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EXHIBIT 1.A.(5)(b)(2)(a)
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ML LIFE INSURANCE COMPANY OF NEW YORK NEW YORK,
NEW YORK
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ADDITIONAL INSURANCE RIDER
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RIDER SCHEDULE Insured No. 1: Xxxxxxx Xxx
Insured No. 2: Xxxx Xxx
Owner: Xxxx Xxx
Issue Date: September 30, 1992
Policy Number: SPECIMEN
Rider Face Amount: $500,000.00
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INSURANCE BENEFITS The rider provides additional insurance converge to the insureds. It is
payable to the beneficiary at the death of the last surviving insured. The
rider face amount provided by this rider is shown on the above rider
schedule.
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CHANGING THE RIDER The owner may elect to change the rider face amount prior to either
FACE AMOUNT insured's attained age 85. The minimum change in the rider face amount is
$100,000. One (1) such change is permitted each year. The minimum
additional insurance rider face amount is $100,000. To request a change in
rider face amount, you must provide satisfactory notice to us. The
effective date of change will be the policy anniversary date next following
underwriting approval of the change. As of the effective date of change,
the guarantee period will change. See HOW WE DETERMINE THE GUARANTEE
PERIOD.
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INCREASING THE RIDER If both insureds are alive, you may increase the rider face amount.
FACE AMOUNT Satisfactory evidence of insurability will be required before we will
increase the rider face amount. We will not allow an increase on the first
policy anniversary if the face amount of the policy plus the new rider face
amount provide a guarantee period of less than one year from the effective
date of the increase. An increase in face amount will decrease the
guarantee period.
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DECREASING THE RIDER Beginning in policy year 8, you may decrease the rider face amount but not
FACE AMOUNT below the amount required to keep the policy qualified as life insurance
under federal income tax laws. A decrease in face amount will increase the
guarantee period.
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HOW WE DETERMINE THE WHEN A CHANGE IN RIDER FACE AMOUNT IS REQUESTED
GUARANTEE PERIOD As of the effective date of change, we will redetermine the guarantee
period as follows:
(1) We take the fixed base described in the policy as of such date.
(2) Based on the policy year, the face amount of the policy, plus
the rider face amount, and the amount in (1), we will
redetermine the guarantee period.
Our computations are based on an annual interest rate of 5% and the
guaranteed maximum cost of insurance rates shown in Appendix 1.
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COST OF RIDER The cost of the rider is determined by dividing the rider face amount by
$1000 and multiplying the result by the current cost of insurance rate per
$1000 based on the policy year and sex and underwriting class of both
insureds. The cost of the rider is deducted from the investment base as
described in the policy. See INVESTMENT BASE IN EACH INVESTMENT DIVISION in
the policy.
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INCONTESTABILITY AND The incontestability and suicide provisions of the policy also apply to
SUICIDE this rider. We can contest the validity of any change in the rider face
amount requested by owner if any material misstatements are made in any
application required for that change. We will not contest any change in
the rider face amount requested by the owner after the change has been in
effect during either insured's lifetime for two years from the effective
date of such change. If either insured commits suicide within two years of
the effective date of any increase in the rider face amount requested by
the owner, we will terminate the coverage attributable to such increase in
rider face amount and pay only a limited benefit. The limited benefit will
be the amount of cost of insurance deductions made for such increase.
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WHEN THIS RIDER WILL This rider will terminate on the date the policy terminates or lapses.
TERMINATE
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GENERAL The rider is a part of the policy. It has no cash or loan value. Its
benefit is subject to all the terms of this rider and the policy.
ML LIFE INSURANCE COMPANY OF NEW YORK
/S/ XXXXX X. XXXXXXXX /S/ XXXXX XXXXX
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Xxxxx X. Xxxxxxxx Xxxxx Xxxxx
Secretary President
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