SUN LIFE
[GRAPHIC]OF CANADA (U.S.)
FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE
Nonparticipating
Group Policy Owner Bank of Newport
Group Policy Number G001
This Group Policy is the legal contract between the Group Policy
Owner and Sun Life Assurance Company of Canada (U.S.) (the
"Company" or "We"). We agree to provide the rights and benefits
described in this Policy to the persons entitled in the manner set
forth herein, subject to the provisions on the pages which follow.
Signed at Wellesley Hills, Massachusetts, on the Issue Date.
X. Xxxxx Xxxxxx, President Xxxxx X. Xxxx, Secretary
THIS GROUP POLICY IS THE LEGAL CONTRACT WITH US. WE WILL ISSUE CERTIFICATES OF
INSURANCE IN THE FORM OF SCHEDULE A, AS ATTACHED HERETO, TO EACH CERTIFICATE
OWNER ("OWNER") PURSUANT TO THIS GROUP POLICY. THE PROVISIONS OF THE ATTACHED
CERTIFICATE FORM A PART OF THIS GROUP POLICY. FLEXIBLE PREMIUMS ARE PAYABLE
DURING THE LIFETIME OF EACH INSURED PRIOR TO MATURITY FOR THE APPLICABLE
CERTIFICATE. CERTIFICATE PROCEEDS ARE PAYABLE TO THE BENEFICIARY AT THE DEATH OF
THE INSURED PRIOR TO MATURITY AND WHILE THE CERTIFICATE IS IN FORCE. THE CASH
SURRENDER VALUE, IF ANY, OF A CERTIFICATE IS PAYABLE ON THE DATE OF MATURITY.
NEITHER THIS GROUP POLICY NOR THE CERTIFICATE IS ELIGIBLE FOR DIVIDENDS.
RIGHT TO RETURN POLICY
PLEASE READ THIS GROUP POLICY CAREFULLY. IF NOT SATISFIED, THE GROUP POLICY
OWNER MAY RETURN IT BY DELIVERING OR MAILING IT TO US AT ONE SUN LIFE EXECUTIVE
PARK, ATTENTION: CORPORATE MARKETS, WELLESLEY HILLS, MASSACHUSETTS 02481, OR TO
THE SALES REPRESENTATIVE THROUGH WHOM THE GROUP POLICY WAS PURCHASED WITHIN 10
DAYS FROM THE DATE OF RECEIPT OR WITHIN 45 DAYS AFTER THE APPLICATION IS SIGNED
WHICHEVER PERIOD ENDS LATER (THE "FREE LOOK PERIOD"). THE GROUP POLICY AND ANY
CERTIFICATES ISSUED PURSUANT TO IT WILL THEN BE DEEMED VOID AS THOUGH THEY HAD
NEVER BEEN APPLIED FOR. EACH CERTIFICATE OWNER WILL RECEIVE A REFUND EQUAL TO
THE SUM, AS CALCULATED FOR THAT CERTIFICATE, OF (1) THE DIFFERENCE BETWEEN ANY
PREMIUM PAYMENTS MADE, INCLUDING FEES AND CHARGES, AND THE AMOUNTS ALLOCATED TO
THE VARIABLE ACCOUNT, (2) THE VALUE OF THE AMOUNTS ALLOCATED TO THE VARIABLE
ACCOUNT ON THE DATE THE CANCELLATION REQUEST IS RECEIVED BY THE COMPANY OR THE
SALES REPRESENTATIVE THROUGH WHOM THE POLICY WAS PURCHASED, AND (3) ANY FEES OR
CHARGES IMPOSED ON AMOUNTS ALLOCATED TO THE VARIABLE ACCOUNT.
TABLE OF CONTENTS
1. POLICY SPECIFICATIONS................................................................................3
2. GENERAL PROVISIONS...................................................................................4
Group Policy Owner Rights and Responsibilities......................................................4
Certificates........................................................................................4
Premium.............................................................................................4
Entire..............................................................................................4
Termination.........................................................................................4
Riders and Endorsements...................................................................................
Applications..............................................................................................
Schedule A-The Certificate................................................................................
1. POLICY SPECIFICATIONS
Group Policy Owner Bank of Newport
Group Policy Number G001
Office ABC Insurance Agency
Issue Date January 1, 1998
Governing Law Rhode Island
2. GENERAL PROVISIONS
GROUP POLICY OWNER RIGHTS AND RESPONSIBILITIES: The Group Policy Owner, as
described in Section 1, owns this Policy. Except for ownership rights, if
any, expressly reserved to the Group Policy Owner (e.g. Termination), each
Certificate Owner shall be entitled to exercise all incidents of ownership in
connection with the Certificate without any requirement that the consent of
the Group Policy Owner be obtained.
The Certificate Owner will give Us any facts that We may need to administer
the insurance under this contract. All of the Certificate Owner's records
which may be relevant to the insurance coverage provided will be available to
Us to inspect when and as often as We may reasonably require.
CERTIFICATES: An eligible employee may be required to fill out a Certificate
Application which will be attached to the Certificate if issued. We will
issue to the Certificate Owner a Certificate of Insurance, evidencing
coverage for each such Insured. The Certificate is merely a summary of the
rights, duties and benefits available under this Group Policy. The
Certificate is not a legal contract, and if there is any conflict between the
Certificate and this Group Policy, this Group Policy is the controlling
document. The Certificate will state the Certificate Owner's rights and
benefits and to whom benefits are payable. The provisions of the Certificate
in the form of Schedule A form a part of this Policy.
PREMIUM: Premium may be paid by the Certificate Owner. The amount of Premium
to allocate to each Certificate must be indicated with each payment from
whatever source. An initial Premium must be paid to start coverage. The
Effective Date of Coverage is described in the Certificate. In the event a
Certificate has insufficient value, We will send a Premium bill to the
Certificate Owner, which, if not paid subject to a grace period of 61 days
from the date of insufficient value, the Certificate will terminate.
ENTIRE CONTRACT: We have issued this Policy in consideration of the
Certificate Application and remittance of necessary Premium. This Policy and
other attached, related papers, if any, constitute the entire contract with
Us. Each Certificate Application shall be, at Certificate issue, the basis
for issuance of the particular Certificate and at that date shall become a
part of this Policy. A copy shall be attached to the Certificate. All
statements made by the Group Policy Owner, Associated Entities, any
Certificate Owner or any Insured are representations and not warranties.
Misstatements will not be used in any contest or to reduce any claim under
this Policy unless they are in writing. A copy of the Application containing
such misstatement must have been given to the Group Policy Owner, the
Certificate Owner or the Beneficiary as applicable. We cannot contest this
Policy after it has been in force for two years from the Issue Date, and, in
the case of each Certificate, we cannot contest it after that Certificate has
been in force during the lifetime of the Insured for two years from its
Certificate Date.
NONPARTICIPATING. Neither the Group Policy nor the Certificates pay
dividends or share in any surplus earnings of the Company.
TERMINATION: This Policy may be changed or ended by agreement between Us and
the Group Policy Owner without the consent of, or notice to, any person
claiming rights or benefits under this Policy. We may end this Policy or any
of its provisions by giving notice in writing to the Group Policy Owner which
will, without further action by us, terminate all benefits under the
Certificates which have been issued pursuant to this Group Policy.
RIDERS AND ENDORSEMENTS
APPLICATIONS
SCHEDULE A-THE CERTIFICATE
SUN LIFE
[GRAPHIC]OF CANADA (U.S.)
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SUN LIFE ASSURANCE COMPANY OF CANADA (U.S.) U.S HEADQUARTERS OFFICE:
One Sun Life Executive Park
Wellesley Hills, MA 02481
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FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE
NONPARTICIPATING
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