SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK
SUN LIFE INSURANCE AND ANNUITY COMPANY
OF NEW YORK
Insured[Xxxx Xxx]
Policy Number[V00#00001]
|
This Policy is a legal contract in which We, Sun Life Insurance
and
Annuity Company of New York, promise to provide the kind of insurance
described below. Upon death of the Insured, We agree to pay the
Beneficiary such amounts as then become due and payable. Until that
time,
We agree to provide You, as Owner, the other rights and benefits
of this
Policy. These rights and benefits are subject to the provisions on
the
pages which follow.
|
Signed at Wellesley Hills, Massachusetts,
on the Issue Date.
[]
[Xxxxxx X. Xxxxxxxxx], President
[]
[Xxxxx X. Xxxx], Secretary
|
As described in Section 7, the amount of the Death Benefit or the duration
of the Death Benefit may increase or decrease to reflect the investment
experience of the Variable Account.
The Account Value in each Sub-Account of the Variable Account may increase
or decrease in accordance with the investment experience of that Sub-Account
of
the Variable Account. There is no minimum guaranteed Account Value for amounts
in the Sub-Accounts of the Variable Account.
Upon receipt of Due Proof , the Policy Proceeds are payable at the death
of
the Insured and while this Policy is in force. Please see Section 7.
This Policy does not participate in dividends and will not share in any
surplus earnings of the Company.
Flexible Premiums are payable during the lifetime of the Insured and while
the Policy is in force. See Section 6.
RIGHT TO RETURN POLICY PERIOD. Please read Your Policy carefully. If You
are not satisfied with it, You may return it by delivering or mailing it to
Us
at One Sun Life Executive Park, Attn: Corporate Markets, Wellesley Hills,
Massachusetts 02481, or to the sales representative through whom You purchased
this Policy within 10 days from the date of receipt (the "Free Look Period").
This Policy will then be deemed void as though it had never been applied for.
You will receive a refund equal to the sum of Premiums paid.
TABLE OF CONTENTS
1. POLICY SPECIFICATIONS*
2. TABLE OF GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1,000
OF NET AMOUNT AT RISK FOR SPECIFIED FACE AMOUNT AND APB*
3. DEFINITIONS*
4. GENERAL PROVISIONS*
Entire Contract*
Alteration*
Modification*
Assignments*
Nonparticipating*
Misstatement of Age or Sex*
Suicide*
Incontestability*
Report to Owner*
Illustrations*
Owner and Beneficiary*
Important Notice About this Policy After Age 100*
Claims of Creditors*
5. THE VARIABLE ACCOUNT*
Fixed Account*
Sub-Accounts*
Addition, Deletion or Substitution of Investments*
Transfers Between Investment Options*
6. PREMIUMS*
Planned Periodic Premiums*
Premium*
Premium Expense Loads*
Allocation of Net Premium*
Modified Endowment Contract*
7. DEATH BENEFIT*
Death Benefit Compliance Test*
Death Benefit and Death Benefit Option*
Changes in Specified Face Amount and APB*
Decreases in Specified Face Amount and APB*
Increases in Specified Face Amount and APB*
Changes in the Death Benefit Option*
8. ACCOUNT VALUE*
Account Value*
Net Investment Factor*
Loan Account*
Daily Risk Percentage, Monthly Expense Charge and Deferred Expense Load
on
Policy Year 1 Premium*
Monthly Cost of Insurance*
Monthly Cost of Insurance Rates*
Basis of Computation*
Directed Deductions*
Insufficient Value*
Grace Period*
Splitting Units*
Account Value after Attained Age 100*
9. POLICY BENEFITS*
Benefits at Death*
Payment of Claims*
Surrender*
Partial Surrender*
Allocation of Partial Surrender*
Policy Loan*
Deferral of Payment*
Termination*
Reinstatement*
RIDERS AND ENDORSEMENTS*
1. POLICY SPECIFICATIONS
Insured[Xxxx Xxx]
Policy Number[V00#00001]
Office[ABC Insurance Agency]
Issue Age, Sex[35] [Male]
Class[Preferred] - [Guaranteed Issue]
Specified Face Amount[$100,000]
Additional Protection Benefit (APB) Face Amount [$00,000]
Total Face Amount[$100,000]
Minimum Specified Face Amount[$5,000]
Minimum Total Face Amount[$50,000]
Minimum Premium[$990]
Planned Periodic Premium[$1,400]
Billing Period[Annual]
Issue Date[January 1, 2004]
CurrencyUnited States Dollars
Owner[XYZ Corporation]
Beneficiary[As stated in the Application unless subsequently changed]
Death Benefit Option[Option A: Specified Face Amount]
Variable Account
Name[J]
Securities & Exchange Commission Registration[Unit Investment
Trust]
THE PLANNED PERIODIC PREMIUM SHOWN ABOVE MAY BE INSUFFICIENT TO CONTINUE
COVERAGE FOR THE LIFETIME OF THE INSURED. THE PERIOD FOR WHICH THIS POLICY
WILL
REMAIN IN FORCE DEPENDS ON THE AMOUNT AND TIMING OF PREMIUMS PAID, DEDUCTIONS
FOR BENEFITS AND RIDERS, CHANGES IN THE SPECIFIED FACE AMOUNT OR IN ANY
ADDITIONAL PROTECTION BENEFIT FACE AMOUNT, CHANGE IN THE DEATH BENEFIT OPTION,
INTEREST RATE CREDITED ON THE FIXED ACCOUNT, SUB-ACCOUNT PERFORMANCE, POLICY
LOANS, PARTIAL SURRENDERS AND FEES. ADDITIONAL AMOUNTS, EITHER EXCESS INTEREST
OR REDUCED CHARGES, WHICH WE MAY EMPLOY ARE NOT GUARANTEED. WE RESERVE THE
RIGHT
TO CHANGE SAID AMOUNTS WHICH MAY REQUIRE MORE PREMIUM TO BE PAID THAN WAS
ILLUSTRATED OR THE ACCOUNT VALUES MAY BE LESS THAN THOSE ILLUSTRATED.
1. POLICY SPECIFICATIONS (CONTINUED)
[Xxxx Xxx][V00#00001]
Premium Expense Load
Policy Years 1 through 7
On Premium paid during the Policy Year up to and including Target
Premium12.50%
On Premium paid during the Policy Year in excess of Target
Premium5.50%
Policy Years 8 and after on all Premium3.25%
Deferred Expense Load on Policy Year 1 Premium
Policy Years 2 through 7
On Premium paid during Policy Year 1 up to and including Target
Premium1%
On Premium paid during Policy Year 1 in excess of Target Premium0%
Target Premium$3,965
Monthly Expense Charge in All Months$5.00
Mortality and Expense Risk Percentage0.90%
Daily Risk Percentage0.0024548%
Minimum Enhancement Benefit0.2% of Premium in Policy Year 1
0.0% of Premium in Policy Years 2 and after
Policy Loan Interest Rate (payable in arrears)5% annually during Policy
Years 1 through 10
4.25% annually in Policy Years 11 and after
Interest Credited on Loan Account4% annually
Fixed Account
Guaranteed Interest Crediting Rate2% (0.005426% daily)
Transfer Percentage25%
Transfer Period4 Policy Years
Transfer Minimum$5,000
Guaranteed Mortality Tables
Male1980 Commissioner's Standard Ordinary Mortality Table A
-------------------------------------------------------------------------------------------------------------------------------------------------
Supplemental Benefits and Changes
TypeEffective Date of CoverageFace Amount
-------------------------------------------------------------------------------------------------------------------------------------------------
1. POLICY SPECIFICATIONS (CONTINUED)
[Xxxx Xxx][V00#00001]
Net Premium Allocation Percentages (as of Month Day, Year)
AIM Variable Insurance Funds
Sub-Account - AIM V.I. Basic Value Fund (Series I)
Sub-Account - AIM V.I. Mid Cap Core Equity Fund (Series I)
Xxxxx American Fund
Sub-Account - Xxxxx American MidCap Growth Portfolio (Class O)
AllianceBernstein Variable Products Series Fund, Inc.
Sub-Account - AllianceBernstein VPS International Value Portfolio (Class
A)
Delaware Variable Insurance Products Trust
Sub-Account - Delaware VIP Growth Opportunities Series (Standard
Class)
Sub-Account - Delaware VIP REIT Series (Standard Class)
Sub-Account - Delaware VIP Small Cap Value Series (Standard Class)
Sub-Account - Delaware VIP Trend Series (Standard Class)
Dreyfus Stock Index Fund, Inc.
Sub-Account - Dreyfus Stock Index Fund, Inc. (Initial Shares)
Dreyfus Variable Investment Fund
Sub-Account - Dreyfus VIF Appreciation Portfolio (Initial Shares)
Dreyfus Investment Portfolios
Sub-Account - Dreyfus Emerging Leaders Portfolio (Initial Shares)
Sub-Account - Dreyfus MidCap Stock Portfolio (Initial Shares)
Sub-Account - Dreyfus Technology Growth Portfolio (Initial Shares)
DWS Investments VIT Funds
Sub-Account - DWS Small Cap Index VIP (Class A)
DWS Variable Series II
Sub-Account - DWS Dreman Financial Services VIP (Class A)
Sub-Account - DWS Dreman High Return Equity VIP (Class A)
Sub-Account - DWS Dreman Small Cap Value VIP (Class A)
FAM Variable Series Funds, Inc.
Sub-Account - Mercury Value Opportunities V.I. Fund (Class 1)
Fidelity Variable Insurance Products Funds
Sub-Account - FidelityVIP Contrafundâ Portfolio (Initial Class)
Sub-Account - Fidelity VIP Growth Portfolio (Initial Class)
Sub-Account - Fidelity VIP Growth & Income Portfolio (Initial
Class)
Sub-Account - Fidelity VIP High Income Portfolio (Initial Class)
Sub-Account - Fidelity VIP Investment Grade Bond Portfolio (Initial
Class)
Sub-Account - Fidelity VIP Money Market Portfolio (Service Class)
Sub-Account - Fidelity VIP Overseas Portfolio (Initial Class)
Franklin Xxxxxxxxx Variable Insurance Products Trust
Sub-Account - Xxxxxxxx Xxxxx-Mid Cap Growth Fund (Class 1)
Sub-Account - Mutual Shares Securities Fund (Class 1)
Sub-Account - Xxxxxxxxx Foreign Securities Fund (Class 1)
Sub-Account - Xxxxxxxxx Growth Securities Fund Class 1)
Sub-Account - Franklin Real Estate Fund (Class 1)
Janus Aspen Series
Sub-Account - Janus Aspen Series Mid Cap Value Portfolio (Institutional
Shares)
Lord Xxxxxx Series Fund, Inc.
Sub-Account - Lord Xxxxxx Series Fund - Growth and Income Portfolio (Class
VC)
Sub-Account - Lord Xxxxxx Series Fund - Mid-Cap Value Portfolio (Class
VC)
MFS/Sun Life Series Trust
Sub-Account - MFS/Sun Life Global Growth Series (Initial Class)
Sub-Account - MFS/Sun Life Government Securities Series (Initial
Class)
Sub-Account - MFS/Sun Life International Growth Series (Initial
Class)
Sub-Account - MFS/Sun Life Massachusetts Investors Growth Stock Series
(Initial Class)
Sub-Account - MFS/Sun Life Mid Cap Growth Series (Initial Class)
Sub-Account - MFS/Sun Life New Discovery Series (Initial Class)
Sub-Account - MFS/Sun Life Research International Series (Initial
Class)
Sub-Account - MFS/Sun Life Total Return Series (Initial Class)
Sub-Account - MFS/Sun Life Utilities Series (Initial Class)
Sub-Account - MFS/Sun Life Value Series (Initial Class)
Xxxxxxxxxxx Variable Account Funds
Sub-Account - Xxxxxxxxxxx Capital Appreciation Fund/ VA (Non-Service)
Sub-Account - Xxxxxxxxxxx Global Securities Fund/VA (Non-Service)
Sub-Account - Xxxxxxxxxxx Main Street Small Cap Fundâ /VA (Non-Service)
PIMCO Variable Insurance Trust
Sub-Account - PIMCO VIT High Yield Portfolio (Adm)
Sub-Account - PIMCO VIT Low Duration Portfolio (Adm)
Sub-Account - PIMCO VIT Real Return Portfolio (Adm)
Sub-Account - PIMCO VIT Total Return Portfolio (Adm)
Royce Capital Fund
Sub-Account - Royce Capital Fund - Small-Cap Portfolio
Sun Capital Advisers TrustSM
Sub-Account - Sun Capital Real Estate Fundâ (Initial Class)
X.Xxxx Price Equity Series, Inc.
Sub-Account - X. Xxxx Price Blue Chip Growth Portfolio
Sub-Account - X. Xxxx Price Equity Income Portfolio
The Universal Institutional Funds, Inc.
Sub-Account - Xxx Xxxxxx UIF Mid Cap Growth Portfolio (Class I)
Xxx Xxxxxx Life Investment Trust
Sub-Account - Xxx Xxxxxx LIT Xxxxxxxx Portfolio (Class I)
Sub-Account - Xxx Xxxxxx LIT Strategic Growth Portfolio (Class I)
Sub-Account - Xxx Xxxxxx LIT Growth and Income Portfolio (Class I)
Xxxxxx Advisors Trust
Sub-Account - Xxxxxx X.X. Xxxxxxx Companies
Fixed Account
1. POLICY SPECIFICATIONS (CONTINUED)
Table of Death Benefit Percentages
|
|
|
|
Applicable Percentage
|
|||||
|
Age
|
Males
|
Females
|
|
Age
|
Males
|
Females
|
||
|
20
|
652.075903%
|
778.151619%
|
|
60
|
191.114633%
|
220.052229%
|
||
|
21
|
633.349847%
|
753.355710%
|
|
61
|
186.314604%
|
213.870352%
|
||
|
22
|
614.980318%
|
729.257794%
|
|
62
|
181.716404%
|
207.892160%
|
||
|
23
|
596.880405%
|
705.839936%
|
|
63
|
177.319861%
|
202.133920%
|
||
|
24
|
579.037186%
|
683.084932%
|
|
64
|
173.125605%
|
196.616702%
|
||
|
25
|
561.442372%
|
661.013110%
|
|
65
|
169.129843%
|
191.342626%
|
||
|
26
|
544.091902%
|
639.567673%
|
|
66
|
165.325349%
|
186.299855%
|
||
|
27
|
527.030221%
|
618.765282%
|
|
67
|
161.698196%
|
181.469516%
|
||
|
28
|
510.315466%
|
598.585650%
|
|
68
|
158.235179%
|
176.826489%
|
||
|
29
|
493.974353%
|
579.037153%
|
|
69
|
154.922717%
|
172.342815%
|
||
|
30
|
478.045863%
|
560.096664%
|
|
70
|
151.752596%
|
168.008822%
|
||
|
31
|
462.542456%
|
541.766338%
|
|
71
|
148.725025%
|
163.826709%
|
||
|
32
|
447.503399%
|
524.021568%
|
|
72
|
145.843512%
|
159.808480%
|
||
|
33
|
432.913214%
|
506.839289%
|
|
73
|
143.115169%
|
155.973072%
|
||
|
34
|
418.797333%
|
490.197881%
|
|
74
|
140.547964%
|
152.337523%
|
||
|
35
|
405.147332%
|
474.130357%
|
|
75
|
138.141711%
|
148.909180%
|
||
|
36
|
391.964646%
|
458.591987%
|
|
76
|
135.888518%
|
145.683184%
|
||
|
37
|
379.246566%
|
443.620611%
|
|
77
|
133.774563%
|
142.647010%
|
||
|
38
|
366.996881%
|
429.212365%
|
|
78
|
131.782145%
|
139.781891%
|
||
|
39
|
355.205087%
|
415.359271%
|
|
79
|
129.891441%
|
137.068672%
|
||
|
40
|
343.867177%
|
402.062080%
|
|
80
|
128.089931%
|
134.495051%
|
||
|
41
|
332.967790%
|
389.304801%
|
|
81
|
126.374030%
|
132.057984%
|
||
|
42
|
322.505054%
|
377.069641%
|
|
82
|
124.745292%
|
129.760103%
|
||
|
43
|
312.446328%
|
365.327872%
|
|
83
|
123.211875%
|
127.607672%
|
||
|
44
|
302.786890%
|
354.034209%
|
|
84
|
121.782951%
|
125.606945%
|
||
|
45
|
293.501734%
|
343.165729%
|
|
85
|
120.459001%
|
123.754142%
|
||
|
46
|
284.583384%
|
332.700548%
|
|
86
|
119.233244%
|
122.039128%
|
||
|
47
|
276.007451%
|
322.610502%
|
|
87
|
118.092479%
|
120.447528%
|
||
|
48
|
267.760364%
|
312.876821%
|
|
88
|
117.020623%
|
118.962426%
|
||
|
49
|
259.823815%
|
303.493913%
|
|
89
|
115.999109%
|
117.565137%
|
||
|
50
|
252.191767%
|
294.448321%
|
|
90
|
115.007413%
|
116.235810%
|
||
|
51
|
244.848953%
|
285.731601%
|
|
91
|
114.023111%
|
114.953081%
|
||
|
52
|
237.799987%
|
277.328936%
|
|
92
|
113.020611%
|
113.693106%
|
||
|
53
|
231.038850%
|
269.234772%
|
|
93
|
111.970831%
|
112.429309%
|
||
|
54
|
224.562972%
|
261.450048%
|
|
94
|
110.840005%
|
111.131782%
|
||
|
55
|
218.369381%
|
253.952530%
|
|
95
|
109.606420%
|
109.774949%
|
||
|
56
|
212.442484%
|
246.725338%
|
|
96
|
108.264878%
|
108.349379%
|
||
|
57
|
206.771079%
|
239.745561%
|
|
97
|
106.838384%
|
106.872273%
|
||
|
58
|
201.334733%
|
232.986303%
|
|
98
|
105.386317%
|
105.395066%
|
||
|
59
|
196.119909%
|
226.424182%
|
|
99
|
104.000000%
|
104.000000%
|
||
2. TABLE OF GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE
RATES
PER $1,000 OF NET AMOUNT AT RISK FOR SPECIFIED FACE AMOUNT
AND
APB
|
|
|
|
Monthly Rates
|
|||||
|
Age
|
Males
|
Females
|
|
Age
|
Males
|
Females
|
||
|
20
|
0.15836
|
0.08751
|
|
60
|
1.34180
|
0.78979
|
||
|
21
|
0.15919
|
0.08917
|
|
61
|
1.46381
|
0.84488
|
||
|
22
|
0.15752
|
0.09084
|
|
62
|
1.60173
|
0.91417
|
||
|
23
|
0.15502
|
0.09251
|
|
63
|
1.75809
|
1.00267
|
||
|
24
|
0.15169
|
0.09501
|
|
64
|
1.93206
|
1.10539
|
||
|
25
|
0.14752
|
0.09668
|
|
65
|
2.12283
|
1.21731
|
||
|
26
|
0.14419
|
0.09918
|
|
66
|
2.32623
|
1.33511
|
||
|
27
|
0.14252
|
0.10168
|
|
67
|
2.54312
|
1.45461
|
||
|
28
|
0.14169
|
0.10501
|
|
68
|
2.77350
|
1.57247
|
||
|
29
|
0.14252
|
0.10835
|
|
69
|
3.02328
|
1.69955
|
||
|
30
|
0.14419
|
0.11251
|
|
70
|
3.30338
|
1.84590
|
||
|
31
|
0.14836
|
0.11668
|
|
71
|
3.62140
|
2.02325
|
||
|
32
|
0.15252
|
0.12085
|
|
72
|
3.98666
|
2.24419
|
||
|
33
|
0.15919
|
0.12502
|
|
73
|
4.40599
|
2.51548
|
||
|
34
|
0.16669
|
0.13168
|
|
74
|
4.87280
|
2.83552
|
||
|
35
|
0.17586
|
0.13752
|
|
75
|
5.37793
|
3.19685
|
||
|
36
|
0.18670
|
0.14669
|
|
76
|
5.91225
|
3.59370
|
||
|
37
|
0.20004
|
0.15752
|
|
77
|
6.46824
|
4.01942
|
||
|
38
|
0.21505
|
0.17003
|
|
78
|
7.04089
|
4.47410
|
||
|
39
|
0.23255
|
0.18503
|
|
79
|
7.64551
|
4.97042
|
||
|
40
|
0.25173
|
0.20171
|
|
80
|
8.30507
|
5.52957
|
||
|
41
|
0.27424
|
0.22005
|
|
81
|
9.03761
|
6.17118
|
||
|
42
|
0.29675
|
0.23922
|
|
82
|
9.86724
|
6.91414
|
||
|
43
|
0.32260
|
0.25757
|
|
83
|
10.80381
|
7.77075
|
||
|
44
|
0.34929
|
0.27674
|
|
84
|
11.82571
|
8.72632
|
||
|
45
|
0.37931
|
0.29675
|
|
85
|
12.91039
|
9.76952
|
||
|
46
|
0.41017
|
0.31677
|
|
86
|
14.03509
|
10.89151
|
||
|
47
|
0.44353
|
0.33761
|
|
87
|
15.18978
|
12.08770
|
||
|
48
|
0.47856
|
0.36096
|
|
88
|
16.36948
|
13.35774
|
||
|
49
|
0.51777
|
0.38598
|
|
89
|
17.57781
|
14.70820
|
||
|
50
|
0.55948
|
0.41350
|
|
90
|
18.82881
|
16.15259
|
||
|
51
|
0.60870
|
0.44270
|
|
91
|
20.14619
|
17.71416
|
||
|
52
|
0.66377
|
0.47523
|
|
92
|
21.57655
|
19.43814
|
||
|
53
|
0.72636
|
0.51276
|
|
93
|
23.20196
|
21.40786
|
||
|
54
|
0.79730
|
0.55114
|
|
94
|
25.28174
|
23.83051
|
||
|
55
|
0.87326
|
0.59118
|
|
95
|
28.27411
|
27.16158
|
||
|
56
|
0.95591
|
0.63123
|
|
96
|
33.10677
|
32.32378
|
||
|
57
|
1.04192
|
0.66961
|
|
97
|
41.68475
|
41.21204
|
||
|
58
|
1.13378
|
0.70633
|
|
98
|
58.01259
|
57.81394
|
||
|
59
|
1.23235
|
0.74556
|
|
99
|
83.33333
|
83.33333
|
||
3. DEFINITIONS
Account Value: The sum of the amounts in each Sub-Account of the Variable
Account, the Fixed Account and the Loan Account.
Additional Protection Benefit Face Amount:The amount of
additional life insurance coverage. See Section 1.
Anniversary: The same day in each succeeding year as the day of the year
corresponding to the Issue Date.
APB Death Benefit: The death benefit associated with APB.
Application: Your application for this Policy, a copy of which is attached
hereto and incorporated herein.
Attained Age: The Insured's Issue Age plus the number of completed Policy
Years.
Base Death Benefit: The death benefit under the Policy, exclusive of any
APN or any other supplemental benefits.
Beneficiary: The person or entity entitled to receive the Policy Proceeds
as they become due after the death of the Insured.
Business Day: Any day that We are open for business.
Cash Surrender Value: The Gross Cash Surrender Value decreased by the
balance of any outstanding Policy Debt.
Class: The risk, underwriting and substandard table rating, if any,
classification of the Insured. See Section 1.
Company:Sun Life Insurance and Annuity Company of New
York
Daily Risk Percentage: The daily rate for deduction of the mortality and
expense risk charge as specified in Section 1.
Death Benefit: The sum of the Base Death Benefit and the APB Death
Benefit.
Deferred Expense Load on Policy Year 1 Premium: Expense charge assessed
in
the second and subsequent Policy Years, up to and including Policy Year 7,
based
on Premium paid during Policy Year 1. See Section 1.
Due Proof: Such evidence as We may reasonably require in order to establish
that Policy Proceeds are due and payable.
Effective Date of Coverage: Initially, the Investment Start Date; with
respect to any increase in the Total Face Amount, the Monthly Anniversary Day
that falls on or next follows the date We approve the supplemental application
for such increase; with respect to any decrease in the Total Face Amount, the
Monthly Anniversary Day that falls on or next follows the date We receive Your
request.
Enhancement Benefit: Additional value, no less than the minimum specified
in Section 1, to be payable on all Surrenders (excepting Surrenders made as
part
of an exchange under Internal Revenue Code §1035).
Fixed Account: The portion of the Account Value funded by assets invested
in the General Account.
Fund: A mutual fund in which a Sub-Account invests.
General Account: The assets held by Us other than those allocated to the
Sub-Accounts of the Variable Account or any other separate account of the
Company.
Gross Cash Surrender Value: The Account Value increased by the Enhancement
Benefit, if any.
Insured: The person on whose life this Policy is issued.
Investment Option: Any of the Sub-Accounts of the Variable Account or the
Fixed Account.
Investment Start Date: The date the first Premium is applied, which will
be
the later of the Issue Date, the Business Day We approve the application for
this Policy, or the Business Day We receive a Premium equal to or in excess
of
the Minimum Premium.
Issue Age: The Insured's age as of the Insured's birthday nearest the Issue
Date.
Issue Date: The date specified as such in Section 1, from which
Anniversaries, Policy Years and Policy Months are measured.
Loan Account: An account established for this Policy, the value of which
is
the principal amount of any outstanding loan against this Policy, plus credited
interest thereon.
Minimum Premium: The Premium amount specified as such in Section 1.
Monthly Anniversary Day: The same day in each succeeding month as the day
of the month corresponding to the Issue Date.
Monthly Cost of Insurance: A deduction made on a monthly basis for the
insurance coverage provided by this Policy. See Section 8.
Monthly Expense Charge: A per Policy deduction, made on a monthly basis,
for administration and other expenses. See Section 1.
Mortality and Expense Risk Percentage: The annual percentage rate deducted
from the Account Value in the Sub-Accounts for the mortality and expense risk
charge. This annual rate is converted to a daily rate, the Daily Risk
Percentage, and deducted from the Variable Account on a daily basis. See Section
1.
Net Premium: The Premium less the Premium Expense Load.
Our Principal Office: Sun Life Insurance and Annuity Company of New York
(Attn: Corporate Markets), One Sun Life Executive Park, Wellesley Hills,
Massachusetts, 02481, or such other address as We may hereafter specify to
You
by written notice.
Owner: The person, persons or entity entitled to all rights and benefits
under this Policy, unless otherwise stated.
Partial Surrender: A surrender of a portion of the Account Value in
exchange for a payment to the Owner in accordance with the terms of Section
9.
Planned Periodic Premium:The Premium amount specified as such
in Section 1.
Policy: This life insurance contract, including the attached copy of the
Application and any attached copies of supplemental applications for increases
in the Total Face Amount.
Policy Debt: The principal amount of any outstanding loan against this
Policy, plus accrued but unpaid interest on such loan.
Policy Month:A one-month period commencing on the Issue Date or any Monthly
Anniversary Day and ending on the next Monthly Anniversary Day.
Policy Proceeds: The amount determined in accordance with the terms of
this
Policy which is payable at the death of the Insured. This amount is the Death
Benefit as described in Section 7, decreased by the
amount of any outstanding Policy Debt, and increased by the amounts payable
under any supplemental benefits.
Policy Year: A one-year period commencing on the Issue Date or any
Anniversary and ending on the next Anniversary.
Premium: An amount paid to Us by the Owner or on the Owner's behalf as
consideration for the benefits provided by this Policy.
Premium Expense Load: The percentage charge applied to Premium. See Section
1.
Specified Face Amount: The amount of life insurance coverage under the
Policy. See Section 1.
Sub-Accounts: Accounts into which the assets of the Variable Account are
divided.
Target Premium: The amount of Premium specified as such in Section 1. The
Premium Expense Load and Deferred Expense Load on Policy Year 1 Premium
deduction varies depending on whether Premiums paid in a given Policy Year
are
below, equal to or above Target Premium.
Total Face Amount: The Specified Face Amount plus Additional Protection
Benefit Face Amount. See Section 1.
Unit: A unit of measurement that We use to calculate the value of Your
investment in each Sub-Account.
Unit Value: The value of each Unit of a Sub-Account, as determined by
Us.
Valuation Date: A day that the New York Stock Exchange (or its successor;
or, if the securities in which the assets of the Sub-Account are invested are
not traded on the New York Stock Exchange, any principal exchange on which
such
securities are traded), We and, with respect to a Sub-Account, the relevant
Fund
are open for business. At a minimum, a Valuation Date will occur once each
Policy Month. We will determine Unit Values for each Valuation Date as of the
close of the New York Stock Exchange on that Valuation Date.
Valuation Period: The period of time from one Valuation Date to the next
subsequent Valuation Date.
Variable Account: A separate account of the Company consisting of assets
set aside by the Company, the investment performance of which is kept separate
from that of the general assets of the Company as specified in Section 1.
We, Our and Us Sun Life Insurance and Annuity Company of
New York
You and Your: In this Policy, You and Your refer to the
Owner of this Policy. In the Application, You and Your refer to the proposed
Insured.
4. GENERAL PROVISIONS
Entire Contract. Your entire contract with Us consists of this Policy,
including the attached copy of the Application, any attached copies of
supplemental applications for increases in the Total Face Amount, any riders
and
any endorsements. All statements made in the Application or in a supplemental
application are representations and not warranties. We relied and will rely
on
these statements when approving the issuance of this Policy, increase in Total
Face Amount, increase in Death Benefit over Premium paid, reinstatement, or
change in Death Benefit Option of this Policy. No statement can be used by
Us in
defense of a claim unless the statement was made in the Application or in a
supplemental application and was a material misrepresentation. Any illustrations
prepared in connection with this Policy do not form a part of Our contract
with
You and are intended solely to provide information about possible future
performance, based solely upon data available at the time such illustrations
are
prepared.
Alteration. Sales representatives do not have the authority to alter or
modify this Policy or to waive any of its provisions. The only persons with
this
authority are Our president, actuary, secretary or one of Our vice presidents.
Modification. Upon written notice to You, We may modify this Policy if
such
modification (1) is necessary to make this Policy, the Variable Account or
the
Fixed Account comply with any law or regulation issued by a governmental agency
to which the Company, the Variable Account or the Fixed Account is subject;
or
(2) is necessary to assure continued qualification of this Policy under the
Internal Revenue Code or other federal or state laws as a life insurance policy;
or (3) is necessary to reflect a change in the operation of the Variable Account
or the Sub-Accounts; or (4) adds, deletes or otherwise changes Investment
Options. We also reserve the right to modify certain provisions of this Policy
as stated in those provisions. In the event of any such modification, We may
make appropriate amendment to this Policy to reflect such modification.
Assignments. During the lifetime of the Insured, You may assign all or
some
of Your rights under this Policy. All assignments must be filed at Our Principal
Office and must be in a form satisfactory to Us. The assignment will then be
effective as of the date You signed the form, subject to any action taken before
it was recorded by Us at Our Principal Office. We are not responsible for the
validity or legal effect of any Assignment. Neither this Policy nor any of
Your
rights or those of a Beneficiary under it may be assigned or transferred without
Our permission.
Nonparticipating. This Policy does not pay dividends and will not share
in
any surplus earnings of the Company.
Misstatement of Age or Sex. If the age or sex of the Insured is stated
incorrectly in the Application, the amounts payable by Us will be adjusted
as
follows:
- Misstatement discovered at death: The Death Benefit will be recalculated to that which would be purchased by the most recently charged Monthly Cost of Insurance Rate for the correct age or sex.
- Misstatement discovered prior to death: The Account Value will be recalculated from the Issue Date using the Monthly Cost of Insurance Rates based on the correct age or sex.
Suicide. If the Insured commits suicide within two years after the Issue
Date, We will not pay any part of the Policy Proceeds. We will refund to You
the
Premiums paid, less the amount of any Policy Debt and less any Partial
Surrenders.
Incontestability. After this Policy has been in force during the lifetime
of the Insured for a period of two years from its Issue Date, We cannot contest
it except for non-payment of Premiums in accordance with the Insufficient Value
provision of Section 8. However, any increase in the Total Face Amount which
is
effective after the Issue Date will be incontestable only after such increase
has been in force during the lifetime of the Insured for two years from the
Effective Date of Coverage of such increase. Any increase in Death Benefit
over
Premium paid or increase in Death Benefit due to a Death Benefit Option change
will be incontestable only after such increase has been in force during the
lifetime of the Insured for two years from the date of the increase. Further,
any reinstatement will be incontestable after the reinstated policy has been
in
force during the lifetime of the Insured for two years from the effective date
of reinstatement. Contestability will be based only on material
misrepresentations made in the application(s).
Report to Owner. We will send You a report at least once each Policy Year.
The report will show current Policy values, Premiums paid, and deductions made
since the last report. It will also show the balance of any Policy Debt. There
is no charge for this report.
Illustrations. Upon request, We will provide You with an illustration of
future Account Value and Death Benefits. This illustration will be furnished
to
You for a nominal fee not to exceed $25.
Owner and Beneficiary. The Owner is as stated in Section 1. The Owner has
the sole and absolute power to exercise all rights and privileges under this
Policy without the consent of any other person unless You provide otherwise
by
written notice.The Beneficiary has no rights under this Policy until the death
of the Insured. A Beneficiary is any person or entity, named in Our records
as
the proper recipient of the Policy Proceeds. While the Insured is alive, you
may
change the Owner and Beneficiary by written notice. No change or revocation
will
take effect unless we acknowledge receipt on the notice. If such acknowledgment
occurs, then (1) a change of Beneficiary will take effect on the date the notice
is signed, and (2) a change or a revocation of Owner will take effect as of
the
date specified in the notice, or if no such date is specified, on the date
the
notice is signed. If there is no Beneficiary living when the
Insured dies, We will pay the Policy Proceeds to You. If You are also the
Insured, the Policy Proceeds will be paid to Your estate. The Beneficiary
designation in effect on the Policy Date is stated in theApplication for this
Policy.
Important Notice About this Policy After Age 100.This Policy
may not qualify as life insurance after the Insured attains age 100 and may
therefore be subject to adverse tax consequences. Please consult a tax advisor
before deciding to continue this Policy after the Insured's age
100.
Policy loans and repayment of Policy loans (see Section 9), partial
withdrawals (see Section 9) and transfers (see Section 5) are permitted after
the Insured attains age 100. The fact that the Insured has attained age 100
will
not in itself adversely affect Your rights under this Policy as regards Policy
loans and their repayment, partial withdrawals and transfers.
Claims of Creditors.The Policy Proceeds will be exempt from
the claims of creditors to the extent permitted by the laws of the jurisdiction
in which this Policy was delivered.
5. THE VARIABLE ACCOUNT
The assets of the Variable Account shall be kept separate from Our other
assets. We have the right to transfer to the General Account any assets of
the
Variable Account which are in excess of the reserves and other Policy
liabilities of the Variable Account. Although the assets maintained in the
Variable Account will not be charged with any liabilities arising out of any
other business conducted by Us, all obligations arising under this Policy,
including the promise to make all benefit payments, are Our general corporate
obligations.
At Our election, and subject to any necessary vote by those having voting
rights, the Variable Account may be operated as a unit investment trust or
a
management company under the Investment Company Act of 1940. It may be
registered under the Investment Company Act of 1940 or de-registered in the
event registration is no longer required. In the event of any change in the
operation of the Variable Account pursuant to this provision, We may make
appropriate amendment to this Policy to reflect the change and take such other
action as may be necessary and appropriate to effect the change.
Fixed Account. The Fixed Account represents the portion of the Account
Value funded by assets invested in the General Account. The guaranteed interest
crediting rate is specified in Section 1 of this Policy. Interest in excess
of
the guaranteed rate may be applied to the amount in the Fixed Account at such
increased rates and in such manner as We may determine, based on Our
expectations of future experience with respect to interest, mortality costs,
persistency, expenses, taxes, as well as size, timing and frequency of deposits.
Interest credited will be computed on a compound interest basis.
Sub-Accounts. The assets of the Variable Account are divided into
Sub-Accounts. Each Sub-Account invests exclusively in a Fund. Income, gains
and
losses, whether or not realized, from the assets of each Sub-Account are
credited or charged against that Sub-Account without regard to income, gains
or
losses in other Sub-Accounts of the Variable Account. All amounts allocated
to
the Variable Account will be used to purchase shares of one or more of the
Funds, as You designate. Deductions and surrenders from the Variable Account
will, in effect, be made by redeeming the number of Fund shares at net asset
value equal in total value to the amount to be deducted. The Variable Account
will be fully invested in Fund shares at all times. The assets of the Variable
Account are valued at least as often as any Policy benefits vary, but at least
monthly.
The Sub-Accounts available under this Policy are further described in
supplementary materials.
Addition, Deletion or Substitution of Investments. Shares of any or all
of
the Funds may not always be available for purchase by the Sub-Accounts of the
Variable Account, or We may decide that further investment in any such shares
is
no longer appropriate. In either event, shares of other registered open-end
investment companies or unit investment trusts may be substituted both for
Fund
shares already purchased by the Variable Account and/or as the security to
be
purchased in the future, provided that these substitutions have been approved
by
the Securities and Exchange Commission. In addition, the investment policies
of
the separate account will not be changed without the approval of the
Superintendent of Insurance of the State of New York. We also reserve the right
to eliminate or combine existing Sub-Accounts or to transfer assets between
Sub-Accounts upon a Sub-Account elimination or combination. In the event of
a
substitution or other act pursuant to this provision, We may make appropriate
amendment to this Policy to reflect the substitution.
Transfers Between Investment Options. Subject to Our rules as they may
exist from time to time and to any limits that may be imposed by the Funds,
You
may transfer to another Sub-Account, or to the Fixed Account, all or a portion
of the Account Value allocated to a Sub-Account. We will make transfers pursuant
to an authorized request received at Our Principal Office.
All transfers are subject to Our consent. We reserve the right to impose
limitations on transfers, including, but not limited to: (1) the minimum amount
that may be transferred; (2) the frequency of transfers; and (3) the minimum
amount that may remain in a Sub-Account following a transfer from that
Sub-Account.
In any Policy Year, transfers from the Fixed Account to another Sub-Account
in the Variable Account are limited to the greater of (a) or (b) where:
(a) is the Transfer Percentage, as specified in Section 1,multiplied by
the
greatest amount in the Fixed Account during the Transfer Period; and
(b) is the Transfer Minimum as specified in Section 1.
Once during each Policy Year You may transfer to the Fixed Account 100%
of
the portion of the Account Value attributable to the Variable Sub-Accounts
at
the time Your request is received. You may apply the Cash Surrender Value to
purchase a guaranteed fixed paid-up benefit based on the mortality table stated
in the Basis of Computation provision in Section 8 and the minimum Fixed Account
interest rate stated in Section 1.
6. PREMIUMS
All Premium payments are payable to Us and should be sent to Our Principal
Office.
Planned Periodic Premiums. While You are not required to make subsequent
Premium payments according to a fixed schedule, You may select a planned
periodic Premium schedule and corresponding billing period, subject to Our
Premium limits. Except as otherwise provided herein, the billing period must
be
annual or semi-annual. We will send You reminder notices for the planned
periodic Premium at each billing period as specified in Section 1 unless
reminder notices have been suspended as described below.
You are not required to pay the planned periodic Premium. You may increase
or decrease the planned periodic Premium subject to Our limits. You may skip
a
planned payment or make unscheduled payments. Unscheduled payments are subject
to Our approval. You may change Your planned payment schedule or the billing
period, subject to Our approval. Depending on the investment performance of
the
Investment Options You select, the planned periodic Premium may not be
sufficient to keep this Policy in force. You may need to make additional
payments in order to prevent termination of Your Policy. We will suspend
reminder notices at your request, and We reserve the right to suspend reminder
notices if Premiums are not being paid (except for notices in connection with
the grace period). We will notify You prior to suspending reminder
notices.
Premium. We reserve the right to limit the number of Premium payments We
accept in any Policy Year. No Premium payment may be less than $100 without
Our
consent, although We will accept a smaller Premium payment if it is necessary
to
keep this Policy in force. We reserve the right not to accept a Premium payment
that causes the Death Benefit to increase by an amount that exceeds the Premium
received. Evidence of insurability satisfactory to Us may be required before
We
accept such a Premium. We will not accept Premium payments that would, in Our
opinion, cause the Policy to fail to qualify as life insurance under applicable
tax law. If a Premium payment is made in excess of these limits, We will accept
only that portion of the Premium within those limits and will refund the
remainder to You.We will also not accept any Premium payments made
after the Anniversary on which the Insured is Attained Age 100, except as needed
to keep this Policy from lapsing.
Premium Expense Loads. The Premium Expense Load and Deferred Expense Load
on Policy Year 1 Premium will not be greater than as specified in Section 1.
The
Loads will be determined by Us from time to time based on Our expectations
of
future experience with respect to persistency, interest rates, expenses, profit
and taxes.
Allocation of Net Premium. Except as otherwise provided herein, Net Premium
will be allocated to the Investment Options in accordance with the allocation
percentages specified by You, subject to special provisions applicable during
the Free Look Period. For any Premium received during the Free Look Period,
We
will allocate the Net Premium to the Sub-Account that invests exclusively in
shares of the money market Portfolio. Account Value in the money market
Sub-Account will be transferred to the Investment Options in accordance with
the
allocation percentages specified by You when this period expires. While there
are no limitations concerning the number of Investment Options to which Net
Premium may be allocated, We reserve the right to impose minimum allocation
amounts, as determined by the Fund, for any or all Investment Options.
You may change the allocation percentages at any time pursuant to a request
submitted to Our Principal Office in a form acceptable to Us.
An allocation change will be effective as of the date We receive the
request for that change provided that it is received on a Valuation Day before
the close of the New York Stock Exchange. If a request is received on a day
that
is not a Valuation Day or after the close of the New York Stock Exchange on
a
Valuation Day it will become effective on the next Valuation Day.
Modified Endowment Contract. At the time a Premium is received that would,
in Our opinion, cause this Policy to become a modified endowment contract based
on Our reasonable interpretation of Section 7702A of the Internal Revenue Code,
We will so notify You or Your sales representative within one Business Day,
and
will not credit the Premium unless We have received specific instructions to
do
so. Any such Premium received will be held, for a period of time no greater
than
90 days, in a non-interest bearing account. This Premium will be refunded at
the
end of the 90-day period if we have not, at that time, received specific
instruction from You or Your sales representative concerning the Premium.
7. DEATH BENEFIT
Death Benefit Compliance Test. The Death Benefit compliance test is the
cash value accumulation test.
Death Benefit and Death Benefit Option. Prior to the Insured's Attained
Age
100, the Death Benefit depends upon the Death Benefit Option in effect at the
time of the Insured's death. The Death Benefit Option in effect on the Issue
Date is specified in Section 1. The three options are:
Option A - Specified Face Amount. The Base Death Benefit is the greater
of
the Specified Face Amount, or the Gross Cash Surrender Value multiplied by
the
applicable Death Benefit Percentage specified in Section 1.
Option B - Specified Face Amount plus Gross Cash Surrender Value. The Base
Death Benefit is the greater of the Specified Face Amount plus Gross Cash
Surrender Value, or the Gross Cash Surrender Value multiplied by the applicable
Death Benefit Percentage specified in Section 1.
Option C - Specified Face Amount plus cumulative Premiums paid. The Base
Death Benefit is the greater of the Specified Face Amount plus the sum of all
Premium payments less any Partial Surrenders, or the Gross Cash Surrender Value
multiplied by the applicable Death Benefit Percentage specified in Section
1.
The APB Death Benefit is the greater of zero or the result of the APB Face
Amount minus the excess, if any, of the Base Death Benefit over:
-
- the Specified Face Amount if Option A
- the Specified Face Amount plus Gross Cash Surrender Value if Option B or
- the Specified Face Amount plus cumulative Premiums paid less any Partial Surrenders if Option C
Death Benefit equals the sum of the Base Death Benefit and the APB Death
Benefit.
On any Monthly Anniversary Day where the Death Benefit is defined as the
Cash Surrender Value multiplied by the applicable Death Benefit Percentage,
and
the Death Benefit less the Gross Cash Surrender Value exceeds the greater of
(1)
the Total Face Amount and (2) the Death Benefit less the Gross Cash Surrender
Value on the prior Monthly Anniversary Day, We reserve the right to distribute
Account Value to You as a Partial Surrender to the extent necessary so that
the
Death Benefit less the Gross Cash Surrender Value does not exceed the greater
of
(1) and (2) above.
After the Insured's Attained Age 100, the Death Benefit will be equal to
the Gross Cash Surrender Value.
The Policy Proceeds will be paid as they become due upon the death of the
Insured. If the Insured dies while this Policy is in force, We will make a
lump
sum payment when We receive Due Proof of that death.
The APB is shown in Section 1. The APB will terminate at the earliest of
the following dates:
a. receipt of Your written request for
termination,
b. lapse of this Policy because of Insufficient
Value,
c. the Insured's Attained Age 100 or
d. termination of this Policy.
Changes in Specified Face Amount and APB. You may change the Specified
Face
Amount or APB Face Amount. You must send Your request for a change to Our
Principal Office, in writing. If We approve the changes, each such change will
be effective on the Effective Date of Coverage for the change.
Decreases in Specified Face Amount and APB. The Specified Face Amount may
not decrease to less than the Minimum Specified Face Amount specified in Section
1. A decrease in Specified Face Amount or APB Face Amount may not decrease
this
Policy's Total Face Amount to an amount less than the Minimum Total Face Amount
specified in Section 1. A decrease in Specified Face Amount or APB Face Amount
will be applied in the following order:
· first, to the most recent
increase, either Specified Face Amount or APB Face Amount, if any,
whichever is most recent. If issued at the same time, APB first;
· second, to the next most recent
increases, either Specified Face Amount or APB Face Amount, if any, in reverse
chronological order. If issued at the same time, APB first;
· third, to the initial APB Face
Amount, if any; and
· finally, to the initial
Specified Face Amount
Increases in Specified Face Amount and APB. An increase in the Specified
Face Amount or APB Face Amount is subject to Our underwriting rules in effect
at
the time of the increase. You may be required to submit evidence of the
Insured's insurability satisfactory to Us.
Changes in the Death Benefit Option. Changes in the Death Benefit Option
are subject to Our underwriting rules in effect at the time of the change.
Requests for a change in the Death Benefit Option must be made in writing to
Our
Service Office. You will be required to submit evidence of insurability if,
at
the time of a death benefit option change, the subsequent net amount at risks
are increased. Otherwise, a change in death benefit option is not subject to
evidence of insurability. The effective date of the change will be the
Anniversary on or next following the date We approve Your request.
8. ACCOUNT VALUE
Account Value. The Account Value varies depending upon the Net Premium,
Deferred Expense Load on Policy Year 1 Premium, Mortality and Expense Risk
Percentage deductions, Monthly Expense Charges, Monthly Cost of Insurance
charges, Policy loans, loan repayments, Partial Surrenders, fees and the Net
Investment Factor for the Sub-Accounts to which Your Account Value is
allocated.
We measure the amounts in the Sub-Accounts in terms of Units and Unit
Values. On any given date, the amount You have in a Sub-Account is equal to
the
Unit Value multiplied by the number of Units credited to You in that
Sub-Account. Amounts allocated to a Sub-Account will be used to purchase Units
of that Sub-Account. Units are redeemed when You make Partial Surrenders,
undertake Policy loans or transfer amounts from a Sub-Account, and for payment
of the mortality and expense risk charge, the Monthly Expense Charge, the
Monthly Cost of Insurance charge and the Deferred Expense Load on Policy Year
1
Premium. The number of Units of each Sub-Account purchased or redeemed is
determined by dividing the dollar amount of the transaction by the Unit Value
for the Sub-Account. The Unit Value for each Sub-Account is established by
Us
for the first Valuation Date. The Unit Value for any subsequent Valuation Date
is equal to the Unit Value for the preceding Valuation Date multiplied by the
Net Investment Factor (determined as provided below). The Unit Value of a
Sub-Account for any Valuation Date is determined as of the close of the
Valuation Period ending on that Valuation Date.
Transactions are processed on the date We receive a Premium at Our
Principal Office or any acceptable request is received at Our Principal Office.
If Your Premium or request is received on a date that is not a Valuation Date,
or after the close of the New York Stock Exchange on a Valuation Date, the
transaction will be processed on the next subsequent Valuation Date.
The Account Value for Investment Options on the Investment Start Date
equals:
·that portion of Net Premium
received and allocated to Investment Options, less
·the Monthly Expense Charges due
on the Issue Date and subsequent Monthly Anniversary Days through the Investment
Start Date, less
·the Monthly Cost of Insurance
deductions due from the Issue Date through the Investment Start Date.
The Account Value for Investment Options on subsequent Valuation Dates
is
equal to:
·the Account Value attributable
to
each Sub-Account on the preceding Valuation Date multiplied by that
Sub-Account's Net Investment Factor, less the Daily Risk Percentage multiplied
by the number of days in the Valuation Period multiplied by the Account Value
in
the Sub-Account, plus
·the value of the Fixed Account
on
the preceding Valuation Date, accrued at interest, plus
·that portion of Net Premium
received and allocated to each Investment Option during the current Valuation
Period, plus
·that portion of any loan
repayment allocated to any Investment Option during the current Valuation
Period, plus
- if that day is an Anniversary, any amount transferred to an Investment Option by which the Account Value in the Loan Account exceeds the outstanding Policy loan, less
- that portion of any Partial Surrender deducted from each Investment Option during the current Valuation Period, less
·that portion of any Policy loan
transferred from each Investment Option to the Loan Account during the current
Valuation Period, less
- if an Anniversary occurs during the current Valuation Period, that portion of the Deferred Expense Load on Policy Year 1 Premium charged to each Investment Option, less
·if a Monthly Anniversary Day
occurs during the current Valuation Period, that portion of the Monthly Expense
Charge due for the Policy Month just beginning charged to each Investment
Option, less
·if a Monthly Anniversary Day
occurs during the current Valuation Period, that portion of the Monthly Cost
of
Insurance for the Policy Month just ending charged to each Investment Option,
less
·if You surrender during the
current Valuation Period, that portion of the pro-rata Monthly Cost of Insurance
for the Policy Month charged to each Investment Option.
Net Investment Factor. The Net Investment Factor for each Sub-Account for
any Valuation Period is determined by dividing (1) by (2) where:
(1) is the net result of:
(I) the net asset value of a Fund share held in the Sub-Account determined
as of the end of the Valuation Period, plus
(II) the amount of any dividend or other distribution declared on amounts
held in the Sub-Account if the "ex-dividend" date occurs during the Valuation
Period, which for some assets will not be credited with investment experience
until the dividend is paid, plus or minus
(III) a credit or charge with respect to any taxes reserved for by Us,
or
paid by Us if not previously reserved for, during the Valuation Period which
are
determined by Us to be attributable to the operation of the Sub-Account;
and
(2) is the net asset value of a Fund share held in the Sub-Account
determined as of the end of the preceding Valuation Period.
Loan Account. The Loan Account is an account established for this Policy,
the value of which is the principal amount of any outstanding Policy loan
against this Policy, plus credited interest thereon.
The Account Value in the Loan Account is zero on the Investment Start Date.
The Account Value in the Loan Account on subsequent Valuation Dates
equals:
·the Account Value in the Loan
Account on the preceding day credited with interest at the Interest Credited
on
Loan Account rate specified in Section 1, plus
·any amount transferred from any
Investment Option to the Loan Account for Policy loans requested on that day,
less
·any loan repayments made on that
day, less
·if that day is an Anniversary,
any amount transferred to an Investment Option by which the Account Value in
the
Loan Account exceeds the outstanding Policy loan.
Daily Risk Percentage, Monthly Expense Charge and Deferred Expense Load
on
Policy Year 1 Premium. These deductions will be determined by Us from time
to
time based on, among other factors, Our expectations of future experience with
respect to interest, mortality experience, persistency, expenses, profit and
taxes. However, these deductions will not be greater than that specified in
Section 1.
Monthly Cost of Insurance. We deduct a Monthly Cost of Insurance charge
from Your Account Value to cover anticipated costs of providing insurance
coverage. This charge is made, in arrears, at the end of each Policy Month.
If
You Surrender this Policy on any day other than a Monthly Anniversary Day,
a
pro-rata charge will be made.
The Monthly Cost of Insurance equals the sum of (1), (2) (3), and (4) where
(1) is the Specified Face Amount Monthly Cost of Insurance Rate (described
below) multiplied by the net amount at risk divided by 1,000. The net amount
at
risk equals the Base Death Benefit at the end of the Policy Month before the
deduction of the Monthly Cost of Insurance less the Gross Cash Surrender Value
at the end of the Policy Month before the deduction of the Monthly Cost of
Insurance;
(2) is the APB Face Amount Monthly Cost of Insurance Rate (described below)
multiplied by the net amount at risk divided by 1,000. The net amount at risk
equals the APB Death Benefit at the end of the Policy Month before the deduction
of the Monthly Cost of Insurance
(3) is the monthly rider cost for any riders which are a part of this
Policy (with the monthly rider cost as described in the rider itself); and
(4) is any Flat Extra specified in Section 1 of this Policy, times the
Total Face Amount divided by 1000.
The Account Value deduction occurs first to the initial Total Face Amount
and second to successive increases.
The cost of insurance deductions described above are determined separately
for the initial Specified Face Amount and the APB Face Amount and each increase
in Specified Face Amount or APB Face Amount.
Monthly Cost of Insurance Rates. The Monthly Cost of Insurance Rates are
based on the length of time this Policy has been in force, the Insured's Sex,
Issue Age and Class. The Monthly Cost of Insurance Rates will be determined
by
Us from time to time based on, among other factors, Our expectations of future
experience with respect to interest, mortality experience, persistency,
expenses, profit and taxes. However, the Monthly Cost of Insurance Rates for
the
Specified Face Amount and APB Face Amount will not be greater than those shown
in Section 2.
Basis of Computation. Guaranteed Maximum Monthly Cost of Insurance Rates
are based on the Guaranteed Mortality Table specified in Section 1. We have
filed a detailed statement of Our methods for computing Account Value with
the
insurance department in the jurisdiction where this Policy is delivered.
Directed Deductions. You may allocate the mortality and expense risk
charge, the Monthly Expense Charge, Deferred Expense Load on Policy Year 1
Premium or the Monthly Cost of Insurance deductions among Investment Options.
The deductions will be allocated among the selected Investment Options in the
same proportion that the Account Value attributable to each of those Investment
Options bears to the aggregate value of the Account Value in all Investment
Options selected. If You do not specify the allocation, or to the extent the
aggregate value of the Account Value in all Investment Options selected is
less
than the deduction, deductions will be allocated among Investment Options in
the
same proportion that the Account Value attributable to each Investment Option
bears to the total Account Value less the Loan Account immediately prior to
the
deduction.
Insufficient Value. If, on a Valuation Date, the Account Value less the
outstanding Policy Debt is less than or equal to zero, then this Policy will
terminate for no value, subject to the Grace Period provision.
Grace Period. If, on a Valuation Date, this Policy will terminate by reason
of insufficient value, We will allow a grace period. This grace period will
allow 61 days from that Valuation Date for the payment of a Premium sufficient
to keep this Policy in force for three months. Notice of Premium due will be
mailed to Your last known address or the last known address of any assignee
of
record within 30 days after that Valuation Date. We will assume that Your last
known address is the address shown on the Application (or notice of assignment),
unless We receive notice of a change in address in a form satisfactory to Us.
If
the Premium due is not paid within 61 days after the beginning of the Grace
Period, then this Policy will terminate without value at the end of the 61
day
period. This Policy will continue to remain in force during the Grace Period.
If
the Policy Proceeds become payable by Us during the Grace Period, they will
be
reduced by any overdue deductions.
Splitting Units. We reserve the right to split or combine the value of
Units. In effecting any such change, strict equity will be preserved and no
change will have a material effect on the benefits or other provisions of this
Policy.
Account Value after Attained Age 100. If this Policy is in force beyond
the
Insured's Attained Age 100, the Account Value of this Policy will be determined
in the same manner as it was prior to the Insured's Attained Age 100, except
that we will not deduct for Monthly Cost of Insurance charges. We will not
accept any more Premium payments after the Insured's Attained Age 100.
9. POLICY BENEFITS
Benefits at Death. The Policy Proceeds will be paid in one lump sum payment
as they become due upon the death of the Insured while this Policy is in force.
Payment will include interest on the Policy Proceeds at the rate required by
applicable law from the date of death until the date of payment.
Payment of Claims. When this Policy becomes a claim by death of the
Insured, settlement will be made upon Our receipt of Due Proof of death.
Surrender. You may Surrender this Policy for the Cash Surrender Value at
any time.
Partial Surrender. You may make a Partial Surrender of this Policy once
each Policy Year after the first Policy Year by request to Our Principal Office,
in a form satisfactory to Us. The maximum amount of any Partial Surrender is
the
Account Value decreased by the balance of any outstanding Policy Debt. Unless
You provide evidence satisfactory to Us that the Insured is still insurable,
the
Total Face Amount will be reduced to the extent necessary so that (1) does
not
exceed (2) where
(1) is the Death Benefit increased by the amounts payable under
supplemental benefits less the Account Value immediately after the Partial
Surrender; and
(2) is the Death Benefit increased by the amounts payable under
supplemental benefits less the Account Value immediately before the Partial
Surrender.
If You provide such evidence, You will have the option of keeping the Death
Benefit equal to what it was immediately prior to the Partial Surrender. The
Specified Face Amount remaining in force after the Partial Surrender must be
no
lower than the Minimum Specified Face Amount shown in Section 1. A Partial
Surrender may not decrease this Policy's Total Face Amount shown in Section
1 to
an amount less than the Minimum Total Face Amount shown in Section 1.
Allocation of Partial Surrender. You may allocate the Partial Surrender
among the Investment Options. However, We reserve the right to restrict Partial
Surrenders from the Fixed Account. If You do not specify the allocation, then
the Partial Surrender will be allocated among Investment Options in the same
proportion that the Account Value attributable to each Investment Option bears
to the total Account Value less the Loan Account immediately prior to the
Partial Surrender.
Policy Loan. You may request a Policy loan of up to this Policy's Account
Value, decreased by the sum of (a) and (b) where
- is the amount of any outstanding Policy Debt on the date the Policy loan is made; and
- is the sum of the projected monthly deductions, described in Section 8, to the next
Anniversary.
Account Value equal to the Policy loan will be transferred from the
Investment Options to the Loan Account on the date the Policy loan is made.
You
may allocate the Policy loan among the Investment Options; however, We reserve
the right to restrict loans from the Fixed Account. If You do not specify the
allocation, then the Policy loan shall be allocated among the Investment Options
in the same proportion that the Account Value attributable to each Investment
Option bears to the total Account Value less the Loan Account immediately prior
to the Policy Loan.
Interest on the Policy loan will accrue daily at the Policy Loan Interest
Rate specified in Section 1. This interest shall be due and payable to Us in
arrears on each Anniversary. Any unpaid interest will be added to the principal
amount as an additional Policy loan and will bear interest at the same rate
and
in the same manner as the prior Policy loan.
All amounts paid by You that We receive will be credited to Your Policy
as
Premium unless We have received notice, in form satisfactory to Us, that the
amounts paid are for loan repayment. Loan repayments will first reduce the
outstanding balance of the Policy loan and then accrued but unpaid interest
on
such loans. We will accept repayment of any Policy loan at any time while this
Policy is in force. The amount of the loan repayment up to the outstanding
balance of the Policy loan will be transferred from the Loan Account to the
Investment Options. You may allocate the loan repayment among the Investment
Options. If You do not specify the allocation, then the loan repayment shall
be
allocated among the Investment Options in the same proportion that the Account
Value of each Investment Option bears to the total Account Value less the Loan
Account immediately prior to the loan repayment. We may require that loan
repayments, up to the amount of the loan allocated to the Fixed Account, first
be allocated back to the Fixed Account.
Deferral of Payment. We will usually pay any amount due from the Variable
Account within seven days after the Valuation Date following Our receipt of
notice, in a form acceptable to Us, giving rise to such payment or, in the
case
of death of the Insured, of Due Proof of such death. Payment of any amount
payable from the Variable Account on death, Surrender, Partial Surrender or
Policy loan may be postponed whenever:
·the New York Stock Exchange
("NYSE") is closed other than customary weekend and holiday closing, or trading
on the NYSE is otherwise restricted,
·the Securities and Exchange
Commission or other regulatory agency with jurisdiction, by order, permits
postponement for the protection of Policy Owners, or
·an emergency exists as determined
by the Securities and Exchange Commission, as a result of which disposal of
securities is not reasonably practicable, or it is not reasonably practicable
to
determine the value of the assets of the Variable Account.
We reserve the right to defer payment of any portion of the Cash Surrender
Value, Policy loan or Partial Surrender payable from the Fixed Account for
a
period not exceeding six months from the date We receive Your request.
We will not postpone or defer any payment that is to be used to pay
premiums. If payment of any portion of the Cash Surrender Value or Policy loan
is deferred for more than ten business days, We will add to that payment
interest at the rate required by applicable law.
Termination. This Policy terminates on the earlier of the date We receive
Your request to Surrender, the expiration date of the Grace Period due to
insufficient value or the date of death of the Insured.
Reinstatement. Prior to the death of the Insured, this Policy may be
reinstated provided this Policy has not been surrendered for the Cash Surrender
Value, and provided that:
- You make Your reinstatement request within three years from the Policy termination date;
- You submit satisfactory evidence of the Insured's insurability to Us;
- You pay an amount sufficient to put the Policy in force.
An amount sufficient to put the Policy in force is not less than:
- the Monthly Deductions which were overdue at the end of the grace period; plus
- any excess of the Policy Debt over the Account Value at the end of the grace period; plus
- three times the Monthly Cost of Insurance deductions applicable at the date of
reinstatement; plus
4. three times the Monthly Expense Charge.
The Specified Face Amount and the APB Face Amount of the reinstated policy
cannot exceed the Specified Face Amount and the APB Face Amount at the time
of
termination. The Account Value on the Policy reinstatement date will
reflect:
- the Account Value at the time of termination; plus
- the Net Premium attributable to Premiums paid to reinstate the Policy; less
- the monthly deductions which were overdue at the end of the grace period; less
- any excess of the Policy Debt over the Account Value at the end of the grace period; less
- the Monthly Expense Charge; less
- the monthly mortality and expense risk charge; less
- the Monthly Cost of Insurance deduction applicable on the date of reinstatement.
The effective date of reinstatement will be the Monthly Anniversary Date
that falls on or next allows the date We approve Your request.
Any Policy Debt at the time of termination must be repaid or carried over
to the reinstated Policy.
RIDERS AND ENDORSEMENTS
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK
Nonparticipating
