ANNUAL STATEMENT. Jackson National Life Insurance Company of New York NAIC Group Code

Similar documents
* * LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION

ANNUAL STATEMENT FOR THE YEAR 2013 OF THE PRUDENTIAL INSURANCE COMPANY OF AMERICA ASSETS

* * LIFE AND ACCIDENT AND HEALTH COMPANIES ASSOCIATION EDITION

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2017 OF THE CONDITION AND AFFAIRS OF THE PACIFIC LIFE & ANNUITY COMPANY

ANNUAL STATEMENT FOR THE YEAR 2016 OF THE COLONIAL PENN LIFE INSURANCE COMPANY ASSETS

Continental American Insurance Company ASSETS

First Reliance Standard Life Insurance Company ASSETS

ANNUAL STATEMENT OF THE

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2017 OF THE CONDITION AND AFFAIRS OF THE. Wilco Life Insurance Company

* * LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION

Incorporated/Organized 09/15/2006 Commenced Business 04/24/2007. (Street and Number) Guaynabo, PR, US ,

ANNUAL STATEMENT OF THE AMERICAN MEMORIAL LIFE INSURANCE COMPANY TO THE

Incorporated/Organized 09/15/1885 Commenced Business 09/15/1885. (Street and Number) Atlanta, GA ,

American Savings Life Insurance Company

ANNUAL STATEMENT OF THE

ASSETS. ANNUAL STATEMENT FOR THE YEAR 2008 OF THE MML Bay State Life Insurance Company. 4 Net Admitted Assets. 3 Net Admitted Assets (Cols.

ANNUAL STATEMENT FOR THE YEAR 2016 OF THE NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION ASSETS

ANNUAL STATEMENT FOR THE YEAR 2017 OF THE Wilton Reassurance Life Company of New York ASSETS

ANNUAL STATEMENT FOR THE YEAR 2016 OF THE UNUM LIFE INSURANCE COMPANY OF AMERICA ASSETS

Great-West Life & Annuity Insurance Company ASSETS

ANNUAL STATEMENT FOR THE YEAR 2016 OF THE WASHINGTON NATIONAL INSURANCE COMPANY ASSETS

AXA EQUITABLE LIFE INSURANCE COMPANY ASSETS

Reliance Standard Life Insurance Company ASSETS

Incorporated/Organized 02/24/1906 Commenced Business 04/12/1906. (Street and Number) Portland, OR, US ,

COOPERATIVA DE SEGUROS DE VIDA DE PR, COSVI

Reliance Standard Life Insurance Company ASSETS

ANNUAL STATEMENT OF THE

NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY ASSETS

AS OF DECEMBER 31,2009 OF THE CONDITION AND AFFAIRS OF THE

ANNUAL STATEMENT OF THE

Incorporated/Organized 12/17/2000 Commenced Business 11/07/1877. (Street and Number) Indianapolis, IN 46282,

ANNUAL STATEMENT. Insurance Department BETHESDA STATE OF MARYLAND STATE OF. in the TO THE OF THE OF THE LIFE AND ACCIDENT AND HEALTH 2012

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2017 OF THE CONDITION AND AFFAIRS OF THE. Wilcac Life Insurance Company

Urb. Ind. Tres Monjitas 297 Ave. Chardón.. San Juan... PR P

ANNUAL STATEMENT FOR THE YEAR 2017 OF THE TEACHERS INSURANCE and ANNUITY ASSOCIATION of AMERICA ASSETS

ANNUAL STATEMENT OF THE ARKANSAS TITLE INSURANCE COMPANY

Incorporated/Organized 05/15/1851 Commenced Business 08/01/1851. (Street and Number) Springfield, MA 01111,

ANNUAL STATEMENT OF THE

IIII II III II III II III II3III II III II III II III II III II III II III II III II III II III II III II III II iil II ii) I IIII

ANNUAL STATEMENT OF THE SAFECO INSURANCE COMPANY OF ILLINOIS TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

Statutory Statement Contact Jon Ritchie (Area Code) (Telephone Number) (Extension)

ANNUAL STATEMENT OF THE STEWART

Incorporated/Organized 07/30/2001 Commenced Business 10/10/2005. (Street and Number) San Juan, PR ,

ANNUAL STATEMENT OF THE PEERLESS INSURANCE COMPANY

ANNUAL STATEMENT OF THE. STEWART Title Insurance Company TO THE. Insurance Department OF THE STATE OF NEW YORK FOR THE YEAR ENDED.

ANNUAL STATEMENT OF THE AMERICAN STATES PREFERRED INSURANCE COMPANY TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

Hawaii Employers' Mutual Insurance Company, Inc.

ANNUAL STATEMENT For the Year Ending December 31, 2016 OF THE CONDITION AND AFFAIRS OF THE MOUNT BEACON INSURANCE COMPANY

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2017 OF THE CONDITION AND AFFAIRS OF THE. The State Life Insurance Company

ANNUAL STATEMENT. Missouri Employers Mutual Insurance Company

COOPERATIVA DE SEGUROS DE VIDA DE PR, COSVI

ANNUAL STATEMENT OF THE IRONSHORE INDEMNITY INC.

ANNUAL STATEMENT STANDARD INSURANCE COMPANY

ANNUAL STATEMENT OF THE AMERICAN ECONOMY INSURANCE COMPANY TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

* * LIFE AND ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2008 OF THE CONDITION AND AFFAIRS OF THE. Penn Treaty Network America Insurance Company

ANNUAL STATEMENT OF THE THE OHIO CASUALTY INSURANCE COMPANY TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2016 OF THE CONDITION AND AFFAIRS OF THE AMICA LIFE INSURANCE COMPANY

iiii ii iii ii iii ii iio ii iii ii iii ii its ii iii ii iii ii s~i ii iii ii iii ii oii ii iii ii iii ii iii ii iii ii ioi i iiii

ANNUAL STATEMENT OF THE MONTGOMERY MUTUAL INSURANCE COMPANY TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

OFFICERS Name Title Name Title 1. Glorimar Rivero President 2. Mary Letty Hernandez Treasurer 3. Maria S. Toledo Secretary 4.

ANNUAL STATEMENT For the Year Ended DECEMBER 31, 2016 OF THE CONDITION AND AFFAIRS OF THE Safepoint Insurance Company

Incorporated/Organized 05/15/1851 Commenced Business 08/01/1851. (Street and Number) Springfield, MA 01111,

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2015 OF THE CONDITION AND AFFAIRS OF THE COVENTRY INSURANCE COMPANY

ANNUAL STATEMENT OF THE GENERAL INSURANCE COMPANY OF AMERICA TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

Q02. Statement as of September 30, 2017 of the

FIDELITY & GUARANTY LIFE INSURANCE COMPANY ASSETS

Q02. Statement as of March 31, 2017 of the

Q02. Statement as of June 30, 2017 of the

ANNUAL STATEMENT OF THE PEERLESS INSURANCE COMPANY

Statutory Statement Contact Jennifer Gravelle (Area Code) (Telephone Number) (Extension)

ANNUAL STATEMENT OF THE LIBERTY COUNTY MUTUAL INSURANCE COMPANY TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

ANNUAL STATEMENT OF THE EMPLOYERS INSURANCE COMPANY OF WAUSAU TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

* * PROPERTY AND CASUALTY COMPANIES ASSOCIATION EDITION

OFFICERS Name Title Name Title 1. Victor Jose Salgado Jr President 2. Ana Maria Salgado Secretary 3. Ana Maria Salgado Treasurer 4.

Incorporated/Organized 05/15/1851 Commenced Business 08/01/1851. (Street and Number) Springfield, MA 01111,

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2010 OF THE CONDITION AND AFFAIRS OF THE ADRIATIC INS CO

Annual Statement for the year 2016 of the GENWORTH FINANCIAL ASSURANCE CORPORATION ASSETS

Annual Statement for the year 2016 of the GENWORTH MORTGAGE INSURANCE CORPORATION ASSETS

Statutory Statement Contact Priscilla Carter (Area Code) (Telephone Number) (Extension)

Statutory Statement Contact Priscilla Carter (Area Code) (Telephone Number) (Extension)

ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2016 OF THE CONDITION AND AFFAIRS OF THE. Guarantee Insurance Company

Q02. Statement for March 31, 2017 of the

Q02. Statement as of March 31, 2015 of the

ANNUAL STATEMENT OF THE PEERLESS INDEMNITY INSURANCE COMPANY TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

ANNUAL STATEMENT OF THE OHIO SECURITY INSURANCE COMPANY TO THE. Insurance Department OF THE FOR THE YEAR ENDED. December 31, 2016

AmTrust Title Insurance Company ASSETS

Erie Insurance Company of New York ASSETS

ANNUAL STATEMENT OF THE GOLDEN EAGLE INSURANCE CORPORATION TO THE. Insurance Department OF THE FOR THE YEAR ENDED.

Q02. Statement as of March 31, 2017 of the

DIRECTORS OR TRUSTEES Roger William Crandall - Chairman Michael Robert Fanning Michael Thomas Rollings Mark Douglas Roellig

Q02. Statement for March 31, 2017 of the

Q02. Statement for June 30, 2018 of the

ASSETS. STATEMENT AS OF JUNE 30, 2017 OF THE Genworth Life and Annuity Insurance Company. Current Statement Date 4 December 31.

ANNUAL STATEMENT OF THE

United Home Insurance Company

QUARTERLY STATEMENT AS OF MARCH 31, 2017 OF THE CONDITION AND AFFAIRS OF THE Neighborhood Health Plan of Rhode Island

OFFICERS Name Title Name Title 1. Orlando Gonzalez President 2. Jose Mercado VP of Finance OTHER

Northern Capital Insurance Company

DIRECTORS OR TRUSTEES Roger William Crandall - Chairman Michael Robert Fanning Michael Thomas Rollings Mark Douglas Roellig

Transcription:

LIFE ACCIDENT AND HEALTH COMPANIES - ASSOCIATION EDITION ANNUAL STATEMENT Organized under the Laws of FOR THE YEAR ENDED DECEMBER, 005 OF THE CONDITION AND AFFAIRS OF THE I II 804000500000 Jackson National Life Insurance Company of New York NAIC Group Code ~ ~ NAIC Company Code 6040 Employer's 0 Number (Current) (Prior) New York, State of Domicile or Port of Entry -87709 New York Country of Domicile Incorporated/Organized Statutory Home Office 07//995 900 Westchester Avenue, Suite 05 (Street and Number) United States of America Commenced Business 08/6/996 Purchase, NY 0577 (City or Town, State and Zip Code) Main Administrative Office Lansing, MI 4895 (City or Town, State and Zip Code) Corporate Way (Street and Number) 57-8-5500 (Area Code) (Telephone Number) Mail Address 900 Westchester Avenue, Suite 05 (Street and Number or P.O. Box) Purchase, NY 0577 (City or Town, State and Zip Code) Primary Location of Books and Records Internet Website Address Purchase, NY 0577 (City or Town, State and Zip Code) 900 Westchester Avenue, Suite 05 (Street and Number) www.jnlny.com 57-8-5500 (Area Code) (Telephone Number) Statutory Statement Contact statinlny@jnli.com (E-maii Address) Robert Arthur Fritts (Name) 57-8-5500 (Area COde) (Telephone Number) 57-706-5505 (FAX Number) Policyowner Relations Contact Lansing, MI 4895 (City or Town, State and Zip Code) Corporate Way (Street and Number) 57-67 -679 (Area Code) (Teiephone Number) President Secretary Ciark Preston Manning Jr. Thomas John Meyer OFFICERS Treasurer Actuary Andrew Boutwell Hopping Richard David Ash Michael Andrew Wells Chief Operating Officer James Ronald Sopha Executive Vice President Robert Arthur Fritts Senior Vice President John Bruce Banez Vice President Joseph Mark Clark Vice President Gerald William Decius Vice President Julia Anne Goatley Vice President Everett William Kunzelman Vice President Russell Erwin Peck Vice President James Brian Quinn Vice President John Howard Brown Juiia Anne Goatley Herbert George May III Russell Erwin Peck Gary Howard Torgow # OTHER Clifford James Jack Executive Vice President Herbert George May III Chief Administrative Officer Stephen Anthony Hrapkiewicz Jr. Senior Vice President James Patrick Binder Vice President Marianne Clone Vice President Phillip Brian Eaves # Vice President James Glenn Golembiewski Vice President Keith Richard Moore Vice President Bradley Jay Powell Vice President Kathleen Marie Smith # Vice President DIRECTORS OR TRUSTEES Marianne Clone Donald Bernard Henderson Jr. Joanne Palumbo McCallie David Lee Porteous Julius George Napoles Executive Vice President Lisa Carol Drake Senior Vice President Paul Chadwick Myers Senior Vice President John Howard Brown Vice President James Bradley Croom Vice President James Douglas Garrison Vice President Timo Pentti Kokko Vice President Mark Daniel Nerud Vice President Laura Louene Prieskorn Vice President Robert Marquis Tucker Jr. Vice President Donald Thomas DeCarlo Andrew Boutwell Hopping Thomas John Meyer Bradley Jay Powell State of County of Michigan Ingham S8: The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and ciear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and expianations therein contained, annexed or referred to, Is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: () state law may differ; or, () that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers aiso includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by v ious reguiators in lieu of or in addition to the enclosed st tem t. Clark Preston Manning, Jr. President Subscribed and sworn to before me this ~5th day of ~ ~.'. Febru:ry J :~()'f\~.. (.!~'Y Phillips Notary Public November 0, 0 a. Is this an original filing?.. b. If no,. State the amendment number... Date filed... Number of pages attached.. Yes [ X ] No [

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK ASSETS Assets Current Year Nonadmitted Assets Net Admitted Assets (Cols. - ) Prior Year 4 Net Admitted Assets. Bonds (Schedule D). Stocks (Schedule D):. Preferred stocks. Common stocks. Mortgage loans on real estate (Schedule B):. First liens. Other than first liens 4. Real estate (Schedule A): 4. Properties occupied by the company (less $ encumbrances) 4. Properties held for the production of income (less $ encumbrances) 4. Properties held for sale (less $ encumbrances) 5. Cash ($, Schedule E - Part ), cash equivalents ($, Schedule E - Part ) and short-term investments ($, Schedule DA) 6. Contract loans (including $ premium notes) 7. Other invested assets (Schedule BA) 8. Receivables for securities 9. Aggregate write-ins for invested assets 0. Subtotals, cash and invested assets (Lines to 9). Title plants less $ charged off (for Title insurers only). Investment income due and accrued. Premiums and considerations:. Uncollected premiums and agents' balances in the course of collection. Deferred premiums and agents' balances and installments booked but deferred and not yet due (including $ earned but unbilled premiums). Accrued retrospective premiums 4. Reinsurance: 4. Amounts recoverable from reinsurers 4. Funds held by or deposited with reinsured companies 4. Other amounts receivable under reinsurance contracts 5. Amounts receivable relating to uninsured plans 6. Current federal and foreign income tax recoverable and interest thereon 6. Net deferred tax asset 7. Guaranty funds receivable or on deposit 8. Electronic data processing equipment and software 9. Furniture and equipment, including health care delivery assets ($ ) 0. Net adjustment in assets and liabilities due to foreign exchange rates. Receivables from parent, subsidiaries and affiliates. Health care ($ ) and other amounts receivable. Aggregate write-ins for other than invested assets 4. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 0 to ) 5. From Separate Accounts, Segregated Accounts and Protected Cell Accounts 6. Total (Lines 4 and 5) 090. 090. 090. DETAILS OF WRITE-INS 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 090 thru 090 plus 0998)(Line 9 above) 0. 0.!" #" $ % 0. &'# ' ' 98. Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 0 plus 98)(Line above)

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK LIABILITIES, SURPLUS AND OTHER FUNDS Prior Year Current Year. Aggregate reserve for life contracts $ (Exh. 5, Line 9999999) less $ included in Line 6. (including $ Modco Reserve). Aggregate reserve for accident and health contracts (Exhibit 6, Line 7, Col. ) (including $ Modco Reserve). Liability for deposit-type contracts (Exhibit 7, Line 4, Col. ) (including $ Modco Reserve) 4. Contract claims: 4. Life (Exhibit 8, Part, Line 4.4, Col. less sum of Cols. 9, 0 and ) 4. Accident and health (Exhibit 8, Part, Line 4.4, sum of Cols. 9, 0 and ) 5. Policyholders dividends $ and coupons $ due and unpaid (Exhibit 4, Line 0) 6. Provision for policyholders dividends and coupons payable in following calendar year - estimated amounts: 6. Dividends apportioned for payment (including $ Modco) 6. Dividends not yet apportioned (including $ Modco) 6. Coupons and similar benefits (including $ Modco) 7. Amount provisionally held for deferred dividend policies not included in Line 6 8. Premiums and annuity considerations for life and accident and health contracts received in advance less $ discount; including $ accident and health premiums (Exhibit, Part, Col., sum of lines 4 and 4) 9. Contract liabilities not included elsewhere: 9. Surrender values on canceled contracts 9. Provision for experience rating refunds, including $ accident and health experience rating refunds 9. Other amounts payable on reinsurance including $ assumed and $ ceded 9.4 Interest maintenance reserve (IMR, Line 6) 0. Commissions to agents due or accrued-life and annuity contracts $ accident and health $ and deposit-type contract funds $. Commissions and expense allowances payable on reinsurance assumed. General expenses due or accrued (Exhibit, Line, Col. 6). Transfers to Separate Accounts due or accrued (net) (including $ accrued for expense allowances recognized in reserves, net of reinsured allowances) 4. Taxes, licenses and fees due or accrued, excluding federal income taxes (Exhibit, Line 9, Col. 5) 5. Current federal and foreign income taxes including $ on realized capital gains (losses) 5. Net deferred tax liability 6. Unearned investment income 7. Amounts withheld or retained by company as agent or trustee 8. Amounts held for agents'account, including $ agents'credit balances 9. Remittances and items not allocated 0. Net adjustment in assets and liabilities due to foreign exchange rates. Liability for benefits for employees and agents if not included above. Borrowed money $ and interest thereon $. Dividends to stockholders declared and unpaid 4. Miscellaneous liabilities: 4. Asset valuation reserve (AVR, Line 6, Col. 7) 4. Reinsurance in unauthorized companies 4. Funds held under reinsurance treaties with unauthorized reinsurers 4.4 Payable to parent, subsidiaries and affiliates 4.5 Drafts outstanding 4.6 Liability for amounts held under uninsured accident and health plans 4.7 Funds held under coinsurance 4.8 Payable for securities 4.9 Capital notes $ and interest thereon $ 5. Aggregate write-ins for liabilities 6. Total Liabilities excluding Separate Accounts business (Lines to 5) 7. From Separate Accounts Statement 8. Total Liabilities (Lines 6 and 7) 9. Common capital stock 0. Preferred capital stock. Aggregate write-ins for other than special surplus funds. Surplus notes. Gross paid in and contributed surplus (Page, Line, Col. plus Page 4, Line 5., Col. ) 4. Aggregate write-ins for special surplus funds 5. Unassigned funds (surplus) 6. Less treasury stock, at cost: 6. shares common (value included in Line 9 $ 6. shares preferred (value included in Line 0 $ 7. Surplus (Total Lines +++4+5-6) (including $ in Separate Accounts Statement) 8. Totals of Lines 9, 0 and 7 (Page 4, Line 55) 9. Totals of Lines 8 and 8 (Page, Line 6, Col. ) DETAILS OF WRITE-INS 50. 50. 50. 598. Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598)(Line 5 above) 0. 0. 0. 98. Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 0 plus 98)(Line above) 40. 40. 40. 498. Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 40 plus 498)(Line 4 above)

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK SUMMARY OF OPERATIONS (Excluding Unrealized Capital Gains and Losses) Current Year Prior Year. Premiums and annuity considerations for life and accident and health contracts (Exhibit, Part, Line 0.4, Col., less Col. ). Considerations for supplementary contracts with life contingencies. Net investment income (Exhibit of Net Investment Income, Line 7) 4. Amortization of interest maintenance reserve (IMR, Line 5) 5. Separate Accounts net gain from operations excluding unrealized gains or losses 6. Commissions and expense allowances on reinsurance ceded (Exhibit, Part, Line 6., Col. ) 7. Reserve adjustments on reinsurance ceded 8. Miscellaneous Income: 8. Income from fees associated with investment management, administration and contract guarantees from Separate Accounts 8. Charges and fees for deposit-type contracts 8. Aggregate write-ins for miscellaneous income 9. Total (Lines to 8.) 0. Death benefits. Matured endowments (excluding guaranteed annual pure endowments). Annuity benefits (Exhibit 8, Part, Line 6.4, Cols. 4 + 8). Disability benefits and benefits under accident and health contracts 4. Coupons, guaranteed annual pure endowments and similar benefits 5. Surrender benefits and withdrawals for life contracts 6. Group conversions 7. Interest and adjustments on contract or deposit-type contract funds 8. Payments on supplementary contracts with life contingencies 9. Increase in aggregate reserves for life and accident and health contracts 0. Totals (Lines 0 to 9). Commissions on premiums, annuity considerations, and deposit-type contract funds (direct business only) (Exhibit, Part, Line, Col. ). Commissions and expense allowances on reinsurance assumed (Exhibit, Part, Line 6., Col. ). General insurance expenses (Exhibit, Line 0, Cols.,, and 4) 4. Insurance taxes, licenses and fees, excluding federal income taxes (Exhibit, Line 7, Cols. + + ) 5. Increase in loading on deferred and uncollected premiums 6. Net transfers to or (from) Separate Accounts net of reinsurance 7. Aggregate write-ins for deductions 8. Totals (Lines 0 to 7) 9. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 8) 0. Dividends to policyholders. Net gain from operations after dividends to policyholders and before federal income taxes (Line 9 minus Line 0). Federal and foreign income taxes incurred (excluding tax on capital gains). Net gain from operations after dividends to policyholders and federal income taxes and before realized capital gains or (losses) (Line minus Line ) 4. Net realized capital gains (losses) (excluding gains (losses) transferred to the IMR) less capital gains tax of $ (excluding taxes of $ transferred to the IMR) 5. Net income (Line plus Line 4) CAPITAL AND SURPLUS ACCOUNT 6. Capital and surplus, December, prior year (Page, Line 8, Col. ) 7. Net income (Line 5) 8. Change in net unrealized capital gains (losses) 9. Change in net unrealized foreign exchange capital gain (loss) 40. Change in net deferred income tax 4. Change in nonadmitted assets and related items 4. Change in liability for reinsurance in unauthorized companies 4. Change in reserve on account of change in valuation basis, (increase) or decrease (Exh. 5A, Line 9999999, Col. 4) 44. Change in asset valuation reserve 45. Change in treasury stock (Page, Lines 6. and 6., Col. minus Col. ) 46. Surplus (contributed to) withdrawn from Separate Accounts during period 47. Other changes in surplus in Separate Accounts Statement 48. Change in surplus notes 49. Cumulative effect of changes in accounting principles 50. Capital changes: 50. Paid in 50. Transferred from surplus (Stock Dividend) 50. Transferred to surplus 5. Surplus adjustment: 5. Paid in 5. Transferred to capital (Stock Dividend) 5. Transferred from capital 5.4 Change in surplus as a result of reinsurance 5. Dividends to stockholders 5. Aggregate write-ins for gains and losses in surplus 54. Net change in capital and surplus for the year (Lines 7 through 5) 55. Capital and surplus, December, current year (Lines 6 + 54) (Page, Line 8) DETAILS OF WRITE-INS 08.0. 08.0. 08.0. 08.98. Summary of remaining write-ins for Line 8. from overflow page 08.99. Totals (Lines 08.0 thru 08.0 plus 08.98)(Line 8. above) 70. 70. 70. 798. Summary of remaining write-ins for Line 7 from overflow page 799. Totals (Lines 70 thru 70 plus 798)(Line 7 above) 50. 50. 50. 598. Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 50 plus 598)(Line 5 above) 4

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK CASH FLOW Current Year Prior Year Cash from Operations. Premiums collected net of reinsurance. Net investment income. Miscellaneous income 4. Total (Lines through ) 5. Benefit and loss related payments 6. Net transfers to Separate, Segregated Accounts and Protected Cell Accounts 7. Commissions, expenses paid and aggregate write-ins for deductions 8. Dividends paid to policyholders 9. Federal and foreign income taxes paid (recovered) $ net of tax on capital gains (losses) 0. Total (Lines 5 through 9). Net cash from operations (Line 4 minus Line 0) Cash from Investments. Proceeds from investments sold, matured or repaid:. Bonds. Stocks. Mortgage loans.4 Real estate.5 Other invested assets.6 Net gains or (losses) on cash, cash equivalents and short-term investments.7 Miscellaneous proceeds.8 Total investment proceeds (Lines. to.7). Cost of investments acquired (long-term only):. Bonds. Stocks. Mortgage loans.4 Real estate.5 Other invested assets.6 Miscellaneous applications.7 Total investments acquired (Lines. to.6) 4. Net increase (decrease) in contract loans and premium notes 5. Net cash from investments (Line.8 minus Line.7 minus Line 4) Cash from Financing and Miscellaneous Sources 6. Cash provided (applied): 6. Surplus notes, capital notes 6. Capital and paid in surplus, less treasury stock 6. Borrowed funds 6.4 Net deposits on deposit-type contracts and other insurance liabilities 6.5 Dividends to stockholders 6.6 Other cash provided (applied) 7. Net cash from financing and miscellaneous sources (Lines 6. to 6.4 minus Line 6.5 plus Line 6.6) RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 8. Net change in cash, cash equivalents and short-term investments (Line, plus Lines 5 and 7) 9. Cash, cash equivalents and short-term investments: 9. Beginning of year 9. End of year (Line 8 plus Line 9.) Note: Supplemental disclosures of cash flow information for non-cash transactions: 5

6 ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK ANALYSIS OF OPERATIONS BY LINES OF BUSINESS (Gain and Loss Exhibit) (Excluding Capital Gains and Losses) Ordinary 6 Group Accident and Health 4 5 7 8 9 0 Aggregate of All Total Industrial Life Life Insurance Individual Annuities Supplementary Contracts Credit Life (Group and Individual) Life Insurance (a) Annuities Group Credit (Group and Individual) Other Other Lines of Business. Premiums and annuity considerations for life and accident and health contracts. Considerations for supplementary contracts with life contingencies. Net investment income 4. Amortization of Interest Maintenance Reserve (IMR) 5. Separate Accounts net gain from operations excluding unrealized gains or losses 6. Commissions and expense allowances on reinsurance ceded 7. Reserve adjustments on reinsurance ceded 8. Miscellaneous Income: 8. Fees associated with income from investment management, administration and contract guarantees from Separate Accounts 8. Charges and fees for deposit-type contracts 8. Aggregate write-ins for miscellaneous income 9. Totals (Lines to 8.) 0. Death benefits. Matured endowments (excluding guaranteed annual pure endowments). Annuity benefits. Disability benefits and benefits under accident and health contracts 4. Coupons, guaranteed annual pure endowments and similar benefits 5. Surrender benefits and withdrawals for life contracts 6. Group conversions 7. Interest and adjustments on contract or deposit-type contract funds 8. Payments on supplementary contracts with life contingencies 9. Increase in aggregate reserves for life and accident and health contracts 0. Totals (Lines 0 to 9). Commissions on premiums, annuity considerations and deposit-type contract funds (direct business only). Commissions and expense allowances on reinsurance assumed. General insurance expenses 4. Insurance taxes, licenses and fees, excluding federal income taxes 5. Increase in loading on deferred and uncollected premiums 6. Net transfers to or (from) Separate Accounts net of reinsurance 7. Aggregate write-ins for deductions 8. Totals (Lines 0 to 7) 9. Net gain from operations before dividends to policyholders and federal income taxes (Line 9 minus Line 8) 0. Dividends to policyholders. Net gain from operations after dividends to policyholders and before federal income taxes (Line 9 minus Line 0). Federal income taxes incurred (excluding tax on capital gains). Net gain from operations after dividends to policyholders and federal income taxes and before realized capital gains or (losses) (Line minus Line ) DETAILS OF WRITE-INS 08.0. 08.0. 08.0. 08.98. Summary of remaining write-ins for Line 8. from overflow page 08.99. Totals (Lines 08.0 thru 08.0 plus 08.98) (Line 8. above) 70. 70. 70. 798. Summary of remaining write-ins for Line 7 from overflow page 799. Totals (Lines 70 thru 70 plus 798) (Line 7 above) (a) Includes the following amounts for FEGLI/SGLI: Line, Line 0, Line 6, Line, Line 4

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK ANALYSIS OF INCREASE IN RESERVES DURING THE YEAR Ordinary 6 Group 4 5 7 Total Industrial Life Life Insurance Individual Annuities Supplementary Contracts Credit Life (Group and Individual) Life Insurance 8 Annuities Involving Life or Disability Contingencies (Reserves) (Net of Reinsurance Ceded). Reserve December, prior year. Tabular net premiums or considerations. Present value of disability claims incurred XXX 4. Tabular interest 5. Tabular less actual reserve released 6. Increase in reserve on account of change in valuation basis 7 7. Other increases (net) 8. Totals (Lines to 7) 9. Tabular cost XXX 0. Reserves released by death XXX XXX XXX. Reserves released by other terminations (net). Annuity, supplementary contract and disability payments involving life contingencies. Net transfers to or (from) Separate Accounts 4. Total Deductions (Lines 9 to ) 5. Reserve December, current year

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT OF NET INVESTMENT INCOME Collected During Year Earned During Year. U.S. government bonds (a). Bonds exempt from U.S. tax (a). Other bonds (unaffiliated) (a). Bonds of affiliates (a). Preferred stocks (unaffiliated) (b). Preferred stocks of affiliates (b). Common stocks (unaffiliated). Common stocks of affiliates. Mortgage loans (c) 4. Real estate (d) 5 Contract Loans 6 Cash, cash equivalents and short-term investments (e) 7 Derivative instruments (f) 8. Other invested assets 9. Aggregate write-ins for investment income 0. Total gross investment income. Investment expenses (g). Investment taxes, licenses and fees, excluding federal income taxes (g). Interest expense (h) 4. Depreciation on real estate and other invested assets (i) 5. Aggregate write-ins for deductions from investment income 6. Total deductions (Lines through 5) 7. Net investment income (Line 0 minus Line 6) DETAILS OF WRITE-INS 090. 090. 090. 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 090 thru 090 plus 0998) (Line 9, above) 50.! 50. 50. 598. Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 0 plus 598) (Line 5, above) (a) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (b) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued dividends on purchases. (c) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (d) Includes $ for company s occupancy of its own buildings; and excludes $ interest on encumbrances. (e) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (f) Includes $ accrual of discount less $ amortization of premium. (g) Includes $. investment expenses and $ investment taxes, licenses and fees, excluding federal income taxes, attributable to segregated and Separate Accounts. (h) Includes $ interest on surplus notes and $ interest on capital notes. (i) Includes $ depreciation on real estate and $ depreciation on other invested assets. EXHIBIT OF CAPITAL GAINS (LOSSES) 4 Realized Gain (Loss) On Sales or Maturity Other Realized Adjustments Increases (Decreases) by Adjustment Total. U.S. Government bonds. Bonds exempt from U.S. tax. Other bonds (unaffiliated) "# "# "#. Bonds of affiliates. Preferred stocks (unaffiliated). Preferred stocks of affiliates. Common stocks (unaffiliated) " # " #. Common stocks of affiliates. Mortgage loans 4. Real estate 5. Contract Loans 6. Cash, cash equivalents and short-term investments 7. Derivative instruments 8. Other invested assets 9. Aggregate write-ins for capital gains (losses) 0. Total capital gains (losses) "# "# " # "# DETAILS OF WRITE-INS 090. $ % 090. 090. 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 090 thru 090 plus 0998) (Line 9, above) 8

9 ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT - PART - PREMIUMS AND ANNUITY CONSIDERATIONS FOR LIFE AND ACCIDENT AND HEALTH CONTRACTS Ordinary 5 Group Accident and Health 4 6 7 8 9 0 Aggregate of All Total Industrial Life Life Insurance Individual Annuities Credit Life (Group and Individual) Life Insurance Annuities Group Credit (Group and Individual) Other Other Lines of Business FIRST YEAR (other than single). Uncollected. Deferred and accrued. Deferred, accrued and uncollected:. Direct. Reinsurance assumed. Reinsurance ceded.4 Net (Line + Line ) 4. Advance 5. Line.4 - Line 4 6. Collected during year: 6. Direct 6. Reinsurance assumed 6. Reinsurance ceded 6.4 Net 7. Line 5 + Line 6.4 8. Prior year (uncollected + deferred and accrued - advance) 9. First year premiums and considerations: 9. Direct 9. Reinsurance assumed 9. Reinsurance ceded 9.4 Net (Line 7 - Line 8) SINGLE 0. Single premiums and considerations: 0. Direct 0. Reinsurance assumed 0. Reinsurance ceded 0.4 Net RENEWAL. Uncollected. Deferred and accrued. Deferred, accrued and uncollected:. Direct. Reinsurance assumed. Reinsurance ceded.4 Net (Line + Line ) 4. Advance 5. Line.4 - Line 4 6. Collected during year: 6. Direct 6. Reinsurance assumed 6. Reinsurance ceded 6.4 Net 7. Line 5 + Line 6.4 8. Prior year (uncollected + deferred and accrued - advance) 9. Renewal premiums and considerations: 9. Direct 9. Reinsurance assumed 9. Reinsurance ceded 9.4 Net (Line 7 - Line 8) TOTAL 0. Total premiums and annuity considerations: 0. Direct 0. Reinsurance assumed 0. Reinsurance ceded 0.4 Net (Line 9.4 + 0.4 + 9.4)

0 DIVIDENDS AND COUPONS APPLIED (included in Part ) ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT - PART - DIVIDENDS AND COUPONS APPLIED, REINSURANCE COMMISSIONS AND EXPENSE ALLOWANCES AND COMMISSIONS INCURRED (direct business only) Ordinary 5 Group Accident and Health 4 6 7 8 9 0 Total Industrial Life Life Insurance Individual Annuities Credit Life (Group and Individual) Life Insurance Annuities Group Credit (Group and Individual) Other Aggregate of All Other Lines of Business. To pay renewal premiums. All other REINSURANCE COMMISSIONS AND EXPENSE ALLOWANCES INCURRED. First year (other than single):. Reinsurance ceded. Reinsurance assumed. Net ceded less assumed 4. Single: 4. Reinsurance ceded 4. Reinsurance assumed 4. Net ceded less assumed 5. Renewal: 5. Reinsurance ceded 5. Reinsurance assumed 5. Net ceded less assumed 6. Totals: 6. Reinsurance ceded (Page 6, Line 6) 6. Reinsurance assumed (Page 6, Line ) 6. Net ceded less assumed COMMISSIONS INCURRED (direct business only) 7. First year (other than single) 8. Single 9. Renewal 0. Deposit-type contract funds. Totals (to agree with Page 6, Line )

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT - GENERAL EXPENSES Insurance 5 6 Accident and Health 4 Life Cost Containment All Other All Other Lines of Business Investment Total. Rent. Salaries and wages. Contributions for benefit plans for employees. Contributions for benefit plans for agents. Payments to employees under non-funded benefit plans. Payments to agents under non-funded benefit plans. Other employee welfare. Other agent welfare 4. Legal fees and expenses 4. Medical examination fees 4. Inspection report fees 4.4 Fees of public accountants and consulting actuaries 4.5 Expense of investigation and settlement of policy claims 5. Traveling expenses 5. Advertising 5. Postage, express, telegraph and telephone 5.4 Printing and stationery 5.5 Cost or depreciation of furniture and equipment 5.6 Rental of equipment 5.7 Cost or depreciation of EDP equipment and software 6. Books and periodicals 6. Bureau and association fees 6. Insurance, except on real estate 6.4 Miscellaneous losses 6.5 Collection and bank service charges 6.6 Sundry general expenses 6.7 Group service and administration fees 6.8 Reimbursements by uninsured accident and health plans 7. Agency expense allowance 7. Agents balances charged off (less $ recovered) 7. Agency conferences other than local meetings 9. Real estate expenses 9. Investment expenses not included elsewhere 9. Aggregate write-ins for expenses 0. General expenses incurred (a). General expenses unpaid December, prior year. General expenses unpaid December, current year. Amounts receivable relating to uninsured accident and health plans, prior year 4. Amounts receivable relating to uninsured accident and health plans, current year 5. General expenses paid during year (Lines 0+--+4) DETAILS OF WRITE-INS 09.0. 09.0.!" 09.0. #$%& 09.98. Summary of remaining write-ins for Line 9. from overflow pag 09.99. Totals (Lines 09.0 thru 09.0 plus 09.98) (Line 9. above) (a) Includes management fees of $ to affiliates and $ to non-affiliates. EXHIBIT - TAXES, LICENSES AND FEES (EXCLUDING FEDERAL INCOME TAXES) Insurance 4 5 Life Accident and Health All Other Lines of Business Investment Total. Real estate taxes. State insurance department licenses and fees ' ( ' (. State taxes on premiums 4. Other state taxes, including $ for employee benefits 5. U.S. Social Security taxes 6. All other taxes 7. Taxes, licenses and fees incurred '( '( 8. Taxes, licenses and fees unpaid December, prior year '( '( 9. Taxes, licenses and fees unpaid December, current year ' ( ' ( 0. Taxes, licenses and fees paid during year (Lines 7 + 8-9) '( '( EXHIBIT 4 - DIVIDENDS OR REFUNDS. Applied to pay renewal premiums. Applied to shorten the endowment or premium-paying period. Applied to provide paid-up additions 4. Applied to provide paid-up annuities 5. Total Lines through 4 6. Paid in cash 7. Left on deposit 8. Aggregate write-ins for dividend or refund options 9. Total Lines 5 through 8 0. Amount due and unpaid NONE. Provision for dividends or refunds payable in the following calendar year. Terminal dividends. Provision for deferred dividend contracts 4. Amount provisionally held for deferred dividend contracts not included in Line 5. Total Lines 0 through 4 6. Total from prior year 7. Total Dividends or refunds (Lines 9 + 5-6) DETAILS OF WRITE-INS 080. 080. 080. 0898. Summary of remaining write-ins for Line 8 from overflow page 0899. Totals (Lines 080 thru 080 plus 0898) (Line 8 above) Life Accident and Health

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT 5 - AGGREGATE RESERVE FOR LIFE CONTRACTS Valuation Standard Total Industrial 4 Ordinary 5 Credit (Group and Individual) 6 Group LIFE INSURANCE:! 099997. Totals (Gross) 099998. Reinsurance ceded "#$ "#$ 099999. Life Insurance: Totals (Net) #$$# #$$# ANNUITIES (excluding supplementary contracts with life contingencies): # "$"" XXX # XXX "#" " ## #" " XXX $$ " XXX "# # $"## XXX ##$ XXX "#" # #### #" XXX "$"$ XXX ""#" ### $$$ #$ XXX "# XXX $" " ## $$" " XXX " XXX $ $"# $# # " XXX " XXX $" ## ##$# XXX ##$# XXX "# $ XXX $ XXX $# ""# XXX ""# XXX %&# # # # XXX $#" XXX $ %&# # ## # XXX ##"$ " XXX $ %&#$# #"#$ XXX #" $ XXX " %&#$ ## XXX "$$" XXX " %&#$" # $ $ XXX "$ # XXX $ %&#"# $" XXX $" XXX 099997. Totals (Gross) $ XXX $##"$ XXX "" 099998. Reinsurance ceded XXX XXX 099999. Annuities: Totals (Net) $ XXX $##"$ XXX "" SUPPLEMENTARY CONTRACTS WITH LIFE CONTINGENCIES: 099998. Reinsurance ceded 099999. SCWLC: Totals (Net) ACCIDENTAL DEATH BENEFITS: '() 0499997. Totals (Gross) 0499998. Reinsurance ceded 0499999. Accidental Death Benefits: Totals (Net) DISABILITY-ACTIVE LIVES: #% & ))*% 0599997. Totals (Gross) 0599998. Reinsurance ceded 0599999. Disability-Active Lives: Totals (Net) DISABILITY-DISABLED LIVES: #% &+)!%, #))*% # # 0699997. Totals (Gross) # # 0699998. Reinsurance ceded 0699999. Disability-Disabled Lives: Totals (Net) # # MISCELLANEOUS RESERVES: -,!)./),*0(%,)!)%,0)! /,!!), %!,!)% ## ## #-,!, ),* )*)!!) *!/%,(!),!!)!,*!) )4 ##" ##" -,!!)) %% )4))*%,0!%() %%) " #" " #" -,!!)) %%%/,)))*%,0!%() %%) "" "" -,!!)) %%5%4!5())*%,0!%() %%) $#$ $#$ 0799997. Totals (Gross) "$" "$" 0799998. Reinsurance ceded $$ $$ 0799999. Miscellaneous Reserves: Totals (Net) $$ $$ 9999999. Totals (Net) - Page, Line $ " " ""

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT 5 - INTERROGATORIES. Has the reporting entity ever issued both participating and non-participating contracts?. If not, state which kind is issued.. Does the reporting entity at present issue both participating and non-participating contracts?. If not, state which kind is issued.. Does the reporting entity at present issue or have in force contracts that contain non-guaranteed elements? If so, attach a statement that contains the determination procedures, answers to the interrogatories and an actuarial opinion as described in the instructions. 4. Has the reporting entity any assessment or stipulated premium contracts in force? If so, state: 4. Amount of insurance? $ 4. Amount of reserve? $ 4. Basis of reserve: 4.4 Basis of regular assessments: 4.5 Basis of special assessments: 4.6 Assessments collected during the year $ 5. If the contract loan interest rate guaranteed in any one or more of its currently issued contracts is less than 5%, not in advance, state the contract loan rate guarantees on any such contracts. 6. Does the reporting entity hold reserves for any annuity contracts that are less than the reserves that would be held on a standard basis? 6. If so, state the amount of reserve on such contracts on the basis actually held: $ 6. That would have been held (on an exact or approximate basis) using the actual ages of the annuitants; the interest rate(s) used in 6.; and the same mortality basis used by the reporting entity for the valuation of comparable annuity benefits issued to standard lives. If the reporting entity has no comparable annuity benefits for standard lives to be valued, the mortality basis shall be the table most recently approved by the state of domicile for valuing individual annuity benefits: $ Attach statement of methods employed in their valuation. 7. Does the reporting entity have any Synthetic GIC contracts or agreements in effect as of December of the current year? 7. If yes, state the total dollar amount of assets covered by these contracts or agreements $ 7. Specify the basis (fair value, amortized cost, etc.) for determining the amount: 7. State the amount of reserves established for this business: $ 7.4 Identify where the reserves are reported in the blank: EXHIBIT 5A - CHANGES IN BASES OF VALUATION DURING THE YEAR Valuation Basis 4 Increase in Actuarial Reserve Due to Description of Valuation Class NONE Changed From Changed To Change 9999999 - Total (Column 4, only) Exhibit 6 - Aggregate Reserves for Accident and Health Contracts N O N E, 4

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT 7 - DEPOSIT TYPE CONTRACTS Total Guaranteed Interest Contracts Annuities Certain 4 Supplemental Contracts 5 Dividend Accumulations or Refunds 6 Premium and Other Deposit Funds. Balance at the beginning of the year before reinsurance. Deposits received during the year. Investment earnings credited to the account 4. Other net change in reserves 5. Fees and other charges assessed 6. Surrender charges 7. Net surrender or withdrawal payments 8. Other net transfers to or (from) Separate Accounts 5 9. Balance at the end of current year before reinsurance (Lines +++4-5-6-7-8) 0. Reinsurance balance at the beginning of the year. Net change in reinsurance assumed. Net change in reinsurance ceded. Reinsurance balance at the end of the year (Lines 0+-) 4. Net balance at the end of current year after reinsurance (Lines 9 + )

. Due and unpaid:. In course of settlement: ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT 8 - CLAIMS FOR LIFE AND ACCIDENT AND HEALTH CONTRACTS PART - Liability End of Current Year Ordinary 6 Group Accident and Health 4 5 7 8 9 0 Total Industrial Life Life Insurance Individual Annuities Supplementary Contracts Credit Life (Group and Individual) Life Insurance Annuities Group Credit (Group and Individual). Direct. Reinsurance assumed. Reinsurance ceded.4 Net. Resisted. Direct. Reinsurance assumed. Reinsurance ceded.4 Net (b) (b) (b) (b) Other 6. Other. Direct. Reinsurance assumed. Reinsurance ceded.4 Net (b) (b) (b) (b) (b) (b) (b). Incurred but unreported:. Direct. Reinsurance assumed. Reinsurance ceded.4 Net (b) (b) (b) (b) (b) (b) (b) 4. TOTALS 4. Direct 4. Reinsurance assumed 4. Reinsurance ceded 4.4 Net (a) (a) (a) (a) Including matured endowments (but not guaranteed annual pure endowments) unpaid amounting to $ in Column, $ in Column and $ in Column 7. (b) Include only portion of disability and accident and health claim liabilities applicable to assumed "accrued" benefits. Reserves (including reinsurance assumed and net of reinsurance ceded) for unaccrued benefits for Ordinary Life Insurance $ Individual Annuities $, Credit Life (Group and Individual) $, and Group Life $, are included in Page, Line, (See Exhibit 5, Section on Disability Disabled Lives); and for Group Accident and Health $ Credit (Group and Individual) Accident and Health $, and Other Accident and Health $ are included in Page, Line (See Exhibit 6, Claim Reserve).

7 ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT 8 - CLAIMS FOR LIFE AND ACCIDENT AND HEALTH CONTRACTS PART - Incurred During the Year Ordinary 6 Group Accident and Health 4 5 7 8 9 0 Total Industrial Life (a) Life Insurance (b) Individual Annuities Supplementary Contracts Credit Life (Group and Individual) Life Insurance (c) Annuities Group Credit (Group and Individual). Settlements During the Year:. Direct. Reinsurance assumed. Reinsurance ceded.4 Net (d). Liability December, current year from Part :. Direct. Reinsurance assumed. Reinsurance ceded.4 Net. Amounts recoverable from reinsurers December, current year 4. Liability December, prior year: 4. Direct 4. Reinsurance assumed 4. Reinsurance ceded 4.4 Net 5. Amounts recoverable from reinsurers December, prior year 6. Incurred Benefits 6. Direct 6. Reinsurance assumed 6. Reinsurance ceded 6.4 Net (a) Including matured endowments (but not guaranteed annual pure endowments) amounting to $ in Line., $ in Line.4. $ in Line 6., and $ in Line 6.4. (b) Including matured endowments (but not guaranteed annual pure endowments) amounting to $ in Line., $ in Line.4. $ in Line 6., and $ in Line 6.4. (c) Including matured endowments (but not guaranteed annual pure endowments) amounting to $ in Line., $ in Line.4. $ in Line 6., and $ in Line 6.4. (d) Includes $ premiums waived under total and permanent disability benefits. Other

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK EXHIBIT OF NON-ADMITTED ASSETS Current Year Total Nonadmitted Assets Prior Year Total Nonadmitted Assets Change in Total Nonadmitted Assets (Col. - Col. ). Bonds (Schedule D). Stocks (Schedule D):. Preferred stocks. Common stocks. Mortgage loans on real estate (Schedule B):. First liens. Other than first liens 4. Real estate (Schedule A): 4. Properties occupied by the company 4. Properties held for the production of income 4. Properties held for sale 5. Cash (Schedule E - Part ), cash equivalents (Schedule E - Part ) and short-term investments (Schedule DA) 6. Contract loans 7. Other invested assets (Schedule BA) 8. Receivables for securities 9. Aggregate write-ins for invested assets 0. Subtotals, cash and invested assets (Lines to 9). Title plants (for Title insurers only). Investment income due and accrued. Premiums and considerations:. Uncollected premiums and agents'balances in the course of collection. Deferred premiums, agents'balances and installments booked but deferred and not yet due. Accrued retrospective premiums 4. Reinsurance: 4. Amounts recoverable from reinsurers 4. Funds held by or deposited with reinsured companies 4. Other amounts receivable under reinsurance contracts 5. Amounts receivable relating to uninsured plans 6. Current federal and foreign income tax recoverable and interest thereon 6. Net deferred tax asset 7. Guaranty funds receivable or on deposit 8. Electronic data processing equipment and software 9. Furniture and equipment, including health care delivery assets 0. Net adjustment in assets and liabilities due to foreign exchange rates. Receivable from parent, subsidiaries and affiliates. Health care and other amounts receivable. Aggregate write-ins for other than invested assets 4. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 0 to ) 5. From Separate Accounts, Segregated Accounts and Protected Cell Accounts 6. Total (Lines 4 and 5) 090. 090. 090. DETAILS OF WRITE-INS 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 090 thru 090 plus 0998)(Line 9 above) 0. 0.! 0. 98. Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 0 plus 98)(Line above) 8

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK. Summary of Significant Accounting Policies A. Accounting Practices The financial statements of the Company are presented on the basis of accounting practices prescribed or permitted by the New York State Insurance Department. The New York State Insurance Department recognizes statutory accounting practices prescribed or permitted by the State of New York for determining and reporting the financial condition and results of operations of an insurance company and for determining its solvency under New York Insurance Law. The New York State Insurance Department has adopted in its entirety, subject to certain conflicts and exceptions with New York Insurance Law, the National Association of Insurance Commissioners' (NAIC) Accounting Practices and Procedures Manual (NAIC SAP). A reconciliation of the Company's net income and capital and surplus between NAIC SAP and practices prescribed or permitted by the State of New York is shown below. //005 //004 Net income, New York state basis $,89,47 $ 4,8,7 Adjustments: Continuous CARVM per New York state basis 88,58,06 0,67,07 Curtate CARVM per NAIC SAP 87,04,4 0,744,050 Decrease in aggregate reserves to reflect curtate CARVM,567,69,89,0 Increase in federal income taxes (87,84) (55,587) Net income, NAIC SAP $,7, $ 6,660,67 Statutory Capital and Surplus, New York state basis $,449,98 $,4,0 Adjustments: Continuous CARVM per New York state basis,854,998,567,566,46,505 Curtate CARVM per NAIC SAP,84,485,967,556,47,544 Decrease in aggregate reserves to reflect curtate CARVM,5,600 9,944,96 Tax effect of change in reserves to reflect curtate CARVM (44,094) (56,5) Statutory Capital and Surplus, NAIC SAP $ 4,87,704 $,0,74 B. Use of Estimates in the Preparation of the Financial Statements The preparation of financial statements in conformity with Statutory Accounting Principles requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. It also requires disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the period. Actual results could differ from those estimates. C. Accounting Policy Life premiums are recognized as income over the premium paying period of the related policies. Annuity considerations are recognized as revenue when received. Expenses incurred in connection with acquiring new insurance business, including acquisition costs such as sales commissions, are charged to operations as incurred. In addition, the Company uses the following accounting policies: () Short-term investments are stated at amortized cost. () Bonds not backed by other loans are stated at amortized cost except those with an NAIC rating of 6, which are carried at the lower of amortized cost or fair value. Acquisition discounts and premiums are amortized into investment income through call or maturity dates using the interest method. () Common stocks are stated at fair value. (4) The Company does not have investments in preferred stocks. (5) The Company does not have investments in mortgage loans. 9

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK (6) Loan-backed and structured securities are stated at amortized cost except those with an NAIC rating of 6, which are carried at the lower of amortized cost or fair value. The retrospective yield adjustment method is used to value all securities except in cases where the yield has become negative, which are valued using the prospective adjustment method (see Note 5.D.()). (7) The Company does not have investments in subsidiary, controlled and affiliated companies. (8) The Company does not have investments in joint ventures, partnerships or limited liability companies. (9) The Company does not have investments in derivative instruments. (0) The Company anticipates investment income as a factor in the premium deficiency calculation. () The Company does not write accident and health business. () The Company did not modify its capitalization policy from the prior period.. Accounting Changes and Corrections of Errors The Company had no material changes in accounting principles, correction of errors or changes in estimates for the years ended December, 005 and 004.. Business Combinations and Goodwill A. Statutory Purchase Method The Company did not have business combinations during the year accounted for as a statutory purchase. B. Statutory Merger The Company did not have business combinations during the year accounted for as a statutory merger. C. Assumption Reinsurance The Company did not have goodwill resulting from assumption reinsurance during the year. D. Impairment Loss The Company did not recognize an impairment loss during the year with respect to business combinations and goodwill. 4. Discontinued Operations The Company did not have transactions during the year with respect to discontinued operations. 5. Investments A. Mortgage Loans, including Mezzanine Real Estate Loans The Company does not have investments in mortgage loans. B. Debt Restructuring In connection with certain problem credit workouts (often related to bankruptcy proceedings or a debtor s Offer to Exchange ), the Company (creditor) receives cash and/or newly issued securities in partial or full satisfaction of outstanding debtor obligations. To the extent such transactions meet the definition of a troubled debt restructuring, they are accounted for at fair value with any associated losses realized. C. Reverse Mortgages The Company does not have investments in reverse mortgages. D. Loan-backed Securities () Actual historical and projected future cash flows are used in determining book values for all of the Company s loan-backed securities. () Principal prepayment assumptions for loan-backed securities, including structured securities, are obtained from broker dealers, independent providers of broker dealer estimates, or internal models. 9.

ANNUAL STATEMENT FOR THE YEAR 005 OF THE JACKSON NATIONAL LIFE INSURANCE CO. OF NEW YORK () In 005, no loan-backed securities were changed from the retrospective to prospective adjustment methodology due to negative yields. E. Repurchase Agreements Company investment policies for repurchase agreements require collateral securities to have a fair value of at least 0% of the purchase price paid. At December, 005, the Company has no investment in repurchase agreements. F. Real Estate The Company does not have investments in real estate. 6. Joint Ventures, Partnerships and Limited Liability Companies The Company does not have investments in joint ventures, partnerships or limited liability companies. 7. Investment Income A. Due and accrued income was excluded from surplus on the following basis: Bonds - securities in default and otherwise where collection of interest is uncertain. B. Income due and accrued on investments where collection is not likely has been excluded from net investment income. At December, 005, the amount excluded was $566,907. No additional nonadmitted amounts have been charged to surplus. 8. Derivative Instruments The Company does not have investments in derivative instruments. 9. Income Taxes A. The components of the net deferred tax assets at December, 005 and December, 004 are as follows: //005 //004 Total of all deferred tax assets (admitted and nonadmitted) $,97,980 $,587,6 Total of all deferred tax liabilities (,9,459) (,4,70) Net deferred tax assets,040,5,46,966 Total deferred tax assets nonadmitted in accordance with SSAP No. 0, Income Taxes 9,50,5 8,556,966 Total of net deferred tax assets admitted $,59,000 $,906,000 Increase in deferred tax assets nonadmitted $ 944,555 $ 7,587 B. Deferred tax liabilities are not recognized for the following amounts: () There are no temporary differences for which deferred tax liabilities have not been recognized. Accordingly, there are no events that would cause unrecognized temporary differences to become taxable. () There are no unrecognized temporary differences. () There are no unrecognized deferred tax liabilities related to investments in foreign subsidiaries and foreign corporate joint ventures that are essentially permanent in duration. (4) There are no other deferred tax liabilities not recognized. C. Current income taxes incurred consist of the following major components: //005 //004 Current income tax expense $ 6,80,88 $ 7,59,000 Prior year overaccrual of tax reserves (55,88) (460,6) Current tax on operations 6,5,000 7,068,67 Federal taxes on capital gains 86,04 8,55 Prior year (over)/ under accrual of tax on capital gains -,05 Current income taxes incurred $ 6,,04 $ 7,80,97 9.