NOTICE OF RIGHT TO EXAMINE CONTRACT. Within 10 days after this Contract is first received, it may be cancelled for any reason without penalty (e.g., no Contingent Deferred Sales Charge will be deducted) by delivering or mailing it to the representative through whom it was purchased or to the Servicing Office of LNY. When the Contract is received at the Servicing Office, LNY will return the Contract Value plus an amount to reflect any deducted daily charges (daily charges are described in Section 4.04) as of the date of cancellation where permitted by law. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE VARIABLE ACCOUNT, ARE VARIABLE. THE AMOUNTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT (SEE ARTICLE 4 AND ARTICLE 8). PRIOR TO THE ANNUITY COMMENCEMENT DATE, THE MAXIMUM MORTALITY AND EXPENSE RISK AND ADMINISTRATIVE CHARGE IS 1.70% AND THEREAFTER IS 1.40%. THE SMALLEST RATE OF INVESTMENT RETURN REQUIRED TO ENSURE THAT THE DOLLAR AMOUNT OF VARIABLE ANNUITY PAYMENTS DOES NOT DECREASE IS: 4.40% IF THE ASSUMED INTEREST RATE (AIR) IS 3.0%, 5.40% IF THE AIR IS 4.0%, OR 6.40% IF THE AIR IS 5.0%. Signed for Lincoln Life & Annuity Company of New York at its Home Office in Syracuse, New York. /s/ Xxxxx X.Xxxxxxxx Xxxxx X.Xxxxxxxx, President Form 30070BNYL 5/03 Table of Contents Article Page 2 Purchase Payments 6 3 Contract Value 7
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within 30 days after delivery of this Contract to You, You may return it to Us for a full refund of any premium paid, less the cost for services provided. The Contract will be deemed void from the beginning. [EFFECTIVE DATE OF CONTRACT: [January 1, 2017 ]] Renewal Provision. Subject to all Contract terms and provisions, including those describing Termination of the Contract, You may renew and keep this Contract in force by paying the premiums as they become due. We agree to arrange or provide services under the terms and provisions of this Contract. In consideration of the application for this Contract and the payment of premiums as stated herein, We agree to arrange [or provide] services and supplies in accordance with and subject to the terms of this Contract. This Contract is delivered in New Jersey and is governed by the laws thereof. This Contract takes effect on the Effective Date, if it is duly attested below. It continues as long as the required premiums are paid, unless it ends as described in its General Provisions. [Secretary President] [[Member]: Xxxx Xxx Identification Number: 125689 Effective Date: January 1, 2017 [Product Name: XXXX]] [Include legal name, trade name, phone, fax and e-mail numbers by which consumers may contact the carrier, including at least one toll-free number for Members] [Include language taglines as required by 45 C.F.R. 155.205(c)(2)(iii)(A)]
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within 10 days after this Contract is first received, it may be cancelled for any reason without penalty (e.g., no Contingent Deferred Sales Charge will be deducted) by delivering or mailing it to the representative through whom it was purchased or to the Servicing Office of LNY. When the Contract is received at the Servicing Office, LNY will return the Contract Value plus an amount to reflect any deducted daily charges (daily charges are described in Section 3.04) as of the date of cancellation where permitted by law.
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within 30 days after delivery of this Contract to You, You may return it to Us for a full refund of any premium paid, less the cost for services provided. The Contract will be deemed void from the beginning. [EFFECTIVE DATE OF CONTRACT: [January 1, 2014 ]] Renewal Provision. Subject to all Contract terms and provisions, including those describing Termination of the Contract, You may renew and keep this Contract in force by paying the premiums as they become due. We agree to arrange or provide services under the terms and provisions of this Contract. In consideration of the application for this Contract and the payment of premiums as stated herein, We agree to arrange [or provide] services and supplies in accordance with and subject to the terms of this Contract. This Contract is delivered in New Jersey and is governed by the laws thereof. This Contract takes effect on the Effective Date, if it is duly attested below. It continues as long as the required premiums are paid, unless it ends as described in its General Provisions. [Secretary President] [[Member]: Xxxx Xxx Identification Number: 125689 Effective Date: January 1, 2015 [Product Name: XXXX]] [Include legal name, trade name, phone, fax and e-mail numbers by which consumers may contact the carrier, including at least one toll-free number for Members] The initial monthly premium rates, in U.S. dollars, for the coverage provided under this Contract are set forth on the [rate sheet] for this Contract for the effective date shown on the first page of this Contract. We have the right to prospectively change any Premium rate(s) set forth above at the times and in the manner established by the provision of this Contract entitled "General Provisions." SCHEDULE OF SERVICES AND SUPPLIES [Using Copayment] INPATIENT [$100 to $500] Copayment/day for a maximum of 5 days/admission. Maximum Copayment [ dollar amount equal to 10 times the per day copayment]/Calendar Year. Unlimited days. OUTPATIENT [amount consistent with N.J.A.C. 11:22-5.5(a)] Copayment/visit INPATIENT VISIT $[0] Copayment OUTPATIENT VISIT amount consistent with N.J.A.C. 11:22-5.5(a)]] Copayment/visit; no Copayment if any other Copayment applies. EMERGENCY ROOM $100 Copayment/visit/Member (waived if admitted within 24 hours) Note: The Emergency Room Copayment is payable in addition to the applicable Copayment and Coinsurance, if any. [URGENT CARE [amount consistent with N.J.A.C. 11:22-5.5(a)]] INPATIENT $0 Copayment OUTPATIENT [amount consistent wit...
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within [10] days after this Contract is first received, it may be cancelled for any reason without penalty (e.g., no Contingent Deferred Sales Charge will be deducted) by delivering or mailing it to the representative through whom it was purchased or to the Home Office of LNL. Upon cancellation, LNL will return the Contract Value as of the Valuation Date on which LNL receives the cancellation request. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE VARIABLE ACCOUNT, ARE VARIABLE. THE AMOUNTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT (SEE ARTICLE 4 AND ARTICLE 7). Signed for The Lincoln National Life Insurance Company at its Home Office located at [0000 X. Xxxxxxx St. in Fort Xxxxx, Indiana 46802.] /s/ Xxx X. Xxxxxx /s/ Xxxx X. Xxxxxxxx ------------------------ ---------------------------------- Xxx X. Xxxxxx, President Xxxx X. Xxxxxxxx SVP & Chief Administrative Officer Form 30070-CD-B 5/03 Table of Contents Article Page ---- 1 Definitions 4 3 Contract Value 7 4 Variable Account 8 5 Transfers, Withdrawals and Surrenders 10 7 Annuity Payment Options 15 8 Beneficiary 18 9 Suspension or Deferral of Payments 19 10 General Provisions 20 CONTRACT SPECIFICATIONS Contract Number: [XX-0123456] Annuitant: [Xxxxxxx Xxxxxxx] Age at Issue: [35] Contract Date: [May 1, 2001] Initial Purchase Payment: [$5,000] Maturity Date: [May 1, 2056] Owner(s): [Xxxxxxx Xxxxxxx] [Xxxx Xxxxxxx]
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within 10 days after this Contract is first received, it may be cancelled for any reason without penalty (e.g., no Contingent Deferred Sales Charge will be deducted or no Interest Adjustment) by delivering or mailing it to the representative through whom it was purchased or to the Servicing Office of LNY. When the Contract is received at the Servicing Office, LNY will return the Contract Value plus an amount to reflect any deducted daily charges (daily charges are described in Section 3.04) as of the date of cancellation where permitted by law. UPON A TRANSFER, WITHDRAWAL OR SURRENDER, PAYMENTS AND VALUES ALLOCATED TO THE FIXED ACCOUNT MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT, REFERRED TO AS AN INTEREST ADJUSTMENT IN THIS CONTRACT, WHICH MAY RESULT IN UPWARD OR DOWNWARD ADJUSTMENTS IN AMOUNTS TRANSFERRED, WITHDRAWN OR SURRENDERED BY THE OWNER. CASH SURRENDER BENEFITS ARE AVAILABLE WITHOUT AN INTEREST ADJUSTMENT AT THE END OF EACH GUARANTEED PERIOD AND AT OTHER TIMES AS DESCRIBED IN SECTION 5.06.
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within 30 days after delivery of this Contract to You, You may return it to Us for a full refund of any premium paid, less the cost for services provided. The Contract will be deemed void from the beginning.
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within 10 days after this Contract is first received, it may be cancelled for any reason without penalty (e.g., no Surrender Charge will be deducted) by delivering or mailing it to the financial professional through whom it was purchased or to Our Servicing Office. When the Contract is received at Our Servicing Office, We will return the greater of (a) all Purchase Payments approved and added to this Contract by the Purchase Payments Acceptance Deadline, including an amount to reflect any deducted fees and daily charges; or (b) the Contract Value. The refund will be determined as of the date the Contract was mailed to Our Servicing Office or delivered to an authorized financial professional or Our Servicing Office.
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within [10] days after this Contract is first received, it may be cancelled for any reason without penalty (e.g., no Sales Charge will be deducted) by delivering or mailing it to the representative through whom it was purchased or to the Home Office of LNL. Upon cancellation, LNL will return the value of the Variable Account as of the Valuation Date on which LNL receives the cancellation request and any Sales Charge deducted from Gross Purchase Payments. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE VARIABLE ACCOUNT, ARE VARIABLE. THE AMOUNTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT (SEE ARTICLE 4 AND ARTICLE 7). Signed for The Lincoln National Life Insurance Company at its Home Office located at [0000 X. Xxxxxxx St. in Fort Xxxxx, Indiana 46802.] /s/ Xxx X. Xxxxxx /s/ Xxxx XxXxxx Xxx X. Xxxxxx, President Xxxx XxXxxx SVP & Chief Operating Officer Form 30070-A 8/03 Table of Contents Article Page 2 Gross Purchase Payments 6 3 Contract Value 7 4 Variable Account 8 5 Transfers, Withdrawals and Surrenders 10 7 Annuity Payment Options 15 8 Beneficiary 18 9 Suspension or Deferral of Payments 19
NOTICE OF RIGHT TO EXAMINE CONTRACT. Within [10] days after this Contract is first received, it may be cancelled for any reason without penalty (e.g., no Sales Charge will be deducted) by delivering or mailing it to the representative through whom it was purchased or to the Home Office of LNL. Upon cancellation, LNL will return the value of the Variable Account as of the Valuation Date on which LNL receives the cancellation request and any Sales Charge deducted from Gross Purchase Payments. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE VARIABLE ACCOUNT, ARE VARIABLE. THE AMOUNTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT (SEE ARTICLE 4 AND ARTICLE 7). Signed for The Lincoln National Life Insurance Company at its Home Office located at [0000 X. Xxxxxxx St. in Fort Xxxxx, Indiana 46802.] 1 Definitions 4 2 Gross Purchase Payments 6 3 Contract Value 7 4 Variable Account 8 5 Transfers, Withdrawals and Surrenders 10 6 Death Benefits 12 7 Annuity Payment Options 15 8 Beneficiary 18 9 Suspension or Deferral of Payments 19 10 General Provisions 20
