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EXHIBIT 1.A.(5)(b)(2)(a)
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ML LIFE INSURANCE COMPANY OF NEW YORK NEW YORK,
NEW YORK
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ADDITIONAL INSURANCE RIDER
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RIDER SCHEDULE Insured No. 1: Xxxxxxx Xxx
Owner: Xxxx Xxx
Issue Date: September 30, 1992
Policy Number: SPECIMEN
Rider Face Amount: $500,000.00
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INSURANCE BENEFITS This rider provides additional insurance coverage to
the insured. It is payable to the beneficiary at the
death of the insured. The rider face amount provided
by this rider is shown on the above rider schedule.
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CHANGING THE The owner may elect to change the rider face amount
RIDER prior to insured's attained age 85. The minimum change
in the rider face amount is $100,000. One (1) such change
is permitted each year. The minimum additional insurance
rider face amount is $100,000. To request a change in rider
face amount, you must provide satisfactory notice to us.
The effective date of change will be the policy anniversary
date next following underwriting approval of the change. As
of the effective date of change, the guarantee period will
change. See HOW WE DETERMINE THE GUARANTEE PERIOD.
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INCREASING THE If insured is alive, you may increase the rider
RIDER FACE face amount. Satisfactory evidence of insurability will
AMOUNT be required before we will increase the rider face amount.
We will not allow an increase on the first policy
anniversary if the face amount of the policy plus the new
rider face amount provide a guarantee period of less than
AIVUS92NY SPECIMEN
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one year from the effective date of the increase. An
increase in face amount will decrease the guarantee period.
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DECREASING THE Beginning in policy year 8, you may decrease the rider RIDER
FACE face amount but not below the amount required to keep
AMOUNT the policy qualified as life insurance under federal income
tax laws. A decrease in the face amount will increase the
guarantee period.
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HOW WE DETERMINE WHEN A CHANGE IN RIDER FACE AMOUNT IS REQUESTED
THE GUARANTEE As of the effective date of change, we will redetermine
PERIOD the guarantee period as follows:
(1) We take the fixed base described in the policy as of
such date.
(2) Based on the policy year, the face amount of the
policy, plus the rider face amount, and the amount in
(1), we will redetermine the guarantee period.
Our computations are based on an annual interest rate of 5%
and the guaranteed maximum cost of insurance rates shown in
Appendix 1.
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COST OF RIDER The cost of the rider is determined by dividing the rider
face amount by $1000 and multiplying the result by the
current cost of insurance rate per $1000 based on the policy
year and sex and underwriting class of the insured. The
cost of the rider is deducted from the investment base as
described in the policy. See INVESTMENT BASE IN EACH
INVESTMENT DIVISION in the policy.
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INCONTESTABILITY The incontestability and suicide provisions of the
AND SUICIDE policy also apply to this rider. We can contest the
validity of any change in the rider face amount requested by
the owner if any material misstatements are made in any
application required for that change. We will not contest
any change in the rider face amount requested by the owner
after the change has been in effect during the insureds'
lifetime for two years from the effective date of such
change. If the insured commits suicide within two years of
the effective date of any increase in the rider face amount
requested by the owner, we will terminate the coverage
attributable to such increase in rider face amount and pay
only a limited benefit. The limited benefit will be the
amount of cost of insurance deductions made for such
increase.
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WHEN THIS This rider will terminate on the date the policy
RIDER WILL terminates or lapses.
TERMINATE
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GENERAL This rider is a part of the policy. It has no cash or loan
value. Its benefit is subject to all the terms of this
rider and the policy.
ML LIFE INSURANCE COMPANY OF NEW YORK
/s/ XXXXX X. XXXXXXXX /s/ XXXXX XXXXX
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Xxxxx X. Xxxxxxxx Xxxxx Xxxxx
Secretary President
AIVUS92NY SPECIMEN
