EX-26.D.I 2 dex26di.htm SPECIMEN FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE POLICY Specimen Flexible Premium Variable Life Insurance Policy

EXHIBIT 26(d)(i)

Specimen Flexible Premium Variable Life Insurance Policy


 

 

   Home Office: Columbus, Ohio
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO    Administrative Office:
(A STOCK COMPANY)    [PO Box 5068
   Clearwater, FL 33758]

 

 

 

IN THIS POLICY, the Primary Insured is named on the Policy Schedule page. Western Reserve Life Assurance Co. of Ohio will be referred to as WE, OUR or US.

 

 

IF THE PRIMARY INSURED DIES while this Policy is In Force, WE WILL PAY the Death Benefit Proceeds to the Beneficiary upon receipt of due proof of the Primary Insured’s death. THE AMOUNT OF THE DEATH BENEFIT PROCEEDS WILL INCREASE OR DECREASE DEPENDING ON THE INVESTMENT EXPERIENCE OF THE SUBACCOUNTS IN THE SEPARATE ACCOUNT AND ON THE DEATH BENEFIT OPTION SELECTED AS DESCRIBED IN THE DEATH BENEFIT PROVISIONS.

CASH VALUES WILL INCREASE OR DECREASE IN ACCORDANCE WITH THE POLICY VALUE PROVISIONS AND THE INVESTMENT EXPERIENCE OF THE SUBACCOUNTS IN THE SEPARATE ACCOUNT. CASH VALUES ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.

THE PROVISIONS on the following pages are part of this Policy. This Policy is a legal contract between the Owner and Us. If the Owner chooses to exercise any of the rights of this Policy, it may result in termination of the benefits provided under certain Riders. READ THE POLICY CAREFULLY.

IN WITNESS WHEREOF, We have signed this Policy at Our Administrative Office in [Clearwater, Florida] as of the Policy Date.

 

LOGO   LOGO
Secretary   President

RIGHT TO EXAMINE POLICY

The Owner may cancel this Policy by returning it to Us at [4333 Edgewood Road NE, Cedar Rapids, Iowa 52499], or to the representative through whom it was purchased, within ten (10) days of receipt. If the Policy is returned within this period, it will be void from the beginning and a refund will be made to the Owner. The refund will equal the sum of:

 

  1. The difference between the premiums paid and the amounts allocated to any Accounts under the Policy; plus

 

  2. The total amounts of Monthly Deductions made and any other charges imposed on amounts allocated to the Accounts; plus

 

  3. The value of the amounts allocated to the Accounts on the date We or Our agent receives the returned Policy.

If State law prohibits the calculation above, the refund will be the total of all premiums paid for this Policy.

Flexible Premium Variable Life Insurance Policy

Death Benefit Proceeds Payable at Death of Primary Insured

Flexible Premiums Payable During Lifetime of Primary Insured

Non Participating — No Dividends

Some Benefits Reflect Investment Results

 

VL18    


 

 

POLICY GUIDE

 

 

Policy Schedule

   3   

Death Benefit

   10

Glossary

   5   

Specified Amount

   10

Accounts

   5   

Option Type

   11

Amount at Risk

   5   

Compliance with Federal Tax Code

   12

Attained Age

   5   

Changes

   12

Anniversary

   5   

Death Benefit Proceeds

   13

Base Policy

   5    Premium Provisions    13

Beneficiary

   5   

Payment

   13

Cash Value

   5   

Premiums

   13

Death Benefit Proceeds

   5   

Grace Period

   14

Fixed Account

   5   

No Lapse Guarantee

   14

Funds

   5   

Changes to the Minimum

  

In Force

   5   

    Monthly Guarantee Premium

   14

Initial Premium

   5   

Reinstatement

   14

Internal Revenue Code

   5    Separate Account Provisions    15

Issue Age

   6   

The Separate Account

   15

Lapse

   6   

Subaccounts

   15

Minimum Monthly Guarantee Premium

   6   

Market Timing

   15

Monthiversary

   6   

Transfers

   16

Monthly Deduction

   6   

Changes

   16

Net Premium

   6   

Unit Value

   17

Net Surrender Value

   6    Fixed Account Provisions    17

No Lapse Date

   6   

Fixed Account

   17

No Lapse Guarantee

   6   

Fixed Account Interest Rate

   18

Planned Premium

   6   

Transfers

   18

Policy Date

   6    Policy Value Provisions    18

Qualified Additional Benefit

   7   

Net Premium

   18

Reallocation Account

   7   

Allocation of Net Premiums

   18

Reallocation Date

   7   

Monthly Deductions

   19

Record Date

   7   

Recovery of Monthly Deductions

   19

Reinstatement

   7   

Monthly Policy Charge

   19

Rider

   7   

Monthly Cost of Insurance

   19

SEC

   7   

Monthly Cost of Insurance Rates

   20

Separate Account

   7   

Monthly Per Unit Charge

   20

Subaccount

   7   

Subaccount Value

   21

Surrender

   7   

Fixed Account Value

   21

Termination

   7   

Cash Value

   21

Valuation Date

   7   

Surrender

   22

Valuation Period

   7   

Net Surrender Value

   22

Written Notice

   8   

Surrender Charge

   22

General Provisions

   8   

Withdrawals

   22

The Policy

   8   

Continuation of Insurance

   23

Ownership

   8   

Insufficient Value

   23

Beneficiary

   8   

Basis of Computations

   23

Assignment

   9   

Policy Loans

   23

Incontestability

   9    Settlement Options    24

Suicide

   9   

Effective Date and First Payment Due

   24

Issue Age and Sex

   10   

Improvement of Monthly Annuity

   24

Annual Report

   10   

Availability

   24

Termination

   10   

Age

   24

Policy Payment

   10   

Proof of Age and Sex

   24

Conversion Rights

   10   

Proof of Survival

   24

Protection of Proceeds

   10   

Interest and Mortality

   24

Death Benefit Provisions

   10   

Table of Optional Methods of Settlement

   25

 

VL18   Page 2  


Western Reserve Life Insurance Co. of Ohio

Office:  [Clearwater, Florida]

Policy Schedule

 

 

Policy Number:   [0123456789]    
Primary Insured:   [JOHN DOE]    
Issue Age And Sex:   [35 - Male]   Policy Date:   [February 1, 2008]
Specified Amount:   $[50,000.00]   Record Date:   [February 1, 2008]
Option Type:   [A]   No Lapse Date:   [February 1, 2028]
Planned Premium:   $[700.00]   Reallocation Date:   [February 16, 2008]
Payment Frequency:   [Annually]   Minimum Monthly  
Initial Premium:   $[700.00]   Guarantee Premium:   $[45.71]
Rate Class:   [Non-Tobacco]    
Rate Band:   [Band 1]    

 

Life Insurance Compliance Test:   [Guideline Premium Test]
Minimum Specified Amount  

Band 1:

    $50,000.00

Band 2:

  $250,000.00

Band 3:

  $500,000.00
Separate Account Provisions  

Separate Account:

  [WRL Series Life Account]

Mortality and Expense Risk Charge

 

Current:

 

Policy Years [1-10]:

  [.75% (Annually)]

Policy Years [11-15]:

  [.60% (Annually)]

Policy Years [16-20]:

  [.30% (Annually)]

Policy Years [21+]:

  [.00% (Annually)]

Guaranteed:

   .90% (Annually)

Reallocation Account:

  Fixed Account

 

Policy Value Provisions
Premium Expense Charge:

Band

 

Policy Years

 

Premium Expense Charge

 

Policy Years

 

Premium Expense Charge

1   1-10   6.0%   11+   2.5%
2   1-10   3.0%   11+   2.5%
3   All Policy Years   0%    

 

Monthly Policy Charge:

 

Current Through Age 110:

  [$10.00]

Current Beginning at Attained Age 111:

  [$    .00]

Guaranteed Through Age 110:

  $12.00

Guaranteed Beginning at Attained Age 111:

  $    .00

Monthly Per Unit Charge Per $1,000 of Specified Amount:

 

Current (Policy Years 1-10):

  [$.11]

Guaranteed (Policy Years 1-10):

   $.11

Fixed Account Value Limit:

  $[5,000.00-$250,000.00]

 

VL18   PAGE 3  


Western Reserve Life Insurance Co. of Ohio

Office:  [Clearwater, Florida]

Policy Schedule (Continued)

 

 

Policy Number: [0123456789]

Limitation Percentage

The Limitation Percentage is a percentage based on the Primary Insured’s Attained Age at the beginning of the policy year and is used in calculating the death benefit as shown in the Option Type section of the Death Benefit Provisions.

For The Guideline Premium Test, the Limitation Percentages are as follows:

 

Primary Insured’s

Attained Age

  

Limitation Percentage

40 and under

   250%

41 through 45

   250% minus 7% for each Age over Age 40

46 through 50

   215% minus 6% for each Age over Age 45

51 through 55

   185% minus 7% for each Age over Age 50

56 through 60

   150% minus 4% for each Age over Age 55

61 through 65

   130% minus 2% for each Age over Age 60

66 through 70

   120% minus 1% for each Age over Age 65

71 through 75

   115% minus 2% for each Age over Age 70

76 through 90

   105%

91 through 95

   105% minus 1% for each Age over Age 90

96 through 99

   100%

100 plus

   101%

 

VL18   PAGE 3A  


Western Reserve Life Insurance Co. of Ohio

Office:  [Clearwater, Florida]

Policy Schedule (Continued)

 

 

Policy Number: [0123456789]

Table of Surrender Charges

(Per $1,000 of Initial Specified Amount as of the Policy Date)

The Table of Surrender Charges is applicable only to the Initial Specified Amount. Upon any increase to the Specified Amount, an additional Surrender Charge will be incurred.

Specified Amount: $[50,000.00]

Policy Date: [February 1, 2008]

 

End of Year*

  

Surrender Charge

AT ISSUE    $19.68
1    $19.68
2    $18.70
3    $17.32
4    $15.55
5    $13.38
6    $10.82
7    $7.87
8    $4.92
9    $1.97
10+    $0.00

 

* The Surrender Charge on any date other than an end of year will be pro-rated between the two end of year charges.

 

VL18   PAGE 3B  


Western Reserve Life Insurance Co. of Ohio

Office:  [Clearwater, Florida]

Rider Information

 

 

Policy Number: [0123456789]

 

           Monthly Deduction  

Base Policy

      $ [19.93 ]

Number:

   [0123456789]   

Insured:

   [John Doe]   

Face Amount:

   $[50,000.00]   

Rate Class:

   [Non-Tobacco]   

Primary Insured Rider Plus

      $ [  1.51 ]

Number:

   [0123456789]   

Insured:

   [John Doe]   

Face Amount:

   $[50,000.00]   

Rate Class:

   [Non-Tobacco]   

Other Insured Rider

      $ [  1.91 ]

Number:

   [0123456789]   

Insured:

   [Jane Doe]   

Issue Age:

   [35]   

Sex:

   [Female]   

Face Amount:

   $[50,000.00]   

Rate Class:

   [Non-Tobacco]   

The Monthly Deductions shown above are applicable for the first policy month. For Monthly Deductions after the first policy month, refer to the Rider form.

 

VL18   PAGE 4  


Western Reserve Life Insurance Co. of Ohio

Office:  [Clearwater, Florida]

Policy Schedule

 

 

Policy Number: [0123456789]

Table of Guaranteed Maximum Life Insurance Rates Per $1,000

Guaranteed Rate Basis for Initial Specified Amount on Primary Insured

    Commissioners 2001 Standard Ordinary Tobacco or Non-Tobacco Mortality Table

    [John Doe]

    [Male Lives]

    [Non-Tobacco]

Current Cost of Insurance Rates are less than or equal to the Guaranteed Rates. We guarantee that for the first [3] years from issue, the Current Cost of Insurance Rates will not change.

Current Monthly Cost of Insurance Rates per $1,000

 

Attained Age

  

Monthly Rate

35    .08866
36    .09262
37    .09816

Guaranteed Monthly Cost of Insurance Rates per $1,000

 

Attained Age

  

Monthly Rate

  

Attained Age

  

Monthly Rate

38    0.11083    66      1.48166
39    0.11750    67      1.61666
40    0.12666    68      1.75916
41    0.13750    69      1.91916
42    0.15083    70      2.10583
43    0.16666    71      2.33250
44    0.18416    72      2.59750
45    0.20333    73      2.87666
46    0.22250    74      3.17666
47    0.23833    75      3.50333
48    0.25083    76      3.87166
49    0.26666    77      4.30000
50    0.28750    78      4.79750
51    0.31416    79      5.35500
52    0.34666    80      5.97666
53    0.38416    81      6.65250
54    0.43166    82      7.36833
55    0.48500    83      8.15000
56    0.54000    84      9.01916
57    0.59333    85      9.98583
58    0.64666    86    11.04916
59    0.70916    87    12.19833
60    0.78500    88    13.42000
61    0.87750    89    14.70166
62    0.98500    90    15.97833
63    1.10250    91    17.23500
64    1.22500    92    18.55166
65    1.35250    93    19.94000

 

VL18   PAGE 4A  


Western Reserve Life Insurance Co. of Ohio

Office:  [Clearwater, Florida]

Policy Schedule

 

 

Policy Number: [0123456789]

Table of Guaranteed Maximum Life Insurance Rates Per $1,000

(-Continued-)

 

Attained Age

  

Monthly Rate

  

Attained Age

  

Monthly Rate

  94    21.40250    103    35.37000
  95    22.85083    104    37.10583
  96    24.26500    105    38.93416
  97    25.77166    106    40.87500
  98    27.37833    107    42.93416
  99    29.09250    108    45.11916
100    30.73000    109    47.43500
101    32.18250    110    49.88750
102    33.72750    111      0.00000

 

VL18   PAGE 4A Continued  


Western Reserve Life Insurance Co. of Ohio

Office:  [Clearwater, Florida]

Policy Schedule

 

 

Policy Number: [0123456789]

Table of Guaranteed Maximum Life Insurance Rates Per $1,000

Guaranteed Rate Basis for Initial Specified Amount on Primary Insured Rider Plus

    Commissioners 2001 Standard Ordinary Tobacco or Non-Tobacco Mortality Table

    [John Doe]

    [Male Lives]

    [Non-Tobacco]

 

Attained Age

  

Monthly Rate

  

Attained Age

  

Monthly Rate

35    0.09333    68      1.75916
36    0.09750    69      1.91916
37    0.10333    70      2.10583
38    0.11083    71      2.33250
39    0.11750    72      2.59750
40    0.12666    73      2.87666
41    0.13750    74      3.17666
42    0.15083    75      3.50333
43    0.16666    76      3.87166
44    0.18416    77      4.30000
45    0.20333    78      4.79750
46    0.22250    79      5.35500
47    0.23833    80      5.97666
48    0.25083    81      6.65250
49    0.26666    82      7.36833
50    0.28750    83      8.15000
51    0.31416    84      9.01916
52    0.34666    85      9.98583
53    0.38416    86    11.04916
54    0.43166    87    12.19833
55    0.48500    88    13.42000
56    0.54000    89    14.70166
57    0.59333    90    15.97833
58    0.64666    91    17.23500
59    0.70916    92    18.55166
60    0.78500    93    19.94000
61    0.87750    94    21.40250
62    0.98500    95    22.85083
63    1.10250    96    24.26500
64    1.22500    96    25.77166
65    1.35250    97    27.37833
66    1.48166    99    29.09250
67    1.61666      

 

VL18   PAGE 4B  


Western Reserve Life Insurance Co. of Ohio

Office:  [Clearwater, Florida]

Policy Schedule

 

 

Policy Number: [0123456789]

Table of Guaranteed Maximum Life Insurance Rates Per $1,000

Guaranteed Rate Basis for Initial Specified Amount on Other Insured Rider

    Commissioners 2001 Standard Ordinary Tobacco or Non-Tobacco Mortality Table

    [Jane Doe]

    [Female Lives]

    [Non-Tobacco]

 

Attained Age

  

Monthly Rate

  

Attained Age

  

Monthly Rate

35    0.07666    68      1.23333
36    0.08250    69      1.34333
37    0.08750    70      1.46750
38    0.09166    71      1.60916
39    0.09666    72      1.76416
40    0.10250    73      1.93333
41    0.10916    74      2.12083
42    0.11666    75      2.32666
43    0.12583    76      2.55250
44    0.13666    77      2.80250
45    0.14916    78      3.07500
46    0.16416    79      3.37416
47    0.18166    80      3.74583
48    0.20083    81      4.20250
49    0.22250    82      4.68583
50    0.24666    83      5.19333
51    0.27416    84      5.75916
52    0.30500    85      6.33250
53    0.33750    86      7.01000
54    0.37166    87      7.84666
55    0.41083    88      8.72916
56    0.45333    89      9.60750
57    0.49833    90    10.25416
58    0.54500    91    10.87250
59    0.59250    92    11.89750
60    0.64250    93    13.28666
61    0.69750    94    15.01666
62    0.75583    95    16.89916
63    0.81750    96    18.75333
64    0.88500    97    19.95666
65    0.96000    98    20.61000
66    1.04166    99    21.96583
67    1.13250      

 

VL18   PAGE 4C  


GLOSSARY

  
Accounts    Allocation options including the Fixed Account and the Subaccounts of the Separate Account.
Administrative Office    Our office located in [Clearwater, Florida].
Amount at Risk    The death benefit, as described in the Death Benefit Provisions, less the Cash Value of the Policy.
Attained Age    The Issue Age plus the number of completed policy years.
Anniversary    The same day and month as the policy date for each succeeding year the Policy remains In Force.
Base Policy    The Policy excluding any attached Riders.
Beneficiary    The person or persons specified by the Owner to receive the Death Benefit Proceeds upon the death of the Primary Insured.
Cash Value    At the end of any Valuation Period, the Cash Value of the Policy is equal to the sum of the Subaccount Values plus the Fixed Account value.
Death Benefit Proceeds    The amount payable upon the death of the Primary Insured in accordance with the Death Benefit Provisions.
Fixed Account    An allocation option other than the Separate Account. The Fixed Account is part of Our general account. The portion of the Cash Value in the Fixed Account will earn interest as described in the Fixed Account Provisions.
Funds    Designated mutual fund(s) registered with the SEC as investment companies under the Investment Company Act of 1940. Each Subaccount invests Net Premiums allocated to the Subaccount in a corresponding portfolio of a Fund.
In Force    Condition under which the coverage of the Policy or Rider, if any, is active.
Initial Premium    The amount which must be paid before coverage begins. The Initial Premium is shown on the Policy Schedule pages.
Internal Revenue Code    The Internal Revenue Code of 1986, as amended.

 

VL18   Page 5  


Issue Age    The age of the Primary Insured, in years, on his or her birthday on or prior to the Policy Date.
Lapse    Termination of the Policy at the end of the grace period.
Mailing Office    Our office located at [4333 Edgewood Road NE, Cedar Rapids, IA 52499].
Minimum Monthly Guarantee Premium    The Minimum Monthly Guarantee Premium for the first month is shown on the Policy Schedule pages. The cumulative Minimum Monthly Guarantee Premium is used by Us to determine whether a grace period will begin.
Monthiversary    The day of each month coinciding with the Policy Date. If there is no day in a calendar month that coincides with the Policy Date, the Monthiversary will be the first day of the following month.
Monthly Deduction    Set of charges We deduct from the Policy’s Cash Value on each Monthiversary.
Mortality and Expense Risk Charge    The Mortality and Expense Risk charge is a daily deduction from each Subaccount that is taken before determining the unit value of that Subaccount.
Net Premium    The portion of the premium available for allocation as set forth in the Policy Value Provisions.
Net Surrender Value    The amount payable upon Surrender in accordance with the Policy Value Provisions.
No Lapse Date    The date, as set forth on the Policy Schedule pages, prior to which the Policy will not Lapse if certain conditions are met, even though the Net Surrender Value is insufficient to meet the Monthly Deductions.
No Lapse Guarantee    The guarantee that We will not begin a grace period provided the total premium received meets the requirements set forth in the No Lapse Guarantee provision.
Planned Premium    Premiums paid according to a periodic payment schedule, which allows the Owner to pay level premiums at fixed intervals over a specified period of time. Planned Premiums are not required to be paid according to their schedule. The Owner may change the amount, frequency, and period over which Planned Premiums are paid.
Policy Date    The date coverage is effective and Monthly Deductions commence under the Policy. Policy months, years and anniversaries are measured from the Policy Date, as shown on the Policy Schedule pages.

 

VL18   Page 6  


Premium Expense Charge    The Premium Expense Charge is deducted from each premium payment before determining the net premium that will be credited to the cash value.
Qualified Additional Benefit    Any Rider providing coverage for a Qualified Additional Benefit under Section 7702 of the Internal Revenue Code.
Reallocation Account    A portion of the Fixed Account where We hold the Net Premium(s) from the Record Date until the Reallocation Date.
Reallocation Date    The date on which any premiums are reallocated from the Reallocation Account to the Accounts as elected by the Owner on the application. The Reallocation Date is shown on the Policy Schedule pages.
Record Date    The date the Policy is recorded on Our books. The Record Date is shown on the Policy Schedule pages.
Reinstatement    Restoration of coverage under the Policy after it has Lapsed. Reinstatement is subject to the requirements of the Reinstatement section of the Premium Provisions.
Rider    Any attachment to the Policy which provides additional coverage or benefits.
SEC    The United States Securities and Exchange Commission.
Separate Account    A separate investment account shown on the Policy Schedule pages that is composed of several Subaccounts established to receive and invest Net Premiums under the Policy.
Subaccount    A sub-division of the Separate Account. Each Subaccount invests exclusively in the shares of a specified Fund portfolio.
Surrender    The Termination of the Policy at the option of the Owner.
Termination    Condition under which the Policy or any Rider is no longer In Force.
Valuation Date    Any date We are required by law to value the assets of the Separate Account.
Valuation Period    The period commencing at the end of one Valuation Date and continuing to the end of the next succeeding Valuation Date.

 

VL18   Page 7  


Written Notice    A notice by the Owner to Us requesting or exercising a right of the Owner as provided by the provisions of the Policy. In order for a notice to be considered a Written Notice:
  

1.      It must be in writing and signed by the Owner;

  

2.      It must be in a form acceptable to Us; and

  

3.      It must contain the information and documentation, as determined in Our sole discretion, necessary for Us to take the action requested or for the Owner to exercise the right specified.

   A Written Notice will not be considered complete until all necessary supporting documentation required or requested by Us has been received by Us at Our Mailing Office.

GENERAL PROVISIONS

 

The Policy    The Policy is issued in consideration of the attached application and payment of the Initial Premium. The Policy, the attached application, and any additional applications at the time of Reinstatement constitute the entire contract. All statements in these applications, in the absence of fraud, will be deemed representations and not warranties. No statement can be used to void the Policy or be used in defense of a claim unless it is contained in the written application. No policy provision can be waived or changed except by endorsement. Such endorsement must be signed by our President or Secretary.
   Upon notice to the Owner, We may amend the Policy:
  

1.      To make the Policy comply with any law or regulation issued by a government agency to which We are subject;

  

2.      To assure qualification of the Policy under the Internal Revenue Code or other federal or state laws relating to variable life insurance policies; or

  

3.      To reflect a change in the operation of the Separate Account.

   In the event that We so amend the Policy, We will send the Owner a copy of the amendment. The Owner may refuse such amendment by giving us notice in writing. Any refusal, however, may have adverse tax or other consequences to the Owner.
Ownership    The Policy belongs to the Owner. The Owner, as named in the application or subsequently changed, may exercise all rights under the Policy during the Primary Insured’s lifetime, including the right to transfer ownership. If the Owner should die during the Primary Insured’s lifetime, ownership of the Policy will pass to the Owner’s estate if no Contingent Owner is named.
   We will not be bound by any change in the ownership designation unless it is made by Written Notice. The change will be effective on the date the Written Notice is accepted by Us. If We request, the Policy must be returned to Our Mailing Office for endorsement.
Beneficiary    The Beneficiary, as named in the application or subsequently changed, will receive the benefits payable upon the death of the Primary Insured. If the Beneficiary dies before the Primary Insured, the Contingent Beneficiary, if named, becomes the Beneficiary.

 

VL18   Page 8  


   If any Beneficiary dies at the same time as the Primary Insured, or within thirty (30) days after the Primary Insured, that Beneficiary’s interest in the death benefit will end if We have not paid any benefits to that Beneficiary. If the interests of all designated Beneficiaries have ended when the Primary Insured dies, We will pay the death benefit to the Owner. If the Owner is not living at that time, We will pay the death benefit to the Owner’s estate.
   We will not be bound by any change in the Beneficiary designation unless it is made by Written Notice. The change will be effective on the date the Written Notice was signed; however, no change will apply to any payment We made before the Written Notice is received by Us. If We request, the Policy must be returned to Our Mailing Office for endorsement.
Assignment    The Policy may be assigned. We will not be bound by any assignment unless it is made by Written Notice and received at Our Mailing Office. The assignment will be effective on the date it was signed; however, no change will apply to any payment We made before the Written Notice was received by Us. We assume no responsibility for the validity of any assignment.
Incontestability    The Policy shall be incontestable after it has been In Force for two (2) years from the Policy Date during the lifetime of the Primary Insured. For any portion of the Specified Amount that is issued as a result of a conversion, the contestability period is measured from the later of the Policy Date of the policy that was converted or the latest effective date of reinstatement of that converted policy.
   A new two-year contestability period shall apply to each increase in Specified Amount that requires evidence of insurability, on the effective date of the increase. The new contestability period shall apply only to statements made in the application for the increase.
   If the Policy is reinstated, a new two year contestability period (in addition to any remaining contestability period) shall apply from the date of the application for Reinstatement and will apply only to statements made in the application for Reinstatement.
Suicide    If the Primary Insured dies by suicide, while sane or insane, within two (2) years from the Policy Date or within two (2) years from the effective date of any Reinstatement of the Policy, the Policy shall terminate and Our total liability, including all Riders attached to the Policy, will be limited to the total premiums paid, less any loans and prior withdrawals, during such period. For any portion of the Specified Amount that is issued as a result of a conversion, the suicide period is measured from the later of the Policy Date of the policy that was converted or the latest effective date of reinstatement of that converted policy.
   If the Primary Insured dies by suicide, while sane or insane, within two (2) years from the effective date of any increase in insurance that requires evidence of insurability, Our total liability with respect to such increase will be its Cost of Insurance charges and any Per Unit Charges.

 

VL18   Page 9  


Issue Age and Sex    If the Primary Insured’s date of birth or sex is not correctly stated, the death benefit will be adjusted based on what the Cost of Insurance charge and Per Unit Charge for the most recent Monthly Deduction would have purchased based on the Primary Insured’s correct date of birth and sex. No adjustment will be made to the Cash Value.
Annual Report    This is a statement of the Policy’s activities during the Policy year. We will send a report to the Owner at least once a year, or as requested.
Termination    The Policy will terminate on the earliest of:
  

1.      The date of the Primary Insured’s death;

  

2.      The end of the grace period; or

  

3.      The date of Surrender.

Policy Payment    All proceeds to be paid upon Termination will be paid in one sum unless otherwise elected under the Settlement Options of the Policy.
   All payments and transfers from the Subaccounts will be processed as provided in the Policy, unless one of the following situations exists:
  

1.      The New York Stock Exchange is closed;

  

2.      The SEC requires that trading be restricted or declares an emergency; or

  

3.      The SEC allows Us to defer payments to protect Our policyowners.

   We may defer payments of any Fixed Account values for the period permitted by law, but not for more than six (6) months.
Conversion Rights    At any time upon written request within the first two (2) policy years, the Owner may elect to transfer all Subaccount Values to the Fixed Account without a transfer charge.
Protection of Proceeds    Unless the Owner so directs in writing, no Beneficiary may assign any payments under the Policy before such payment is due. To the extent permitted by law, no payments under the Policy will be subject to the claims of creditors of any Beneficiary.

DEATH BENEFIT PROVISIONS

 

Death Benefit    The death benefit is based upon the Specified Amount, Option Type, and the Life Insurance Compliance Test applicable at the time of death.
Specified Amount    The Specified Amount is shown on the Policy Schedule pages, unless changed in accordance with the Changes section of this provision or by Rider, or reduced by a cash withdrawal.

 

VL18   Page 10  


Option Type    The Option Type is shown on the Policy Schedule pages, unless changed in accordance with the Changes section of this provision.
   If Option Type A is in effect, the death benefit is the greatest of:
  

1.      The Specified Amount; or

  

2.      The minimum death benefit a or b below, corresponding to the Life Insurance Compliance Test shown on the Policy Schedule pages:

  

a.      Guideline Premium Test: The Limitation Percentage as shown on the Policy Schedule pages, multiplied by the Cash Value of the Policy on the date of the Primary Insured’s death; or

  

b.      Cash Value Accumulation Test: The Limitation Percentage as shown on the Policy Schedule pages, multiplied by the difference of the Cash Value of the Policy on the date of the Primary Insured’s death and any applicable Net Single Premium for Riders (which are Qualified Additional Benefits) on the date of the Primary Insured’s death, as shown on the Policy Schedule pages; or

  

3.      The amount required for the Policy to qualify as a life insurance contract under Section 7702 of the Internal Revenue Code.

   If Option Type B is in effect, the death benefit is the greatest of:
  

1.      The Specified Amount plus the Cash Value of the Policy on the date of the Primary Insured’s death; or

  

2.      The minimum death benefit a or b below, corresponding to the Life Insurance Compliance Test shown on the Policy Schedule pages:

  

a.      Guideline Premium Test: The Limitation Percentage as shown on the Policy Schedule pages, multiplied by the Cash Value of the Policy on the date of the Primary Insured’s death; or

  

b.      Cash Value Accumulation Test: The Limitation Percentage as shown on the Policy Schedule pages, multiplied by the difference of the Cash Value of the Policy on the date of the Primary Insured’s death and any applicable Net Single Premium for Riders (which are Qualified Additional Benefits) on the date of the Primary Insured’s death, as shown on the Policy Schedule pages; or

  

3.      The amount required for the Policy to qualify as a life insurance contract under Section 7702 of the Internal Revenue Code.

   If Option Type C is in effect, the death benefit is the greatest of:
  

1.      The Option Type A benefit; or

  

2.      The Specified Amount multiplied by the factor K, plus the Cash Value of the Policy on the date of the Primary Insured’s death, where the factor K is equal to the lesser of:

  

a.      1; or

  

b.      .04 multiplied by (95 minus the Primary Insured’s Attained Age at death).

  

The factor K will never be less than zero; or

  

3.      The amount required for the Policy to qualify as a life insurance contract under Section 7702 of the Internal Revenue Code.

 

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Compliance with Federal Tax Code    The Policy is intended to qualify under Section 7702 of the Internal Revenue Code as a life insurance contract for federal tax purposes. The provisions of the Policy (including any Rider or endorsement) will be interpreted or amended to ensure such qualification, regardless of any language to the contrary.
   To the extent that the death benefit is increased to maintain qualification as a life insurance policy, We will make appropriate adjustments to any Monthly Deductions and any supplemental coverage and benefits (retroactively and prospectively) that are consistent with such an increase. We may deduct retroactive adjustments from the Cash Value or from any death benefits payable. Prospective adjustments will be reflected in the Monthly Deductions.
   The Owner may choose either the Guideline Premium Test or the Cash Value Accumulation Test to qualify the Policy as a life insurance contract under Section 7702. The choice made by the Owner is shown on the Policy Schedule pages as Life Insurance Compliance Test. Once made, the choice may not be changed.
Changes    After the third policy year, the Owner may change the Option Type by Written Notice. Changes will be effective on the first Monthiversary on or next following the day We receive Written Notice. No Changes in Option Type will be allowed if the resulting Specified Amount would be less than the Band 1 Minimum Specified Amount shown on the Policy Schedule pages.
   We will adjust the Specified Amount so that the Amount at Risk, on the effective date of change to a new Option Type, is the same as under the prior Option Type.
   The Specified Amount may be increased at any time, and may be decreased at any time after the third policy year, by Written Notice. Until the later of the end of the Surrender Charge period or the Anniversary on or following the Primary Insured’s 65th birthday, We may limit any decrease to no more than 20% of the then current Specified Amount. All changes to the Specified Amount are subject to the following:
  

1.      Any decrease will become effective on the first Monthiversary on or next following the date We receive Written Notice. Any such decrease will reduce the Specified Amount in the following order:

  

a.      Against the Specified Amount provided by the most recent increase;

  

b.      Against the next most recent increases successively; and

  

c.      Against the Specified Amount provided under the original application.

  

No decrease will be allowed if:

  

a.      The Specified Amount after any requested decrease would be less than the Band 1 Minimum Specified Amount shown on the Policy Schedule pages; or

  

b.      The requested decrease would force a cash withdrawal in order to maintain compliance with the definition of a life insurance contract as defined by the Internal Revenue Code and applicable regulations; or

  

c.      The decrease would cause the Policy to enter a grace period.

 

VL18   Page 12  


  

2.      Any request for an increase in Specified Amount must be applied for on a supplemental application, and it must include evidence of insurability satisfactory to Us. Such increase, if approved by Us, will become effective on the first Monthiversary on or next following Our written approval. Requested increases in Specified Amount must be for a minimum of $10,000, and must be applied for prior to the Primary Insured’s 86th birthday.

   Only one change in the Option Type will be allowed within each policy year and only one change in the Specified Amount will be allowed within each policy year. Changes to Option Type are permitted prior to the Anniversary on or following the Primary Insured’s 95th birthday.
   If the Specified Amount is changed and the resulting Specified Amount causes a change in the Rate Band, the Premium Expense Charge, Cost of Insurance and Per Unit Charges for the new Rate Band will apply starting with the effective date of the change.
Death Benefit Proceeds    The Death Benefit Proceeds is the amount payable by Us under the Policy, provided the Policy has not terminated prior to the death of the Primary Insured. Except as provided in the Suicide section of the General Provisions, the Death Benefit Proceeds will be equal to:
  

1.      The death benefit; minus

  

2.      Any Monthly Deductions due under the Recovery of Monthly Deductions provision; minus

  

3.      Any outstanding policy loans; minus

  

4.      Any accrued loan interest.

PREMIUM PROVISIONS

 

Payment    The Initial Premium shown on the Policy Schedule pages must be paid on or before the Policy Date. All premiums after the Initial Premium are payable at Our Mailing Office.
Premiums    The amount and frequency of Planned Premiums are shown on the Policy Schedule pages. The amount and frequency may be changed upon request, subject to Our approval.
   While the Policy is In Force, additional premiums may be paid at any time. We may limit or refund any premium if:
  

1.      The amount is below Our current minimum payment requirement; or

  

2.      The premium would increase the death benefit by more than the amount of the premium; or

  

3.      The premium would disqualify the Policy as a life insurance contract as defined by the Internal Revenue Code and applicable regulations.

 

VL18   Page 13  


   We may require evidence of insurability before accepting a premium that would increase the death benefit by more than the amount of the premium.
   No future payments will be accepted after the Anniversary on or following the Primary Insured’s 111th birthday, with the exception of loan interest and loan repayments.
Grace Period    If the Net Surrender Value on any Monthiversary is not sufficient to cover the Monthly Deductions on such day, We will mail a grace period notice to the Owner’s last known address and to any assignee of record. In the notice, a grace period of sixty-one (61) days is allowed for payment of premiums after the mailing date of the notice. The notice also shows the minimum payment required and the final date on which such payment must be received by Us to keep the Policy In Force. The Policy will remain In Force during the grace period. If the minimum amount due is not received by Us within the grace period, all coverage under the Policy and any Riders will terminate, without value, at the end of the grace period.
No Lapse Guarantee    Until the No Lapse Date shown on the Policy Schedule pages, no grace period will begin provided the total premiums received (minus any withdrawals, outstanding loans and accrued loan interest) equals or exceeds the Policy’s cumulative Minimum Monthly Guarantee Premium for each month from the Policy Date up to and including the current month. The Policy’s Minimum Monthly Guarantee Premium for the first month is shown on the Policy Schedule pages. The Policy’s Minimum Monthly Guarantee Premium for a subsequent month is the same as the first month unless there is a policy change or the Specified Amount is changed.
Changes to the Minimum Monthly Guarantee Premium    If the Specified Amount is increased or decreased or if there is a policy change, the Minimum Monthly Guarantee Premium will be adjusted at the time of the change. The Owner will be notified by Us of the new Minimum Monthly Guarantee Premium.
Reinstatement    If the Policy Lapses, it may be reinstated subject to the following:
  

1.      Receipt at Our Mailing Office of a Written Notice requesting Reinstatement. Such notice must be within five (5) years of the date of Termination;

  

2.      Receipt of evidence of insurability, satisfactory to Us;

  

3.      Receipt at Our Mailing Office of a premium sufficient to reinstate the Policy.

  

If reinstated after the No-Lapse Date, the required premium will be an amount sufficient to provide a net premium, as follows:

  

a.      Any uncollected Monthly Deductions due up to the time of Termination; plus

  

b.      Two (2) Monthly Deductions due in advance at the time of Reinstatement; plus

  

c.      An amount sufficient to increase the Cash Value above the surrender charges in effect at the time of Reinstatement.

 

VL18   Page 14  


   If reinstated before the No-Lapse Date, the required premium will be the lesser of the premium described above or the following:
  

 

a.      The total Minimum Monthly Guarantee Premium from issue through the month of Lapse; plus

 

b.      Two (2) months of Minimum Monthly Guarantee Premium; minus

 

c.      Any premiums already paid net of any withdrawals, outstanding loans and accrued loan interest.

   The effective date of Reinstatement shall be the date We approve the application for Reinstatement. Any policy loan as of the date of Termination will not be reinstated. Any Cash Value equal to the policy loan on the date of Reinstatement will also not be reinstated. On the first Monthiversary following Reinstatement, any previously uncollected Monthly Deductions due up to the time of the Policy’s Termination date will be taken.

SEPARATE ACCOUNT PROVISIONS

 

The Separate Account    The variable benefits under the Policy are provided through the Separate Account as shown on the Policy Schedule pages. The assets of the Separate Account are Our property. Assets equal to the reserve and other contractual liabilities under all policies issued in connection with the Separate Account will not be charged with liabilities arising out of any other business We may conduct. If the assets of the Separate Account exceed the liabilities arising under the policies supported by the Separate Account, then the excess may be used to cover the liabilities of Our general account. The assets of the Separate Account shall be valued as often as any policy benefits vary, but no less frequently than monthly.
Subaccounts    The Separate Account has various Subaccounts with different objectives. We may add or remove any Subaccount of the Separate Account. Income, if any, and any gains or losses, realized or unrealized, from assets in each Subaccount are credited to, or charged against, the amount allocated to that Subaccount without regard to income, gains, or losses in other Subaccounts. Any amount charged against the investment base for federal or state income taxes will be deducted from that Subaccount. The assets of each Subaccount are invested in shares of a corresponding Fund portfolio. The value of a portfolio share is based on the value of the assets of the portfolio, determined at the end of each Valuation Period in accordance with applicable law.
Market Timing    One or more of the Subaccounts may have been designed to accommodate large and frequent transfers. Large and frequent transfers may increase transaction costs and negatively affect performance of Subaccounts that invest in Fund(s) that are not designed to accommodate these types of transfers. We may reject any premium payment or transfer request if, in our judgment or in the judgment of any underlying Fund, the payment or transfer or series of transfers would have a negative impact on the Subaccounts or Fund portfolios operations, or if a Fund portfolio would reject our purchase order. We may impose other restrictions on transfers, levy a transfer fee or even prohibit transfers if the Owner, in our view, has abused, or appears likely to abuse, the transfer privilege. We may, at the direction of any underlying Fund, provide Owner transaction data to the underlying Fund and block Owner trades involving certain Subaccounts.

 

VL18   Page 15  


   We may reject or restrict transfer requests or require that any transfer request be made in writing via United States Postal Service First Class mail, or any other reasonable remedial measures.
   We may implement, administer and assess a charge for any fee or restriction imposed by a Fund, including redemption fees imposed by a Fund on Subaccount assets that are redeemed out of the Fund in connection with a transfer. The Fund determines the amount of any redemption fee, and the fee would be retained by or paid to the Fund. Any redemption fees imposed by a Fund would not be retained by or paid to Us.
Transfers    The Owner may transfer all or a portion of the Policy’s value in each Subaccount to other Subaccounts or the Fixed Account subject to the limitations imposed under the Transfers section of the Fixed Account Provisions of the Policy. We may charge a $25 fee for each transfer in excess of twelve per policy year. This charge will be deducted from the funds transferred. A request for a transfer must be made in a form satisfactory to Us. The transfer will ordinarily take effect on the first Valuation Date on or following the date the request is received at Our Mailing Office. We may establish rules regarding, among other things, the minimum and maximum amounts you may transfer and the frequency of transfers.
Changes    As permitted by applicable law, We may make changes to the Separate Account and Subaccounts which may include:
  

1.      Transferring assets of the Separate Account or any Subaccount, which We determine to be associated with the class of contracts to which the Policy belongs, to another separate account or subaccount. In the event We make such a transfer, the term “Separate Account” or “Subaccount” as used in the Policy shall mean the separate account or subaccount to which We transfer the assets;

  

2.      Removing, combining, or adding Subaccounts and making the combined or added Subaccounts available for allocation of Net Premiums;

  

3.      Closing certain Subaccounts to allocations of new Net Premiums by current or new Owners;

  

4.      Combining the Separate Account or any Subaccount(s) with one or more different Separate Account(s) or Subaccount(s);

  

5.      Establishing additional Separate Accounts or Subaccounts to invest in new portfolios of the Fund(s).

  

6.      Operating the Separate Account as a management investment company;

  

7.      Managing the Separate Account at the direction of a committee;

  

8.      Endorsing the Policy, as permitted by law, to reflect changes to the Separate Account and Subaccounts as may be required by applicable law;

  

9.      Changing the investment objective of a Subaccount;

 

VL18   Page 16  


  

10.    Substituting, adding, or deleting Fund portfolios in which Subaccounts currently invest Net Premiums, to include portfolios of newly designated Funds;

  

11.    Funding additional classes of variable life insurance contracts through the Separate Account; and

  

12.    Restricting or eliminating any voting privileges of owners or other persons who have voting privileges in connection with the operation of the Separate Account.

   As required by law or regulation, We will not make changes unless We first file a statement with and receive approval from the appropriate official of the State of Our domicile, or unless such change is deemed approved in accordance with law or regulation. If required, such approval of any change will also be filed with the insurance department of the state where the Policy is delivered.
Unit Value    Some of the policy values fluctuate with the investment results of the Subaccounts. In order to determine how investment results affect the policy values, a unit value is determined for each Subaccount. The unit value of each Subaccount was originally established at $10 per unit. The unit value may increase or decrease from one Valuation Period to the next. Unit values also will vary between Subaccounts. The unit value of any Subaccount at the end of a Valuation Period is the result of:
  

1.      The total value of the assets held in the Subaccount. This value is determined by multiplying the number of shares of the designated Fund portfolio owned by the Subaccount times the net asset value per share; minus

  

2.      The accrued risk charge for adverse mortality and expense experience. The daily amount of this charge is equal to the daily net assets of the Subaccount, multiplied by the daily equivalent of the Mortality and Expense Risk Charge. The maximum annual factor for the Mortality and Expense Risk Charge is shown on the Policy Schedule pages; minus

  

3.      The accrued amount of reserve for any taxes or other economic burden resulting from the application of tax laws that are determined by Us to be properly attributable to the Subaccount; and the result divided by

  

4.      The number of outstanding units in the Subaccount.

   The use of the unit value in determining policy values is described in the Policy Value Provisions.

FIXED ACCOUNT PROVISIONS

 

Fixed Account    The Owner may allocate any portion of the Net Premiums to the Fixed Account. The Fixed Account is part of Our general account. Our general account consists of all assets that We own except those in the Separate Account and other separate accounts We may have. Except as limited by law, We have sole control over investment of the assets in Our general account. The Owner may allocate Net Premiums to the Fixed Account and transfer amounts between the Separate Account and the Fixed Account (subject to the following Transfers section).

 

VL18   Page 17  


Fixed Account Interest Rate    The Net Premium allocated to the Fixed Account will accrue interest from the Valuation Date on which We allocate it to the Fixed Account, as described in the Policy Value Provisions. Interest on the Fixed Account will be compounded daily at a minimum guaranteed effective annual interest rate of 2% per year. We may declare from time to time various higher current interest rates on the unloaned portion of the Fixed Account. We will never declare an interest rate that is lower than the guaranteed minimum effective annual interest rate.
Transfers    On transfers from the Fixed Account to a Subaccount, We may impose the following limitations:
  

1.      Written Notice must be received by Us within thirty (30) days after an Anniversary;

  

2.      The transfer will take place on the date We receive such Written Notice.

  

3.      The maximum amount that may be transferred is the greater of: (a) 25% of the amount in the Fixed Account; or (b) the amount transferred in the prior policy year from the Fixed Account.

   Unless We otherwise consent, transfers or allocation of Premiums to the Fixed Account may be restricted if the Fixed Account Value excluding the loan reserve following the transfer or allocation will exceed the Fixed Account Value Limit shown on the Policy Schedule pages. This restriction will not apply for any transfer made under the Conversion Rights section of the General Provisions of the Policy.
   We may charge a $25 fee for each transfer in excess of twelve (12) per policy year. This charge will be deducted from the funds transferred.
   We may defer payment of any amounts from the Fixed Account for no longer than six (6) months after We receive such Written Notice.

POLICY VALUE PROVISIONS

 

Net Premium    The Net Premium equals the premium paid during a policy year multiplied by 100% minus the applicable Premium Expense Charge shown on the Policy Schedule pages.
Allocation of Net Premiums    Net Premiums will be allocated to the Subaccounts of the Separate Account and the Fixed Account on the first Valuation Date on or following the date the premium is received at Our Mailing Office. Any Net Premium received prior to the Policy Date will be allocated on the first Valuation Date on or following the Policy Date. All Net Premiums allocated prior to the Reallocation Date will be allocated to the Reallocation Account. On the first Valuation Date on or following the Reallocation Date, the values in the Reallocation Account will be transferred in accordance with the Owner’s allocation as shown in the application.
   We may limit any allocation to any Account to no less than 1%. No fractional percentages may be permitted. The allocation may be changed by the Owner. The request for change of allocations must be in a form satisfactory to Us. The allocation change will be effective on the date the request for change is recorded by Us.

 

VL18   Page 18  


Monthly Deductions    On each Monthiversary prior to the Anniversary on or following the Primary Insured’s 111th birthday, a Monthly Deduction will be taken equal to the sum of the following:
  

1.      The Monthly Policy Charge for the Policy;

  

2.      The Monthly Cost of Insurance for the Policy;

  

3.      The Monthly Per Unit Charge for the Policy; and

  

4.      The portion of the Monthly Deductions for benefits provided by Riders attached to the Policy, if any.

   If self directed monthly deductions are elected, the deduction withdrawn from each Account will equal the monthly deduction times the selected percentage for that account. If self directed monthly deductions are not elected or if any of the selected Accounts would be reduced to zero by the deductions then deductions will be withdrawn from each Account in proportion to the value each bears to the Cash Value.
   The election of self directed monthly deductions may be changed by the Owner. The request for this change must be in a form satisfactory to Us. The change in self directed monthly deductions will be effective on the date the request for change is recorded by Us. The Monthly Deductions will be reduced to zero after the Anniversary on or following the Primary Insured’s 111th birthday.
Recovery of Monthly Deductions    If the Net Surrender Value on any Monthiversary is not sufficient to cover the Monthly Deduction due on such day, the Cash Value of the Policy may be negative. This may occur while the Policy is being supported by the No Lapse Guarantee or during the grace period. Any such negative values will be accrued without any accumulation of interest and must be repaid by the Owner out of future premiums. If the Primary Insured dies before the Owner pays the amount due, We will subtract the amount required to provide insurance to the date the Primary Insured died from any Death Benefit Proceeds.
Monthly Policy Charge    The Current and Guaranteed Monthly Policy Charge are shown on the Policy Schedule pages. We may increase the Current Monthly Policy Charge up to the Guaranteed Monthly Policy Charge after the first policy year. Any change in this charge will be applied uniformly to all policies in effect for the same length of time.
Monthly Cost of Insurance    The Monthly Cost of Insurance on each Monthiversary is determined as follows:
  

 

1.      Determine the death benefit on the Monthiversary.

  

2.      Reduce the death benefit by the Cash Value on the Monthiversary in the following order until all Cash Value has been applied.

  

a.      Against the Specified Amount provided under the original application;

  

b.      Against the Specified Amount provided by the oldest increase;

  

c.      Against the Specified Amount provided by the next oldest increase and each successive increase; and

  

d.      Against the Specified Amount provided by the most recent increase.

 

VL18   Page 19  


   This results in the Amount at Risk for the Policy.
  

3.      Divide the Amount at Risk by 1,000 to arrive at the number of thousands of Amount at Risk.

  

4.      Multiply the number of thousands of Amount at Risk by the appropriate Monthly Cost of Insurance Rate(s) to arrive at the Monthly Cost of Insurance.

Monthly Cost of Insurance Rates    To determine the Monthly Cost of Insurance Rates, We will refer to the Current Cost of Insurance rate tables in effect for the Policy using the Primary Insured’s sex and Issue Age, Rate Band, Rate Class any rating, and the duration from the Policy Date or from the date of any increase in Specified Amount. Different Monthly Cost of Insurance Rates may apply to increases in the Specified Amount following the Policy Date. Monthly Cost of Insurance Rates may be changed by Us from time to time. A change in the Cost of Insurance rates will apply to all persons of the same Attained Age, sex, Rate Band, Rate Class any rating, and whose policies or increases have been in effect for the same length of time. The rates, before applying any rating will not exceed those shown in the Table of Guaranteed Maximum Life Insurance Rates on the Policy Schedule pages.
Monthly Per Unit Charge    The Monthly Per Unit Charge for the Policy and any Riders is part of the Monthly Deductions and is calculated each Monthiversary as follows:
  

1.      The Current Per Unit Charge for the Specified Amount on the Policy Date; plus

  

2.      The Current Per Unit Charge for any in-force Rider that has a Per Unit Charge; plus

  

3.      The Current Per Unit Charge for each increase in Specified Amount caused by either a Rider or a requested increase; less

  

4.      The Current Per Unit Charge for any Specified Amounts that have been decreased.

   For each of items 1 to 3 above, the Monthly Per Unit Charge will be charged for no more than ten (10) years from the Policy Date or from the date any Rider or any increase becomes effective. The Current Per Unit Charge rates on the Policy Date and the Guaranteed Per Unit Charge rates for the Policy and for each applicable Rider are shown on the Policy Schedule pages.
   If the Specified Amount is increased, the Monthly Per Unit Charge for the Specified Amount increase will be charged for no more than ten (10) years from the date of the increase, and will be calculated as follows:
  

1.      The increase in the Specified Amount, divided by 1,000, times

  

2.      The Current Per Unit Charge rate.

   The Monthly Per Unit Charge rate for each increase will be based on the Primary Insured’s Attained Age at the time of the increase. We may increase the Monthly Per Unit Charge rate up to the Guaranteed Per Unit Charge rate after the first policy year. Any change in this charge will be applied uniformly to all persons of the same Attained Age, Rate Band, and whose policies or increases have been in effect for the same length of time.

 

VL18   Page 20  


   To calculate item 4 above, any decrease in the Specified Amount will reduce the Monthly Per Unit Charge then in effect by the amount of the Monthly Per Unit Charge associated with the Specified Amounts that were decreased. Decreases in the Specified Amount may place the total Specified Amount into a lower Rate Band, resulting in the application of a higher Monthly Per Unit Charge rate to the total in-force Specified Amount. The Current Per Unit Charge rate at issue and the Guaranteed Per Unit Charge rate are shown on the Policy Schedule pages.
   The Rate Band in effect at the time of each Monthly Deduction will be used to determine the appropriate Monthly Per Unit Charge rate(s) that apply to the calculation of the Monthly Per Unit Charge for each segment of the Specified Amount then In Force.
Subaccount Value    At the end of any Valuation Period, the Subaccount Value is equal to the number of units that the Policy has in the Subaccount, multiplied by the unit value of that Subaccount.
  

The  number of units that the Policy has in each Subaccount is equal to:

  

1.      The initial units purchased on the Reallocation Date; plus

  

2.      Units purchased at the time additional Net Premiums are allocated to the Subaccount; plus

  

3.      Units purchased through transfers from another Subaccount or the Fixed Account; minus

  

4.      Those units that are redeemed to pay for Monthly Deductions as they are due (if any); minus

  

5.      Any units that are redeemed to pay for cash withdrawals; minus

  

6.      Any units that are redeemed as part of a transfer to another Account.

   The number of units purchased in or redeemed from a Subaccount is determined by dividing the dollar amount of each purchase or redemption by the unit value of the Subaccount as of the first Valuation Date on or following the date of purchase or redemption.
Fixed Account Value    At the end of any Valuation Period, the Fixed Account value is equal to:
  

1.      The sum of all Net Premiums allocated to the Fixed Account; plus

  

2.      Any amounts transferred from a Subaccount to the Fixed Account; plus

  

3.      Total interest credited to the Fixed Account; minus

  

4.      Any amounts charged to pay for Monthly Deductions as they are due; minus

  

5.      Any amounts withdrawn from the Fixed Account to pay for cash withdrawals; minus

  

6.      Any amounts transferred from the Fixed Account to a Subaccount.

Cash Value    At the end of any Valuation Period, the Cash Value of the Policy is equal to the sum of the Subaccount Values plus the Fixed Account value.

 

VL18   Page 21  


Surrender    While the Policy is In Force, the Owner may Surrender the Policy for the Net Surrender Value. Payment will usually be made within seven (7) days of receipt of Written Notice, subject to the Policy Payment section of the General Provisions.
Net Surrender Value    The Net Surrender Value is the amount payable upon Surrender of the Policy. At the end of any Valuation Period, the Net Surrender Value is equal to:
  

1.      The Cash Value as of such date, minus

  

2.      Any Surrender Charge as of such date, minus

  

3.      Any outstanding policy loan, minus

  

4.      Any accrued loan interest.

Surrender Charge    During the first ten (10) policy years, a Surrender Charge will be incurred upon Surrender of the Policy. This charge will be based upon the Table of Surrender Charges shown on the Policy Schedule pages.
   During the first ten (10) years following each increase in the Specified Amount, an additional Surrender Charge will be effective based upon the amount of the increase and the Attained Age and Rate Class of the Primary Insured at the time of the increase.
   No Surrender Charge is taken when a Specified Amount decrease occurs, and the full Surrender Charge remains in effect until Surrender of the Policy.
Withdrawals    Cash withdrawals may be made any time after the first policy year and while the Policy is In Force. Only one withdrawal is allowed during a policy year. During the first ten (10) policy years, the amount of a withdrawal may be limited to no less than $500 and to no more than 10% of the Net Surrender Value. After the first ten (10) policy years, the amount of a withdrawal may be limited to no less than $500 and to no more than the Net Surrender Value less $500. The remaining Net Surrender Value following a withdrawal may not be less than $500. The request for a withdrawal must be by Written Notice to Us. A processing fee of the lesser of 2% of the amount withdrawn or $25.00 will be deducted from each withdrawal amount and the balance paid to the Owner.
   When a withdrawal is made, the Cash Value shall be reduced by the amount of the withdrawal. If the death benefit is Option Type A, or if the death benefit is Option Type C and the Attained Age is seventy-one (71) or greater, the Specified Amount shall also be reduced by the amount of the withdrawal. These reductions will result in a reduction in the death benefit, which may be determined from the Death Benefit Provisions. No withdrawal will be allowed if the resulting Specified Amount would be less than the Band 1 minimum Specified Amount shown on the Policy Schedule pages.
   The Accounts from which the withdrawal will be made may be specified in the Written Notice. If no Account is specified, the withdrawal amount will be withdrawn from each Account in accordance with the Owner’s current premium allocation instructions. Payment will usually be made within seven (7) days of Written Notice, subject to the Policy Payment section of the General Provisions of the Policy.

 

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Continuation of Insurance    Subject to the Grace Period section of the Premium Provisions, insurance coverage under the Policy and any benefits provided by Rider will be continued In Force until the Net Surrender Value is insufficient to cover Monthly Deductions. This provision shall not continue any Rider beyond the date of its Termination, as provided in the Rider.
Insufficient Value    If the Net Surrender Value on any Monthiversary is not sufficient to cover the Monthly Deductions then due, the Policy shall terminate subject to the Grace Period section of the Premium Provisions.
Basis of Computations    Policy values and reserves are at least equal to those required by law. If required, a detailed statement of the method of computation of values and reserves has been filed with the insurance department of the State in which the Policy was delivered.
Policy Loans    After the first policy year and during the continuance of the Policy, the Owner can borrow against the Policy an amount which is not greater than 90% of the Net Surrender Value minus loan interest that will accrue prior to the next Policy Anniversary. The amount of any policy loan may be limited to no less than $500, except as noted below.
   When a loan is made, an amount equal to the loan will be withdrawn from the Accounts and transferred to the loan reserve. The loan reserve is a portion of the Fixed Account used as collateral for any policy loan. We will credit the amount in the loan reserve with an effective annual interest rate of 2.00%. The Owner may specify the Account(s) from which the withdrawal will be made. If no Account is specified, the withdrawal will be made from each Account in accordance with the Owner’s current premium allocation instructions.
   The loan date is the date We process a loan request. Payment will usually be made within seven (7) days of the date We receive a proper loan request, subject to the Policy Payment section of the General Provisions of the Policy. The Policy will be the sole security for the loan.
   While the Policy is In Force, any loan may be repaid. Any amounts received on the Policy will be considered premiums unless clearly marked as loan repayments.
   On each policy Anniversary, We charge an annual interest rate on each policy loan. Interest not paid when due will be added to the loan and will bear interest up to the maximum policy loan rate. The annual interest rate is guaranteed not to exceed 3.00%. From time to time, We may declare various lower policy loan interest rates. We may also apply different loan interest rates to different parts of the loan.
   After the tenth policy year, We will declare a preferred loan charge rate on an amount equal to the Cash Value minus total premiums paid (less any cash withdrawals) and minus any outstanding loan amount, including accrued loan interest. After the Anniversary on or following the Primary Insured’s 111th birthday, all loans are considered preferred loans. The preferred loan interest rate charged is guaranteed not to exceed 2.25%.

 

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   At each Anniversary, We will compare the amount of the outstanding loan to the amount in the loan reserve. At each such time, if this amount plus any accrued loan interest exceeds the amount in the loan reserve, We will withdraw the difference from the Accounts and transfer it to the loan reserve, in the same fashion as when a loan is made. If the amount in the loan reserve exceeds the amount of the outstanding loan, plus any accrued loan interest, We will withdraw the difference from the loan reserve and transfer it to the Accounts in accordance with the Owner’s current allocation instructions. However, We may require that the transfer be directed to the Fixed Account if such loans were originally transferred from the Fixed Account.
SETTLEMENT OPTIONS
Effective Date and First Payment Due    The effective date of a settlement provision will be either the date of Surrender or the date of death. The first payment will be on the effective date of the settlement provision.
Improvement of Monthly Annuity    The payee will receive the greater of:
  

 

1. The income rate guaranteed in the Policy, or

   2. Our income rates in effect at the time income payments commence.
Availability    If the payee is not a natural person, an optional method of settlement is only available with Our permission. No optional method of settlement is available if:
   1. The payee is an assignee, or
   2. The periodic payment is less than $100.
Age    Age, when required, means age nearest birthday on the effective date of the option. An adjustment will be made in determining the age of the payee(s) when using the tables under Options B and C to obtain the amount of each monthly payment for each $1,000.00 of proceeds applied. The monthly payment for other age or sex combinations will be furnished upon request.

Age Adjustment Table

 

Annuity Commencement Date

  

Adjusted Age

Before 2010    Actual Age
2010-2019    Actual Age minus 1
2020-2026    Actual Age minus 2
2027-2033    Actual Age minus 3
2034-2040    Actual Age minus 4
After 2040    Determined by Us

 

Proof of Age and Sex    Prior to making the first payment under the Policy, We may require satisfactory evidence of the date of birth and sex of any payee.
Proof of Survival    Prior to making any payment under the Policy, We may require satisfactory evidence that any payee is alive on the due date of such payment.
Interest and Mortality    All settlement options are based on the Annuity 2000 Mortality Table, if applicable, and a guaranteed annual interest rate of 2%.

 

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TABLE OF OPTIONAL METHODS OF SETTLEMENT
DESCRIPTION AND TABLES OF MONTHLY INSTALLMENT
PER $1,000 OF PROCEEDS
Option A — Fixed Period    The proceeds will be paid in equal installments. The amount of each monthly installment is determined by multiplying the appropriate factor times the proceeds as of the effective date of settlement divided by $1,000. The installments will be paid over a fixed period determined from the following table:

 

Fixed Period (In Months)

  

Factor

  60    17.49
120      9.18
180      6.42
240      5.04

 

Option B — Life Income    The proceeds will be paid in equal installments determined by the following table. Such payments are payable:
  

1.      During the payee’s lifetime only (Life Annuity); or

  

2.      During a 10-year fixed period certain and for the payee’s remaining lifetime (Certain Period); or

  

3.      Until the sum of installments paid equals the annuity proceeds applied and for the payee’s remaining lifetime (Installment Refund).

 

Payee’s  

Life Annuity

 

Certain Period

 

Installment Refund

Age

 

Male

 

Female

 

Male

 

Female

 

Male

 

Female

55     3.60     3.45     3.57     3.43     3.37     3.29
60     4.07     3.87     4.01     3.83     3.72     3.62
65     4.72     4.43     4.59     4.35     4.16     4.05
70     5.63     5.22     5.32     5.05     4.72     4.59
75     6.87     6.38     6.18     5.94     5.47     5.32
80     8.62     8.08     7.12     6.96     6.41     6.29
85   11.09   10.63     7.97     7.93     7.63     7.58

 

Option C — Joint and Survivor Life Income    The proceeds will be paid in equal installments during the joint lifetime of two (2) payees:

 

1.      Continuing upon the death of the first payee for the remaining lifetime of the survivor, or

  

2.      Reduced by one-third upon the death of the first payee and continuing for the remaining lifetime of the survivor.

  
  

Joint Life Income with Full

Amount to Survivor

The sample ages shown are

Adjusted Ages.

  

Joint Life Income with 2/3

to Survivor

The sample ages shown are Adjusted Ages.

  
  
  

 

   

Female

     

Female

Male

 

55

 

60

 

65

 

70

 

75

     

Male

 

55

 

60

 

65

 

70

 

75

55   3.06   3.19   3.31   3.41   3.48     55   3.35   3.53   3.73   3.94   4.16
60   3.17   3.37   3.55   3.72   3.85     60   3.53   3.75   3.99   4.25   4.53
65   3.27   3.52   3.79   4.05   4.27     65   3.72   3.98   4.28   4.61   4.98
70   3.34   3.65   4.00   4.37   4.73     70   3.91   4.22   4.59   5.01   5.49
75   3.38   3.73   4.16   4.65   5.18     75   4.10   4.46   4.90   5.43   6.05

 

VL18   Page 25  


WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO

 

 

Flexible Premium Variable Life Insurance Policy

Death Benefit Proceeds Payable at Death of Primary Insured

Flexible Premiums Payable During Lifetime of Primary Insured

Non Participating — No Dividends

Some Benefits Reflect Investment Results

 

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