INSURED PERSON XXXXXXX XXX
[GRAPHIC: EQUITABLE LOGO]
POLICY OWNER XXXXXXX XXX
VARIABLE LIFE
POLICY NUMBER XX XXX XXX INSURANCE
POLICY
--------------------------------------------------------------------------------
DRAFT 2
WE AGREE to pay the Insurance Benefit of this policy and to provide its other
benefits and rights in accordance with its provisions.
FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE POLICY
This is a flexible premium variable life insurance policy. You can, within
limits:
o make premium payments at any time and in any amount;
o change the death benefit option;
o change the allocation of net premiums and deductions among your investment
options; and
o transfer amounts among your investment options.
This policy is guaranteed not to lapse during the first five policy years, if
premiums are paid in accordance with the no lapse guarantee provision and any
outstanding loan and accrued loan interest does not exceed the cash surrender
value.
All of these rights and benefits are subject to the terms and conditions of this
policy. All requests for policy changes are subject to our approval and may
require evidence of insurability.
We put your net premiums into your Policy Account. You may allocate them to one
or more investment funds of our Separate Account(s) (SA) or to our Guaranteed
Interest Account (GIA).
The portion of your Policy Account that is in an investment fund of our SA will
vary up or down depending on the unit value of such investment fund, which in
turn depends on the investment performance of the securities held by that fund.
There are no minimum guarantees as to such portion of your Policy Account.
The portion of your Policy Account that is in our GIA will accumulate, after
deductions, at rates of interest we determine. Such rates will not be less than
3% a year.
The amount and duration of the death benefit may be variable or fixed under
specified conditions. See the death benefit provision for a description of the
variable death benefit.
This is a non-participating policy.
RIGHT TO EXAMINE POLICY. You may examine this policy and if for any reason you
are not satisfied with it, you may cancel it by returning this policy with a
written request for cancellation to our administrative office by the 10th day
after you receive it. If you do this, we will refund the premiums that were paid
minus any outstanding loan and accrued loan interest.
READ YOUR POLICY CAREFULLY. It is a legal contract between you and The Equitable
Life Assurance Society of the United States.
/s/ Xxxxxxxxxxx X. Xxxxxxx /s/ Xxxxxxx Xxxxxxx
------------------------------------ ---------------------------------------
Xxxxxxxxxxx X. Xxxxxxx Xxxxxxx Xxxxxxx, Senior Vice President,
Chairman and Chief Executive Officer Secretary and Associate General Counsel
No. 02-100
INSURED PERSON XXXXXXX XXX
[GRAPHIC: EQUITABLE LOGO]
POLICY OWNER XXXXXXX XXX
VARIABLE LIFE
POLICY NUMBER XX XXX XXX INSURANCE
POLICY
--------------------------------------------------------------------------------
DRAFT 2
WE AGREE to pay the Insurance Benefit of this policy and to provide its other
benefits and rights in accordance with its provisions.
FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE POLICY
This is a flexible premium variable life insurance policy. You can, within
limits:
o make premium payments at any time and in any amount;
o change the death benefit option;
o change the allocation of net premiums and deductions among your investment
options; and
o transfer amounts among your investment options.
This policy is guaranteed not to lapse during the first five policy years, if
premiums are paid in accordance with the no lapse guarantee provision and any
outstanding loan and accrued loan interest does not exceed the cash surrender
value.
All of these rights and benefits are subject to the terms and conditions of this
policy. All requests for policy changes are subject to our approval and may
require evidence of insurability.
We put your net premiums into your Policy Account. You may allocate them to one
or more investment funds of our Separate Account(s) (SA) or to our Guaranteed
Interest Account (GIA).
The portion of your Policy Account that is in an investment fund of our SA will
vary up or down depending on the unit value of such investment fund, which in
turn depends on the investment performance of the securities held by that fund.
There are no minimum guarantees as to such portion of your Policy Account.
The portion of your Policy Account that is in our GIA will accumulate, after
deductions, at rates of interest we determine. Such rates will not be less than
3% a year.
The amount and duration of the death benefit may be variable or fixed under
specified conditions. See the death benefit provision for a description of the
variable death benefit.
This is a non-participating policy.
RIGHT TO EXAMINE POLICY. You may examine this policy and if for any reason you
are not satisfied with it, you may cancel it by returning this policy with a
written request for cancellation to our administrative office by the 10th day
after you receive it. If you do this, we will refund the policy account value
calculated as of the day the policy was returned plus any charges deducted from
premiums that were paid and minus any outstanding loan and accrued loan
interest.
READ YOUR POLICY CAREFULLY. It is a legal contract between you and The Equitable
Life Assurance Society of the United States.
/s/ Xxxxxxxxxxx X. Xxxxxxx /s/ Xxxxxxx Xxxxxxx
------------------------------------- ---------------------------------------
Xxxxxxxxxxx X. Xxxxxxx Xxxxxxx Xxxxxxx, Senior Vice President,
President and Chief Executive Officer Secretary and Associate General Counsel
Contents
--------
Policy Information 3
Table of Maximum Monthly Charges for
Benefits 4
Those Who Benefit from this Policy 5
The Insurance Benefit We Pay 5
Changing the Face Amount of Insurance or
the Death Benefit
Option 7
The Premiums You Pay 7 IN THIS POLICY: ADMINISTRATIVE OFFICE:
--------------- ----------------------
Your Policy Account and How it "We," "our" and "us" mean The Equitable The address of our Administrative
Works 9 Life Assurance Society of the United Office is shown on Page 3. You
States. should send correspondence to that
Your Investment Options 10 office. Premium payments should be
"You" and "your" mean the owner of this sent to the address listed on your
The Value of Your Policy Account 11 policy at the time an owner's right is billing notice.
exercised.
The Cash Surrender Value of
this Policy 12 Unless otherwise stated, all references
to interest in this policy are
How a Loan Can Be Made 13 effective annual rates of interest.
Our Separate Account(s) (SA) 14
Our Annual Report to You 15
How Benefits are Paid 15
Attained age means age on the birthday Copies of the application for this
Other Important Information 16 nearest to the beginning of the current policy and any additional benefit
policy year. riders are attached to the policy.
Table of Guaranteed Payments 19
INTRODUCTION
The premiums you pay, after deductions are made in accordance with the Table of
Expense Charges in the Policy Information section, are put into your Policy
Account. Amounts in your Policy Account are allocated at your direction to one
or more investment funds of our SA or to our GIA.
The investment funds of our SA invest in securities and other investments whose
value is subject to market fluctuations and investment risk. There is no
guarantee of principal or investment experience.
Our GIA earns interest at rates we declare. The principal, after deductions, is
guaranteed.
If death benefit Option A is in effect, the death benefit is the Face Amount of
Insurance, and the amount of the death benefit is fixed except when it is a
percentage of your Policy Account. If death benefit Option B is in effect, the
death benefit is the Face Amount of Insurance plus the amount in your Policy
Account. The amount of the death benefit is variable. Under either option, the
death benefit will never be less than a percentage of your Policy Account as
stated in the "Death Benefit" provision.
This policy is guaranteed not to lapse during the first five policy years, if
premiums are paid in accordance with the No Lapse Guarantee provision and any
outstanding loan and accrued loan interest does not exceed the cash surrender
value
We make monthly deductions from your Policy Account to cover the cost of the
benefits provided by this policy and the cost of any benefits provided by riders
to this policy. If you give up this policy for its Net Cash Surrender Value or
reduce the Face Amount of Insurance, we may deduct a surrender charge from your
Policy Account.
This is only a summary of what this policy provides. You should read all of it
carefully. Its terms govern your rights and our obligations.
No. 02-100
POLICY INFORMATION
INSURED PERSON XXXXXXX XXX
POLICY OWNER XXXXXXX XXX
FACE AMOUNT
OF BASE POLICY $200,000
DEATH BENEFIT OPTION A (SEE PAGE 6) SEPARATE ACCOUNT [FP]
POLICY NUMBER XX XXX XXX ISSUE AGE 35
BENEFICIARY XXXXXXXX XXX SEX MALE
REGISTER DATE MARCH 4, 2002 RATING CLASS: PREFERRED
NON-TOBACCO USER
DATE OF ISSUE MARCH 4, 2002
A MINIMUM INITIAL PREMIUM PAYMENT OF $xx.xx IS DUE ON OR BEFORE DELIVERY OF THE
POLICY.
THE PLANNED PERIODIC PREMIUM OF [$xxx] IS PAYABLE [QUARTERLY].
NO LAPSE GUARANTEE PERIOD IS 5 YEARS FROM THE REGISTER DATE. SEE NO LAPSE
GUARANTEE PROVISION.
PAGE 3-CONTINUED FOR TABLE OF NO LAPSE GUARANTEE PREMIUMS.
PREMIUM PAYMENTS ARE FOR THE INSURANCE BENEFIT INCLUDING ANY ADDITIONAL BENEFIT
RIDERS LISTED BELOW.
THE PLANNED PERIODIC PREMIUMS SHOWN ABOVE MAY NOT BE SUFFICIENT TO CONTINUE THE
POLICY AND LIFE INSURANCE COVERAGE IN FORCE DURING THE LIFETIME OF THE INSURED.
THE PERIOD FOR WHICH THE POLICY AND COVERAGE WILL CONTINUE IN FORCE WILL DEPEND
ON: (1) THE AMOUNT, TIMING AND FREQUENCY OF PREMIUM PAYMENTS; (2) CHANGES IN THE
FACE AMOUNT OF INSURANCE AND THE DEATH BENEFIT OPTIONS; (3) CHANGES IN THE
INTEREST RATES CREDITED TO OUR GIA AND THE INVESTMENT PERFORMANCE OF THE
INVESTMENT FUNDS OF OUR SA; (4) CHANGES IN THE MONTHLY DEDUCTIONS FROM THE
POLICY ACCOUNT FOR THIS POLICY AND ANY BENEFITS PROVIDED BY RIDERS TO THIS
POLICY; AND (5) LOAN AND PARTIAL NET CASH SURRENDER VALUE WITHDRAWAL ACTIVITY.
No. 02-100-3 PAGE 3
(CONTINUED ON NEXT PAGE)
ALTERNATE PAGE 3 FOR USE IF INTEGRATED TERM RIDER SELECTED
POLICY INFORMATION
INSURED PERSON XXXXXXX XXX
POLICY OWNER XXXXXXX XXX
FACE AMOUNT
OF BASE POLICY $200,000
FACE AMOUNT OF
INTEGRATED TERM $200,000
TARGET AMOUNT
(BASE PLUS TERM) $400,000
DEATH BENEFIT OPTION A (SEE PAGE 6) SEPARATE ACCOUNT [FP]
POLICY NUMBER XX XXX XXX ISSUE AGE 35
BENEFICIARY XXXXXXXX XXX SEX MALE
REGISTER DATE MARCH 4, 2002 RATING CLASS: PREFERRED
NON-TOBACCO USER
DATE OF ISSUE MARCH 4, 2002
A MINIMUM INITIAL PREMIUM PAYMENT OF $xx.xx IS DUE ON OR BEFORE DELIVERY OF THE
POLICY.
THE PLANNED PERIODIC PREMIUM OF [$xxx] IS PAYABLE [QUARTERLY].
NO LAPSE GUARANTEE PERIOD IS 5 YEARS FROM THE REGISTER DATE. SEE NO LAPSE
GUARANTEE PROVISION.
PAGE 3-CONTINUED FOR TABLE OF NO LAPSE GUARANTEE PREMIUMS.
PREMIUM PAYMENTS ARE FOR THE INSURANCE BENEFIT INCLUDING ANY ADDITIONAL BENEFIT
RIDERS LISTED BELOW.
THE PLANNED PERIODIC PREMIUMS SHOWN ABOVE MAY NOT BE SUFFICIENT TO CONTINUE THE
POLICY AND LIFE INSURANCE COVERAGE IN FORCE DURING THE LIFETIME OF THE INSURED.
THE PERIOD FOR WHICH THE POLICY AND COVERAGE WILL CONTINUE IN FORCE WILL DEPEND
ON: (1) THE AMOUNT, TIMING AND FREQUENCY OF PREMIUM PAYMENTS; (2) CHANGES IN THE
FACE AMOUNT OF INSURANCE AND THE DEATH BENEFIT OPTIONS; (3) CHANGES IN THE
INTEREST RATES CREDITED TO OUR GIA AND THE INVESTMENT PERFORMANCE OF THE
INVESTMENT FUNDS OF OUR SA; (4) CHANGES IN THE MONTHLY DEDUCTIONS FROM THE
POLICY ACCOUNT FOR THIS POLICY AND ANY BENEFITS PROVIDED BY RIDERS TO THIS
POLICY; AND (5) LOAN AND PARTIAL NET CASH SURRENDER VALUE WITHDRAWAL ACTIVITY.
No. 02-100-3 PAGE 3
(CONTINUED ON NEXT PAGE)
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF NO LAPSE GUARANTEE PREMIUMS
GUARANTEE MONTHLY PREMIUM PREMIUM PERIOD
--------- --------------- --------------
NO LAPSE GUARANTEE $xx.xx 5 YEARS
YOU CAN, WITHIN LIMITS, MAKE PREMIUM PAYMENTS AT ANY TIME AND IN ANY AMOUNT.
HOWEVER, THE MONTHLY PREMIUMS SHOWN ABOVE ARE USED TO DETERMINE WHETHER THE NO
LAPSE GUARANTEE PERIOD IS IN EFFECT AS DESCRIBED IN THE GRACE PERIOD PROVISION.
No. 02-100-3 PAGE 3-CONTINUED
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF EXPENSE CHARGES
DEDUCTIONS FROM PREMIUM PAYMENTS:
PREMIUM CHARGE:
WE DEDUCT AN AMOUNT NOT TO EXCEED 10% FROM EACH PREMIUM PAYMENT. WE
RESERVE THE RIGHT TO INCREASE THIS PERCENTAGE LIMIT AS A RESULT OF CHANGES
IN THE TAX LAWS WHICH INCREASE OUR EXPENSES.
DEDUCTIONS FROM YOUR POLICY ACCOUNT:
ADMINISTRATIVE CHARGE:
FIRST POLICY YEAR: WE DEDUCT AT THE BEGINNING OF EACH POLICY MONTH $XXX
FOR EACH $1,000 OF INITIAL BASE POLICY FACE AMOUNT OF INSURANCE PLUS
$20.00.
POLICY YEARS 2 AND LATER: WE DEDUCT AT THE BEGINNING OF EACH POLICY MONTH
$XXX FOR EACH $1,000 OF INITIAL BASE POLICY FACE AMOUNT OF INSURANCE PLUS
AN AMOUNT NOT TO EXCEED $10.00.
No. 02-100-3 PAGE 3-CONTINUED
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF SURRENDER CHARGES
FOR THE BASE POLICY FACE AMOUNT
BEGINNING OF BEGINNING OF
POLICY YEAR CHARGE POLICY YEAR CHARGE
----------- ------ ----------- ------
1 $XXX.XX 7 $XXX.XX
2 XXX.X 8 XXX.XX
3 XXX.XX 9 XXX.XX
4 XXX.XX 10 XXX.XX
5 XXX.XX 11 AND LATER 00.00
6 XXX.XX
A SURRENDER CHARGE WILL BE SUBTRACTED FROM YOUR POLICY ACCOUNT IF THIS POLICY IS
GIVEN UP FOR ITS NET CASH SURRENDER VALUE WITHIN THE FIRST TEN POLICY YEARS. THE
SURRENDER CHARGE IN THE FIRST POLICY MONTH OF EACH POLICY YEAR IS SHOWN IN THE
TABLE ABOVE. THE SURRENDER CHARGE AT ANY TIME DURING THE FIRST SIX POLICY YEARS
IS EQUAL TO THE BEGINNING OF POLICY YEAR CHARGE SHOWN ABOVE. STARTING IN POLICY
YEAR SEVEN, THE SURRENDER CHARGE DECLINES UNIFORMLY IN EQUAL MONTHLY AMOUNTS
UNTIL IT REACHES ZERO IN THE TWELFTH MONTH OF POLICY YEAR TEN.
IF THE BASE POLICY FACE AMOUNT OF INSURANCE IS REDUCED WITHIN THE FIRST TEN
POLICY YEARS, A PROPORTIONATE SHARE OF THE APPLICABLE SURRENDER CHARGE AT THAT
TIME WILL BE DEDUCTED FROM YOUR POLICY ACCOUNT. SEE SURRENDER CHARGES PROVISION
FOR A DESCRIPTION OF THE PROPORTIONATE SURRENDER CHARGE.
ADMINISTRATIVE OFFICE:
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
NATIONAL OPERATIONS CENTER
00000 XXXXXXXXXX XXXXXXX XXXXXXX
XXXXXXXXX, XX 00000
(000) 000-0000
No. 02-100-3 PAGE 3-CONTINUED
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF MAXIMUM MONTHLY
CHARGES FOR BENEFITS
MONTHLY DEDUCTION
BENEFITS FROM POLICY ACCOUNT PERIOD
-------- ------------------- ------
BASIC COST OF INSURANCE MAXIMUM MONTHLY COST OF INSURANCE RATE 65 YEARS
(SEE PAGE 4 - CONTINUED) TIMES
THOUSANDS OF NET AMOUNT AT RISK
BASIC COST OF INSURANCE $0.00 THEREAFTER
No. 02-100-4 PAGE 4-(CONTINUED ON NEXT PAGE)
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF MAXIMUM MONTHLY COST OF INSURANCE RATES
PER $1,000 OF NET AMOUNT AT RISK FOR BASE POLICY
INSURED PERSON'S INSURED PERSON'S INSURED PERSON'S
ATTAINED AGE RATE ATTAINED AGE RATE ATTAINED AGE RATE
------------ ---- ------------ ---- ------------ ----
35 0.14083 55 0.65333 75 5.03667
36 0.14750 56 0.72167 76 5.59000
37 0.15667 57 0.79417 77 6.17500
38 0.16667 58 0.87250 78 6.78667
39 0.17833 59 0.96083 79 7.44000
40 0.19083 60 1.05917 80 8.16167
41 0.20583 61 1.16833 81 8.97250
42 0.22083 62 1.29417 82 9.89750
43 0.23833 63 1.43667 83 10.95167
44 0.25583 64 1.59833 84 12.11833
45 0.27667 65 1.77750 85 13.37417
46 0.29917 66 1.97083 86 14.69833
47 0.32333 67 2.18083 87 16.08083
48 0.34917 68 2.40583 88 17.49667
49 0.37833 69 2.65333 89 18.96583
50 0.41000 70 2.93250 90 20.51167
51 0.44667 71 3.30167 91 22.16500
52 0.48917 72 3.61750 92 23.98667
53 0.53667 73 4.04167 93 26.06583
54 0.59250 74 4.52000 94 28.78417
95 32.81750
96 39.64250
97 53.06583
98 83.33250
99 83.33250
100 AND OVER 00.00000
No. 02-100-4 PAGE 4-CONTINUED
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF MAXIMUM MONTHLY COST OF INSURANCE RATES
PER $1,000 OF INTEGRATED TERM RIDER BENEFIT
INSURED PERSON'S INSURED PERSON'S INSURED PERSON'S
ATTAINED AGE RATE ATTAINED AGE RATE ATTAINED AGE RATE
------------ ---- ------------ ---- ------------ ----
35 0.14083 55 0.65333 75 5.03667
36 0.14750 56 0.72167 76 5.59000
37 0.15667 57 0.79417 77 6.17500
38 0.16667 58 0.87250 78 6.78667
39 0.17833 59 0.96083 79 7.44000
40 0.19083 60 1.05917 80 8.16167
41 0.20583 61 1.16833 81 8.97250
42 0.22083 62 1.29417 82 9.89750
43 0.23833 63 1.43667 83 10.95167
44 0.25583 64 1.59833 84 12.11833
45 0.27667 65 1.77750 85 13.37417
46 0.29917 66 1.97083 86 14.69833
47 0.32333 67 2.18083 87 16.08083
48 0.34917 68 2.40583 88 17.49667
49 0.37833 69 2.65333 89 18.96583
50 0.41000 70 2.93250 90 20.51167
51 0.44667 71 3.30167 91 22.16500
52 0.48917 72 3.61750 92 23.98667
53 0.53667 73 4.04167 93 26.06583
54 0.59250 74 4.52000 94 28.78417
95 32.81750
96 39.64250
97 53.06583
98 83.33250
99 83.33250
No. 02-100-4 PAGE 4-CONTINUED
TABLE OF FACTORS FOR
PAID UP DEATH BENEFIT GUARANTEE
ATTAINED AGE FACTOR ATTAINED AGE FACTOR
------------ ------ ------------ ------
35 0.19902 70 0.63108
36 0.20659 71 0.64643
37 0.21446 72 0.66144
38 0.22260 73 0.67645
39 0.23103 74 0.69115
40 0.23975 75 0.70545
41 0.24877 76 0.71934
42 0.25807 77 0.73285
43 0.26769 78 0.74599
44 0.27760 79 0.75885
45 0.28783 80 0.77146
46 0.29838 81 0.78380
47 0.30925 82 0.79581
48 0.32044 83 0.80741
49 0.33196 84 0.81847
50 0.34382 85 0.82895
51 0.35601 86 0.83885
52 0.36853 87 0.84823
53 0.38135 88 0.85718
54 0.39447 89 0.86584
55 0.40786 90 0.87440
56 0.42150 91 0.88302
57 0.43540 92 0.89193
58 0.44954 93 0.90140
59 0.46394 94 0.91323
60 0.47856 95 0.92832
61 0.49340 96 0.94517
62 0.50842 97 0.96345
63 0.52359 98 0.98168
64 0.53886 99 AND OVER 1.00000
65 0.55419
66 0.56953
67 0.58490
68 0.60028
69 0.61568
No. 02-100-4 PAGE 4-CONTINUED
--------------------------------------------------------------------------------
THOSE WHO BENEFIT FROM THIS POLICY
OWNER. The owner of this policy is the insured person unless otherwise stated in
the application, or later changed.
As the owner, you are entitled to exercise all the rights of this policy while
the insured person is living. To exercise a right, you do not need the consent
of anyone who has only a conditional or future ownership interest in this
policy.
BENEFICIARY. The beneficiary is as stated in the application, unless later
changed. The beneficiary is entitled to the Insurance Benefit of this policy.
One or more beneficiaries for the Insurance Benefit can be named in the
application. If more than one beneficiary is named, they can be classed as
primary or contingent. If two or more persons are named in a class, their shares
in the benefit can be stated. The stated shares in the Insurance Benefit will be
paid to any primary beneficiaries who survive the insured person. If no primary
beneficiaries survive, payment will be made to any surviving contingent
beneficiaries. Beneficiaries who survive in the same class will share the
Insurance Benefit equally, unless you have made another arrangement with us.
If there is no designated beneficiary living at the death of the insured person,
we will pay the Insurance Benefit to the insured person's surviving children in
equal shares. If none survive, we will pay the insured person's estate.
CHANGING THE OWNER OR BENEFICIARY. While the insured person is living, you may
change the owner or beneficiary by written notice in a form satisfactory to us.
You can get such a form from your financial professional or by writing to us at
our Administrative Office. The change will take effect on the date you sign the
notice; however, it will not apply to any payment we make or other action we
take before we receive the notice. If you change the beneficiary, any previous
arrangement you made as to a payment option for benefits is cancelled. You may
choose a payment option for the new beneficiary in accordance with the "How
Benefits Are Paid" section of this policy.
ASSIGNMENT. You may assign this policy, if we agree; however, we will not be
bound by an assignment unless we have received it in writing at our
Administrative Office. Your rights and those of any other person referred to in
this policy will be subject to the assignment. We assume no responsibility for
the validity of an assignment. An absolute assignment will be considered as a
change of ownership to the assignee.
--------------------------------------------------------------------------------
THE INSURANCE BENEFIT WE PAY
We will pay the Insurance Benefit of this policy to the beneficiary when we
receive at our Administrative Office (1) proof that the insured person died
while this policy was in force; and (2) all other requirements we deem
necessary. The Insurance Benefit includes the following amounts, which we will
determine as of the date of the insured person's death:
o the death benefit described on Page 6;
o PLUS any other benefits then due from riders to this policy;
o MINUS any policy loan and accrued interest, or liens;
o MINUS any overdue deductions from your Policy Account if the insured
person dies during a grace period.
We will add interest to the resulting amount in accordance with applicable law.
We will compute the interest at a rate we determine, but not less than the
greater of (a) the rate we are paying on the date of payment under the Deposit
Option provision, or (b) the rate required by any applicable law. Payment of the
Insurance Benefit may also be affected by other provisions of this policy. See
the "Other Important Information" section of this policy, where we specify our
right to contest the policy, the suicide exclusion, and what happens if age or
sex has been misstated. Additional exclusions or limitations (if any) are listed
in the Policy Information section.
5
DEATH BENEFIT. The death benefit of this policy will be determined under either
Option A or Option B, whichever you have chosen and is in effect on the date of
death of the insured person.
Under Option A, the death benefit is the greater of (a) the Face Amount of
Insurance; or (b) a percentage of the amount in your Policy Account on the date
of death of the insured person. Under this option, the amount of the death
benefit is fixed, except when it is determined by such percentage.
Under Option B, the death benefit is the greater of (a) the Face Amount of
Insurance plus the amount in your Policy Account on the date of death of the
insured person; or (b) a percentage of the amount in your Policy Account on the
date of death of the insured person. Under this option the amount of the death
benefit is variable.
The percentages referred to above are the percentages from the following table
for the insured person's age (nearest birthday) at the beginning of the policy
year of determination.
TABLE OF PERCENTAGES
For ages not shown, the percentages shall
decrease by a ratable portion for each full year
INSURED PERSON'S AGE PERCENTAGE INSURED PERSON'S AGE PERCENTAGE
-------------------- ---------- -------------------- ----------
40 and under 250% 65 120%
45 215 70 115
50 185 75 thru 95 105
55 150 99 and over 101
60 130
Section 7702 of the Internal Revenue Code of 1986, as amended (i.e., the
"Code"), gives a definition of life insurance which limits the amounts that may
be paid into a life insurance policy relative to the benefits it provides. Even
if this policy states otherwise, at no time will the "future benefits" under
this policy be less than an amount such that the "premiums paid" do not exceed
the Code's "guideline premium limitations." We may adjust the amount of premium
paid to meet these limitations. Also, at no time will the "death benefit" under
the policy be less than the "applicable percentage" of the "cash surrender
value" of the policy. The above terms are as defined in the Code. In addition,
we may take certain actions, described here and elsewhere in the policy, to meet
the definitions and limitations in the Code, based on our interpretation of the
Code. Please see "Policy Changes -- Applicable Tax Law" for more information.
NO LAPSE GUARANTEE. This policy is guaranteed not to lapse during the first five
policy years if the sum of premium payments accumulated at 4%, less any partial
withdrawals accumulated at 4%, is at least equal to the sum of the No Lapse
Guarantee Premium(s) accumulated at 4%, and any outstanding loan and accrued
loan interest does not exceed the cash surrender value. The no lapse Guarantee
Premium(s) for the base policy life insurance benefits and any additional rider
benefits are shown on page 3-continued. This no lapse guarantee expires at the
end of five years. Certain policy changes after issue will change the No Lapse
Guarantee Premium(s); however, they will not start a new guarantee period.
MATURITY. Coverage under this policy does not terminate at any specific time,
but will continue for as long as the policy remains in force during the lifetime
of the insured person. However, no premium payments (unless needed to keep the
policy in force) or other policy transactions will be permitted after age 100 of
the insured person, except for taking a policy loan, making a loan repayment, or
transferring amounts among your investment options. No deductions for cost of
insurance or administrative charges will be made after age 100 of the insured
person.
6
--------------------------------------------------------------------------------
CHANGING THE FACE AMOUNT OF INSURANCE OR THE DEATH BENEFIT OPTION
You may change the Face Amount of Insurance or the death benefit option by
written request to us at our Administrative Office, subject to the following
conditions:
1. At any time after the second policy year while this policy is in force, you
may ask us to reduce the Face Amount of Insurance but not to less than $200,000
of base policy face amount. Any such reduction in the face amount may not be
less than $10,000. If you reduce the Face Amount of Insurance before the end of
the tenth policy year, we will deduct a proportionate amount of any applicable
surrender charge from your Policy Account. Any such deduction will be made in
accordance with the "Allocations" provision of the policy.
2. At any time after the second policy year while this policy is in force, you
can change your death benefit option. Any requested change to death benefit
Option B must be made while the insured person is not more than attained age 85.
If you ask us to change from Option A to Option B, we will decrease the Face
Amount of Insurance by the amount in your Policy Account on the date the change
takes effect. However, we will decline to make such change if it would reduce
the Face Amount of Insurance to less than $200,000 of base policy face amount.
If you ask us to change from Option B to Option A, we will increase the Face
Amount of Insurance by the amount in your Policy Account on the date the change
takes effect. Such decreases and increases in the Face Amount of Insurance are
made so that the death benefit remains the same on the date the change takes
effect.
3. The change will take effect at the beginning of the policy month that
coincides with or next follows the date we approve your request.
4. We reserve the right to decline to make any change that we determine would
cause this policy to fail to qualify as life insurance under applicable tax law
as interpreted by us.
5. You may ask for a change by completing an application for change, which you
can get from your financial professional or by writing to us at our
Administrative Office. A copy of your application for change will be attached to
the new Policy Information section that we will issue when the change is made.
The new section and the application for change will become a part of this
policy. We may require you to return this policy to our Administrative Office to
make a policy change.
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THE PREMIUMS YOU PAY
The minimum initial premium payment shown in the Policy Information section is
due on or before delivery of this policy. No insurance will take effect before a
premium at least equal to the minimum initial premium is paid. Other premiums
may be paid at our Administrative Office at any time while this policy is in
force.
We will send premium notices to you for the planned periodic premium shown in
the Policy Information section. You may skip planned periodic premium payments.
However, this may adversely affect the duration of the death benefit and your
policy's values. We will assume that any payment you make to us is a premium
payment, unless you tell us in writing that it is a loan repayment.
If you stop paying premiums, insurance coverage will continue for as long as the
Net policy account value is sufficient to cover the monthly deductions described
in the "Monthly Deductions" provision, with a further extension of coverage as
described in the Grace Period provision.
LIMITS. Each premium payment after the initial one must be at least $100. We may
increase this minimum limit 90 days after we send you written notice of such
increase. We reserve the right to limit the amount of any premium payments you
may make if they would immediately result in more than a dollar for dollar
increase in the death benefit (which would happen if the death benefit is
determined as a percentage of the policy account, as described in the "Death
Benefit" provision), unless you provide satisfactory evidence of insurability of
the insured person.
We also reserve the right not to accept premium payments or to return excess
amounts that we determine would cause this policy to fail to qualify as life
insurance under applicable tax law as interpreted by us.
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GRACE PERIOD. At the beginning of each policy month, we compare the Net Policy
Account Value to the total monthly deductions described in the "Monthly
Deductions" provision. If the Net Policy Account Value is sufficient to cover
the total monthly deductions, this policy is not in default.
If the Net Policy Account Value at the beginning of any policy month is not
sufficient to cover the total monthly deductions, but the no lapse guarantee
period is in effect, we will perform the following calculations to determine
whether the policy is in default:
1. Determine the No Lapse Guarantee Premium fund. The No Lapse Guarantee
Premium fund for any policy month is the accumulation of all the no lapse
guarantee premiums shown on Page 3-Continued, from the Register Date up to
that month at 4% interest.
2. Determine the actual premium fund. The actual premium fund for any policy
month is the accumulation of all the premiums received at 4% interest
minus all withdrawals accumulated at 4% interest.
3. If the result in Step 2 is greater than or equal to the result in Step 1,
and any loan and accrued loan interest does not exceed the Policy Account
Vvalue, the policy is not in default. The No Lapse Guarantee will be in
effect and monthly deductions in excess of the Policy Account will be
waived.
4. If the result of Step 2 is less than the result in Step 1, or if the
result of Step 2 is greater than or equal to the result in Step 1 and any
loan and accrued loan interest exceeds the Policy Account Value the policy
is in default as of the first day of that policy month. This is the date
of default.
If the No Lapse Guarantee period has expired (see "No Lapse Guarantee"
provision) the calculations described in Steps 1. - 4. above will not be
performed. In that case, if the Net Policy Account Value at the beginning of any
policy month is less than the monthly deductions for that month, the policy is
in default as of the first day of such policy month.
If the policy is in default, we will send you and any assignee on our records at
last known addresses written notice stating that a grace period of 61 days has
begun starting with the date the notice is mailed. The notice will also state
the amount of payment that is due.
The payment required will not be more than an amount sufficient to increase the
Net Policy Account Value to cover all monthly deductions for 3 months,
calculated assuming no interest or investment performance were credited to or
charged against the Policy Account and no policy changes were made.
If we do not receive such amount at our Administrative Office before the end of
the grace period, we will then (1) withdraw and retain any amount in your Policy
Account; and (2) send a written notice to you and any assignee on our records at
last known addresses stating that this policy has ended without value.
If we receive the requested amount before the end of the grace period, but the
Net Policy Account Value is still insufficient to cover total monthly
deductions, we will send a written notice that a new 61 day grace period has
begun and request an additional payment.
If the insured person dies during a grace period, we will pay the Insurance
Benefit as described on Page 5.
RESTORING YOUR POLICY BENEFITS. If this policy has ended without value, you may
restore policy benefits while the insured person is alive if you:
1. Ask for restoration of policy benefits within 6 months from the end of the
grace period; and
2. Provide evidence of insurability satisfactory to us; and
3. Make a required payment. The required payment will not be more than an
amount sufficient to cover (i) total monthly deductions for 3 months,
calculated from the effective date of restoration; and (ii) the premium
charge. We will determine the amount of this required payment as if no
interest or investment performance were credited to or charged against
your Policy Account.
We must receive the required payment while the insured person is alive. We will
deduct the premium charge from
8
the required payment. The policy account on the date of restoration will be
equal to the balance of the required payment.
The effective date of the restoration of policy benefits will be the beginning
of the policy month which coincides with or next follows the date we approve
your request. We will start to make monthly charges again as of the effective
date of restoration.
We reserve the right to decline to restore this policy if in our opinion it
would cause this policy to fail to qualify as life insurance under applicable
tax law.
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YOUR POLICY ACCOUNT AND HOW IT WORKS
PREMIUM PAYMENTS. When we receive your premium payments, we subtract the expense
charges shown in the table in the "Policy Information" section and any overdue
monthly deductions. We put the balance (the net premium) into your Policy
Account as of the date we receive the premium payment at our Administrative
Office and before any deductions from your Policy Account due on that date are
made. However, we will put the initial net premium payment into your Policy
Account as of the Register Date if it is later than the date of receipt. No
premiums will be applied to your Policy Account until the minimum initial
premium payment, as shown in the "Policy Information" section, is received at
our Administrative Office.
MONTHLY DEDUCTIONS. At the beginning of each policy month we make a deduction
from your Policy Account to cover the monthly administrative charge and to
provide insurance coverage. The first deduction is made on the Register Date. No
deduction is made after age 100 of the insured person. Such deduction for any
policy month is the sum of the following amounts determined as of the beginning
of that month:
o the monthly administrative charge;
o the monthly cost of insurance for the insured person; and
o the monthly cost of any benefits provided by riders to this policy.
The monthly cost of insurance is the sum of (a) our current monthly cost of
insurance rate times the net amount at risk at the beginning of the policy month
divided by $1,000; plus (b) any flat extra charge shown in the "Policy
Information" section. The net amount at risk at any time is the death benefit
(calculated as of that time) minus the amount in your Policy Account at that
time.
We will determine cost of insurance rates from time to time. Any change in the
cost of insurance rates we use will be as described in the "Changes in Policy
Cost Factors" provision. They will never be more than those shown in the Table
of Maximum Cost of Insurance Rates on Page 4-Continued.
OTHER DEDUCTIONS. We also make the following other deductions from your Policy
Account as they occur:
o We deduct a surrender charge if, before the end of the tenth policy year, you
give up this policy for its Net Cash Surrender Value or you reduce the BASE
POLICY Face Amount of Insurance.
o We deduct a charge for certain transfers (see "Transfers" provision).
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YOUR INVESTMENT OPTIONS
ALLOCATIONS. This policy provides investment options for the amount in your
Policy Account. Amounts put into your Policy Account and deductions from it are
allocated to the investment funds of our SA and to the unloaned portion of our
GIA at your direction. You specified your initial premium allocation and
deduction allocation percentages in your application for this policy, a copy of
which is attached to this policy. Unless you change
9
them, such percentages shall also apply to subsequent premium and deduction
allocations.
Allocation percentages must be zero or a whole number not greater than 100. The
sum of the premium allocation percentages and of the deduction allocation
percentages must each equal 100.
You may change such allocation percentages by written notice to our
Administrative Office. A change will take effect on the date we receive it at
our Administrative Office.
If we cannot make a monthly deduction on the basis of the deduction allocation
percentages then in effect, we will make that deduction based on the proportion
that your unloaned value in our GIA and your values in the investment funds of
our SA bear to the total unloaned value in your Policy Account.
TRANSFERS. Transfer requests must be in writing and delivered by U.S. mail to
our Administrative Office unless we accept an alternative form of communication
(such as internet or automated telephone). The use of alternative forms of
communication is subject to our rules then in effect for each such service. We
may provide information about our rules and the use of communications services
in the policy prospectus, prospectus supplements or other notifications, as
mailed to your last known address in our records from time to time. Any
alternative form of communication that we make available may be changed or
discontinued at any time. Communications services may be restricted or denied if
we determine that you are using such services for market timing or other trading
strategies that may disrupt operation of an investment fund of our SA or have a
detrimental effect on the unit value of any investment fund of our SA.
We reserve the right to:
1. limit transfers among or to the investment funds of our SA to no more than
once every 30 days;
2. require a minimum time period between each transfer into or out of one or
more specified investment funds of our SA;
3. establish a maximum dollar amount that may be transferred by an owner on any
transaction date among investment funds of our SA;
4. reject transfer requests from a person acting on behalf of multiple policy
owners unless pursuant to a trading authorization agreement that we have
accepted;
5. impose conditions or limitations on transfer rights, restrict transfers or
refuse any particular transfer if we are concerned that market timing, excessive
trading or other trading strategies may disrupt operation of an investment fund
of our SA or may have a detrimental effect on the unit value of any investment
fund of our SA or determine that you have engaged in any such strategy.
At your written request to our Administrative Office, we will transfer amounts
from your value in any investment fund of our SA to one or more other funds of
our SA or to our GIA. Any such transfer will take effect on the date we receive
your written request at our Administrative Office.
Once during each policy year you may ask us, by written request to our
Administrative Office, to transfer an amount you specify from your unloaned
value in our GIA to one or more investment funds of our SA. We must receive your
request within a period beginning 30 days prior to the policy anniversary and
ending 60 days after the policy anniversary. A transfer request received up to
30 days prior to the policy anniversary will be effective on the anniversary. A
transfer request received on or within 60 days after the policy anniversary will
be effective on the date the request is received at our Administrative Office.
The maximum amount that you may transfer in
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any policy year is the greater of (a) $500, (b) 25% of the unloaned value in the
GIA on the policy anniversary, or (c) the amount transferred from the GIA in the
immediately preceding policy year, if any. In no event will we transfer more
than your unloaned value in our GIA.
The minimum amount that we will transfer from your value in an investment fund
of our SA on any date is the lesser of $500.00 or your value in that investment
fund on that date, except as stated in the next paragraph. The minimum amount
that we will transfer from your value in our GIA is the lesser of $500.00 or
your unloaned value in our GIA as of the date the transfer takes effect, except
as stated in the next paragraph.
We will waive the minimum amount limitations set forth in the immediately
preceding paragraph if the total amount being transferred on that date is at
least $500.00.
We reserve the right to make a transfer charge up to $25.00 for each transfer of
amounts among your investment options. The transfer charge, if any, is deducted
from the amounts transferred from the investment funds of our SA and our GIA
based on the proportion that the amount transferred from each investment fund of
our SA and our GIA bears to the total amount being transferred.
If you ask us to transfer the entire amount of your value in the investment
funds of our SA to our GIA, we will not make a charge for that transfer.
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THE VALUE OF YOUR POLICY ACCOUNT
The amount in your Policy Account at any time is equal to the sum of the amounts
you then have in our GIA and in the investment funds of our SA under this
policy. Your Net Policy Account Value is equal to the amount in your Policy
Account minus any policy loan and accrued loan interest.
YOUR VALUE IN OUR GIA. The amount you have in our GIA at any time is equal to
the amounts allocated and transferred to it, plus the interest credited to it,
minus amounts deducted, transferred and withdrawn from it. We will credit the
amount in our GIA with interest at rates we determine. We will determine such
interest rates periodically in advance for unloaned and loaned amounts in our
GIA. The rates may be different for unloaned and loaned amounts. Any change in
the interest rates we determine will be as described in the "Changes in Policy
Cost Factors" provision. Such interest rates will not be less than 3%. Interest
accrues and is credited on unloaned amounts in the GIA daily. However, we will
credit interest on any portion of the initial net premium allocated to our GIA
from the Register Date if it is later than the date of receipt provided the
initial premium is at least equal to the minimum initial premium shown on Page 3
of the policy.
We credit interest on the loaned portion of our GIA daily. The interest rate we
credit to the loaned portion of our GIA will be at an annual rate up to 2% less
than the loan interest rate we charge. However, we reserve the right to credit a
lower rate than this if in the future tax laws change such that our taxes on
policy loans or policy loan interest are increased. In no event will we credit
less than 3% a year.
On each policy anniversary, and at any time you repay all of a policy loan, we
allocate the interest that has been credited to the loaned portion of our GIA to
the investment funds of our SA and the unloaned portion of our GIA in accordance
with your premium allocation percentages.
YOUR VALUE IN THE INVESTMENT FUNDS OF OUR SA. The amount you have in an
investment fund of our SA under this policy at any time is equal to the number
of units this policy then has in that fund multiplied by the fund's unit value
at that time.
Amounts allocated, transferred or added to an investment fund of our SA are used
to purchase units of that fund; units are redeemed when amounts are deducted,
loaned, transferred or withdrawn. These transactions are called policy
transactions.
11
The number of units a policy has in an investment fund at any time is equal to
the number of units purchased minus the number of units redeemed in that fund to
that time. The number of units purchased or redeemed in a policy transaction is
equal to the dollar amount of the policy transaction divided by the fund's unit
value on the date of the policy transaction. Policy transactions may be made on
any day. The unit value that applies to a transaction made on a business day
will be the unit value for that day. The unit value that applies to a
transaction made on a non-business day will be the unit value for the next
business day.
We determine unit values for the investment funds of our SA at the end of each
business day. Generally, a business day is any day the New York Stock Exchange
is open for trading. A business day immediately preceded by one or more
non-business days will include those non-business days as part of that business
day. For example, a business day which falls on a Monday will consist of that
Monday and the immediately preceding Saturday and Sunday.
The unit value of an investment fund of our SA on any business day is equal to
the unit value for that fund on the immediately preceding business day
multiplied by the net investment factor for that fund on that business day.
The net investment factor for an investment fund of our SA on any business day
is (a) divided by (b), minus (c), where:
(a) is the net asset value of the shares in designated investment companies
that belong to the investment fund at the close of business on such
business day before any policy transactions are made on that day, plus the
amount of any dividend or capital gain distribution paid by the investment
companies on that day;
(b) is the value of the assets in that investment fund at the close of business
on the immediately preceding business day after all policy transactions
were made for that day; and
(c) is a charge for each calendar day in that business day, as defined above,
corresponding to a charge not exceeding .90% yearly for mortality and
expense risks, plus any charge for that day for taxes, amounts set aside as
a reserve for taxes, or any operating expenses of our SA (including,
without limitation, SEC registration fees and auditing fees).
The net asset value of an investment company's shares held in each investment
fund shall be the value reported to us by that investment company.
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THE CASH SURRENDER VALUE OF THIS POLICY
CASH SURRENDER VALUE. The Cash Surrender Value on any date is equal to the
amount in your Policy Account on that date minus any applicable surrender
charge.
NET CASH SURRENDER VALUE. The Net Cash Surrender Value is equal to the Cash
Surrender Value minus any policy loan and accrued loan interest. You may give up
this policy for its Net Cash Surrender Value at any time while the insured
person is living. You may do this by sending us a written request for it and
this policy to our Administrative Office. Your written request for cancellation
or surrender must include the following:
1. A statement that makes it clear that you intend to surrender the contract;
2. The policy number of the policy to be surrendered;
3. The name of the insured person and your name (if other than the insured
person) and address where proceeds should be mailed;
4. Your signature and, if required by the policy or by a legally binding
document of which we have an actual notice, the signature of a collateral
assignee, irrevocable beneficiary, or other person having an interest in the
policy through the legally binding document.
If this policy has a cash surrender value and is being given up for its net cash
surrender value, a completed withholding authorization must also be included
with your written request. If this form is not provided to us with your written
request for surrender, we will withhold income tax on the taxable portion of
your distribution at the mandated federal and state tax rates. We will compute
the Net Cash Surrender Value as of the date we receive
12
your request for it and this policy at our Administrative Office. If the policy
has been lost, stolen or destroyed, you must include a statement in the written
request that the policy was lost, stolen or destroyed with an approximate date
of when the policy was lost, stolen or destroyed. All insurance coverage under
this policy ends on the date we receive your written request.
SURRENDER CHARGES. If you give up this policy for its Net Cash Surrender Value
before the end of the tenth policy year, we will subtract a surrender charge
from your Policy Account. A table of surrender charges for the BASE POLICY face
amount is in the "Policy Information" section.
If the BASE POLICY Face Amount of Insurance is reduced before the end of the
tenth policy year, we will also deduct a proportionate amount of any applicable
surrender charge from your Policy Account. Such deduction will be made in
accordance with the "Allocations" provision.
We have filed a detailed statement of the method of computing surrender charges
with the insurance supervisory official of the jurisdiction in which this policy
is delivered.
PARTIAL NET CASH SURRENDER VALUE WITHDRAWAL. After the first policy year, and
while the insured person is living, you may ask for a partial Net Cash Surrender
Value withdrawal by written request to our Administrative Office. Your request
will be subject to our approval based on our rules in effect when we receive
your request, and to the minimum withdrawal amount of $500.00. We have the right
to decline a request for a partial Net Cash Surrender Value withdrawal if this
would cause the policy to fail to qualify as life insurance under applicable tax
law, as interpreted by us. We will decline a request for a partial Net Cash
Surrender Value withdrawal If this would cause a decrease in base policy face
amount to less than $200,000. A partial withdrawal will result in a reduction in
the Cash Surrender Value and in your Policy Account equal to the amount
withdrawn as well as a reduction in your death benefit. If the death benefit is
Option A, the withdrawal may also result in a decrease in the face amount; there
will be no proportionate surrender charge due to such a decrease.
You may tell us how much of each partial withdrawal is to come from your
unloaned value in our GIA and from your values in each of the investment funds
of our SA. If you do not tell us, we will make the withdrawal on the basis of
your monthly deduction allocation percentages then in effect. If we cannot make
the withdrawal as indicated above, we will make the withdrawal based on the
proportion that your unloaned value in our GIA and your values in the investment
funds of our SA bear to the total unloaned value in your Policy Account.
Such withdrawal and resulting reduction in the death benefit, in the Cash
Surrender Value and in your Policy Account will take effect on the date we
receive your written request at our Administrative Office. We will send you a
new "Policy Information" section if a withdrawal results in a reduction in the
Face Amount of Insurance. It will become a part of this policy. We may require
you to return this policy to our Administrative Office to make a change.
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HOW A LOAN CAN BE MADE
POLICY LOANS. You can take a loan on this policy while it has a loan value. This
policy will be the only security for the loan. Any amount on loan is part of
your Policy Account. We refer to this as the loaned portion of your Policy
Account.
Carry Over Loans. If this policy was issued based, in whole or part, upon a
valid exchange under Section 1035 of the Internal Revenue Code, any transferred
existing loan from the exchanged policy as approved by us will be put into your
Loaned Policy Account. If a refund is made under the "Right to Examine Policy"
provision, we will subtract any policy loan and accrued loan interest from that
refund.
13
LOAN VALUE. The loan value on any date is 90% of the Cash Surrender Value on
that date. The amount of any new loan you take may not be more than the loan
value, less any existing loan and accrued loan interest. If you request an
increase to an existing loan, the additional amount requested will be added to
the amount of the existing loan and accrued loan interest.
Your request for a policy loan must be in writing to our Administrative Office.
You may tell us how much of the requested loan is to be allocated to your
unloaned value in our GIA and your value in each investment fund of our SA. Such
values will be determined as of the date we receive your request. If you do not
tell us, we will allocate the loan on the basis of your monthly deduction
allocation percentages then in effect. If we cannot allocate the loan on the
basis of your direction or those percentages, we will allocate it based on the
proportion that your unloaned value in our GIA and your values in the investment
funds of our SA bear to the total unloaned value in your Policy Account.
The loaned portion of your Policy Account will be maintained as a part of our
GIA. Thus, when a loaned amount is allocated to an investment fund of our SA, we
will redeem units of that investment fund sufficient in value to cover the
amount of the loan so allocated and transfer that amount to our GIA.
LOAN INTEREST. Interest on a loan accrues daily at an adjustable loan interest
rate. We will determine the rate at the beginning of each policy year, subject
to the following paragraphs. It will apply to any new or outstanding loan under
the policy during the policy year next following the date of determination.
The maximum loan interest rate for a policy year shall be the greater of (1) the
"Published Monthly Average," as defined below, for the calendar month that ends
two months before the date of determination or (2) 4%. "Published Monthly
Average" means the Monthly Average Corporates yield shown in Moody's Corporate
Bond Yield Averages published by Xxxxx'x Investors Service, Inc., or any
successor thereto. If such averages are no longer published, we will use such
other averages as may be established by regulation by the insurance supervisory
official of the jurisdiction in which this policy is delivered. We reserve the
right to establish a rate lower than the maximum.
No change in the rate shall be less than 1/2 of 1% a year. We may increase the
rate whenever the maximum rate as determined by clause (1) of the preceding
paragraph exceeds the rate being charged by 1/2 of 1% or more. We will reduce
the rate to or below the maximum rate as determined by clause (1) of the
preceding paragraph if such maximum is lower than the rate being charged by 1/2
of 1% or more.
We will notify you of the initial loan interest rate when you make a loan. We
will also give you advance written notice of any increase in the interest rate
of any outstanding loan.
Loan interest is due on each policy anniversary. If the interest is not paid
when due, it will be added to your outstanding loan and allocated on the basis
of the deduction allocation percentages then in effect. If we cannot make the
allocation on the basis of these percentages, we will make it based on the
proportion that your unloaned values in our GIA and your values in the
investment funds of our SA bear to the total unloaned value in your Policy
Account. The unpaid interest will then be treated as part of the loaned amount
and will bear interest at the loan rate.
When unpaid loan interest is allocated to an investment fund of our SA, we will
redeem units of that investment fund sufficient in value to cover the amount of
the interest so allocated and transfer that amount to your loaned Policy
Account.
LOAN REPAYMENT. You may repay all or part of a policy loan at any time while the
insured person is alive and this policy is in force.
Repayments will first be allocated to our GIA until you have repaid any loaned
amounts that were allocated to our GIA. You may tell us how to allocate
repayments above that amount among our GIA and the investment funds of our SA.
If you do not tell us, we will make the allocation on the basis of the premium
allocation percentages then in effect.
Failure to repay a policy loan or to pay loan interest will not terminate this
policy unless at the beginning of a
14
policy month the Net POLICY ACCOUNT VALUE is less than the total monthly
deduction then due. In that case, the "Grace Period" provision will apply.
A policy loan will have a permanent effect on your benefits under this policy
even if it is repaid.
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OUR SEPARATE ACCOUNT(S) (SA)
We established and we maintain our SA under the laws of New York State. Realized
and unrealized gains and losses from the assets of our SA are credited to or
charged against it without regard to our other income, gains, or losses. Assets
are put in our SA to support this policy and other variable life insurance
policies. Assets may be put in our SA for other purposes, but not to support
contracts or policies other than variable contracts.
The assets of our SA are our property. The portion of its assets equal to the
reserves and other policy liabilities with respect to our SA will not be
chargeable with liabilities arising out of any other business we conduct. We may
transfer assets of an investment fund in excess of the reserves and other
liabilities with respect to that fund to another investment fund or to our
General Account.
INVESTMENT FUNDS. Our SA consists of investment funds. Each fund may invest its
assets in a separate class of shares of a designated investment company, or
companies, or make direct investments in securities. The investment funds of our
SA, that you chose for your initial allocations, are shown on the application
for this policy, a copy of which is attached to this policy. We may from time to
time make other investment funds available to you, or we may create a new SA. We
will provide you with written notice of all material details including
investment objectives and all charges.
We have the right to change or add designated investment companies. We have the
right to add or remove investment funds. We have the right to withdraw assets of
a class of policies to which this policy belongs from an investment fund and put
them in another investment fund. We also have the right to combine any two or
more investment funds. The term investment fund in this policy shall then refer
to any other investment fund in which the assets of a class of policies to which
this policy belongs were placed.
We have the right to:
1. register or deregister any SA available under this policy under the
Investment Company Act of 1940;
2. run any SA available under this policy under the direction of a committee,
and discharge such committee at any time;
3. restrict or eliminate any voting rights of policy owners, or other persons
who have voting rights as to any SA available under this policy; and
4. operate any SA available under this policy, or one or more of its investment
funds, by making direct investments or in any other form. If we do so, we may
invest the assets of such SA, or one or more of the investment funds, in any
legal investments. We will rely upon our own or outside counsel for advice in
this regard. Also, unless otherwise required by law or regulation, an
investment adviser or any investment policy may not be changed without our
consent. If required by law or regulation, the investment policy of an
investment fund of any SA available under this policy will not be changed by
us unless approved by the Superintendent of Insurance of New York State or
deemed approved in accordance with such law or regulation. If so required,
the process for getting such approval is on file with the insurance
supervisory official of the jurisdiction in which this policy is delivered.
If any of these changes result in a material change in the underlying
investments of an investment fund of our SA, we will notify you of such change,
as required by law. If you have value in that investment fund we will, if you
wish, transfer it at your written direction from that fund to another fund(s) of
our SA or to our GIA, and you may then change your premium and deduction
allocation percentages. There will be no charge for such a transfer.
15
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OUR ANNUAL REPORT TO YOU
For each policy year we will send you without charge a report for this policy
that shows the current death benefit, the value you have in our GIA and in each
investment fund of any SA available under this policy, the Cash Surrender Value
and any policy loan with the current loan interest rate. It will also show the
premiums paid and any other information as may be required by the insurance
supervisory official of the jurisdiction in which this policy is delivered.
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HOW BENEFITS ARE PAID
You can have the Insurance Benefit or your Net Cash Surrender Value withdrawals
paid immediately in one sum. Or, you can choose another form of payment for all
or part of them. If you do not arrange for a specific choice before the insured
person dies, the beneficiary will have this right when the insured person dies.
If you do make an arrangement, however, the beneficiary cannot change it after
the insured person dies.
The options are:
1. DEPOSIT. The sum will be left on deposit for a period mutually agreed upon.
We will pay interest at the end of every month, every 3 months, every 6
months or every 12 months, as chosen.
2. INSTALLMENT PAYMENTS. There are two ways that we pay installments:
A. FIXED PERIOD. We will pay the sum in equal installments for a specified
number of years (not more than 30). The installments will be at least
those shown in the Table of Guaranteed Payments.
B. FIXED AMOUNT. We will pay the sum in installments as mutually agreed upon
until the original sum, together with interest on the unpaid balance, is
used up.
3. MONTHLY LIFE INCOME. We will pay the sum as a monthly income for life. The
amount of the monthly payment will be at least that shown in the Table of
Guaranteed Payments. The basis for these payments is the 1983 Individual
Annuity Mortality Table "a" projected with modified Scale G. You may choose
any one of three ways to receive monthly life income. We will guarantee
payments for at least 10 years (called "10 Years Certain"); at least 20 years
(called "20 Years Certain"); or until the payments we make equal the original
sum (called "Refund Certain").
Payments that we make under options 1. - 3. above will not be affected by the
investment experience of any investment fund of our SA after proceeds are
applied under such options.
We will also apply the sum under any other option requested that we make
available at the time of payment.
The payee may name and change a successor payee for any amount we would
otherwise pay to the payee's estate.
Any arrangements involving more than one of the options, or a payee who is not a
natural person (for example, a corporation) or who is a fiduciary, must have our
approval. Also, details of all arrangements will be subject to our rules at the
time the arrangement takes effect. These include rules on the minimum amount we
will apply under an option and minimum amounts for installment payments,
withdrawal or commutation rights, naming payees and successor payees and proving
age and survival.
Payment choices (or any later changes) will be made and will take effect in the
same way as a change of beneficiary. Amounts applied under these options will
not be subject to the claims of creditors or to legal process, to the extent
permitted by law.
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OTHER IMPORTANT INFORMATION
YOUR CONTRACT WITH US. This policy is issued in consideration of payment of a
premium at least equal to the minimum initial premium payment shown in the
"Policy Information" section.
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This policy, any riders or endorsements, and the attached copy of the initial
application and all subsequent applications to change this policy, and all
additional "Policy Information" sections added to this policy, make up the
entire contract. The rights conferred by this policy are in addition to those
provided by applicable Federal and State laws and regulations.
Only our Chairman of the Board, our President or one of our Vice Presidents can
modify this contract or waive any of our rights or requirements under it. The
person making these changes must put them in writing and sign them.
POLICY CHANGES -- APPLICABLE TAX LAW. For you and the beneficiary to receive the
tax treatment accorded to life insurance under Federal law, this policy must
qualify initially and continue to qualify as life insurance under the Code or
successor law. Therefore, we have reserved earlier in this policy the right to
decline to accept premium payments, to decline to change death benefit options,
to decline to change the Face Amount of Insurance, or to decline to make partial
withdrawals that, in our opinion, would cause this policy to fail to qualify as
life insurance under applicable tax law. Further, we reserve the right to make
changes in this policy or its riders (for example, in the percentages on Page
6), or to require additional premium payments, or to make distributions from
this policy or to change the Face Amount of Insurance to the extent we deem it
necessary to continue to qualify this policy as life insurance. Any such changes
will apply uniformly to all policies that are affected. You will be given
advance written notice of such changes.
CHANGES IN POLICY COST FACTORS. Changes in policy cost factors (interest rates
we credit, cost of insurance deductions and expense charges) will be by class
and based upon changes in future expectations for such elements as investment
earnings, mortality, persistency, expenses and taxes. Any change in policy cost
factors will be determined in accordance with procedures and standards on file,
if required, with the insurance supervisory official of the jurisdiction in
which this policy is delivered.
WHEN THE POLICY IS INCONTESTABLE. We have the right to contest the validity of
this policy based on material misstatements made in the initial application for
this policy. We also have the right to contest the validity of any policy change
or restoration based on material misstatements made in any application for that
change or restoration. However, we will not contest the validity of this policy
after it has been in effect during the lifetime of the insured person for two
years from the earlier of the Register Date or the date of issue shown in the
"Policy Information" section. We will not contest any policy change that
requires evidence of insurability, or any restoration of this policy, after the
change or restoration has been in effect for two years during the insured
person's lifetime.
No statement shall be used to contest a claim unless contained in an
application.
All statements made in an application are representations and not warranties.
See any additional benefit riders for modifications of this provision that apply
to them.
WHAT IF AGE OR SEX HAS BEEN MISSTATED? If the insured person's age or sex has
been misstated on any application, the death benefit and any benefits provided
by riders to this policy shall be those which would be purchased by the most
recent deduction for the cost of insurance, and the cost of any benefits
provided by riders, at the correct age and sex.
HOW THE SUICIDE EXCLUSION AFFECTS BENEFITS. If the insured person commits
suicide (while sane or insane) within two years after the earlier of the
Register Date or the date of issue shown in the "Policy Information" section,
our liability will be limited to the payment of a single sum. This sum will be
equal to the premiums paid, minus any loan and accrued loan interest and minus
any partial withdrawal of the Net Cash Surrender Value. If the insured person
commits suicide (while sane or insane) within two years after the effective date
of a change that you asked for that increases the death benefit, then our
liability as to the increase in amount will be limited to the payment of a
single sum equal to the monthly cost of insurance deductions made for such
increase.
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HOW WE MEASURE POLICY PERIODS AND ANNIVERSARIES. We measure policy years, policy
months, and policy anniversaries from the Register Date shown in the "Policy
Information" section. Each policy month begins on the same day in each calendar
month as the day of the month in the Register Date.
HOW, WHEN AND WHAT WE MAY DEFER. We may not be able to obtain the value of the
assets of the investment funds of our SA if (1) the New York Stock Exchange is
closed; or (2) the Securities and Exchange Commission requires trading to be
restricted or declares an emergency. During such times, as to amounts allocated
to the investment funds of our SA, we may defer:
1. Determination and payment of Net Cash Surrender Value withdrawals (except
when used to pay premiums to us);
2. Determination and payment of any death benefit in excess of the Face Amount
of Insurance;
3. Payment of loans (except when used to pay premiums to us) ;
4. Determination of the unit values of the investment funds of our SA; and
5. Any requested transfer.
As to amounts allocated to our GIA, we may defer payment of any Net Cash
Surrender Value withdrawal or loan amount (except when used to pay premiums to
us) for up to six months after we receive a request for it. We will allow
interest, at the rate of at least 3% a year, on any Net Cash Surrender Value
payment derived from our GIA that we defer for 30 days or more.
THE BASIS WE USE FOR COMPUTATION. We provide Cash Surrender Values that are at
least equal to those required by law. If required to do so, we have filed with
the insurance supervisory official of the jurisdiction in which this policy is
delivered a detailed statement of our method of computing such values. We
compute reserves under this policy by the Commissioners Reserve Valuation
Method.
We base minimum cash surrender values and reserves on the Commissioners 1980
Standard Ordinary Male or Female Mortality Tables at attained ages 0-17 or the
Commissioners 1980 Standard Ordinary, Male or Female, Smoker or Non-Smoker,
Mortality Tables at attained ages 18 and over. We also use these tables as the
basis for determining maximum insurance costs, taking account of sex, attained
age, class of risk and tobacco user status of the insured person. We use an
effective annual interest rate of 3%.
POLICY ILLUSTRATIONS. Upon request we will give you an illustration of the
future benefits under this policy, based upon both guaranteed and current cost
factor assumptions.
POLICY CHANGES. You may add additional benefit riders or make other changes,
subject to our rules at the time of change.
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TABLE OF GUARANTEED PAYMENTS
(MINIMUM AMOUNT FOR EACH $1,000 APPLIED)
OPTION 2A OPTION 3
FIXED PERIOD INSTALLMENTS MONTHLY LIFE INCOME
------------------------- -------------------
NUMBER OF 10 YEARS CERTAIN 20 YEARS CERTAIN REFUND CERTAIN
YEARS' MONTHLY ANNUAL ---------------- ---------------- --------------
INSTALLMENTS INSTALLMENT INSTALLMENT AGE MALE FEMALE MALE FEMALE MALE FEMALE
------------ ----------- ----------- --- ---- ------ ---- ------ ---- ------
1 $84.28 $1,000.00 50 $3.48 $3.19 $3.42 $3.17 $3.37 $3.14
2 42.66 506.17 51 3.54 3.23 3.47 3.21 3.42 3.17
3 28.79 341.60 52 3.59 3.28 3.51 3.25 3.46 3.21
4 21.86 259.33 53 3.65 3.32 3.56 3.29 3.51 3.25
5 17.70 210.00 54 3.70 3.37 3.61 3.33 3.56 3.29
6 14.93 177.12 55 3.77 3.42 3.66 3.37 3.61 3.34
7 12.95 153.65 56 3.83 3.47 3.72 3.42 3.67 3.38
8 11.47 136.07 57 3.90 3.52 3.77 3.47 3.72 3.43
9 10.32 122.40 58 3.97 3.58 3.83 3.52 3.78 3.48
10 9.39 111.47 59 4.04 3.64 3.88 3.57 3.84 3.53
11 8.64 102.54 60 4.12 3.70 3.94 3.62 3.90 3.58
12 8.02 95.11 61 4.20 3.76 4.00 3.68 3.97 3.64
13 7.49 88.83 62 4.29 3.83 4.06 3.74 4.04 3.69
14 7.03 83.45 63 4.38 3.90 4.12 3.79 4.11 3.75
15 6.64 78.80 64 4.48 3.98 4.18 3.85 4.19 3.82
16 6.30 74.73 65 4.58 4.06 4.25 3.92 4.26 3.88
17 6.00 71.15 66 4.68 4.14 4.31 3.98 4.35 3.95
18 5.73 67.97 67 4.79 4.23 4.37 4.04 4.43 4.02
19 5.49 65.13 68 4.90 4.32 4.43 4.11 4.52 4.10
20 5.27 62.58 69 5.02 4.42 4.50 4.18 4.62 4.18
21 5.08 60.28 70 5.14 4.52 4.56 4.25 4.71 4.26
22 4.90 58.19 71 5.26 4.63 4.62 4.31 4.82 4.35
23 4.74 56.29 72 5.39 4.75 4.67 4.38 4.92 4.44
24 4.60 54.55 73 5.52 4.87 4.73 4.45 5.03 4.53
25 4.46 52.95 74 5.66 4.99 4.78 4.51 5.14 4.63
26 4.34 51.48 75 5.80 5.12 4.83 4.58 5.27 4.74
27 4.22 50.12 76 5.95 5.26 4.88 4.64 5.39 4.84
28 4.12 48.87 77 6.10 5.40 4.93 4.70 5.53 4.96
29 4.02 47.70 78 6.25 5.55 4.97 4.75 5.66 5.08
30 3.93 46.61 79 6.40 5.70 5.01 4.80 5.80 5.20
80 6.56 5.85 5.04 4.86 5.96 5.33
81 6.72 6.01 5.08 4.90 6.11 5.45
82 6.88 6.18 5.11 4.95 6.27 5.60
83 7.04 6.34 5.13 4.99 6.43 5.73
84 7.20 6.51 5.16 5.03 6.62 5.89
85 & over 7.36 6.67 5.18 5.07 6.81 6.04
If installments are paid every 3 months, they Amounts for Monthly Life Income are based on age nearest birthday
will be 25.23% of the annual installments. If when income starts. Amounts for ages not shown will be furnished on
they are paid every 6 months, they will be request.
50.31% of the annual installments.
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THE EQUITABLE
LIFE ASSURANCE SOCIETY OF THE UNITED STATFS
A Stock Life Insurance Company
Home Office: 0000 Xxxxxx xx xxx Xxxxxxxx, Xxx Xxxx, Xxx Xxxx 00000
Flexible Premium Variable Life Insurance Policy. Insurance benefit payable
upon the death of the insured person while this policy is in force.
Premiums may be paid while the insured person is living. Values provided
by this policy are based on declared interest rates and on the unit values
of the investment funds of a separate account, which in turn depend on the
investment performance of the securities held by such investment funds.
They are not guaranteed as to dollar amount. This is a non-participating
policy.
No.02-100