INSURED PERSONS XXXXXXX XXX [EQUITABLE LOGO]
AND XXXXXXXX XXX
POLICY OWNER(S) XXXXXXX XXX
AND XXXXXXXX XXX VARIABLE LIFE
INSURANCE
POLICY NUMBER XX XXX XXX POLICY
--------------------------------------------------------------------------------
WE AGREE to pay the Insurance Benefit of this policy and to provide its other
benefits and rights in accordance with its provisions.
FLEXIBLE PREMIUM JOINT SURVIVORSHIP VARIABLE LIFE INSURANCE POLICY
This is a flexible premium joint survivorship variable life insurance policy
which provides for insurance payable upon the death of the second of the
insureds to die. You can, within limits:
o make premium payments at any time and in any amount;
o change the death benefit option;
o change the allocation of net premiums and deductions among your investment
options; and
o transfer amounts among your investment options.
THIS POLICY IS GUARANTEED NOT TO LAPSE DURING THE FIRST FIVE POLICY YEARS, IF
PREMIUMS ARE PAID IN ACCORDANCE WITH THE NO LAPSE GUARANTEE PROVISION AND ANY
OUTSTANDING LOAN AND ACCRUED LOAN INTEREST DOES NOT EXCEED THE POLICY ACCOUNT
VALUE.
THIS POLICY IS GUARANTEED NOT TO LAPSE DURING THE EXTENDED PERIOD OF TIME SHOWN
ON PAGE 3, IF PREMIUMS ARE PAID IN ACCORDANCE WITH THE EXTENDED NO LAPSE
GUARANTEE PROVISION AND ANY OUTSTANDING LOAN AND ACCRUED LOAN INTEREST DOES NOT
EXCEED THE POLICY ACCOUNT VALUE.
All of these rights and benefits are subject to the terms and conditions of this
policy. All requests for policy changes are subject to our approval and may
require evidence of insurability.
We put your net premiums into your Policy Account. You may allocate them to one
or more investment funds of our Separate Account(s) (SA) or to our Guaranteed
Interest Account (GIA).
THE PORTION OF YOUR POLICY ACCOUNT THAT IS IN AN INVESTMENT FUND OF OUR SA WILL
VARY UP OR DOWN DEPENDING ON THE UNIT VALUE OF SUCH INVESTMENT FUND, WHICH IN
TURN DEPENDS ON THE INVESTMENT PERFORMANCE OF THE SECURITIES HELD BY THAT FUND.
THERE ARE NO MINIMUM GUARANTEES AS TO SUCH PORTION OF YOUR POLICY ACCOUNT.
The portion of your Policy Account that is in our GIA will accumulate, after
deductions, at rates of interest we determine. Such rates will not be less than
3% a year.
THE AMOUNT AND DURATION OF THE DEATH BENEFIT MAY BE VARIABLE OR FIXED UNDER
SPECIFIED CONDITIONS, AND MAY INCREASE OR DECREASE. SEE THE DEATH BENEFIT
PROVISION FOR A DESCRIPTION OF THE VARIABLE DEATH BENEFIT.
This is a non-participating policy.
RIGHT TO EXAMINE POLICY. YOU MAY EXAMINE THIS POLICY AND IF FOR ANY REASON YOU
ARE NOT SATISFIED WITH IT, YOU MAY CANCEL IT BY RETURNING THIS POLICY WITH A
WRITTEN REQUEST FOR CANCELLATION TO OUR ADMINISTRATIVE OFFICE BY THE 10TH DAY
AFTER YOU RECEIVE IT. IF YOU DO THIS, WE WILL REFUND THE PREMIUMS THAT WERE PAID
MINUS ANY OUTSTANDING LOAN AND ACCRUED LOAN INTEREST.
READ YOUR POLICY CAREFULLY. It is a legal contract between you and The
Equitable Life Assurance Society of the United States.
/s/ Xxxxxxxxxxx X. Xxxxxxx /s/ Xxxxxxx Xxxxxxx
------------------------------------- -------------------------------------
Xxxxxxxxxxx X. Xxxxxxx Xxxxxxx Xxxxxxx, Senior Vice President,
Chairman and Chief Executive Officer Secretary and Associate General Counsel
No. 02-200 E4291
Contents
--------
How Benefits are Paid 15
Policy Information 3
Other Important Information 16
Table of Maximum Monthly Charges for
Benefits 4 Table of Guaranteed Payments 19
Those Who Benefit from this Policy 5
The Insurance Benefit We Pay 5
Reducing the Face Amount of the Base
Policy or Changing the Death Benefit
Option 6 IN THIS POLICY: ADMINISTRATIVE OFFICE:
--------------- ----------------------
The Premiums You Pay 7 "We," "our" and "us" mean The Equitable The address of our Administrative
Life Assurance Society of the United Office is shown on Page 3. You
Your Policy Account and How it States. should send correspondence to that
Works 9 office. Premium payments should be
"You" and "your" mean the owner of this sent to the address listed on your
Your Investment Options 10 policy at the time an owner's right is billing notice.
exercised.
The Value of Your Policy Account 11
Unless otherwise stated, all references
The Cash Surrender Value of to interest in this policy are
this Policy 12 effective annual rates of interest.
How a Loan Can Be Made 13
Attained age means age on the birthday Copies of the application for this
Our Separate Account(s) (SA) 14 nearest to the beginning of the current policy and any additional benefit
policy year. riders are attached to the policy.
Our Annual Report to You 15
INTRODUCTION
The premiums you pay, after deductions are made in accordance with the Table of
Expense Charges in the Policy Information section, are put into your Policy
Account. Amounts in your Policy Account are allocated at your direction to one
or more investment funds of our SA or to our GIA.
The investment funds of our SA invest in securities and other investments whose
value is subject to market fluctuations and investment risk. There is no
guarantee of principal or investment experience.
Our GIA earns interest at rates we declare. The principal, after deductions, is
guaranteed.
If death benefit Option A is in effect, the death benefit is the base policy
face amount and the amount of the death benefit is fixed except when it is a
percentage of your Policy Account. If death benefit Option B is in effect, the
death benefit is the base policy face amount plus the amount in your Policy
Account. The amount of the death benefit is variable. Under either option, the
death benefit will never be less than a percentage of your Policy Account as
stated in the "Death Benefit" provision.
This policy is guaranteed not to lapse during the first five policy years, if
premiums are paid in accordance with the No Lapse Guarantee provision and any
outstanding loan and accrued loan interest does not exceed the policy account
value. This policy is guaranteed not to lapse during the extended period of time
shown on Page 3, if premiums are paid in accordance with the Extended No Lapse
Guarantee provision and any outstanding loan and accrued loan interest does not
exceed the policy account value.
The insurance benefit of this policy is payable upon the death of the second of
the insured persons to die. No benefit is payable upon death of the first of the
insured persons to die.
We make monthly deductions from your Policy Account to cover the cost of the
benefits provided by this policy and the cost of any benefits provided by riders
to this policy. If you give up this policy for its Net Cash Surrender Value or
reduce the base policy face amount, we may deduct a surrender charge from your
Policy Account.
This is only a summary of what this policy provides. You should read all of it
carefully. Its terms govern your rights and our obligations.
No. 02-200 E4291
POLICY INFORMATION
INSURED PERSONS XXXXXXX XXX
AND XXXXXXXX XXX
POLICY OWNER(S) XXXXXXX XXX
AND XXXXXXXX XXX
FACE AMOUNT
OF BASE POLICY $200,000
DEATH BENEFIT OPTION A (SEE PAGE 6) SEPARATE ACCOUNT [FP]
POLICY NUMBER XX XXX XXX ISSUE AGE, SEX; 35 MALE
30 FEMALE
BENEFICIARY SEE PAGE 5
----------
REGISTER DATE NOVEMBER 4, 2002 RATING CLASS: PREFERRED/NON-TOBACCO USER
DATE OF ISSUE NOVEMBER 4, 2002 PREFERRED/NON-TOBACCO USER
A MINIMUM INITIAL PREMIUM PAYMENT OF $ XXX IS DUE ON OR BEFORE DELIVERY OF THE
POLICY.
THE PLANNED PERIODIC PREMIUM OF $XXX IS PAYABLE QUARTERLY.
NO LAPSE GUARANTEE PERIOD IS 5 YEARS FROM THE REGISTER DATE. SEE NO LAPSE
GUARANTEE PROVISION.
EXTENDED NO LAPSE GUARANTEE PERIOD - XX YEARS FROM THE REGISTER DATE--SEE
EXTENDED NO LAPSE GUARANTEE PROVISION.
SEE PAGE 3 - CONTINUED FOR TABLE OF NO LAPSE GUARANTEE AND EXTENDED NO LAPSE
GUARANTEE PREMIUMS.
PREMIUM PAYMENTS ARE FOR THE INSURANCE BENEFIT INCLUDING ANY ADDITIONAL BENEFIT
RIDERS LISTED BELOW.
THE PLANNED PERIODIC PREMIUMS SHOWN ABOVE MAY NOT BE SUFFICIENT TO CONTINUE THE
POLICY AND LIFE INSURANCE COVERAGE IN FORCE. THE PERIOD FOR WHICH THE POLICY AND
COVERAGE WILL CONTINUE IN FORCE WILL DEPEND ON: (1) THE AMOUNT, TIMING AND
FREQUENCY OF PREMIUM PAYMENTS; (2) CHANGES IN THE FACE AMOUNT AND THE DEATH
BENEFIT OPTIONS; (3) CHANGES IN THE INTEREST RATES CREDITED TO OUR GIA AND THE
INVESTMENT PERFORMANCE OF THE INVESTMENT FUNDS OF OUR SA; (4) CHANGES IN THE
MONTHLY DEDUCTIONS FROM THE POLICY ACCOUNT FOR THIS POLICY AND ANY BENEFITS
PROVIDED BY RIDERS TO THIS POLICY; AND (5) LOAN AND PARTIAL NET CASH SURRENDER
VALUE WITHDRAWAL ACTIVITY.
02-200-3 PAGE 3
(CONTINUED ON NEXT PAGE)
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF GUARANTEE PREMIUMS
BENEFITS MONTHLY PREMIUM PREMIUM PERIOD
--------- --------------- --------------
NO LAPSE GUARANTEE $XX 5 YEARS
EXTENDED NO LAPSE GUARANTEE $XX XX YEARS
--- --------
YOU CAN, WITHIN LIMITS, MAKE PREMIUM PAYMENTS AT ANY TIME AND IN ANY AMOUNT.
HOWEVER, THE MONTHLY PREMIUMS SHOWN ABOVE ARE USED TO DETERMINE WHETHER THE NO
LAPSE GUARANTEE AND THE EXTENDED NO LAPSE GUARANTEE BENEFITS ARE IN EFFECT AS
DESCRIBED IN THE GRACE PERIOD PROVISION.
02-200-3 PAGE 3 -CONTINUED
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF EXPENSE CHARGES
DEDUCTION FROM PREMIUM PAYMENTS:
PREMIUM CHARGE:
WE DEDUCT AN AMOUNT NOT TO EXCEED 8% FROM EACH PREMIUM PAYMENT.
WE RESERVE THE RIGHT TO INCREASE THIS PERCENTAGE LIMIT AS A
RESULT OF CHANGES IN THE TAX LAWS WHICH INCREASE OUR EXPENSES.
DEDUCTIONS FROM YOUR POLICY ACCOUNT:
ADMINISTRATIVE CHARGE:
FIRST POLICY YEAR: WE DEDUCT AT THE BEGINNING OF EACH POLICY
MONTH $0.06 FOR EACH $1,000 OF INITIAL BASE POLICY FACE AMOUNT
PLUS $20.00.
POLICY YEARS 2 THROUGH 10: WE DEDUCT AT THE BEGINNING OF EACH
POLICY MONTH $0.06 FOR EACH $1,000 OF INITIAL BASE POLICY FACE
AMOUNT PLUS AN AMOUNT NOT TO EXCEED $10.00.
POLICY YEARS 11 AND LATER: WE DEDUCT AT THE BEGINNING OF EACH
POLICY MONTH AN AMOUNT NOT TO EXCEED $10.00.
MORTALITY AND EXPENSE RISK CHARGE:
WE DEDUCT AT THE BEGINNING OF EACH POLICY MONTH AN AMOUNT NOT
TO EXCEED 0.075% FOR MORTALITY AND EXPENSE RISKS. THIS CHARGE
WILL BE CALCULATED AS A PERCENTAGE OF THE AMOUNT OF THE POLICY
ACCOUNT THAT IS THEN ALLOCATED TO THE INVESTMENT FUNDS OF OUR
SEPARATE ACCOUNT.
02-200-3 PAGE 3 -CONTINUED
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF SURRENDER CHARGES
FOR THE INITIAL BASE POLICY FACE AMOUNT
BEGINNING OF BEGINNING OF
POLICY YEAR CHARGE POLICY YEAR CHARGE
----------- ------ ----------- ------
1 $1624.00 7 $1590.17
2 1624.00 8 1184.17
3 1624.00 9 778.17
4 1624.00 10 372.17
5 1624.00 11 AND LATER 00.00
6 1624.00
A SURRENDER CHARGE WILL BE SUBTRACTED FROM YOUR POLICY ACCOUNT IF THIS POLICY IS
GIVEN UP FOR ITS NET CASH SURRENDER VALUE WITHIN THE FIRST TEN POLICY YEARS. THE
SURRENDER CHARGE IN THE FIRST POLICY MONTH OF EACH POLICY YEAR IS SHOWN IN THE
TABLE ABOVE. THE SURRENDER CHARGE AT ANY TIME DURING THE FIRST SIX POLICY YEARS
IS EQUAL TO THE BEGINNING OF POLICY YEAR CHARGE SHOWN ABOVE. STARTING IN POLICY
YEAR SEVEN, THE SURRENDER CHARGE DECLINES UNIFORMLY IN EQUAL MONTHLY AMOUNTS
UNTIL IT REACHES ZERO IN THE TWELFTH MONTH OF POLICY YEAR TEN.
IF THE BASE POLICY FACE AMOUNT IS REDUCED WITHIN THE FIRST TEN POLICY YEARS, A
PROPORTIONATE SHARE OF THE APPLICABLE SURRENDER CHARGE AT THAT TIME WILL BE
DEDUCTED FROM YOUR POLICY ACCOUNT. SEE SURRENDER CHARGES PROVISION FOR A
DESCRIPTION OF THE PROPORTIONATE SURRENDER CHARGE.
ADMINISTRATIVE OFFICE:
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
NATIONAL OPERATIONS CENTER
00000 XXXXXXXXXX XXXXXXX XXXXXXX
XXXXXXXXX, XX 00000
(000) 000-0000
02-200-3 PAGE 3 -CONTINUED
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF MAXIMUM MONTHLY
CHARGES FOR BENEFITS
MONTHLY DEDUCTION
BENEFITS FROM POLICY ACCOUNT PERIOD
-------- ------------------- ------
BASE POLICY LIFE INSURANCE MAXIMUM MONTHLY COST OF INSURANCE RATE FOR THE 70 YEARS
BASE POLICY (SEE PAGE 4 - CONTINUED) TIMES
THOUSANDS OF NET AMOUNT AT RISK
$0.00 THEREAFTER
02-200-4 PAGE 4
(CONTINUED ON NEXT PAGE)
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF MAXIMUM MONTHLY COST OF INSURANCE RATES
PER $1,000 OF NET AMOUNT AT RISK FOR THE BASE POLICY
POLICY POLICY POLICY
YEAR RATE YEAR RATE YEAR RATE
---- ---- ----
1 .00017 26 .12250 51 5.67417
2 .00058 27 .14450 52 6.42000
3 .00100 28 .17008 53 7.24792
4 .00142 29 .19950 54 8.16500
5 .00200 30 .23383 55 9.15975
6 .00267 31 .27417 56 10.23242
7 .00350 32 .32133 57 11.36883
8 .00442 33 .37767 58 12.57658
9 .00550 34 .44517 59 13.84733
10 .00683 35 .52558 60 15.21925
11 .00842 36 .62000 61 16.71442
12 .01042 37 .73633 62 18.38567
13 .01267 38 .85742 63 20.29133
14 .01525 39 1.00233 64 22.41858
15 .01825 40 1.16825 65 24.09600
16 .02175 41 1.35825 66 26.44333
17 .02592 42 1.57758 67 31.31167
18 .03092 43 1.83383 68
39.58083
19 .03683 44 2.13217 69 54.65417
20 .04383 45 2.47833 70 62.50000
21 .05217 46 2.87608
22 .06200 47 3.32650 71 AND OVER 0.00000
23 .07358 48 3.83000
24 .8742 49 4.38675
25 .10350 50 4.99900
02-200-4 PAGE 4 - CONTINUED
POLICY INFORMATION CONTINUED -- POLICY NUMBER XX XXX XXX
TABLE OF FACTORS FOR
PAID UP DEATH BENEFIT GUARANTEE
POLICY POLICY
YEAR FACTOR YEAR FACTOR
---- ------ ---- ------
1 0.10893 36 0.47330
2 0.11383 37 0.49065
3 0.11895 38 0.50819
4 0.12429 39 0.52596
5 0.12987 40 0.54389
6 0.13569 41 0.56193
7 0.14177 42 0.58004
8 0.14811 43 0.59816
9 0.15473 44 0.61620
10 0.16163 45 0.63408
11 0.16884 46 0.65171
12 0.17635 47 0.66900
13 0.18418 48 0.68588
14 0.19234 49 0.70230
15 0.20085 50 0.71824
16 0.20971 51 0.73367
17 0.21893 52 0.74858
18 0.22854 53 0.76293
19 0.23853 54 0.77668
20 0.24892 55 0.78981
21 0.25972 56 0.80231
22 0.27094 57 0.81421
23 0.28258 58 0.82559
24 0.29465 59 0.83652
25 0.30716 60 0.84714
26 0.32010 61 0.85751
27 0.33349 62 0.86774
28 0.34733 63 0.87789
29 0.36161 64 0.88804
30 0.37633 65 0.89837
31 0.39149 66 0.91020
32 0.40708 67 0.92386
33 0.42309 68 0.93850
34 0.43948 69 0.95391
35 0.45624 70 0.97024
02-200-4 PAGE 4 - CONTINUED
POLICY INFORMATION CONTINUED - POLICY NUMBER XX XXX XXX
---------- TABLE OF PERCENTAGES OF POLICY ACCOUNT --------
YOUNGER INSURED YOUNGER INSURED
PERSON'S AGE PERCENTAGE PERSON'S AGE PERCENTAGE
30 829.1 65 230.3
31 798.1 66 222.7
32 768.3 67 215.5
33 739.6 68 208.6
34 712.0 69 202.0
35 685.4 70 195.6
36 659.9 71 189.6
37 635.3 72 183.8
38 611.7 73 178.2
39 589.0 74 173.0
40 567.3 75 168.0
41 546.3 76 163.4
42 526.2 77 162.4
43 506.9 78 161.5
44 488.4 79 160.6
45 470.5 80 159.7
46 453.4 81 158.7
47 436.9 82 157.8
48 421.1 83 153.2
49 405.9 84 148.9
50 391.3 85 144.8
51 377.3 86 141.1
52 363.8 87 137.5
53 350.8 88 134.0
54 338.4 89 130.7
55 326.5 90 127.5
56 315.0 91 124.5
57 304.0 92 121.5
58 293.5 93 118.5
59 283.3 94 115.5
60 273.5 95 112.5
61 264.1 96 110.0
62 255.1 97 107.5
63 246.5 98 104.9
64 238.2 99 AND OVER 102.0
02-200-4 PAGE 4 - CONTINUED
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THOSE WHO BENEFIT FROM THIS POLICY
OWNER. The owner of this policy is the insured persons jointly and, after the
death of the first of the insureds to die, the surviving insured, unless
otherwise stated in the application, or later changed.
As the owner, you are entitled to exercise all the rights of this policy while
at least one of the insured persons 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. While two or more persons own this policy jointly, the
exercise of rights in the policy must be made by all jointly.
BENEFICIARY. The beneficiary is as stated in the application, unless later
changed. The beneficiary is entitled to the Insurance Benefit of this policy.
One or more beneficiaries for the Insurance Benefit can be named in the
application. If more than one beneficiary is named, they can be classed as
primary or contingent. If two or more persons are named in a class, their shares
in the benefit can be stated. The stated shares in the Insurance Benefit will be
paid to any primary beneficiaries who survive the second of the insured persons
to die. If no primary beneficiaries survive, payment will be made to any
surviving contingent beneficiaries. Beneficiaries who survive in the same class
will share the Insurance Benefit equally, unless you have made another
arrangement with us.
If there is no designated beneficiary living at the death of the second of the
insured persons to die, we will pay the Insurance Benefit to such insured
person's surviving children in equal shares. If none survive, we will pay such
insured person's estate.
CHANGING THE OWNER OR BENEFICIARY. While at least one of the insured persons is
living, you may change the owner or beneficiary by written notice in a form
satisfactory to us. You can get such a form from your financial professional or
by writing to us at our Administrative Office. The change will take effect on
the date you sign the notice; however, it will not apply to any payment we make
or other action we take before we receive the notice. If you change the
beneficiary, any previous arrangement you made as to a payment option for
benefits is cancelled. You may choose a payment option for the new beneficiary
in accordance with the "How Benefits Are Paid" section of this policy.
ASSIGNMENT. You may assign this policy, if we agree; however, we will not be
bound by an assignment unless we have received it in writing at our
Administrative Office. Your rights and those of any other person referred to in
this policy will be subject to the assignment. We assume no responsibility for
the validity of an assignment. An absolute assignment will be considered as a
change of ownership to the assignee.
--------------------------------------------------------------------------------
THE INSURANCE BENEFIT WE PAY
We will pay the Insurance Benefit of this policy to the beneficiary upon the
death of the second of the insured persons to die when we receive at our
Administrative Office (1) proof that both insured persons died while this policy
was in force; and (2) all other requirements we deem necessary. The Insurance
Benefit includes the following amounts, which we will determine as of the date
of death of the second of the insured persons to die:
o the death benefit described in the "Death Benefit" provision;
o PLUS any other benefits then due from riders to this policy;
o MINUS any policy loan and accrued interest, or liens;
o MINUS any overdue deductions from your Policy Account if the second of
the insured persons to die dies during a grace period.
We will add interest to the resulting amount in accordance with applicable law.
We will compute the interest at a rate we determine, but not less than the
greater of (a) the rate we are paying on the date of payment under the Deposit
Option provision, or (b) the rate required by any applicable law. Payment of the
Insurance Benefit may also be affected by other provisions of this policy. See
the "Other Important Information" section of this policy, where we specify our
right to contest the policy, the suicide exclusion, and what happens if age or
sex has been misstated. Additional exclusions or limitations (if any) are listed
in the Policy Information section.
Proof of the first death must be given to us when it occurs, even if no
insurance benefits are to be paid at such time.
DEATH BENEFIT. The death benefit of this policy will be determined under either
Option A or Option B, whichever you have chosen and is in effect on the date of
death of the second of the insured persons to die.
Under Option A, the death benefit is the greater of (a) the base policy face
amount; or (b) a percentage of the amount in your Policy Account on the date of
death of the second of the insured persons to die. Under this option, the amount
of the death benefit is fixed, except when it is determined by such percentage.
02-200-5 PAGE 5
Under Option B, the death benefit is the greater of (a) the base policy face
amount plus the amount in your Policy Account on the date of death of the second
of the insured persons to die; or (b) a percentage of the amount in your Policy
Account on the date of death of the second of the insured persons to die. Under
this option the amount of the death benefit is variable.
The percentages referred to above are the percentages from the table (see Page
4-Continued) for the younger insured person's age (nearest birthday) at the
beginning of the policy year of determination.
This policy is designed to satisfy the definition of life insurance for Federal
income tax purposes under Section 7702 of the Internal Revenue Code of 1986, as
amended (i.e., the "Code"). Accordingly, even if this policy states otherwise,
at no time will the death benefits under the policy be less than the Policy
Account value of the policy, divided by the net single premium per dollar of
insurance which would have to be paid at such time to fund such benefits
consistent with the definition of such terms in the Code. In addition, we may
take certain actions, described here and elsewhere in the policy, to meet the
definitions and limitations in the Code, based on our interpretation of the
Code. Please see "Policy Changes - Applicable Tax Law" for more information.
NO LAPSE GUARANTEE. This policy is guaranteed not to lapse during the first five
policy years if the sum of premium payments accumulated at 4%, less any partial
withdrawals accumulated at 4%, is at least equal to the sum of the monthly No
Lapse Guarantee Premium(s) accumulated at 4%, and any outstanding loan and
accrued loan interest does not exceed the policy account value; see "Guarantee
Premiums" provision. This no lapse guarantee expires at the end of five years.
Certain policy changes after issue will change the No Lapse Guarantee
Premium(s); however, they will not start a new guarantee period.
EXTENDED NO LAPSE GUARANTEE. This policy is guaranteed not to lapse if, during
the extended no lapse guarantee period, the sum of premium payments accumulated
at 4%, less any partial withdrawals accumulated at 4%, is at least equal to the
sum of the monthly Extended No Lapse Guarantee Premium(s) accumulated at 4%, and
any outstanding loan and accrued loan interest does not exceed the policy
account value; see "Guarantee Premiums" provision. The extended no lapse
guarantee period is shown on Page 3. Certain policy changes after issue will
change the Extended No Lapse Guarantee Premium(s); however, they will not start
a new guarantee period.
COVERAGE AFTER AGE 100. Coverage under this policy will continue for as long as
the policy remains in force during the lifetime of either or both insured
persons. However, no premium payments, partial withdrawals, changes in face
amount or changes in death benefit option will be permitted after the policy
anniversary nearest the 100th birthday of the younger insured person; policy
loans, loan repayments, and transfers among your investment options may continue
to be made, subject to our normal rules as stated in other provisions of the
policy pertaining to these items. No deductions for cost of insurance or
administrative charges (except for the mortality and expense risk charge) will
be made after the policy anniversary nearest the 100th birthday of the younger
insured person.
--------------------------------------------------------------------------------
REDUCING THE FACE AMOUNT OF THE BASE POLICY OR CHANGING THE DEATH BENEFIT OPTION
You may reduce the face amount or change the death benefit option by written
request to us at our Administrative Office, subject to the following conditions:
1. After the second policy year while this policy is in force, you may ask us to
reduce the base policy face amount but not to less than $200,000. Any such
reduction in the face amount may not be less than $10,000. If you reduce the
base policy face amount before the end of the tenth policy year, we will deduct
a proportionate amount of any applicable surrender charge from your Policy
Account. Any such deduction will be made in accordance with the "Allocations"
provision of the policy.
2. After the second policy year while this policy is in force, you can change
your death benefit option. Any requested change to death benefit Option B must
be made while the younger insured person is not more than attained age 85. If
you ask us to change from Option A to Option B, we will decrease the base policy
face amount by the amount in your Policy Account on the date the change takes
effect. However, we will decline to make such change if it would reduce the base
policy face amount to less than $200,000. If you ask us to change from Option B
to Option A, we will increase the base policy face amount by the amount in your
Policy Account on the date the change takes effect. Such decreases and increases
in the base policy face amount are made so that the death benefit remains the
same on the date the change takes effect.
3. The change will take effect at the beginning of the policy month that
coincides with or next follows the date we approve your request.
4. We reserve the right to decline to make any change that we determine would
cause this policy to fail to qualify as life insurance under applicable tax law
as interpreted by us.
02-200-5 PAGE 6
5. You may ask for a change by completing an application for change, which you
can get from your financial professional or by writing to us at our
Administrative Office. A copy of your application for change will be attached to
the new Policy Information section that we will issue when the change is made.
The new section and the application for change will become a part of this
policy. We may require you to return this policy to our Administrative Office to
make a policy change.
--------------------------------------------------------------------------------
THE PREMIUMS YOU PAY
The minimum initial premium payment shown in the Policy Information section is
due on or before delivery of this policy. No insurance will take effect before a
premium at least equal to the minimum initial premium is paid. Other premiums
may be paid at our Administrative Office at any time while this policy is in
force.
We will send premium notices to you for the planned periodic premium shown in
the Policy Information section. You may skip planned periodic premium payments.
However, this may adversely affect the duration of the death benefit and your
policy's values. We will assume that any payment you make to us is a premium
payment, unless you tell us in writing that it is a loan repayment.
If you stop paying premiums, insurance coverage will continue for as long as the
Net Policy Account Value is sufficient to cover the monthly deductions described
in the "Monthly Deductions" provision, with a further extension of coverage as
described in the "Grace Period" provision.
GUARANTEE PREMIUMS. You may choose to pay premiums equal to the No Lapse
Guarantee Premium(s) or to the Extended No Lapse Guarantee Premium(s). A table
of these different premium levels for base policy life insurance benefits is
shown on page 3.-Continued; these premiums differ in both amount and duration
for each of these guarantee periods. Guarantee Premiums for any additional
benefit riders are also shown in this table.
The calculations that are described in the "Grace Period" provision refer to a
Guarantee Premium fund. The Guarantee Premium fund at any time means the
accumulation of all the guarantee premiums (for base policy and any additional
benefit riders) for the shortest guarantee period that is still applicable. For
instance, if these calculations are performed during the first five policy
years, the Guarantee Premium fund for any policy month will equal the
accumulation of all the monthly No Lapse Guarantee Premium(s) from the Register
Date of this policy up to that month. After five policy years, the Guarantee
Premium fund for any policy month will equal the accumulation of all the monthly
Extended No Lapse Guarantee Premium(s) from the Register Date of this policy up
to that month.
In order to maintain the longer guarantee period, you must pay at least the
Extended No Lapse Guarantee premium(s), starting from the policy Register Date.
In this way, you are assured that the actual premium fund will always be at
least equal to the Guarantee Premium fund in any calculation. If you pay only
the No Lapse Guarantee Premium during the first five policy years, you may have
to pay an additional amount to maintain the longer Extended No Lapse Guarantee
period.
LIMITS. Each premium payment after the initial one must be at least $100. We may
increase this minimum limit 90 days after we send you written notice of such
increase. We reserve the right to limit the amount of any premium payments you
may make if they would immediately result in more than a dollar for dollar
increase in the death benefit (which would happen if the death benefit is
determined as a percentage of the policy account, as described in the "Death
Benefit" provision), unless you provide satisfactory evidence of insurability of
the insured person(s).
We also reserve the right not to accept premium payments or to return excess
amounts that we determine would cause this policy to fail to qualify as life
insurance under applicable tax law as interpreted by us.
GRACE PERIOD. At the beginning of each policy month, we compare the Net Policy
Account Value to the total monthly deductions described in the "Monthly
Deductions" provision. If the Net Policy Account Value is sufficient to cover
the total monthly deductions, this policy is not in default.
If the Net Policy Account Value at the beginning of any policy month is not
sufficient to cover the total monthly deductions, but the no lapse guarantee or
the extended no lapse guarantee period is in effect, we will perform the
following calculations to determine whether the policy is in default:
1. Determine the Guarantee Premium fund. The Guarantee Premium fund for any
policy month is the accumulation of all the monthly guarantee premiums
applicable to the shortest guarantee period in effect, shown on Page
3-Continued, from the Register Date up to that month at 4% interest.
2. Determine the actual premium fund. The actual premium fund for any policy
month is the accumulation of all the premiums received at 4% interest
minus all withdrawals accumulated at 4% interest.
3. If the result in Step 2 is greater than or equal to the result in Step 1,
and any loan and accrued loan interest does not exceed the Policy Account
Value, the policy is not in default. The guarantee will be in effect and
monthly deductions in excess of the Policy Account will be waived.
02-200-5 PAGE 7
4. If the result of Step 2 is less than the result in Step 1, or if the
result of Step 2 is greater than or equal to the result in Step 1 and any
loan and accrued loan interest exceeds the Policy Account Value, the
policy is in default as of the first day of that policy month. This is
the date of default.
If all guarantee periods have terminated (see "No Lapse Guarantee" and "Extended
No Lapse Guarantee" provisions) the calculations described in Steps 1. - 4.
above will not be performed. In that case, if the Net Policy Account Value at
the beginning of any policy month is less than the monthly deductions for that
month, the policy is in default as of the first day of such policy month.
If the policy is in default, we will send you and any assignee on our records at
last known addresses written notice stating that a grace period of 61 days has
begun starting with the date the notice is mailed. The notice will also state
the amount of payment that is due.
The payment required will not be more than an amount sufficient to increase the
Net Policy Account Value to cover all monthly deductions for 3 months,
calculated assuming no interest or investment performance were credited to or
charged against the Policy Account and no policy changes were made.
If we do not receive such amount at our Administrative Office before the end of
the grace period, we will then (1) withdraw and retain any amount in your Policy
Account; and (2) send a written notice to you and any assignee on our records at
last known addresses stating that this policy has ended without value.
If we receive the requested amount before the end of the grace period, but the
Net Policy Account Value is still insufficient to cover total monthly
deductions, we will send a written notice that a new 61 day grace period has
begun and request an additional payment.
If the second of the insured persons to die dies during a grace period, we will
pay the Insurance Benefit as described on Page 5.
RESTORING YOUR POLICY BENEFITS. If this policy has ended without value, you may
restore policy benefits if both insured persons are alive or if one insured
person is alive and the policy ended without value after the death of the other
insured person. In order to restore benefits, you must:
1. Ask for restoration of policy benefits within 6 months from the end of
the grace period; and
2. Provide evidence of insurability satisfactory to us; and
3. Make a required payment. The required payment will not be more than an
amount sufficient to cover (i) total monthly deductions for 3 months,
calculated from the effective date of restoration; and (ii) the premium
charge. We will determine the amount of this required payment as if no
interest or investment performance were credited to or charged against
your Policy Account.
We must receive the required payment while at least one insured person is alive.
We will deduct the premium charge from the required payment. The policy account
on the date of restoration will be equal to the balance of the required payment.
The effective date of the restoration of policy benefits will be the beginning
of the policy month which coincides with or next follows the date we approve
your request. We will start to make monthly charges again as of the effective
date of restoration. Restoration of this policy will reinstate the balance, if
any, of the No Lapse Guarantee or Extended No Lapse period as measured from the
policy Register Date. We reserve the right to decline to restore this policy if
in our opinion it would cause this policy to fail to qualify as life insurance
under applicable tax law.
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YOUR POLICY ACCOUNT AND HOW IT WORKS
PREMIUM PAYMENTS. When we receive your premium payments, we subtract the expense
charges shown in the table in the "Policy Information" section and any overdue
monthly deductions. We put the balance (the net premium) into your Policy
Account as of the date we receive the premium payment at our Administrative
Office and before any deductions from your Policy Account due on that date are
made. However, we will put the initial net premium payment into your Policy
Account as of the Register Date if it is later than the date of receipt. No
premiums will be applied to your Policy Account until the minimum initial
premium payment, as shown in the "Policy Information" section, is received at
our Administrative Office.
MONTHLY DEDUCTIONS. At the beginning of each policy month we make a deduction
from your Policy Account to cover the monthly administrative charge and to
provide insurance coverage. If you do not submit the full minimum initial
premium with your application, and the minimum initial premium is paid upon
delivery, your monthly charges commence as of the Register Date. Generally, the
Register Date will be earlier than the date coverage begins. Such deduction for
any policy month is the sum of the following amounts determined as of the
beginning of that month:
02-200-7 PAGE 8
o the monthly administrative charge;
o the monthly mortality and expense risk charge;
o the monthly cost of insurance for the insured persons; and
o the monthly cost of any benefits provided by riders to this policy.
The monthly cost of insurance is the sum of (a) our current monthly cost of
insurance rate times the net amount at risk at the beginning of the policy month
divided by $1,000; plus (b) any flat extra charge shown in the "Policy
Information" section. The net amount at risk at any time is the death benefit
(calculated as of that time) minus the amount in your Policy Account at that
time
We will determine cost of insurance rates from time to time. Any change in the
cost of insurance rates we use will be as described in the "Changes in Policy
Cost Factors" provision. They will never be more than those shown in the Table
of Maximum Monthly Cost of Insurance Rates Per $1000 of Net Amount at Risk for
the Base Policy on Page 4-Continued.
No deduction is made (except for the mortality and expense risk charge) after
the policy anniversary nearest the 100th birthday of the younger insured person.
OTHER DEDUCTIONS. We also make the following other deductions from your Policy
Account as they occur:
o We deduct a surrender charge if, before the end of the tenth policy year, you
give up this policy for its Net Cash Surrender Value or you reduce the base
policy face amount.
o We deduct a charge for certain transfers (see "Transfers" provision).
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YOUR INVESTMENT OPTIONS
ALLOCATIONS. This policy provides investment options for the amount in your
Policy Account. Amounts put into your Policy Account and deductions from it are
allocated to the investment funds of our SA and to the unloaned portion of our
GIA at your direction. You specified your initial premium allocation and
deduction allocation percentages in your application for this policy, a copy of
which is attached to this policy. Unless you change them, such percentages shall
also apply to subsequent premium and deduction allocations.
Allocation percentages must be zero or a whole number not greater than 100. The
sum of the premium allocation percentages and of the deduction allocation
percentages must each equal 100.
You may change such allocation percentages by written notice to our
Administrative Office. A change will take effect on the date we receive it at
our Administrative Office.
If we cannot make a monthly deduction on the basis of the deduction allocation
percentages then in effect, we will make that deduction based on the proportion
that your unloaned value in our GIA and your values in the investment funds of
our SA bear to the total unloaned value in your Policy Account.
TRANSFERS. Transfer requests must be in writing and delivered by U.S mail to our
Administrative Office unless we accept an alternative form of communication
(such as internet or automated telephone). The use of alternative forms of
communication is subject to our rules then in effect for each such service. We
may provide information about our rules and the use of communications services
in the policy prospectus, prospectus supplements or other notifications, as
mailed to your last known address in our records from time to time. Any
alternative form of communication that we make available may be changed or
discontinued at any time. Communications services may be restricted or denied if
we determine that you are using such services for market timing or other trading
strategies that may disrupt operation of an investment fund of our SA or have a
detrimental effect on the unit value of any investment fund of our SA.
We reserve the right to:
1. limit transfers among or to the investment funds of our SA to no more than
once every 30 days;
2. require a minimum time period between each transfer into or out of one or
more specified investment funds of our SA;
3. establish a maximum dollar amount that may be transferred by an owner on any
transaction date among investment funds of our SA;
4. reject transfer requests from a person acting on behalf of multiple policy
owners unless pursuant to a trading authorization agreement that we have
accepted;
02-200-9 PAGE 9
5. impose conditions or limitations on transfer rights, restrict transfers or
refuse any particular transfer if we are concerned that market timing, excessive
trading or other trading strategies may disrupt operation of an investment fund
of our SA or may have a detrimental effect on the unit value of any investment
fund of our SA or determine that you have engaged in any such strategy.
At your written request to our Administrative Office, we will transfer amounts
from your value in any investment fund of our SA to one or more other funds of
our SA or to our GIA. Any such transfer will take effect on the date we receive
your written request at our Administrative Office.
Once during each policy year you may ask us, by written request to our
Administrative Office, to transfer an amount you specify from your unloaned
value in our GIA to one or more investment funds of our SA. We must receive your
request within a period beginning 30 days prior to the policy anniversary and
ending 60 days after the policy anniversary. A transfer request received up to
30 days prior to the policy anniversary will be effective on the anniversary. A
transfer request received on or within 60 days after the policy anniversary will
be effective on the date the request is received at our Administrative Office.
The maximum amount that you may transfer in any policy year is the greater of
(a) $500, (b) 25% of the unloaned value in the GIA on the transfer effective
date or (c) the amount transferred from the GIA in the immediately preceding
policy year, if any. In no event will we transfer more than your unloaned value
in our GIA.
The minimum amount that we will transfer from your value in an investment fund
of our SA on any date is the lesser of $500.00 or your value in that investment
fund on that date, except as stated in the next paragraph. The minimum amount
that we will transfer from your value in our GIA is the lesser of $500.00 or
your unloaned value in our GIA as of the date the transfer takes effect, except
as stated in the next paragraph.
We will waive the minimum amount limitations set forth in the immediately
preceding paragraph if the total amount being transferred on that date is at
least $500.00.
We reserve the right to make a transfer charge up to $25.00 for each transfer of
amounts among your investment options. The transfer charge, if any, is deducted
from the amounts transferred from the investment funds of our SA and our GIA
based on the proportion that the amount transferred from each investment fund of
our SA and our GIA bears to the total amount being transferred.
If you ask us to transfer the entire amount of your value in the investment
funds of our SA to our GIA, we will not make a charge for that transfer.
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THE VALUE OF YOUR POLICY ACCOUNT
The amount in your Policy Account at any time is equal to the sum of the amounts
you then have in our GIA and in the investment funds of our SA under this
policy. Your Net Policy Account value is equal to the amount in your Policy
Account minus any policy loan and accrued loan interest.
YOUR VALUE IN OUR GIA. The amount you have in our GIA at any time is equal to
the amounts allocated and transferred to it, plus the interest credited to it,
minus amounts deducted, transferred and withdrawn from it. We will credit the
amount in our GIA with interest at rates we determine. We will determine such
interest rates periodically in advance for unloaned and loaned amounts in our
GIA. The rates may be different for unloaned and loaned amounts. Any change in
the interest rates we determine will be as described in the "Changes in Policy
Cost Factors" provision. Such interest rates will not be less than 3%. Interest
accrues and is credited on unloaned amounts in the GIA daily. However, we will
credit interest on any portion of the initial net premium allocated to our GIA
from the Register Date if it is later than the date of receipt provided the
initial premium is at least equal to the minimum initial premium shown on Page 3
of the policy.
We credit interest on the loaned portion of our GIA daily. The interest rate we
credit to the loaned portion of our GIA will be at an annual rate up to 2% less
than the loan interest rate we charge. However, we reserve the right to credit a
lower rate than this if in the future tax laws change such that our taxes on
policy loans or policy loan interest are increased. In no event will we credit
less than 3% a year.
On each policy anniversary, and at any time you repay all of a policy loan, we
allocate the interest that has been credited to the loaned portion of our GIA to
the investment funds of our SA and the unloaned portion of our GIA in accordance
with your premium allocation percentages.
YOUR VALUE IN THE INVESTMENT FUNDS OF OUR SA. The amount you have in an
investment fund of our SA under this policy at any time is equal to the number
of units this policy then has in that fund multiplied by the fund's unit value
at that time.
Amounts allocated, transferred or added to an investment fund of our SA are used
to purchase units of that fund; units are redeemed when amounts are deducted,
loaned, transferred or withdrawn. These transactions are called policy
transactions.
02-200-9 PAGE 10
The number of units a policy has in an investment fund at any time is equal to
the number of units purchased minus the number of units redeemed in that fund to
that time. The number of units purchased or redeemed in a policy transaction is
equal to the dollar amount of the policy transaction divided by the fund's unit
value on the date of the policy transaction. Policy transactions may be made on
any day. The unit value that applies to a transaction made on a business day
will be the unit value for that day. The unit value that applies to a
transaction made on a non-business day will be the unit value for the next
business day.
We determine unit values for the investment funds of our SA at the end of each
business day. Generally, a business day is any day the New York Stock Exchange
is open for trading. A business day immediately preceded by one or more
non-business days will include those non-business days as part of that business
day. For example, a business day which falls on a Monday will consist of that
Monday and the immediately preceding Saturday and Sunday.
The unit value of an investment fund of our SA on any business day is equal to
the unit value for that fund on the immediately preceding business day
multiplied by the net investment factor for that fund on that business day.
The net investment factor for an investment fund of our SA on any business day
is (a) divided by (b), minus (c), where:
(a) is the net asset value of the shares in designated investment companies
that belong to the investment fund at the close of business on such
business day before any policy transactions are made on that day, plus the
amount of any dividend or capital gain distribution paid by the investment
companies on that day;
(b) is the value of the assets in that investment fund at the close of business
on the immediately preceding business day after all policy transactions
were made for that day; and
(c) is any charge for that day for taxes, amounts set aside as a reserve for
taxes, or any operating expenses of our SA (including, without limitation,
SEC registration fees and auditing fees).
The net asset value of an investment company's shares held in each investment
fund shall be the value reported to us by that investment company.
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THE CASH SURRENDER VALUE OF THIS POLICY
CASH SURRENDER VALUE. The Cash Surrender Value on any date is equal to the
amount in your Policy Account on that date minus any applicable surrender
charge.
NET CASH SURRENDER VALUE. The Net Cash Surrender Value is equal to the Cash
Surrender Value minus any policy loan and accrued loan interest. You may give up
this policy for its Net Cash Surrender Value at any time while either or both
insured persons are living. You may do this by sending us a written request for
it and this policy to our Administrative Office. Your written request for
cancellation or surrender must include the following:
1. A statement that makes it clear that you intend to surrender the contract;
2. The policy number of the policy to be surrendered;
3. The names of the insured persons and your name (if other than the insured
persons) and address where proceeds should be mailed;
4. Your signature and, if required by the policy or by a legally binding
document of which we have an actual notice, the signature of a collateral
assignee or other person having an interest in the policy through the
legally binding document.
If this policy has a cash surrender value and is being given up for its net cash
surrender value, a completed withholding authorization must also be included
with your written request. If this form is not provided to us with your written
request for surrender, we will withhold income tax on the taxable portion of
your distribution at the mandated federal and state tax rates. We will compute
the Net Cash Surrender Value as of the date we receive your request for it and
this policy at our Administrative Office. If the policy has been lost, stolen or
destroyed, you must include a statement in the written request that the policy
was lost, stolen or destroyed with an approximate date of when the policy was
lost, stolen or destroyed. All insurance coverage under this policy ends on the
date we receive your written request.
SURRENDER CHARGES. If you give up this policy for its Net Cash Surrender Value
before the end of the tenth policy year, we will subtract a surrender charge
from your Policy Account. A table of surrender charges for the initial base
policy face amount is in the "Policy Information" section.
If the base policy face amount is reduced before the end of the tenth policy
year, we will also deduct a proportionate amount of any applicable surrender
charge from your Policy Account. Such deduction will be made in accordance with
the
00-000-00 PAGE 11
"Allocations" provision. We will send you a new Policy Information section
in the event of a reduction in the base policy face amount. It will become a
part of this policy. We may require you to return this policy to our
Administrative Office to make a change.
We have filed a detailed statement of the method of computing surrender charges
with the insurance supervisory official of the jurisdiction in which this policy
is delivered.
PARTIAL NET CASH SURRENDER VALUE WITHDRAWAL. After the first policy year, and
while either or both insured persons are living, you may ask for a partial Net
Cash Surrender Value withdrawal by written request to our Administrative Office.
Your request will be subject to our approval based on our rules in effect when
we receive your request, and to the minimum withdrawal amount of $500.00. We
have the right to decline a request for a partial Net Cash Surrender Value
withdrawal if this would cause the policy to fail to qualify as life insurance
under applicable tax law, as interpreted by us. We will decline a request for a
partial Net Cash Surrender Value withdrawal if this would cause a decrease in
the base policy face amount to less than $200,000. A partial withdrawal will
result in a reduction in the Cash Surrender Value and in your Policy Account
equal to the amount withdrawn as well as a reduction in your death benefit. If
the death benefit is Option A, the withdrawal may also result in a decrease in
the face amount; there will be no proportionate surrender charge due to such a
decrease.
You may tell us how much of each partial withdrawal is to come from your
unloaned value in our GIA and from your values in each of the investment funds
of our SA. If you do not tell us, we will make the withdrawal on the basis of
your monthly deduction allocation percentages then in effect. If we cannot make
the withdrawal as indicated above, we will make the withdrawal based on the
proportion that your unloaned value in our GIA and your values in the investment
funds of our SA bear to the total unloaned value in your Policy Account.
Such withdrawal and resulting reduction in the death benefit, in the Cash
Surrender Value and in your Policy Account will take effect on the date we
receive your written request at our Administrative Office. We will send you a
new Policy Information section if a withdrawal results in a reduction in the
face amount. It will become a part of this policy. We may require you to return
this policy to our Administrative Office to make a change.
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HOW A LOAN CAN BE MADE
POLICY LOANS. You can take a loan on this policy while it has a loan value. This
policy will be the only security for the loan. Any amount on loan is part of
your Policy Account. We refer to this as the loaned portion of your Policy
Account.
CARRY OVER LOANS. If this policy was issued based, in whole or part, upon a
valid exchange under Section 1035 of the Internal Revenue Code, any transferred
existing loan from the exchanged policy as approved by us will be put into your
Loaned Policy Account. If a refund is made under the "Right to Examine Policy"
provision, we will subtract any policy loan and accrued loan interest from that
refund.
LOAN VALUE. The loan value on any date is 90% of the Cash Surrender Value on
that date. The amount of any new loan you take may not be more than the loan
value, less any existing loan and accrued loan interest. If you request an
increase to an existing loan, the additional amount requested will be added to
the amount of the existing loan and accrued loan interest.
Your request for a policy loan must be in writing to our Administrative Office.
You may tell us how much of the requested loan is to be allocated to your
unloaned value in our GIA and your value in each investment fund of our SA. Such
values will be determined as of the date we receive your request. If you do not
tell us, we will allocate the loan on the basis of your monthly deduction
allocation percentages then in effect. If we cannot allocate the loan on the
basis of your direction or those percentages, we will allocate it based on the
proportion that your unloaned value in our GIA and your values in the investment
funds of our SA bear to the total unloaned value in your Policy Account.
The loaned portion of your Policy Account will be maintained as a part of our
GIA. Thus, when a loaned amount is allocated to an investment fund of our SA, we
will redeem units of that investment fund sufficient in value to cover the
amount of the loan so allocated and transfer that amount to our GIA.
LOAN INTEREST. Interest on a loan accrues daily at an adjustable loan interest
rate. We will determine the rate at the beginning of each policy year, subject
to the following paragraphs. It will apply to any new or outstanding loan under
the policy during the policy year next following the date of determination.
The maximum loan interest rate for a policy year shall be the greater of (1) the
"Published Monthly Average," as defined below, for the calendar month that ends
two months before the date of determination or (2) 4%. "Published Monthly
Average" means the Monthly Average Corporate Bond yield shown in Xxxxx'x
Corporate Bond Yield Averages published by Xxxxx'x Investors Service, Inc., or
any successor thereto. If such averages are no longer published, we will use
such other averages as may be established by regulation by the insurance
supervisory official of the jurisdiction in which this policy is delivered. We
reserve the right to establish a rate lower than the maximum.
00-000-00 PAGE 12
No change in the rate shall be less than 1/2 of 1% a year. We may increase the
rate whenever the maximum rate as determined by clause (1) of the preceding
paragraph exceeds the rate being charged by 1/2 of 1% or more. We will reduce
the rate to or below the maximum rate as determined by clause (1) of the
preceding paragraph if such maximum is lower than the rate being charged by 1/2
of 1% or more.
We will notify you of the initial loan interest rate when you make a loan. We
will also give you advance written notice of any increase in the interest rate
of any outstanding loan.
Loan interest is due on each policy anniversary. If the interest is not paid
when due, it will be added to your outstanding loan and allocated on the basis
of the deduction allocation percentages then in effect. If we cannot make the
allocation on the basis of these percentages, we will make it based on the
proportion that your unloaned values in our GIA and your values in the
investment funds of our SA bear to the total unloaned value in your Policy
Account. The unpaid interest will then be treated as part of the loaned amount
and will bear interest at the loan rate.
When unpaid loan interest is allocated to an investment fund of our SA, we will
redeem units of that investment fund sufficient in value to cover the amount of
the interest so allocated and transfer that amount to your loaned Policy
Account.
LOAN REPAYMENT. You may repay all or part of a policy loan at any time while
either of the insured persons is alive and this policy is in force.
Repayments will first be allocated to our GIA until you have repaid any loaned
amounts that were allocated to our GIA. You may tell us how to allocate
repayments above that amount among our GIA and the investment funds of our SA.
If you do not tell us, we will make the allocation on the basis of the premium
allocation percentages then in effect.
Failure to repay a policy loan or to pay loan interest will not terminate this
policy unless at the beginning of a policy month the Net Policy Account Value is
less than the total monthly deduction then due. In that case, the "Grace Period"
provision will apply.
A policy loan will have a permanent effect on your benefits under this policy
even if it is repaid.
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OUR SEPARATE ACCOUNT(S) (SA)
We established and we maintain our SA under the laws of New York State. Realized
and unrealized gains and losses from the assets of our SA are credited to or
charged against it without regard to our other income, gains, or losses. Assets
are put in our SA to support this policy and other variable life insurance
policies. Assets may be put in our SA for other purposes, but not to support
contracts or policies other than variable contracts.
The assets of our SA are our property. The portion of its assets equal to the
reserves and other policy liabilities with respect to our SA will not be
chargeable with liabilities arising out of any other business we conduct. We may
transfer assets of an investment fund in excess of the reserves and other
liabilities with respect to that fund to another investment fund or to our
General Account.
INVESTMENT FUNDS. Our SA consists of investment funds. Each fund may invest its
assets in a separate class of shares of a designated investment company, or
companies, or make direct investments in securities. The investment funds of our
SA that you chose for your initial allocations are shown on the application for
this policy, a copy of which is attached to this policy. We may from time to
time make other investment funds available to you, or we may create a new SA. We
will provide you with written notice of all material details including
investment objectives and all charges.
We have the right to change or add designated investment companies. We have the
right to add or remove investment funds. We have the right to withdraw assets of
a class of policies to which this policy belongs from an investment fund and put
them in another investment fund. We also have the right to combine any two or
more investment funds. The term investment fund in this policy shall then refer
to any other investment fund in which the assets of a class of policies to which
this policy belongs were placed.
We have the right to:
1. register or deregister any SA available under this policy under the
Investment Company Act of 1940;
2. run any SA available under this policy under the direction of a committee,
and discharge such committee at any time;
3. restrict or eliminate any voting rights of policy owners, or other persons
who have voting rights as to any SA available under this policy; and
4. operate any SA available under this policy, or one or more of its
investment funds, by making direct investments or in any other form. If we
do so, we may invest the assets of such SA, or one or more of the
investment funds, in any legal investments. We will rely upon our own or
outside counsel for advice in this regard. Also, unless otherwise required
by
00-000-00 PAGE 13
law or regulation, an investment adviser or any investment policy may not
be changed without our consent. If required by law or regulation, the
investment policy of an investment fund of any SA available under this
policy will not be changed by us unless approved by the Superintendent of
Insurance of New York State or deemed approved in accordance with such law
or regulation. If so required, the process for getting such approval is on
file with the insurance supervisory official of the jurisdiction in which
this policy is delivered.
If any of these changes result in a material change in the underlying
investments of an investment fund of our SA, we will notify you of such change,
as required by law. If you have value in that investment fund we will, if you
wish, transfer it at your written direction from that fund to another fund(s) of
our SA or to our GIA, and you may then change your premium and deduction
allocation percentages. There will be no charge for such a transfer.
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OUR ANNUAL REPORT TO YOU
For each policy year we will send you without charge a report for this policy
that shows the current death benefit, the value you have in our GIA and in each
investment fund of any SA available under this policy, the Cash Surrender Value
and any policy loan with the current loan interest rate. It will also show the
premiums paid and any other information as may be required by the insurance
supervisory official of the jurisdiction in which this policy is delivered.
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HOW BENEFITS ARE PAID
You can have the Insurance Benefit or your Net Cash Surrender Value withdrawals
paid immediately in one sum. Or, you can choose another form of payment for all
or part of them. If you do not arrange for a specific choice before the death of
the second insured person to die, the beneficiary will have this right when such
insured person dies. If you do make an arrangement, however, the beneficiary
cannot change it after the such insured person dies.
The options are:
1. DEPOSIT. The sum will be left on deposit for a period mutually agreed upon.
We will pay interest at the end of every month, every 3 months, every 6
months or every 12 months, as chosen.
2. INSTALLMENT PAYMENTS. There are two ways that we pay installments:
A. FIXED PERIOD. We will pay the sum in equal installments for a specified
number of years (not more than 30). The installments will be at least
those shown in the Table of Guaranteed Payments.
B. FIXED AMOUNT. We will pay the sum in installments as mutually agreed
upon until the original sum, together with interest on the unpaid
balance, is used up.
3. MONTHLY LIFE INCOME. We will pay the sum as a monthly income for life. The
amount of the monthly payment will be at least that shown in the Table of
Guaranteed Payments. The basis for these payments is the 1983 Individual
Annuity Mortality Table "a" projected with modified Scale G. You may choose
any one of two ways to receive monthly life income. We will guarantee
payments for at least 10 years (called "10 Years Certain") or at least 20
years (called "20 Years Certain").
Payments that we make under options 1. - 3. above will not be affected by the
investment experience of any investment fund of our SA after proceeds are
applied under such options.
We will also apply the sum under any other option requested that we make
available at the time of payment.
The payee may name and change a successor payee for any amount we would
otherwise pay to the payee's estate.
Any arrangements involving more than one of the options, or a payee who is not a
natural person (for example, a corporation) or who is a fiduciary, must have our
approval. Also, details of all arrangements will be subject to our rules at the
time the arrangement takes effect. These include rules on the minimum amount we
will apply under an option and minimum amounts for installment payments,
withdrawal or commutation rights, naming payees and successor payees and proving
age and survival.
Payment choices (or any later changes) will be made and will take effect in the
same way as a change of beneficiary. Amounts applied under these options will
not be subject to the claims of creditors or to legal process, to the extent
permitted by law.
00-000-00 PAGE 14
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OTHER IMPORTANT INFORMATION
YOUR CONTRACT WITH US. This policy is issued in consideration of payment of a
premium at least equal to the minimum initial premium payment shown in the
"Policy Information" section. This policy, any riders or endorsements, and the
attached copy of the initial application and all subsequent applications to
change this policy, and all additional Policy Information sections added to this
policy, make up the entire contract. The rights conferred by this policy are in
addition to those provided by applicable Federal and State laws and regulations.
Only our Chairman of the Board, our President or one of our Vice Presidents can
modify this contract or waive any of our rights or requirements under it. The
person making these changes must put them in writing and sign them.
POLICY CHANGES -- APPLICABLE TAX LAW. For you and the beneficiary to receive the
tax treatment accorded to life insurance under Federal law, this policy must
qualify initially and continue to qualify as life insurance under the Code or
successor law. Therefore, we have reserved earlier in this policy the right to
decline to accept premium payments, to decline to change death benefit options,
to decline to change the face amount, or to decline to make partial withdrawals
that, in our opinion, would cause this policy to fail to qualify as life
insurance under applicable tax law. Further, we reserve the right to make
changes in this policy or its riders (for example, in the percentages on Page 4-
Continued), or to require additional premium payments, or to make distributions
from this policy or to change the face amount to the extent we deem it necessary
to continue to qualify this policy as life insurance. Any such changes will
apply uniformly to all policies that are affected. You will be given advance
written notice of such changes.
CHANGES IN POLICY COST FACTORS. Changes in policy cost factors (interest rates
we credit to our GIA, cost of insurance deductions and expense charges) will be
on a basis that is equitable to all policyholders of a given class, and will be
determined based on reasonable assumptions as to expenses, mortality, policy and
contract claims, taxes, investment income, and lapses. Any change in policy cost
factors will never result in an interest crediting rate that is lower than that
guaranteed in the policy, or policy charges that exceed the maximum policy
charges guaranteed in the policy. 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. However, with respect to each insured person, we will not contest
the validity of this policy after it has been in effect during the lifetime of
that insured person for two years from the earlier of the Register Date or date
of issue shown in the Policy Information section. At the end of the second
policy year, we will mail you a notice requesting that you tell us if either
insured person has died. Failure to tell us of the death of an insured person
will not avoid a contest, if we have basis to contest the policy, even if the
policy is still in force.
We also have the right to contest the validity of any policy change or
restoration based on material misstatements made in any application for that
change or restoration. We will not contest any policy change that requires
evidence of insurability, or any restoration of this policy, after the change or
restoration has been in effect for two years during the lifetime of the insured
persons or insured person living at the time the change or restoration takes
effect.
No statement shall be used to contest a claim unless contained in an
application.
All statements made in an application are representations and not warranties.
See any additional benefit riders for modifications of this provision that apply
to them.
WHAT IF AGE OR SEX HAS BEEN MISSTATED? If either or both insured person's age or
sex has been misstated on any application, the death benefit and any benefits
provided by riders to this policy shall be those which would be purchased by the
most recent deduction for the cost of insurance, and the cost of any benefits
provided by riders, at the correct ages and sexes.
HOW THE SUICIDE EXCLUSION AFFECTS BENEFITS. If the second of the insured persons
to die commits suicide (while sane or insane) within two years after the earlier
of the Register Date or the date of issue shown in the Policy Information
section, our liability will be limited to the payment of a single sum. This sum
will be equal to the premiums paid, minus any loan and accrued loan interest and
minus any partial withdrawal of the Net Cash Surrender Value. If the second of
the insured persons to die commits suicide (while sane or insane) within two
years after the effective date of a change that you asked for that increases the
death benefit, then our liability as to the increase in amount will be limited
to the payment of a single sum equal to the monthly cost of insurance deductions
made for such increase.
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.
00-000-00 PAGE 15
HOW, WHEN AND WHAT WE MAY DEFER. We may not be able to obtain the value of the
assets of the investment funds of our SA if (1) the New York Stock Exchange is
closed; or (2) the Securities and Exchange Commission requires trading to be
restricted or declares an emergency. During such times, as to amounts allocated
to the investment funds of our SA, we may defer:
1. Determination and payment of Net Cash Surrender Value withdrawals (except
when used to pay premiums to us);
2. Determination and payment of any death benefit in excess of the face amount;
3. Payment of loans (except when used to pay premiums to us);
4. Determination of the unit values of the investment funds of our SA; and
5. Any requested transfer.
As to amounts allocated to our GIA, we may defer payment of any Net Cash
Surrender Value withdrawal or loan amount (except when used to pay premiums to
us) for up to six months after we receive a request for it. We will allow
interest, at the rate of at least 3% a year, on any Net Cash Surrender Value
payment derived from our GIA that we defer for 30 days or more.
THE BASIS WE USE FOR COMPUTATION. We provide Cash Surrender Values that are at
least equal to those required by law. If required to do so, we have filed with
the insurance supervisory official of the jurisdiction in which this policy is
delivered a detailed statement of our method of computing such values. We
compute reserves under this policy by the Commissioners Reserve Valuation
Method.
We use the 1980 Commissioners' Standard Ordinary Male or Female, Smoker or
Non-Smoker Mortality Tables as the basis for determining maximum insurance costs
and minimum cash surrender values. We take account of the sex, issue age, class
of risk and tobacco user status of each insured person and of the policy year.
We use a minimum effective annual interest rate of 3% for the Guaranteed
Interest Account.
CHANGE FROM TOBACCO USER RATES TO NON-TOBACCO USER RATES. Either or both insured
persons, if being charged tobacco user rates, may apply for non-tobacco user
rates. The change, if approved, may result in lower future cost of insurance
rates beginning on the effective date of change to non-tobacco user rates.
However, cost of insurance rates depend on the rating classification of both
insured persons even if only one survives at the time of the application for
change.
Upon request made to our Administrative Office, we will provide forms and
instructions as to how the insured person(s) may apply for non-tobacco user
rates. The change will be based upon our general underwriting rules in effect at
the time of application, and may include criteria with respect to both insured
persons or the surviving insured person other than tobacco use status as well as
a definition of tobacco use different from that applicable at the time this
policy was issued.
The change to non-tobacco user rates, if approved, will take effect at the
beginning of the policy month that coincides with or next follows the date we
approve your request. A copy of your application for the change will be attached
to the new Policy Information section that we will issue when the change is
made. The new section and the application for change will become part of this
policy. We may require you to return this policy to our Administrative Office to
make the change. This change may have adverse tax consequences.
The change to non-tobacco rates will be contestable; however, we will not
contest the change after it has been in effect for two years during the lifetime
of the insured person or insured persons living at the time the change took
effect. In the event of a successful contest, the death benefit and any benefits
provided by riders to this policy shall be those which would be purchased by the
most recent deduction for the cost of insurance, and the cost of any benefits
provided by riders, at tobacco user rates.
POLICY ILLUSTRATIONS. Upon request we will give you an illustration of the
potential future benefits under this policy, based upon both guaranteed and
current cost factor assumptions.
POLICY CHANGES. You may add additional benefit riders or make other changes,
subject to our rules at the time of change.
00-000-00 PAGE 16
TABLE OF GUARANTEED PAYMENTS
(MINIMUM AMOUNT FOR EACH $1,000 APPLIED)
OPTION 2A OPTION 3
FIXED PERIOD INSTALLMENTS MONTHLY LIFE INCOME
------------------------- --------------------
NUMBER OF 10 YEARS CERTAIN 20 YEARS CERTAIN
YEARS' MONTHLY ANNUAL ---------------- -----------------
INSTALLMENTS INSTALLMENT INSTALLMENT AGE MALE FEMALE MALE FEMALE
------------ ----------- ----------- --- ---- ------ ---- ------
1 $84.28 $1,000.00 50 $3.48 $3.19 $3.42 $3.17
2 42.66 506.17 51 3.54 3.23 3.47 3.21
3 28.79 341.60 52 3.59 3.28 3.51 3.25
4 21.86 259.33 53 3.65 3.32 3.56 3.29
5 17.70 210.00 54 3.70 3.37 3.61 3.33
6 14.93 177.12 55 3.77 3.42 3.66 3.37
7 12.95 153.65 56 3.83 3.47 3.72 3.42
8 11.47 136.07 57 3.90 3.52 3.77 3.47
9 10.32 122.40 58 3.97 3.58 3.83 3.52
10 9.39 111.47 59 4.04 3.64 3.88 3.57
11 8.64 102.54 60 4.12 3.70 3.94 3.62
12 8.02 95.11 61 4.20 3.76 4.00 3.68
13 7.49 88.83 62 4.29 3.83 4.06 3.74
14 7.03 83.45 63 4.38 3.90 4.12 3.79
15 6.64 78.80 64 4.48 3.98 4.18 3.85
16 6.30 74.73 65 4.58 4.06 4.25 3.92
17 6.00 71.15 66 4.68 4.14 4.31 3.98
18 5.73 67.97 67 4.79 4.23 4.37 4.04
19 5.49 65.13 68 4.90 4.32 4.43 4.11
20 5.27 62.58 69 5.02 4.42 4.50 4.18
21 5.08 60.28 70 5.14 4.52 4.56 4.25
22 4.90 58.19 71 5.26 4.63 4.62 4.31
23 4.74 56.29 72 5.39 4.75 4.67 4.38
24 4.60 54.55 73 5.52 4.87 4.73 4.45
25 4.46 52.95 74 5.66 4.99 4.78 4.51
26 4.34 51.48 75 5.80 5.12 4.83 4.58
27 4.22 50.12 76 5.95 5.26 4.88 4.64
28 4.12 48.87 77 6.10 5.40 4.93 4.70
29 4.02 47.70 78 6.25 5.55 4.97 4.75
30 3.93 46.61 79 6.40 5.70 5.01 4.80
80 6.56 5.85 5.04 4.86
81 6.72 6.01 5.08 4.90
82 6.88 6.18 5.11 4.95
83 7.04 6.34 5.13 4.99
84 7.20 6.51 5.16 5.03
85 & over 7.36 6.67 5.18 5.07
If installments are paid every 3 months, they will be 25.23% of the annual
installments. If they are paid every 6 months, they will be 50.31% of the annual
installments.
Amounts for Monthly Life Income are based on age nearest birthday when income
starts. Amounts for ages not shown will be furnished on request.
00-000-00 PAGE 17
THE EQUITABLE
LIFE ASSURANCE SOCIETY OF THE UNITED STATFS
A Stock Life Insurance Company
Home Office: 0000 Xxxxxx xx xxx Xxxxxxxx, Xxx Xxxx, Xxx Xxxx 00000
Flexible Premium Joint Survivorship Variable Life Insurance Policy.
Insurance benefit payable upon the death of the second of the insured
persons to die while this policy is in force. Premiums may be paid while
both or either insured person is living and before the policy anniversary
nearest the younger insured person's 100th birthday. Values provided by
this policy are based on declared interest rates and on the unit values of
the investment funds of a separate account, which in turn depend on the
investment performance of the securities held by such investment funds.
They are not guaranteed as to dollar amount. This is a non-participating
policy.
