INSURED PERSON [EQUITABLE VARIABLE LIFE
INSURANCE COMPANY LOGO]
POLICY OWNER
VARIABLE
INITIAL LIFE
INSURANCE BENEFIT INSURANCE
POLICY
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WE AGREE to pay the Insurance Benefit of this policy to the beneficiary upon
receiving proof of the insured person's death.
We will deduct any unpaid policy loan and loan interest and any overdue charges
prior to such payment. We also agree to provide you (the policy Owner) with the
other rights and benefits of this policy.
These agreements are subject to the provisions of this policy.
The amount of the initial premium for this policy is shown on Page 3.
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VARIABLE LIFE INSURANCE PLAN WITH ADDITIONAL PREMIUM OPTION
This is a variable life insurance policy with premium flexibility. You can:
o make additional premium payments, within limits;
o change the allocation of the premiums among your investment options; and
o transfer amounts, within limits, among your investment options.
All of these rights and benefits are subject to the terms and conditions of this
policy.
We will put your initial premium and any subsequent net premiums into your
Policy Account. You may then allocate them to one or more investment divisions
of our Separate Account (SA).
THEAMOUNT OF YOUR POLICY ACCOUNT WILL VARY UP OR DOWN DEPENDING ON THE UNIT
VALUE OF THE INVESTMENT DIVISIONS OF OUR SA, WHICH IN TURN DEPENDS ON THE
INVESTMENT PERFORMANCE OF THE CORRESPONDING PORTFOLIOS OF A DESIGNATED
INVESTMENT COMPANY. THERE ARE NO MINIMUM GUARANTEES AS TO THE AMOUNT OF YOUR
POLICY ACCOUNT.
THE AMOUNT OF THE INSURANCE BENEFIT IS BASED ON THE AMOUNT IN YOUR POLICY
ACCOUNT AND WILL VARY AS DESCRIBED ON PAGE 5.
This is a non-participating policy.
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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 the 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 premium paid under this
policy.
/s/ Xxxxx Xxxxx /s/ Xxxxxx X. Xxxxx Chairman
Xxxxx Xxxxx Secretary Xxxxxx X. Xxxxx of the Board
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No. 87-500
CONTENTS
--------
Policy Information 3
Table of Factors 4
Table of Guaranteed Maximum Percentages
for Cost of Insurance Charges 4A
Those Who Benefit from this Policy 5
The Benefits We Pay 5
The Premiums You Pay 6
Your Investment Options 6
The Value of Your Policy Account 7
The Cash Surrender Value of this Policy 10
How a Loan Can Be Made 10
Our Separate Account (SA) 11
Our Annual Report To You 12
Exchange of Policy 13
How Benefits Are Paid 13
Other Important Information 14
A copy of the application for this policy is at the back of this policy.
ADMINISTRATIVE OFFICE
---------------------
The address of our Administrative Office is shown on Page 3. You should send any
additional premium payments and requests to that address unless instructed
otherwise.
IN THIS POLICY:
--------------
"We," "our," and "us" mean Equitable Variable Life Insurance Company.
"You" and "your" mean the owner of this policy at the time an owner's right is
exercised.
No. 87-500 Page 2
POLICY INFORMATION
Insured Person Xxxxxxx Xxx
Policy Owner Xxxxxxx Xxx
Initial
Insurance Benefit $100,000 Initial Premium $25,172.43
Policy Number XX XXX XXX Benefits Life Insurance
Variable
Beneficiary Xxxxxxxx X. Xxx
Register Date Jul 26, 1987 Issue Age 35
Date of Issue Jul 26, 1987 Sex Male
Additional Premium Minimum Amount is $[1,000]
Policy Loan Minimum Amount is $[500]
Transfer Minimum Amount is $[500]
State of Residence Specimen
**** Administrative Office: Equitable Variable Life Insurance Company ****
Specimen Life Insurance Center
000 Xxxxxxxx Xxxxxx
Xxxx, Xxxxx 00000
87-500-3 Page 3 (continued on next page)
POLICY INFORMATION (CONTINUED) -- POLICY NUMBER XX XXX XXX
POLICY CHARGES
For Transfers: After the first four transfers of amounts in a policy
year among your investment options, we may charge up
to [$25.00] for each additional transfer in that
policy year.
For Additional Premiums: We deduct a [$25.00] administrative charge from each
additional premium before we put it into your Policy
Account.
Surrender Charges: A surrender charge applies to the initial premium
during the first [7] policy years. In the first policy
year it is equal to [7%] of the initial premium. It
decreases by [1%] in each successive policy year to
[1%] of the initial premium in the [seventh] policy
year. Thereafter, no surrender charges apply to the
initial premium. (See Page 10.)
A surrender charge applies to each additional premium
during the first [5] policy years after we receive it
at our Administrative Office. During the policy year
in which we receive an additional premium, the
surrender charge is equal to [5%] of that premium. The
surrender charge for that premium decreases by [1%] in
each successive policy year to [1%] of that premium in
the [fifth] policy year after we receive it.
Thereafter, no surrender charges apply to that
additional premium. (See Page 10.)
87-500-3 Page 3 (continued)
TABLE OF FACTORS
Male
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Attained Attained
Age Factor Age Factor
-------- ------ -------- ------
0 12.3773 50 2.4728
1 12.3773 51 2.4008
2 12.0449 52 2.3317
3 11.7071 53 2.2654
4 11.3737 54 2.2019
5 11.0429 55 2.1412
6 10.7130 56 2.0831
7 10.3850 57 2.0275
8 10.0595 58 1.9742
9 9.7383 59 1.9230
10 9.4234 60 1.8740
11 9.1158 61 1.8269
12 8.8192 62 1.7818
13 8.5355 63 1.7387
14 7.6552 64 1.6976
15 7.4164 65 1.6584
16 7.1912 66 1.6211
17 6.9785 67 1.5855
18 6.7763 68 1.5516
19 6.5819 69 1.5191
20 6.3938 70 1.4880
21 6.2102 71 1.4583
22 6.0300 72 1.4301
23 5.8526 73 1.4033
24 5.6776 74 1.3781
25 5.5051 75 1.3546
26 5.3350 76 1.3325
27 5.1677 77 1.3117
28 5.0038 78 1.2922
29 4.8436 79 1.2737
30 4.6874 80 1.2560
31 4.5354 81 1.2392
32 4.3879 82 1.2232
33 4.2448 83 1.2082
34 4.1064 84 1.1942
35 3.9726 85 1.1812
36 3.8433 86 1.1692
37 3.7186 87 1.1580
38 3.5985 88 1.1475
39 3.4829 89 1.1374
40 3.3717 90 1.1277
41 3.2649 91 1.1181
42 3.1623 92 1.1082
43 3.0636 93 1.0979
44 2.9689 94 1.0869
45 2.8779 95 1.0748
46 2.7904 96 1.0616
47 2.7064 97 1.0476
48 2.6255 98 1.0334
49 2.5477 99 1.0198
Female
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Attained Attained
Age Factor Age Factor
-------- ------ -------- ------
0 14.2337 50 2.8872
1 14.2203 51 2.8017
2 13.8293 52 2.7193
3 13.4342 53 2.6399
4 13.0430 54 2.5636
5 12.6564 55 2.4901
6 12.2761 56 2.4192
7 11.9000 57 2.3508
8 11.5309 58 2.2845
9 11.1681 59 2.2202
10 10.8128 60 2.1577
11 10.4653 61 2.0971
12 10.1276 62 2.0385
13 9.8011 63 1.9820
14 8.4855 64 1.9279
15 9.1817 65 1.8762
16 8.8891 66 1.8268
17 8.6070 67 1.7794
18 8.3350 68 1.7339
19 8.0712 69 1.6899
20 7.8159 70 1.6474
21 7.5693 71 1.6064
22 7.3277 72 1.5670
23 7.0937 73 1.5294
24 6.8663 74 1.4937
25 6.6457 75 1.4601
26 6.4313 76 1.4285
27 6.2233 77 1.3987
28 6.0215 78 1.3706
29 5.8259 79 1.3440
30 5.6364 80 1.3188
31 5.4530 81 1.2949
32 5.2755 82 1.2724
33 5.1035 83 1.2513
34 4.9369 84 1.2316
35 4.7761 85 1.2135
36 4.6205 86 1.1967
37 4.4706 87 1.1811
38 4.2086 88 1.1665
39 4.0727 89 1.1528
40 3.9423 90 1.1398
41 3.8173 91 1.1272
42 3.6973 92 1.1148
43 3.5822 93 1.1024
44 3.4714 94 1.0897
45 3.3649 95 1.0764
46 3.2622 96 1.0624
47 3.1633 97 1.0480
48 3.0679 98 1.0335
49 2.9759 99 1.0198
87-500-4 Page 4
TABLE OF GUARANTEED MAXIMUM PERCENTAGES FOR COST OF
INSURANCE CHARGES PER YEAR
Male
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Attained Annual Attained Annual
Age Percentage Age Percentage
-------- ---------- -------- ----------
0 3.846% 50 .962%
1 1.193 51 .995
2 1.071 52 1.032
3 1.028 53 1.073
4 .965 54 1.118
5 .885 55 1.163
6 .808 56 1.208
7 .735 57 1.249
8 .674 58 1.289
9 .633 59 1.327
10 .602 60 1.368
11 .611 61 1.413
12 .650 62 1.462
13 .730 63 1.516
14 .749 64 1.574
15 .835 65 1.633
16 .915 66 1.689
17 .977 67 1.741
18 1.006 68 1.790
19 1.016 69 1.837
20 1.003 70 1.888
21 .974 71 1.946
22 .930 72 2.013
23 .883 73 2.089
24 .832 74 2.171
25 .779 75 2.251
26 .733 76 2.326
27 .696 77 2.392
28 .665 78 2.446
29 .642 79 2.493
30 .623 80 2.540
31 .614 81 2.590
32 .605 82 2.649
33 .605 83 2.717
34 .606 84 2.789
35 .612 85 2.857
36 .621 86 2.917
37 .636 87 2.965
38 .654 88 2.999
39 .675 89 3.017
40 .698 90 3.016
41 .726 91 2.993
42 .750 92 2.944
43 .778 93 2.865
44 .804 94 2.763
45 .832 95 2.654
46 .858 96 2.562
47 .884 97 2.521
48 .909 98 2.564
49 .936 99 1.948
Female
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Attained Annual Attained Annual
Age Percentage Age Percentage
-------- ---------- -------- ----------
0 3.755% 50 .912%
1 1.127 51 .932
2 1.018 52 .955
3 .962 53 .983
4 .908 54 1.007
5 .867 55 1.029
6 .806 56 1.046
7 .768 57 1.056
8 .722 58 1.059
9 .687 59 1.061
10 .653 60 1.066
11 .639 61 1.081
12 .643 62 1.107
13 .646 63 1.148
14 .664 64 1.195
15 .680 65 1.243
16 .695 66 1.286
17 .707 67 1.321
18 .703 68 1.344
19 .706 69 1.365
20 .700 70 1.391
21 .687 71 1.428
22 .674 72 1.481
23 .661 73 1.551
24 .654 74 1.632
25 .640 75 1.716
26 .632 76 1.799
27 .623 77 1.875
28 .618 78 1.942
29 .613 79 2.006
30 .612 80 2.071
31 .609 81 2.143
32 .606 82 2.224
33 .601 83 2.314
34 .607 84 2.406
35 .608 85 2.494
36 .622 86 2.575
37 .640 87 2.645
38 .639 88 2.703
39 .666 89 2.746
40 .695 90 2.773
41 .726 91 2.780
42 .755 92 2.765
43 .778 93 2.723
44 .800 94 2.657
45 .821 95 2.581
46 .838 96 2.517
47 .854 97 2.498
48 .873 98 2.556
49 .892 99 1.948
87-500-4A Page 4A
THOSE WHO BENEFIT
FROM THIS POLICY
OWNER. The Owner of this policy is the insured person unless stated otherwise 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 Net Insurance Benefit of this
policy. If two or more persons are named, those who survive the insured person
will share the Net 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 Net Insurance Benefit to the surviving children of the insured
person 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 our agent or by writing to us.) The change will
take effect on the date you sign the notice. But, it will not apply to any
payment we may 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 "How Benefits Are Paid" on Page 13.
ASSIGNMENT. You can assign this policy, but we will not be bound by an
assignment unless we have received it in writing. 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.
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THE BENEFITS
WE PAY
We will pay the Insurance Benefit in effect when the insured person dies to the
beneficiary when we receive at our Administrative Office (1) proof of the
insured person's death; and (2) all other requirements we deem necessary before
such payment may be made. Before payment we will deduct any unpaid policy loan
and loan interest and any overdue charges. This net payment is called the Net
Insurance Benefit. The Net Insurance Benefit in effect at any time will be equal
to the Insurance Benefit minus any unpaid policy loan and loan interest, and
minus any overdue excess deduction if the insured person dies during a grace
period (see Page 8). The Insurance Benefit on any day during a policy year is
equal to (a) the amount in your Policy Account on that day less any pro rata
cost of insurance charge for that policy year (see Page 8), times (b) the factor
shown on Page 4 corresponding to the insured person's attained age at the
beginning of that policy year.
We will add interest to the resulting amount for the period from the date of
death to the date of payment. We will compute the interest at a rate we
determine, but not less than the greater of
87-500-5 Page 5
THE BENEFITS
WE PAY (continued)
(a) the rate we are paying on the date of payment under the Deposit Option on
Page 13, or (b) the rate required by any applicable law.
Payment of the Net Insurance Benefit may also be affected by other provisions of
this policy. See Pages 15 and 16, where we specify our right to contest the
policy, the suicide exclusion, and what happens if age or sex has been
misstated. Special exclusions or limitations (if any) are listed on Page 3.
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THE PREMIUMS
YOU PAY
The initial premium payment shown on Page 3 is due on or before delivery of the
policy. No insurance will take effect before this premium is paid.
You may pay additional premiums at any time after the end of the [second] policy
year at our Administrative Office, subject to your giving us evidence of
insurability satisfactory to us. We have the right to limit the number and
amount of such additional premium payments. The minimum amount is shown on Page
3. We may increase this minimum amount 90 days after we send you written notice
of such increase. We will not accept additional premiums after the insured
person attains age 78.
We put the full initial premium for this policy into your Policy Account as of
the later of the Register Date or the date we receive it at our Administrative
Office. After we deduct the administrative charge shown on Page 3, we put the
balance of each additional premium you pay into your Policy Account as of the
later of the date we receive any required evidence of insurability or the date
we receive the additional premium at our Administrative Office.
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YOUR INVESTMENT
OPTIONS
ALLOCATIONS. This policy provides investment options for your Policy Account.
Amounts put into your Policy Account are allocated to the investment divisions
of our SA based upon the premium allocation percentages specified in your
application for this policy, a copy of which is at the back of this policy.
Unless you change them, such percentages shall also apply to subsequent premium
allocations.
Allocation percentages must be zero or a whole number not greater than 100. The
sum of the premium allocation percentages must 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.
TRANSFERS. At your written request to our Administrative Office we will transfer
amounts from your value in any investment division of our SA to one or more
other divisions of our SA. Any such transfer will take effect on the date we
receive your written request for it at our Administrative Office.
The minimum amount that we will transfer from your value in an investment
division of our SA on any date is the lesser of the minimum transfer amount
shown on Page 3 or your value
87-500 Page 6
in that investment division on that date, except as stated in the next
paragraph.
We will waive the minimum amount limitation set forth in the immediately
preceding paragraph if the total amount being transferred on that date is at
least the minimum transfer amount shown on Page 3.
Four transfers may be made in a policy year without charge. We may withdraw an
administrative charge from your Policy Account for additional transfers in a
policy year (see Page 3). We will make the administrative charge based on the
proportion that your value in each investment division of our SA bears to your
total value in the investment divisions.
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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 the investment divisions of our SA under this policy, plus any
Loaned Policy Account (see Page 9).
YOUR VALUE IN THE INVESTMENT DIVISIONS OF OUR SEPARATE ACCOUNT (SA). The amount
you have at any time in an investment division of our SA under this policy is
equal to the number of units this policy then has in that division multiplied by
the division's unit value at that time.
Amounts allocated or transferred to an investment division of our SA are used to
purchase units of that division; units are redeemed when amounts are
transferred, allocated, withdrawn or deducted from an investment division. These
transactions are called "policy transactions."
The number of units a policy has in an investment division at any time is equal
to the number of units purchased minus the number of units redeemed in that
division up 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 division'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 divisions of our SA at the end of
each business day. Generally, a business day is any day we are open and the New
York Stock Exchange is open for trading.
The unit value of an investment division of our SA on any business day is equal
to the unit value for that division on the immediately preceding business day
multiplied by the net investment factor for that division on that business day.
The net investment factor for an investment division of our SA on any business
day is (a) divided by (b), minus (c), minus (d), minus (e), where:
87-500-7 Page 7
THE VALUE OF YOUR
POLICY ACCOUNT
(continued)
(a) in the net asset value of the shares in designated investment companies that
belong to the investment division 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 net asset value of the shares in designated investment companies that
belong to the investment division at the close of business on the immediately
preceding business day after all policy transactions were made for that day;
(c) is a charge not exceeding .00003288 for each day in that "business day", as
defined above, corresponding to a charge not exceeding 1.20% per year, which is
the sum of 1) a charge not exceeding .85% per year for mortality and expense
risks; plus 2) a charge not exceeding .35% per year for administrative costs;
(d) is a daily mortality charge, which when expressed on an annual basis, will
never exceed the Guaranteed Maximum Percentages shown on Page 4A for the insured
person's attained age and sex. For example, if our current mortality charge were
.60% per year, the corresponding mortality charge would be .00001644 for each
day in that "business day", as defined above; and
(e) is a charge for each day in that "business day", as defined above, which we
reserve the right to determine and impose, for taxes or for amounts set aside as
a reserve for taxes.
The net asset value of an investment company's shares held in each investment
division shall be the value reported to us by that investment company.
Instead of making the mortality charge in (d) above, we reserve the right to
make a charge that we determine at the end of a policy year against the amount
in your Policy Account for that policy year's cost of insurance. If we impose
such a charge, we will determine it from time to time. Any change in it will be
as described in "Changes in Policy Cost Factors" on Page 15. Such charge will
never be greater than the amount in your Policy Account, times the annual
percentage shown on Page 4A for the insured person's attained age and sex for
the portion of the policy year for which such charge applies. In determining the
Insurance Benefit (see Page 5) and the Cash Surrender Value (see Page 10), we
will deduct a pro rata cost of insurance charge for the portion of the policy
year for which such change applies. If imposed, subject to the following
paragraph we will deduct such charge from your amount in each investment
division of our SA based upon the proportion that your value in each investment
division bears to your total value in the investment divisions.
If the amount of the deduction for such charge for a policy year exceeds the Net
Cash Surrender Value at the end of that year, we will send a written notice to
you and any assignee on our records at last known addresses stating that a grace
period of 61 days has begun, starting with the end of that policy year. The
notice will also state the amount of the additional premium payment required to
prevent this policy from ending without value at the end of that grace period.
The required additional premium will equal (a) such excess, plus (b) 25% of the
amount in your
87-500-7 Page 8
Policy Account on the date the deduction was due times the percentage shown on
Page 4A for the insured person's attained age on the day following the date the
deduction was due, plus (c) the administrative charge shown on Page 3 for
additional premiums. When we receive such required additional premium payment,
we will deduct such excess and we will apply the remainder as an additional
premium, described on Page 6, except that we will not require evidence of
insurability nor will we impose any timing, amount or age limitations for the
required additional premium.
If we do not receive such required additional premium payment at our
Administrative Office before the end of a grace period, we will then (1)
withdraw the amount in your Policy Account, including any applicable surrender
charge; 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 as of the
end of that grace period.
If the insured person dies during a grace period, we will pay the Net Insurance
Benefit as described on Page 5.
YOUR VALUE IN THE LOANED POLICY ACCOUNT. The amount you have in your Loaned
Policy Account at any time is equal to the amount of any outstanding loan and
interest credited to such Account which has not yet been allocated to the
investment divisions of our SA (see below).
We will credit such Account with interest at annual rates we determine. We will
determine such interest rates annually in advance. The interest rate we
determine each year will apply to the policy year that follows the date of
determination. The annual interest rate will not be less than:
(1) As to the portion of such Account that does not exceed an amount equal to
the lesser of a) 50% of the amount in your Policy Account; or b) the Cash
Surrender Value minus 85% of the total premiums paid under this policy, the rate
we are then charging for policy loan interest; and
(2) As to the balance of such Account, the rate we are then charging for the
policy loan interest reduced by no more than 2%.
We will determine the amount in (1) above each time any of the following occurs:
1) a new loan is made;
2) a partial repayment of a loan is made;
3) a policy anniversary;
based on the amount in your Policy Account, the Cash Surrender Value and total
premiums paid as of that occurrence.
Interest on the amount you have in your Loaned Policy Account will be allocated
on each policy anniversary, or upon full repayment of the loan, to each of the
investment divisions of our SA based on the proportion that your value in each
investment division of our SA bears to your total value in the investment
divisions.
87-500-9 Page 9
THE CASH
SURRENDER VALUE
OF THIS POLICY
CASH SURRENDER VALUE. The Cash Surrender Value on any date is equal to the
amount in the Policy Account on that date minus (a) any pro rata cost of
insurance charge (see Page 8), and minus (b) the total of any applicable
surrender charges.
NET CASH SURRENDER VALUE. The Net Cash Surrender Value is equal to the Cash
Surrender Value minus any unpaid policy loan and 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. We will compute the Net Cash Surrender
Value as of the date we receive your request for it and this policy at our
Administrative Office. All insurance coverage under this policy ends on such
date.
SURRENDER CHARGES. If, during a surrender charge period, you give up this policy
for its Net Cash Surrender Value or it ends without value at the end of a grace
period, we will withdraw the total applicable surrender charges from the Policy
Account. The surrender charge applicable to each premium and the surrender
charge periods are shown in the Policy Information section.
The surrender charge applicable to a premium stays the same throughout a policy
year. It changes only at the beginning of the policy year.
--------------------------------------------------------------------------------
HOW A LOAN
CAN BE MADE
POLICY LOANS. You can get a loan on this policy while it has a loan value. This
policy will be the only security for the loan. The initial loan and each
additional loan must be for at least the minimum loan amount shown on Page 3.
Any amount on loan is part of your Policy Account (see below).
The loan value on any date is 95% of the Cash Surrender Value on that date.
The amount of the loan may not be more than the loan value. Any existing loan
and loan interest will be subtracted from a new loan.
You may request a policy loan by contacting our Administrative Office. You may
tell us how much o the loan is to be allocated from your value in each
investment division of our SA. Such values will be determined as of the date we
receive your request. If you do not tell us, or if we cannot allocate the loan
on the basis of your direction, we will allocate it based on the proportion that
your value in each investment division of our SA bears to your total value in
the investment divisions.
When a loaned amount is allocated from an investment division of our SA, we will
redeem units of that investment division sufficient in value to cover the amount
of the loan so allocated and transfer that amount to your Loaned Policy Account.
LOAN INTEREST. Interest on a loan accrues daily, at an annual rate of 4%. We may
charge a lower rate for any period of time.
87-500-9 Page 10
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 from the
investment divisions of our SA based on the proportion that your value in each
investment division of our SA bears to your total value in the investment
divisions. 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 from an investment division of our SA, we
will redeem units of that investment division sufficient in value to cover the
amount of the interest so allocated and transfer that amount to your Loaned
Policy Account.
When a loan plus loan interest first exceeds the Cash Surrender Value, we will
mail to you and any assignee of record at last known addresses a notice that the
policy will terminate if such excess amount is not repaid within 61 days after
we mail such notice.
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.
We will assume that any payment you make to us while you have a loan is a loan
repayment, unless you tell us in writing that it is an additional premium
payment.
You may tell us how to allocate repayments among the investment divisions 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.
We will deduct any existing loan, and loan interest, from the Insurance Benefit
we pay. A policy loan will have a permanent effect on your benefits under this
policy even it is repaid.
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OUR SEPARATE
ACCOUNT (SA)
The Separate Account is our Separate Account FP (SA). We established and we
maintain it under the laws of New York State. Realized and unrealized gains and
losses from the assets of our SA are credited 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 division in excess of the reserves and other
liabilities with respect to that division to another investment division or to
our General Account.
INVESTMENT DIVISIONS. Our SA consists of "investment divisions." Each division
may invest its assets in a separate class of shares of a designated investment
company or companies. The investment divisions of our SA that you chose for your
initial premium allocations are shown on the application for this policy, a copy
of which is at the back of this policy. We may from time to time make other
investment divisions available to you.
00-000-00 Page 11
OUR SEPARATE
ACCOUNT (SA)
(continued)
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 divisions. We have the right to withdraw
assets of a class of policies to which this policy belongs from an investment
division and put them in another investment division. We also have the right to
combine any two or more investment divisions. The term "investment division" in
this policy shall then refer to any other investment division 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 the Separate Account under the Investment Company Act
of 1940;
2. run the Separate Account 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 the Separate Account; and
4. operate the Separate Account or one or more of the investment divisions by
making direct investments or in any other form. If we do so, we may invest
the assets of the Separate Account or one or more of the investment divisions
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 division of our SA will not be changed 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 filed 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 division of our SA, we will notify you of such
change, as required by law. If you have value in that investment division, and
if you wish, we will transfer it at your written direction from that division
(without charge) to another investment division of our SA, and you may then
change your premium allocation percentages.
--------------------------------------------------------------------------------
OUR ANNUAL
REPORT TO YOU
For each policy year we will send you a report for this policy that shows the
current Insurance Benefit, the number of units, the unit value and the total
value you have in each investment division of our SA, the Cash Surrender Value
and any outstanding policy loan with the current loan interest rate. The report
will also show such other information as may be required by the insurance
supervisory official of the jurisdiction in which this policy is delivered.
00-000-00 Page 12
EXCHANGE OF
POLICY
You may exchange this policy for a policy of permanent fixed benefit life
insurance on the life of the insured person. You may make such an exchange
within 24 months after the Date of Issue shown on Page 3. We will not require
evidence of insurability. We will require that:
1. This policy be in effect on the exchange date; and
2. Any loan and loan interest on this policy be repaid.
The date of exchange will be the later of: (a) the date you send us this policy
and the signed request on our form for such exchange; or (b) the date we receive
at our Administrative Office any sum due to be paid for such exchange.
THE NEW POLICY. The new policy will be our "Flexible Premium Adjustable Life
Plan" policy. It is a policy of permanent fixed benefit life insurance. It will
have the same Register Date, Date of Issue, and Issue Age as this policy. It
will have a face amount equal to the Initial Insurance Benefit under this
policy. The premium for the new policy will be based on our rates in effect on
its Register Date for the same class of risk as under this policy.
Upon request we will tell you the amount of the premium for the new policy, and
of any extra sum required or allowance to be made for a premium or Cash
Surrender Value adjustment that takes appropriate account of the premiums and
cash surrender values under this policy and under the new policy. If so
required, we have filed a detailed statement of the method of computing such an
adjustment with the insurance supervisory official of the jurisdiction in which
this policy is delivered.
--------------------------------------------------------------------------------
HOW BENEFITS
ARE PAID
You can have the Net Insurance Benefit or the Net Cash Surrender Value paid 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.
Payments under the following options will not be affected by the investment
experience of any investment division of our SA after proceeds are applied under
such options.
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.
00-000-00 Page 13
HOW BENEFITS
ARE PAID
(continued)
2. INSTALLMENT PAYMENTS: There are two ways that we pay installments:
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 on Page 17.
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 on Page 17. 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").
4. OTHER: We will apply the sum under any other option requested that we make
available at the time of the insured person's death or Net Cash Surrender
Value withdrawal.
We guarantee interest under the Deposit Option at the rate of 3% a year and
under either Installment Option at 3 1/2% a year. We may raise these guaranteed
rates. We may also allow interest under the Deposit Option and under either
Installment Option at a rate above the guaranteed rate.
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.
--------------------------------------------------------------------------------
OTHER IMPORTANT
INFORMATION
YOUR CONTRACT WITH US. This policy is issued in consideration of payment of the
initial premium shown on Page 3.
00-000-00 Page 14
This policy and the attached copy of the initial application and any subsequent
application in connection with an additional premium payment 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.
PREMIUMS AND POLICY CHANGES -- APPLICABLE TAX LAW. For you and the beneficiary
to receive the tax treatment accorded to life insurance under the Federal law,
this policy must qualify initially and continue to qualify as life insurance
under the Internal Revenue Code or successor law. Therefore, to assure this
qualification for you we reserve the right to refund the portion of any premium
payment or to decline to accept additional premium payments that would cause the
policy to fail to qualify as life insurance under applicable tax law as
interpreted by us. Further, we reserve the right to make changes in this policy
(for example in the factors on Page 4) or to make distributions from the policy
to the extent we deem it necessary 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 (the charge for
the mortality and expense risk, the administrative cost charge, the mortality
charge and the cost of insurance charges) will be by class and based upon
changes in future expectation for such elements as 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 increase in
the Insurance Benefit attributable to any additional premium based on material
misstatements made in any application in connection with that premium. 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 Date of Issue
shown in the Policy Information section. We will not contest any increase in the
Insurance Benefit attributable to any additional premium after such increase 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.
00-000-00 Page 15
OTHER IMPORTANT
INFORMATION
(continued)
WHAT IF AGE OR SEX HAS BEEN MISSTATED? If the insured person's age or sex has
been misstated on the application, the Insurance Benefit will be calculated
using the appropriate factor (see Page 4) for the correct age or sex.
HOW THE SUICIDE EXCLUSION AFFECTS BENEFITS. If the insured person commits
suicide (while sane or insane) within two years after the Date of Issue shown on
Page 3, our liability will be limited to the payment of a single sum. This sum
will be equal to the initial premium paid, minus any unpaid policy loan and loan
interest. If the insured person commits suicide (while sane or insane) within
two years after the date we receive any additional premium for this policy at
our Administrative Office, then our liability as to the portion of the Insurance
Benefit attributable to any such premium will be limited to the payment of a
single sum equal to such premium, minus any unpaid policy loan and loan
interest.
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 divisions 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 divisions of our SA, we may defer:
1. Determination and payment of the Net Cash Surrender Value;
2. Determination and payment of any Net Insurance Benefit;
3. Payment of loans;
4. Determination of the unit values of the investment divisions of our SA; and
5. Any requested transfer.
THE BASIS WE USE FOR COMPUTATION. We provide Cash Surrender Values that are at
least equal to or more than 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 base minimum cash surrender values on the "Commissioner's 1980 Standard
Ordinary Male and Female Mortality Tables."
POLICY CHANGES. You may change this policy to another available plan of
insurance or make other changes, subject to our rules at the time of change.
00-000-00 Page 16
TABLE OF GUARANTEED PAYMENTS
(MINIMUM AMOUNT FOR EACH $1,000 APPLIED)
OPTION 2A
FIXED PERIOD INSTALLMENTS
-------------------------
Number
of Years' Monthly Annual
Installments Installment Installment
------------ ----------- -----------
1 $84.70 $1000.00
2 43.08 508.60
3 29.21 344.86
4 22.28 263.04
5 18.12 213.99
6 15.36 181.32
7 13.38 158.01
8 11.91 140.56
9 10.76 127.00
10 9.84 116.18
11 9.09 107.34
12 8.47 99.98
13 7.94 93.78
14 7.49 88.47
15 7.11 83.89
16 6.77 79.89
17 6.47 76.37
18 6.20 73.25
19 5.97 70.47
20 5.76 67.98
21 5.57 65.74
22 5.40 63.70
23 5.24 61.85
24 5.10 60.17
25 4.97 58.62
26 4.84 57.20
27 4.73 55.90
28 4.63 54.69
29 4.54 53.57
30 4.45 52.53
If installments are paid every 3 months, they will be 25.32% of the annual
installments. If they are paid every 6 months, they will be 50.43% of the annual
installments.
OPTION 3
MONTHLY LIFE INCOME
-------------------
10 Years Certain 20 Years Certain Refund Certain
---------------------- ----------------------- -----------------------
AGE Male Female Male Female Male Female
--- ---- ------ ---- ------ ---- ------
50 $4.50 $3.96 $4.27 $3.89 $4.28 $3.87
51 4.58 4.02 4.32 3.94 4.35 3.93
52 4.67 4.09 4.38 4.00 4.42 3.99
53 4.75 4.16 4.44 4.06 4.50 4.05
54 4.85 4.24 4.50 4.12 4.58 4.11
55 4.94 4.32 4.56 4.18 4.66 4.18
56 5.04 4.40 4.62 4.24 4.74 4.25
57 5.15 4.49 4.68 4.31 4.83 4.33
58 5.26 4.58 4.74 4.38 4.93 4.41
59 5.37 4.68 4.81 4.45 5.03 4.49
60 5.49 4.78 4.86 4.52 5.13 4.58
61 5.62 4.89 4.92 4.59 5.24 4.67
62 5.75 5.00 4.98 4.66 5.35 4.77
63 5.88 5.12 5.04 4.73 5.48 4.88
64 6.03 5.25 5.09 4.80 5.60 4.99
65 6.17 5.39 5.14 4.88 5.74 5.10
66 6.32 5.53 5.19 4.95 5.88 5.22
67 6.48 5.68 5.24 5.01 6.03 5.35
68 6.64 5.83 5.28 5.08 6.18 5.49
69 6.80 6.00 5.32 5.14 6.35 5.64
70 6.97 6.17 5.35 5.20 6.53 5.79
71 7.15 6.34 5.38 5.26 6.71 5.96
72 7.32 6.53 5.41 5.30 6.91 6.13
73 7.50 6.72 5.43 5.35 7.12 6.32
74 7.67 6.92 5.45 5.38 7.34 6.52
75 7.85 7.12 5.47 5.42 7.58 6.73
76 8.02 7.32 5.48 5.44 7.82 6.96
77 8.19 7.53 5.49 5.46 8.09 7.21
78 8.36 7.75 5.50 5.48 8.38 7.47
79 8.52 7.96 5.50 5.49 8.67 7.75
80 8.67 8.16 5.51 5.50 9.00 8.05
81 8.81 8.36 5.51 5.51 9.34 8.39
82 8.94 8.55 5.51 5.51 9.70 8.73
83 9.06 8.73 5.51 5.51 10.10 9.12
84 9.16 8.90 5.51 5.51 10.52 9.53
85 & over 9.26 9.05 5.51 5.51 10.96 9.97
Amounts for Monthly Life Income are based on the age nearest birthday when
income starts. Amounts for ages not shown will be furnished on request.
No. 87-500 Page 17
[EQUITABLE VARIABLE LIFE INSURANCE COMPANY LOGO]
A Stock Life Insurance Company
Home Office: 000 Xxxxxxx Xxxxxx, Xxx Xxxx, X.X. 10019
----------------------------------------------------------------------
Variable Life Insurance Plan with Additional Premium Option. Insurance
payable upon death. Values provided by this policy are based on the
investment experience of the investment divisions of a separate
account which in turn depends on the investment performance of the
corresponding portfolios of investment companies. They are not
guaranteed as to dollar amount. Investment options are described on
Page 6. This is a non-participating policy.
----------------------------------------------------------------------
No. 87-500
