SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Filing at a Glance Company: Assured Life Association Product Name: Assured Life 2011 Rate SERFF Tr Num: ABAI-127306981 State: Pennsylvania Increase- Plan D TOI: MS07I Individual Medicare Supplement - SERFF Status: Closed-Approved State Tr Num: Medicare Select 2010 Sub-TOI: MS07I.004 Plan D 2010 Co Tr Num: State Status: Approved Filing Type: Rate - Other -(Not M.U. or G.I. Reviewer(s): Michael Gurgiolo (AH) Product) Author: Jenna Stotts Disposition Date: 07/22/2011 Date Submitted: 07/01/2011 Disposition Status: Approved Implementation Date Requested: 10/01/2011 Implementation Date: 10/01/2011 General Information Project Name: 2011 Annual Rate Filing -MTA42 Status of Filing in Domicile: Pending Project Number: Assured Life 2011 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: 9.9% Filing Status Changed: 07/22/2011 State Status Changed: 07/22/2011 Deemer Date: Created By: Jenna Stotts Submitted By: Jenna Stotts Corresponding Filing Tracking Number: Filing Description: The purpose of this filing is to request a 9.9% rate increase in Plan D for the Company’s 2010 Standardized Select Medicare Supplement to be effective on August 1, 2011 for new business and on October 1, 2011 for existing business This filing demonstrates that the loss ratios, rates and benefits associated with these forms comply with all applicable regulations pertaining to Medicare Supplement insurance products and that the rates are reasonable in relation to the benefits provided. Company and Contact PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Filing Contact Information Jenna Stotts, jstotts@allenbailey.com 8310-I Capital of Texas Hwy North 512-502-8800 [Phone] Suite 370 512-502-8638 [FAX] Austin, TX 78731 Filing Company Information (This filing was made by a third party - allenbaileyandassociatesinc) Assured Life Association CoCode: 56499 State of Domicile: Colorado 8000 East Maplewood Avenue, Suite 105 Group Code: 614 Company Type: Fraternal Benefit Society Greenwood Village, CO 80111 Group Name: State ID Number: (800) 777-9777 ext. [Phone] FEIN Number: 84-0356870 --------- Filing Fees Fee Required? No Retaliatory? No Fee Explanation: Per Company: Yes COMPANY AMOUNT DATE PROCESSED TRANSACTION # Assured Life Association $0.00 07/01/2011 PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Correspondence Summary Dispositions Status Created By Created On Date Submitted Approved Michael Gurgiolo (AH) 07/22/2011 07/22/2011 PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Medicare Select 2010 Sub-TOI: MS07I.004 Plan D 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Disposition Disposition Date: 07/22/2011 Implementation Date: 10/01/2011 Status: Approved Comment: Dear Ms. Stotts, The proposed rate increase of 9.9% is approved for the subject form, to take effect on August 1, 2011 for new issues and October 1, 2011 for renewals. Sincerely, Michael Gurgiolo PA Ins. Dept. Company Name: Overall % Overall % Rate Written # of Policy Written Maximum % Minimum % Indicated Impact: Premium Holders Premium for Change (where Change (where Change: Change for Affected for this this Program: required): required): this Program: Program: Assured Life Association 0.000% 0.000% $ $ 9.900% 9.900% PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Schedule Schedule Item Schedule Item Status Public Access Supporting Document Transmittal Letter (A&H) Yes Supporting Document Actuarial Certification (A&H) Yes Supporting Document Actuarial Memorandum and Explanatory Yes Information (A&H) Supporting Document Advertisements (A&H) Yes Supporting Document Authorization to File (A&H) Yes Supporting Document Certification of Plan A and B (A&H) Yes Supporting Document Insert Page Explanation (A&H) Yes Supporting Document Rate Table (A&H) Yes Supporting Document Replacement Form with Highlighted Yes Changes (A&H) Supporting Document Variability Explanation (A&H) Yes Rate Select Plan D Yes PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Form Schedule PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Medicare Select 2010 Sub-TOI: MS07I.004 Plan D 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Rate Information Rate data applies to filing. Filing Method: SERFF Rate Change Type: Increase Overall Percentage of Last Rate Revision: 9.000% Effective Date of Last Rate Revision: 07/23/2010 Filing Method of Last Filing: SERFF Company Rate Information Company Name: Overall % Overall % Rate Written # of Policy Written Maximum % Minimum % Indicated Impact: Premium Holders Premium for Change (where Change (where Change: Change for Affected for this this Program: required): required): this Program: Program: Assured Life Association 0.000% 0.000% 9.900% 9.900% PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Rate/Rule Schedule Schedule Document Name: Affected Form Rate Rate Action Information: Attachments Item Numbers: Action:* Status: (Separated with commas) Select Plan D MTA42 Revised Previous State Filing MUTA- WOW_ALA Number: 1266921 ZIPFACTORS 08 06.22.2011.pdf Percent Rate Change 9.900 D-MTA42.pdf Request: PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Alabama 350 F 1.00 Arizona 85337 H 1.10 Arkansas 723 CE 1.17 Alabama 351 F 1.00 Arizona 85338 H 1.10 California 900 CS 1.38 Alabama 352 F 1.00 Arizona 85339 H 1.10 California 901 CS 1.38 Alabama 354 F 1.00 Arizona 85340 H 1.10 California 902 CS 1.38 Alabama 355 F 1.00 Arizona 85341 F 1.00 California 903 CS 1.38 Alabama 356 F 1.00 Arizona 85342 H 1.10 California 904 CS 1.38 Alabama 357 F 1.00 Arizona 85343 H 1.10 California 905 CS 1.38 Alabama 358 F 1.00 Arizona 85344 F 1.00 California 906 CS 1.38 Alabama 359 F 1.00 Arizona 85345 H 1.10 California 907 CS 1.38 Alabama 360 F 1.00 Arizona 85346 F 1.00 California 908 CS 1.38 Alabama 361 F 1.00 Arizona 85347 F 1.00 California 909 CS 1.38 Alabama 362 F 1.00 Arizona 85348 F 1.00 California 910 CS 1.38 Alabama 363 F 1.00 Arizona 85349 F 1.00 California 911 CS 1.38 Alabama 364 F 1.00 Arizona 85350 F 1.00 California 912 CS 1.38 Alabama 365 F 1.00 Arizona 85351 H 1.10 California 913 CS 1.38 Alabama 366 F 1.00 Arizona 85352 F 1.00 California 914 CS 1.38 Alabama 367 F 1.00 Arizona 85353 H 1.10 California 915 CS 1.38 Alabama 368 F 1.00 Arizona 85354 H 1.10 California 916 CS 1.38 Alabama 369 F 1.00 Arizona 85355 H 1.10 California 917 CS 1.38 Alaska 995 F 1.00 Arizona 85356 F 1.00 California 918 CS 1.38 Alaska 996 F 1.00 Arizona 85357 F 1.00 California 919 CD 1.16 Alaska 997 F 1.00 Arizona 85358 H 1.10 California 920 CD 1.16 Alaska 998 F 1.00 Arizona 85359 F 1.00 California 921 CD 1.16 Alaska 999 F 1.00 Arizona 85360 F 1.00 California 922 CD 1.16 Arizona 850 H 1.10 Arizona 85361 H 1.10 California 923 CD 1.16 Arizona 851 H 1.10 Arizona 85362 H 1.10 California 924 CD 1.16 Arizona 852 H 1.10 Arizona 85363 H 1.10 California 925 CD 1.16 Arizona 855 F 1.00 Arizona 85364 F 1.00 California 926 CS 1.38 Arizona 856 H 1.10 Arizona 85365 F 1.00 California 927 CS 1.38 Arizona 857 H 1.10 Arizona 85366 F 1.00 California 928 CS 1.38 Arizona 859 F 1.00 Arizona 85367 F 1.00 California 930 CD 1.16 Arizona 860 F 1.00 Arizona 85369 F 1.00 California 931 CD 1.16 Arizona 863 F 1.00 Arizona 85371 F 1.00 California 932 F 1.00 Arizona 864 H 1.10 Arizona 85372 H 1.10 California 933 F 1.00 Arizona 865 F 1.00 Arizona 85373 H 1.10 California 934 F 1.00 Arizona 85301 H 1.10 Arizona 85374 H 1.10 California 935 F 1.00 Arizona 85302 H 1.10 Arizona 85375 H 1.10 California 936 F 1.00 Arizona 85303 H 1.10 Arizona 85376 H 1.10 California 937 F 1.00 Arizona 85304 H 1.10 Arizona 85377 H 1.10 California 938 F 1.00 Arizona 85305 H 1.10 Arizona 85378 H 1.10 California 939 F 1.00 Arizona 85306 H 1.10 Arizona 85379 H 1.10 California 940 CD 1.16 Arizona 85307 H 1.10 Arizona 85380 H 1.10 California 941 CD 1.16 Arizona 85308 H 1.10 Arizona 85381 H 1.10 California 942 CD 1.16 Arizona 85309 H 1.10 Arizona 85382 H 1.10 California 943 CD 1.16 Arizona 85310 H 1.10 Arizona 85383 H 1.10 California 944 CD 1.16 Arizona 85311 H 1.10 Arizona 85384 H 1.10 California 945 CD 1.16 Arizona 85312 H 1.10 Arizona 85385 H 1.10 California 946 CD 1.16 Arizona 85313 H 1.10 Arizona 85386 H 1.10 California 947 CD 1.16 Arizona 85314 H 1.10 Arizona 85387 H 1.10 California 948 CD 1.16 Arizona 85315 H 1.10 Arizona 85388 H 1.10 California 949 CD 1.16 Arizona 85316 H 1.10 Arizona 85389 H 1.10 California 950 F 1.00 Arizona 85317 H 1.10 Arizona 85390 H 1.10 California 951 F 1.00 Arizona 85318 H 1.10 Arizona 85391 H 1.10 California 952 F 1.00 Arizona 85319 H 1.10 Arizona 85392 H 1.10 California 953 F 1.00 Arizona 85320 H 1.10 Arizona 85393 H 1.10 California 954 F 1.00 Arizona 85321 F 1.00 Arizona 85394 H 1.10 California 955 F 1.00 Arizona 85322 H 1.10 Arizona 85395 H 1.10 California 956 F 1.00 Arizona 85323 H 1.10 Arizona 85396 H 1.10 California 957 F 1.00 Arizona 85324 H 1.10 Arkansas 716 F 1.00 California 958 F 1.00 Arizona 85325 F 1.00 Arkansas 717 F 1.00 California 959 F 1.00 Arizona 85326 H 1.10 Arkansas 724 F 1.00 California 960 F 1.00 Arizona 85327 H 1.10 Arkansas 725 F 1.00 California 961 F 1.00 Arizona 85328 F 1.00 Arkansas 726 F 1.00 Colorado 800 H 1.10 Arizona 85329 H 1.10 Arkansas 727 F 1.00 Colorado 801 H 1.10 Arizona 85330 H 1.10 Arkansas 728 F 1.00 Colorado 802 H 1.10 Arizona 85331 H 1.10 Arkansas 729 F 1.00 Colorado 803 F 1.00 Arizona 85332 H 1.10 Arkansas 718 BX 1.09 Colorado 805 F 1.00 Arizona 85333 F 1.00 Arkansas 719 BX 1.09 Colorado 807 F 1.00 Arizona 85334 F 1.00 Arkansas 720 BX 1.09 Colorado 808 F 1.00 Arizona 85335 H 1.10 Arkansas 721 BX 1.09 Colorado 809 F 1.00 Arizona 85336 F 1.00 Arkansas 722 CE 1.17 Colorado 810 F 1.00 1 of 8 0WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Colorado 811 F 1.00 Colorado 80610 F 1.00 Florida 346 F 1.00 Colorado 812 F 1.00 Colorado 80611 F 1.00 Florida 347 F 1.00 Colorado 813 F 1.00 Colorado 80612 F 1.00 Florida 349 F 1.00 Colorado 814 F 1.00 Colorado 80614 H 1.10 Georgia 300 BZ 1.12 Colorado 815 F 1.00 Colorado 80615 F 1.00 Georgia 301 BZ 1.12 Colorado 816 F 1.00 Colorado 80620 F 1.00 Georgia 302 BZ 1.12 Colorado 80401 H 1.10 Colorado 80621 F 1.00 Georgia 303 BZ 1.12 Colorado 80402 H 1.10 Colorado 80622 F 1.00 Georgia 304 F 1.00 Colorado 80403 H 1.10 Colorado 80623 F 1.00 Georgia 305 F 1.00 Colorado 80419 H 1.10 Colorado 80624 F 1.00 Georgia 306 F 1.00 Colorado 80420 F 1.00 Colorado 80631 F 1.00 Georgia 307 F 1.00 Colorado 80421 F 1.00 Colorado 80632 F 1.00 Georgia 308 F 1.00 Colorado 80422 F 1.00 Colorado 80633 F 1.00 Georgia 309 F 1.00 Colorado 80423 F 1.00 Colorado 80634 F 1.00 Georgia 310 F 1.00 Colorado 80424 F 1.00 Colorado 80638 F 1.00 Georgia 311 BZ 1.12 Colorado 80425 H 1.10 Colorado 80639 F 1.00 Georgia 312 F 1.00 Colorado 80426 F 1.00 Colorado 80640 H 1.10 Georgia 313 BZ 1.12 Colorado 80427 F 1.00 Colorado 80642 F 1.00 Georgia 314 BZ 1.12 Colorado 80428 F 1.00 Colorado 80643 F 1.00 Georgia 315 F 1.00 Colorado 80430 F 1.00 Colorado 80644 F 1.00 Georgia 316 F 1.00 Colorado 80432 F 1.00 Colorado 80645 F 1.00 Georgia 317 F 1.00 Colorado 80433 H 1.10 Colorado 80646 F 1.00 Georgia 318 F 1.00 Colorado 80434 F 1.00 Colorado 80648 F 1.00 Georgia 319 F 1.00 Colorado 80435 F 1.00 Colorado 80649 F 1.00 Georgia 398 F 1.00 Colorado 80436 F 1.00 Colorado 80650 F 1.00 Georgia 399 BZ 1.12 Colorado 80437 H 1.10 Colorado 80651 F 1.00 Hawaii 967 F 1.00 Colorado 80438 F 1.00 Colorado 80652 F 1.00 Hawaii 968 F 1.00 Colorado 80439 H 1.10 Colorado 80653 F 1.00 Idaho 832 F 1.00 Colorado 80440 F 1.00 Colorado 80654 F 1.00 Idaho 833 F 1.00 Colorado 80442 F 1.00 Connecticut 060 F 1.00 Idaho 834 F 1.00 Colorado 80443 F 1.00 Connecticut 061 F 1.00 Idaho 835 F 1.00 Colorado 80444 F 1.00 Connecticut 062 F 1.00 Idaho 836 F 1.00 Colorado 80446 F 1.00 Connecticut 063 F 1.00 Idaho 837 F 1.00 Colorado 80447 F 1.00 Connecticut 064 F 1.00 Idaho 838 F 1.00 Colorado 80448 F 1.00 Connecticut 065 F 1.00 Illinois 600 CA 1.13 Colorado 80449 F 1.00 Connecticut 066 F 1.00 Illinois 601 CA 1.13 Colorado 80451 F 1.00 Connecticut 067 F 1.00 Illinois 602 CA 1.13 Colorado 80452 F 1.00 Connecticut 068 F 1.00 Illinois 603 CA 1.13 Colorado 80453 H 1.10 Connecticut 069 F 1.00 Illinois 604 CA 1.13 Colorado 80454 H 1.10 Delaware 197 F 1.00 Illinois 605 CA 1.13 Colorado 80455 F 1.00 Delaware 198 F 1.00 Illinois 606 CA 1.13 Colorado 80456 F 1.00 Delaware 199 F 1.00 Illinois 607 CA 1.13 Colorado 80457 H 1.10 District of Columbia 200 F 1.00 Illinois 608 CA 1.13 Colorado 80459 F 1.00 District of Columbia 202 F 1.00 Illinois 609 F 1.00 Colorado 80461 F 1.00 District of Columbia 203 F 1.00 Illinois 610 F 1.00 Colorado 80463 F 1.00 District of Columbia 204 F 1.00 Illinois 611 F 1.00 Colorado 80465 H 1.10 District of Columbia 205 F 1.00 Illinois 612 F 1.00 Colorado 80466 F 1.00 Florida 320 F 1.00 Illinois 613 F 1.00 Colorado 80467 F 1.00 Florida 321 F 1.00 Illinois 614 F 1.00 Colorado 80468 F 1.00 Florida 322 F 1.00 Illinois 615 F 1.00 Colorado 80469 F 1.00 Florida 323 F 1.00 Illinois 616 F 1.00 Colorado 80470 H 1.10 Florida 324 F 1.00 Illinois 617 F 1.00 Colorado 80471 F 1.00 Florida 325 F 1.00 Illinois 618 F 1.00 Colorado 80473 F 1.00 Florida 326 F 1.00 Illinois 619 F 1.00 Colorado 80474 F 1.00 Florida 327 F 1.00 Illinois 620 F 1.00 Colorado 80475 F 1.00 Florida 328 F 1.00 Illinois 621 F 1.00 Colorado 80476 F 1.00 Florida 329 F 1.00 Illinois 622 F 1.00 Colorado 80477 F 1.00 Florida 330 DQ 1.69 Illinois 623 F 1.00 Colorado 80478 F 1.00 Florida 331 DQ 1.69 Illinois 624 F 1.00 Colorado 80479 F 1.00 Florida 332 DQ 1.69 Illinois 625 F 1.00 Colorado 80480 F 1.00 Florida 333 DQ 1.69 Illinois 626 F 1.00 Colorado 80481 F 1.00 Florida 334 CP 1.33 Illinois 627 F 1.00 Colorado 80482 F 1.00 Florida 335 F 1.00 Illinois 628 F 1.00 Colorado 80483 F 1.00 Florida 336 F 1.00 Illinois 629 F 1.00 Colorado 80487 F 1.00 Florida 337 F 1.00 Indiana 460 F 1.00 Colorado 80488 F 1.00 Florida 338 F 1.00 Indiana 461 F 1.00 Colorado 80497 F 1.00 Florida 339 F 1.00 Indiana 462 CD 1.16 Colorado 80498 F 1.00 Florida 340 DQ 1.69 Indiana 463 CD 1.16 Colorado 80601 H 1.10 Florida 341 F 1.00 Indiana 464 CD 1.16 Colorado 80602 H 1.10 Florida 342 F 1.00 Indiana 465 F 1.00 Colorado 80603 H 1.10 Florida 344 F 1.00 Indiana 466 F 1.00 2 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Indiana 467 F 1.00 Kentucky 413 F 1.00 Michigan 480 CO 1.32 Indiana 468 F 1.00 Kentucky 414 F 1.00 Michigan 481 CO 1.32 Indiana 469 F 1.00 Kentucky 415 F 1.00 Michigan 482 CO 1.32 Indiana 470 F 1.00 Kentucky 416 CA 1.13 Michigan 483 CO 1.32 Indiana 471 F 1.00 Kentucky 417 CA 1.13 Michigan 484 CO 1.32 Indiana 472 F 1.00 Kentucky 418 CA 1.13 Michigan 485 CO 1.32 Indiana 473 F 1.00 Kentucky 419 F 1.00 Michigan 486 BX 1.09 Indiana 474 F 1.00 Kentucky 420 F 1.00 Michigan 487 BX 1.09 Indiana 475 F 1.00 Kentucky 421 F 1.00 Michigan 488 BX 1.09 Indiana 476 F 1.00 Kentucky 422 F 1.00 Michigan 489 BX 1.09 Indiana 477 F 1.00 Kentucky 423 F 1.00 Michigan 490 F 1.00 Indiana 478 F 1.00 Kentucky 424 F 1.00 Michigan 491 F 1.00 Indiana 479 F 1.00 Kentucky 425 CA 1.13 Michigan 492 BX 1.09 Iowa 500 F 1.00 Kentucky 426 CA 1.13 Michigan 493 F 1.00 Iowa 501 F 1.00 Kentucky 427 CA 1.13 Michigan 494 F 1.00 Iowa 502 F 1.00 Louisiana 700 BY 1.11 Michigan 495 F 1.00 Iowa 503 H 1.10 Louisiana 701 BY 1.11 Michigan 496 F 1.00 Iowa 504 F 1.00 Louisiana 703 F 1.00 Michigan 497 F 1.00 Iowa 505 F 1.00 Louisiana 704 BY 1.11 Michigan 498 F 1.00 Iowa 506 F 1.00 Louisiana 705 F 1.00 Michigan 499 F 1.00 Iowa 507 H 1.10 Louisiana 706 F 1.00 Minnesota 556 F 1.00 Iowa 508 F 1.00 Louisiana 707 BY 1.11 Minnesota 557 F 1.00 Iowa 509 H 1.10 Louisiana 708 BY 1.11 Minnesota 558 F 1.00 Iowa 510 H 1.10 Louisiana 710 F 1.00 Minnesota 559 F 1.00 Iowa 511 H 1.10 Louisiana 711 BY 1.11 Minnesota 560 F 1.00 Iowa 512 F 1.00 Louisiana 712 BY 1.11 Minnesota 561 F 1.00 Iowa 513 F 1.00 Louisiana 713 F 1.00 Minnesota 562 F 1.00 Iowa 514 F 1.00 Louisiana 714 F 1.00 Minnesota 563 F 1.00 Iowa 515 H 1.10 Maine 039 F 1.00 Minnesota 564 F 1.00 Iowa 516 H 1.10 Maine 040 F 1.00 Minnesota 565 F 1.00 Iowa 520 F 1.00 Maine 041 F 1.00 Minnesota 566 F 1.00 Iowa 521 F 1.00 Maine 042 F 1.00 Minnesota 567 F 1.00 Iowa 522 F 1.00 Maine 043 F 1.00 Minnesota 55001 BV 1.07 Iowa 523 F 1.00 Maine 044 F 1.00 Minnesota 55002 F 1.00 Iowa 524 F 1.00 Maine 045 F 1.00 Minnesota 55003 BV 1.07 Iowa 525 F 1.00 Maine 046 F 1.00 Minnesota 55005 CD 1.16 Iowa 526 H 1.10 Maine 047 F 1.00 Minnesota 55006 F 1.00 Iowa 527 H 1.10 Maine 048 F 1.00 Minnesota 55007 F 1.00 Iowa 528 H 1.10 Maine 049 F 1.00 Minnesota 55008 F 1.00 Kansas 660 F 1.00 Maryland 206 F 1.00 Minnesota 55009 F 1.00 Kansas 661 H 1.10 Maryland 207 F 1.00 Minnesota 55010 BV 1.07 Kansas 662 H 1.10 Maryland 208 F 1.00 Minnesota 55011 CD 1.16 Kansas 664 F 1.00 Maryland 209 F 1.00 Minnesota 55012 F 1.00 Kansas 665 F 1.00 Maryland 210 F 1.00 Minnesota 55013 F 1.00 Kansas 666 F 1.00 Maryland 211 F 1.00 Minnesota 55014 CD 1.16 Kansas 667 F 1.00 Maryland 212 F 1.00 Minnesota 55016 BV 1.07 Kansas 668 F 1.00 Maryland 214 F 1.00 Minnesota 55017 F 1.00 Kansas 669 F 1.00 Maryland 215 F 1.00 Minnesota 55018 F 1.00 Kansas 670 F 1.00 Maryland 216 F 1.00 Minnesota 55019 F 1.00 Kansas 671 F 1.00 Maryland 217 F 1.00 Minnesota 55020 BV 1.07 Kansas 672 H 1.10 Maryland 218 F 1.00 Minnesota 55021 F 1.00 Kansas 673 F 1.00 Maryland 219 F 1.00 Minnesota 55024 BV 1.07 Kansas 674 F 1.00 Massachusetts 010 F 1.00 Minnesota 55025 BV 1.07 Kansas 675 F 1.00 Massachusetts 011 F 1.00 Minnesota 55026 F 1.00 Kansas 676 F 1.00 Massachusetts 012 F 1.00 Minnesota 55027 F 1.00 Kansas 677 F 1.00 Massachusetts 013 F 1.00 Minnesota 55029 F 1.00 Kansas 678 F 1.00 Massachusetts 014 F 1.00 Minnesota 55030 F 1.00 Kansas 679 F 1.00 Massachusetts 015 F 1.00 Minnesota 55031 BV 1.07 Kentucky 400 F 1.00 Massachusetts 016 F 1.00 Minnesota 55032 F 1.00 Kentucky 401 F 1.00 Massachusetts 017 F 1.00 Minnesota 55033 BV 1.07 Kentucky 402 F 1.00 Massachusetts 018 F 1.00 Minnesota 55036 F 1.00 Kentucky 403 F 1.00 Massachusetts 019 F 1.00 Minnesota 55037 F 1.00 Kentucky 404 F 1.00 Massachusetts 020 F 1.00 Minnesota 55038 BV 1.07 Kentucky 405 F 1.00 Massachusetts 021 F 1.00 Minnesota 55040 F 1.00 Kentucky 406 F 1.00 Massachusetts 022 F 1.00 Minnesota 55041 F 1.00 Kentucky 407 CA 1.13 Massachusetts 023 F 1.00 Minnesota 55042 BV 1.07 Kentucky 408 CA 1.13 Massachusetts 024 F 1.00 Minnesota 55043 BV 1.07 Kentucky 409 CA 1.13 Massachusetts 025 F 1.00 Minnesota 55044 BV 1.07 Kentucky 410 BV 1.07 Massachusetts 026 F 1.00 Minnesota 55045 F 1.00 Kentucky 411 BV 1.07 Massachusetts 027 F 1.00 Minnesota 55046 F 1.00 Kentucky 412 F 1.00 Massachusetts 055 F 1.00 Minnesota 55047 BV 1.07 3 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Minnesota 55049 F 1.00 Minnesota 55161 CD 1.16 Minnesota 55357 CD 1.16 Minnesota 55051 F 1.00 Minnesota 55164 CD 1.16 Minnesota 55358 F 1.00 Minnesota 55052 F 1.00 Minnesota 55165 CD 1.16 Minnesota 55359 CD 1.16 Minnesota 55053 F 1.00 Minnesota 55166 CD 1.16 Minnesota 55360 BV 1.07 Minnesota 55054 BV 1.07 Minnesota 55168 CD 1.16 Minnesota 55361 CD 1.16 Minnesota 55055 BV 1.07 Minnesota 55169 CD 1.16 Minnesota 55362 F 1.00 Minnesota 55056 F 1.00 Minnesota 55170 CD 1.16 Minnesota 55363 F 1.00 Minnesota 55057 F 1.00 Minnesota 55171 CD 1.16 Minnesota 55364 CD 1.16 Minnesota 55060 F 1.00 Minnesota 55172 CD 1.16 Minnesota 55365 F 1.00 Minnesota 55063 F 1.00 Minnesota 55175 CD 1.16 Minnesota 55366 F 1.00 Minnesota 55065 BV 1.07 Minnesota 55177 CD 1.16 Minnesota 55367 BV 1.07 Minnesota 55066 F 1.00 Minnesota 55182 CD 1.16 Minnesota 55368 BV 1.07 Minnesota 55067 F 1.00 Minnesota 55187 CD 1.16 Minnesota 55369 CD 1.16 Minnesota 55068 BV 1.07 Minnesota 55188 CD 1.16 Minnesota 55370 F 1.00 Minnesota 55069 F 1.00 Minnesota 55190 CD 1.16 Minnesota 55371 F 1.00 Minnesota 55070 CD 1.16 Minnesota 55191 CD 1.16 Minnesota 55372 BV 1.07 Minnesota 55071 BV 1.07 Minnesota 55199 CD 1.16 Minnesota 55373 F 1.00 Minnesota 55072 F 1.00 Minnesota 55301 F 1.00 Minnesota 55374 CD 1.16 Minnesota 55073 BV 1.07 Minnesota 55302 F 1.00 Minnesota 55375 CD 1.16 Minnesota 55074 F 1.00 Minnesota 55303 CD 1.16 Minnesota 55376 F 1.00 Minnesota 55075 BV 1.07 Minnesota 55304 CD 1.16 Minnesota 55377 F 1.00 Minnesota 55076 BV 1.07 Minnesota 55305 CD 1.16 Minnesota 55378 BV 1.07 Minnesota 55077 BV 1.07 Minnesota 55306 BV 1.07 Minnesota 55379 BV 1.07 Minnesota 55078 F 1.00 Minnesota 55307 F 1.00 Minnesota 55380 F 1.00 Minnesota 55079 F 1.00 Minnesota 55308 F 1.00 Minnesota 55381 F 1.00 Minnesota 55080 F 1.00 Minnesota 55309 F 1.00 Minnesota 55382 F 1.00 Minnesota 55082 BV 1.07 Minnesota 55310 F 1.00 Minnesota 55383 BV 1.07 Minnesota 55083 BV 1.07 Minnesota 55311 CD 1.16 Minnesota 55384 CD 1.16 Minnesota 55084 F 1.00 Minnesota 55312 F 1.00 Minnesota 55385 F 1.00 Minnesota 55085 BV 1.07 Minnesota 55313 F 1.00 Minnesota 55386 BV 1.07 Minnesota 55087 F 1.00 Minnesota 55314 F 1.00 Minnesota 55387 BV 1.07 Minnesota 55088 F 1.00 Minnesota 55315 BV 1.07 Minnesota 55388 BV 1.07 Minnesota 55089 F 1.00 Minnesota 55316 CD 1.16 Minnesota 55389 F 1.00 Minnesota 55090 BV 1.07 Minnesota 55317 BV 1.07 Minnesota 55390 F 1.00 Minnesota 55092 F 1.00 Minnesota 55318 BV 1.07 Minnesota 55391 CD 1.16 Minnesota 55101 CD 1.16 Minnesota 55319 F 1.00 Minnesota 55392 CD 1.16 Minnesota 55102 CD 1.16 Minnesota 55320 F 1.00 Minnesota 55393 F 1.00 Minnesota 55103 CD 1.16 Minnesota 55321 F 1.00 Minnesota 55394 BV 1.07 Minnesota 55104 CD 1.16 Minnesota 55322 BV 1.07 Minnesota 55395 F 1.00 Minnesota 55105 CD 1.16 Minnesota 55323 CD 1.16 Minnesota 55396 F 1.00 Minnesota 55106 CD 1.16 Minnesota 55324 F 1.00 Minnesota 55397 BV 1.07 Minnesota 55107 CD 1.16 Minnesota 55325 F 1.00 Minnesota 55398 F 1.00 Minnesota 55108 CD 1.16 Minnesota 55327 CD 1.16 Minnesota 55399 BV 1.07 Minnesota 55109 CD 1.16 Minnesota 55328 F 1.00 Minnesota 55400 CD 1.16 Minnesota 55110 CD 1.16 Minnesota 55329 F 1.00 Minnesota 55401 CD 1.16 Minnesota 55111 CD 1.16 Minnesota 55330 F 1.00 Minnesota 55402 CD 1.16 Minnesota 55112 CD 1.16 Minnesota 55331 CD 1.16 Minnesota 55403 CD 1.16 Minnesota 55113 CD 1.16 Minnesota 55332 F 1.00 Minnesota 55404 CD 1.16 Minnesota 55114 CD 1.16 Minnesota 55333 F 1.00 Minnesota 55405 CD 1.16 Minnesota 55115 CD 1.16 Minnesota 55334 F 1.00 Minnesota 55406 CD 1.16 Minnesota 55116 CD 1.16 Minnesota 55335 F 1.00 Minnesota 55407 CD 1.16 Minnesota 55117 CD 1.16 Minnesota 55336 F 1.00 Minnesota 55408 CD 1.16 Minnesota 55118 BV 1.07 Minnesota 55337 BV 1.07 Minnesota 55409 CD 1.16 Minnesota 55119 CD 1.16 Minnesota 55338 F 1.00 Minnesota 55410 CD 1.16 Minnesota 55120 BV 1.07 Minnesota 55339 BV 1.07 Minnesota 55411 CD 1.16 Minnesota 55121 BV 1.07 Minnesota 55340 CD 1.16 Minnesota 55412 CD 1.16 Minnesota 55122 BV 1.07 Minnesota 55341 F 1.00 Minnesota 55413 CD 1.16 Minnesota 55123 BV 1.07 Minnesota 55342 F 1.00 Minnesota 55414 CD 1.16 Minnesota 55124 BV 1.07 Minnesota 55343 CD 1.16 Minnesota 55415 CD 1.16 Minnesota 55125 BV 1.07 Minnesota 55344 CD 1.16 Minnesota 55416 CD 1.16 Minnesota 55126 CD 1.16 Minnesota 55345 CD 1.16 Minnesota 55417 CD 1.16 Minnesota 55127 CD 1.16 Minnesota 55346 CD 1.16 Minnesota 55418 CD 1.16 Minnesota 55128 BV 1.07 Minnesota 55347 CD 1.16 Minnesota 55419 CD 1.16 Minnesota 55129 BV 1.07 Minnesota 55348 CD 1.16 Minnesota 55420 CD 1.16 Minnesota 55130 CD 1.16 Minnesota 55349 F 1.00 Minnesota 55421 CD 1.16 Minnesota 55133 CD 1.16 Minnesota 55350 F 1.00 Minnesota 55422 CD 1.16 Minnesota 55144 CD 1.16 Minnesota 55352 BV 1.07 Minnesota 55423 CD 1.16 Minnesota 55145 CD 1.16 Minnesota 55353 F 1.00 Minnesota 55424 CD 1.16 Minnesota 55146 CD 1.16 Minnesota 55354 F 1.00 Minnesota 55425 CD 1.16 Minnesota 55150 BV 1.07 Minnesota 55355 F 1.00 Minnesota 55426 CD 1.16 Minnesota 55155 CD 1.16 Minnesota 55356 CD 1.16 Minnesota 55427 CD 1.16 4 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Minnesota 55428 CD 1.16 Missouri 649 F 1.00 Nevada 89032 CB 1.14 Minnesota 55429 CD 1.16 Missouri 650 F 1.00 Nevada 89033 CB 1.14 Minnesota 55430 CD 1.16 Missouri 651 F 1.00 Nevada 89034 F 1.00 Minnesota 55431 CD 1.16 Missouri 652 F 1.00 Nevada 89036 CB 1.14 Minnesota 55432 CD 1.16 Missouri 653 F 1.00 Nevada 89037 F 1.00 Minnesota 55433 CD 1.16 Missouri 654 F 1.00 Nevada 89039 F 1.00 Minnesota 55434 CD 1.16 Missouri 655 F 1.00 Nevada 89040 F 1.00 Minnesota 55435 CD 1.16 Missouri 656 F 1.00 Nevada 89041 F 1.00 Minnesota 55436 CD 1.16 Missouri 657 F 1.00 Nevada 89042 F 1.00 Minnesota 55437 CD 1.16 Missouri 658 F 1.00 Nevada 89043 F 1.00 Minnesota 55438 CD 1.16 Montana 590 F 1.00 Nevada 89044 CB 1.14 Minnesota 55439 CD 1.16 Montana 591 F 1.00 Nevada 89045 F 1.00 Minnesota 55440 CD 1.16 Montana 592 F 1.00 Nevada 89046 F 1.00 Minnesota 55441 CD 1.16 Montana 593 F 1.00 Nevada 89047 F 1.00 Minnesota 55442 CD 1.16 Montana 594 F 1.00 Nevada 89048 F 1.00 Minnesota 55443 CD 1.16 Montana 595 F 1.00 Nevada 89049 F 1.00 Minnesota 55444 CD 1.16 Montana 596 F 1.00 Nevada 89050 F 1.00 Minnesota 55445 CD 1.16 Montana 597 F 1.00 Nevada 89052 CB 1.14 Minnesota 55446 CD 1.16 Montana 598 F 1.00 Nevada 89053 CB 1.14 Minnesota 55447 CD 1.16 Montana 599 F 1.00 Nevada 89054 CB 1.14 Minnesota 55448 CD 1.16 Nebraska 683 F 1.00 Nevada 89060 F 1.00 Minnesota 55449 CD 1.16 Nebraska 684 F 1.00 Nevada 89061 F 1.00 Minnesota 55450 CD 1.16 Nebraska 686 F 1.00 Nevada 89067 F 1.00 Minnesota 55454 CD 1.16 Nebraska 687 F 1.00 Nevada 89070 F 1.00 Minnesota 55455 CD 1.16 Nebraska 688 F 1.00 Nevada 89074 CB 1.14 Minnesota 55458 CD 1.16 Nebraska 689 F 1.00 Nevada 89077 CB 1.14 Minnesota 55459 CD 1.16 Nebraska 690 F 1.00 Nevada 89081 CB 1.14 Minnesota 55460 CD 1.16 Nebraska 691 F 1.00 Nevada 89084 CB 1.14 Minnesota 55467 CD 1.16 Nebraska 692 F 1.00 Nevada 89085 CB 1.14 Minnesota 55468 CD 1.16 Nebraska 693 F 1.00 Nevada 89086 CB 1.14 Minnesota 55470 CD 1.16 Nebraska 680 CA 1.13 Nevada 89087 CB 1.14 Minnesota 55472 CD 1.16 Nebraska 681 CA 1.13 New Hampshire 002 F 1.00 Minnesota 55473 BV 1.07 Nebraska 685 CA 1.13 New Hampshire 030 F 1.00 Minnesota 55474 CD 1.16 Nevada 889 CB 1.14 New Hampshire 031 F 1.00 Minnesota 55478 CD 1.16 Nevada 891 CB 1.14 New Hampshire 032 F 1.00 Minnesota 55479 CD 1.16 Nevada 893 F 1.00 New Hampshire 033 F 1.00 Minnesota 55480 CD 1.16 Nevada 894 F 1.00 New Hampshire 034 F 1.00 Minnesota 55483 CD 1.16 Nevada 895 F 1.00 New Hampshire 035 F 1.00 Minnesota 55484 CD 1.16 Nevada 897 F 1.00 New Hampshire 036 F 1.00 Minnesota 55485 CD 1.16 Nevada 898 F 1.00 New Hampshire 037 F 1.00 Minnesota 55486 CD 1.16 Nevada 89001 F 1.00 New Hampshire 038 F 1.00 Minnesota 55487 CD 1.16 Nevada 89002 CB 1.14 New Jersey 070 F 1.00 Minnesota 55488 CD 1.16 Nevada 89003 F 1.00 New Jersey 071 F 1.00 Mississippi 386 F 1.00 Nevada 89004 F 1.00 New Jersey 072 F 1.00 Mississippi 387 F 1.00 Nevada 89005 F 1.00 New Jersey 073 F 1.00 Mississippi 388 F 1.00 Nevada 89006 F 1.00 New Jersey 074 F 1.00 Mississippi 389 F 1.00 Nevada 89007 F 1.00 New Jersey 075 F 1.00 Mississippi 390 F 1.00 Nevada 89008 F 1.00 New Jersey 076 F 1.00 Mississippi 391 F 1.00 Nevada 89009 CB 1.14 New Jersey 077 F 1.00 Mississippi 392 F 1.00 Nevada 89010 F 1.00 New Jersey 078 F 1.00 Mississippi 393 F 1.00 Nevada 89011 CB 1.14 New Jersey 079 F 1.00 Mississippi 394 CA 1.13 Nevada 89012 CB 1.14 New Jersey 080 F 1.00 Mississippi 395 CA 1.13 Nevada 89013 F 1.00 New Jersey 081 F 1.00 Mississippi 396 F 1.00 Nevada 89014 CB 1.14 New Jersey 082 F 1.00 Mississippi 397 F 1.00 Nevada 89015 CB 1.14 New Jersey 083 F 1.00 Missouri 630 I 1.15 Nevada 89016 CB 1.14 New Jersey 084 F 1.00 Missouri 631 I 1.15 Nevada 89017 F 1.00 New Jersey 085 F 1.00 Missouri 633 I 1.15 Nevada 89018 F 1.00 New Jersey 086 F 1.00 Missouri 634 F 1.00 Nevada 89019 F 1.00 New Jersey 087 F 1.00 Missouri 635 F 1.00 Nevada 89020 F 1.00 New Jersey 088 F 1.00 Missouri 636 F 1.00 Nevada 89021 F 1.00 New Jersey 089 F 1.00 Missouri 637 F 1.00 Nevada 89022 F 1.00 New Mexico 870 F 1.00 Missouri 638 F 1.00 Nevada 89023 F 1.00 New Mexico 871 CJ 1.24 Missouri 639 F 1.00 Nevada 89024 F 1.00 New Mexico 872 CJ 1.24 Missouri 640 I 1.15 Nevada 89025 F 1.00 New Mexico 873 F 1.00 Missouri 641 I 1.15 Nevada 89026 F 1.00 New Mexico 874 F 1.00 Missouri 644 F 1.00 Nevada 89027 F 1.00 New Mexico 875 F 1.00 Missouri 645 F 1.00 Nevada 89028 F 1.00 New Mexico 877 F 1.00 Missouri 646 F 1.00 Nevada 89029 F 1.00 New Mexico 878 F 1.00 Missouri 647 F 1.00 Nevada 89030 CB 1.14 New Mexico 879 F 1.00 Missouri 648 F 1.00 Nevada 89031 CB 1.14 New Mexico 880 F 1.00 5 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor New Mexico 881 F 1.00 New York 10926 BU 1.06 North Dakota 580 F 1.00 New Mexico 882 F 1.00 New York 10927 CP 1.33 North Dakota 581 F 1.00 New Mexico 883 F 1.00 New York 10928 BU 1.06 North Dakota 582 F 1.00 New Mexico 884 F 1.00 New York 10930 BU 1.06 North Dakota 583 F 1.00 New York 005 CP 1.33 New York 10931 CP 1.33 North Dakota 584 F 1.00 New York 100 CP 1.33 New York 10932 BU 1.06 North Dakota 585 F 1.00 New York 101 CP 1.33 New York 10933 BU 1.06 North Dakota 586 F 1.00 New York 102 CP 1.33 New York 10940 BU 1.06 North Dakota 587 F 1.00 New York 103 CP 1.33 New York 10941 BU 1.06 North Dakota 588 F 1.00 New York 104 CP 1.33 New York 10943 BU 1.06 Ohio 430 F 1.00 New York 105 CP 1.33 New York 10949 BU 1.06 Ohio 431 F 1.00 New York 106 CP 1.33 New York 10950 BU 1.06 Ohio 432 F 1.00 New York 107 CP 1.33 New York 10951 CP 1.33 Ohio 433 F 1.00 New York 108 CP 1.33 New York 10952 CP 1.33 Ohio 434 F 1.00 New York 110 CP 1.33 New York 10953 BU 1.06 Ohio 435 F 1.00 New York 111 CP 1.33 New York 10954 CP 1.33 Ohio 436 G 1.05 New York 112 CP 1.33 New York 10956 CP 1.33 Ohio 437 F 1.00 New York 113 CP 1.33 New York 10958 BU 1.06 Ohio 438 F 1.00 New York 114 CP 1.33 New York 10959 BU 1.06 Ohio 439 BX 1.09 New York 115 CP 1.33 New York 10960 CP 1.33 Ohio 440 G 1.05 New York 116 CP 1.33 New York 10962 CP 1.33 Ohio 441 BX 1.09 New York 117 CP 1.33 New York 10963 BU 1.06 Ohio 442 G 1.05 New York 118 CP 1.33 New York 10964 CP 1.33 Ohio 443 G 1.05 New York 119 CP 1.33 New York 10965 CP 1.33 Ohio 444 BX 1.09 New York 120 BU 1.06 New York 10968 CP 1.33 Ohio 445 BX 1.09 New York 121 BU 1.06 New York 10969 BU 1.06 Ohio 446 F 1.00 New York 122 BU 1.06 New York 10970 CP 1.33 Ohio 447 F 1.00 New York 123 BU 1.06 New York 10973 BU 1.06 Ohio 448 F 1.00 New York 124 BU 1.06 New York 10974 CP 1.33 Ohio 449 F 1.00 New York 125 BU 1.06 New York 10975 BU 1.06 Ohio 450 F 1.00 New York 126 BU 1.06 New York 10976 CP 1.33 Ohio 451 F 1.00 New York 127 BU 1.06 New York 10977 CP 1.33 Ohio 452 F 1.00 New York 128 F 1.00 New York 10979 BU 1.06 Ohio 453 F 1.00 New York 129 F 1.00 New York 10980 CP 1.33 Ohio 454 F 1.00 New York 130 F 1.00 New York 10981 BU 1.06 Ohio 455 F 1.00 New York 131 F 1.00 New York 10982 CP 1.33 Ohio 456 F 1.00 New York 132 F 1.00 New York 10983 CP 1.33 Ohio 457 F 1.00 New York 133 F 1.00 New York 10984 CP 1.33 Ohio 458 F 1.00 New York 134 F 1.00 New York 10985 BU 1.06 Ohio 459 F 1.00 New York 135 F 1.00 New York 10986 CP 1.33 Oklahoma 730 BW 1.08 New York 136 F 1.00 New York 10987 BU 1.06 Oklahoma 731 BW 1.08 New York 137 F 1.00 New York 10988 BU 1.06 Oklahoma 732 F 1.00 New York 138 F 1.00 New York 10989 CP 1.33 Oklahoma 733 F 1.00 New York 139 F 1.00 New York 10990 BU 1.06 Oklahoma 734 F 1.00 New York 140 BU 1.06 New York 10992 BU 1.06 Oklahoma 735 F 1.00 New York 141 BU 1.06 New York 10993 CP 1.33 Oklahoma 736 F 1.00 New York 142 BU 1.06 New York 10994 CP 1.33 Oklahoma 737 F 1.00 New York 143 BU 1.06 New York 10995 CP 1.33 Oklahoma 738 F 1.00 New York 144 F 1.00 New York 10996 BU 1.06 Oklahoma 739 F 1.00 New York 145 F 1.00 New York 10997 BU 1.06 Oklahoma 740 F 1.00 New York 146 F 1.00 New York 10998 BU 1.06 Oklahoma 741 BW 1.08 New York 147 F 1.00 North Carolina 270 F 1.00 Oklahoma 742 F 1.00 New York 148 F 1.00 North Carolina 271 F 1.00 Oklahoma 743 F 1.00 New York 149 F 1.00 North Carolina 272 F 1.00 Oklahoma 744 F 1.00 New York 10901 CP 1.33 North Carolina 273 F 1.00 Oklahoma 745 F 1.00 New York 10910 BU 1.06 North Carolina 274 F 1.00 Oklahoma 746 F 1.00 New York 10911 CP 1.33 North Carolina 275 F 1.00 Oklahoma 747 F 1.00 New York 10912 BU 1.06 North Carolina 276 F 1.00 Oklahoma 748 F 1.00 New York 10913 CP 1.33 North Carolina 277 F 1.00 Oklahoma 749 F 1.00 New York 10914 BU 1.06 North Carolina 278 F 1.00 Oregon 970 F 1.00 New York 10915 BU 1.06 North Carolina 279 F 1.00 Oregon 971 F 1.00 New York 10916 BU 1.06 North Carolina 280 F 1.00 Oregon 972 F 1.00 New York 10917 BU 1.06 North Carolina 281 F 1.00 Oregon 973 F 1.00 New York 10918 BU 1.06 North Carolina 282 F 1.00 Oregon 974 F 1.00 New York 10919 BU 1.06 North Carolina 283 F 1.00 Oregon 975 F 1.00 New York 10920 CP 1.33 North Carolina 284 F 1.00 Oregon 976 F 1.00 New York 10921 BU 1.06 North Carolina 285 F 1.00 Oregon 977 F 1.00 New York 10922 BU 1.06 North Carolina 286 F 1.00 Oregon 978 F 1.00 New York 10923 CP 1.33 North Carolina 287 F 1.00 Oregon 979 F 1.00 New York 10924 BU 1.06 North Carolina 288 F 1.00 Panama 000 F 1.00 New York 10925 BU 1.06 North Carolina 289 F 1.00 Pennsylvania 150 BB 1.21 6 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Pennsylvania 151 BB 1.21 Tennessee 372 F 1.00 Utah 845 F 1.00 Pennsylvania 152 BB 1.21 Tennessee 373 F 1.00 Utah 846 F 1.00 Pennsylvania 153 BB 1.21 Tennessee 374 F 1.00 Utah 847 F 1.00 Pennsylvania 154 BB 1.21 Tennessee 375 F 1.00 Vermont 050 F 1.00 Pennsylvania 155 F 1.00 Tennessee 376 F 1.00 Vermont 051 F 1.00 Pennsylvania 156 BB 1.21 Tennessee 377 F 1.00 Vermont 052 F 1.00 Pennsylvania 157 F 1.00 Tennessee 378 F 1.00 Vermont 053 F 1.00 Pennsylvania 158 F 1.00 Tennessee 379 F 1.00 Vermont 054 F 1.00 Pennsylvania 159 F 1.00 Tennessee 380 F 1.00 Vermont 056 F 1.00 Pennsylvania 160 F 1.00 Tennessee 381 F 1.00 Vermont 057 F 1.00 Pennsylvania 161 F 1.00 Tennessee 382 F 1.00 Vermont 058 F 1.00 Pennsylvania 162 F 1.00 Tennessee 383 F 1.00 Vermont 059 F 1.00 Pennsylvania 163 F 1.00 Tennessee 384 F 1.00 Virgin Island 008 F 1.00 Pennsylvania 164 F 1.00 Tennessee 385 F 1.00 Virginia 201 F 1.00 Pennsylvania 165 F 1.00 Texas 733 F 1.00 Virginia 220 BZ 1.12 Pennsylvania 166 F 1.00 Texas 750 BW 1.08 Virginia 221 BZ 1.12 Pennsylvania 167 F 1.00 Texas 751 BW 1.08 Virginia 222 BZ 1.12 Pennsylvania 168 F 1.00 Texas 752 J 1.20 Virginia 223 BZ 1.12 Pennsylvania 169 F 1.00 Texas 753 BW 1.08 Virginia 224 F 1.00 Pennsylvania 170 F 1.00 Texas 754 BW 1.08 Virginia 225 F 1.00 Pennsylvania 171 F 1.00 Texas 755 F 1.00 Virginia 226 F 1.00 Pennsylvania 172 F 1.00 Texas 756 F 1.00 Virginia 227 F 1.00 Pennsylvania 173 F 1.00 Texas 757 BW 1.08 Virginia 228 F 1.00 Pennsylvania 174 F 1.00 Texas 758 F 1.00 Virginia 229 F 1.00 Pennsylvania 175 F 1.00 Texas 759 F 1.00 Virginia 230 F 1.00 Pennsylvania 176 F 1.00 Texas 760 F 1.00 Virginia 231 F 1.00 Pennsylvania 177 F 1.00 Texas 761 BW 1.08 Virginia 232 BZ 1.12 Pennsylvania 178 F 1.00 Texas 762 F 1.00 Virginia 233 F 1.00 Pennsylvania 179 F 1.00 Texas 763 F 1.00 Virginia 234 F 1.00 Pennsylvania 180 F 1.00 Texas 764 F 1.00 Virginia 235 F 1.00 Pennsylvania 181 F 1.00 Texas 765 F 1.00 Virginia 236 F 1.00 Pennsylvania 182 F 1.00 Texas 766 F 1.00 Virginia 237 BZ 1.12 Pennsylvania 183 F 1.00 Texas 767 F 1.00 Virginia 238 F 1.00 Pennsylvania 184 F 1.00 Texas 768 F 1.00 Virginia 239 F 1.00 Pennsylvania 185 F 1.00 Texas 769 F 1.00 Virginia 240 F 1.00 Pennsylvania 186 F 1.00 Texas 770 J 1.20 Virginia 241 F 1.00 Pennsylvania 187 F 1.00 Texas 771 J 1.20 Virginia 242 BZ 1.12 Pennsylvania 188 F 1.00 Texas 772 J 1.20 Virginia 243 F 1.00 Pennsylvania 189 CP 1.33 Texas 773 J 1.20 Virginia 244 F 1.00 Pennsylvania 190 CP 1.33 Texas 774 J 1.20 Virginia 245 F 1.00 Pennsylvania 191 CP 1.33 Texas 775 J 1.20 Virginia 246 BZ 1.12 Pennsylvania 192 CP 1.33 Texas 776 J 1.20 Washington 980 F 1.00 Pennsylvania 193 CP 1.33 Texas 777 J 1.20 Washington 981 F 1.00 Pennsylvania 194 CP 1.33 Texas 778 F 1.00 Washington 982 F 1.00 Pennsylvania 195 F 1.00 Texas 779 F 1.00 Washington 983 F 1.00 Pennsylvania 196 F 1.00 Texas 780 F 1.00 Washington 984 F 1.00 Puerto Rico 006 F 1.00 Texas 781 F 1.00 Washington 985 F 1.00 Puerto Rico 007 F 1.00 Texas 782 J 1.20 Washington 986 F 1.00 Puerto Rico 009 F 1.00 Texas 783 F 1.00 Washington 988 F 1.00 Rhode Island 028 F 1.00 Texas 784 BW 1.08 Washington 989 F 1.00 Rhode Island 029 F 1.00 Texas 785 F 1.00 Washington 990 F 1.00 South Carolina 290 F 1.00 Texas 786 F 1.00 Washington 991 F 1.00 South Carolina 291 F 1.00 Texas 787 F 1.00 Washington 992 F 1.00 South Carolina 292 F 1.00 Texas 788 F 1.00 Washington 993 F 1.00 South Carolina 293 F 1.00 Texas 789 F 1.00 Washington 994 F 1.00 South Carolina 294 H 1.10 Texas 790 F 1.00 West Virginia 247 F 1.00 South Carolina 295 H 1.10 Texas 791 F 1.00 West Virginia 248 F 1.00 South Carolina 296 F 1.00 Texas 792 F 1.00 West Virginia 249 F 1.00 South Carolina 297 F 1.00 Texas 793 J 1.20 West Virginia 250 F 1.00 South Carolina 298 H 1.10 Texas 794 J 1.20 West Virginia 251 F 1.00 South Carolina 299 H 1.10 Texas 795 F 1.00 West Virginia 252 F 1.00 South Dakota 570 F 1.00 Texas 796 F 1.00 West Virginia 253 F 1.00 South Dakota 571 F 1.00 Texas 797 F 1.00 West Virginia 254 F 1.00 South Dakota 572 F 1.00 Texas 798 F 1.00 West Virginia 255 F 1.00 South Dakota 573 F 1.00 Texas 799 F 1.00 West Virginia 256 F 1.00 South Dakota 574 F 1.00 Texas 885 F 1.00 West Virginia 257 F 1.00 South Dakota 575 F 1.00 Utah 840 F 1.00 West Virginia 258 F 1.00 South Dakota 576 F 1.00 Utah 841 F 1.00 West Virginia 259 F 1.00 South Dakota 577 F 1.00 Utah 842 F 1.00 West Virginia 260 F 1.00 Tennessee 370 F 1.00 Utah 843 F 1.00 West Virginia 261 F 1.00 Tennessee 371 F 1.00 Utah 844 F 1.00 West Virginia 262 F 1.00 7 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor West Virginia 263 F 1.00 Wisconsin 53058 BX 1.09 Wisconsin 53152 BX 1.09 West Virginia 264 F 1.00 Wisconsin 53059 BX 1.09 Wisconsin 53153 BX 1.09 West Virginia 265 F 1.00 Wisconsin 53060 BX 1.09 Wisconsin 53154 CH 1.22 West Virginia 266 F 1.00 Wisconsin 53061 BX 1.09 Wisconsin 53156 BX 1.09 West Virginia 267 F 1.00 Wisconsin 53062 BX 1.09 Wisconsin 53157 BX 1.09 West Virginia 268 F 1.00 Wisconsin 53063 BX 1.09 Wisconsin 53158 CH 1.22 Wisconsin 532 CH 1.22 Wisconsin 53064 BX 1.09 Wisconsin 53159 CH 1.22 Wisconsin 534 CH 1.22 Wisconsin 53065 BX 1.09 Wisconsin 53167 BX 1.09 Wisconsin 535 BX 1.09 Wisconsin 53066 BX 1.09 Wisconsin 53168 BX 1.09 Wisconsin 537 BX 1.09 Wisconsin 53069 BX 1.09 Wisconsin 53170 BX 1.09 Wisconsin 538 BX 1.09 Wisconsin 53070 BX 1.09 Wisconsin 53171 CH 1.22 Wisconsin 539 F 1.00 Wisconsin 53072 CH 1.22 Wisconsin 53172 CH 1.22 Wisconsin 540 F 1.00 Wisconsin 53073 BX 1.09 Wisconsin 53176 BX 1.09 Wisconsin 541 F 1.00 Wisconsin 53074 BX 1.09 Wisconsin 53177 CH 1.22 Wisconsin 542 F 1.00 Wisconsin 53075 BX 1.09 Wisconsin 53178 BX 1.09 Wisconsin 543 F 1.00 Wisconsin 53076 CH 1.22 Wisconsin 53179 BX 1.09 Wisconsin 544 BX 1.09 Wisconsin 53078 BX 1.09 Wisconsin 53181 BX 1.09 Wisconsin 545 F 1.00 Wisconsin 53079 BX 1.09 Wisconsin 53182 CH 1.22 Wisconsin 546 F 1.00 Wisconsin 53080 BX 1.09 Wisconsin 53183 BX 1.09 Wisconsin 547 F 1.00 Wisconsin 53081 BX 1.09 Wisconsin 53184 BX 1.09 Wisconsin 548 F 1.00 Wisconsin 53082 BX 1.09 Wisconsin 53185 BX 1.09 Wisconsin 549 BX 1.09 Wisconsin 53083 BX 1.09 Wisconsin 53186 CH 1.22 Wisconsin 53001 BX 1.09 Wisconsin 53085 BX 1.09 Wisconsin 53187 CH 1.22 Wisconsin 53002 BX 1.09 Wisconsin 53086 BX 1.09 Wisconsin 53188 CH 1.22 Wisconsin 53003 BX 1.09 Wisconsin 53088 BX 1.09 Wisconsin 53189 CH 1.22 Wisconsin 53004 BX 1.09 Wisconsin 53089 CH 1.22 Wisconsin 53190 BX 1.09 Wisconsin 53005 CH 1.22 Wisconsin 53090 BX 1.09 Wisconsin 53191 BX 1.09 Wisconsin 53006 BX 1.09 Wisconsin 53091 BX 1.09 Wisconsin 53192 BX 1.09 Wisconsin 53007 CH 1.22 Wisconsin 53092 CH 1.22 Wisconsin 53194 CH 1.22 Wisconsin 53008 CH 1.22 Wisconsin 53093 BX 1.09 Wisconsin 53195 BX 1.09 Wisconsin 53009 BX 1.09 Wisconsin 53094 BX 1.09 Wisconsin 53199 BX 1.09 Wisconsin 53010 BX 1.09 Wisconsin 53095 BX 1.09 Wyoming 820 F 1.00 Wisconsin 53011 BX 1.09 Wisconsin 53097 CH 1.22 Wyoming 821 F 1.00 Wisconsin 53012 CH 1.22 Wisconsin 53098 BX 1.09 Wyoming 822 F 1.00 Wisconsin 53013 BX 1.09 Wisconsin 53099 BX 1.09 Wyoming 823 F 1.00 Wisconsin 53014 BX 1.09 Wisconsin 53101 BX 1.09 Wyoming 824 F 1.00 Wisconsin 53015 BX 1.09 Wisconsin 53102 CH 1.22 Wyoming 825 F 1.00 Wisconsin 53016 BX 1.09 Wisconsin 53103 BX 1.09 Wyoming 826 F 1.00 Wisconsin 53017 CH 1.22 Wisconsin 53104 CH 1.22 Wyoming 827 F 1.00 Wisconsin 53018 BX 1.09 Wisconsin 53105 BX 1.09 Wyoming 828 F 1.00 Wisconsin 53019 BX 1.09 Wisconsin 53108 CH 1.22 Wyoming 829 F 1.00 Wisconsin 53020 BX 1.09 Wisconsin 53109 CH 1.22 Wyoming 830 F 1.00 Wisconsin 53021 BX 1.09 Wisconsin 53110 CH 1.22 Wyoming 831 F 1.00 Wisconsin 53022 CH 1.22 Wisconsin 53114 BX 1.09 Wyoming 834 F 1.00 Wisconsin 53023 BX 1.09 Wisconsin 53115 BX 1.09 Wisconsin 53024 CH 1.22 Wisconsin 53118 BX 1.09 Wisconsin 53026 BX 1.09 Wisconsin 53119 BX 1.09 Wisconsin 53027 BX 1.09 Wisconsin 53120 BX 1.09 Wisconsin 53029 BX 1.09 Wisconsin 53121 BX 1.09 Wisconsin 53031 BX 1.09 Wisconsin 53122 CH 1.22 Wisconsin 53032 BX 1.09 Wisconsin 53125 BX 1.09 Wisconsin 53033 CH 1.22 Wisconsin 53126 CH 1.22 Wisconsin 53034 BX 1.09 Wisconsin 53127 BX 1.09 Wisconsin 53035 BX 1.09 Wisconsin 53128 BX 1.09 Wisconsin 53036 BX 1.09 Wisconsin 53129 CH 1.22 Wisconsin 53037 CH 1.22 Wisconsin 53130 CH 1.22 Wisconsin 53038 BX 1.09 Wisconsin 53132 CH 1.22 Wisconsin 53039 BX 1.09 Wisconsin 53137 BX 1.09 Wisconsin 53040 BX 1.09 Wisconsin 53138 BX 1.09 Wisconsin 53042 BX 1.09 Wisconsin 53139 BX 1.09 Wisconsin 53044 BX 1.09 Wisconsin 53140 CH 1.22 Wisconsin 53045 CH 1.22 Wisconsin 53141 CH 1.22 Wisconsin 53046 CH 1.22 Wisconsin 53142 CH 1.22 Wisconsin 53047 BX 1.09 Wisconsin 53143 CH 1.22 Wisconsin 53048 BX 1.09 Wisconsin 53144 CH 1.22 Wisconsin 53049 BX 1.09 Wisconsin 53146 CH 1.22 Wisconsin 53050 BX 1.09 Wisconsin 53147 BX 1.09 Wisconsin 53051 CH 1.22 Wisconsin 53148 BX 1.09 Wisconsin 53052 CH 1.22 Wisconsin 53149 BX 1.09 Wisconsin 53056 BX 1.09 Wisconsin 53150 CH 1.22 Wisconsin 53057 BX 1.09 Wisconsin 53151 CH 1.22 8 of 8 Assured Life Association Date: 06/29/2011 Page 1 of 1 Schedule of Monthly Rates For Policy Form MTA42 - Pennsylvania Male Tobacco User Attained Age Thru 64 108.75 65 108.75 66 112.31 67 117.09 68 120.96 69 124.99 70 128.91 71 132.70 72 136.36 73 139.73 74 142.89 75 145.76 76 148.55 77 151.22 78 153.76 79 156.22 80 158.68 81 161.09 82 168.34 83 170.62 84 172.88 85 175.07 86 177.25 87 181.26 88 183.50 89 185.81 90 188.21 91 190.65 92 195.04 93 197.66 94 200.41 95 203.19 96 205.95 97 208.60 98 211.30 99 214.07 NON-TOBACCO PREMIUMS ARE 13% LOWER THAN TOBACCO PREMIUMS. FEMALE PREMIUMS ARE 13% LOWER THAN MALE PREMIUMS. TO OBTAIN QUARTERLY, SEMIANNUAL, AND ANNUAL PREMIUMS, MULTIPLY THE ABOVE QUOTED PREMIUMS BY 3, 6, AND 12 RESPECTIVELY. MTA42 PA BASE RATE 12/14/2010 0003 Printed by: req29418 SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Supporting Document Schedules Item Status: Status Date: Satisfied - Item: Transmittal Letter (A&H) Comments: Attachment: cover letter pa-select.pdf Item Status: Status Date: Satisfied - Item: Actuarial Certification (A&H) Comments: Attachment: Actuarial Certification.pdf Item Status: Status Date: Satisfied - Item: Actuarial Memorandum and Explanatory Information (A&H) Comments: Attachment: ALA 2010 sel act memo all plans_PA with exhibits.pdf Item Status: Status Date: Bypassed - Item: Advertisements (A&H) Bypass Reason: N/A Comments: Item Status: Status Date: Satisfied - Item: Authorization to File (A&H) PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Comments: Attachment: ALA Filing Authorization.pdf Item Status: Status Date: Satisfied - Item: Certification of Plan A and B (A&H) Comments: Attachment: PA AB Cert.pdf Item Status: Status Date: Bypassed - Item: Insert Page Explanation (A&H) Bypass Reason: N/A Comments: Item Status: Status Date: Bypassed - Item: Rate Table (A&H) Bypass Reason: n/a Comments: Item Status: Status Date: Bypassed - Item: Replacement Form with Highlighted Changes (A&H) Bypass Reason: n/a Comments: Item Status: Status Date: Bypassed - Item: Variability Explanation (A&H) PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM SERFF Tracking Number: ABAI-127306981 State: Pennsylvania Filing Company: Assured Life Association State Tracking Number: Company Tracking Number: TOI: MS07I Individual Medicare Supplement - Sub-TOI: MS07I.004 Plan D 2010 Medicare Select 2010 Product Name: Assured Life 2011 Rate Increase- Plan D Project Name/Number: 2011 Annual Rate Filing -MTA42/Assured Life 2011 Bypass Reason: n/a Comments: PDF Pipeline for SERFF Tracking Number ABAI-127306981 Generated 07/23/2011 04:04 AM July 1, 2011 SERFF FILING Commissioner of Insurance Attn: Individual Medicare Supplement – Rate Change Filing RE: Assured Life Association NAIC # 56499 FEIN 84-0356870 Individual Medicare Supplement Insurance Policies MTA40, MTA41, MTA42, MTA43, and MTA44 Dear Sir: The purpose of this filing is to request the rate increase amounts shown below for the Company’s 2010 Standardized Select Medicare Supplement Plans to be effective on August 1, 2011 for new business and on October 1, 2011 for existing business. Plan Requested Rate Increase B 9.9% C 9.9% D 9.9% F 9.9% G 9.9% This filing demonstrates that the loss ratios, rates and benefits associated with these forms comply with all applicable regulations pertaining to Medicare Supplement insurance products and that the rates are reasonable in relation to the benefits provided. If you have any questions or require additional information, please do not hesitate to contact me by phone at (512) 502-8800 or via email at jstotts@baileyramsey.com. Thank you for your consideration. Sincerely, Jenna Stotts Compliance Analyst Pennsylvania Actuarial Certification Gerber Life Insurance Company I, Thomas E. Pyle, ASA, MAAA, of Bailey, Ramsey & Associates, Inc., am the Consulting Actuary for Gerber Life Insurance Company and am a member of the American Academy of Actuaries in good standing. I certify that the premium rates being submitted: Are calculated in a manner that complies with accepted actuarial practices; Are uniformly applied to the policies included in the filing; and Comply with all applicable Pennsylvania insurance laws and regulations. June 29, 2011 Thomas E. Pyle, ASA, MAAA Date Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) I. Purpose of Filing The purpose of this filing is to request the rate increase amounts shown below for the Company’s 2010 Standardized Medicare Supplement Select Plans to be effective on August 1, 2011 for new business and on October 1, 2011 for existing business. Plan Requested Rate Increase B 9.9% C 9.9% D 9.9% F 9.9% G 9.9% This filing demonstrates that the loss ratios, rates and benefits associated with these forms comply with all applicable regulations pertaining to Medicare Supplement insurance products and that the rates are reasonable in relation to the benefits provided. II. General Description Type of Certificate The certificates are individual health insurance certificates designed to supplement the benefits provided by Medicare. Coverage provided by the certificates will be automatically adjusted to coincide with changes in Medicare deductibles, coinsurance payments or other Medicare benefits. Description of Benefits Standardized Medicare Supplement benefits provided the following benefits by all plans (“basic benefits”): 1. Coverage of Part A Medicare eligible expenses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare benefit period. 2. Coverage of Part A Medicare eligible expenses for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. 3. Upon exhaustion of the Medicare Hospital inpatient coverage including the lifetime reserve days, coverage of 100% of the Medicare Part A Eligible Expenses for hospitalization paid at the applicable prospective payment system Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) rate or other appropriate Medicare standard of payment, subject to a lifetime maximum benefit of an additional 365 days. 4. Coverage under Medicare Parts A and B for the reasonable cost of the first three pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in accordance with federal regulations. 5. Coverage for the coinsurance amount, or in the case of hospital outpatient department services, the copayment amount, of Medicare eligible expenses under Part B regardless of hospital confinement, subject to the Medicare Part B deductible. 6. Coverage of cost sharing for all Part A Medicare eligible hospice care and respite care expenses. In addition to the basic benefits, Select Plan B provides the following benefit: 1. Coverage for all of the Medicare Part A inpatient hospital deductible amounts per benefit period if confined in a participating hospital. For confinement in a non-participating hospital, the insured is responsible for paying the Medicare Part A inpatient hospital deductible unless: (1) admission is for Emergency Care; (2) the insured is admitted outside the Geographic Service Area and requires urgently needed services; or (3) the services required are not available at a participating hospital. In addition to the basic benefits, Select Plan C provides the following benefits: 1. Coverage for all of the Medicare Part A inpatient hospital deductible amounts per benefit period if confined in a participating hospital. For confinement in a non-participating hospital, the insured is responsible for paying the Medicare Part A inpatient hospital deductible unless: (1) admission is for Emergency Care; (2) the insured is admitted outside the Geographic Service Area and requires urgently needed services; or (3) the services required are not available at a participating hospital. 2. Coverage for the actual billed charges, up to the coinsurance amount, from the 21st day through the 100th day in a Medicare benefit period for post hospital skilled nursing facility care eligible under Part A. 3. Coverage to the extent not covered by Medicare for 80% of the billed charges for Medicare-eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) care began during the first 60 consecutive days of each trip outside the United States subject to a $250 calendar year deductible and a lifetime maximum benefit of $50,000. 4. Coverage for all of the Medicare Part B deductible amount per calendar year regardless of hospital confinement. In addition to the basic benefits, Select Plan D provides the following benefits: 1. Coverage for all of the Medicare Part A inpatient hospital deductible amounts per benefit period if confined in a participating hospital. For confinement in a non-participating hospital, the insured is responsible for paying the Medicare Part A inpatient hospital deductible unless: (1) admission is for Emergency Care; (2) the insured is admitted outside the Geographic Service Area and requires urgently needed services; or (3) the services required are not available at a participating hospital. 2. Coverage for the actual billed charges, up to the coinsurance amount, from the 21st day through the 100th day in a Medicare benefit period for post hospital skilled nursing facility care eligible under Part A. 3. Coverage to the extent not covered by Medicare for 80% of the billed charges for Medicare-eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which care began during the first 60 consecutive days of each trip outside the United States subject to a $250 calendar year deductible and a lifetime maximum benefit of $50,000. In addition to the basic benefits, Select Plan F provides the following benefits: 1. Coverage for all of the Medicare Part A inpatient hospital deductible amounts per benefit period if confined in a participating hospital. For confinement in a non-participating hospital, the insured is responsible for paying the Medicare Part A inpatient hospital deductible unless: (1) admission is for Emergency Care; (2) the insured is admitted outside the Geographic Service Area and requires urgently needed services; or (3) the services required are not available at a participating hospital. 2. Coverage for the actual billed charges, up to the coinsurance amount, from the 21st day through the 100th day in a Medicare benefit period for post hospital skilled nursing facility care eligible under Part A. Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) 3. Coverage to the extent not covered by Medicare for 80% of the billed charges for Medicare-eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which care began during the first 60 consecutive days of each trip outside the United States subject to a $250 calendar year deductible and a lifetime maximum benefit of $50,000. 4. Coverage for all of the Medicare Part B deductible amount per calendar year regardless of hospital confinement. 5. Coverage for all of the difference between the actual Medicare Part B charge as billed, not to exceed any charge limitation established by the Medicare program or state law, and the Medicare-approved Part B charge. In addition to the basic benefits, Select Plan G provides the following benefits: 1. Coverage for all of the Medicare Part A inpatient hospital deductible amounts per benefit period if confined in a participating hospital. For confinement in a non-participating hospital, the insured is responsible for paying the Medicare Part A inpatient hospital deductible unless: (1) admission is for Emergency Care; (2) the insured is admitted outside the Geographic Service Area and requires urgently needed services; or (3) the services required are not available at a participating hospital. 2. Coverage for the actual billed charges, up to the coinsurance amount, from the 21st day through the 100th day in a Medicare benefit period for post hospital skilled nursing facility care eligible under Part A. 3. Coverage to the extent not covered by Medicare for 80% of the billed charges for Medicare-eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which care began during the first 60 consecutive days of each trip outside the United States subject to a $250 calendar year deductible and a lifetime maximum benefit of $50,000. 4. Coverage for all of the difference between the actual Medicare Part B charge as billed, not to exceed any charge limitation established by the Medicare program or state law, and the Medicare-approved Part B charge. Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) Renewability These plans are guaranteed renewable for the lifetime of the insured, but premiums may be changed on a class basis. Marketing Method These plans will be marketed through individual agent solicitation. Underwriting Method These plans are subject to underwriting approval. However, during the open enrollment periods and for individuals eligible for guaranteed issue under all applicable state laws and regulations, certificates will be issued without underwriting. Issue Age Limits These plans are available to persons age 65 and older who have Medicare parts A and B and to persons under age 65 who have Medicare part B. Premium Bases Premiums are sex-distinct, smoker-distinct and vary by attained age. Premiums also vary by the geographical region (zip code) in which the insured resides. III. Scope and Reason for Rate Request A rate revision is requested due to medical claim trend and Medicare changes (i.e. deductible) incurred since the last rate filing for the product. This rate revision applies to all rates uniformly and it is assumed that the new rate will become effective August 1, 2011 for new business and on October 1, 2011 for existing business (or the approval date if later) and apply on the next certificate premium due date (subject to premium change notification requirements). IV. Rating Methodology and Assumptions General Method Claim costs were combined with the assumptions shown in this section, using standard actuarial techniques, to produce test gross premiums that would produce a minimum loss ratio of 65%. These test premiums were adjusted for smoothness, for competitive purposes and to achieve profit objectives while still Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) satisfying regulatory requirements. We anticipate annual adjustments in premium rates to reflect medical trend and changes in benefit provisions. All assumptions used were based on originally filed assumptions weighted for current in-force detailed in this section. Medical trend of 8.0% was used for all plans. When applicable, the rate increase requested is based on an actual to expected loss ratio analysis. Morbidity Assumptions Claim costs are based on Tillinghast’s Medicare Supplement claim costs, trended forward to current levels. Additional information was obtained from industry experience derived from companies offering similar products. To reflect the impact of underwriting, the following selection factors were used: Certificate Age Ages Ages Ages Year 65 66-75 76-84 85+ 1 1.00 0.75 0.80 0.85 2 1.00 0.85 0.90 0.95 3 1.00 1.00 1.00 1.00 4 1.00 1.00 1.00 1.00 5+ 1.00 1.00 1.00 1.00 * For initial age 65, selection factors for durations 1 and 2 are equal to the duration 3 selection factor. Lapse Assumptions The following lapse assumptions were used. A weighted lapse rate by state and plan inforce was used for the nationwide business as shown on Exhibit IV. Year Plans B, C, D, F, G 1 18.0% 2 16.0% 3 14.0% 4 14.0% 5 12.0% 6+ 10.0% Mortality 1990-95 ALB Aggregate Ultimate, Male and Female Interest Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) 5.0% per annum Mode of Premium Certificates may be issued on an annual, semi-annual, quarterly or monthly PAC mode. Distribution by Sex In determining expected loss ratios, the following sex distribution is assumed: Issue Age Male Female 64-65 45.0% 55.0% 66-69 44.0% 56.0% 70-74 43.0% 57.0% 75-79 42.0% 58.0% 80-84 39.0% 61.0% 85+ 35.0% 65.0% Distribution by Smoker Classification In determining expected loss ratios, it is assumed that 95% non-smokers and 5% smokers purchase these plans. Distribution by Issue Age Where credible experience was available, actual distribution by age was used in this filing. Otherwise, the distribution by issue age presented in the original filing was assumed. V. Proposed Rates and Rating Factors The proposed premium rates are attached as Exhibit I. These rates are intended to apply for the lifetime of the insured, assuming no increase in medical costs and no benefit changes. The rates will apply to all new issues as well as current certificates on and subsequent to the date approval of this rate filing. Should a certificateholder move outside of the state of issue, the rate charged will continue to be dependent on the issuing state. VI. Rate History and In-Force Certificate Counts Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) The original approval date, rate history, credibility calculation, and in-force certificate counts are shown in Exhibit II. VII. Historical Experience and Projected Loss Ratios Expected loss ratios were used to determine the expected inception to date and expected lifetime incurred loss ratios based on the distribution of business assumed in the initial filing. When available, projections using actual experience were then made using the rating methodology and assumptions detailed in Section IV using standard actuarial techniques. The base period was from the date of the first issue through March 31, 2011 based on national experience. The projection assumes an annual 8.0% medical trend in claim costs each year for all plans. Premiums are assumed to increase at the same rate as medical trend. The results of these projections and all pertinent assumptions are summarized in Exhibit III and Exhibit IV. The rate increase requested is based on an actual to expected loss ratio analysis, using NAIC guidelines for the maximum rate increase allowable with full credibility given at 2,000 certificates and zero credibility given at 250 polices. State and plan experience was weighted with expected distributions in order to project future loss ratios and in determining the final rate increase. Where actual experience is available, Exhibit III shows the third year loss ratio will meet or exceed the 65% minimum loss ratio standard with the proposed rate increase as it contains the state (if applicable) and nationwide historical and projected incurred claims and earned premiums by duration and calendar year. The loss ratio projection shown in Exhibit IV demonstrates that each plan meets minimum loss ratio standards for the ratios of the present value of claims to premiums as well as for the lifetime loss ratio. This loss ratio demonstration utilizes the loss ratios from the initial filing, shown in Exhibit V, and assumes an 8.0% annual trend in claim costs for all plans. VIII. Future Rate Adjustments The company will adjust future premiums, subject to regulatory approval, based on the preceding assumptions using an actual to expected loss ratio basis. IX. Actuarial Certification I hereby certify that, to the best of my knowledge and judgment, the following items are true with respect to this filing: the assumptions represent my best judgment as to the reasonable value for each assumption and are consistent with the issuer's business plan at the time of the filing; the anticipated lifetime loss ratio, future loss ratios, and third-year loss ratio all exceed the applicable ratio; the filed rates maintain the proper relationship between certificates which had different rating methodologies; the filing was prepared based on the current Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) standards and practices as promulgated by the Actuarial Standards Board including the data quality standard of practice; the filing is in compliance with applicable laws and regulations in the state in which this is filed; and the premiums are not inadequate, excessive, unfairly discriminatory or unreasonable in relation to the benefits provided. June 24, 2011 Thomas E. Pyle, ASA, MAAA Date Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) Addendum Commission Rates: All Issue Ages Certificate Years 1-6: 26.5% Certificate Years 7-10: 9.5% Certificate Years 11+: 0.0% Assured Life Association Actuarial Memorandum Forms MTA40, MTA41, MTA42, MTA43 and MTA44 (Pennsylvania) Loss Ratio Certification I hereby certify that the following are the expected lifetime loss ratio for these forms: 2010 Select B (MTA40): 72.9% C (MTA41): 72.9% D (MTA42): 73.2% F (MTA43): 73.2% G(MTA44): 73.2% Each of which is in excess of the minimum pricing loss ratio required for this form of insurance. June 30, 2011 Thomas E. Pyle, ASA, MAAA Date Assured Life Association Date: 06/29/2011 Page 1 of 1 Schedule of Monthly Rates For Policy Form MTA40 - Pennsylvania Male Tobacco User Attained Age Thru 64 110.69 65 110.69 66 114.25 67 119.10 68 122.95 69 126.90 70 130.74 71 134.43 72 137.97 73 141.19 74 144.16 75 146.79 76 149.35 77 151.78 78 154.05 79 156.23 80 158.41 81 160.51 82 167.41 83 169.32 84 171.19 85 172.98 86 174.74 87 178.28 88 180.07 89 181.91 90 183.81 91 185.71 92 189.50 93 191.54 94 193.69 95 195.82 96 197.91 97 199.88 98 201.85 99 203.86 NON-TOBACCO PREMIUMS ARE 13% LOWER THAN TOBACCO PREMIUMS. FEMALE PREMIUMS ARE 13% LOWER THAN MALE PREMIUMS. TO OBTAIN QUARTERLY, SEMIANNUAL, AND ANNUAL PREMIUMS, MULTIPLY THE ABOVE QUOTED PREMIUMS BY 3, 6, AND 12 RESPECTIVELY. MTA40 PA BASE RATE 12/14/2010 0003 Printed by: req29418 Assured Life Association Date: 06/29/2011 Page 1 of 1 Schedule of Monthly Rates For Policy Form MTA41 - Pennsylvania Male Tobacco User Attained Age Thru 64 135.72 65 135.72 66 140.16 67 146.17 68 150.99 69 155.98 70 160.83 71 165.52 72 170.03 73 174.18 74 178.04 75 181.51 76 184.91 77 188.15 78 191.22 79 194.18 80 197.15 81 200.06 82 208.96 83 211.69 84 214.38 85 216.96 86 219.57 87 224.42 88 227.06 89 229.72 90 232.52 91 235.33 92 240.55 93 243.58 94 246.78 95 249.99 96 253.18 97 256.22 98 259.32 99 262.51 NON-TOBACCO PREMIUMS ARE 13% LOWER THAN TOBACCO PREMIUMS. FEMALE PREMIUMS ARE 13% LOWER THAN MALE PREMIUMS. TO OBTAIN QUARTERLY, SEMIANNUAL, AND ANNUAL PREMIUMS, MULTIPLY THE ABOVE QUOTED PREMIUMS BY 3, 6, AND 12 RESPECTIVELY. MTA41 PA BASE RATE 12/14/2010 0003 Printed by: req29418 Assured Life Association Date: 06/29/2011 Page 1 of 1 Schedule of Monthly Rates For Policy Form MTA43 - Pennsylvania Male Tobacco User Attained Age Thru 64 136.20 65 136.20 66 140.67 67 146.69 68 151.54 69 156.54 70 161.42 71 166.11 72 170.64 73 174.80 74 178.66 75 182.16 76 185.56 77 188.80 78 191.87 79 194.85 80 197.83 81 200.73 82 209.67 83 212.40 84 215.09 85 217.70 86 220.29 87 225.15 88 227.81 89 230.48 90 233.25 91 236.09 92 241.32 93 244.36 94 247.56 95 250.77 96 253.96 97 257.01 98 260.11 99 263.31 NON-TOBACCO PREMIUMS ARE 13% LOWER THAN TOBACCO PREMIUMS. FEMALE PREMIUMS ARE 13% LOWER THAN MALE PREMIUMS. TO OBTAIN QUARTERLY, SEMIANNUAL, AND ANNUAL PREMIUMS, MULTIPLY THE ABOVE QUOTED PREMIUMS BY 3, 6, AND 12 RESPECTIVELY. MTA43 PA BASE RATE 12/14/2010 0003 Printed by: req29418 Assured Life Association Date: 06/29/2011 Page 1 of 1 Schedule of Monthly Rates For Policy Form MTA44 - Pennsylvania Male Tobacco User Attained Age Thru 64 109.17 65 109.17 66 112.75 67 117.55 68 121.43 69 125.47 70 129.42 71 133.22 72 136.89 73 140.28 74 143.44 75 146.31 76 149.11 77 151.80 78 154.34 79 156.79 80 159.28 81 161.70 82 168.97 83 171.25 84 173.51 85 175.69 86 177.88 87 181.91 88 184.15 89 186.46 90 188.86 91 191.31 92 195.71 93 198.34 94 201.10 95 203.88 96 206.63 97 209.29 98 212.00 99 214.77 NON-TOBACCO PREMIUMS ARE 13% LOWER THAN TOBACCO PREMIUMS. FEMALE PREMIUMS ARE 13% LOWER THAN MALE PREMIUMS. TO OBTAIN QUARTERLY, SEMIANNUAL, AND ANNUAL PREMIUMS, MULTIPLY THE ABOVE QUOTED PREMIUMS BY 3, 6, AND 12 RESPECTIVELY. MTA44 PA BASE RATE 12/14/2010 0003 Printed by: req29418 Assured Life Association Date: 06/29/2011 Page 1 of 1 Schedule of Monthly Rates For Policy Form MTA42 - Pennsylvania Male Tobacco User Attained Age Thru 64 108.75 65 108.75 66 112.31 67 117.09 68 120.96 69 124.99 70 128.91 71 132.70 72 136.36 73 139.73 74 142.89 75 145.76 76 148.55 77 151.22 78 153.76 79 156.22 80 158.68 81 161.09 82 168.34 83 170.62 84 172.88 85 175.07 86 177.25 87 181.26 88 183.50 89 185.81 90 188.21 91 190.65 92 195.04 93 197.66 94 200.41 95 203.19 96 205.95 97 208.60 98 211.30 99 214.07 NON-TOBACCO PREMIUMS ARE 13% LOWER THAN TOBACCO PREMIUMS. FEMALE PREMIUMS ARE 13% LOWER THAN MALE PREMIUMS. TO OBTAIN QUARTERLY, SEMIANNUAL, AND ANNUAL PREMIUMS, MULTIPLY THE ABOVE QUOTED PREMIUMS BY 3, 6, AND 12 RESPECTIVELY. MTA42 PA BASE RATE 12/14/2010 0003 Printed by: req29418 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Alabama 350 F 1.00 Arizona 85337 H 1.10 Arkansas 723 CE 1.17 Alabama 351 F 1.00 Arizona 85338 H 1.10 California 900 CS 1.38 Alabama 352 F 1.00 Arizona 85339 H 1.10 California 901 CS 1.38 Alabama 354 F 1.00 Arizona 85340 H 1.10 California 902 CS 1.38 Alabama 355 F 1.00 Arizona 85341 F 1.00 California 903 CS 1.38 Alabama 356 F 1.00 Arizona 85342 H 1.10 California 904 CS 1.38 Alabama 357 F 1.00 Arizona 85343 H 1.10 California 905 CS 1.38 Alabama 358 F 1.00 Arizona 85344 F 1.00 California 906 CS 1.38 Alabama 359 F 1.00 Arizona 85345 H 1.10 California 907 CS 1.38 Alabama 360 F 1.00 Arizona 85346 F 1.00 California 908 CS 1.38 Alabama 361 F 1.00 Arizona 85347 F 1.00 California 909 CS 1.38 Alabama 362 F 1.00 Arizona 85348 F 1.00 California 910 CS 1.38 Alabama 363 F 1.00 Arizona 85349 F 1.00 California 911 CS 1.38 Alabama 364 F 1.00 Arizona 85350 F 1.00 California 912 CS 1.38 Alabama 365 F 1.00 Arizona 85351 H 1.10 California 913 CS 1.38 Alabama 366 F 1.00 Arizona 85352 F 1.00 California 914 CS 1.38 Alabama 367 F 1.00 Arizona 85353 H 1.10 California 915 CS 1.38 Alabama 368 F 1.00 Arizona 85354 H 1.10 California 916 CS 1.38 Alabama 369 F 1.00 Arizona 85355 H 1.10 California 917 CS 1.38 Alaska 995 F 1.00 Arizona 85356 F 1.00 California 918 CS 1.38 Alaska 996 F 1.00 Arizona 85357 F 1.00 California 919 CD 1.16 Alaska 997 F 1.00 Arizona 85358 H 1.10 California 920 CD 1.16 Alaska 998 F 1.00 Arizona 85359 F 1.00 California 921 CD 1.16 Alaska 999 F 1.00 Arizona 85360 F 1.00 California 922 CD 1.16 Arizona 850 H 1.10 Arizona 85361 H 1.10 California 923 CD 1.16 Arizona 851 H 1.10 Arizona 85362 H 1.10 California 924 CD 1.16 Arizona 852 H 1.10 Arizona 85363 H 1.10 California 925 CD 1.16 Arizona 855 F 1.00 Arizona 85364 F 1.00 California 926 CS 1.38 Arizona 856 H 1.10 Arizona 85365 F 1.00 California 927 CS 1.38 Arizona 857 H 1.10 Arizona 85366 F 1.00 California 928 CS 1.38 Arizona 859 F 1.00 Arizona 85367 F 1.00 California 930 CD 1.16 Arizona 860 F 1.00 Arizona 85369 F 1.00 California 931 CD 1.16 Arizona 863 F 1.00 Arizona 85371 F 1.00 California 932 F 1.00 Arizona 864 H 1.10 Arizona 85372 H 1.10 California 933 F 1.00 Arizona 865 F 1.00 Arizona 85373 H 1.10 California 934 F 1.00 Arizona 85301 H 1.10 Arizona 85374 H 1.10 California 935 F 1.00 Arizona 85302 H 1.10 Arizona 85375 H 1.10 California 936 F 1.00 Arizona 85303 H 1.10 Arizona 85376 H 1.10 California 937 F 1.00 Arizona 85304 H 1.10 Arizona 85377 H 1.10 California 938 F 1.00 Arizona 85305 H 1.10 Arizona 85378 H 1.10 California 939 F 1.00 Arizona 85306 H 1.10 Arizona 85379 H 1.10 California 940 CD 1.16 Arizona 85307 H 1.10 Arizona 85380 H 1.10 California 941 CD 1.16 Arizona 85308 H 1.10 Arizona 85381 H 1.10 California 942 CD 1.16 Arizona 85309 H 1.10 Arizona 85382 H 1.10 California 943 CD 1.16 Arizona 85310 H 1.10 Arizona 85383 H 1.10 California 944 CD 1.16 Arizona 85311 H 1.10 Arizona 85384 H 1.10 California 945 CD 1.16 Arizona 85312 H 1.10 Arizona 85385 H 1.10 California 946 CD 1.16 Arizona 85313 H 1.10 Arizona 85386 H 1.10 California 947 CD 1.16 Arizona 85314 H 1.10 Arizona 85387 H 1.10 California 948 CD 1.16 Arizona 85315 H 1.10 Arizona 85388 H 1.10 California 949 CD 1.16 Arizona 85316 H 1.10 Arizona 85389 H 1.10 California 950 F 1.00 Arizona 85317 H 1.10 Arizona 85390 H 1.10 California 951 F 1.00 Arizona 85318 H 1.10 Arizona 85391 H 1.10 California 952 F 1.00 Arizona 85319 H 1.10 Arizona 85392 H 1.10 California 953 F 1.00 Arizona 85320 H 1.10 Arizona 85393 H 1.10 California 954 F 1.00 Arizona 85321 F 1.00 Arizona 85394 H 1.10 California 955 F 1.00 Arizona 85322 H 1.10 Arizona 85395 H 1.10 California 956 F 1.00 Arizona 85323 H 1.10 Arizona 85396 H 1.10 California 957 F 1.00 Arizona 85324 H 1.10 Arkansas 716 F 1.00 California 958 F 1.00 Arizona 85325 F 1.00 Arkansas 717 F 1.00 California 959 F 1.00 Arizona 85326 H 1.10 Arkansas 724 F 1.00 California 960 F 1.00 Arizona 85327 H 1.10 Arkansas 725 F 1.00 California 961 F 1.00 Arizona 85328 F 1.00 Arkansas 726 F 1.00 Colorado 800 H 1.10 Arizona 85329 H 1.10 Arkansas 727 F 1.00 Colorado 801 H 1.10 Arizona 85330 H 1.10 Arkansas 728 F 1.00 Colorado 802 H 1.10 Arizona 85331 H 1.10 Arkansas 729 F 1.00 Colorado 803 F 1.00 Arizona 85332 H 1.10 Arkansas 718 BX 1.09 Colorado 805 F 1.00 Arizona 85333 F 1.00 Arkansas 719 BX 1.09 Colorado 807 F 1.00 Arizona 85334 F 1.00 Arkansas 720 BX 1.09 Colorado 808 F 1.00 Arizona 85335 H 1.10 Arkansas 721 BX 1.09 Colorado 809 F 1.00 Arizona 85336 F 1.00 Arkansas 722 CE 1.17 Colorado 810 F 1.00 1 of 8 0WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Colorado 811 F 1.00 Colorado 80610 F 1.00 Florida 346 F 1.00 Colorado 812 F 1.00 Colorado 80611 F 1.00 Florida 347 F 1.00 Colorado 813 F 1.00 Colorado 80612 F 1.00 Florida 349 F 1.00 Colorado 814 F 1.00 Colorado 80614 H 1.10 Georgia 300 BZ 1.12 Colorado 815 F 1.00 Colorado 80615 F 1.00 Georgia 301 BZ 1.12 Colorado 816 F 1.00 Colorado 80620 F 1.00 Georgia 302 BZ 1.12 Colorado 80401 H 1.10 Colorado 80621 F 1.00 Georgia 303 BZ 1.12 Colorado 80402 H 1.10 Colorado 80622 F 1.00 Georgia 304 F 1.00 Colorado 80403 H 1.10 Colorado 80623 F 1.00 Georgia 305 F 1.00 Colorado 80419 H 1.10 Colorado 80624 F 1.00 Georgia 306 F 1.00 Colorado 80420 F 1.00 Colorado 80631 F 1.00 Georgia 307 F 1.00 Colorado 80421 F 1.00 Colorado 80632 F 1.00 Georgia 308 F 1.00 Colorado 80422 F 1.00 Colorado 80633 F 1.00 Georgia 309 F 1.00 Colorado 80423 F 1.00 Colorado 80634 F 1.00 Georgia 310 F 1.00 Colorado 80424 F 1.00 Colorado 80638 F 1.00 Georgia 311 BZ 1.12 Colorado 80425 H 1.10 Colorado 80639 F 1.00 Georgia 312 F 1.00 Colorado 80426 F 1.00 Colorado 80640 H 1.10 Georgia 313 BZ 1.12 Colorado 80427 F 1.00 Colorado 80642 F 1.00 Georgia 314 BZ 1.12 Colorado 80428 F 1.00 Colorado 80643 F 1.00 Georgia 315 F 1.00 Colorado 80430 F 1.00 Colorado 80644 F 1.00 Georgia 316 F 1.00 Colorado 80432 F 1.00 Colorado 80645 F 1.00 Georgia 317 F 1.00 Colorado 80433 H 1.10 Colorado 80646 F 1.00 Georgia 318 F 1.00 Colorado 80434 F 1.00 Colorado 80648 F 1.00 Georgia 319 F 1.00 Colorado 80435 F 1.00 Colorado 80649 F 1.00 Georgia 398 F 1.00 Colorado 80436 F 1.00 Colorado 80650 F 1.00 Georgia 399 BZ 1.12 Colorado 80437 H 1.10 Colorado 80651 F 1.00 Hawaii 967 F 1.00 Colorado 80438 F 1.00 Colorado 80652 F 1.00 Hawaii 968 F 1.00 Colorado 80439 H 1.10 Colorado 80653 F 1.00 Idaho 832 F 1.00 Colorado 80440 F 1.00 Colorado 80654 F 1.00 Idaho 833 F 1.00 Colorado 80442 F 1.00 Connecticut 060 F 1.00 Idaho 834 F 1.00 Colorado 80443 F 1.00 Connecticut 061 F 1.00 Idaho 835 F 1.00 Colorado 80444 F 1.00 Connecticut 062 F 1.00 Idaho 836 F 1.00 Colorado 80446 F 1.00 Connecticut 063 F 1.00 Idaho 837 F 1.00 Colorado 80447 F 1.00 Connecticut 064 F 1.00 Idaho 838 F 1.00 Colorado 80448 F 1.00 Connecticut 065 F 1.00 Illinois 600 CA 1.13 Colorado 80449 F 1.00 Connecticut 066 F 1.00 Illinois 601 CA 1.13 Colorado 80451 F 1.00 Connecticut 067 F 1.00 Illinois 602 CA 1.13 Colorado 80452 F 1.00 Connecticut 068 F 1.00 Illinois 603 CA 1.13 Colorado 80453 H 1.10 Connecticut 069 F 1.00 Illinois 604 CA 1.13 Colorado 80454 H 1.10 Delaware 197 F 1.00 Illinois 605 CA 1.13 Colorado 80455 F 1.00 Delaware 198 F 1.00 Illinois 606 CA 1.13 Colorado 80456 F 1.00 Delaware 199 F 1.00 Illinois 607 CA 1.13 Colorado 80457 H 1.10 District of Columbia 200 F 1.00 Illinois 608 CA 1.13 Colorado 80459 F 1.00 District of Columbia 202 F 1.00 Illinois 609 F 1.00 Colorado 80461 F 1.00 District of Columbia 203 F 1.00 Illinois 610 F 1.00 Colorado 80463 F 1.00 District of Columbia 204 F 1.00 Illinois 611 F 1.00 Colorado 80465 H 1.10 District of Columbia 205 F 1.00 Illinois 612 F 1.00 Colorado 80466 F 1.00 Florida 320 F 1.00 Illinois 613 F 1.00 Colorado 80467 F 1.00 Florida 321 F 1.00 Illinois 614 F 1.00 Colorado 80468 F 1.00 Florida 322 F 1.00 Illinois 615 F 1.00 Colorado 80469 F 1.00 Florida 323 F 1.00 Illinois 616 F 1.00 Colorado 80470 H 1.10 Florida 324 F 1.00 Illinois 617 F 1.00 Colorado 80471 F 1.00 Florida 325 F 1.00 Illinois 618 F 1.00 Colorado 80473 F 1.00 Florida 326 F 1.00 Illinois 619 F 1.00 Colorado 80474 F 1.00 Florida 327 F 1.00 Illinois 620 F 1.00 Colorado 80475 F 1.00 Florida 328 F 1.00 Illinois 621 F 1.00 Colorado 80476 F 1.00 Florida 329 F 1.00 Illinois 622 F 1.00 Colorado 80477 F 1.00 Florida 330 DQ 1.69 Illinois 623 F 1.00 Colorado 80478 F 1.00 Florida 331 DQ 1.69 Illinois 624 F 1.00 Colorado 80479 F 1.00 Florida 332 DQ 1.69 Illinois 625 F 1.00 Colorado 80480 F 1.00 Florida 333 DQ 1.69 Illinois 626 F 1.00 Colorado 80481 F 1.00 Florida 334 CP 1.33 Illinois 627 F 1.00 Colorado 80482 F 1.00 Florida 335 F 1.00 Illinois 628 F 1.00 Colorado 80483 F 1.00 Florida 336 F 1.00 Illinois 629 F 1.00 Colorado 80487 F 1.00 Florida 337 F 1.00 Indiana 460 F 1.00 Colorado 80488 F 1.00 Florida 338 F 1.00 Indiana 461 F 1.00 Colorado 80497 F 1.00 Florida 339 F 1.00 Indiana 462 CD 1.16 Colorado 80498 F 1.00 Florida 340 DQ 1.69 Indiana 463 CD 1.16 Colorado 80601 H 1.10 Florida 341 F 1.00 Indiana 464 CD 1.16 Colorado 80602 H 1.10 Florida 342 F 1.00 Indiana 465 F 1.00 Colorado 80603 H 1.10 Florida 344 F 1.00 Indiana 466 F 1.00 2 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Indiana 467 F 1.00 Kentucky 413 F 1.00 Michigan 480 CO 1.32 Indiana 468 F 1.00 Kentucky 414 F 1.00 Michigan 481 CO 1.32 Indiana 469 F 1.00 Kentucky 415 F 1.00 Michigan 482 CO 1.32 Indiana 470 F 1.00 Kentucky 416 CA 1.13 Michigan 483 CO 1.32 Indiana 471 F 1.00 Kentucky 417 CA 1.13 Michigan 484 CO 1.32 Indiana 472 F 1.00 Kentucky 418 CA 1.13 Michigan 485 CO 1.32 Indiana 473 F 1.00 Kentucky 419 F 1.00 Michigan 486 BX 1.09 Indiana 474 F 1.00 Kentucky 420 F 1.00 Michigan 487 BX 1.09 Indiana 475 F 1.00 Kentucky 421 F 1.00 Michigan 488 BX 1.09 Indiana 476 F 1.00 Kentucky 422 F 1.00 Michigan 489 BX 1.09 Indiana 477 F 1.00 Kentucky 423 F 1.00 Michigan 490 F 1.00 Indiana 478 F 1.00 Kentucky 424 F 1.00 Michigan 491 F 1.00 Indiana 479 F 1.00 Kentucky 425 CA 1.13 Michigan 492 BX 1.09 Iowa 500 F 1.00 Kentucky 426 CA 1.13 Michigan 493 F 1.00 Iowa 501 F 1.00 Kentucky 427 CA 1.13 Michigan 494 F 1.00 Iowa 502 F 1.00 Louisiana 700 BY 1.11 Michigan 495 F 1.00 Iowa 503 H 1.10 Louisiana 701 BY 1.11 Michigan 496 F 1.00 Iowa 504 F 1.00 Louisiana 703 F 1.00 Michigan 497 F 1.00 Iowa 505 F 1.00 Louisiana 704 BY 1.11 Michigan 498 F 1.00 Iowa 506 F 1.00 Louisiana 705 F 1.00 Michigan 499 F 1.00 Iowa 507 H 1.10 Louisiana 706 F 1.00 Minnesota 556 F 1.00 Iowa 508 F 1.00 Louisiana 707 BY 1.11 Minnesota 557 F 1.00 Iowa 509 H 1.10 Louisiana 708 BY 1.11 Minnesota 558 F 1.00 Iowa 510 H 1.10 Louisiana 710 F 1.00 Minnesota 559 F 1.00 Iowa 511 H 1.10 Louisiana 711 BY 1.11 Minnesota 560 F 1.00 Iowa 512 F 1.00 Louisiana 712 BY 1.11 Minnesota 561 F 1.00 Iowa 513 F 1.00 Louisiana 713 F 1.00 Minnesota 562 F 1.00 Iowa 514 F 1.00 Louisiana 714 F 1.00 Minnesota 563 F 1.00 Iowa 515 H 1.10 Maine 039 F 1.00 Minnesota 564 F 1.00 Iowa 516 H 1.10 Maine 040 F 1.00 Minnesota 565 F 1.00 Iowa 520 F 1.00 Maine 041 F 1.00 Minnesota 566 F 1.00 Iowa 521 F 1.00 Maine 042 F 1.00 Minnesota 567 F 1.00 Iowa 522 F 1.00 Maine 043 F 1.00 Minnesota 55001 BV 1.07 Iowa 523 F 1.00 Maine 044 F 1.00 Minnesota 55002 F 1.00 Iowa 524 F 1.00 Maine 045 F 1.00 Minnesota 55003 BV 1.07 Iowa 525 F 1.00 Maine 046 F 1.00 Minnesota 55005 CD 1.16 Iowa 526 H 1.10 Maine 047 F 1.00 Minnesota 55006 F 1.00 Iowa 527 H 1.10 Maine 048 F 1.00 Minnesota 55007 F 1.00 Iowa 528 H 1.10 Maine 049 F 1.00 Minnesota 55008 F 1.00 Kansas 660 F 1.00 Maryland 206 F 1.00 Minnesota 55009 F 1.00 Kansas 661 H 1.10 Maryland 207 F 1.00 Minnesota 55010 BV 1.07 Kansas 662 H 1.10 Maryland 208 F 1.00 Minnesota 55011 CD 1.16 Kansas 664 F 1.00 Maryland 209 F 1.00 Minnesota 55012 F 1.00 Kansas 665 F 1.00 Maryland 210 F 1.00 Minnesota 55013 F 1.00 Kansas 666 F 1.00 Maryland 211 F 1.00 Minnesota 55014 CD 1.16 Kansas 667 F 1.00 Maryland 212 F 1.00 Minnesota 55016 BV 1.07 Kansas 668 F 1.00 Maryland 214 F 1.00 Minnesota 55017 F 1.00 Kansas 669 F 1.00 Maryland 215 F 1.00 Minnesota 55018 F 1.00 Kansas 670 F 1.00 Maryland 216 F 1.00 Minnesota 55019 F 1.00 Kansas 671 F 1.00 Maryland 217 F 1.00 Minnesota 55020 BV 1.07 Kansas 672 H 1.10 Maryland 218 F 1.00 Minnesota 55021 F 1.00 Kansas 673 F 1.00 Maryland 219 F 1.00 Minnesota 55024 BV 1.07 Kansas 674 F 1.00 Massachusetts 010 F 1.00 Minnesota 55025 BV 1.07 Kansas 675 F 1.00 Massachusetts 011 F 1.00 Minnesota 55026 F 1.00 Kansas 676 F 1.00 Massachusetts 012 F 1.00 Minnesota 55027 F 1.00 Kansas 677 F 1.00 Massachusetts 013 F 1.00 Minnesota 55029 F 1.00 Kansas 678 F 1.00 Massachusetts 014 F 1.00 Minnesota 55030 F 1.00 Kansas 679 F 1.00 Massachusetts 015 F 1.00 Minnesota 55031 BV 1.07 Kentucky 400 F 1.00 Massachusetts 016 F 1.00 Minnesota 55032 F 1.00 Kentucky 401 F 1.00 Massachusetts 017 F 1.00 Minnesota 55033 BV 1.07 Kentucky 402 F 1.00 Massachusetts 018 F 1.00 Minnesota 55036 F 1.00 Kentucky 403 F 1.00 Massachusetts 019 F 1.00 Minnesota 55037 F 1.00 Kentucky 404 F 1.00 Massachusetts 020 F 1.00 Minnesota 55038 BV 1.07 Kentucky 405 F 1.00 Massachusetts 021 F 1.00 Minnesota 55040 F 1.00 Kentucky 406 F 1.00 Massachusetts 022 F 1.00 Minnesota 55041 F 1.00 Kentucky 407 CA 1.13 Massachusetts 023 F 1.00 Minnesota 55042 BV 1.07 Kentucky 408 CA 1.13 Massachusetts 024 F 1.00 Minnesota 55043 BV 1.07 Kentucky 409 CA 1.13 Massachusetts 025 F 1.00 Minnesota 55044 BV 1.07 Kentucky 410 BV 1.07 Massachusetts 026 F 1.00 Minnesota 55045 F 1.00 Kentucky 411 BV 1.07 Massachusetts 027 F 1.00 Minnesota 55046 F 1.00 Kentucky 412 F 1.00 Massachusetts 055 F 1.00 Minnesota 55047 BV 1.07 3 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Minnesota 55049 F 1.00 Minnesota 55161 CD 1.16 Minnesota 55357 CD 1.16 Minnesota 55051 F 1.00 Minnesota 55164 CD 1.16 Minnesota 55358 F 1.00 Minnesota 55052 F 1.00 Minnesota 55165 CD 1.16 Minnesota 55359 CD 1.16 Minnesota 55053 F 1.00 Minnesota 55166 CD 1.16 Minnesota 55360 BV 1.07 Minnesota 55054 BV 1.07 Minnesota 55168 CD 1.16 Minnesota 55361 CD 1.16 Minnesota 55055 BV 1.07 Minnesota 55169 CD 1.16 Minnesota 55362 F 1.00 Minnesota 55056 F 1.00 Minnesota 55170 CD 1.16 Minnesota 55363 F 1.00 Minnesota 55057 F 1.00 Minnesota 55171 CD 1.16 Minnesota 55364 CD 1.16 Minnesota 55060 F 1.00 Minnesota 55172 CD 1.16 Minnesota 55365 F 1.00 Minnesota 55063 F 1.00 Minnesota 55175 CD 1.16 Minnesota 55366 F 1.00 Minnesota 55065 BV 1.07 Minnesota 55177 CD 1.16 Minnesota 55367 BV 1.07 Minnesota 55066 F 1.00 Minnesota 55182 CD 1.16 Minnesota 55368 BV 1.07 Minnesota 55067 F 1.00 Minnesota 55187 CD 1.16 Minnesota 55369 CD 1.16 Minnesota 55068 BV 1.07 Minnesota 55188 CD 1.16 Minnesota 55370 F 1.00 Minnesota 55069 F 1.00 Minnesota 55190 CD 1.16 Minnesota 55371 F 1.00 Minnesota 55070 CD 1.16 Minnesota 55191 CD 1.16 Minnesota 55372 BV 1.07 Minnesota 55071 BV 1.07 Minnesota 55199 CD 1.16 Minnesota 55373 F 1.00 Minnesota 55072 F 1.00 Minnesota 55301 F 1.00 Minnesota 55374 CD 1.16 Minnesota 55073 BV 1.07 Minnesota 55302 F 1.00 Minnesota 55375 CD 1.16 Minnesota 55074 F 1.00 Minnesota 55303 CD 1.16 Minnesota 55376 F 1.00 Minnesota 55075 BV 1.07 Minnesota 55304 CD 1.16 Minnesota 55377 F 1.00 Minnesota 55076 BV 1.07 Minnesota 55305 CD 1.16 Minnesota 55378 BV 1.07 Minnesota 55077 BV 1.07 Minnesota 55306 BV 1.07 Minnesota 55379 BV 1.07 Minnesota 55078 F 1.00 Minnesota 55307 F 1.00 Minnesota 55380 F 1.00 Minnesota 55079 F 1.00 Minnesota 55308 F 1.00 Minnesota 55381 F 1.00 Minnesota 55080 F 1.00 Minnesota 55309 F 1.00 Minnesota 55382 F 1.00 Minnesota 55082 BV 1.07 Minnesota 55310 F 1.00 Minnesota 55383 BV 1.07 Minnesota 55083 BV 1.07 Minnesota 55311 CD 1.16 Minnesota 55384 CD 1.16 Minnesota 55084 F 1.00 Minnesota 55312 F 1.00 Minnesota 55385 F 1.00 Minnesota 55085 BV 1.07 Minnesota 55313 F 1.00 Minnesota 55386 BV 1.07 Minnesota 55087 F 1.00 Minnesota 55314 F 1.00 Minnesota 55387 BV 1.07 Minnesota 55088 F 1.00 Minnesota 55315 BV 1.07 Minnesota 55388 BV 1.07 Minnesota 55089 F 1.00 Minnesota 55316 CD 1.16 Minnesota 55389 F 1.00 Minnesota 55090 BV 1.07 Minnesota 55317 BV 1.07 Minnesota 55390 F 1.00 Minnesota 55092 F 1.00 Minnesota 55318 BV 1.07 Minnesota 55391 CD 1.16 Minnesota 55101 CD 1.16 Minnesota 55319 F 1.00 Minnesota 55392 CD 1.16 Minnesota 55102 CD 1.16 Minnesota 55320 F 1.00 Minnesota 55393 F 1.00 Minnesota 55103 CD 1.16 Minnesota 55321 F 1.00 Minnesota 55394 BV 1.07 Minnesota 55104 CD 1.16 Minnesota 55322 BV 1.07 Minnesota 55395 F 1.00 Minnesota 55105 CD 1.16 Minnesota 55323 CD 1.16 Minnesota 55396 F 1.00 Minnesota 55106 CD 1.16 Minnesota 55324 F 1.00 Minnesota 55397 BV 1.07 Minnesota 55107 CD 1.16 Minnesota 55325 F 1.00 Minnesota 55398 F 1.00 Minnesota 55108 CD 1.16 Minnesota 55327 CD 1.16 Minnesota 55399 BV 1.07 Minnesota 55109 CD 1.16 Minnesota 55328 F 1.00 Minnesota 55400 CD 1.16 Minnesota 55110 CD 1.16 Minnesota 55329 F 1.00 Minnesota 55401 CD 1.16 Minnesota 55111 CD 1.16 Minnesota 55330 F 1.00 Minnesota 55402 CD 1.16 Minnesota 55112 CD 1.16 Minnesota 55331 CD 1.16 Minnesota 55403 CD 1.16 Minnesota 55113 CD 1.16 Minnesota 55332 F 1.00 Minnesota 55404 CD 1.16 Minnesota 55114 CD 1.16 Minnesota 55333 F 1.00 Minnesota 55405 CD 1.16 Minnesota 55115 CD 1.16 Minnesota 55334 F 1.00 Minnesota 55406 CD 1.16 Minnesota 55116 CD 1.16 Minnesota 55335 F 1.00 Minnesota 55407 CD 1.16 Minnesota 55117 CD 1.16 Minnesota 55336 F 1.00 Minnesota 55408 CD 1.16 Minnesota 55118 BV 1.07 Minnesota 55337 BV 1.07 Minnesota 55409 CD 1.16 Minnesota 55119 CD 1.16 Minnesota 55338 F 1.00 Minnesota 55410 CD 1.16 Minnesota 55120 BV 1.07 Minnesota 55339 BV 1.07 Minnesota 55411 CD 1.16 Minnesota 55121 BV 1.07 Minnesota 55340 CD 1.16 Minnesota 55412 CD 1.16 Minnesota 55122 BV 1.07 Minnesota 55341 F 1.00 Minnesota 55413 CD 1.16 Minnesota 55123 BV 1.07 Minnesota 55342 F 1.00 Minnesota 55414 CD 1.16 Minnesota 55124 BV 1.07 Minnesota 55343 CD 1.16 Minnesota 55415 CD 1.16 Minnesota 55125 BV 1.07 Minnesota 55344 CD 1.16 Minnesota 55416 CD 1.16 Minnesota 55126 CD 1.16 Minnesota 55345 CD 1.16 Minnesota 55417 CD 1.16 Minnesota 55127 CD 1.16 Minnesota 55346 CD 1.16 Minnesota 55418 CD 1.16 Minnesota 55128 BV 1.07 Minnesota 55347 CD 1.16 Minnesota 55419 CD 1.16 Minnesota 55129 BV 1.07 Minnesota 55348 CD 1.16 Minnesota 55420 CD 1.16 Minnesota 55130 CD 1.16 Minnesota 55349 F 1.00 Minnesota 55421 CD 1.16 Minnesota 55133 CD 1.16 Minnesota 55350 F 1.00 Minnesota 55422 CD 1.16 Minnesota 55144 CD 1.16 Minnesota 55352 BV 1.07 Minnesota 55423 CD 1.16 Minnesota 55145 CD 1.16 Minnesota 55353 F 1.00 Minnesota 55424 CD 1.16 Minnesota 55146 CD 1.16 Minnesota 55354 F 1.00 Minnesota 55425 CD 1.16 Minnesota 55150 BV 1.07 Minnesota 55355 F 1.00 Minnesota 55426 CD 1.16 Minnesota 55155 CD 1.16 Minnesota 55356 CD 1.16 Minnesota 55427 CD 1.16 4 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Minnesota 55428 CD 1.16 Missouri 649 F 1.00 Nevada 89032 CB 1.14 Minnesota 55429 CD 1.16 Missouri 650 F 1.00 Nevada 89033 CB 1.14 Minnesota 55430 CD 1.16 Missouri 651 F 1.00 Nevada 89034 F 1.00 Minnesota 55431 CD 1.16 Missouri 652 F 1.00 Nevada 89036 CB 1.14 Minnesota 55432 CD 1.16 Missouri 653 F 1.00 Nevada 89037 F 1.00 Minnesota 55433 CD 1.16 Missouri 654 F 1.00 Nevada 89039 F 1.00 Minnesota 55434 CD 1.16 Missouri 655 F 1.00 Nevada 89040 F 1.00 Minnesota 55435 CD 1.16 Missouri 656 F 1.00 Nevada 89041 F 1.00 Minnesota 55436 CD 1.16 Missouri 657 F 1.00 Nevada 89042 F 1.00 Minnesota 55437 CD 1.16 Missouri 658 F 1.00 Nevada 89043 F 1.00 Minnesota 55438 CD 1.16 Montana 590 F 1.00 Nevada 89044 CB 1.14 Minnesota 55439 CD 1.16 Montana 591 F 1.00 Nevada 89045 F 1.00 Minnesota 55440 CD 1.16 Montana 592 F 1.00 Nevada 89046 F 1.00 Minnesota 55441 CD 1.16 Montana 593 F 1.00 Nevada 89047 F 1.00 Minnesota 55442 CD 1.16 Montana 594 F 1.00 Nevada 89048 F 1.00 Minnesota 55443 CD 1.16 Montana 595 F 1.00 Nevada 89049 F 1.00 Minnesota 55444 CD 1.16 Montana 596 F 1.00 Nevada 89050 F 1.00 Minnesota 55445 CD 1.16 Montana 597 F 1.00 Nevada 89052 CB 1.14 Minnesota 55446 CD 1.16 Montana 598 F 1.00 Nevada 89053 CB 1.14 Minnesota 55447 CD 1.16 Montana 599 F 1.00 Nevada 89054 CB 1.14 Minnesota 55448 CD 1.16 Nebraska 683 F 1.00 Nevada 89060 F 1.00 Minnesota 55449 CD 1.16 Nebraska 684 F 1.00 Nevada 89061 F 1.00 Minnesota 55450 CD 1.16 Nebraska 686 F 1.00 Nevada 89067 F 1.00 Minnesota 55454 CD 1.16 Nebraska 687 F 1.00 Nevada 89070 F 1.00 Minnesota 55455 CD 1.16 Nebraska 688 F 1.00 Nevada 89074 CB 1.14 Minnesota 55458 CD 1.16 Nebraska 689 F 1.00 Nevada 89077 CB 1.14 Minnesota 55459 CD 1.16 Nebraska 690 F 1.00 Nevada 89081 CB 1.14 Minnesota 55460 CD 1.16 Nebraska 691 F 1.00 Nevada 89084 CB 1.14 Minnesota 55467 CD 1.16 Nebraska 692 F 1.00 Nevada 89085 CB 1.14 Minnesota 55468 CD 1.16 Nebraska 693 F 1.00 Nevada 89086 CB 1.14 Minnesota 55470 CD 1.16 Nebraska 680 CA 1.13 Nevada 89087 CB 1.14 Minnesota 55472 CD 1.16 Nebraska 681 CA 1.13 New Hampshire 002 F 1.00 Minnesota 55473 BV 1.07 Nebraska 685 CA 1.13 New Hampshire 030 F 1.00 Minnesota 55474 CD 1.16 Nevada 889 CB 1.14 New Hampshire 031 F 1.00 Minnesota 55478 CD 1.16 Nevada 891 CB 1.14 New Hampshire 032 F 1.00 Minnesota 55479 CD 1.16 Nevada 893 F 1.00 New Hampshire 033 F 1.00 Minnesota 55480 CD 1.16 Nevada 894 F 1.00 New Hampshire 034 F 1.00 Minnesota 55483 CD 1.16 Nevada 895 F 1.00 New Hampshire 035 F 1.00 Minnesota 55484 CD 1.16 Nevada 897 F 1.00 New Hampshire 036 F 1.00 Minnesota 55485 CD 1.16 Nevada 898 F 1.00 New Hampshire 037 F 1.00 Minnesota 55486 CD 1.16 Nevada 89001 F 1.00 New Hampshire 038 F 1.00 Minnesota 55487 CD 1.16 Nevada 89002 CB 1.14 New Jersey 070 F 1.00 Minnesota 55488 CD 1.16 Nevada 89003 F 1.00 New Jersey 071 F 1.00 Mississippi 386 F 1.00 Nevada 89004 F 1.00 New Jersey 072 F 1.00 Mississippi 387 F 1.00 Nevada 89005 F 1.00 New Jersey 073 F 1.00 Mississippi 388 F 1.00 Nevada 89006 F 1.00 New Jersey 074 F 1.00 Mississippi 389 F 1.00 Nevada 89007 F 1.00 New Jersey 075 F 1.00 Mississippi 390 F 1.00 Nevada 89008 F 1.00 New Jersey 076 F 1.00 Mississippi 391 F 1.00 Nevada 89009 CB 1.14 New Jersey 077 F 1.00 Mississippi 392 F 1.00 Nevada 89010 F 1.00 New Jersey 078 F 1.00 Mississippi 393 F 1.00 Nevada 89011 CB 1.14 New Jersey 079 F 1.00 Mississippi 394 CA 1.13 Nevada 89012 CB 1.14 New Jersey 080 F 1.00 Mississippi 395 CA 1.13 Nevada 89013 F 1.00 New Jersey 081 F 1.00 Mississippi 396 F 1.00 Nevada 89014 CB 1.14 New Jersey 082 F 1.00 Mississippi 397 F 1.00 Nevada 89015 CB 1.14 New Jersey 083 F 1.00 Missouri 630 I 1.15 Nevada 89016 CB 1.14 New Jersey 084 F 1.00 Missouri 631 I 1.15 Nevada 89017 F 1.00 New Jersey 085 F 1.00 Missouri 633 I 1.15 Nevada 89018 F 1.00 New Jersey 086 F 1.00 Missouri 634 F 1.00 Nevada 89019 F 1.00 New Jersey 087 F 1.00 Missouri 635 F 1.00 Nevada 89020 F 1.00 New Jersey 088 F 1.00 Missouri 636 F 1.00 Nevada 89021 F 1.00 New Jersey 089 F 1.00 Missouri 637 F 1.00 Nevada 89022 F 1.00 New Mexico 870 F 1.00 Missouri 638 F 1.00 Nevada 89023 F 1.00 New Mexico 871 CJ 1.24 Missouri 639 F 1.00 Nevada 89024 F 1.00 New Mexico 872 CJ 1.24 Missouri 640 I 1.15 Nevada 89025 F 1.00 New Mexico 873 F 1.00 Missouri 641 I 1.15 Nevada 89026 F 1.00 New Mexico 874 F 1.00 Missouri 644 F 1.00 Nevada 89027 F 1.00 New Mexico 875 F 1.00 Missouri 645 F 1.00 Nevada 89028 F 1.00 New Mexico 877 F 1.00 Missouri 646 F 1.00 Nevada 89029 F 1.00 New Mexico 878 F 1.00 Missouri 647 F 1.00 Nevada 89030 CB 1.14 New Mexico 879 F 1.00 Missouri 648 F 1.00 Nevada 89031 CB 1.14 New Mexico 880 F 1.00 5 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor New Mexico 881 F 1.00 New York 10926 BU 1.06 North Dakota 580 F 1.00 New Mexico 882 F 1.00 New York 10927 CP 1.33 North Dakota 581 F 1.00 New Mexico 883 F 1.00 New York 10928 BU 1.06 North Dakota 582 F 1.00 New Mexico 884 F 1.00 New York 10930 BU 1.06 North Dakota 583 F 1.00 New York 005 CP 1.33 New York 10931 CP 1.33 North Dakota 584 F 1.00 New York 100 CP 1.33 New York 10932 BU 1.06 North Dakota 585 F 1.00 New York 101 CP 1.33 New York 10933 BU 1.06 North Dakota 586 F 1.00 New York 102 CP 1.33 New York 10940 BU 1.06 North Dakota 587 F 1.00 New York 103 CP 1.33 New York 10941 BU 1.06 North Dakota 588 F 1.00 New York 104 CP 1.33 New York 10943 BU 1.06 Ohio 430 F 1.00 New York 105 CP 1.33 New York 10949 BU 1.06 Ohio 431 F 1.00 New York 106 CP 1.33 New York 10950 BU 1.06 Ohio 432 F 1.00 New York 107 CP 1.33 New York 10951 CP 1.33 Ohio 433 F 1.00 New York 108 CP 1.33 New York 10952 CP 1.33 Ohio 434 F 1.00 New York 110 CP 1.33 New York 10953 BU 1.06 Ohio 435 F 1.00 New York 111 CP 1.33 New York 10954 CP 1.33 Ohio 436 G 1.05 New York 112 CP 1.33 New York 10956 CP 1.33 Ohio 437 F 1.00 New York 113 CP 1.33 New York 10958 BU 1.06 Ohio 438 F 1.00 New York 114 CP 1.33 New York 10959 BU 1.06 Ohio 439 BX 1.09 New York 115 CP 1.33 New York 10960 CP 1.33 Ohio 440 G 1.05 New York 116 CP 1.33 New York 10962 CP 1.33 Ohio 441 BX 1.09 New York 117 CP 1.33 New York 10963 BU 1.06 Ohio 442 G 1.05 New York 118 CP 1.33 New York 10964 CP 1.33 Ohio 443 G 1.05 New York 119 CP 1.33 New York 10965 CP 1.33 Ohio 444 BX 1.09 New York 120 BU 1.06 New York 10968 CP 1.33 Ohio 445 BX 1.09 New York 121 BU 1.06 New York 10969 BU 1.06 Ohio 446 F 1.00 New York 122 BU 1.06 New York 10970 CP 1.33 Ohio 447 F 1.00 New York 123 BU 1.06 New York 10973 BU 1.06 Ohio 448 F 1.00 New York 124 BU 1.06 New York 10974 CP 1.33 Ohio 449 F 1.00 New York 125 BU 1.06 New York 10975 BU 1.06 Ohio 450 F 1.00 New York 126 BU 1.06 New York 10976 CP 1.33 Ohio 451 F 1.00 New York 127 BU 1.06 New York 10977 CP 1.33 Ohio 452 F 1.00 New York 128 F 1.00 New York 10979 BU 1.06 Ohio 453 F 1.00 New York 129 F 1.00 New York 10980 CP 1.33 Ohio 454 F 1.00 New York 130 F 1.00 New York 10981 BU 1.06 Ohio 455 F 1.00 New York 131 F 1.00 New York 10982 CP 1.33 Ohio 456 F 1.00 New York 132 F 1.00 New York 10983 CP 1.33 Ohio 457 F 1.00 New York 133 F 1.00 New York 10984 CP 1.33 Ohio 458 F 1.00 New York 134 F 1.00 New York 10985 BU 1.06 Ohio 459 F 1.00 New York 135 F 1.00 New York 10986 CP 1.33 Oklahoma 730 BW 1.08 New York 136 F 1.00 New York 10987 BU 1.06 Oklahoma 731 BW 1.08 New York 137 F 1.00 New York 10988 BU 1.06 Oklahoma 732 F 1.00 New York 138 F 1.00 New York 10989 CP 1.33 Oklahoma 733 F 1.00 New York 139 F 1.00 New York 10990 BU 1.06 Oklahoma 734 F 1.00 New York 140 BU 1.06 New York 10992 BU 1.06 Oklahoma 735 F 1.00 New York 141 BU 1.06 New York 10993 CP 1.33 Oklahoma 736 F 1.00 New York 142 BU 1.06 New York 10994 CP 1.33 Oklahoma 737 F 1.00 New York 143 BU 1.06 New York 10995 CP 1.33 Oklahoma 738 F 1.00 New York 144 F 1.00 New York 10996 BU 1.06 Oklahoma 739 F 1.00 New York 145 F 1.00 New York 10997 BU 1.06 Oklahoma 740 F 1.00 New York 146 F 1.00 New York 10998 BU 1.06 Oklahoma 741 BW 1.08 New York 147 F 1.00 North Carolina 270 F 1.00 Oklahoma 742 F 1.00 New York 148 F 1.00 North Carolina 271 F 1.00 Oklahoma 743 F 1.00 New York 149 F 1.00 North Carolina 272 F 1.00 Oklahoma 744 F 1.00 New York 10901 CP 1.33 North Carolina 273 F 1.00 Oklahoma 745 F 1.00 New York 10910 BU 1.06 North Carolina 274 F 1.00 Oklahoma 746 F 1.00 New York 10911 CP 1.33 North Carolina 275 F 1.00 Oklahoma 747 F 1.00 New York 10912 BU 1.06 North Carolina 276 F 1.00 Oklahoma 748 F 1.00 New York 10913 CP 1.33 North Carolina 277 F 1.00 Oklahoma 749 F 1.00 New York 10914 BU 1.06 North Carolina 278 F 1.00 Oregon 970 F 1.00 New York 10915 BU 1.06 North Carolina 279 F 1.00 Oregon 971 F 1.00 New York 10916 BU 1.06 North Carolina 280 F 1.00 Oregon 972 F 1.00 New York 10917 BU 1.06 North Carolina 281 F 1.00 Oregon 973 F 1.00 New York 10918 BU 1.06 North Carolina 282 F 1.00 Oregon 974 F 1.00 New York 10919 BU 1.06 North Carolina 283 F 1.00 Oregon 975 F 1.00 New York 10920 CP 1.33 North Carolina 284 F 1.00 Oregon 976 F 1.00 New York 10921 BU 1.06 North Carolina 285 F 1.00 Oregon 977 F 1.00 New York 10922 BU 1.06 North Carolina 286 F 1.00 Oregon 978 F 1.00 New York 10923 CP 1.33 North Carolina 287 F 1.00 Oregon 979 F 1.00 New York 10924 BU 1.06 North Carolina 288 F 1.00 Panama 000 F 1.00 New York 10925 BU 1.06 North Carolina 289 F 1.00 Pennsylvania 150 BB 1.21 6 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor Pennsylvania 151 BB 1.21 Tennessee 372 F 1.00 Utah 845 F 1.00 Pennsylvania 152 BB 1.21 Tennessee 373 F 1.00 Utah 846 F 1.00 Pennsylvania 153 BB 1.21 Tennessee 374 F 1.00 Utah 847 F 1.00 Pennsylvania 154 BB 1.21 Tennessee 375 F 1.00 Vermont 050 F 1.00 Pennsylvania 155 F 1.00 Tennessee 376 F 1.00 Vermont 051 F 1.00 Pennsylvania 156 BB 1.21 Tennessee 377 F 1.00 Vermont 052 F 1.00 Pennsylvania 157 F 1.00 Tennessee 378 F 1.00 Vermont 053 F 1.00 Pennsylvania 158 F 1.00 Tennessee 379 F 1.00 Vermont 054 F 1.00 Pennsylvania 159 F 1.00 Tennessee 380 F 1.00 Vermont 056 F 1.00 Pennsylvania 160 F 1.00 Tennessee 381 F 1.00 Vermont 057 F 1.00 Pennsylvania 161 F 1.00 Tennessee 382 F 1.00 Vermont 058 F 1.00 Pennsylvania 162 F 1.00 Tennessee 383 F 1.00 Vermont 059 F 1.00 Pennsylvania 163 F 1.00 Tennessee 384 F 1.00 Virgin Island 008 F 1.00 Pennsylvania 164 F 1.00 Tennessee 385 F 1.00 Virginia 201 F 1.00 Pennsylvania 165 F 1.00 Texas 733 F 1.00 Virginia 220 BZ 1.12 Pennsylvania 166 F 1.00 Texas 750 BW 1.08 Virginia 221 BZ 1.12 Pennsylvania 167 F 1.00 Texas 751 BW 1.08 Virginia 222 BZ 1.12 Pennsylvania 168 F 1.00 Texas 752 J 1.20 Virginia 223 BZ 1.12 Pennsylvania 169 F 1.00 Texas 753 BW 1.08 Virginia 224 F 1.00 Pennsylvania 170 F 1.00 Texas 754 BW 1.08 Virginia 225 F 1.00 Pennsylvania 171 F 1.00 Texas 755 F 1.00 Virginia 226 F 1.00 Pennsylvania 172 F 1.00 Texas 756 F 1.00 Virginia 227 F 1.00 Pennsylvania 173 F 1.00 Texas 757 BW 1.08 Virginia 228 F 1.00 Pennsylvania 174 F 1.00 Texas 758 F 1.00 Virginia 229 F 1.00 Pennsylvania 175 F 1.00 Texas 759 F 1.00 Virginia 230 F 1.00 Pennsylvania 176 F 1.00 Texas 760 F 1.00 Virginia 231 F 1.00 Pennsylvania 177 F 1.00 Texas 761 BW 1.08 Virginia 232 BZ 1.12 Pennsylvania 178 F 1.00 Texas 762 F 1.00 Virginia 233 F 1.00 Pennsylvania 179 F 1.00 Texas 763 F 1.00 Virginia 234 F 1.00 Pennsylvania 180 F 1.00 Texas 764 F 1.00 Virginia 235 F 1.00 Pennsylvania 181 F 1.00 Texas 765 F 1.00 Virginia 236 F 1.00 Pennsylvania 182 F 1.00 Texas 766 F 1.00 Virginia 237 BZ 1.12 Pennsylvania 183 F 1.00 Texas 767 F 1.00 Virginia 238 F 1.00 Pennsylvania 184 F 1.00 Texas 768 F 1.00 Virginia 239 F 1.00 Pennsylvania 185 F 1.00 Texas 769 F 1.00 Virginia 240 F 1.00 Pennsylvania 186 F 1.00 Texas 770 J 1.20 Virginia 241 F 1.00 Pennsylvania 187 F 1.00 Texas 771 J 1.20 Virginia 242 BZ 1.12 Pennsylvania 188 F 1.00 Texas 772 J 1.20 Virginia 243 F 1.00 Pennsylvania 189 CP 1.33 Texas 773 J 1.20 Virginia 244 F 1.00 Pennsylvania 190 CP 1.33 Texas 774 J 1.20 Virginia 245 F 1.00 Pennsylvania 191 CP 1.33 Texas 775 J 1.20 Virginia 246 BZ 1.12 Pennsylvania 192 CP 1.33 Texas 776 J 1.20 Washington 980 F 1.00 Pennsylvania 193 CP 1.33 Texas 777 J 1.20 Washington 981 F 1.00 Pennsylvania 194 CP 1.33 Texas 778 F 1.00 Washington 982 F 1.00 Pennsylvania 195 F 1.00 Texas 779 F 1.00 Washington 983 F 1.00 Pennsylvania 196 F 1.00 Texas 780 F 1.00 Washington 984 F 1.00 Puerto Rico 006 F 1.00 Texas 781 F 1.00 Washington 985 F 1.00 Puerto Rico 007 F 1.00 Texas 782 J 1.20 Washington 986 F 1.00 Puerto Rico 009 F 1.00 Texas 783 F 1.00 Washington 988 F 1.00 Rhode Island 028 F 1.00 Texas 784 BW 1.08 Washington 989 F 1.00 Rhode Island 029 F 1.00 Texas 785 F 1.00 Washington 990 F 1.00 South Carolina 290 F 1.00 Texas 786 F 1.00 Washington 991 F 1.00 South Carolina 291 F 1.00 Texas 787 F 1.00 Washington 992 F 1.00 South Carolina 292 F 1.00 Texas 788 F 1.00 Washington 993 F 1.00 South Carolina 293 F 1.00 Texas 789 F 1.00 Washington 994 F 1.00 South Carolina 294 H 1.10 Texas 790 F 1.00 West Virginia 247 F 1.00 South Carolina 295 H 1.10 Texas 791 F 1.00 West Virginia 248 F 1.00 South Carolina 296 F 1.00 Texas 792 F 1.00 West Virginia 249 F 1.00 South Carolina 297 F 1.00 Texas 793 J 1.20 West Virginia 250 F 1.00 South Carolina 298 H 1.10 Texas 794 J 1.20 West Virginia 251 F 1.00 South Carolina 299 H 1.10 Texas 795 F 1.00 West Virginia 252 F 1.00 South Dakota 570 F 1.00 Texas 796 F 1.00 West Virginia 253 F 1.00 South Dakota 571 F 1.00 Texas 797 F 1.00 West Virginia 254 F 1.00 South Dakota 572 F 1.00 Texas 798 F 1.00 West Virginia 255 F 1.00 South Dakota 573 F 1.00 Texas 799 F 1.00 West Virginia 256 F 1.00 South Dakota 574 F 1.00 Texas 885 F 1.00 West Virginia 257 F 1.00 South Dakota 575 F 1.00 Utah 840 F 1.00 West Virginia 258 F 1.00 South Dakota 576 F 1.00 Utah 841 F 1.00 West Virginia 259 F 1.00 South Dakota 577 F 1.00 Utah 842 F 1.00 West Virginia 260 F 1.00 Tennessee 370 F 1.00 Utah 843 F 1.00 West Virginia 261 F 1.00 Tennessee 371 F 1.00 Utah 844 F 1.00 West Virginia 262 F 1.00 7 of 8 WOODMEN OF THE WORLD/ASSURED LIFE ASSOCIATION INDIVIDUAL STANDARDIZED MEDICARE SUPPLEMENT AREA RATING FACTORS BY STATE AND ZIP CODE State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor State Zip Code Alpha Code Factor West Virginia 263 F 1.00 Wisconsin 53058 BX 1.09 Wisconsin 53152 BX 1.09 West Virginia 264 F 1.00 Wisconsin 53059 BX 1.09 Wisconsin 53153 BX 1.09 West Virginia 265 F 1.00 Wisconsin 53060 BX 1.09 Wisconsin 53154 CH 1.22 West Virginia 266 F 1.00 Wisconsin 53061 BX 1.09 Wisconsin 53156 BX 1.09 West Virginia 267 F 1.00 Wisconsin 53062 BX 1.09 Wisconsin 53157 BX 1.09 West Virginia 268 F 1.00 Wisconsin 53063 BX 1.09 Wisconsin 53158 CH 1.22 Wisconsin 532 CH 1.22 Wisconsin 53064 BX 1.09 Wisconsin 53159 CH 1.22 Wisconsin 534 CH 1.22 Wisconsin 53065 BX 1.09 Wisconsin 53167 BX 1.09 Wisconsin 535 BX 1.09 Wisconsin 53066 BX 1.09 Wisconsin 53168 BX 1.09 Wisconsin 537 BX 1.09 Wisconsin 53069 BX 1.09 Wisconsin 53170 BX 1.09 Wisconsin 538 BX 1.09 Wisconsin 53070 BX 1.09 Wisconsin 53171 CH 1.22 Wisconsin 539 F 1.00 Wisconsin 53072 CH 1.22 Wisconsin 53172 CH 1.22 Wisconsin 540 F 1.00 Wisconsin 53073 BX 1.09 Wisconsin 53176 BX 1.09 Wisconsin 541 F 1.00 Wisconsin 53074 BX 1.09 Wisconsin 53177 CH 1.22 Wisconsin 542 F 1.00 Wisconsin 53075 BX 1.09 Wisconsin 53178 BX 1.09 Wisconsin 543 F 1.00 Wisconsin 53076 CH 1.22 Wisconsin 53179 BX 1.09 Wisconsin 544 BX 1.09 Wisconsin 53078 BX 1.09 Wisconsin 53181 BX 1.09 Wisconsin 545 F 1.00 Wisconsin 53079 BX 1.09 Wisconsin 53182 CH 1.22 Wisconsin 546 F 1.00 Wisconsin 53080 BX 1.09 Wisconsin 53183 BX 1.09 Wisconsin 547 F 1.00 Wisconsin 53081 BX 1.09 Wisconsin 53184 BX 1.09 Wisconsin 548 F 1.00 Wisconsin 53082 BX 1.09 Wisconsin 53185 BX 1.09 Wisconsin 549 BX 1.09 Wisconsin 53083 BX 1.09 Wisconsin 53186 CH 1.22 Wisconsin 53001 BX 1.09 Wisconsin 53085 BX 1.09 Wisconsin 53187 CH 1.22 Wisconsin 53002 BX 1.09 Wisconsin 53086 BX 1.09 Wisconsin 53188 CH 1.22 Wisconsin 53003 BX 1.09 Wisconsin 53088 BX 1.09 Wisconsin 53189 CH 1.22 Wisconsin 53004 BX 1.09 Wisconsin 53089 CH 1.22 Wisconsin 53190 BX 1.09 Wisconsin 53005 CH 1.22 Wisconsin 53090 BX 1.09 Wisconsin 53191 BX 1.09 Wisconsin 53006 BX 1.09 Wisconsin 53091 BX 1.09 Wisconsin 53192 BX 1.09 Wisconsin 53007 CH 1.22 Wisconsin 53092 CH 1.22 Wisconsin 53194 CH 1.22 Wisconsin 53008 CH 1.22 Wisconsin 53093 BX 1.09 Wisconsin 53195 BX 1.09 Wisconsin 53009 BX 1.09 Wisconsin 53094 BX 1.09 Wisconsin 53199 BX 1.09 Wisconsin 53010 BX 1.09 Wisconsin 53095 BX 1.09 Wyoming 820 F 1.00 Wisconsin 53011 BX 1.09 Wisconsin 53097 CH 1.22 Wyoming 821 F 1.00 Wisconsin 53012 CH 1.22 Wisconsin 53098 BX 1.09 Wyoming 822 F 1.00 Wisconsin 53013 BX 1.09 Wisconsin 53099 BX 1.09 Wyoming 823 F 1.00 Wisconsin 53014 BX 1.09 Wisconsin 53101 BX 1.09 Wyoming 824 F 1.00 Wisconsin 53015 BX 1.09 Wisconsin 53102 CH 1.22 Wyoming 825 F 1.00 Wisconsin 53016 BX 1.09 Wisconsin 53103 BX 1.09 Wyoming 826 F 1.00 Wisconsin 53017 CH 1.22 Wisconsin 53104 CH 1.22 Wyoming 827 F 1.00 Wisconsin 53018 BX 1.09 Wisconsin 53105 BX 1.09 Wyoming 828 F 1.00 Wisconsin 53019 BX 1.09 Wisconsin 53108 CH 1.22 Wyoming 829 F 1.00 Wisconsin 53020 BX 1.09 Wisconsin 53109 CH 1.22 Wyoming 830 F 1.00 Wisconsin 53021 BX 1.09 Wisconsin 53110 CH 1.22 Wyoming 831 F 1.00 Wisconsin 53022 CH 1.22 Wisconsin 53114 BX 1.09 Wyoming 834 F 1.00 Wisconsin 53023 BX 1.09 Wisconsin 53115 BX 1.09 Wisconsin 53024 CH 1.22 Wisconsin 53118 BX 1.09 Wisconsin 53026 BX 1.09 Wisconsin 53119 BX 1.09 Wisconsin 53027 BX 1.09 Wisconsin 53120 BX 1.09 Wisconsin 53029 BX 1.09 Wisconsin 53121 BX 1.09 Wisconsin 53031 BX 1.09 Wisconsin 53122 CH 1.22 Wisconsin 53032 BX 1.09 Wisconsin 53125 BX 1.09 Wisconsin 53033 CH 1.22 Wisconsin 53126 CH 1.22 Wisconsin 53034 BX 1.09 Wisconsin 53127 BX 1.09 Wisconsin 53035 BX 1.09 Wisconsin 53128 BX 1.09 Wisconsin 53036 BX 1.09 Wisconsin 53129 CH 1.22 Wisconsin 53037 CH 1.22 Wisconsin 53130 CH 1.22 Wisconsin 53038 BX 1.09 Wisconsin 53132 CH 1.22 Wisconsin 53039 BX 1.09 Wisconsin 53137 BX 1.09 Wisconsin 53040 BX 1.09 Wisconsin 53138 BX 1.09 Wisconsin 53042 BX 1.09 Wisconsin 53139 BX 1.09 Wisconsin 53044 BX 1.09 Wisconsin 53140 CH 1.22 Wisconsin 53045 CH 1.22 Wisconsin 53141 CH 1.22 Wisconsin 53046 CH 1.22 Wisconsin 53142 CH 1.22 Wisconsin 53047 BX 1.09 Wisconsin 53143 CH 1.22 Wisconsin 53048 BX 1.09 Wisconsin 53144 CH 1.22 Wisconsin 53049 BX 1.09 Wisconsin 53146 CH 1.22 Wisconsin 53050 BX 1.09 Wisconsin 53147 BX 1.09 Wisconsin 53051 CH 1.22 Wisconsin 53148 BX 1.09 Wisconsin 53052 CH 1.22 Wisconsin 53149 BX 1.09 Wisconsin 53056 BX 1.09 Wisconsin 53150 CH 1.22 Wisconsin 53057 BX 1.09 Wisconsin 53151 CH 1.22 8 of 8 EXHIBIT II - Rate History & In-Force Counts Assured Life Association PENNSYLVANIA Medicare Supplement Plan B As of March 31, 2011 -- RATE HISTORY -- Rate Submission Approval Date Rate Change New Form Approval May 30, 2006 n/a Rate Increase Filed on November 30, 2007 Withdrawn Rate Increase January 14, 2009 9.0% Rate Increase March 11, 2010 9.0% Rate Increase July 23, 2010 9.0% -- IN-FORCE POLICIES & AVERAGE PREMIUM SUMMARY-- State - PA Nationwide Calendar Year Policies Avg Premium Policies Avg Premium 2005 0 $ - 0 $ - 2006 0 $ - 2 $ 1,732.32 2007 0 $ - 2 $ 1,614.00 2008 0 $ - 1 $ 1,947.00 2009 0 $ - 0 $ - 2010 0 $ - 0 $ - 2011 0 $ - 0 $ - EXHIBIT II - Rate History & In-Force Counts Assured Life Association PENNSYLVANIA Medicare Supplement Plan C As of March 31, 2011 -- RATE HISTORY -- Rate Submission Approval Date Rate Change New Form Approval May 30, 2006 n/a Rate Increase Filed on November 30, 2007 Withdrawn Rate Increase January 14, 2009 9.0% Rate Increase March 12, 2010 9.0% Rate Increase July 23, 2010 9.0% -- IN-FORCE POLICIES & AVERAGE PREMIUM SUMMARY-- State - PA Nationwide Calendar Year Policies Avg Premium Policies Avg Premium 2005 0 $ - 0 $ - 2006 0 $ - 0 $ - 2007 0 $ - 0 $ - 2008 0 $ - 0 $ - 2009 0 $ - 8 $ 1,182.13 2010 0 $ - 14 $ 1,417.43 2011 0 $ - 14 $ 1,569.14 EXHIBIT II - Rate History & In-Force Counts Assured Life Association PENNSYLVANIA Medicare Supplement Plan D As of March 31, 2011 -- RATE HISTORY -- Rate Submission Approval Date Rate Change New Form Approval May 30, 2006 n/a Rate Increase Filed on November 30, 2007 Withdrawn Rate Increase January 14, 2009 9.0% Rate Increase March 11, 2010 9.0% Rate Increase July 23, 2010 5.0% -- IN-FORCE POLICIES & AVERAGE PREMIUM SUMMARY-- State - PA Nationwide Calendar Year Policies Avg Premium Policies Avg Premium 2005 0 $ - 0 $ - 2006 0 $ - 0 $ - 2007 0 $ - 0 $ - 2008 0 $ - 0 $ - 2009 0 $ - 5 $ 1,189.80 2010 0 $ - 8 $ 1,193.50 2011 0 $ - 11 $ 1,297.73 EXHIBIT II - Rate History & In-Force Counts Assured Life Association PENNSYLVANIA Medicare Supplement Plan F As of March 31, 2011 -- RATE HISTORY -- Rate Submission Approval Date Rate Change New Form Approval May 30, 2006 n/a Rate Increase Filed on November 30, 2007 Withdrawn Rate Increase January 14, 2009 9.0% Rate Increase March 11, 2010 9.0% Rate Increase July 23, 2010 9.0% -- IN-FORCE POLICIES & AVERAGE PREMIUM SUMMARY-- State - PA Nationwide Calendar Year Policies Avg Premium Policies Avg Premium 2005 0 $ - 0 $ - 2006 0 $ - 21 $ 1,446.35 2007 0 $ - 15 $ 1,527.93 2008 0 $ - 11 $ 1,554.18 2009 0 $ - 77 $ 1,435.21 2010 0 $ - 250 $ 1,425.12 2011 0 $ - 278 $ 1,613.51 EXHIBIT II - Rate History & In-Force Counts Assured Life Association PENNSYLVANIA Medicare Supplement Plan G As of March 31, 2011 -- RATE HISTORY -- Rate Submission Approval Date Rate Change New Form Approval May 30, 2006 n/a Rate Increase Filed on November 30, 2007 Withdrawn Rate Increase January 14, 2009 9.0% Rate Increase March 12, 2010 9.0% Rate Increase July 23, 2010 9.0% -- IN-FORCE POLICIES & AVERAGE PREMIUM SUMMARY-- State - PA Nationwide Calendar Year Policies Avg Premium Policies Avg Premium 2005 0 $ - 0 $ - 2006 0 $ - 4 $ 1,618.35 2007 0 $ - 2 $ 1,715.00 2008 0 $ - 0 $ - 2009 0 $ - 44 $ 1,293.75 2010 0 $ - 164 $ 1,262.91 2011 0 $ - 171 $ 1,436.36 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE All Medicare Supplement Plans As of March 31, 2011 Proposed Rate Increase: 9.9% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 20,135 16,819 1,139 46,100 472,899 92,633 1,427 651,152 2 0 13,440 11,510 741 46,399 347,529 100,670 1,805 522,093 3 0 9,646 7,074 782 31,575 444,880 105,438 1,582 600,976 4 0 4,657 5,424 739 38,711 447,001 93,320 1,443 591,294 5 0 1,761 3,924 718 38,752 398,096 85,137 1,322 529,709 6 0 1,101 4,677 776 34,720 363,189 77,992 1,211 483,666 7 0 1,385 4,811 680 31,675 332,711 71,446 1,109 443,817 8 0 1,386 4,242 621 29,017 304,784 65,441 406,509 9 0 1,242 3,870 569 26,581 279,168 372,423 10 0 1,133 3,545 521 24,347 341,723 11 0 1,038 3,247 477 313,525 12 0 951 2,975 287,421 Total 0 20,135 30,259 22,295 58,572 527,265 477,500 592,466 599,970 533,881 487,068 446,194 408,742 374,389 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 14,191 9,588 1,077 12,184 340,780 138,974 1,556 518,351 2 0 8,661 12,411 149 28,138 323,355 109,819 1,997 484,529 3 0 8,785 9,143 908 25,215 300,981 116,636 1,750 463,419 4 0 0 3,763 5,520 183 22,478 306,663 103,273 1,596 443,475 5 0 0 0 885 5,500 130 22,818 273,225 94,164 1,461 398,183 6 0 0 0 0 897 4,766 142 20,452 249,127 86,217 1,338 362,939 7 0 0 0 0 0 820 4,971 125 18,648 228,102 78,940 1,225 332,831 8 832 4,385 114 17,074 208,848 72,268 304,645 9 746 3,998 104 15,633 191,197 279,001 10 680 3,661 95 14,312 255,884 11 623 3,352 87 234,654 12 570 3,069 215,061 Total 0 14,191 18,249 22,273 25,238 376,231 494,124 440,550 454,059 403,957 368,328 337,243 308,777 282,679 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 70.5% 57.0% 94.5% 26.4% 72.1% 150.0% 109.1% 79.6% 2 64.4% 107.8% 20.1% 60.6% 93.0% 109.1% 110.6% 92.8% 3 91.1% 129.2% 116.2% 79.9% 67.7% 110.6% 110.7% 77.1% 4 80.8% 101.8% 24.8% 58.1% 68.6% 110.7% 110.6% 75.0% 5 50.3% 140.1% 18.1% 58.9% 68.6% 110.6% 110.5% 75.2% 6 81.5% 101.9% 18.3% 58.9% 68.6% 110.5% 110.5% 75.0% 7 59.2% 103.3% 18.3% 58.9% 68.6% 110.5% 110.4% 75.0% 8 60.1% 103.4% 18.3% 58.8% 68.5% 110.4% 74.9% 9 60.1% 103.3% 18.3% 58.8% 68.5% 74.9% 10 60.0% 103.3% 18.3% 58.8% 74.9% 11 60.0% 103.2% 18.3% 74.8% 12 60.0% 103.2% 74.8% Total 70.5% 60.3% 99.9% 43.1% 71.4% 103.5% 74.4% 75.7% 75.7% 75.6% 75.6% 75.5% 75.5% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 48.1% 48.1% 46.7% 58.9% 59.0% 59.1% 59.0% 58.3% 2 58.7% 57.5% 53.1% 69.1% 69.0% 69.1% 69.2% 68.5% 3 70.6% 68.7% 61.3% 76.7% 77.0% 77.0% 76.8% 76.8% 4 76.9% 71.6% 69.4% 76.7% 76.9% 77.0% 76.8% 76.9% 5 77.3% 73.4% 70.3% 76.6% 76.9% 76.9% 76.7% 76.8% 6 78.2% 74.5% 71.2% 76.6% 76.8% 76.9% 76.7% 76.8% 7 79.4% 75.5% 72.0% 76.5% 76.8% 76.8% 76.6% 76.8% 8 80.6% 76.5% 72.8% 76.5% 76.7% 76.8% 76.7% 9 81.6% 77.4% 73.5% 76.4% 76.7% 76.7% 10 82.7% 78.3% 74.3% 76.4% 76.7% 11 83.6% 79.1% 75.0% 76.6% 12 84.6% 79.9% 76.6% Expected Loss Ratios 48.1% 52.8% 62.6% 61.5% 60.1% 67.7% 75.6% 76.9% 76.9% 76.8% 76.8% 76.8% 76.7% A/E 0.000 1.466 1.142 1.595 0.701 1.188 1.529 0.984 0.984 0.984 0.984 0.984 0.984 0.984 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan B As of March 31, 2011 Proposed Rate Increase: 9.9% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 1,494 1,555 420 0 0 0 0 3,469 2 0 1,015 1,157 0 0 0 0 0 2,172 3 0 799 57 0 0 0 0 0 856 4 0 41 0 0 0 0 0 0 41 5 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 10 0 0 0 0 0 0 11 0 0 0 0 0 12 0 0 0 0 Total 0 1,494 2,570 2,376 98 0 0 0 0 0 0 0 0 0 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 1,694 1,632 35 0 0 0 3,361 2 0 1,170 3,202 0 0 0 4,372 3 0 2,283 0 0 0 2,283 4 0 0 0 0 0 0 5 0 0 0 0 0 0 6 0 0 0 0 0 0 7 0 0 0 0 0 0 8 0 9 0 10 0 11 0 12 0 Total 0 1,694 2,801 5,519 0 0 0 0 0 0 0 0 0 0 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 113.4% 104.9% 8.3% 96.9% 2 115.2% 276.8% 201.3% 3 285.8% 0.0% 266.8% 4 0.0% 0.0% 5 6 7 8 9 10 11 12 Total 113.4% 109.0% 232.3% 0.0% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 46.0% 46.1% 47.4% 46.2% 2 52.9% 53.1% 53.0% 3 61.1% 61.1% 61.1% 4 63.1% 63.1% 5 6 7 8 9 10 11 12 Expected Loss Ratios 46.0% 48.8% 54.8% 62.0% A/E 0.000 2.467 2.233 4.240 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan C As of March 31, 2011 Proposed Rate Increase: 9.9% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 0 0 0 3,104 13,495 2,338 0 18,936 2 0 0 0 0 3,238 14,282 2,265 0 19,785 3 0 0 0 0 4,172 12,689 2,175 0 19,036 4 0 0 0 0 3,248 11,388 1,905 0 16,541 5 0 0 0 0 2,876 10,075 1,730 0 14,682 6 0 0 0 0 2,578 9,148 1,580 0 13,306 7 0 0 0 0 2,341 8,355 1,442 0 12,138 8 0 0 0 0 2,138 7,627 1,316 11,082 9 0 0 0 0 1,952 6,961 10,114 10 0 0 0 0 1,781 9,229 11 0 0 0 0 8,420 12 0 0 0 7,677 Total 0 0 0 0 3,104 16,733 20,791 18,202 16,439 14,559 13,219 12,073 11,022 10,058 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 0 0 0 2,392 9,358 1,896 0 13,646 2 0 0 0 0 3,691 13,392 1,503 18,586 3 0 0 0 0 3,220 9,737 1,461 14,419 4 0 0 0 0 0 2,051 8,847 1,280 12,178 5 0 0 0 0 0 1,839 7,824 1,161 10,824 6 0 0 0 0 0 1,648 7,098 1,059 9,805 7 0 0 0 0 0 1,495 6,476 966 8,936 8 1,364 5,905 880 8,149 9 1,244 5,382 7,428 10 1,134 6,770 11 6,169 12 5,619 Total 0 0 0 0 2,392 13,050 18,508 13,292 12,148 10,751 9,754 8,899 8,114 7,396 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 77.0% 69.4% 81.1% 72.1% 2 114.0% 93.8% 66.4% 93.9% 3 77.2% 76.7% 67.2% 75.7% 4 63.2% 77.7% 67.2% 73.6% 5 63.9% 77.7% 67.1% 73.7% 6 63.9% 77.6% 67.0% 73.7% 7 63.9% 77.5% 67.0% 73.6% 8 63.8% 77.4% 66.9% 73.5% 9 63.7% 77.3% 73.4% 10 63.6% 73.4% 11 73.3% 12 73.2% Total 77.0% 78.0% 89.0% 73.0% 73.9% 73.8% 73.8% 73.7% 73.6% 73.5% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 61.8% 60.2% 60.0% 60.4% 2 70.2% 70.0% 69.7% 70.0% 3 77.5% 77.4% 77.2% 77.4% 4 77.5% 77.4% 77.2% 77.4% 5 77.5% 77.3% 77.1% 77.3% 6 77.4% 77.3% 77.0% 77.3% 7 77.4% 77.2% 77.0% 77.2% 8 77.3% 77.1% 76.9% 77.1% 9 77.1% 77.0% 77.0% 10 77.0% 76.9% 11 76.8% 12 76.7% Expected Loss Ratios 61.8% 62.1% 70.4% 76.5% 77.4% 77.3% 77.2% 77.2% 77.1% 77.0% A/E 0.000 0.000 0.000 0.000 1.246 1.256 1.265 0.955 0.955 0.955 0.955 0.955 0.955 0.955 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan D As of March 31, 2011 Proposed Rate Increase: 9.9% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 0 0 0 2,172 6,248 3,480 0 11,901 2 0 0 0 0 2,136 4,497 3,984 0 10,618 3 0 0 0 0 1,763 5,591 3,908 0 11,263 4 0 0 0 0 1,904 5,539 3,496 0 10,939 5 0 0 0 0 1,846 4,890 3,184 0 9,920 6 0 0 0 0 1,655 4,454 2,907 0 9,016 7 0 0 0 0 1,507 4,066 2,653 0 8,227 8 0 0 0 0 1,376 3,711 2,420 7,507 9 0 0 0 0 1,256 3,385 6,849 10 0 0 0 0 1,146 6,247 11 0 0 0 0 5,696 12 0 0 0 5,191 Total 0 0 0 0 2,172 8,384 9,741 11,479 11,294 10,041 9,145 8,349 7,620 6,951 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 0 0 0 1,610 5,063 2,111 0 8,783 2 0 0 0 0 309 5,274 1,897 7,480 3 0 0 0 0 1,377 5,148 1,928 8,453 4 0 0 0 0 0 1,168 5,285 1,728 8,180 5 0 0 0 0 0 1,173 4,675 1,574 7,422 6 0 0 0 0 0 1,054 4,258 1,437 6,749 7 0 0 0 0 0 960 3,888 1,312 6,160 8 876 3,549 1,197 5,622 9 800 3,238 5,130 10 730 4,680 11 4,268 12 3,890 Total 0 0 0 0 1,610 5,371 8,763 8,212 8,386 7,457 6,792 6,201 5,660 5,164 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 74.1% 81.0% 60.6% 73.8% 2 14.4% 117.3% 47.6% 70.4% 3 78.1% 92.1% 49.3% 75.1% 4 61.3% 95.4% 49.4% 74.8% 5 63.5% 95.6% 49.4% 74.8% 6 63.7% 95.6% 49.4% 74.9% 7 63.7% 95.6% 49.4% 74.9% 8 63.7% 95.6% 49.5% 74.9% 9 63.7% 95.6% 74.9% 10 63.7% 74.9% 11 74.9% 12 74.9% Total 74.1% 64.1% 90.0% 71.5% 74.3% 74.3% 74.3% 74.3% 74.3% 74.3% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 56.3% 57.2% 58.4% 55.3% 57.4% 2 67.1% 67.7% 68.2% 66.1% 67.7% 3 76.2% 76.2% 76.2% 76.1% 76.2% 4 76.2% 76.2% 76.2% 76.1% 76.2% 5 76.2% 76.2% 76.2% 76.1% 76.2% 6 76.2% 76.2% 76.2% 76.1% 76.2% 7 76.2% 76.2% 76.3% 76.1% 76.2% 8 76.2% 76.2% 76.3% 76.2% 9 76.2% 76.2% 76.2% 10 76.2% 76.3% 11 76.3% 12 76.3% Expected Loss Ratios 56.3% 59.7% 65.9% 73.4% 76.2% 76.2% 76.2% 76.2% 76.2% 76.2% A/E 0.000 0.000 0.000 0.000 1.317 1.072 1.365 0.974 0.974 0.974 0.974 0.974 0.974 0.974 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan F As of March 31, 2011 Proposed Rate Increase: 9.9% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 16,188 12,729 719 28,045 282,622 61,832 783 402,919 2 0 11,341 9,484 741 28,494 219,817 70,393 983 341,253 3 0 8,460 7,017 782 23,145 282,524 72,852 862 395,643 4 0 4,616 5,424 742 27,869 282,152 64,596 788 386,187 5 0 1,761 4,192 848 27,712 251,377 59,004 722 345,615 6 0 1,315 5,274 912 24,846 229,616 54,103 662 316,727 7 0 1,617 5,400 799 22,695 210,544 49,613 607 291,275 8 0 1,608 4,767 730 20,810 193,070 45,495 267,037 9 0 1,442 4,354 670 19,083 177,044 244,939 10 0 1,317 3,992 614 17,499 225,148 11 0 1,208 3,661 563 206,947 12 0 1,107 3,357 190,053 Total 0 16,188 24,071 18,663 40,419 319,083 311,043 389,309 391,619 348,688 318,504 292,048 267,809 245,581 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 11,958 7,052 991 5,954 189,613 97,334 860 313,761 2 0 6,985 8,486 151 15,333 170,852 77,331 1,095 280,232 3 0 6,156 7,535 909 16,003 153,247 81,113 960 265,923 4 0 0 2,578 5,523 179 13,448 155,112 71,943 876 249,658 5 0 0 0 886 5,646 142 13,552 138,236 65,663 803 224,929 6 0 0 0 0 929 4,957 155 12,155 126,169 60,161 736 205,262 7 0 0 0 0 0 797 5,144 136 11,093 115,598 55,125 674 188,568 8 803 4,542 124 10,164 105,921 50,510 172,685 9 721 4,146 114 9,313 97,054 158,327 10 658 3,798 104 8,534 145,433 11 603 3,480 96 133,574 12 552 3,189 122,621 Total 0 11,958 14,037 15,632 16,217 212,264 290,943 250,782 256,974 228,693 208,729 191,241 175,232 160,562 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 73.9% 55.4% 137.8% 21.2% 67.1% 157.4% 109.9% 77.9% 2 61.6% 89.5% 20.3% 53.8% 77.7% 109.9% 111.3% 82.1% 3 72.8% 107.4% 116.3% 69.1% 54.2% 111.3% 111.4% 67.2% 4 55.8% 101.8% 24.1% 48.3% 55.0% 111.4% 111.3% 64.6% 5 50.3% 134.7% 16.8% 48.9% 55.0% 111.3% 111.2% 65.1% 6 70.6% 94.0% 17.0% 48.9% 54.9% 111.2% 111.1% 64.8% 7 49.3% 95.3% 17.0% 48.9% 54.9% 111.1% 111.0% 64.7% 8 50.0% 95.3% 17.0% 48.8% 54.9% 111.0% 64.7% 9 50.0% 95.2% 17.0% 48.8% 54.8% 64.6% 10 49.9% 95.1% 17.0% 48.8% 64.6% 11 49.9% 95.1% 17.0% 64.5% 12 49.9% 95.0% 64.5% Total 73.9% 58.3% 83.8% 40.1% 66.5% 93.5% 64.4% 65.6% 65.6% 65.5% 65.5% 65.4% 65.4% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 48.5% 48.6% 46.3% 59.4% 59.2% 59.3% 59.2% 58.4% 2 59.6% 58.3% 53.1% 69.6% 69.3% 69.2% 69.4% 68.6% 3 71.8% 68.8% 61.3% 76.6% 77.1% 77.1% 76.9% 76.8% 4 77.0% 71.6% 69.4% 76.5% 77.0% 77.1% 76.8% 76.9% 5 77.3% 73.4% 70.3% 76.5% 76.9% 77.0% 76.8% 76.9% 6 78.2% 74.5% 71.2% 76.4% 76.9% 76.9% 76.7% 76.8% 7 79.4% 75.5% 72.0% 76.3% 76.8% 76.8% 76.6% 76.7% 8 80.6% 76.5% 72.8% 76.3% 76.7% 76.7% 76.7% 9 81.6% 77.4% 73.5% 76.2% 76.6% 76.6% 10 82.7% 78.3% 74.3% 76.2% 76.6% 11 83.6% 79.1% 75.0% 76.5% 12 84.6% 79.9% 76.5% Expected Loss Ratios 48.5% 53.8% 64.0% 62.9% 60.4% 67.9% 75.6% 77.0% 76.9% 76.9% 76.8% 76.7% 76.7% A/E 0.000 1.522 1.084 1.309 0.638 1.101 1.377 0.853 0.853 0.853 0.853 0.853 0.853 0.853 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan G As of March 31, 2011 Proposed Rate Increase: 9.9% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 2,454 2,534 0 12,778 170,535 25,558 640 214,498 2 0 1,083 870 0 12,530 116,375 27,091 824 158,773 3 0 387 0 0 6,877 153,426 29,429 721 190,840 4 0 0 0 0 8,914 156,865 25,902 656 192,337 5 0 0 0 0 9,086 139,713 23,570 600 172,970 6 0 0 0 0 8,131 127,137 21,548 548 157,364 7 0 0 0 0 7,399 116,227 19,696 501 143,824 8 0 0 0 0 6,764 106,239 17,996 131,457 9 0 0 0 0 6,183 97,067 120,113 10 0 0 0 0 5,649 109,754 11 0 0 0 0 100,255 12 0 0 0 91,525 Total 0 2,454 3,618 1,257 12,778 183,065 148,809 190,071 196,204 174,467 158,763 145,139 132,667 121,213 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 539 947 0 5,019 137,164 37,348 628 181,646 2 0 463 750 0 8,382 121,542 26,618 820 158,575 3 0 372 0 0 5,445 107,741 29,265 718 143,540 4 0 0 0 0 0 4,745 111,487 25,782 653 142,667 5 0 0 0 0 0 4,895 99,391 23,458 597 128,342 6 0 0 0 0 0 4,385 90,434 21,445 546 116,810 7 0 0 0 0 0 3,990 82,673 19,603 499 106,764 8 3,647 75,570 17,911 97,584 9 3,334 69,047 89,165 10 3,046 81,476 11 74,424 12 67,951 Total 0 539 1,410 1,122 5,019 145,546 164,334 139,733 146,467 130,276 118,535 108,363 99,052 90,503 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 22.0% 37.4% 39.3% 80.4% 146.1% 98.3% 84.7% 2 42.7% 86.3% 66.9% 104.4% 98.3% 99.4% 99.9% 3 96.0% 79.2% 70.2% 99.4% 99.5% 75.2% 4 53.2% 71.1% 99.5% 99.5% 74.2% 5 53.9% 71.1% 99.5% 99.5% 74.2% 6 53.9% 71.1% 99.5% 99.5% 74.2% 7 53.9% 71.1% 99.5% 99.5% 74.2% 8 53.9% 71.1% 99.5% 74.2% 9 53.9% 71.1% 74.2% 10 53.9% 74.2% 11 74.2% 12 74.2% Total 22.0% 39.0% 89.3% 39.3% 79.5% 110.4% 73.5% 74.7% 74.7% 74.7% 74.7% 74.7% 74.7% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 46.4% 46.6% 57.7% 58.6% 58.6% 59.6% 58.2% 2 54.8% 55.0% 68.1% 68.6% 68.8% 69.7% 68.4% 3 64.3% 76.8% 76.8% 76.8% 76.8% 76.8% 4 76.8% 76.8% 76.8% 76.8% 76.8% 5 76.8% 76.8% 76.8% 76.8% 76.8% 6 76.8% 76.8% 76.8% 76.8% 76.8% 7 76.8% 76.8% 76.8% 76.8% 76.8% 8 76.8% 76.8% 76.8% 76.8% 9 76.8% 76.8% 76.8% 10 76.8% 76.8% 11 76.8% 12 76.8% Expected Loss Ratios 46.4% 49.1% 57.9% 57.7% 59.2% 67.2% 75.6% 76.8% 76.8% 76.8% 76.8% 76.8% 76.8% A/E 0.000 0.474 0.794 1.541 0.681 1.342 1.642 0.972 0.972 0.972 0.972 0.972 0.972 0.972 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE All Medicare Supplement Plans As of March 31, 2011 Proposed Rate Increase: 0.0% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 20,135 16,819 1,139 46,100 472,899 91,642 1,421 650,155 2 0 13,440 11,510 741 46,399 341,752 94,895 1,643 510,380 3 0 9,646 7,074 782 29,828 406,502 95,940 1,439 551,211 4 0 4,657 5,424 735 35,082 406,734 84,913 1,313 538,860 5 0 1,761 3,864 715 35,261 362,235 77,468 1,203 482,506 6 0 1,067 4,407 706 31,592 330,472 70,967 1,102 440,314 7 0 1,255 4,377 619 28,822 302,740 65,010 1,009 403,832 8 0 1,261 3,860 565 26,403 277,329 59,546 369,890 9 0 1,130 3,521 517 24,187 254,020 338,874 10 0 1,031 3,226 474 22,154 310,940 11 0 944 2,955 434 285,282 12 0 865 2,707 261,529 Total 0 20,135 30,259 22,295 58,572 527,265 468,889 544,278 545,923 485,788 443,192 406,000 371,921 340,663 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 14,191 9,588 1,077 12,184 340,780 139,138 1,703 518,662 2 0 8,661 12,411 149 28,138 324,995 113,726 2,003 490,081 3 0 8,785 9,143 908 24,633 305,132 116,974 1,755 467,331 4 0 0 3,763 5,520 184 22,868 310,608 103,571 1,601 448,114 5 0 0 0 885 5,519 141 23,384 276,735 94,436 1,465 402,567 6 0 0 0 0 899 4,969 142 20,959 252,328 86,466 1,342 367,105 7 0 0 0 0 0 834 5,021 125 19,110 231,032 79,168 1,228 336,519 8 853 4,429 114 17,498 211,531 72,477 308,028 9 765 4,038 104 16,021 193,653 282,097 10 697 3,697 95 14,667 258,724 11 638 3,385 87 237,258 12 584 3,099 217,448 Total 0 14,191 18,249 22,273 25,238 376,231 495,368 449,374 458,985 408,339 372,324 340,901 312,126 285,746 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 70.5% 57.0% 94.5% 26.4% 72.1% 151.8% 119.8% 79.8% 2 64.4% 107.8% 20.1% 60.6% 95.1% 119.8% 121.9% 96.0% 3 91.1% 129.2% 116.2% 82.6% 75.1% 121.9% 122.0% 84.8% 4 80.8% 101.8% 25.1% 65.2% 76.4% 122.0% 121.9% 83.2% 5 50.3% 142.8% 19.8% 66.3% 76.4% 121.9% 121.8% 83.4% 6 84.2% 112.7% 20.1% 66.3% 76.4% 121.8% 121.8% 83.4% 7 66.5% 114.7% 20.1% 66.3% 76.3% 121.8% 121.7% 83.3% 8 67.6% 114.7% 20.1% 66.3% 76.3% 121.7% 83.3% 9 67.7% 114.7% 20.1% 66.2% 76.2% 83.2% 10 67.6% 114.6% 20.1% 66.2% 83.2% 11 67.6% 114.6% 20.1% 83.2% 12 67.6% 114.5% 83.1% Total 70.5% 60.3% 99.9% 43.1% 71.4% 105.6% 82.6% 84.1% 84.1% 84.0% 84.0% 83.9% 83.9% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 48.1% 48.1% 46.7% 58.9% 59.0% 59.1% 59.0% 58.3% 2 58.7% 57.5% 53.1% 69.1% 69.0% 69.1% 69.2% 68.5% 3 70.6% 68.7% 61.3% 76.7% 77.0% 77.0% 76.8% 76.7% 4 76.9% 71.6% 69.4% 76.7% 76.9% 77.0% 76.8% 76.9% 5 77.3% 73.4% 70.3% 76.6% 76.9% 76.9% 76.7% 76.8% 6 78.2% 74.5% 71.2% 76.6% 76.8% 76.9% 76.7% 76.8% 7 79.4% 75.5% 72.0% 76.5% 76.8% 76.8% 76.6% 76.8% 8 80.6% 76.5% 72.8% 76.5% 76.7% 76.8% 76.7% 9 81.6% 77.4% 73.5% 76.4% 76.7% 76.7% 10 82.7% 78.3% 74.3% 76.4% 76.7% 11 83.6% 79.1% 75.0% 76.6% 12 84.6% 79.9% 76.6% Expected Loss Ratios 48.1% 52.8% 62.6% 61.5% 60.1% 67.6% 75.5% 76.9% 76.9% 76.8% 76.8% 76.8% 76.7% A/E 0.000 1.466 1.142 1.595 0.701 1.188 1.562 1.093 1.093 1.093 1.093 1.093 1.093 1.093 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan B As of March 31, 2011 Proposed Rate Increase: 0.0% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 1,494 1,555 420 0 0 0 0 3,469 2 0 1,015 1,157 0 0 0 0 0 2,172 3 0 799 57 0 0 0 0 0 856 4 0 41 0 0 0 0 0 0 41 5 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 10 0 0 0 0 0 0 11 0 0 0 0 0 12 0 0 0 0 Total 0 1,494 2,570 2,376 98 0 0 0 0 0 0 0 0 0 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 1,694 1,632 35 0 0 0 3,361 2 0 1,170 3,202 0 0 0 4,372 3 0 2,283 0 0 0 2,283 4 0 0 0 0 0 0 5 0 0 0 0 0 0 6 0 0 0 0 0 0 7 0 0 0 0 0 0 8 0 9 0 10 0 11 0 12 0 Total 0 1,694 2,801 5,519 0 0 0 0 0 0 0 0 0 0 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 113.4% 104.9% 8.3% 96.9% 2 115.2% 276.8% 201.3% 3 285.8% 0.0% 266.8% 4 0.0% 0.0% 5 6 7 8 9 10 11 12 Total 113.4% 109.0% 232.3% 0.0% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 46.0% 46.1% 47.4% 46.2% 2 52.9% 53.1% 53.0% 3 61.1% 61.1% 61.1% 4 63.1% 63.1% 5 6 7 8 9 10 11 12 Expected Loss Ratios 46.0% 48.8% 54.8% 62.0% A/E 0.000 2.467 2.233 4.240 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan C As of March 31, 2011 Proposed Rate Increase: 0.0% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 0 0 0 3,104 13,495 2,333 0 18,932 2 0 0 0 0 3,238 14,111 2,254 0 19,603 3 0 0 0 0 3,955 11,735 1,979 0 17,668 4 0 0 0 0 2,940 10,362 1,734 0 15,036 5 0 0 0 0 2,617 9,168 1,574 0 13,359 6 0 0 0 0 2,346 8,324 1,438 0 12,107 7 0 0 0 0 2,130 7,602 1,313 0 11,045 8 0 0 0 0 1,945 6,940 1,198 10,083 9 0 0 0 0 1,776 6,334 9,203 10 0 0 0 0 1,621 8,398 11 0 0 0 0 7,662 12 0 0 0 6,986 Total 0 0 0 0 3,104 16,733 20,399 16,928 14,958 13,247 12,028 10,985 10,029 9,152 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 0 0 0 2,392 9,358 1,898 0 13,649 2 0 0 0 0 3,691 13,510 1,608 18,810 3 0 0 0 0 3,143 9,853 1,430 14,426 4 0 0 0 0 0 2,049 8,813 1,253 12,115 5 0 0 0 0 0 1,847 7,793 1,136 10,777 6 0 0 0 0 0 1,655 7,070 1,037 9,762 7 0 0 0 0 0 1,502 6,450 945 8,897 8 1,370 5,882 862 8,114 9 1,249 5,361 7,395 10 1,139 6,740 11 6,142 12 5,594 Total 0 0 0 0 2,392 13,050 18,551 13,510 12,091 10,701 9,708 8,857 8,077 7,361 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 77.0% 69.4% 81.4% 72.1% 2 114.0% 95.7% 71.4% 96.0% 3 79.5% 84.0% 72.3% 81.6% 4 69.7% 85.1% 72.3% 80.6% 5 70.6% 85.0% 72.2% 80.7% 6 70.6% 84.9% 72.1% 80.6% 7 70.5% 84.8% 72.0% 80.6% 8 70.4% 84.8% 71.9% 80.5% 9 70.3% 84.6% 80.4% 10 70.2% 80.3% 11 80.2% 12 80.1% Total 77.0% 78.0% 90.9% 79.8% 80.8% 80.8% 80.7% 80.6% 80.5% 80.4% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 61.8% 60.2% 60.0% 60.4% 2 70.2% 70.0% 69.7% 70.0% 3 77.5% 77.4% 77.2% 77.4% 4 77.5% 77.4% 77.2% 77.4% 5 77.5% 77.3% 77.1% 77.3% 6 77.4% 77.3% 77.0% 77.3% 7 77.4% 77.2% 77.0% 77.2% 8 77.3% 77.1% 76.9% 77.1% 9 77.1% 77.0% 77.0% 10 77.0% 76.9% 11 76.8% 12 76.7% Expected Loss Ratios 61.8% 62.1% 70.3% 76.4% 77.4% 77.3% 77.2% 77.2% 77.1% 77.0% A/E 0.000 0.000 0.000 0.000 1.246 1.256 1.293 1.045 1.045 1.045 1.045 1.045 1.045 1.045 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan D As of March 31, 2011 Proposed Rate Increase: 0.0% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 0 0 0 2,172 6,248 3,433 0 11,853 2 0 0 0 0 2,136 4,424 3,618 0 10,178 3 0 0 0 0 1,675 5,194 3,556 0 10,425 4 0 0 0 0 1,714 5,040 3,181 0 9,935 5 0 0 0 0 1,680 4,450 2,897 0 9,027 6 0 0 0 0 1,506 4,053 2,645 0 8,204 7 0 0 0 0 1,372 3,700 2,414 0 7,485 8 0 0 0 0 1,252 3,377 2,202 6,831 9 0 0 0 0 1,143 3,080 6,232 10 0 0 0 0 1,043 5,684 11 0 0 0 0 5,183 12 0 0 0 4,723 Total 0 0 0 0 2,172 8,384 9,531 10,525 10,276 9,137 8,321 7,597 6,933 6,325 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 0 0 0 1,610 5,063 2,125 0 8,798 2 0 0 0 0 309 5,300 1,899 7,507 3 0 0 0 0 1,354 5,275 1,940 8,569 4 0 0 0 0 0 1,175 5,320 1,739 8,234 5 0 0 0 0 0 1,197 4,707 1,583 7,487 6 0 0 0 0 0 1,075 4,287 1,446 6,808 7 0 0 0 0 0 979 3,914 1,320 6,213 8 894 3,573 1,204 5,671 9 816 3,260 5,174 10 744 4,720 11 4,305 12 3,924 Total 0 0 0 0 1,610 5,371 8,779 8,348 8,457 7,520 6,849 6,254 5,709 5,208 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 74.1% 81.0% 61.9% 74.2% 2 14.4% 119.8% 52.5% 73.8% 3 80.8% 101.6% 54.5% 82.2% 4 68.5% 105.6% 54.7% 82.9% 5 71.2% 105.8% 54.7% 82.9% 6 71.4% 105.8% 54.7% 83.0% 7 71.4% 105.8% 54.7% 83.0% 8 71.4% 105.8% 54.7% 83.0% 9 71.4% 105.8% 83.0% 10 71.4% 83.0% 11 83.1% 12 83.1% Total 74.1% 64.1% 92.1% 79.3% 82.3% 82.3% 82.3% 82.3% 82.3% 82.3% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 56.3% 57.2% 58.4% 55.3% 57.4% 2 67.1% 67.7% 68.2% 66.1% 67.7% 3 76.2% 76.2% 76.2% 76.1% 76.2% 4 76.2% 76.2% 76.2% 76.1% 76.2% 5 76.2% 76.2% 76.2% 76.1% 76.2% 6 76.2% 76.2% 76.2% 76.1% 76.2% 7 76.2% 76.2% 76.3% 76.1% 76.2% 8 76.2% 76.2% 76.3% 76.2% 9 76.2% 76.2% 76.2% 10 76.2% 76.3% 11 76.3% 12 76.3% Expected Loss Ratios 56.3% 59.7% 65.8% 73.4% 76.2% 76.2% 76.2% 76.2% 76.2% 76.2% A/E 0.000 0.000 0.000 0.000 1.317 1.072 1.400 1.080 1.080 1.080 1.080 1.080 1.080 1.080 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan F As of March 31, 2011 Proposed Rate Increase: 0.0% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 16,188 12,729 719 28,045 282,622 61,049 778 402,131 2 0 11,341 9,484 741 28,494 216,043 65,943 895 332,941 3 0 8,460 7,017 782 21,961 258,018 66,290 785 363,311 4 0 4,616 5,424 739 25,220 256,735 58,777 717 352,228 5 0 1,761 4,124 844 25,215 228,732 53,689 657 315,022 6 0 1,274 4,972 829 22,607 208,932 49,229 603 288,447 7 0 1,464 4,913 727 20,650 191,578 45,143 553 265,028 8 0 1,463 4,337 664 18,935 175,677 41,396 242,982 9 0 1,312 3,962 609 17,364 161,096 222,874 10 0 1,198 3,633 559 15,922 204,866 11 0 1,099 3,331 512 188,305 12 0 1,008 3,055 172,932 Total 0 16,188 24,071 18,663 40,419 319,083 305,191 357,239 356,341 317,278 289,812 265,740 243,685 223,458 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 11,958 7,052 991 5,954 189,613 97,442 941 313,950 2 0 6,985 8,486 151 15,333 171,895 79,719 1,101 283,670 3 0 6,156 7,535 909 15,734 155,489 81,554 965 268,341 4 0 0 2,578 5,523 180 13,685 157,449 72,332 881 252,628 5 0 0 0 886 5,668 155 13,924 140,317 66,018 807 227,776 6 0 0 0 0 933 5,175 155 12,488 128,068 60,487 740 208,046 7 0 0 0 0 0 811 5,204 136 11,398 117,338 55,423 678 190,990 8 825 4,595 124 10,443 107,516 50,784 174,910 9 740 4,194 114 9,569 98,515 160,366 10 676 3,843 104 8,768 147,306 11 619 3,521 96 135,294 12 567 3,226 124,200 Total 0 11,958 14,037 15,632 16,217 212,264 291,851 255,976 260,213 231,575 211,360 193,652 177,441 162,586 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 73.9% 55.4% 137.8% 21.2% 67.1% 159.6% 120.9% 78.1% 2 61.6% 89.5% 20.3% 53.8% 79.6% 120.9% 123.0% 85.2% 3 72.8% 107.4% 116.3% 71.6% 60.3% 123.0% 123.1% 73.9% 4 55.8% 101.8% 24.3% 54.3% 61.3% 123.1% 123.0% 71.7% 5 50.3% 137.4% 18.4% 55.2% 61.3% 123.0% 122.9% 72.3% 6 73.2% 104.1% 18.7% 55.2% 61.3% 122.9% 122.8% 72.1% 7 55.4% 105.9% 18.7% 55.2% 61.2% 122.8% 122.7% 72.1% 8 56.4% 106.0% 18.7% 55.2% 61.2% 122.7% 72.0% 9 56.4% 105.9% 18.7% 55.1% 61.2% 72.0% 10 56.4% 105.8% 18.7% 55.1% 71.9% 11 56.3% 105.7% 18.7% 71.8% 12 56.3% 105.6% 71.8% Total 73.9% 58.3% 83.8% 40.1% 66.5% 95.6% 71.7% 73.0% 73.0% 72.9% 72.9% 72.8% 72.8% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 48.5% 48.6% 46.3% 59.4% 59.2% 59.3% 59.2% 58.4% 2 59.6% 58.3% 53.1% 69.6% 69.3% 69.2% 69.4% 68.6% 3 71.8% 68.8% 61.3% 76.6% 77.1% 77.1% 76.9% 76.7% 4 77.0% 71.6% 69.4% 76.5% 77.0% 77.1% 76.8% 76.9% 5 77.3% 73.4% 70.3% 76.5% 76.9% 77.0% 76.8% 76.8% 6 78.2% 74.5% 71.2% 76.4% 76.9% 76.9% 76.7% 76.8% 7 79.4% 75.5% 72.0% 76.3% 76.8% 76.8% 76.6% 76.7% 8 80.6% 76.5% 72.8% 76.3% 76.7% 76.7% 76.7% 9 81.6% 77.4% 73.5% 76.2% 76.6% 76.6% 10 82.7% 78.3% 74.3% 76.2% 76.6% 11 83.6% 79.1% 75.0% 76.5% 12 84.6% 79.9% 76.5% Expected Loss Ratios 48.5% 53.8% 64.0% 62.9% 60.4% 67.9% 75.5% 77.0% 76.9% 76.9% 76.8% 76.7% 76.7% A/E 0.000 1.522 1.084 1.309 0.638 1.101 1.408 0.949 0.949 0.949 0.949 0.949 0.949 0.949 EXHIBIT III - Nationwide Durational Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan G As of March 31, 2011 Proposed Rate Increase: 0.0% Earned Premium Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 2,454 2,534 0 12,778 170,535 25,402 638 214,341 2 0 1,083 870 0 12,530 114,757 26,050 750 156,040 3 0 387 0 0 6,495 140,251 26,778 656 174,567 4 0 0 0 0 8,095 142,734 23,569 597 174,994 5 0 0 0 0 8,268 127,127 21,447 546 157,388 6 0 0 0 0 7,399 115,684 19,607 499 143,189 7 0 0 0 0 6,733 105,757 17,922 456 130,868 8 0 0 0 0 6,155 96,669 16,375 119,615 9 0 0 0 0 5,626 88,323 109,293 10 0 0 0 0 5,140 99,867 11 0 0 0 0 91,224 12 0 0 0 83,281 Total 0 2,454 3,618 1,257 12,778 183,065 146,654 175,034 178,530 158,751 144,461 132,065 120,716 110,294 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Claims 0 0 0 0 0 0 - 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 0 539 947 0 5,019 137,164 37,400 688 181,758 2 0 463 750 0 8,382 122,113 28,074 821 160,602 3 0 372 0 0 5,300 109,241 29,307 719 144,939 4 0 0 0 0 0 4,836 112,903 25,819 654 144,211 5 0 0 0 0 0 5,016 100,651 23,492 598 129,756 6 0 0 0 0 0 4,493 91,580 21,476 546 118,095 7 0 0 0 0 0 4,088 83,721 19,631 499 107,939 8 3,737 76,528 17,936 98,657 9 3,416 69,923 90,146 10 3,121 82,373 11 75,243 12 68,699 Total 0 539 1,410 1,122 5,019 145,546 164,813 142,838 148,047 131,681 119,814 109,532 100,121 91,479 TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE Incurred Loss Ratios 0 0 0 0 0 0 0 0 0 0 0 0 0 Calendar Year Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 22.0% 37.4% 39.3% 80.4% 147.2% 107.8% 84.8% 2 42.7% 86.3% 66.9% 106.4% 107.8% 109.4% 102.9% 3 96.0% 81.6% 77.9% 109.4% 109.5% 83.0% 4 59.7% 79.1% 109.5% 109.5% 82.4% 5 60.7% 79.2% 109.5% 109.5% 82.4% 6 60.7% 79.2% 109.5% 109.5% 82.5% 7 60.7% 79.2% 109.5% 109.5% 82.5% 8 60.7% 79.2% 109.5% 82.5% 9 60.7% 79.2% 82.5% 10 60.7% 82.5% 11 82.5% 12 82.5% Total 22.0% 39.0% 89.3% 39.3% 79.5% 112.4% 81.6% 82.9% 82.9% 82.9% 82.9% 82.9% 82.9% Durational Loss Ratios Calendar Year (adjusted for actual Issue Age and Duration Distribution) Duration 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Total 1 46.4% 46.6% 57.7% 58.6% 58.6% 59.6% 58.2% 2 54.8% 55.0% 68.1% 68.6% 68.8% 69.7% 68.4% 3 64.3% 76.8% 76.8% 76.8% 76.8% 76.8% 4 76.8% 76.8% 76.8% 76.8% 76.8% 5 76.8% 76.8% 76.8% 76.8% 76.8% 6 76.8% 76.8% 76.8% 76.8% 76.8% 7 76.8% 76.8% 76.8% 76.8% 76.8% 8 76.8% 76.8% 76.8% 76.8% 9 76.8% 76.8% 76.8% 10 76.8% 76.8% 11 76.8% 12 76.8% Expected Loss Ratios 46.4% 49.1% 57.9% 57.7% 59.2% 67.2% 75.6% 76.8% 76.8% 76.8% 76.8% 76.8% 76.8% A/E 0.000 0.474 0.794 1.541 0.681 1.342 1.672 1.080 1.080 1.080 1.080 1.080 1.080 1.080 EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE All Medicare Supplement Plans As of March 31, 2011 Proposed Rate Increase: 9.90% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 162,271 268,672 165.57% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 315,229 225,452 71.52% 13.0% 0.0% 14.5% 8.0% 2005 0 0 2006 20,135 14,191 70.48% 2007 30,259 18,249 60.31% 2008 22,295 22,273 99.90% 2009 58,572 25,238 43.09% 2010 527,265 376,231 71.36% 2011 477,500 494,124 103.48% Accum Value of Past @ 12/31/11 1,201,787 1,001,486 83.33% Combined Value @ 12/31/11 5,607,350 4,325,219 77.13% Present Value of Future @ 12/31/11 4,405,564 3,323,733 75.44% 2012 592,466 440,550 74.36% 12.0% 2.1% 14.0% 8.0% 2013 599,970 454,059 75.68% 2.0% 2.0% 12.5% 8.0% 2014 533,881 403,957 75.66% 0.0% 1.9% 10.5% 8.0% 2015 487,068 368,328 75.62% 0.0% 1.8% 10.0% 8.0% 2016 446,194 337,243 75.58% 0.0% 1.8% 10.0% 8.0% 2017 408,742 308,777 75.54% 0.0% 1.8% 10.0% 8.0% 2018 374,389 282,679 75.50% 0.0% 1.8% 10.0% 8.0% 2019 343,596 259,303 75.47% 0.0% 2.0% 10.0% 8.0% 2020 315,299 237,844 75.43% 0.0% 1.9% 10.0% 8.0% 2021 289,057 217,975 75.41% 0.0% 1.8% 10.0% 8.0% 2022 264,853 199,779 75.43% 0.0% 1.8% 10.0% 8.0% 2023 242,585 183,061 75.46% 0.0% 1.8% 10.0% 8.0% 2024 222,081 167,669 75.50% 0.0% 1.7% 10.0% 8.0% 2025 203,357 153,610 75.54% 0.0% 1.8% 10.0% 8.0% 2026 186,180 140,727 75.59% 0.0% 1.7% 10.0% 8.0% 2027 170,336 129,022 75.75% 0.0% 1.6% 10.0% 8.0% 2028 155,782 118,292 75.93% 0.0% 1.6% 10.0% 8.0% 2029 142,350 108,365 76.13% 0.0% 1.5% 10.0% 8.0% 2030 129,972 99,194 76.32% 0.0% 1.4% 10.0% 8.0% 2031 118,654 90,788 76.51% 0.0% 1.4% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan B As of March 31, 2011 Proposed Rate Increase: 9.90% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 0 0 Trend** Aging Rate Trend Partial Year Projection 4-12 2011 0 0 0.0% 0.0% 0.0% 2.0% 2005 0 0 2006 1,494 1,694 113.45% 2007 2,570 2,801 108.99% 2008 2,376 5,519 232.34% 2009 98 0 0.00% 2010 0 0 2011 0 0 Accum Value of Past @ 12/31/11 7,888 11,957 151.58% Combined Value @ 12/31/11 7,888 11,957 151.58% Present Value of Future @ 12/31/11 0 0 2012 0 0 0.0% 0.0% 0.0% 2.0% 2013 0 0 0.0% 0.0% 0.0% 2.0% 2014 0 0 0.0% 0.0% 0.0% 2.0% 2015 0 0 0.0% 0.0% 0.0% 2.0% 2016 0 0 0.0% 0.0% 0.0% 2.0% 2017 0 0 0.0% 0.0% 0.0% 2.0% 2018 0 0 0.0% 0.0% 0.0% 2.0% 2019 0 0 0.0% 0.0% 0.0% 2.0% 2020 0 0 0.0% 0.0% 0.0% 2.0% 2021 0 0 0.0% 0.0% 0.0% 2.0% 2022 0 0 0.0% 0.0% 0.0% 2.0% 2023 0 0 0.0% 0.0% 0.0% 2.0% 2024 0 0 0.0% 0.0% 0.0% 2.0% 2025 0 0 0.0% 0.0% 0.0% 2.0% 2026 0 0 0.0% 0.0% 0.0% 2.0% 2027 0 0 0.0% 0.0% 0.0% 2.0% 2028 0 0 0.0% 0.0% 0.0% 2.0% 2029 0 0 0.0% 0.0% 0.0% 2.0% 2030 0 0 0.0% 0.0% 0.0% 2.0% 2031 0 0 0.0% 0.0% 0.0% 2.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan C As of March 31, 2011 Proposed Rate Increase: 9.90% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 4,605 6,948 150.90% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 16,187 11,560 71.41% 13.0% 0.0% 14.8% 8.0% 2005 0 0 2006 0 0 2007 0 0 2008 0 0 2009 3,104 2,392 77.05% 2010 16,733 13,050 77.99% 2011 20,791 18,508 89.02% Accum Value of Past @ 12/31/11 42,558 35,537 83.50% Combined Value @ 12/31/11 162,704 123,804 76.09% Present Value of Future @ 12/31/11 120,146 88,267 73.47% 2012 18,202 13,292 73.02% 9.0% 1.9% 14.0% 8.0% 2013 16,439 12,148 73.90% 1.0% 1.7% 12.8% 8.0% 2014 14,559 10,751 73.85% 0.0% 1.7% 10.8% 8.0% 2015 13,219 9,754 73.79% 0.0% 1.6% 10.0% 8.0% 2016 12,073 8,899 73.71% 0.0% 1.4% 10.0% 8.0% 2017 11,022 8,114 73.62% 0.0% 1.4% 10.0% 8.0% 2018 10,058 7,396 73.53% 0.0% 1.4% 10.0% 8.0% 2019 9,179 6,740 73.44% 0.0% 1.4% 10.0% 8.0% 2020 8,374 6,143 73.35% 0.0% 1.4% 10.0% 8.0% 2021 7,635 5,594 73.27% 0.0% 1.3% 10.0% 8.0% 2022 6,958 5,093 73.20% 0.0% 1.2% 10.0% 8.0% 2023 6,341 4,637 73.13% 0.0% 1.3% 10.0% 8.0% 2024 5,778 4,222 73.07% 0.0% 1.2% 10.0% 8.0% 2025 5,265 3,845 73.02% 0.0% 1.3% 10.0% 8.0% 2026 4,797 3,501 72.97% 0.0% 1.2% 10.0% 8.0% 2027 4,371 3,190 72.97% 0.0% 1.2% 10.0% 8.0% 2028 3,983 2,908 72.99% 0.0% 1.3% 10.0% 8.0% 2029 3,628 2,649 73.02% 0.0% 1.2% 10.0% 8.0% 2030 3,303 2,413 73.05% 0.0% 1.2% 10.0% 8.0% 2031 3,008 2,198 73.08% 0.0% 1.2% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan D As of March 31, 2011 Proposed Rate Increase: 9.90% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 2,678 3,908 145.92% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 7,063 4,855 68.74% 10.0% 0.0% 14.7% 8.0% 2005 0 0 2006 0 0 2007 0 0 2008 0 0 2009 2,172 1,610 74.13% 2010 8,384 5,371 64.06% 2011 9,741 8,763 89.96% Accum Value of Past @ 12/31/11 21,302 16,504 77.48% Combined Value @ 12/31/11 103,174 77,057 74.69% Present Value of Future @ 12/31/11 81,872 60,553 73.96% 2012 11,479 8,212 71.54% 11.0% 1.8% 14.0% 8.0% 2013 11,294 8,386 74.25% 4.0% 1.7% 12.7% 8.0% 2014 10,041 7,457 74.27% 0.0% 1.6% 10.7% 8.0% 2015 9,145 6,792 74.27% 0.0% 1.5% 10.0% 8.0% 2016 8,349 6,201 74.27% 0.0% 1.4% 10.0% 8.0% 2017 7,620 5,660 74.29% 0.0% 1.4% 10.0% 8.0% 2018 6,951 5,164 74.30% 0.0% 1.4% 10.0% 8.0% 2019 6,341 4,712 74.31% 0.0% 1.4% 10.0% 8.0% 2020 5,783 4,298 74.32% 0.0% 1.3% 10.0% 8.0% 2021 5,270 3,917 74.33% 0.0% 1.2% 10.0% 8.0% 2022 4,801 3,569 74.34% 0.0% 1.2% 10.0% 8.0% 2023 4,374 3,251 74.34% 0.0% 1.2% 10.0% 8.0% 2024 3,984 2,962 74.35% 0.0% 1.2% 10.0% 8.0% 2025 3,630 2,699 74.36% 0.0% 1.2% 10.0% 8.0% 2026 3,306 2,460 74.40% 0.0% 1.2% 10.0% 8.0% 2027 3,012 2,246 74.55% 0.0% 1.2% 10.0% 8.0% 2028 2,745 2,051 74.73% 0.0% 1.2% 10.0% 8.0% 2029 2,499 1,872 74.92% 0.0% 1.2% 10.0% 8.0% 2030 2,275 1,709 75.10% 0.0% 1.2% 10.0% 8.0% 2031 2,071 1,560 75.29% 0.0% 1.2% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan F As of March 31, 2011 Proposed Rate Increase: 9.90% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 101,399 160,562 158.35% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 209,644 130,380 62.19% 12.0% 0.0% 14.5% 8.0% 2005 0 0 2006 16,188 11,958 73.87% 2007 24,071 14,037 58.32% 2008 18,663 15,632 83.76% 2009 40,419 16,217 40.12% 2010 319,083 212,264 66.52% 2011 311,043 290,943 93.54% Accum Value of Past @ 12/31/11 773,758 592,963 76.63% Combined Value @ 12/31/11 3,668,329 2,484,408 67.73% Present Value of Future @ 12/31/11 2,894,571 1,891,445 65.34% 2012 389,309 250,782 64.42% 11.0% 2.2% 13.9% 8.0% 2013 391,619 256,974 65.62% 2.0% 2.0% 12.5% 8.0% 2014 348,688 228,693 65.59% 0.0% 2.0% 10.5% 8.0% 2015 318,504 208,729 65.53% 0.0% 1.9% 10.0% 8.0% 2016 292,048 191,241 65.48% 0.0% 1.9% 10.0% 8.0% 2017 267,809 175,232 65.43% 0.0% 1.9% 10.0% 8.0% 2018 245,581 160,562 65.38% 0.0% 1.9% 10.0% 8.0% 2019 225,814 147,530 65.33% 0.0% 2.2% 10.0% 8.0% 2020 207,609 135,546 65.29% 0.0% 2.1% 10.0% 8.0% 2021 190,672 124,426 65.26% 0.0% 2.0% 10.0% 8.0% 2022 175,009 114,236 65.27% 0.0% 2.0% 10.0% 8.0% 2023 160,552 104,846 65.30% 0.0% 1.9% 10.0% 8.0% 2024 147,196 96,173 65.34% 0.0% 1.9% 10.0% 8.0% 2025 134,992 88,248 65.37% 0.0% 1.9% 10.0% 8.0% 2026 123,775 80,972 65.42% 0.0% 1.9% 10.0% 8.0% 2027 113,383 74,315 65.54% 0.0% 1.8% 10.0% 8.0% 2028 103,816 68,202 65.70% 0.0% 1.7% 10.0% 8.0% 2029 94,963 62,533 65.85% 0.0% 1.6% 10.0% 8.0% 2030 86,779 57,279 66.01% 0.0% 1.5% 10.0% 8.0% 2031 79,288 52,460 66.16% 0.0% 1.5% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE with PROPOSED RATE INCREASE Medicare Supplement Plan G As of March 31, 2011 Proposed Rate Increase: 9.90% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 53,589 97,254 181.48% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 95,220 67,081 70.45% 14.0% 0.0% 14.5% 8.0% 2005 0 0 2006 2,454 539 21.97% 2007 3,618 1,410 38.98% 2008 1,257 1,122 89.25% 2009 12,778 5,019 39.28% 2010 183,065 145,546 79.51% 2011 148,809 164,334 110.43% Accum Value of Past @ 12/31/11 369,645 332,517 89.96% Combined Value @ 12/31/11 1,789,500 1,391,556 77.76% Present Value of Future @ 12/31/11 1,419,855 1,059,039 74.59% 2012 190,071 139,733 73.52% 12.0% 1.9% 14.0% 8.0% 2013 196,204 146,467 74.65% 2.0% 1.7% 12.5% 8.0% 2014 174,467 130,276 74.67% 0.0% 1.7% 10.5% 8.0% 2015 158,763 118,535 74.66% 0.0% 1.6% 10.0% 8.0% 2016 145,139 108,363 74.66% 0.0% 1.6% 10.0% 8.0% 2017 132,667 99,052 74.66% 0.0% 1.6% 10.0% 8.0% 2018 121,213 90,503 74.66% 0.0% 1.5% 10.0% 8.0% 2019 110,765 82,704 74.67% 0.0% 1.5% 10.0% 8.0% 2020 101,186 75,554 74.67% 0.0% 1.5% 10.0% 8.0% 2021 92,376 68,979 74.67% 0.0% 1.4% 10.0% 8.0% 2022 84,310 62,986 74.71% 0.0% 1.4% 10.0% 8.0% 2023 76,935 57,510 74.75% 0.0% 1.4% 10.0% 8.0% 2024 70,198 52,505 74.80% 0.0% 1.4% 10.0% 8.0% 2025 64,060 47,943 74.84% 0.0% 1.4% 10.0% 8.0% 2026 58,454 43,779 74.89% 0.0% 1.4% 10.0% 8.0% 2027 53,327 40,047 75.10% 0.0% 1.4% 10.0% 8.0% 2028 48,636 36,634 75.32% 0.0% 1.3% 10.0% 8.0% 2029 44,341 33,502 75.55% 0.0% 1.3% 10.0% 8.0% 2030 40,410 30,625 75.79% 0.0% 1.2% 10.0% 8.0% 2031 36,823 27,994 76.02% 0.0% 1.2% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE All Medicare Supplement Plans As of March 31, 2011 Proposed Rate Increase: 0.00% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 162,271 268,672 165.57% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 306,617 226,696 73.93% 13.0% 0.0% 14.5% 8.0% 2005 0 0 2006 20,135 14,191 70.48% 2007 30,259 18,249 60.31% 2008 22,295 22,273 99.90% 2009 58,572 25,238 43.09% 2010 527,265 376,231 71.36% 2011 468,889 495,368 105.65% Accum Value of Past @ 12/31/11 1,192,855 1,002,776 84.07% Combined Value @ 12/31/11 5,206,492 4,366,420 83.86% Present Value of Future @ 12/31/11 4,013,637 3,363,644 83.81% 2012 544,278 449,374 82.56% 12.0% 2.1% 14.0% 8.0% 2013 545,923 458,985 84.07% 2.0% 2.0% 12.5% 8.0% 2014 485,788 408,339 84.06% 0.0% 1.9% 10.5% 8.0% 2015 443,192 372,324 84.01% 0.0% 1.8% 10.0% 8.0% 2016 406,000 340,901 83.97% 0.0% 1.8% 10.0% 8.0% 2017 371,921 312,126 83.92% 0.0% 1.8% 10.0% 8.0% 2018 340,663 285,746 83.88% 0.0% 1.8% 10.0% 8.0% 2019 312,645 262,116 83.84% 0.0% 2.0% 10.0% 8.0% 2020 286,896 240,425 83.80% 0.0% 1.9% 10.0% 8.0% 2021 263,018 220,340 83.77% 0.0% 1.8% 10.0% 8.0% 2022 240,995 201,947 83.80% 0.0% 1.8% 10.0% 8.0% 2023 220,733 185,047 83.83% 0.0% 1.8% 10.0% 8.0% 2024 202,076 169,488 83.87% 0.0% 1.7% 10.0% 8.0% 2025 185,038 155,276 83.92% 0.0% 1.8% 10.0% 8.0% 2026 169,409 142,254 83.97% 0.0% 1.7% 10.0% 8.0% 2027 154,992 130,422 84.15% 0.0% 1.6% 10.0% 8.0% 2028 141,749 119,575 84.36% 0.0% 1.6% 10.0% 8.0% 2029 129,527 109,540 84.57% 0.0% 1.5% 10.0% 8.0% 2030 118,264 100,270 84.78% 0.0% 1.4% 10.0% 8.0% 2031 107,966 91,773 85.00% 0.0% 1.4% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan B As of March 31, 2011 Proposed Rate Increase: 0.00% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 0 0 Trend** Aging Rate Trend Partial Year Projection 4-12 2011 0 0 0.0% 0.0% 0.0% 2.0% 2005 0 0 2006 1,494 1,694 113.45% 2007 2,570 2,801 108.99% 2008 2,376 5,519 232.34% 2009 98 0 0.00% 2010 0 0 2011 0 0 Accum Value of Past @ 12/31/11 7,888 11,957 151.58% Combined Value @ 12/31/11 7,888 11,957 151.58% Present Value of Future @ 12/31/11 0 0 2012 0 0 0.0% 0.0% 0.0% 2.0% 2013 0 0 0.0% 0.0% 0.0% 2.0% 2014 0 0 0.0% 0.0% 0.0% 2.0% 2015 0 0 0.0% 0.0% 0.0% 2.0% 2016 0 0 0.0% 0.0% 0.0% 2.0% 2017 0 0 0.0% 0.0% 0.0% 2.0% 2018 0 0 0.0% 0.0% 0.0% 2.0% 2019 0 0 0.0% 0.0% 0.0% 2.0% 2020 0 0 0.0% 0.0% 0.0% 2.0% 2021 0 0 0.0% 0.0% 0.0% 2.0% 2022 0 0 0.0% 0.0% 0.0% 2.0% 2023 0 0 0.0% 0.0% 0.0% 2.0% 2024 0 0 0.0% 0.0% 0.0% 2.0% 2025 0 0 0.0% 0.0% 0.0% 2.0% 2026 0 0 0.0% 0.0% 0.0% 2.0% 2027 0 0 0.0% 0.0% 0.0% 2.0% 2028 0 0 0.0% 0.0% 0.0% 2.0% 2029 0 0 0.0% 0.0% 0.0% 2.0% 2030 0 0 0.0% 0.0% 0.0% 2.0% 2031 0 0 0.0% 0.0% 0.0% 2.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan C As of March 31, 2011 Proposed Rate Increase: 0.00% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 4,605 6,948 150.90% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 15,794 11,603 73.47% 13.0% 0.0% 14.8% 8.0% 2005 0 0 2006 0 0 2007 0 0 2008 0 0 2009 3,104 2,392 77.05% 2010 16,733 13,050 77.99% 2011 20,399 18,551 90.94% Accum Value of Past @ 12/31/11 42,151 35,582 84.42% Combined Value @ 12/31/11 151,823 123,704 81.48% Present Value of Future @ 12/31/11 109,672 88,122 80.35% 2012 16,928 13,510 79.81% 9.0% 1.9% 14.0% 8.0% 2013 14,958 12,091 80.83% 1.0% 1.7% 12.8% 8.0% 2014 13,247 10,701 80.78% 0.0% 1.7% 10.8% 8.0% 2015 12,028 9,708 80.71% 0.0% 1.6% 10.0% 8.0% 2016 10,985 8,857 80.63% 0.0% 1.4% 10.0% 8.0% 2017 10,029 8,077 80.53% 0.0% 1.4% 10.0% 8.0% 2018 9,152 7,361 80.43% 0.0% 1.4% 10.0% 8.0% 2019 8,352 6,709 80.33% 0.0% 1.4% 10.0% 8.0% 2020 7,620 6,114 80.24% 0.0% 1.4% 10.0% 8.0% 2021 6,947 5,568 80.15% 0.0% 1.3% 10.0% 8.0% 2022 6,331 5,069 80.07% 0.0% 1.2% 10.0% 8.0% 2023 5,770 4,615 80.00% 0.0% 1.3% 10.0% 8.0% 2024 5,257 4,202 79.93% 0.0% 1.2% 10.0% 8.0% 2025 4,791 3,827 79.87% 0.0% 1.3% 10.0% 8.0% 2026 4,365 3,484 79.82% 0.0% 1.2% 10.0% 8.0% 2027 3,978 3,175 79.82% 0.0% 1.2% 10.0% 8.0% 2028 3,625 2,894 79.85% 0.0% 1.3% 10.0% 8.0% 2029 3,301 2,637 79.88% 0.0% 1.2% 10.0% 8.0% 2030 3,005 2,402 79.91% 0.0% 1.2% 10.0% 8.0% 2031 2,737 2,188 79.94% 0.0% 1.2% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan D As of March 31, 2011 Proposed Rate Increase: 0.00% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 2,678 3,908 145.92% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 6,853 4,871 71.08% 10.0% 0.0% 14.7% 8.0% 2005 0 0 2006 0 0 2007 0 0 2008 0 0 2009 2,172 1,610 74.13% 2010 8,384 5,371 64.06% 2011 9,531 8,779 92.11% Accum Value of Past @ 12/31/11 21,085 16,521 78.35% Combined Value @ 12/31/11 95,658 77,653 81.18% Present Value of Future @ 12/31/11 74,573 61,132 81.98% 2012 10,525 8,348 79.32% 12.0% 1.8% 14.0% 8.0% 2013 10,276 8,457 82.30% 4.0% 1.7% 12.7% 8.0% 2014 9,137 7,520 82.31% 0.0% 1.6% 10.7% 8.0% 2015 8,321 6,849 82.31% 0.0% 1.5% 10.0% 8.0% 2016 7,597 6,254 82.32% 0.0% 1.4% 10.0% 8.0% 2017 6,933 5,709 82.33% 0.0% 1.4% 10.0% 8.0% 2018 6,325 5,208 82.35% 0.0% 1.4% 10.0% 8.0% 2019 5,769 4,752 82.36% 0.0% 1.4% 10.0% 8.0% 2020 5,262 4,334 82.37% 0.0% 1.3% 10.0% 8.0% 2021 4,795 3,950 82.38% 0.0% 1.2% 10.0% 8.0% 2022 4,368 3,599 82.39% 0.0% 1.2% 10.0% 8.0% 2023 3,980 3,279 82.40% 0.0% 1.2% 10.0% 8.0% 2024 3,625 2,988 82.41% 0.0% 1.2% 10.0% 8.0% 2025 3,303 2,722 82.41% 0.0% 1.2% 10.0% 8.0% 2026 3,009 2,481 82.47% 0.0% 1.2% 10.0% 8.0% 2027 2,741 2,265 82.62% 0.0% 1.2% 10.0% 8.0% 2028 2,497 2,068 82.83% 0.0% 1.2% 10.0% 8.0% 2029 2,274 1,888 83.03% 0.0% 1.2% 10.0% 8.0% 2030 2,070 1,723 83.24% 0.0% 1.2% 10.0% 8.0% 2031 1,885 1,573 83.45% 0.0% 1.2% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan F As of March 31, 2011 Proposed Rate Increase: 0.00% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 101,399 160,562 158.35% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 203,791 131,289 64.42% 12.0% 0.0% 14.5% 8.0% 2005 0 0 2006 16,188 11,958 73.87% 2007 24,071 14,037 58.32% 2008 18,663 15,632 83.76% 2009 40,419 16,217 40.12% 2010 319,083 212,264 66.52% 2011 305,191 291,851 95.63% Accum Value of Past @ 12/31/11 767,687 593,905 77.36% Combined Value @ 12/31/11 3,404,366 2,511,126 73.76% Present Value of Future @ 12/31/11 2,636,679 1,917,221 72.71% 2012 357,239 255,976 71.65% 11.0% 2.2% 13.9% 8.0% 2013 356,341 260,213 73.02% 2.0% 2.0% 12.5% 8.0% 2014 317,278 231,575 72.99% 0.0% 2.0% 10.5% 8.0% 2015 289,812 211,360 72.93% 0.0% 1.9% 10.0% 8.0% 2016 265,740 193,652 72.87% 0.0% 1.9% 10.0% 8.0% 2017 243,685 177,441 72.82% 0.0% 1.9% 10.0% 8.0% 2018 223,458 162,586 72.76% 0.0% 1.9% 10.0% 8.0% 2019 205,472 149,389 72.71% 0.0% 2.2% 10.0% 8.0% 2020 188,907 137,254 72.66% 0.0% 2.1% 10.0% 8.0% 2021 173,496 125,995 72.62% 0.0% 2.0% 10.0% 8.0% 2022 159,244 115,675 72.64% 0.0% 2.0% 10.0% 8.0% 2023 146,089 106,167 72.67% 0.0% 1.9% 10.0% 8.0% 2024 133,936 97,385 72.71% 0.0% 1.9% 10.0% 8.0% 2025 122,831 89,361 72.75% 0.0% 1.9% 10.0% 8.0% 2026 112,625 81,992 72.80% 0.0% 1.9% 10.0% 8.0% 2027 103,169 75,252 72.94% 0.0% 1.8% 10.0% 8.0% 2028 94,464 69,062 73.11% 0.0% 1.7% 10.0% 8.0% 2029 86,409 63,321 73.28% 0.0% 1.6% 10.0% 8.0% 2030 78,962 58,001 73.45% 0.0% 1.5% 10.0% 8.0% 2031 72,145 53,121 73.63% 0.0% 1.5% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. EXHIBIT IV - Nationwide Calendar Year Experience Assured Life Association NATIONWIDE EXPERIENCE Medicare Supplement Plan G As of March 31, 2011 Proposed Rate Increase: 0.00% Discount Rate: 5.00% Shock Lapse (% of RI): 0.00% Premium Claims Incurred ASSUMPTIONS* Year Earned Incurred Loss Ratio Aging Prem Lapse Medical 1-3 2011 53,589 97,254 181.48% Trend** Aging Rate Trend Partial Year Projection 4-12 2011 93,065 67,560 72.59% 13.0% 0.0% 14.5% 8.0% 2005 0 0 2006 2,454 539 21.97% 2007 3,618 1,410 38.98% 2008 1,257 1,122 89.25% 2009 12,778 5,019 39.28% 2010 183,065 145,546 79.51% 2011 146,654 164,813 112.38% Accum Value of Past @ 12/31/11 367,410 333,014 90.64% Combined Value @ 12/31/11 1,661,347 1,404,997 84.57% Present Value of Future @ 12/31/11 1,293,937 1,071,983 82.85% 2012 175,034 142,838 81.61% 12.0% 1.9% 14.0% 8.0% 2013 178,530 148,047 82.93% 2.0% 1.7% 12.5% 8.0% 2014 158,751 131,681 82.95% 0.0% 1.7% 10.5% 8.0% 2015 144,461 119,814 82.94% 0.0% 1.6% 10.0% 8.0% 2016 132,065 109,532 82.94% 0.0% 1.6% 10.0% 8.0% 2017 120,716 100,121 82.94% 0.0% 1.6% 10.0% 8.0% 2018 110,294 91,479 82.94% 0.0% 1.5% 10.0% 8.0% 2019 100,787 83,596 82.94% 0.0% 1.5% 10.0% 8.0% 2020 92,071 76,369 82.95% 0.0% 1.5% 10.0% 8.0% 2021 84,055 69,723 82.95% 0.0% 1.4% 10.0% 8.0% 2022 76,715 63,665 82.99% 0.0% 1.4% 10.0% 8.0% 2023 70,005 58,130 83.04% 0.0% 1.4% 10.0% 8.0% 2024 63,874 53,071 83.09% 0.0% 1.4% 10.0% 8.0% 2025 58,290 48,460 83.14% 0.0% 1.4% 10.0% 8.0% 2026 53,188 44,251 83.20% 0.0% 1.4% 10.0% 8.0% 2027 48,523 40,479 83.42% 0.0% 1.4% 10.0% 8.0% 2028 44,255 37,030 83.67% 0.0% 1.3% 10.0% 8.0% 2029 40,347 33,863 83.93% 0.0% 1.3% 10.0% 8.0% 2030 36,769 30,956 84.19% 0.0% 1.2% 10.0% 8.0% 2031 33,506 28,296 84.45% 0.0% 1.2% 10.0% 8.0% * Represent full year assumptions. ** Includes aging and underwriting selection wear off. Assured Life Association Actuarial Memorandum Select Form MTA40 (Pennsylvania) Exhibit V - Certificate Year Loss Ratios (Plan B) Certificate Year 65 - 69 70 - 74 75 - 79 80 - 85 86+ Composite 1 66.4% 54.7% 57.6% 55.1% 57.1% 61.3% 2 73.5% 65.4% 68.2% 65.1% 67.0% 70.1% 3 78.3% 76.7% 75.5% 72.1% 70.2% 76.6% 4 78.3% 76.5% 75.3% 71.9% 70.0% 76.6% 5 78.1% 76.2% 75.0% 71.6% 69.8% 76.5% 6 78.0% 75.9% 72.6% 70.7% 68.8% 76.0% 7 77.8% 75.7% 72.4% 70.5% 68.6% 76.0% 8 77.6% 75.5% 72.1% 70.2% 68.4% 75.9% 9 77.4% 75.3% 71.9% 70.0% 68.1% 75.8% 10 77.2% 75.0% 71.6% 69.7% 67.9% 75.7% 11 77.0% 72.6% 70.7% 68.8% 67.7% 75.1% 12 76.7% 72.4% 70.5% 68.6% 67.4% 75.0% 13 76.5% 72.1% 70.2% 68.4% 67.7% 74.9% 14 76.2% 71.9% 70.0% 68.1% 68.0% 74.8% 15 76.0% 71.6% 69.7% 67.9% 68.3% 74.7% 16 74.9% 70.7% 68.8% 67.7% 68.6% 73.8% 17 74.7% 70.5% 68.6% 67.4% 69.0% 73.7% 18 73.1% 70.2% 68.4% 67.7% 69.3% 72.5% 19 72.9% 70.0% 68.1% 68.0% 69.6% 72.3% 20 72.6% 69.7% 67.9% 68.3% 69.9% 72.1% PV at Issue 75.4% 70.8% 69.7% 66.6% 65.6% 72.9% Assured Life Association Actuarial Memorandum Select Form MTA41 (Pennsylvania) Exhibit V - Certificate Year Loss Ratios (Plan C) Certificate Year 65 - 69 70 - 74 75 - 79 80 - 85 86+ Composite 1 67.0% 55.2% 58.3% 56.0% 58.3% 61.9% 2 73.6% 65.6% 68.6% 65.8% 67.9% 70.3% 3 78.5% 76.9% 75.9% 72.8% 71.2% 76.9% 4 78.5% 76.7% 75.7% 72.5% 70.9% 76.8% 5 78.3% 76.4% 75.4% 72.2% 70.6% 76.7% 6 78.2% 76.1% 72.8% 71.1% 69.6% 76.2% 7 78.0% 75.8% 72.5% 70.8% 69.3% 76.1% 8 77.7% 75.5% 72.1% 70.5% 69.0% 76.0% 9 77.5% 75.2% 71.8% 70.2% 68.7% 75.8% 10 77.2% 74.9% 71.5% 69.9% 68.3% 75.6% 11 76.8% 72.2% 70.4% 68.8% 68.0% 74.9% 12 76.5% 71.9% 70.1% 68.5% 67.7% 74.7% 13 76.1% 71.5% 69.7% 68.2% 67.9% 74.5% 14 75.8% 71.1% 69.4% 67.9% 68.1% 74.3% 15 75.4% 70.7% 69.1% 67.5% 68.4% 74.1% 16 74.1% 69.6% 68.0% 67.2% 68.6% 72.9% 17 73.7% 69.2% 67.6% 66.8% 68.8% 72.6% 18 71.7% 68.8% 67.3% 67.0% 69.0% 71.1% 19 71.3% 68.5% 66.9% 67.2% 69.2% 70.8% 20 70.9% 68.1% 66.5% 67.4% 69.4% 70.4% PV at Issue 75.3% 70.7% 69.9% 67.1% 66.5% 72.9% Assured Life Association Actuarial Memorandum Select Form MTA42 (Pennsylvania) Exhibit V - Certificate Year Loss Ratios (Plan D) Certificate Year 65 - 69 70 - 74 75 - 79 80 - 85 86+ Composite 1 66.3% 54.8% 57.9% 55.7% 58.0% 61.4% 2 73.3% 65.5% 68.5% 65.8% 68.1% 70.2% 3 78.2% 76.8% 76.0% 73.0% 71.5% 76.7% 4 78.1% 76.7% 75.8% 72.8% 71.3% 76.7% 5 78.0% 76.5% 75.6% 72.6% 71.2% 76.7% 6 77.9% 76.3% 73.3% 71.8% 70.4% 76.3% 7 77.8% 76.1% 73.1% 71.6% 70.2% 76.2% 8 77.7% 76.0% 72.9% 71.5% 70.1% 76.2% 9 77.6% 75.8% 72.8% 71.3% 70.0% 76.2% 10 77.4% 75.6% 72.6% 71.2% 69.8% 76.1% 11 77.2% 73.3% 71.8% 70.4% 69.7% 75.6% 12 77.0% 73.1% 71.6% 70.2% 69.5% 75.5% 13 76.9% 72.9% 71.5% 70.1% 70.0% 75.5% 14 76.7% 72.8% 71.3% 70.0% 70.4% 75.5% 15 76.5% 72.6% 71.2% 69.8% 70.9% 75.4% 16 75.5% 71.8% 70.4% 69.7% 71.3% 74.6% 17 75.4% 71.6% 70.2% 69.5% 71.8% 74.5% 18 73.8% 71.5% 70.1% 70.0% 72.2% 73.3% 19 73.7% 71.3% 70.0% 70.4% 72.7% 73.2% 20 73.5% 71.2% 69.8% 70.9% 73.1% 73.1% PV at Issue 75.5% 71.2% 70.4% 67.6% 66.9% 73.2% Assured Life Association Actuarial Memorandum Select Form MTA43 (Pennsylvania) Exhibit V - Certificate Year Loss Ratios (Plan F) Certificate Year 65 - 69 70 - 74 75 - 79 80 - 85 86+ Composite 1 67.2% 55.4% 58.6% 56.3% 58.5% 62.1% 2 73.8% 65.8% 68.8% 66.0% 68.2% 70.6% 3 78.8% 77.2% 76.2% 73.0% 71.5% 77.1% 4 78.8% 77.0% 75.9% 72.7% 71.2% 77.1% 5 78.6% 76.7% 75.7% 72.4% 70.8% 77.0% 6 78.5% 76.4% 73.1% 71.4% 69.8% 76.5% 7 78.3% 76.1% 72.8% 71.1% 69.5% 76.4% 8 78.0% 75.8% 72.4% 70.8% 69.2% 76.3% 9 77.8% 75.5% 72.1% 70.5% 68.9% 76.1% 10 77.5% 75.2% 71.8% 70.2% 68.6% 75.9% 11 77.1% 72.5% 70.7% 69.1% 68.3% 75.2% 12 76.8% 72.2% 70.4% 68.8% 68.0% 75.0% 13 76.4% 71.8% 70.0% 68.5% 68.2% 74.8% 14 76.1% 71.4% 69.7% 68.2% 68.4% 74.6% 15 75.7% 71.1% 69.4% 67.8% 68.7% 74.4% 16 74.4% 69.9% 68.3% 67.5% 68.9% 73.2% 17 74.0% 69.5% 67.9% 67.2% 69.1% 73.0% 18 72.1% 69.2% 67.6% 67.3% 69.3% 71.4% 19 71.6% 68.8% 67.2% 67.5% 69.5% 71.1% 20 71.2% 68.4% 66.9% 67.7% 69.7% 70.7% PV at Issue 75.6% 71.0% 70.1% 67.4% 66.7% 73.2% Assured Life Association Actuarial Memorandum Select Form MTA44 (Pennsylvania) Exhibit V - Certificate Year Loss Ratios (Plan G) Certificate Year 65 - 69 70 - 74 75 - 79 80 - 85 86+ Composite 1 66.3% 54.8% 57.9% 55.7% 58.0% 61.4% 2 73.3% 65.5% 68.5% 65.8% 68.1% 70.2% 3 78.1% 76.8% 76.0% 73.0% 71.5% 76.7% 4 78.1% 76.7% 75.8% 72.8% 71.3% 76.7% 5 78.0% 76.5% 75.6% 72.6% 71.2% 76.7% 6 77.9% 76.3% 73.3% 71.8% 70.4% 76.3% 7 77.8% 76.1% 73.1% 71.6% 70.2% 76.2% 8 77.7% 76.0% 72.9% 71.5% 70.1% 76.2% 9 77.5% 75.8% 72.8% 71.3% 70.0% 76.2% 10 77.4% 75.6% 72.6% 71.2% 69.8% 76.1% 11 77.2% 73.3% 71.8% 70.4% 69.7% 75.6% 12 77.0% 73.1% 71.6% 70.2% 69.5% 75.5% 13 76.9% 72.9% 71.5% 70.1% 70.0% 75.5% 14 76.7% 72.8% 71.3% 70.0% 70.4% 75.5% 15 76.5% 72.6% 71.2% 69.8% 70.9% 75.4% 16 75.5% 71.8% 70.4% 69.7% 71.3% 74.6% 17 75.4% 71.6% 70.2% 69.5% 71.8% 74.5% 18 73.8% 71.5% 70.1% 70.0% 72.2% 73.3% 19 73.7% 71.3% 70.0% 70.4% 72.7% 73.2% 20 73.5% 71.2% 69.8% 70.9% 73.2% 73.1% PV at Issue 75.5% 71.2% 70.4% 67.6% 66.9% 73.2% June 1, 2011 TO WHOM IT MAY CONCERN: This letter serves as acknowledgement that Assured Life Association has engaged the actuarial firm of Bailey, Ramsey and Associates, Inc. to act on our behalf in filing the enclosed policy forms. Any questions regarding these filings should be addressed to: Ms. Kim Hefner Compliance Manager Allen Bailey and Associates, Inc. 8310 Capital of Texas Highway North Suite 370 Austin, TX 78731 Phone: (512) 502-8800 Fax: (512) 502-8638 Thank you. Diane L Muller, Corporate Secretary CERTIFICATION Assured Life Association Policy Forms: MTA40, MTA41, MTA42, MTA43, MTA44 I certify that Assured Life Association is making available for purchase both Plan A and Plan B as required by 31 Pa. Code §89.776(2) and §89.777(a). Dated June 30, 2011 by: Jenna Stotts Printed or typed name of individual whose signature appears above Compliance Analyst Title of individual whose signature appears above