $50 million

d. / / Over $10 million but not more than $25 million

e. / / Over $2 million but not more than $10 million

f. / / Not more than $2 million

g. / / None