SOUTHLAND SEPARATE ACCOUNT L1
S-6EL24/A, 1996-05-10
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<PAGE>
 
         
     As Filed with the Securities and Exchange Commission on May 10, 1996     

                                                       Registration No. 33-97852

                       SECURITIES AND EXCHANGE COMMISSION
                             Washington, DC  20549
                            
                        Pre-Effective Amendment No. 2 to

                                    FORM S-6     

               FOR REGISTRATION UNDER THE SECURITIES ACT OF 1933
                    OF SECURITIES OF UNIT INVESTMENT TRUSTS
                           REGISTERED ON FORM N-8B-2


                         SOUTHLAND SEPARATE ACCOUNT L1
                             (Exact name of trust)

                        SOUTHLAND LIFE INSURANCE COMPANY
                              (Name of depositor)

                          5780 Powers Ferry Road, N.W.
                               Atlanta, GA  30340
         (Complete address of depositor's principal executive offices)

     (Name and complete address
     of agent for service)               Copy to:
     B. Scott Burton, Esq.               Stephen E. Roth, Esq.
     Associate General Counsel           Sutherland, Asbill & Brennan
     Southland Life Insurance Company    1275 Pennsylvania Avenue, N.W.
     5780 Powers Ferry Road, N.W.        Washington, DC  20004-2404
     Atlanta, GA  30340


                 Approximate date of proposed public offering:
 As soon as practicable after the effective date of this Registration Statement

    Securities Being Offered:  Individual Variable Life Insurance Contracts
     Pursuant to Rule 24f-2 of the Investment Company Act of 1940, the
Registrant has elected to register an indefinite amount of the securities being
offered. The $500 registration fee pursuant to Rule 24f-2 was paid with the
initial filing on October 6, 1995.

     The Registrant hereby amends this Registration Statement on such dates as
may be necessary to delay its effective date until the Registrant shall file a
further amendment which specifically states that this Registration Statement
shall thereafter become effective in accordance with Section 8(a) of the
Securities Act of 1933 or until the Registration Statement shall become
effective on such date as the Commission, acting pursuant to said Section 8(a),
may determine.
<PAGE>
 
                         SOUTHLAND SEPARATE ACCOUNT L1
                        SOUTHLAND LIFE INSURANCE COMPANY

                Cross Reference to Items Required by form N-8B-2

N-8B-2 Item    Caption in Prospectus
- -----------    ---------------------

1              Cover Page                       
2              Cover Page                       
3              Not applicable                   
4              Distribution of the Policies     
5              The Variable Account             
6              The Variable Account             
7              Not applicable                   
8              The Variable Account             
9              Legal Proceedings                 
10             Summary and Diagram; Facts About the Policy; Withdrawals;
               Surrenders; Your Right to Transfer; Right to Convert Policy;
               Premiums and Allocations; Reinstatement; Voting Privileges;
               Authority to Change Policy Terms
11             The Portfolios
12             The Portfolios                                                
13             Policy Charges and Fees                                       
14             Facts About the Policy                                        
15             Premiums and Allocations -- Crediting Premiums                
16             The Portfolios                                                
17             Withdrawals; Surrenders; When We Make Payments                
18             The Variable Account                                          
19             Reports to Owners                                             
20             Authority to Change Policy Terms; Other Policy Provisions     
21             Policy Loans                                                  
22             Not applicable                                                
23             Southland's Directors and Officers                            
24             Not applicable                                                
25             Facts About Southland and the Variable Account                
26             Policy Charges and Fees                                       
27             Facts About Southland and the Variable Account                
28             Southland's Directors and Officers                            
29             Facts About Southland and the Variable Account                
30             Not applicable                                                
31             Not applicable                                                
32             Not applicable                                                
33             Not applicable                                                
34             Not applicable                                                
35             Facts About Southland and the Variable Account                
<PAGE>
 
36             Not applicable                                  
37             Not applicable                                                 
38             Distribution of the Policies                                   
39             Distribution of the Policies                                   
40             Distribution of the Policies                                   
41             Distribution of the Policies                                   
42             Not applicable                                                 
43             Not applicable                                                 
44             Subaccount Accumulation Value; Facts About the Policy          
45             Not applicable                                                 
46             Subaccount Accumulation Value; Facts About the Policy          
47             The Variable Account; The Portfolios                           
48             Facts About Southland and the Variable Account                 
49             Not applicable                                                 
50             Not applicable                                                 
51             Facts About the Policy; Distribution of the Policies           
52             Changes Relating to the Variable Account                       
53             Federal Tax Considerations                                     
54             Not applicable                                                 
55             Hypothetical Illustrations                                     
56             Not applicable                                                 
57             Not applicable                                                 
58             Not applicable                                                 
59             Financial Statements                                           
<PAGE>
 
              A FLEXIBLE PREMIUM ADJUSTABLE COMBINATION FIXED AND
                         VARIABLE LIFE INSURANCE POLICY
                                   issued by
                      Southland Life Insurance Company and
                         Southland Separate Account L1

                5780 Powers Ferry Road, N.W., Atlanta, GA  30340
                                 (770) 980-5100
    
This prospectus describes a flexible premium adjustable combination fixed and
variable life insurance policy (the "Policy") offered by Southland Life
Insurance Company ("Southland," "we," "us," or the "Company"). The Policy is
designed to provide lifetime insurance protection on the Insured named in the
Policy and at the same time provide flexibility to vary the amount and timing of
premiums and to change the amount of death benefits payable under the Policy.
This flexibility allows the purchaser ("you," "your," or the "Owner") to provide
for changing insurance needs under a single insurance policy.     

The Owner may allocate net premiums and Policy values to one or more of the
Subaccounts of Southland Separate Account L1 (the "Variable Account") or to the
Guaranteed Interest Account, or to both within certain limits. Twenty-one (21)
Subaccounts are currently available under the Policy.  The Subaccounts invest in
shares of corresponding Portfolios of The Alger American Fund, Fidelity Variable
Insurance Products Fund, Fidelity Variable Insurance Products Fund II, Janus
Aspen Series, and INVESCO Variable Investment Funds, Inc.  The Guaranteed
Interest Account guarantees a minimum fixed rate of interest.

The Accumulation Value will vary daily with the investment results of the
Subaccounts  and interest credited to any Guaranteed Interest Account
allocations.  We do not guarantee any minimum Cash Surrender Value for amounts
allocated to the Subaccounts.
    
You can select from two death benefit options available under the Policy: a
level death benefit ("Stated Death Benefit or death benefit type A") and an
increasing death benefit ("Stated Death Benefit Plus Accumulation Value or death
benefit type B").  See "DEATH BENEFIT AND CHANGES IN DEATH BENEFIT TYPE," 
page 41. Southland guarantees that the death benefit will never be less than the
Stated Death Benefit (less any unrepaid policy loans and past due charges) so
long as the Policy is in force.     
    
The Policy provides for a Cash Surrender Value that can be obtained by
surrendering the Policy.  Because this value is based on the performance of the
Portfolios, to the extent of allocations to the Variable Account, there is no
guaranteed Cash Surrender Value.  If the Cash Surrender Value is insufficient to
cover the charges due under the Policy, the Policy will lapse without value.
The Policy also provides for Policy loans and permits Withdrawals within 
limits.     

It may not be advantageous to replace existing insurance with the Policy.
Within certain limits, you may return the Policy or convert it to a life
insurance policy with benefits that do not vary with the investment results of a
separate account.
<PAGE>
 
THESE SECURITIES HAVE NOT BEEN APPROVED OR DISAPPROVED BY THE SECURITIES AND
EXCHANGE COMMISSION NOR HAS THE SECURITIES AND EXCHANGE COMMISSION PASSED UPON
THE ACCURACY OR ADEQUACY OF THIS PROSPECTUS.  ANY REPRESENTATION TO THE CONTRARY
IS A CRIMINAL OFFENSE.
    
This prospectus sets forth concisely the information you should know before
deciding to purchase a Policy.  It should be retained for future reference.     
    
This prospectus must be accompanied or preceded by current prospectuses for the
Portfolios.  The Portfolio prospectuses should be read in conjunction with this
prospectus.     
<PAGE>
 
                               TABLE OF CONTENTS
<TABLE>    
<CAPTION>
 
                                                         Page
                                                         ----
<S>                                                       <C>
DEFINITIONS.............................................   1
 
SUMMARY AND DIAGRAM.....................................   5
 
HISTORICAL PERFORMANCE INFORMATION......................  10
 
HYPOTHETICAL ILLUSTRATIONS..............................  18
 
FACTS ABOUT SOUTHLAND AND THE VARIABLE ACCOUNT..........  22
   THE VARIABLE ACCOUNT.................................  22
   THE PORTFOLIOS.......................................  23
   CHANGES RELATING TO THE VARIABLE ACCOUNT.............  26
 
FACTS ABOUT THE POLICY..................................  27
   PREMIUMS AND ALLOCATIONS.............................  27
   YOUR ACCUMULATION VALUE..............................  31
   YOUR RIGHT TO TRANSFER...............................  34
   DOLLAR COST AVERAGING FACILITY.......................  35
   AUTOMATIC REBALANCING................................  36
   WITHDRAWALS..........................................  37
   SURRENDERS...........................................  39
   POLICY LOANS.........................................  39
   TELEPHONE PRIVILEGES.................................  41
   DEATH BENEFIT AND CHANGES IN DEATH BENEFIT TYPE......  41
   MATURITY BENEFIT.....................................  44
   PAYMENT OPTIONS......................................  45
   WHEN WE MAKE PAYMENTS................................  45
 
THE GUARANTEED INTEREST ACCOUNT.........................  45
 
POLICY CHARGES AND FEES.................................  46
   CHARGES DEDUCTED FROM PREMIUMS.......................  46
   SURRENDER CHARGE.....................................  47
   MONTHLY DEDUCTIONS FROM YOUR NET ACCUMULATION VALUE..  50
   OTHER ADMINISTRATIVE CHARGES.........................  52
   CHARGES DEDUCTED FROM THE SUBACCOUNTS................  53
   PORTFOLIO EXPENSES...................................  53
   PERSISTENCY REFUND...................................  54
   GROUP OR SPONSORED ARRANGEMENTS......................  55
</TABLE>      

                                      -i-
<PAGE>
 
<TABLE>     
<S>                                                       <C>  
ADDITIONAL POLICY INFORMATION...........................  55
   THE OWNER............................................  55
   THE BENEFICIARY......................................  55
   CHANGE OF OWNER OR BENEFICIARY.......................  56
   RIGHT TO CONVERT POLICY..............................  56
   REINSTATEMENT........................................  57
   OTHER POLICY PROVISIONS..............................  57
   AUTHORITY TO CHANGE POLICY TERMS.....................  57
 
ADDITIONAL BENEFITS.....................................  58
   ACCIDENTAL DEATH BENEFIT RIDER.......................  58
   ADJUSTABLE TERM INSURANCE RIDER......................  58
   ADDITIONAL INSURED RIDER.............................  59
   CHILDREN'S INSURANCE RIDER...........................  60
   EXCHANGE OF INSURED RIDER............................  60
   GUARANTEED INSURABILITY RIDER........................  60
   WAIVER OF THE COST OF INSURANCE RIDER................  60
   WAIVER OF SPECIFIED PREMIUM RIDER....................  60
 
FEDERAL TAX CONSIDERATIONS..............................  61
 
OTHER INFORMATION.......................................  65
   REPORTS TO OWNERS....................................  65
   DISTRIBUTION OF THE POLICIES.........................  65
   VOTING PRIVILEGES....................................  66
   LEGAL PROCEEDINGS....................................  67
   SOUTHLAND'S DIRECTORS AND OFFICERS...................  68
   EXPERTS..............................................  70
   LEGAL MATTERS........................................  71
   FINANCIAL STATEMENTS.................................  71
</TABLE>     
    
This prospectus does not constitute an offering in any jurisdiction in which
such offering may not lawfully be made. No person is authorized to make any
representations in connection with this offering other than those contained in
this prospectus.     

                                     -ii-
<PAGE>
 
                                  DEFINITIONS

    
Accumulation Value:  The "Accumulation Value" is the combined value of your
Policy in all of the Subaccounts of the Variable Account, the Guaranteed
Interest Account and the values held in the General Account to secure Policy
loans.     
    
Adjustable Term Insurance Rider:  The "Adjustable Term Insurance Rider" is
available to add death benefit coverage to your Policy. The amount of death
benefit coverage provided under this rider is the difference between the Base
Death Benefit and the Target Death Benefit.     
    
Age:  The Insured's "Age" at any time is his or her age on the birthday nearest
the Policy Date increased by the number of full Policy Years elapsed since the
Policy Date.     
    
Base Death Benefit:  The "Base Death Benefit" depends on the death benefit type
you choose.  Under type A, the Base Death Benefit is the greater of Stated Death
Benefit or a multiple of the Accumulation Value on the date of the Insured's
death.  Under type B, the Base Death Benefit is the greater of the Stated Death
Benefit plus the Accumulation Value, or a multiple of the Accumulation Value, on
the date of the Insured's death. See "DEATH BENEFIT AND CHANGES IN DEATH BENEFIT
TYPE," page 41.     

Beneficiary:  The "Beneficiary" is the person to whom the death benefit (payable
on the death of an Insured) is paid.

Cash Surrender Value:  The "Cash Surrender Value" of the Policy on any Valuation
Day is the Net Accumulation Value minus any Surrender Charge that would apply
that day.

Code:  The "Code" is the Internal Revenue Code of 1986, as amended.
    
Customer Service Center:  The Southland "Customer Service Center" is the
Company's offices at P.O. Box 173789, Denver, CO 80217-3789.  For overnight
delivery, the address is 8515 East Orchard Road, 9T2, Denver, CO 80111.     
    
Death Benefit:  The "Death Benefit" is the Base Death Benefit plus any
additional life insurance proceeds provided by any riders.  If the Adjustable
Term Insurance Rider is in effect, the Death Benefit is equal to the Target
Death Benefit plus any additional life insurance proceeds provided by any other
riders.     
    
Death Proceeds:  The "Death Proceeds" are the proceeds payable to the
Beneficiary by us upon due proof of death of the Insured while the Policy is in
force equal to: [1] the Base Death Benefit (or Target Death Benefit, if
applicable); plus [2] any additional life insurance proceeds provided by any
riders; minus [3] any outstanding Policy Debt; minus [4] any monthly deductions
due and not yet deducted.     

                                      -1-
<PAGE>
 
    
Free Look Period:  The "Free Look Period" is the period during which you may
return the Policy and receive a refund or cancel an increase in Stated Death
Benefit.  See "Free Look Period," page 28.     

General Account:  The "General Account" represents our corporate assets other
than those segregated in any separate account established by us.
    
Gross Withdrawal:  A "Gross Withdrawal" is the total of the amount of a
Withdrawal plus any applicable Withdrawal Transaction Charge and any applicable
Surrender Charge.     

Guaranteed Interest Account:  The "Guaranteed Interest Account" is a part of our
General Account, to which a portion of the Accumulation Value may be allocated
and which provides guarantees of principal and interest.

Guaranteed Interest Account Accumulation Value:  The "Guaranteed Interest
Account Accumulation Value" is the value under the Policy in the Guaranteed
Interest Account.
    
Insured:  The "Insured" means the person upon whose life the Policy is 
issued.     
    
Monthly Processing Date:  The "Monthly Processing Date" is the date each month
on which the monthly deductions from the Accumulation Value are deducted.  See
"Monthly Deductions," page 50.  The first Monthly Processing Date will be the
Policy Date or the date on which the initial Net Premium is allocated to your
Policy, if later.   Subsequent Monthly Processing Dates will be the same date as
the Policy Date each month thereafter unless this is not a Valuation Day, in
which case the Monthly Processing Date occurs on the next Valuation Day.     
    
Net Accumulation Value:  The "Net Accumulation Value" on any Valuation Day is
the Accumulation Value on that day less Policy loans (and interest thereon) and
if other than the Monthly Processing Date, the monthly deduction that would be
deducted on the next Monthly Processing Date.     
    
Net Premium:  The "Net Premium" is the premium amount paid less any sales and
tax charges.  These charges are deducted from each premium before the premium is
applied to your Accumulation Value.     
    
No-Lapse Premium:  The "No-Lapse Premium" is a benchmark monthly premium
calculated for each Policy based on the Age, sex and rate class of the Insured,
the requested Stated Death Benefit and any supplemental benefits.  It is used
for purposes of the No-Lapse Guarantee.     
    
No-Lapse Guarantee:  The "No-Lapse Guarantee" refers to our guarantee to keep
the Policy in force during the first three Policy Years, regardless of the
sufficiency of the Cash Surrender Value, so long as total premiums paid, less
Withdrawals, are at least equal to the cumulative amount of No-Lapse Premiums
for the Policy months the Policy has been in force.     

                                      -2-
<PAGE>
 
Owner:  The "Owner" is the person(s) who owns the Policy and who is entitled to
exercise all rights and privileges provided in the Policy.

Policy Anniversary:  The "Policy Anniversary" is the first day of each Policy
Year.

Policy Date:  The "Policy Date" is shown on the Schedule and is the date the
Policy becomes effective.
    
Policy Debt:  The "Policy Debt" is equal to unrepaid Policy loans (including
unpaid interest added to the loan) plus accrued interest not yet due.     

Policy Year:  Each "Policy Year" starts on the same day and month as the Policy
Date.
    
Portfolio:  A "Portfolio" refers to a series of a mutual fund in which assets of
a corresponding Subaccount are invested.     

SEC:  The "SEC" is the Securities and Exchange Commission.
    
Stated Death Benefit:  The "Stated Death Benefit" is a dollar amount used to
determine the death benefit under the Policy.  On any day, it is the initial
Stated Death Benefit, as adjusted for any subsequent increases or decreases that
have taken effect.     

Subaccount:  A "Subaccount" is a subdivision of the Variable Account, the assets
of which are invested in a corresponding Portfolio.

Subaccount Accumulation Value:  The "Subaccount Accumulation Value" is the value
under a Policy in a particular Subaccount.
    
Surrender:  A "Surrender" is a Written Request for the Cash Surrender Value that
terminates the Policy.     
    
Target Death Benefit:  The "Target Death Benefit" is the death benefit specified
by the Owner when an Adjustable Term Insurance Rider is added to the 
Policy.     
    
Target Premium:  The "Target Premium" refers to an annualized premium amount we
use to calculate the sales load charge, the sales surrender charge and the cost
of insurance charge.  A Target Premium is determined for the Initial Stated
Death Benefit, and an additional Target Premium is determined for each increase
in Stated Death Benefit.  The Target Premium generally is less than planned
premiums for a Policy Year.  It may be more or less than the No-Lapse Premium
for a Policy Year, depending on the supplemental benefits added to the 
Policy.     

Valuation Day:  For each Subaccount, a "Valuation Day" is each day on which the
New York Stock Exchange and Southland's Customer Service Center are both open
for business except for a

                                      -3-
<PAGE>
 
    
day that a Subaccount's corresponding Portfolio does not value its shares.  The
New York Stock Exchange is currently closed on weekends and on the following
holidays:  New Year's Day, Presidents' Day, Good Friday, Memorial Day, July
Fourth, Labor Day, Thanksgiving Day and Christmas Day.  Southland's Customer
Service Center is normally not open on the following days:  the Monday before
New Year's Day, July Fourth or Christmas Day, if any of these holidays falls on
a Tuesday; the Friday after New Year's Day, July Fourth or Christmas Day, if any
of these holidays falls on a Thursday; and the Friday after Thanksgiving 
Day.     

Valuation Period:  A "Valuation Period" begins at 4:00 p.m. Eastern time on a
Valuation Day and ends at 4:00 p.m. Eastern time on the next succeeding
Valuation Day.
    
We, us, our, Southland and the Company:  "We," "us," "our," "Southland," and
"the Company" refer to Southland Life Insurance Company.     

Withdrawal:  A "Withdrawal" refers to the surrender of a portion of the Net
Accumulation Value.

Written Notice or Written Request:  A "Written Notice" or "Written Request" is a
notice or request in a form satisfactory to the Company which is signed by the
Owner and received at the Customer Service Center.
    
You and your:  "You" and "your" refer to the Owner of the Policy.     

                                      -4-
<PAGE>
 
                              SUMMARY AND DIAGRAM
    
The following summary of prospectus information and diagram of the Policy should
be read in conjunction with the detailed information appearing elsewhere in this
prospectus.  Unless otherwise indicated, the description of the Policy in this
prospectus assumes that the Policy is in force and there is no outstanding
Policy Debt.     
    
The Policy is similar in many ways to fixed-benefit life insurance.  As with
fixed-benefit life insurance, the Owner of a Policy pays premiums for insurance
coverage on the person insured.  Also like fixed-benefit life insurance, the
Policy provides for accumulation of Net Premiums and a Cash Surrender Value that
is payable if the Policy is surrendered during the Insured's lifetime.  As with
fixed-benefit life insurance, the Cash Surrender Value during the early Policy
Years may be substantially lower than the premiums paid.     
    
However, the Policy differs from fixed-benefit life insurance in several
important respects.  Unlike fixed-benefit life insurance, the Death Benefit of a
Policy may, and the Accumulation Value will, increase or decrease to reflect the
investment performance of the Subaccounts to which Accumulation Value is
allocated.  Also, there is no guaranteed minimum Cash Surrender Value.
Nonetheless, Southland guarantees to keep the Policy in force during the first
three (3) Policy Years so long as the No-Lapse Premium requirement has been met
and Policy Debt is not excessive.  See "THREE-YEAR GUARANTEE," page 29.
Otherwise, if the Cash Surrender Value is insufficient to pay charges due, the
Policy will lapse without value after a grace period.  See "PREMIUMS TO PREVENT
LAPSE," page 30.     

Purpose of the Policy

The Policy is designed to be a long-term investment providing significant
insurance benefits.  The Policy should be considered in conjunction with other
insurance policies owned by the Owner.  It may not be advantageous to replace
existing insurance policies with the Policy.

Tax Considerations
    
Southland intends for the Policy to satisfy the definition of a life insurance
contract under section 7702 of the Code.  Under certain circumstances, a Policy
could be treated as a "modified endowment contract."  Southland will monitor
Policies and will attempt to notify an Owner on a timely basis if his or her
Policy is in jeopardy of becoming a modified endowment contract.  For further
discussion of the tax status of a Policy and the tax consequences of being
treated as a life insurance contract or a modified endowment contract, see
"FEDERAL TAX CONSIDERATIONS," page 61.     

                                      -5-
<PAGE>
 
Free Look Period and Conversion Right
    
For a limited time after the Policy is issued, you have the right to cancel your
Policy and receive a refund equal to all premiums paid.  See "FREE LOOK PERIOD,"
page 28.  Until the end of this limited period, Net Premiums paid will be
invested in the Subaccount investing in the VIP Money Market Portfolio.  See
"NET PREMIUM ALLOCATIONS," page 31.  For a limited time after an increase in
Stated Death Benefit takes effect, you have the right to cancel the increase.
See "Changes in Stated Death Benefit," page 43.  At any time within the first
24 Policy Months (or first 24 Policy Months after an increase in Stated Death
Benefit), you may convert your Policy to a flexible premium (non-variable)
adjustable life insurance policy.  See "RIGHT TO CONVERT POLICY," page 56.     

Owner Inquiries
    
If you have any questions, you may write to us at the Customer Service Center or
call us at (800) 224-3035.     

Diagram

The following diagram illustrates how the Policy works.

                                      -6-
<PAGE>
 
                               DIAGRAM OF POLICY
 
    
- --------------------------------------------------------------------------------
                               PREMIUM PAYMENTS
*  You select a payment plan but are not required to pay premiums according to
   the plan. You can vary the amount and frequency and can skip planned
   premiums. See "Planned Premiums" for rules and limits.
 
*  Minimum initial premium and planned premium depend on the Insured's Age, sex,
   underwriting class, Stated Death Benefit selected, and any supplemental
   riders.
 
*  Unplanned premiums may be made, within limits. See "Premiums."
 
*  Under certain circumstances, extra premiums may be required to prevent lapse.
   See "Premiums to Prevent Lapse."
- --------------------------------------------------------------------------------
 

- --------------------------------------------------------------------------------
                           DEDUCTIONS FROM PREMIUMS
*  For sales load (4% of premiums up to an amount equal to 10 Target Premiums
   and, after an increase in Stated Death Benefit, 4% of premiums up to 10
   Target Premiums for that increase).
*  For state premium tax (2.5% of premiums).
*  For DAC tax (1.5% of premiums).  See "Policy Charges and Fees."
- --------------------------------------------------------------------------------
 
- --------------------------------------------------------------------------------
                                 NET PREMIUMS
*  You direct the allocation of Net Premiums among 21 Subaccounts of the
   Variable Account and the Guaranteed Interest Account. See "Net Premium
   Allocations" for rules and limits and applicable charges.
 
*  The Subaccounts invest in corresponding portfolios ("Funds") of The Alger
   American Fund ("Alger"), Fidelity Variable Insurance Products Fund ("VIP
   Fund"), Fidelity Variable Insurance Products Fund II ("VIP Fund II"), Janus
   Aspen Series ("Janus"), and INVESCO Variable Investment Funds ("INVESCO").
   See "The Portfolios." Funds available are:
<TABLE> 
   <S>                                                     <C> 
   Alger - American Small Capitalization Portfolio         Fidelity - VIP Fund II -Asset Manager Portfolio
   Alger - American MidCap Growth Portfolio                Fidelity - VIP Fund II - Index 500 Portfolio
   Alger - American Growth Portfolio                       Janus - Growth Portfolio 
   Alger - American Leveraged AllCap Portfolio             Janus - Aggressive Growth Portfolio
   Fidelity - VIP Fund - High Income Portfolio             Janus - Worldwide Growth  Portfolio
   Fidelity - VIP Fund - Money Market Portfolio            Janus - International Growth Portfolio
   Fidelity - VIP Fund - Equity-Income Portfolio           Janus - Balanced Portfolio 
   Fidelity - VIP Fund - Growth Portfolio                  Janus - Short-term Bond Portfolio
   Fidelity - VIP Fund - Contrafund Portfolio              INVESCO - Industrial Income Portfolio
   Fidelity - VIP Fund - Overseas Portfolio                INVESCO - Utilities Portfolio
   Fidelity - VIP Fund - Investment Grade Bond Portfolio
</TABLE> 
 
 
*  Interest is credited on amounts allocated to the Guaranteed Interest Account
   at a minimum guaranteed rate of 3.5%. See "The Guaranteed Interest Account"
   and "Your Right to Transfer" for rules and limits on Guaranteed Interest
   Account allocations.
- --------------------------------------------------------------------------------
      

                                      -7-
<PAGE>
 
    
- --------------------------------------------------------------------------------
                            DEDUCTIONS FROM ASSETS
 
*  Monthly deduction for cost of insurance, $20 initial monthly charge during
   the first Policy Year, $6 monthly charge for administrative expenses, and
   supplemental benefit charges. See "Policy Charges and Fees."
 
*  Daily charge at an annual rate of 0.90% from assets in the Subaccounts for
   mortality and expense risks. See "Charges Deducted From the Subaccounts."
   This charge is not deducted from Guaranteed Interest Account Accumulation
   Value.
 
*  Investment advisory fees and fund expenses are deducted from the assets
   of each Fund.  See "Portfolio Expenses."
- -----------------------------------------------------------------------------
 

- --------------------------------------------------------------------------------
                              ACCUMULATION VALUE
*  Is the amount in the Subaccounts and in the Guaranteed Interest Account
   credited to your Policy plus the values held in the General Account to secure
   Policy Debt. It is equal to Net Premiums, as adjusted each Valuation Day to
   reflect Subaccount investment experience, interest credited on any Guaranteed
   Interest Account allocations, charges deducted and other Policy transactions
   (such as Policy loans, transfers and withdrawals). See "Your Accumulation
   Value," "Guaranteed Interest Account Accumulation Value," and "Subaccount
   Accumulation Value."
 
*  Varies from day to day. There is no minimum guaranteed Accumulation Value.
   The Policy may lapse if the Cash Surrender Value is insufficient to cover the
   monthly deduction then due.
 
*  Accumulation Value can be transferred among the Subaccounts and the
   Guaranteed Interest Account. See "Your Right to Transfer" for rules and
   limits. Policy loans reduce the amount available for allocations and
   transfers.
 
*  Dollar cost averaging and automatic rebalancing programs are available. See
   "Dollar Cost Averaging Facility" and "Automatic Rebalancing."
 
*  Accumulation Value is the starting point for calculating certain values under
   a Policy, such as the Cash Surrender Value, Net Accumulation Value, and the
   Death Benefit used to determine Death Proceeds.
 
*  A persistency refund may be credited each month the Policy or a coverage
   segment of Stated Death Benefit remains in force after the tenth Policy
   Anniversary. The persistency refund is equivalent to 0.35% on an annualized
   basis (0.02917% monthly) of the Net Accumulation Value for that segment.
- -----------------------------------------------------------------------------
     

                                      -8-
<PAGE>
 
    
- ------------------------------                  --------------------------------
        CASH BENEFITS                                   DEATH BENEFITS
 *  Loans may be taken for                         *  Death benefit should
 amounts up to 90% of Cash                         be excludable from the
 Surrender Value, at a                             gross income of the
 maximum net interest rate                         Beneficiary.  See "Tax
 of 6%.  See "Policy                               Treatment of Policy
 Loans" and "Tax Treatment                         Benefits."
 of Policy Benefits."
                                                   *  Available as lump sum
 *  Withdrawals generally                          or under a variety of
 can be made up to 12                              payment options.  See
 times a Policy Year                               "Payment Options."
 provided there is
 sufficient remaining Cash                         *  Minimum Death Benefit
 Surrender Value.  A                               available is $100,000.
 Withdrawal transaction                            
 charge equal to the                               *   Death Benefit is         
 lesser of $25 or 2% of                            equal to Base Death       
 the amount requested for                          Benefit plus any          
 Withdrawal will apply to                          additional insurance      
 each Withdrawal after the                         provided by rider. If the 
 first in a Policy Year.                           Adjustable Term Insurance 
 See "Withdrawals" and                             Rider is in effect, the   
 "Withdrawal Transaction                           Death Benefit is equal to 
 Charge" for rules and                             the Target Death Benefit     
 limits.  If a Withdrawal                          plus any additional life    
 results in a decrease in                          insurance proceeds provided
 Stated Death Benefit                              by any other riders. See  
 during the first 14                               "Additional Benefits."    
 Policy Years or first 14                                                    
 years following an                                *  Base Death Benefit      
 increase in Stated Death                          available in two death     
 Benefit, a portion of the                         benefit types: type A      
 Sales Surrender Charge                            (larger of Stated Death    
 may be deducted from Net                          Benefit or a multiple of   
 Accumulation Value.  See                          Accumulation Value); or    
 "Surrender Charge."                               type B (larger of Stated   
                                                   Death Benefit plus         
 *  Payment options are                            Accumulation Value or a    
 available.  See "Payment                          multiple of Accumula tion  
 Options."                                         Value).  See "Death        
                                                   Benefit and Changes in     
 *   The Policy can be                             Death Benefit Type."        
 surrendered at any time                           
 for its Cash Surrender                            *  Flexibility to change  
 Value (Accumulation Value                         Stated Death Benefit and  
 minus Policy Debt, any                            to change Death Benefit   
 applicable Surrender                              type.  See "Death Benefit 
 Charge and the next                               and Changes in Death      
 monthly deduction).                               Benefit Type" for rules   
                                                   and limits.                
 *   The surrender charge                          
 consists of an                                    *   A surrender charge     
 administrative surrender                          will apply if Stated       
 charge and a sales                                Death Benefit is           
 surrender charge.  The                            decreased upon a           
 administrative surrender                          requested decrease or      
 charge is $4.00 per                               withdrawal or on           
 $1,000 of Stated Death                            surrender of the Policy,   
 Benefit (or increase in                           if, in any case, it        
 Stated Death Benefit) for                         occurs within 14 Policy    
 the first nine Policy                             Years after the Policy     
 Years (or first nine                              was issued or 14 years     
 years following an                                after an increase in       
 increase in Stated Death                          Stated Death Benefit.      
 Benefit), and decreases                           See "Surrender Charge."     
 annually during the                               
 following five years to
 $0.  The sales surrender
 charge is equal to 50% of
 actual premiums paid up
 to one Target Premium
 plus 40% of any
 additional premiums paid
 up to two additional
 Target Premiums for the
 Stated Death Benefit (or
 increase) during the
 first nine Policy Years
 (or the first nine years
 following an increase in
 Stated Death Benefit),
 and decreases annually
 during the following five
 years to 0%.  In any
 case, the maximum sales
 surrender charge for each
 death benefit segment is
 equal to 130% of one
 Target Premium (50% of
 one Target Premium plus
 40% of each of two
 additional Target
 Premiums) for the death
 benefit segment.
 However, during the first
 two Policy Years (or two
 years following an
 increase in Stated Death
 Benefit), the sales
 surrender charge is
 limited to 26% of
 premiums paid up to one
 Target Premium, plus 6%
 of premi ums paid between
 one and two Target
 Premiums, and 5% of any
 other premiums paid.  The
 sales surrender charge
 deducted on a Surrender
 of a Policy takes into
 account any portion of
 the sales surrender
 charge deducted on a
 prior decrease in Stated
 Death Benefit.
- ---------------------------                      ----------------------------
     

                                      -9-
<PAGE>
 
                       HISTORICAL PERFORMANCE INFORMATION
    
The following information demonstrates how the historical investment experience
of the Portfolio underlying each Subaccount of the Variable Account would have
affected the Cash Surrender Value, Accumulation Value and Death Benefit of a
hypothetical Policy if issued on the date the Portfolio commenced operations.
The historical illustrations should be distinguished from the hypothetical
illustrations, which follow, which are based on assumed rates of return for the
30 years illustrated, rather than historical returns of the Portfolios.  The
"average annual total return" of a Portfolio shown below refers to the income
generated by the Portfolio, net of Portfolio operating expenses, plus capital
gains or losses, realized or unrealized, expressed on an annual basis, and has
been calculated in accordance with SEC standardized rules.  "Annual total 
return" is the actual year-by-year results of the Portfolio's performance and is
calculated in the same manner as average annual total return except that it is 
limited to the return for the one year period ended on the date shown. Average
annual total return reflects the hypothetical annually compounded return that
would have produced the same cumulative return as the Portfolio achieved if the
Portfolio's performance had been constant over the entire period. The
calculation of average annual total return and annual total return assumes the
investment of all dividends and other distributions in additional shares of the
Portfolio. Because average annual total returns tend to smooth out variations in
the return of a Portfolio, they are not the same as actual year-by-year results.
Average annual total return and annual total return figures are based on
historical earnings and are not intended to indicate future performance.     
    
The following illustrations are based on the payment of a $4,500 annual premium,
paid at the beginning of each year, for a hypothetical Policy with a $250,000
Stated Death Benefit, death benefit type A, issued to a standard, non-tobacco
male, Age 45.  In each case, it is assumed that all premiums are and remain
allocated to the Subaccount illustrated for the periods shown and that no Policy
loans or Withdrawals are made during the periods shown.  The amounts shown for
the Cash Surrender Value, Accumulation Value and Death Benefit take into account
the charges against premiums and monthly deductions (based on current cost of
insurance charges) for the hypothetical Policy, the daily charge against the
Variable Account for mortality and expense risks, and the Portfolio's charges
and expenses during the years shown.  See "POLICY CHARGES AND FEES," page 46.
They are calculated as of the end of each yearly period shown.     

Non-Tobacco Male, Age 45                   Guideline Premium Test
Preferred Risk Class                       Death Benefit Option 1
Stated Death Benefit $250,000              Annual Premium $4,500

- -----------------------------------------------
 Alger American Small Capitalization Portfolio
- -----------------------------------------------
<TABLE>     
<CAPTION> 
<S>                                                <C> 
Portfolio Average Annual Total Return for:
1 year ended 12/31/95:                              44.31%
5 years ended 12/31/95:                             20.59%
Since inception (9/21/88):                          22.60%
</TABLE>     

                                      -10-
<PAGE>
 
<TABLE>    
<CAPTION>
                                               Cash             
             Annual Total   Accumulation     Surrender    Death  
 Year Ended:    Return          Value          Value     Benefit 
- ------------    ------          -----          -----    -------- 
<S>          <C>               <C>           <C>        <C>      
  12/31/89      64.48%        $ 5,266        $ 3,296    $250,000    
  12/31/90       8.71%          9,158          6,938     250,000  
  12/31/91      57.54%         19,553         15,403     250,000  
  12/31/92       3.55%         23,389         19,239     250,000  
  12/31/93      13.28%         29,953         25,803     250,000  
  12/31/94      -4.38%         31,454         27,304     250,000  
  12/31/95      44.31%         49,872         45,722     250,000  
</TABLE>      
- ----------------------------------------
 Alger American MidCap Growth Portfolio
- ----------------------------------------
     
Portfolio Average Annual Total
 Return for:
   1 year ended 12/31/95:            44.45%
   Since inception (5/3/93):         29.02%     
<TABLE>     
<CAPTION> 
                                                 Cash
                  Annual Total   Accumulation  Surrender    Death
 Year Ended:        Return          Value        Value     Benefit
- ------------        ------          -----        -----     -------
<S>               <C>              <C>         <C>         <C> 
  12/31/94           5.30%        $ 7,891      $ 5,671    $250,000    
  12/31/95          44.45%         16,064       11,914     250,000    
</TABLE>      
 
- ---------------------------------------- 
    Alger American Growth Portfolio
- ----------------------------------------
     
Portfolio Average Annual Total Return for:
   1 year ended 12/31/95:                     36.37%
   5 years ended 12/31/95:                    21.73%
   Since inception (9/21/88):                 19.44%     

<TABLE>     
<CAPTION> 
                                               Cash
                Annual Total   Accumulation  Surrender   Death  
 Year Ended:      Return          Value        Value    Benefit 
- ------------      ------          -----        -----    ------- 
<S>             <C>              <C>         <C>        <C>     
  12/31/89        1.30%         $ 3,024      $ 1,054   $250,000          
  12/31/90        1.69%           6,270        4,050    250,000          
  12/31/91        0.52%           9,409        5,259    250,000          
  12/31/92        0.33%          12,523        8,373    250,000          
  12/31/93       22.47%          19,185       15,035    250,000          
  12/31/94        1.45%          22,533       18,383    250,000          
  12/31/95       36.37%          34,998       30,848    250,000  
 
</TABLE>     

                                      -11-
<PAGE>
 
- -------------------------------------------
 Alger American Leveraged AllCap Portfolio
- -------------------------------------------
    
Portfolio Cumulative Total Return:
     Since inception (1/25/95) through 12/31/95:      74.30%      
 
- ------------------------------------------- 
    Fidelity - VIP Fund - Money Market
                  Portfolio
- -------------------------------------------
     
Portfolio Average Annual Total
 Return for:
    1 year ended 12/31/95:                             5.87%
    5 years ended 12/31/95:                            4.66%
    10 years ended 12/31/95:                           6.09%     

<TABLE>     
<CAPTION> 
                                             Cash               
              Annual Total  Accumulation   Surrender    Death   
 Year Ended:     Return        Value         Value     Benefit  
- ------------     ------        -----         -----     -------  
<S>            <C>            <C>           <C>        <C>      
  12/31/85       8.11%       $ 3,263       $ 1,293    $250,000  
  12/31/86       6.70%         6,855         4,635     250,000  
  12/31/87       6.44%        10,610         6,460     250,000  
  12/31/88       7.39%        14,719        10,569     250,000  
  12/31/89       9.12%        19,425        15,275     250,000  
  12/31/90       8.04%        24,285        20,135     250,000  
  12/31/91       6.09%        28,967        24,817     250,000  
  12/31/92       3.90%        33,240        29,090     250,000  
  12/31/93       3.23%        37,554        33,404     250,000  
  12/31/94       4.25%        42,404        38,946     250,000  
  12/31/95       5.87%        48,520        45,752     250,000   
</TABLE>      
 
- --------------------------------------------- 
 Fidelity - VIP Fund - High Income Portfolio
- ---------------------------------------------
     
Portfolio Average Annual Total Return for:
        1 year ended 12/31/95:            20.72%
        5 years ended 12/31/95:           18.92%
        Since inception (9/10/85):        11.47%     
<TABLE>     
<CAPTION> 
                                                   Cash             
                  Annual Total   Accumulation    Surrender    Death 
 Year Ended:         Return         Value          Value     Benefit
- ------------         ------         -----          -----     -------
<S>                <C>             <C>            <C>       <C>     
  12/31/86           17.68%       $ 3,600        $ 1,630    $250,000
  12/31/87            1.22%         6,819          4,599     250,000
  12/31/88           11.64%        11,111          6,961     250,000
  12/31/89           -4.17%        13,564          9,414     250,000
  12/31/90           -2.23%        16,232         12,082     250,000 

</TABLE>      

                                      -12-
<PAGE>
 
<TABLE>     
<CAPTION> 
<S>                  <C>           <C>        <C>        <C> 
  12/31/91           35.08%        26,196     22,046     250,000
  12/31/92           23.17%        36,050     31,900     250,000
  12/31/93           20.40%        47,077     42,927     250,000
  12/31/94           -1.64%        49,299     45,149     250,000
  12/31/95           20.72%        63,282     59,824     250,000
 
</TABLE>      
- ------------------------------------------ 
    Fidelity - VIP Fund - Equity-Income
                  Portfolio
- ------------------------------------------
     
Portfolio Average Annual Total Return for:
   1 year ended 12/31/95:                        35.09%
   5 years ended 12/31/95:                       21.32%
   Since inception (10/9/86):                    13.33%     

<TABLE>     
<CAPTION> 
                                                 Cash
                Annual Total   Accumulation   Surrender   Death  
 Year Ended:      Return           Value        Value    Benefit 
- ------------      ------           -----        -----    ------- 
<S>              <C>              <C>          <C>       <C>     
  12/31/87        -1.13%         $ 2,939      $   969   $250,000                
  12/31/88        22.71%           7,558        5,338    250,000                
  12/31/89        17.34%          12,565        8,415    250,000                
  12/31/90       -15.29%          13,164        9,014    250,000                
  12/31/91        31.44%          21,464       17,314    250,000                
  12/31/92        16.89%          28,685       24,535    250,000                
  12/31/93        18.29%          37,530       33,380    250,000                
  12/31/94         7.07%          43,389       39,239    250,000                
  12/31/95        35.09%          62,932       58,782    250,000  
 
</TABLE>      

- ------------------------------------------ 
 Fidelity - VIP Fund - Growth Portfolio
- ------------------------------------------
     
Portfolio Average Annual Total Return for:
        1 year ended 12/31/95:                  35.36%
        5 years ended 12/31/95:                 20.78%
        Since inception (10/9/86):              14.83%     
 
<TABLE>     
<CAPTION> 
                                                    Cash
                 Annual Total     Accumulation    Surrender   Death 
 Year Ended:       Return            Value          Value    Benefit
- ------------       ------            -----          -----    -------
<S>              <C>                <C>            <C>       <C>    
  12/31/87         3.66%           $ 3,107        $ 1,137   $250,000
  12/31/88        15.58%             7,284          5,064    250,000
  12/31/89        31.51%            13,785          9,635    250,000
  12/31/90       -11.73%            14,806         10,656    250,000
  12/31/91        45.51%            26,194         22,044    250,000
  12/31/92         9.32%            31,939         27,789    250,000 

</TABLE>      

                                      -13-
<PAGE>
 
<TABLE>  
<CAPTION> 
<S>               <C>           <C>        <C>       <C> 
  12/31/93        19.37%        41,742     37,592    250,000
  12/31/94        -0.02%        44,673     40,523    250,000
  12/31/95        35.36%        64,789     60,639    250,000
</TABLE>  
 
- ------------------------------------- 
    Fidelity - VIP Fund - Overseas
                Portfolio
- -------------------------------------
     
Portfolio Average Annual Total Return for:
    1 year ended 12/31/95:                             9.74%
    5 years ended 12/31/95:                            8.13%
    Since inception (1/28/87):                         7.31%     

<TABLE>    
<CAPTION> 
                                                  Cash 
                 Annual Total    Accumulation   Surrender    Death
 Year Ended:       Return           Value         Value     Benefit  
- ------------       ------           -----       ---------   -------     
<S>              <C>             <C>            <C>        <C> 
  12/31/88         8.13%          $ 3,263       $ 1,293    $250,000             
  12/31/89        26.28%            8,200         5,980     250,000          
  12/31/90        -1.67%           11,081         6,931     250,000          
  12/31/91         8.00%           15,312        11,162     250,000          
  12/31/92       -10.72%           16,337        12,187     250,000          
  12/31/93        37.35%           26,788        22,638     250,000          
  12/31/94         1.72%           30,287        26,137     250,000          
  12/31/95         9.68%           36,556        32,406     250,000          
</TABLE>     
 
- --------------------------------------------------
 Fidelity - VIP II Fund - Investment Grade Bond
                     Portfolio
- --------------------------------------------------
     
Portfolio Average Annual Total Return for:
        1 year ended 12/31/95:                            17.32%
        5 years ended 12/31/95:                            9.23%
        Since inception (12/5/88):                         8.29%     
 
<TABLE>     
<CAPTION> 
                                               Cash
                Annual Total  Accumulation   Surrender    Death
 Year Ended:      Return          Value        Value     Benefit
- ------------      ------      ------------   ---------   -------
<S>             <C>           <C>            <C>        <C> 
  12/31/89        10.26%        $ 3,338       $ 1,368   $250,000
  12/31/90         6.21%          6,901         4,681    250,000                
  12/31/91        16.38%         11,699         7,549    250,000                
  12/31/92         6.65%         15,770        11,620    250,000                
  12/31/93        10.96%         20,920        16,770    250,000                
  12/31/94        -3.76%         23,014        18,864    250,000                
  12/31/95        17.32%         30,600        26,450    250,000                
</TABLE>     

                                      -14-
<PAGE>
 
- -----------------------------------------
 Fidelity - VIP II Fund - Asset Manager
                 Portfolio
- -----------------------------------------
     
Portfolio Average Annual Total Return for:
        1 year ended 12/31/95:                        16.96%
        5 years ended 12/31/95:                       12.76%
        Since inception (9/6/89):                     11.24%     
 
<TABLE>     
<CAPTION> 
                                                  Cash
                 Annual Total   Accumulation   Surrender    Death
 Year Ended:       Return          Value         Value     Benefit
- ------------       ------       ------------   ---------   -------   
<S>              <C>            <C>            <C>         <C> 
  12/31/90         6.72%          $ 3,214       $ 1,244    $250,000
  12/31/91        22.56%            7,884         5,664     250,000             
  12/31/92        11.71%           12,301         8,151     250,000             
  12/31/93        21.23%           18,718        14,568     250,000             
  12/31/94        -6.09%           20,389        16,239     250,000             
  12/31/95        16.96%           27,451        23,301     250,000             
</TABLE>      

- ----------------------------------------------- 
 Fidelity - VIP II Fund - Index 500 Portfolio
- -----------------------------------------------
     
Portfolio Average Annual Total Return for:
        1 year ended 12/31/95:                   37.19%
        Since inception (8/27/92):               15.54%     
 
<TABLE>     
<CAPTION> 
                                                          Cash
                         Annual Total     Accumulation  Surrender   Death
           Year Ended:      Return           Value        Value    Benefit
           -----------      ------        ------------  ---------  -------
           <S>           <C>              <C>           <C>        <C>   
            12/31/93        9.74%          $ 3,320       $1,350    $250,000
            12/31/94        1.04%            6,525        4,305     250,000
            12/31/95       37.19%           13,366        9,216     250,000 
</TABLE>      
- ---------------------------------------------------------- 
           Fidelity - VIP II Fund - Contrafund
- ----------------------------------------------------------
    
Portfolio Cumulative Total Return:
     Since inception (1/3/95) through 12/31/95:      39.72%      


- ----------------------------------------------------------    
           INVESCO Utilities Portfolio
- ----------------------------------------------------------

<TABLE>     
<CAPTION> 
<S>                                              <C>  
Portfolio Average Annual Total Return for:
     1 year ended 12/31/95:                      9.08%
     Since inception (1/1/95):                   9.08%
</TABLE>      

                                      -15-
<PAGE>
 
<TABLE>     
<CAPTION> 
                                                        Cash
                       Annual Total     Accumulation  Surrender    Death  
Year Ended:               Return           Value        Value      Benefit 
- -----------               ------         -----------  ---------    -------  
<S>                    <C>              <C>           <C>          <C>      
12/31/95                  9.08%           $3,297        $1,327     $250,000  
</TABLE>      

- -------------------------------------- 
INVESCO Industrial Income Portfolio
- --------------------------------------
<TABLE>     
<S>                                                       <C> 
Portfolio Average Annual Total
 Return for:
      1 year ended 12/31/95:                              29.25%
      Since inception (8/10/94):                          20.89%
</TABLE>      
<TABLE>     
<CAPTION> 
                                                        Cash
                       Annual Total     Accumulation  Surrender     Death   
Year Ended:               Return           Value        Value      Benefit  
- -----------               ------        ------------  ---------    -------  
<S>                    <C>              <C>           <C>         <C>    
12/31/95                  29.25%          $4,009       $2,039     $250,000
</TABLE>                                                                       
 
- -------------------------------- 
Janus Growth Portfolio
- --------------------------------
<TABLE>     
<S>                                                       <C>    
Portfolio Average Annual Total
 Return for:
      1 year ended 12/31/95:                              30.17%
      Since inception (9/14/93):                          15.25%
</TABLE>      
<TABLE>     
<CAPTION> 
                                                        Cash
                       Annual Total     Accumulation  Surrender     Death  
Year Ended:               Return           Value        Value      Benefit 
- -----------               ------        ------------  --------     ------- 
<S>                    <C>              <C>           <C>         <C>     
12/31/94                  2.76%           $3,075       $1,105     $250,000
12/31/95                 30.17%            8,223        6,003      250,000
</TABLE>       

- -------------------------------------- 
 Janus Aggressive Growth Portfolio
- --------------------------------------
<TABLE>     
<S>                                                       <C>     
Portfolio Average Annual Total
 Return for:
      1 year ended 12/31/95:                              27.48%
      Since inception (9/14/93):                          27.68%
</TABLE>      
<TABLE>     
<CAPTION> 
                                                        Cash
                       Annual Total     Accumulation  Surrender     Death  
Year Ended:               Return           Value        Value      Benefit 
- -----------               ------        -----------   ---------    ------- 
<S>                    <C>              <C>           <C>         <C>     
12/31/94                  16.33%          $3,552       $1,582     $250,000 
12/31/95                  27.48%           8,648        6,428      250,000 
</TABLE>      

- ------------------------------------- 
Janus Worldwide Growth Portfolio
- -------------------------------------    
<TABLE>     
<S>                                                       <C> 
Portfolio Average Annual Total
 Return for:
      1 year ended 12/31/95:                              27.37%
      Since inception (9/14/93):                          20.74%
</TABLE>      

                                      -16-
<PAGE>
 
<TABLE>     
<CAPTION> 
                                                            Cash
                             Annual Total  Accumulation   Surrender     Death  
Year Ended:                     Return         Value        Value      Benefit 
- -----------                     ------         -----        -----      ------- 
<S>                             <C>            <C>          <C>        <C>     
12/31/94                        1.53%         $3,032       $1,062     $250,000 
12/31/95                       27.37%          7,981        5,761      250,000 
</TABLE>      



- ----------------------------------------- 
Janus International Growth Portfolio
- -----------------------------------------      
<TABLE>     
<CAPTION> 
<S>                                                       <C> 
Portfolio Average Annual Total
 Return for:
      1 year ended 12/31/95:                              23.15%
      Since inception (5/2/94):                           11.39%
</TABLE>      
<TABLE>     
<CAPTION> 
                                                            Cash
                             Annual Total   Accumulation  Surrender     Death  
Year Ended:                     Return         Value        Value      Benefit 
- -----------                     ------         -----        -----      ------- 
<S>                             <C>            <C>          <C>        <C>     
12/31/95                        23.15%        $3,793       $1,823     $250,000 
</TABLE>      
 
- -------------------------------- 
Janus Balanced Portfolio
- --------------------------------           
<TABLE>                                                     
<CAPTION> 
<S>                                                       <C> 
Portfolio Average Annual Total
 Return for:
   1 year ended 12/31/95:                                 24.79%
   Since inception (9/14/93):                             13.96%
</TABLE>      
<TABLE>     
<CAPTION> 
                                                            Cash
                             Annual Total   Accumulation  Surrender     Death  
Year Ended:                     Return         Value        Value      Benefit 
- -----------                     ------         -----        -----      ------- 
<S>                             <C>            <C>          <C>        <C>     
12/31/94                        0.84%         $3,008       $1,038     $250,000 
12/31/95                       24.79%          7,780        5,560      250,000 
</TABLE>      
 
- --------------------------------- 
Janus Short-Term Bond Portfolio
- ---------------------------------     
<TABLE>     
<CAPTION> 
<S>                                                       <C>   
 
Portfolio Average Annual Total
 Return for:
      1 year ended 12/31/95:                              9.54%
      Since inception (9/14/93):                          4.61%
</TABLE>      
<TABLE>     
<CAPTION> 
                                                            Cash
                             Annual Total   Accumulation  Surrender     Death  
Year Ended:                     Return         Value        Value      Benefit 
- -----------                     ------         -----        -----      ------- 
<S>                             <C>            <C>          <C>        <C>     
12/31/94                        0.92%         $3,010       $1,040     $250,000
12/31/95                        9.54%          6,775        4,555      250,000
</TABLE>     

                                      -17-
<PAGE>
 
                           HYPOTHETICAL ILLUSTRATIONS
    
The following illustrations have been prepared to show how certain values under
a hypothetical Policy would change with varying levels of investment performance
over an extended period of time. In particular, the illustrations show how
Policy Values, Cash Surrender Values and Death Benefits under a Policy covering
an Insured of the male sex, non-tobacco and Age 45 on the Policy Date, would
vary over time if planned premiums were paid annually and the return on the
assets in the Funds were a uniform gross annual rate (before any expenses) of
0%, 6% or 12%. The illustrations also show values if planned premiums were
instead accumulated at 5% interest. The hypothetical investment rates of return
are for purposes of illustration only and should not be deemed a representation
of past or future investment rates of return. Actual rates of return for a
particular Policy may be more or less than the hypothetical investment rates of
return and will depend on a number of factors including the investment
allocations made by an Owner, prevailing rates and rates of inflation. Also,
values would be different from those shown if the gross annual investment
returns averaged 0%, 6%, and 12% over a period of years but fluctuated above and
below those averages for individual Policy Years.    

    
The illustrations assume that the assets in the Funds are subject to an annual
expense ratio of 0.9033% of the average daily net assets.  This annual expense
ratio is based on the average of the expense ratios of each of the Portfolios
available under the Policies for the last fiscal year and take into account
current expense reimbursement arrangements.  For information on Portfolio
expenses, see the prospectuses for the Portfolios accompanying this prospectus.
     
    
The illustrations also reflect the deduction of sales load, premium tax and DAC
tax charges from premiums and the monthly administrative and cost of insurance
charges from Accumulation Value for the hypothetical Insured.  Our current cost
of insurance charges and the higher guaranteed maximum cost of insurance charges
we have the contractual right to charge are reflected in separate illustrations
on each of the following pages.  All the illustrations reflect the fact that no
other charges for federal or state income taxes are currently made against the
Variable Account and assume no Policy Debt or charges for supplemental benefits.
In particular, the illustrations assume that no Adjustable Term Insurance Rider
is in effect.     
    
In addition, the illustrations reflect the daily charge to the Variable Account
for Southland's assumption of mortality and expense risks, which is equivalent
to an effective annual charge of 0.90%. The current assumption illustrations
also reflect monthly application of the persistency refund that is equal to
0.35% (on an annualized basis) of the Variable Accumulation Value for Policies
held for more than 10 years. After deduction of Portfolio expenses and the
mortality and expense risk charge, the illustrated gross annual investment rates
of return of 0%, 6% and 12% would correspond to approximate net annual rates 
of -1.79%, 4.16% and 10.10%, respectively for years one through ten and 
thereafter, -1.44%, 4.51%, and 10.45%, respectively. The guaranteed assumption
illustrations do not reflect the application of the persistency refund and
therefore the approximate net annual rates for the Variable Account do not
change after year 10. Net annual rates of return for the Variable Account are
not equal to net annual rates of return for the Policy because the Variable
Account rates do not reflect all changes to the Policy.    
    
The illustrations are based on our sex distinct rates for non-tobacco users.
Upon request, we will furnish a comparable illustration based upon the proposed
Insured's individual circumstances. Such illustrations may assume different
hypothetical rates of return than those illustrated in the following
illustrations.    
                                      -18-
<PAGE>
 
                             FUTURE DIMENSIONS VUL
    
       Male Age 45, Preferred Non-Tobacco, Band 2, Death Benefit Type A
                           Assuming Current Charges     
<TABLE>    
<CAPTION>
                                                                                          --- End of Policy Year ---
- ------------------------------------------------------------------------------------------------------------------------------------
      Duration            Attained Age            Premium Paid     Accumulation Value     Cash Surrender Value       Death Benefit
- ------------------------------------------------------------------------------------------------------------------------------------

<S>                          <C>                    <C>                   <C>                  <C>                   <C>
             1                    45                  $4,500               $ 2,947                $   977              $250,000
             2                    46                   4,500                 6,023                  3,803               250,000
             3                    47                   4,500                 9,026                  4,876               250,000
             4                    48                   4,500                11,985                  7,835               250,000
             5                    49                   4,500                14,903                 10,753               250,000
             6                    50                   4,500                17,779                 13,629               250,000
             7                    51                   4,500                20,614                 16,464               250,000
             8                    52                   4,500                23,448                 19,298               250,000
             9                    53                   4,500                26,380                 22,230               250,000
            10                    54                   4,500                29,269                 25,812               250,000
            11                    55                   4,500                32,421                 29,653               250,000
            12                    56                   4,500                35,446                 33,371               250,000
            13                    57                   4,500                38,329                 36,946               250,000
            14                    58                   4,500                41,069                 40,376               250,000
            15                    59                   4,500                43,665                 43,665               250,000
            16                    60                   4,500                46,103                 46,103               250,000
            17                    61                   4,500                48,370                 48,370               250,000
            18                    62                   4,500                50,452                 50,452               250,000
            19                    63                   4,500                52,330                 52,330               250,000
            20                    64                   4,500                53,984                 53,984               250,000
            21                    65                   4,500                55,391                 55,391               250,000
            22                    66                   4,500                56,577                 56,577               250,000
            23                    67                   4,500                57,521                 57,521               250,000
            24                    68                   4,500                58,200                 58,200               250,000
            25                    69                   4,500                58,590                 58,590               250,000
            26                    70                   4,500                58,661                 58,661               250,000
            27                    71                   4,500                58,388                 58,388               250,000
            28                    72                   4,500                57,738                 57,738               250,000
            29                    73                   4,500                56,674                 56,674               250,000
            30                    74                   4,500                55,142                 55,142               250,000
                                                                                                                
          Age 65                                       4,500                53,984                 53,984               250,000
 
Gross Investment Rate:                      0.00%

</TABLE>     
    
The hypothetical investment rates of return shown above are illustrative only
and should not be deemed a representation of past or future investment rates of
return.  Actual rates of return may be more or less than those shown and will
depend on a number of factors, including the investment allocations made by an
Owner and the investment experience of the Portfolios.  The Death Benefit,
investment value and Cash Surrender Value for a Policy would be different from
those shown if the actual gross annual rates of return averaged 0%, 6% or 12%
over a period of years, but also fluctuated above or below those averages for
individual Policy Years.  They would also be different if any Policy loans or
Withdrawals were made.  No representations can be made by Southland Life
Insurance Company or the Variable Account or the Portfolios that these
hypothetical rates of return can be achieved for any one year or sustained over
a period of time.     

                                      -19-
<PAGE>
 
                             FUTURE DIMENSIONS VUL
    
      Male Age 45, Preferred Non-Tobacco, Band 2, Death Benefit TYPE A
                           Assuming Current Charges      
<TABLE>    
<CAPTION>
                                                                                           --- End of Policy Year ---
- ------------------------------------------------------------------------------------------------------------------------------------
         Duration            Attained Age            Premium Paid    Accumulation Value      Cash Surrender Value     Death Benefit
- ------------------------------------------------------------------------------------------------------------------------------------
<S>                          <C>                    <C>                   <C>                   <C>                    <C>
             1                      45                $4,500               $ 3,157                 $ 1,187            $250,000
             2                      46                 4,500                 6,635                   4,415             250,000
             3                      47                 4,500                10,239                   6,089             250,000
             4                      48                 4,500                14,008                   9,858             250,000
             5                      49                 4,500                17,948                  13,798             250,000
             6                      50                 4,500                22,066                  17,916             250,000
             7                      51                 4,500                26,372                  22,222             250,000
             8                      52                 4,500                30,915                  26,765             250,000
             9                      53                 4,500                35,811                  31,661             250,000
            10                      54                 4,500                40,390                  37,472             250,000
            11                      55                 4,500                46,619                  43,851             250,000
            12                      56                 4,500                52,496                  50,421             250,000
            13                      57                 4,500                58,555                  57,173             250,000
            14                      58                 4,500                64,809                  64,116             250,000
            15                      59                 4,500                71,267                  71,267             250,000
            16                      60                 4,500                77,931                  77,931             250,000
            17                      61                 4,500                84,807                  84,807             250,000
            18                      62                 4,500                91,900                  91,900             250,000
            19                      63                 4,500                99,214                  99,214             250,000
            20                      64                 4,500               106,757                 106,757             250,000
            21                      65                 4,500               114,538                 114,538             250,000
            22                      66                 4,500               122,604                 122,604             250,000
            23                      67                 4,500               130,975                 130,975             250,000
            24                      68                 4,500               139,676                 139,676             250,000
            25                      69                 4,500               148,734                 148,734             250,000
            26                      70                 4,500               158,186                 158,186             250,000
            27                      71                 4,500               168,078                 168,078             250,000
            28                      72                 4,500               178,463                 178,463             250,000
            29                      73                 4,500               189,406                 189,406             250,000
            30                      74                 4,500               200,981                 200,981             250,000
                                                                                                        
          Age 65                                       4,500               106,757                 106,757             250,000
 
Gross Investment Rate:                      6.00%
</TABLE>     
    
The hypothetical investment rates of return shown above are illustrative only
and should not be deemed a representation of past or future investment rates of
return.  Actual rates of return may be more or less than those shown and will
depend on a number of factors, including the investment allocations made by an
Owner and the investment experience of the Portfolios.  The Death Benefit,
investment value and Cash Surrender Value for a Policy would be different from
those shown if the actual gross annual rates of return averaged 0%, 6% or 12%
over a period of years, but also fluctuated above or below those averages for
individual Policy Years.  They would also be different if any Policy loans or
Withdrawals were made.  No representations can be made by Southland Life
Insurance Company or the Variable Account or the Portfolios that these
hypothetical rates of return can be achieved for any one year or sustained over
a period of time.     

                                      -20-
<PAGE>
 
                             FUTURE DIMENSIONS VUL
    
      MALE AGE 45, PREFERRED NON-TOBACCO, BAND 2, DEATH BENEFIT TYPE A
                           ASSUMING CURRENT CHARGES     
<TABLE>    
<CAPTION>
 
                                                                                          --- End of Policy Year ---
- ------------------------------------------------------------------------------------------------------------------------------------
                                                                                                      Cash
         Duration            Attained Age          Premium Paid       Accumulation Value          Surrender Value      Death Benefit
- ------------------------------------------------------------------------------------------------------------------------------------

<S>                          <C>                    <C>                <C>                      <C>                      <C>
             1                      45                $4,500               $  3,368                 $  1,398              $250,000
             2                      46                 4,500                  7,272                    5,052               250,000
             3                      47                 4,500                 11,556                    7,406               250,000
             4                      48                 4,500                 16,289                   12,139               250,000
             5                      49                 4,500                 21,520                   17,370               250,000
             6                      50                 4,500                 27,301                   23,151               250,000
             7                      51                 4,500                 33,690                   29,540               250,000
             8                      52                 4,500                 40,794                   36,644               250,000
             9                      53                 4,500                 48,800                   44,650               250,000
            10                      54                 4,500                 57,647                   54,190               250,000
            11                      55                 4,500                 67,810                   65,043               250,000
            12                      56                 4,500                 78,990                   76,915               250,000
            13                      57                 4,500                 91,288                   89,906               250,000
            14                      58                 4,500                104,838                  104,146               250,000
            15                      59                 4,500                119,787                  119,787               250,000
            16                      60                 4,500                136,296                  136,296               250,000
            17                      61                 4,500                154,550                  154,550               250,000
            18                      62                 4,500                174,764                  174,764               250,000
            19                      63                 4,500                197,187                  197,187               250,000
            20                      64                 4,500                222,037                  222,037               250,000
            21                      65                 4,500                249,418                  249,418               250,000
            22                      66                 4,500                279,567                  279,567               250,000
            23                      67                 4,500                312,760                  312,760               250,000
            24                      68                 4,500                349,301                  349,301               250,000
            25                      69                 4,500                389,523                  389,523               250,000
            26                      70                 4,500                433,796                  433,796               250,000
            27                      71                 4,500                482,622                  482,622               250,000
            28                      72                 4,500                536,507                  536,507               250,000
            29                      73                 4,500                596,023                  596,023               250,000
            30                      74                 4,500                661,821                  661,821               250,000
                                                                                                      
          Age 65                                       4,500                222,037                  222,037               250,000
 
Gross Investment Rate:                     12.00%
</TABLE>     
    
The hypothetical investment rates of return shown above are illustrative only
and should not be deemed a representation of past or future investment rates of
return.  Actual rates of return may be more or less than those shown and will
depend on a number of factors, including the investment allocations made by an
Owner and the investment experience of the Portfolios.  The Death Benefit,
investment value and Cash Surrender Value for a Policy would be different from
those shown if the actual gross annual rates of return averaged 0%, 6% or 12%
over a period of years, but also fluctuated above or below those averages for
individual Policy Years.  They would also be different if any Policy loans or
Withdrawals were made.  No representations can be made by Southland Life
Insurance Company or the Variable Account or the Portfolios that these
hypothetical rates of return can be achieved for any one year or sustained over
a period of time.     

     
                             FUTURE DIMENSIONS VUL
 
               MALE AGE 45, PREFERRED NON-TOBACCO, BAND 2, DEATH
                               BENEFIT TYPE A
                          ASSUMING GUARANTEED CHARGES     
    
<TABLE>
<CAPTION>

                                                             --- End of Policy Year ---
- -------------------------------------------------------------------------------------------------
                                                    Accumulation         Cash
     Duration        Attained Age  Premium Paid        Value       Surrender Value  Death Benefit
- -------------------------------------------------------------------------------------------------
<S>                  <C>           <C>           <C>            <C>              <C>
         1                 45        $4,500          $ 2,945           $   975       $250,000
         2                 46         4,500            6,020             3,800        250,000
         3                 47         4,500            8,982             4,832        250,000
         4                 48         4,500           11,828             7,678        250,000
         5                 49         4,500           14,554            10,404        250,000
         6                 50         4,500           17,157            13,007        250,000
         7                 51         4,500           19,625            15,475        250,000
         8                 52         4,500           21,986            17,836        250,000
         9                 53         4,500           24,329            20,179        250,000
        10                 54         4,500           26,499            23,041        250,000
        11                 55         4,500           28,484            25,716        250,000
        12                 56         4,500           30,271            28,196        250,000
        13                 57         4,500           31,855            30,473        250,000
        14                 58         4,500           33,225            32,532        250,000
        15                 59         4,500           34,358            34,358        250,000
        16                 60         4,500           35,233            35,233        250,000
        17                 61         4,500           35,826            35,826        250,000
        18                 62         4,500           36,099            36,099        250,000
        19                 63         4,500           36,010            36,010        250,000
        20                 64         4,500           35,510            35,510        250,000
        21                 65         4,500           34,553            34,558        250,000
        22                 66         4,500           33,098            33,098        250,000
        23                 67         4,500           31,091            31,091        250,000
        24                 68         4,500           28,478            28,478        250,000
        25                 69         4,500           25,180            25,180        250,000
        26                 70         4,500           21,081            21,081        250,000
        27                 71         4,500           15,891            15,891        250,000
        28                 72         4,500            9,692             9,692        250,000
        29                 73         4,500            2,093             2,093        250,000
        30                 74         LAPSE           LAPSE             LAPSE         LAPSE
                     
      Age 65                          4,500           35,510            35,510        250,000
 
Gross Investment Rate:                 0.00%
</TABLE>     

    
THE EXPENSE CHARGES AND COST OF INSURANCE RATES WILL NEVER BE GREATER THAN THOSE
USED TO CALCULATE THE ABOVE VALUES.  THE HYPOTHETICAL INVESTMENT RATES OF RETURN
SHOWN ABOVE ARE ILLUSTRATIVE ONLY AND SHOULD NOT BE DEEMED A REPRESENTATION OF
PAST OR FUTURE INVESTMENT RATES OF RETURN.  ACTUAL RATES OF RETURN MAY BE MORE
OR LESS THAN THOSE SHOWN AND WILL DEPEND ON A NUMBER OF FACTORS, INCLUDING THE
INVESTMENT ALLOCATIONS MADE BY AN OWNER AND THE INVESTMENT EXPERIENCE OF THE
PORTFOLIOS.  THE DEATH BENEFIT, INVESTMENT VALUE AND CASH SURRENDER VALUE FOR A
POLICY WOULD BE DIFFERENT FROM THOSE SHOWN IF THE ACTUAL GROSS ANNUAL RATES OF
RETURN AVERAGED 0%, 6% OR 12% OVER A PERIOD OF YEARS, BUT ALSO FLUCTUATED ABOVE
OR BELOW THOSE AVERAGES FOR INDIVIDUAL POLICY YEARS.  THEY WOULD ALSO BE
DIFFERENT IF ANY POLICY LOANS OR WITHDRAWALS WERE MADE.  NO REPRESENTATIONS CAN
BE MADE BY SOUTHLAND LIFE INSURANCE COMPANY OR THE VARIABLE ACCOUNT OR THE
PORTFOLIOS THAT THESE HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY ONE
YEAR OR SUSTAINED OVER A PERIOD OF TIME.     

 
    
                             FUTURE DIMENSIONS VUL
 
               MALE AGE 45, PREFERRED NON-TOBACCO, BAND 2, DEATH
                               BENEFIT TYPE A
                          ASSUMING GUARANTEED CHARGES     
<TABLE>
<CAPTION>
    
                                                      --- End of Policy Year ---
- ------------------------------------------------------------------------------------------
                                             Accumulation        Cash
    Duration     Attained Age  Premium Paid     Value       Surrender Value  Death Benefit
- ------------------------------------------------------------------------------------------
<S>              <C>           <C>           <C>            <C>              <C>
         1             45        $4,500      $  3,156          $  1,186       $250,000
         2             46         4,500         6,632             4,412        250,000
         3             47         4,500        10,194             6,044        250,000
         4             48         4,500        13,844             9,694        250,000
         5             49         4,500        17,577            13,427        250,000
         6             50         4,500        21,397            17,247        250,000
         7             51         4,500        25,293            21,143        250,000
         8             52         4,500        29,299            25,149        250,000
         9             53         4,500        33,515            29,365        250,000
        10             54         4,500        37,790            34,333        250,000
        11             55         4,500        42,118            39,351        250,000
        12             56         4,500        46,491            44,416        250,000
        13             57         4,500        50,908            49,526        250,000
        14             58         4,500        55,365            54,673        250,000
        15             59         4,500        59,849            59,849        250,000
        16             60         4,500        64,347            64,347        250,000
        17             61         4,500        68,847            68,847        250,000
        18             62         4,500        73,327            73,327        250,000
        19             63         4,500        77,762            77,762        250,000
        20             64         4,500        82,125            82,125        250,000
        21             65         4,500        86,395            86,395        250,000
        22             66         4,500        90,556            90,556        250,000
        23             67         4,500        94,591            94,591        250,000
        24             68         4,500        98,480            98,480        250,000
        25             69         4,500       102,197           102,197        250,000
        26             70         4,500       105,694           105,694        250,000
        27             71         4,500       108,819           108,819        250,000
        28             72         4,500       111,662           111,662        250,000
        29             73         4,500       114,039           114,039        250,000
        30             74         4,500       115,839           115,839        250,000
       
      Age 65                      4,500        82,125            82,125        250,000
 
Gross Investment Rate:             6.00%
</TABLE>     

    
THE EXPENSE CHARGES AND COST OF INSURANCE RATES WILL NEVER BE GREATER THAN THOSE
USED TO CALCULATE THE ABOVE VALUES.  THE HYPOTHETICAL INVESTMENT RATES OF RETURN
SHOWN ABOVE ARE ILLUSTRATIVE ONLY AND SHOULD NOT BE DEEMED A REPRESENTATION OF
PAST OR FUTURE INVESTMENT RATES OF RETURN.  ACTUAL RATES OF RETURN MAY BE MORE
OR LESS THAN THOSE SHOWN AND WILL DEPEND ON A NUMBER OF FACTORS, INCLUDING THE
INVESTMENT ALLOCATIONS MADE BY AN OWNER AND THE INVESTMENT EXPERIENCE OF THE
PORTFOLIOS.  THE DEATH BENEFIT, INVESTMENT VALUE AND CASH SURRENDER VALUE FOR A
POLICY WOULD BE DIFFERENT FROM THOSE SHOWN IF THE ACTUAL GROSS ANNUAL RATES OF
RETURN AVERAGED 0%, 6% OR 12% OVER A PERIOD OF YEARS, BUT ALSO FLUCTUATED ABOVE
OR BELOW THOSE AVERAGES FOR INDIVIDUAL POLICY YEARS.  THEY WOULD ALSO BE
DIFFERENT IF ANY POLICY LOANS OR WITHDRAWALS WERE MADE.  NO REPRESENTATIONS CAN
BE MADE BY SOUTHLAND LIFE INSURANCE COMPANY OR THE VARIABLE ACCOUNT OR THE
PORTFOLIOS THAT THESE HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY ONE
YEAR OR SUSTAINED OVER A PERIOD OF TIME.     

     
                             FUTURE DIMENSIONS VUL

               MALE AGE 45, PREFERRED NON-TOBACCO, BAND 2, DEATH
                               BENEFIT TYPE A
                          ASSUMING GUARANTEED CHARGES     
    
<TABLE>
<CAPTION>
                                                      --- End of Policy Year ---
- ------------------------------------------------------------------------------------------
                                             Accumulation         Cash
    Duration     Attained Age  Premium Paid     Value       Surrender Value  Death Benefit
- ------------------------------------------------------------------------------------------
<S>              <C>           <C>           <C>            <C>              <C>
         1            45        $4,500        $  3,367          $  1,397       $250,000
         2            46         4,500           7,270             5,050        250,000
         3            47         4,500          11,509             7,359        250,000
         4            48         4,500          16,118            11,968        250,000
         5            49         4,500          21,129            16,979        250,000
         6            50         4,500          26,583            22,433        250,000
         7            51         4,500          32,515            28,365        250,000
         8            52         4,500          39,012            34,862        250,000
         9            53         4,500          46,237            42,087        250,000
        10            54         4,500          54,105            50,647        250,000
        11            55         4,500          62,682            59,914        250,000
        12            56         4,500          72,043            69,968        250,000
        13            57         4,500          82,283            80,901        250,000
        14            58         4,500          93,506            92,814        250,000
        15            59         4,500         105,826           105,826        250,000
        16            60         4,500         119,377           119,377        250,000
        17            61         4,500         134,319           134,319        250,000
        18            62         4,500         150,833           150,833        250,000
        19            63         4,500         169,138           169,138        250,000
        20            64         4,500         189,499           189,499        250,000
        21            65         4,500         212,235           212,235        250,000
        22            66         4,500         237,285           237,285        250,000
        23            67         4,500         264,685           264,685        250,000
        24            68         4,500         294,652           294,652        250,000
        25            69         4,500         327,425           327,425        250,000
        26            70         4,500         363,257           363,257        250,000
        27            71         4,500         402,553           402,553        250,000
        28            72         4,500         445,763           445,763        250,000
        29            73         4,500         493,314           493,314        250,000
        30            74         4,500         545,751           545,751        250,000
 
      Age 65                     4,500         189,499           189,499        250,000
 
Gross Investment Rate:           12.00%
</TABLE>     

    
THE EXPENSE CHARGES AND COST OF INSURANCE RATES WILL NEVER BE GREATER THAN THOSE
USED TO CALCULATE THE ABOVE VALUES.  THE HYPOTHETICAL INVESTMENT RATES OF RETURN
SHOWN ABOVE ARE ILLUSTRATIVE ONLY AND SHOULD NOT BE DEEMED A REPRESENTATION OF
PAST OR FUTURE INVESTMENT RATES OF RETURN.  ACTUAL RATES OF RETURN MAY BE MORE
OR LESS THAN THOSE SHOWN AND WILL DEPEND ON A NUMBER OF FACTORS, INCLUDING THE
INVESTMENT ALLOCATIONS MADE BY AN OWNER AND THE INVESTMENT EXPERIENCE OF THE
PORTFOLIOS.  THE DEATH BENEFIT, INVESTMENT VALUE AND CASH SURRENDER VALUE FOR A
POLICY WOULD BE DIFFERENT FROM THOSE SHOWN IF THE ACTUAL GROSS ANNUAL RATES OF
RETURN AVERAGED 0%, 6% OR 12% OVER A PERIOD OF YEARS, BUT ALSO FLUCTUATED ABOVE
OR BELOW THOSE AVERAGES FOR INDIVIDUAL POLICY YEARS.  THEY WOULD ALSO BE
DIFFERENT IF ANY POLICY LOANS OR WITHDRAWALS WERE MADE.  NO REPRESENTATIONS CAN
BE MADE BY SOUTHLAND LIFE INSURANCE COMPANY OR THE VARIABLE ACCOUNT OR THE
PORTFOLIOS THAT THESE HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY ONE
YEAR OR SUSTAINED OVER A PERIOD OF TIME.     

                                      -21-
<PAGE>
 
                 FACTS ABOUT SOUTHLAND AND THE VARIABLE ACCOUNT

    
Southland Life Insurance Company is a stock life insurance company organized
under the laws of the State of Texas in 1908.  Our headquarters are located at
5780 Powers Ferry Road, N. W., Atlanta, Georgia  30327-4390.   We are admitted
to do business in the District of Columbia and all states except New York and
Vermont.  Southland intends to sell the Policy in all states except Alabama, New
York and Vermont.  Our total assets exceeded $1.8 billion, and our shareholder's
equity exceeded $386 million on a generally accepted accounting principles basis
as of December 31, 1995.  (See Financial Statements.)  We offer a complete line
of life insurance and retirement products, including annuities, individual and
group life, and pension products.      
    
Southland may from time to time publish in advertisements, sales literature, and
reports to Owners, the ratings and other information assigned to it by one or
more independent rating organizations such as A.M. Best Company, Standard &
Poor's, Moody's, and Duff & Phelps.  The purpose of the ratings is to reflect
the financial strength and/or claims-paying ability of Southland and should not
be considered as bearing on the investment performance of assets held in the
Variable Account.  Each year the A.M. Best Company reviews the financial status
of thousands of insurers, culminating in the assignment of Best's Ratings.
These ratings reflect their current opinion of the relative financial strength
and operating performance of an insurance company in comparison to the norms of
the life/health insurance industry.  In addition, the claims-paying ability of
Southland as measured by Standard & Poor's Insurance Ratings Services, Moody's,
or Duff & Phelps may be referred to in advertisements or sales literature or in
reports to Owners.  These ratings are opinions of an operating insurance
company's financial capacity to meet the obligations of its insurance and
annuity policies in accordance with their terms, including its obligations under
the Guaranteed Interest Account provisions of this Contract.  Such ratings do
not reflect the investment in the Variable Account.      
    
Southland is a wholly-owned indirect subsidiary of Internationale Nederlanden
Group, N.V. ("ING"), one of the world's five largest diversified financial
services organizations.  ING is headquartered in The Hague, Netherlands and has
consolidated assets exceeding $247.2 billion as of December 31, 1995.      

THE VARIABLE ACCOUNT
    
All obligations under the Policy are general obligations of Southland.  The
Variable Account is a separate investment account used to support our variable
life policies and for other purposes as permitted by applicable laws and
regulations.  The assets of the Variable Account are our property, but are kept
separate from our General Account and our other variable accounts.  We may offer
other variable life insurance policies supported by the Variable Account that
are not discussed in this prospectus.  The Variable Account may also invest in
other portfolios that are not available to the Policy described in this
Prospectus.      

                                     -22-
<PAGE>
 
    
Income, gains and losses, realized or unrealized, from assets in the Variable
Account are credited to or charged against the Variable Account without regard
to other income, gains or losses of the Company.  That portion of the assets of
the Variable Account which is equal to the reserves and other Policy liabilities
with respect to the Variable Account is not chargeable with liabilities arising
out of any other business Southland may conduct.  It may, however, be subject to
liabilities arising from Subaccounts whose assets are attributable to other
variable life insurance policies offered by the Variable Account.  If the assets
exceed the required reserves and other Policy liabilities, we may transfer the
excess to our General Account.  The assets in the Variable Account will at all
times, equal or exceed the sum of the Subaccount Accumulation Values of all
Policies supported by the Variable Account.      
    
The Variable Account was established on February 25, 1994, and may invest in
mutual funds or other investment portfolios which we determine to be suitable
for the Policy's purposes.  The Variable Account meets the definition of a
separate account under federal securities laws.  It is registered with the SEC
under the Investment Company Act of 1940 (the "1940 Act") as a unit investment
trust.  Such registration does not involve any supervision by the SEC of the
management of the Variable Account or Southland.  It is governed by the laws of
Texas, our state of domicile, and may also be governed by laws of other states
in which we do business.  We have established other separate accounts, of which
Southland Separate Account A1 is registered with the SEC under the 1940 Act. 
     
    
The Variable Account has twenty-one (21) Subaccounts, each of which invests in
shares of a corresponding Portfolio.  Therefore, the investment experience of
your Policy depends on the experience of the Subaccounts you select.  These
Portfolios are available only to serve as the underlying investment for variable
life insurance policies and variable annuity contracts issued through separate
accounts of Southland as well as other life insurance companies, and in some
cases, directly to certain qualified plans.  They are not available directly to
investors.      

THE PORTFOLIOS

Each Subaccount invests in a corresponding Portfolio.  See the Prospectus for
each of the Portfolios being considered for details.
    
Shares of these Portfolios are sold to separate accounts of insurance companies,
which may or may not be affiliated with Southland or each other, a practice
known as "shared funding."  They are also sold to separate accounts to serve as
the underlying investment for both variable life insurance policies and variable
annuity contracts, a practice known as "mixed funding."  Shares also may be sold
directly to qualified pension and retirement plans.  There is a possibility that
a material conflict may arise between the interests of Owners of our Policies,
whose Accumulation Values are allocated to a Subaccount investing in a
Portfolio, and of owners of other policies whose accumulation values are also
allocated to a separate account investing in that Portfolio, between the
interests of policyowners generally, or between certain classes of policyowners,
and retirement plans or participants in such retirement plans.  In the event of
any such material      


                                     -23-
<PAGE>
 
    
conflict, Southland will consider what action may be appropriate, including
removing the Portfolio from the Variable Account or replacing the Portfolio with
another portfolio.  There are certain risks associated with mixed and shared
funding and with the sale of shares to qualified pension and retirement plans,
as disclosed in the prospectuses for those Portfolios who sell to such plans. 
     
    
Each of the Portfolios is a separate series of an open-end diversified
management investment company (mutual fund) which receives investment advice
from one or more registered investment advisers.  The Portfolios as well as
their investment objectives are described below.  There is no guarantee that any
Portfolio will meet its investment objectives.  Meeting objectives depends on
various factors, including, in certain cases, how well the portfolio manager
anticipates changing economic and market conditions.      
    
Southland may receive compensation from an affiliate(s) of certain of the
Portfolios based upon an annual percentage of the average assets held in that
Portfolio by Southland. These amounts are intended to compensate Southland for
administrative and other services provided by Southland to the Portfolios and/or
the affiliate(s).     

Please refer to the prospectus for each of the Portfolios you are considering
for more information.  A description of the objectives and investments of each
Portfolio follows:

The Alger American Fund
    
Alger American Small Capitalization Portfolio--seeks long-term capital
appreciation by investing at least 65% of its total assets in equity securities
of companies that, at the time of purchase of the securities, have total market
capitalization within the range of companies included in the Russell 2000 Growth
Index, updated quarterly.      
    
Alger American Growth Portfolio--seeks long-term capital appreciation by
investing in a diversified, actively managed portfolio of equity securities,
primarily of companies with total market capitalization of $1 billion or
greater.      
    
Alger American MidCap Growth Portfolio--seeks long-term capital appreciation by
investing at least 65% of its total assets in equity securities of companies
that, at the time of purchase of the securities, have total market
capitalization within the range of companies included in the S&P MidCap 400
Index, updated quarterly.      
 
Alger American Leveraged AllCap Portfolio--seeks long-term capital appreciation
by investing in a diversified, actively managed portfolio of equity securities.
The Portfolio may engage in leveraging (up to 33-1/3% of its assets) and options
and futures transactions, which are deemed to be speculative and which may cause
the Portfolio's net asset value to be more volatile than the net asset value of
a fund that does not engage in these activities.


                                     -24-
<PAGE>
 
Variable Insurance Products Fund ("VIP") &
Variable Insurance Products Fund II ("VIP II")
    
VIP Money Market Portfolio--seeks as high a level of current income as is
consistent with preserving capital and providing liquidity.  The Portfolio will
invest only in high quality U.S. dollar-denominated money market securities of
domestic and foreign issuers.      
    
VIP High Income Portfolio--seeks high income by investing primarily in high-
yielding, lower-rated, fixed-income securities.  Growth of capital is also
considered in security selection.      
    
VIP Equity-Income Portfolio--seeks reasonable income by investing primarily in
income-producing equity securities.  In selecting investments, the Portfolio
also considers potential for capital appreciation.      
    
VIP Growth Portfolio--seeks capital appreciation by investing primarily in
common stocks, although the Portfolio is not limited to any one type of
security.      
    
VIP Overseas Portfolio--seeks long-term growth of capital primarily through
investments in foreign securities.  It provides a means for investors to
diversify their own portfolios by participating in companies and economies
outside of the United States.      
    
VIP II Investment Grade Bond Portfolio--seeks to obtain as high a level of
current income as is consistent with the preservation of capital by investing
primarily in a broad range of investment-grade fixed income securities.      
    
VIP II Asset Manager Portfolio--seeks high total return with reduced risk over
the long term by allocating its assets among domestic and foreign stocks, bonds,
and short-term fixed-income instruments.      
    
VIP II Index 500 Portfolio--seeks to provide investment results that correspond
to the total return (i.e., the combination of capital changes and income) of
common stocks publicly traded in the United States.  In seeking this objective,
the Portfolio attempts to duplicate the composition and total return of the
Standard & Poor's Composite Index of 500 Stocks while keeping transaction costs
and other expenses low.  The Portfolio is designed as a long-term investment
option.      
    
VIP II Contrafund Portfolio--seeks capital appreciation by investing mainly in
equity securities of companies that are considered undervalued or out-of-favor
by the Portfolio's manager.      

                                     -25-
<PAGE>
 
INVESCO Variable Investment Funds, Inc.
    
Industrial Income Portfolio--seeks the best possible current income while
following sound investment practices.  Capital growth potential is an
additional, but secondary, consideration in the selection of portfolio
securities.  The Portfolio seeks to achieve its investment objective by
investing in securities which will provide a relatively high yield and stable
return and which, over a period of years, also may provide capital appreciation.
     
    
Utilities Portfolio--seeks capital appreciation and income through investments
primarily in equity securities of corporations principally engaged in the public
utilities business.      
    
Janus Aspen Series      
    
Growth Portfolio--is a diversified fund that seeks long-term growth of capital
by investing primarily in common stocks, with an emphasis on companies with
larger market capitalizations.      
    
Aggressive Growth Portfolio--is a non-diversified Portfolio that seeks long-term
growth of capital by investing primarily in common stocks, with an emphasis on
securities issued by medium-sized companies.      
    
Worldwide Growth Portfolio--a diversified Portfolio that seeks long-term growth
of capital by investing primarily in common stocks of foreign and domestic
issuers.      
    
International Growth Portfolio--a diversified Portfolio that seeks long-term
growth of capital by investing primarily in common stocks of foreign issuers. 
     
    
Balanced Portfolio--is a diversified Portfolio that seeks a long-term growth of
capital balanced by current income. The Portfolio normally invests 40-60% of its
assets in securities selected primarily for their growth potential and 40-60% of
its assets in securities selected primarily for their income potential.      

Short-Term Bond Portfolio--a diversified Portfolio that seeks a high level of
current income while minimizing interest rate risk while investing in shorter
term fixed-income securities.  Its average weighted maturity is normally less
than three years.

CHANGES RELATING TO THE VARIABLE ACCOUNT

We may, from time to time, make the following changes, subject to obtaining any
required approvals from the SEC and any insurance regulatory authorities:

(1)   create new separate accounts for the Policy;

(2)   combine separate accounts, including the Variable Account;


                                     -26-
<PAGE>
 
(3)   add new Subaccounts to or remove existing Subaccounts from the Variable
      Account or combine Subaccounts;

(4)   make new Subaccounts or other Subaccounts available to such classes of
      policies or contracts as we may determine;

(5)   add new Portfolios or remove existing Portfolios;

(6)   if shares of a Portfolio are no longer available for investment or if we
      determine that investment in a Portfolio is no longer appropriate in light
      of the purposes of the Variable Account, substitute a different Portfolio
      for any existing Portfolio;

(7)   deregister the Variable Account under the 1940 Act if such registration is
      no longer required;

(8)   operate the Variable Account as a management investment company under the
      1940 Act or as any other form permitted by law; and

(9)   make any changes to the Variable Account or its operations as may be
      required by the 1940 Act or other applicable law or regulations.

Owners will be notified of any changes.

                             FACTS ABOUT THE POLICY

PREMIUMS AND ALLOCATIONS

Applying for a Policy
    
If you want to purchase a Policy, you must complete an application and submit it
to one of our authorized agents.  You also must pay an initial premium at least
equal to the minimum required.  See "Premiums," below.  Your initial premium can
be submitted with the application or at a later date, but Policy coverage will
not become effective until the Policy is delivered to you and the initial
premium in good order is received at our Customer Service Center while the
Insured is alive and prior to any change in health as shown in the application.
     
    
We require satisfactory evidence of the Insured's insurability, which may
include a medical examination of the Insured.  Generally, we will issue a Policy
covering an Insured up to age 75 if evidence of insurability satisfies our
underwriting rules.  We may, in our sole discretion, issue a Policy covering an
Insured over age 75.  Acceptance of an application depends on our underwriting
rules, and we reserve the right to reject an application for any reason.      


                                     -27-
<PAGE>
 
    
When you complete an application, you select a premium payment plan (see
"Planned Premiums," below), designate Net Premium allocation percentages (see
"Net Premium Alloca tions," below), and select the Initial Stated Death Benefit
(subject to a minimum of $100,000) and Death Benefit type (see "DEATH BENEFIT
AND CHANGES IN DEATH BENEFIT TYPE," page 41).  You also may apply for
supplemental benefits (see "ADDITIONAL BENEFITS," page 58), dollar cost
averaging (see "DOLLAR COST AVERAGING FACILITY," page 35), and telephone
transfer privileges (see "TELEPHONE PRIVILEGES," page 41).      

Free Look Period
    
You may cancel your Policy during your "free-look" period.  This period expires
20 days after you receive your Policy, 45 days after your application is signed,
or 10 days after we mail or deliver a notice of withdrawal right, whichever is
latest.  The Policy will be deemed to be received by you 15 days after it is 
mailed from the Customer Service Center. If you decide to cancel the Policy, you
must return it by mail or other delivery to our Customer Service Center or to
our authorized agent who sold it. Immediately after mailing or delivering it to
our Customer Service Center or authorized agent, the Policy will be deemed void
from the beginning. The amount of the refund will equal the premiums paid. This
refund will be paid within seven days after our Customer Service Center receives
your cancellation request and Policy.     
    
You also may cancel an increase in Stated Death Benefit during your "free-look"
period for the increase.  The period will expire 20 days after you receive a new
schedule for your Policy reflecting the increase, 45 days after your application
for the increase is signed, or 10 days after we mail or deliver a notice of
withdrawal right for the increase, whichever is latest.  If you cancel an
increase, we will refund to your Accumulation Value any charges deducted that
are attributable to the increase (e.g., sales load and cost of insurance
                                  ----                                  
charges) and adjust the Stated Death Benefit.      

Premiums
    
The minimum initial premium required depends on a number of factors, such as the
Age, sex and risk class of the proposed Insured, the desired Stated Death
Benefit, any supplemental benefits and the planned premiums you propose to make.
In any event, the initial premium must be at least equal to two No-Lapse
Premiums.  See "Planned Premiums" and "Premiums to Prevent Lapse," below.
Sample minimum initial premiums are shown in Appendix A.      
    
Additional premiums may be paid in any amount and at any time, subject to the
following limits.  First, a premium must be at least $100 and must be sent to
our Customer Service Center.  We may require satisfactory evidence of
insurability before accepting any premium which would result in an increase in
the difference between the Accumulation Value and the Death Benefit.      
    
Second, we reserve the right to limit total premiums paid in a Policy Year to
the planned premiums selected (see "Planned Premiums," below).  In addition,
total premiums paid in a Policy Year may not exceed guideline premium
limitations for life insurance set forth in Section      

                                     -28-
<PAGE>
 
    
7702 of the Code or any successor provision thereto.  We will refund any portion
of any premium that is determined to be in excess of the premium limit
established by law to qualify a Policy as life insurance.  (The amount refunded
will be the excess premium plus any gain attributable to the excess premium.)
In addition, we will monitor Policies and will attempt to notify the Owner on a
timely basis if his or her Policy is in jeopardy of becoming a modified
endowment contract under the Code.  See "FEDERAL TAX CONSIDERATIONS," page 61.
     
Lastly, no premium will be accepted after the Maturity Date.
    
If you have a Policy loan outstanding, any payment submitted other than a
planned premium will be treated as a loan repayment unless you indicate
otherwise when submitting the payment. (See "POLICY LOANS," page 39).  If no
Policy loan is outstanding, any payment submitted by you is treated as a premium
payment.      

Planned Premiums
    
When applying for a Policy, you select a plan for paying level premiums at
specified intervals, e.g., monthly, quarterly, semi-annually or annually, until
the Maturity Date.  You are not required to pay premiums in accordance with this
plan; rather, you can pay more or less than planned or skip a planned premium
entirely.  You can change the amount and frequency of planned premiums whenever
you want by sending a Written Request specifying the requested change to our
Customer Service Center.  However, we reserve the right to limit the amount of a
premium or the total premiums paid, as discussed above.  We will send you
reminder notices for planned premiums, unless you have arranged to pay planned
premiums by pre-authorized checking account deductions.      

Three-Year Guarantee
    
We guarantee that a Policy will remain in force during the first three Policy
Years, regardless of the sufficiency of the Cash Surrender Value, if the total
premiums paid less any Withdrawals and Policy Debt are greater than the No-Lapse
Premium multiplied by the number of months the Policy has been in force. The No-
Lapse Premium for your Policy generally will be less than the monthly amount of
planned premiums you select to pay. The above is tested on each Monthly
Processing Date. If the Net Accumulation Value is less than or equal to zero,
the charges will be temporarily deferred until the Net Accumulation Value is
positive. Whenever the Net Accumulation Value becomes positive, a portion or all
of the charges deferred will be deducted from the Accumulation Value. This
process will continue until the end of the Three-Year Guarantee period. If there
is a balance of deferred charges at the end of this period and there is not
sufficient Accumulation Value to pay such charges, a grace period will begin.
The Three-Year Guarantee will not prevent the termination of the Policy if the
Cash Surrender Value becomes insufficient because of excessive Policy Debt. See
"POLICY LOANS," page 39.     

                                     -29-
<PAGE>
 
Premiums upon Increase in Stated Death Benefit
    
Depending on the Accumulation Value at the time of an increase in the Stated
Death Benefit and the amount of the increase requested, an additional premium or
change in the amount of planned premiums may be advisable.  See "CHANGES IN
STATED DEATH BENEFIT," page 43.  We will notify you if an additional premium is
necessary or a change appropriate.      
    
If you increase your Policy's Stated Death Benefit during the first three Policy
Years, we will extend the Three-Year Guarantee (see above) to three years after
the effective date of the increase.      

Premiums to Prevent Lapse

Failure to pay planned premiums will not necessarily cause a Policy to lapse.
Conversely, paying all planned premiums will not necessarily guarantee that a
Policy will not lapse (except when the Three-Year Guarantee is in effect).
Rather, whether a Policy lapses depends on whether its Cash Surrender Value is
insufficient to cover the monthly deduction when due.

If the Cash Surrender Value on a Monthly Processing Date is less than the amount
of the monthly deduction to be deducted on that date (See "MONTHLY DEDUCTIONS
FROM NET ACCUMULATION VALUE") and the Three-Year Guarantee is not in effect, the
Policy will be in default and a grace period will begin.  This could happen if
investment experience has been sufficiently unfavorable that it has resulted in
a decrease in the Cash Surrender Value or the Cash Surrender Value has decreased
because insufficient premiums have been paid to offset the monthly deductions.

Grace Period
    
If your Policy goes into default, you will be allowed a 61-day grace period to
pay a premium sufficient to cover past due charges plus an amount sufficient to
keep the Policy and any riders in force for two (2) months following receipt.
We will send notice of the amount required to be paid during the grace period
("grace period premium") to your last known address and to any assignee of
record.  The grace period will begin when the notice is sent.  Your Policy will
remain in effect during the grace period.  If the Insured should die during the
grace period before the grace period premium is paid, the Death Benefit will
still be payable to the Beneficiary, although the amount paid will reflect a
reduction for the monthly deductions due on or before the date of the Insured's
death.  See "Amount of Death Proceeds," page 41.  If the grace period premium
is not paid before the grace period ends, your Policy will lapse.  It will have
no value and no benefits will be payable, although for a limited period you will
have the right to reinstate your Policy.  See "REINSTATEMENT," page 57.      
    
A grace period also may begin if Policy Debt becomes excessive.  See "POLICY
LOANS," page 39.      

                                     -30-
<PAGE>
 
Net Premium Allocations
    
In the application, you specify the percentage of Net Premium to be allocated to
each Subaccount or the Guaranteed Interest Account.  The sum of your allocations
must equal 100%, and each allocation percentage must be a whole number of at
least 5%.  Net Premiums received that are directed to be invested in the
Guaranteed Interest Account are allocated to that Account.  However, until the
Free Look Period expires, all Net Premiums allocated to a Subaccount are
invested in the Subaccount investing in the VIP Money Market Portfolio (the
"Money Market Subaccount").  At the end of this period, the Accumulation Value
in the Money Market Subaccount is transferred to and allocated to the
Subaccounts based on the net premium allocation percentages in the application.
See "Free Look Period," page 28.      
    
The Net Premium allocation percentages specified in the application will apply
to subsequent premiums until you change them.  You can change the allocation
percentages at any time provided they total 100% and each is a whole number, by
sending a Written Notice specifying the new allocation percentage to our
Customer Service Center.  The change will apply to all premiums received with or
after our receipt of your Written Notice.  If you change your Net Premium
allocation percentages more than five times during a Policy Year, we have the
right to deduct a $25 charge proportionally from your Subaccount Accumulation
Values and Guaranteed Interest Account Accumulation Value as of the Valuation
Day the allocation change is effective.  See "OTHER ADMINISTRATIVE CHARGES."
     
Crediting Premiums
    
The initial Net Premium will be credited to the Policy as of the Policy Date or
the date it is received at our Customer Service Center, if later.  Planned
premiums and unplanned premiums not requiring additional underwriting will be
credited to the Policy and the resulting Net Premiums will be allocated on the
Valuation Day the premium is received by our Customer Service Center in
accordance with the Net Premium allocation percentages then in effect.  However,
any premium requiring additional underwriting will be allocated to the Money
Market Subaccount until underwriting has been completed and the premium has been
accepted.  When accepted, the Accumulation Value in the Money Market Subaccount
attributable to the resulting Net Premium will be credited to the Policy and
allocated to the Subaccounts and Guaranteed Interest Account in accordance with
the Net Premium allocation percentages then in effect.  If an additional premium
is rejected, we will return the premium, without any adjustment for investment
experience.      

YOUR ACCUMULATION VALUE
    
The Accumulation Value of your Policy is the sum of Variable Accumulation Value
and the Guaranteed Interest Account Accumulation Value and any values held in
the General Account to secure policy loans.  The Variable Accumulation Value is
the sum of all the Subaccount Accumulation Values.      


                                     -31-
<PAGE>
 
Subaccount Accumulation Value

The Subaccount Accumulation Value for any Subaccount as of the Policy Date is
equal to the amount of the initial Net Premium allocated to that Subaccount.

On subsequent Valuation Days, the amount of the Subaccount Accumulation Value is
calculated as:

1.  The number of Accumulation Units in that Subaccount as of the beginning of
    the current Valuation Period multiplied by that Subaccount's Accumulation
    Unit value for the current Valuation Period; plus

2.  Any additional Net Premiums allocated to that Subaccount during the current
    Valuation Period; plus

3.  Any Accumulation Value transferred to the Subaccount during the current
    Valuation Period (including any amounts released from the Policy Loan
    Account and allocated to that Subaccount during the current Valuation
    Period); minus
    
4.  Any Accumulation Value transferred from the Subaccount during the current
    Valuation Period (including any amounts transferred to the Policy Loan
    Account and the portion of any Excess Transfer Charge allocated to the
    Subaccount during the current Valuation Period); minus      

5.  The portion of any Gross Withdrawals allocated to that Subaccount during the
    current Valuation Period (including the portion of the Surrender Charge
    resulting from a decrease in Stated Death Benefit allocated to the
    Subaccount during the current Valuation Period); minus

6.  The portion of the monthly deduction allocated to such Subaccount, if a
    Monthly Processing Date occurs during the current Valuation Period.

Accumulation Unit Value.  Net Premiums allocated to a Subaccount or amounts
transferred to a Subaccount are converted into Accumulation Units.  For any
Subaccount, the number of Accumulation Units credited is determined by dividing
the dollar amount directed to the Subaccount by the value of the Accumulation
Unit for that Subaccount for the Valuation Period on which the Net Premium is
received or the transfer is effective.  In this manner, an increase in
Subaccount Accumulation Value under a Policy occurs by the addition of
Accumulation Units of that Subaccount.
    
The Accumulation Unit Value for each Subaccount was arbitrarily set initially at
$10 when the Subaccount began investing in the underlying Portfolio.
Thereafter, for any Subaccount, the Accumulation Unit Value for a     

                                     -32-
<PAGE>
 
Valuation Period equals the Accumulation Unit Value for the preceding Valuation
Period multiplied by the Accumulation Experience Factor (described below) for
the Valuation Period.
    
Decreases in Subaccount Accumulation Value under a Policy are effected by the
cancellation of Accumulation Units of a Subaccount.  Therefore, Surrenders,
Withdrawals, loans, transfers out of a Subaccount, payment of a Death Benefit,
and the monthly deduction all result in the cancellation of an appropriate
number of Accumulation Units of one or more Subaccounts.  Accumulation Units
generally are canceled as of the end of the Valuation Period in which the
Company received notice of or instructions regarding the event or the deduction
is made.      

The Accumulation Experience Factor.  For each Subaccount, the Accumulation
Experience Factor reflects the investment experience of the Portfolio in which
that Subaccount invests and the charges assessed against that Subaccount for a
Valuation Period.  The Accumulation Experience Factor is calculated by dividing
(1) by (2) and subtracting (3) from the result, where:

(1)  is the result of:

a.   the net asset value per share of the Portfolio held in the Subaccount,
     determined at the end of the current Valuation Period; plus

b.   the per share amount of any dividend or capital gains distributions made by
     the Portfolio held in the Subaccount, if the "ex-dividend" date occurs
     during the current Valuation Period; plus or minus

c.   a per share charge or credit for any taxes reserved for, which is
     determined by the Company to have resulted from the operations of the
     Subaccount.

(2)  is the net asset value per share of the Portfolio held in the Subaccount,
     determined at the end of the last prior Valuation Period.

(3)  is a daily factor representing the mortality and expense risk charge
     deducted from the Subaccount, adjusted for the number of days in the
     Valuation Period.

Guaranteed Interest Account Accumulation Value

The Guaranteed Interest Account Accumulation Value as of the Policy Date is
equal to the amount of the initial Net Premium allocated to the Guaranteed
Interest Account.  On subsequent Valuation Days, the Guaranteed Interest Account
Accumulation Value is calculated as follows:

1.   The Guaranteed Interest Account Accumulation Value as of the end of the
     preceding Valuation Period plus any interest earned during the Valuation
     Period; plus


                                     -33-
<PAGE>
 
    
2.  Any additional Net Premiums allocated to the Guaranteed Interest Account
    plus interest credited to those premiums during the current Valuation
    Period; plus      

3.  Any Accumulation Value transferred to the Guaranteed Interest Account during
    the current Valuation Period (including any amounts released from the Policy
    Loan Account and allocated to the Guaranteed Interest Account during the
    current Valuation Period); minus

4.  Any Accumulation Value transferred from the Guaranteed Interest Account
    during the current Valuation Period (including any amounts transferred to
    the Policy Loan Account and the portion of any Excess Transfer Charge
    allocated to the Guaranteed Interest Account during the current Valuation
    Period); minus

5.  The portion of any Gross Withdrawals allocated to the Guaranteed Interest
    Account during the current Valuation Period (including the portion of any
    Surrender Charges resulting from a decrease in Stated Death Benefit
    allocated to the Guaranteed Interest Account during the current Valuation
    Period); minus

6.  The portion of the monthly deduction allocated to the Guaranteed Interest
    Account, if a Monthly Processing Date occurs during the current Valuation
    Period.

YOUR RIGHT TO TRANSFER
    
After the initial Free Look Period, you may transfer your Net Accumulation Value
among the Subaccounts and, subject to the special rules described below, to and
from the Guaranteed Interest Account.  The minimum amount that may be
transferred from each Subaccount or the Guaranteed Interest Account is $100 or
the balance in the Subaccount or the Guaranteed Interest Account, if less.  The
minimum amount that can remain in a Subaccount or the Guaranteed Interest
Account following a transfer is $100.  Percentages must be in whole numbers.
Transfer requests that do not comply with these requirements will not be
effected.  Transfers due to the operation of Dollar Cost Averaging or Automatic
Rebalancing are not included in determining the limit on the number of transfers
allowed without a charge. (See "DOLLAR COST AVERAGING FACILITY, page 35" and
"AUTOMATIC REBALANCING," page 36.) All transfers effected during a single
Valuation Period will be counted as one transfer for purposes of determining the
excess transfer charge. We reserve the right to limit the number of transfers
per Policy Year to 12. The table below summarizes the number of transfers
permitted in any one Policy Year without an excess transfer charge, the total
number of transfers permitted in a Policy Year and the excess transfer charge
under current rules.    
                                     -34-
<PAGE>
 
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------
<S>                        <C>  
Free Transfers                                            12
- --------------------------------------------------------------------------------
Total Number of Transfers                              Unlimited
Permitted
- --------------------------------------------------------------------------------
Excess Transfer Charge      $25 for each transfer in excess of 12 during any
                            Policy Year
- --------------------------------------------------------------------------------
</TABLE>

Transfers may be made based upon instructions given by Written Notice or by
telephone.

Right to Restrict Transfers.  The Company reserves the right to modify,
restrict, suspend or eliminate the transfer privileges (including the telephone
transfer facility) at any time, for any class of Policies, for any reason.  In
particular, the Company reserves the right to not honor transfers requested by a
third party holding a power of attorney from an Owner where that third party
requests simultaneous transfers on behalf of the Owners of two or more Policies.

Special Rules for the Guaranteed Interest Account.  Once during the first 30
days of each Policy Year, you may transfer amounts to or from the Guaranteed
Interest Account.  Transfer requests received within 30 days prior to the Policy
Anniversary will be considered requests to transfer on the Policy Anniversary.
A request to transfer to or from the Guaranteed Interest Account that is
received on the Policy Anniversary or within the following 30 days will be
processed if it is the first such transfer request received during the 30 day
period.  Requests for transfers to or from the Guaranteed Interest Account
received at any other time will not be processed.
    
The maximum transfer amount from the Guaranteed Interest Account to the
Subaccounts of the Variable Account in any Policy Year is the greatest of:      
    
(a)  25% of the Guaranteed Interest Account Accumulation Value immediately prior
     to the first transfer or Withdrawal in that Policy Year from the Guaranteed
     Interest Account;      

(b)  $100; or

(c)  the sum of the amounts that were transferred out of and withdrawn from the
     Guaranteed Interest Account in the prior Policy Year.

DOLLAR COST AVERAGING FACILITY

If elected at the time of the application or at any time thereafter by Written
Notice, an Owner may systematically transfer on a monthly basis, specified
dollar amounts from the Money Market Subaccount to other Subaccounts.  This is
known as the dollar-cost averaging ("Dollar Cost Averaging") method of
investment.  The fixed dollar amount will purchase more Accumulation Units of a
Subaccount when their value is lower and fewer units when their value is higher.
Over time, the cost per unit averages out to be less than if all purchases of
units had been made at the highest value and greater than if all purchases had
been made at the lowest value.  The Dollar Cost Averaging method of investment
reduces the risk of making purchases only when the price

                                     -35-
<PAGE>
 
of Accumulation Units is high.  It does not assure a profit or protect against a
loss in declining markets.
    
Owners may elect Dollar Cost Averaging only if their Subaccount Accumulation
Value in the Money Market Subaccount is at least $10,000 at the time of the
election.  The minimum transfer amount out of the Money Market Subaccount for
Dollar Cost Averaging is $100 per month.  The maximum transfer amount out of the
Money Market Subaccount for Dollar Cost Averaging is the Subaccount Accumulation
Value in that Subaccount, at the time of election, divided by 12.  If Dollar
Cost Averaging transfers are to be made to more than one Subaccount, allocations
of the transfer amount must be designated as whole number percentages.  Dollar
allocations may not be made.  If you elect to transfer to more than one
Subaccount, the minimum percentage that may be transferred to any Subaccount is
5% of the total amount transferred under the facility.      
    
Transfers for Dollar Cost Averaging will be effected on the Monthly Processing
Dates.  Once elected, Dollar Cost Averaging remains in effect for a Policy until
the Subaccount Accumulation Value in the Subaccount from which the transfers are
made is depleted, the Maturity Date occurs or until the Owner cancels the
election by Written Notice received at least seven days in advance of the next
transfer date.  There is no additional charge for using Dollar Cost Averaging.
The Company reserves the right to discontinue offering the Dollar Cost Averaging
facility at any time and for any reason.      

You may change the transfer amount or the Subaccounts to which transfers are to
be made once each Policy Year, subject to the above limitations.  Any transfer
under this facility will not be included for the purposes of computing the
excess transfer charge.

AUTOMATIC REBALANCING
    
You may implement an automatic rebalancing program for your Variable
Accumulation Value.  Accumulation Value allocated to the Subaccounts can be
expected to increase or decrease at different rates.  An automatic rebalancing
program automatically reallocates your Accumulation Value among the Subaccounts
each quarter to return the allocation to the most recent Net Premium allocation
percentages you specify for the Subaccounts. Automatic Rebalancing is intended
to transfer Accumulation Value from those Subaccounts that have increased in
value to those that have declined, or not increased as much, in value. Over
time, this method of investing may help an Owner "buy low and sell high,"
although there can be no assurance that this objective will be achieved.
Automatic Rebalancing does not guarantee profits, nor does it assure that an
Owner will not have losses.     
    
You may select an automatic rebalancing program when you apply for the Policy or
at a later date by completing the Automatic Rebalancing form and returning it to
our Customer Service Center.  We require that you allocate no more than 35% of
your Premiums to any one Subaccount and that you allocate your Net Premiums to
at least five Subaccounts while this feature is in effect.  If at any time
during the operation of the Automatic Rebalancing feature you      

                                     -36-
<PAGE>
 
    
request a change in Net Premium allocation which does not meet these
requirements, we will notify you that your request must be changed.  We will not
process such a request unless you also request that the Automatic Rebalancing
feature be discontinued.  When you request a change in premium allocation that
meets these requirements, your Accumulation Value will be reallocated as of the
Valuation Day that we receive your written allocation instructions.  Amounts
will be transferred among the Subaccounts to match the allocation for Net
Premiums.  During the operation of Automatic Rebalancing, you may not change
your allocation percentage to the Guaranteed Interest Account by more than 25%
of the percentage previously allocated to the Guaranteed Interest Account.  If
you change your Net Premium allocation more than five (5) times per Policy Year,
there will be a $25 charge taken from your Accumulation Value which will be
deducted proportionately from the Subaccount Accumulation Values and Guaranteed
Interest Account Accumulation Value as of the Valuation Day the allocation
change is effective.      
    
As of the first Valuation Day of each calendar quarter, we will transfer
Accumulation Value among the Subaccounts to the extent necessary to return the
allocation to your specifications.  Automatic Rebalancing may not begin until
the first Monthly Processing Date following the end of the Free Look Period.
Automatic Rebalancing will continue until we receive a Written Request or
telephone request at our Customer Service Center to terminate.  Other transfers
may not be made during the operation of Automatic Rebalancing.      

You may select either Dollar Cost Averaging or Automatic Rebalancing, but not
both.

WITHDRAWALS
    
You may make Withdrawals under your Policy after the first Policy Year under the
following rules.  You must submit a Written Request for the Withdrawal (unless
you have elected telephone privileges).  We must receive your request during the
Insured's lifetime.  The maximum Withdrawal is the amount which will leave $500
as Cash Surrender Value for the Policy.  The amount withdrawn from the
Guaranteed Interest Account may not be greater than the total Withdrawal times
the ratio of the Accumulation Value in the Guaranteed Interest Account to the
total unborrowed Accumulation Value immediately prior to the Withdrawal.  A
Withdrawal cannot cause the Stated Death Benefit to be reduced below the minimum
Stated Death Benefit of $50,000.  No more than 12 Withdrawals may be made during
a Policy Year, and each Withdrawal must be at least $500.  An administrative
charge (the withdrawal transaction charge) will be assessed on any Withdrawal
made during a Policy Year after the first Withdrawal.  See "WITHDRAWAL
TRANSACTION CHARGE," page 52.  If death benefit type A is in effect and a
Withdrawal occurs during the first 14 Policy Years or first 14 years following
an increase in Stated Death Benefit, a surrender charge will apply.  See
"SURRENDER CHARGE," page 47.  Any withdrawal transaction charge and surrender
charge will be deducted along with the amount requested to be withdrawn and will
be considered part of the Gross Withdrawal.  The following describes how Policy
values will be reduced by a Withdrawal and whether a surrender charge also may
apply.      


                                     -37-
<PAGE>
 
    
When you request a Withdrawal, you can direct how the Gross Withdrawal will be
deducted from your Accumulation Value in the Subaccounts and the Guaranteed
Interest Account.  If you provide no directions, the Gross Withdrawal will be
deducted from your Accumulation Value in the Subaccounts and the Guaranteed
Interest Account on a pro rata basis.  See "THE GUARANTEED INTEREST ACCOUNT,"
page 33.      
    
If death benefit type A is in effect, a Withdrawal will reduce the Accumulation
Value and may reduce the Stated Death Benefit. However, if the Withdrawal is the
first Withdrawal of that Policy Year, the Insured's attained Age is less than 81
at the time of the Withdrawal, the Withdrawal occurs less than 16 years
following the Policy Date, and the withdrawal is less than 5% of the Stated
Death Benefit, then the Withdrawal will not reduce the Stated Death Benefit. If
the above conditions are met and the amount of the Withdrawal exceeds the
greater of 10% of the Accumulation Value immediately prior to the Withdrawal and
5% of the Stated Death Benefit, the Stated Death Benefit will only be reduced by
the amount by which the Withdrawal exceeds the greater of 10% of the
Accumulation Value immediately prior to the Withdrawal and 5% of the Stated
Death Benefit. The Accumulation Value will be reduced, dollar for dollar, by the
Gross Withdrawal amount. The Stated Death Benefit will be reduced in proportion
to the reduction in Accumulation Value caused by the Withdrawal. The decrease in
Accumulation Value will occur on the day we process the Withdrawal; however, the
decrease in Stated Death Benefit will be effective as of the next Monthly
Processing Date. See "Changes in Stated Death Benefit," page 43 for a discussion
of how a decrease is effected if there has been a prior increase in Stated Death
Benefit. If the reduction occurs while the surrender charge is in effect
(generally, during the first 14 Policy Years and the first 14 years after an
increase in Stated Death Benefit), a portion of the sales surrender charge may
be assessed. See "SURRENDER CHARGE," page 47.     
    
If death benefit type B is in effect, a withdrawal will reduce the Accumulation
Value dollar for dollar but the Stated Death Benefit will not be reduced as the
Accumulation Value reflects the decrease.      
    
If the Stated Death Benefit is reduced by a Withdrawal, the Base Death Benefit
scheduled in the Adjustable Term Insurance Rider, if any, for the current year
and all future years will be reduced by an equal amount.  No Withdrawal will be
allowed if the Stated Death Benefit remaining in force after the Withdrawal
would be reduced below $50,000 and the Base Death Benefit scheduled in the
Adjustable Term Insurance Rider would be below $100,000, or the Stated Death
Benefit is reduced below $100,000 for Policies without the Adjustable Term
Insurance Rider.      
    
We generally will pay a Withdrawal request within seven days following the
Valuation Day we receive the request.  See "WHEN WE MAKE PAYMENTS," page 45.
Withdrawals may have adverse tax consequences.  See "FEDERAL TAX
CONSIDERATIONS," page 61.      


                                     -38-
<PAGE>
 
SURRENDERS
    
You may surrender your Policy at any time for its Cash Surrender Value.  We must
receive the Policy and Written Request for the surrender during the Insured's
lifetime.  A surrender charge may apply.  See "SURRENDER CHARGE," page 47.  We
will pay the Cash Surrender Value within seven (7) days following our receipt of
the request.  We will cancel the Policy as of the date of the Written Request.
Your Policy will terminate and cease to be in force if it is surrendered.  It
cannot be reinstated later.  A surrender may have tax consequences.  See
"FEDERAL TAX CONSIDERATIONS," page 61.      

POLICY LOANS
    
You may obtain a Policy loan from us at any time after the first Policy
Anniversary by submitting a Written Request for a Policy loan to our Customer
Service Center.  The minimum amount you may borrow is $100.  The maximum loan
amount is 90% of your Cash Surrender Value on the Valuation Day we receive your
Written Request.  Outstanding Policy loans reduce the amount available for new
loans.  Policy loans will be processed as of the Valuation Day your Written
Request is received and loan proceeds generally will be sent to you within seven
days.  See "WHEN WE MAKE PAYMENTS," page 45.  Loans under a Policy classified
as a modified endowment contract may be subject to adverse tax consequences,
including a 10% penalty.  See "Distributions From Policies Classified as
Modified Endowment Contracts," page 64.      
    
We will charge interest daily on any outstanding Policy loan at a maximum annual
rate of 6%.  Interest is due and payable on each Policy Anniversary date while a
Policy loan is outstanding.  If interest is not paid when due, the amount of the
interest is added to the loan and becomes part of the outstanding Policy loan.
     
    
You may repay all or part of your Policy Debt at any time while the Insured is
living prior to the Maturity Date and the Policy is in force.  Policy Debt is
equal to all outstanding policy loans and any accrued and unpaid interest on
those loans.  Loan repayments must be sent to our Customer Service Center and
will be credited as of the date received.  Such repayments will be credited
first to interest then to principal.  If there is an outstanding Policy loan,
any payment which is not a planned premium received before the Maturity Date
is considered a loan repayment unless otherwise indicated.  If the Death Benefit
becomes payable while a Policy loan is outstanding, the Policy Debt will be
deducted in calculating the Death Benefit.  If the Policy Debt exceeds the
Accumulation Value less any Surrender Charges on any Valuation Day, the Policy
will be in default.  We will send you, and any assignee of record, notice of the
default.  You will have a 61-day grace period to submit a sufficient payment to
avoid termination.  The notice will specify the amount that must be repaid to
prevent termination.  If your Policy terminates because of excessive Policy
Debt, it cannot be reinstated.      
    
When a Policy loan is made (or when interest is not paid when due), an amount
equal to the loan proceeds (or due and unpaid interest) is transferred from the
Accumulation Value in the      

                                     -39-
<PAGE>
 
    
Subaccounts or Guaranteed Interest Account.  This withdrawal is made pro rata on
the basis of Accumulation Value in each Subaccount and the Guaranteed Interest
Account unless you direct a different allocation when requesting the loan and as
long as at least $100 remains in the Subaccount or Guaranteed Interest Account
after the deduction.  The amount withdrawn is then transferred to the Policy
Loan Account in the General Account.  Conversely, when a loan is repaid, an
amount equal to the repayment will be transferred from the Policy Loan Account
to the Subaccounts and the Guaranteed Interest Account and allocated as you
direct when submitting the repayment.  If you provide no direction, the amount
will be allocated in accordance with your then effective Net Premium allocation
percentages.  Thus, a loan or loan repayment will have no immediate effect on
the Accumulation Value, but other Policy values, such as the Net Accumulation
Value and Cash Surrender Value, will be reduced or increased immediately by the
amount transferred to or from the Policy Loan Account.      
    
The amount in the Policy Loan Account will be credited with interest at a
minimum guaranteed annual rate of 4%.  The interest earned is transferred to the
Subaccounts of the Variable Account and the Guaranteed Interest Account on each
Policy Anniversary in the same proportion that Net Premiums are being allocated.
     
Certain loan amounts taken after the earlier of:
    
1.  the tenth Policy Anniversary, or
2.  the fifth Policy Anniversary if the Insured's Age is 60 or greater,      
    
will be considered preferred loan amounts as described below.  During each
Policy Year of preferred loan eligibility, the first loan made during that year
will be considered a preferred loan amount up to a maximum of 10% of the Net
Accumulation Value.  Any amount loaned later in that Policy Year will not be
considered a preferred loan amount.  If the preferred loan amount made during
any Policy Year is less than the maximum allowed, the balance may not be carried
over to increase the eligible preferred loan amount of any subsequent Policy
Year.  Beginning with the 21st Policy Year, all loan balances will be considered
to be preferred loan amounts.  The amount of any Accumulation Value in the
Guaranteed Interest Account equal to any preferred loan amount on the Policy
will be credited with interest at the rate of 4%.      
    
A Policy loan, whether or not repaid, will have a permanent effect on the Death
Benefit and Accumulation Values because the investment results of the
Subaccounts of the Variable Account and current interest rates credited on
Accumulation Value in the Guaranteed Interest Account will apply only to the
non-loaned portion of the Accumulation Value.  The longer the loan is
outstanding, the greater the effect is likely to be.  Depending on the
investment results of the Subaccounts or credited interest rates for the
Guaranteed Interest Account while the Policy loan is outstanding, the effect
could be favorable or unfavorable.  Policy loans may increase the potential for
lapse if investment results of the Subaccounts are less than anticipated.  Also,
Policy loans could, particularly if not repaid, make it more likely than
otherwise for a Policy to      

                                     -40-
<PAGE>
 
    
terminate.  See "FEDERAL TAX CONSIDERATIONS," page 61, for a discussion of
adverse tax consequences if a Policy lapses with Policy loans outstanding.      

TELEPHONE PRIVILEGES
    
If you have elected this privilege in a form required by us, you may make
transfers or request Withdrawals and Policy loans by telephoning our Customer
Service Center.  Any telephone request for Withdrawals or Policy loans must be
for an amount less than $25,000.      
    
Our Customer Service Center will employ reasonable procedures to confirm that
instructions communicated by telephone are genuine.  Such procedures may
include, among others, requiring some form of personal identification prior to
acting upon instructions received by telephone, providing written confirmation
of such transactions, and/or tape recording of telephone instructions.  Your
request for telephone privileges authorizes us to record telephone calls.  If
reasonable procedures are not used in confirming instructions, we may be liable
for any losses due to unauthorized or fraudulent instructions.  We reserve the
right to discontinue this privilege at any time.      

DEATH BENEFIT AND CHANGES IN DEATH BENEFIT TYPE
    
Payment of Death Proceeds      
    
As long as the Policy remains in force, we will pay the Death Proceeds after we
receive at our Customer Service Center satisfactory proof of the Insured's
death.  We may require return of the Policy.  The Death Proceeds will be paid in
a lump sum to the Beneficiary generally within seven days after receipt of such
proof (see "WHEN WE MAKE PAYMENTS," page 45) or, if a payment option is
elected, at different dates determined by the payment option elected (see
"PAYMENT OPTIONS," page 45.)  See "Selecting and Changing the Beneficiary,"
page 44.      

Amount of Death Proceeds
    
The Death Proceeds are equal to the sum of the Base Death Benefit on the date of
the Insured's death, plus any life insurance proceeds provided by rider, minus
any Policy Debt on that date and, if the date of death occurred during a grace
period, minus the past due monthly deductions.  See "Grace Period," page 30.
If the Adjustable Term Insurance Rider is in effect, the Death Proceeds are
calculated as described above using the Target Death Benefit instead of the Base
Death Benefit.  See "Selecting a Level of Death Benefits," page 44.  Under
certain circum stances, the amount of the Death Proceeds may be further
adjusted.  See "OTHER POLICY PROVISIONS," page 57.     

If part or all of the Death Proceeds are paid in one sum, Southland will pay
interest on this sum from the date we determine the Death Proceeds to the date
of payment, or until a payment option is selected.  Interest will be at the rate
we declare, or at any higher rate required by law.


                                     -41-
<PAGE>
 
Base Death Benefit and Death Benefit Types
    
The Owner may choose one of two death benefit types, which will determine the
Base Death Benefit.  Under death benefit type A, the Base Death Benefit is the
greater of the Stated Death Benefit or a multiple of the Accumulation Value on
the date of the Insured's death.  Under death benefit type B, the Base Death
Benefit is the greater of the Stated Death Benefit plus the Accumulation Value,
or a multiple of the Accumulation Value, on the date of the Insured's death.
     
    
If investment performance is favorable, the amount of the Base Death Benefit may
increase.  However, under type A, the Base Death Benefit ordinarily will not
change for several years as a result of any favorable investment performance and
may not change at all, whereas under type B, the Base Death Benefit will vary
directly with the investment performance of the Accumulation Value.  To see how
and when investment performance may begin to affect the Base Death Benefit,
please see the illustrations beginning on page 18.      
    
In both cases, the multiple of the Accumulation Value depends on the Insured's
attained Age at death.  The table of multiples in effect as of the issue date is
shown below.  If the table becomes inconsistent with any federal income tax laws
and/or regulations, we reserve the right to change it.      

<TABLE>
<CAPTION>
 
- --------------------------------------------------------------------------------
                          Death Benefit Multiples
- --------------------------------------------------------------------------------
             Multiple of              Multiple of              Multiple of
 Attained   Accumulation   Attained  Accumulation   Attained  Accumulation
   Age         Value         Age        Value         Age        Value
- --------------------------------------------------------------------------------
<S>         <C>            <C>       <C>            <C>       <C>
  0 - 40       2.50        54            1.57         68          1.17
    41         2.43        55            1.50         69          1.16
    42         2.36        56            1.46         70          1.15
    43         2.29        57            1.42         71          1.13
    44         2.22        58            1.38         72          1.11
    45         2.15        59            1.34         73          1.09
    46         2.09        60            1.30         74          1.07
    47         2.03        61            1.28      75 - 90        1.05
    48         1.97        62            1.26         91          1.04
    49         1.91        63            1.24         92          1.03
    50         1.85        64            1.22         93          1.02
    51         1.78        65            1.20         94          1.01
    52         1.71        66            1.19      90 - 100       1.00
    53         1.64        67            1.18
- ---------------------------------------------------------------------------
</TABLE>


                                     -42-
<PAGE>
 
Initial Stated Death Benefit and Death Benefit Type
    
The initial Stated Death Benefit is set at the time the Policy is issued.  The
minimum initial Stated Death Benefit is $100,000.  You may change the initial
Stated Death Benefit from time to time, as discussed below.  You select the
death benefit type when you apply for the Policy.  You also may change the death
benefit type, as discussed below.      

Changes in Death Benefit Type
    
After the first Policy Year, you may change the death benefit type on your
Policy on any Policy Anniversary subject to the following rules.  You must
submit a Written Request.  After any change, the Stated Death Benefit must be at
least $50,000.  The effective date of the change will be the Monthly Processing
Date that coincides with or next follows the Valuation Day after we approve the
Written Request for the change.      
    
When a change from type A to type B is made, the Stated Death Benefit after the
change is effected will be equal to the Stated Death Benefit before the change
less the Accumulation Value on the effective date of the change.  When a change
from type B to type A is made, the Stated Death Benefit after the change will be
equal to the Stated Death Benefit before the change is effected plus the
Accumulation Value on the effective date of the change.      

Changes in Stated Death Benefit
    
After the first Policy Year, you may request an increase in the Stated Death
Benefit, and after the second Policy Year, you may request a decrease in the
Stated Death Benefit, subject to the following conditions.  No change will be
permitted that would result in your Policy not satisfying the requirements of
section 7702 of the Code.      
    
An increase or decrease can be requested by Written Request only during the 30-
day period preceding a Policy Anniversary.  Any increase in the Stated Death
Benefit must be at least $10,000 and an application must be submitted, along
with evidence of insurability satisfactory to Southland.  A change in planned
premiums may be advisable.  See "Premiums upon Increase in Stated Death
Benefit," page 30.  The increase in Stated Death Benefit will become effective
as of the Policy Anniversary on or following the date the increase is approved.
You must return your Policy so we can amend the Policy to reflect the increase.
If the increase becomes effective during the first three Policy Years, the
Three-Year Guarantee will be extended for three years from the effective date of
the increase.  See "Three-Year Guarantee," page 29.  A Target Premium will be
established for the increase, and the portion of premiums paid thereafter
allocated to the increase will be subject to a 4% sales charge until an amount
equal to 10 Target Premiums for the increase has been paid.  See "Sales Charge."
     
    
Any decrease in the Stated Death Benefit must be at least $10,000, and the
Stated Death Benefit after the decrease must be at least $50,000.  In addition,
no decrease may be made until at least      

                                     -43-
<PAGE>
 
two years following the effective date of an increase in Stated Death Benefit.
A decrease in Stated Death Benefit will become effective as of the Policy
Anniversary on or following our receipt of Written Request.

If increases in the initial Stated Death Benefit are in effect, a decrease in
Stated Death Benefit will be allocated to each segment of the Stated Death
Benefit in the same proportion as the Target Premium for each segment bears to
the total Target Premiums for the Policy.
    
If a decrease in Stated Death Benefit occurs during the first 14 Policy Years,
or during the first 14 years following an increase in Stated Death Benefit, a
Surrender Charge may apply.  See "SURRENDER CHARGE," page 47.      

Selecting a Level of Death Benefits
    
When you apply for a Policy, you may select a level of death benefits in excess
of the Base Death Benefit for the Policy by adding to the Policy an Adjustable
Term Insurance Rider on the life of the Insured.  The Adjustable Term Insurance
Rider specifies a fixed dollar amount of Death Benefit in excess of the initial
Base Death Benefit called the Target Death Benefit.  The amount of the Target
Death Benefit may be set to vary as often as each Policy Year.  The amount of
Death Benefit provided by the Adjustable Term Insurance Rider on any day is the
difference between the Target Death Benefit specified and the Base Death Benefit
then in effect.  The amount provided therefore adjusts daily for variations in
the Base Death Benefit under the Policy.      
    
Adding the Adjustable Term Insurance Rider will increase insurance coverage
without increasing the Base Death Benefit.  There is no defined premium for the
amount of coverage provided by the Adjustable Term Insurance Rider, and,
therefore, no sales or Surrender Charges associated with such coverage.
However, a cost of insurance charge is deducted monthly from your Accumulation
Value for the Adjustable Term Insurance Rider amount in effect.  See "Cost of
Insurance Charge," page 51 and "ADDITIONAL BENEFITS," page 58.  Owners should
consult their sales representatives when deciding whether to add the Adjustable
Term Insurance Rider to their Policy.      

Selecting and Changing the Beneficiary

You select a Beneficiary in your application.  You may later change the
Beneficiary in accordance with the terms of the Policy.  If the Insured dies and
there is no surviving Beneficiary, the Owner's estate will be the Beneficiary.

MATURITY BENEFIT

If the Insured is living at Age 100 and the Policy is in force, Southland will
pay you the Net Accumulation Value and the Policy will terminate unless you
exercise your right to continue the

                                     -44-
<PAGE>
 
Policy.  The tax consequences associated with continuing a Policy beyond
attained Age 100 are unclear.  A tax advisor should be consulted before
exercising this right.

PAYMENT OPTIONS

The Policy offers a wide variety of optional ways of receiving proceeds payable
under the Policy, such as on surrender, death or maturity, other than in a lump
sum.  Any agent authorized to sell this Policy can explain these options upon
request.  None of these options vary with the investment performance of a
separate account because they are all forms of fixed-benefit annuities.

WHEN WE MAKE PAYMENTS
    
Payments of Withdrawals, Surrenders or Death Proceeds from the Subaccounts will
usually be made within seven days of the Valuation Day the Company receives a
Written Request and all required information at our Customer Service Center.
However, we may postpone the processing of any such transactions for any of the
following reasons:      

a)  When the New York Stock Exchange ("NYSE") is closed for trading other than
    for customary holiday or weekend closings, or trading on the NYSE is
    otherwise restricted, as determined by the SEC;

b)  When the SEC determines that an emergency exists that would make the
    disposal of securities held in the Variable Account or the determination of
    the value of the Variable Account's assets not reasonably practicable; or

c)  When the SEC by order permits a delay for the protection of Policyowners.

We may defer up to six months the payment of any Withdrawal or proceeds from the
Guaranteed Interest Account.  Interest will be credited at the currently
declared rate of interest for the Guaranteed Interest Account until payment is
made.


                        THE GUARANTEED INTEREST ACCOUNT

You may allocate all or a portion of your Net Premiums and transfer your Net
Accumulation Value to or from the Guaranteed Interest Account, which is part of
our General Account and which pays interest at a declared rate.  The General
Account supports our non-variable insurance and annuity obligations.  Because of
exemptive and exclusionary provisions, interests in the Guaranteed Interest
Account have not been registered under the Securities Act of 1933, and neither
the Guaranteed Interest Account nor the General Account has been registered as
an investment company under the 1940 Act.  Accordingly, neither the General
Account, the Guaranteed Interest Account nor any interest therein are generally
subject to regulation under

                                     -45-
<PAGE>
 
these Acts.  As a result, the staff of the SEC has not reviewed the disclosures
which are included in this prospectus which relate to the General Account and
the Guaranteed Interest Account.  These disclosures, however, may be subject to
certain provisions of the federal securities laws relating to the accuracy and
completeness of statements made in this prospectus.  For more details regarding
the General Account, see your Policy.
    
You may accumulate amounts in the Guaranteed Interest Account by (i) allocating
Net Premiums, (ii) transferring amounts from the Subaccounts, and (iii) earning
interest on amounts you already have in the Guaranteed Interest Account.  (See
"PREMIUMS AND ALLOCATIONS," page 27.)      
    
The amount you have in the Guaranteed Interest Account at any time is the sum of
all Net Premiums allocated to this Account, all transfers, and earned interest.
This amount is reduced by amounts transferred out of or withdrawn from the
Guaranteed Interest Account and deductions allocated to the Guaranteed Interest
Account.  (See "GUARANTEED INTEREST ACCOUNT ACCUMULATION VALUE," page 33.)      
    
We pay a declared interest rate on all amounts that you have in the Guaranteed
Interest Account.  These interest rates will never be less than the minimum
guaranteed effective annual interest rate of 3.5%.  When a Net Premium is
received or an amount is transferred into the Guaranteed Interest Account, an
interest rate will be credited to that amount.  The rate will be guaranteed for
a twelve-month period.  Thereafter, interest rates credited to that amount (and
amounts earned on that amount) will be similarly guaranteed for successive
periods of at least twelve-months at the then current interest rate.  Therefore,
different interest rates may apply to different amounts in the Guaranteed
Interest Account, depending on when and how the amount was initially allocated.
For purposes of crediting interest, amounts deducted, transferred or withdrawn
from the Guaranteed Interest Account are accounted for on a first-in-first-out
basis.  Interest at the guaranteed minimum rate or such higher rate as Southland
may determine will be paid regardless of the actual investment experience of the
General Account.  We bear the full amount of the investment risk for the amount
allocated to the Guaranteed Interest Account while the Owner assumes the risk
that interest credited may not exceed the guaranteed minimum rate.      

                            POLICY CHARGES AND FEES

CHARGES DEDUCTED FROM PREMIUMS
    
Certain expenses are deducted from your premium payments.  The remainder of each
premium (the Net Premium) is then added to your Accumulation Value.  The
expenses which are deducted from your premium include the tax charges and the
sales charge.      

State Premium Tax Charge.  All states levy taxes on life insurance premium
payments.  The amount of these taxes vary from state to state, and may vary from
jurisdiction to jurisdiction within a state.  We currently deduct an amount
equal to 2.5% of each premium to pay applicable


                                     -46-
<PAGE>
 
premium taxes.  The 2.5% rate approximates the average tax rate we expect to pay
on premiums from all states.

DAC Tax Charge.  A charge currently equal to 1.5% of each premium payment is
deducted to cover our estimated cost for the federal income tax treatment of
deferred acquisition costs determined solely by the amount of life insurance
premiums we receive.  This charge for deferred acquisition costs is reasonable
in relation to Southland's increased federal income tax burden under Section 848
of the Code resulting from the receipt of premium payments.

We reserve the right to increase or decrease the premium expense charge for
taxes due to any change in tax law.  We further reserve the right to increase or
decrease the premium expense charge for the federal income tax treatment of
deferred acquisition costs due to any change in the cost to us.
    
Sales Charge.  A charge equal to 4.0% of each premium paid up to an aggregate
amount equal to ten Target Premiums for your Policy, or to ten Target Premiums
for an increase after an increase in Stated Death Benefit, is deducted to
compensate us for a portion of the cost of selling the Policy.  This deduction
from premiums is only a portion of the total sales charge that will be assessed
against your Accumulation Value in the event you surrender your Policy during
the 14 Policy Years following the Policy Date or 14 Policy Years following an
increase in the Stated Death Benefit.  See "Sales Surrender Charge," page 48.
     
For a Policy with an increase in Stated Death Benefit, premiums paid are
allocated to the Initial Stated Death Benefit and each increase in the Stated
Death Benefit (each portion of the Death Benefit is referred to as a "segment")
in the same proportion that the Target Premium for each segment bears to the
total Target Premium for the Policy after the increase is taken into account.
    
The sales charge covers the cost of distribution, costs of preparing our sales
literature, other promotional expenses, and other direct and indirect expenses.
The amount of this charge cannot be specifically related to sales expenses in a
particular year since we recover these costs over the period the Policies remain
in effect.  We pay the sales expenses from our own resources, including the
sales charge, any sales Surrender Charge we may collect and any profit we may
earn on the mortality and expense risk charge deducted under the Policy.  The
sales charge may be reduced or waived for certain group or sponsored
arrangements or corporate purchasers.      

SURRENDER CHARGE
    
We assess a surrender charge against your Accumulation Value upon a Surrender or
lapse of your Policy in the first 14 Policy Years, or the 14 years following an
increase in Stated Death Benefit.  An increase in the Stated Death Benefit as a
result of a change in the death benefit option is not treated as an increase for
purposes of the surrender charge. The surrender charge consists of two charges:
an administrative surrender charge and a sales surrender charge.      

                                     -47-
<PAGE>
 
    
If the Stated Death Benefit of your Policy is reduced due to a requested
decrease or a Withdrawal effected during the first 14 Policy Years or 14 years
following an increase in the Stated Death Benefit, we may deduct a portion of
the sales surrender charge (but no administrative surrender charge) from your
Net Accumulation Value.  We also may recalculate the sales surrender charge in
effect after the reduction is taken into account.  See "CHANGES IN STATED DEATH
BENEFIT," page 43.  Decreases in the Stated Death Benefit as a result of a
change in your death benefit option do not result in a surrender charge
deduction from your Net Accumulation Value or in a recalculation of the
remaining sales surrender charge.      
    
The surrender charge is designed to recover our expenses in issuing and
distributing the Policies.      

Administrative Surrender Charge
    
The administrative surrender charge is calculated separately for the initial
Stated Death Benefit and for each increase in Stated Death Benefit (the initial
Stated Death Benefit and each increase in Stated Death Benefit is referred to as
a "death benefit segment").  The charge is equal to $4.00 per $1,000 of Stated
Death Benefit for each death benefit segment.  The administrative surrender
charge in effect on any Valuation Day is taken into account when calculating the
Cash Surrender Value payable on a Surrender.  The administrative surrender
charge is not deducted on a reduction in Stated Death Benefit.  The
administrative surrender charge remains level for the first 9 Policy Years or 9
years after an increase in Stated Death Benefit, then decreases by one-sixth of
the amount in effect at the end of the 9th Policy Year until it reaches zero at
the beginning of the 15th year, or the year in which the Insured reaches Age 98,
whichever is earlier.      
    
The administrative surrender charge is designed to partially cover the
administrative expenses associated with setting up your Policy (other than sales
expenses), such as application processing, establishment of Policy records and
insurance underwriting costs.  It also includes costs associated with the
development and operation of our systems for administering the Policies.  We do
not expect to profit from the administrative surrender charge.      

Sales Surrender Charge
    
The sales surrender charge is calculated separately for the Target Premium for
the Policy as issued, and for the Target Premium for any increase in Stated
Death Benefit.  Target Premiums are not based on the planned premiums you
determine when you purchase the Policy.  Target Premiums are actuarially
determined based on the Age, sex and risk class of the Insured.  See "PREMIUMS,"
page 28.  The Target Premium for your Policy, as originally issued, and for any
increase in Stated Death Benefit made after the Policy Date will be listed in
the schedule attached to your Policy.  The amount of the sales surrender charge
in a Policy Year is not necessarily related to our actual sales expenses in that
year.  To the extent sales expenses are not covered by the sales surrender
charge, we will cover them from other funds.      


                                     -48-
<PAGE>
 
    
In the case of each death benefit segment, the sales surrender charge is equal
to 50% of actual premiums paid up to one Target Premium, plus 40% of any
additional premiums paid up to the next two Target Premiums, for the death
benefit segment.  In any case, the maximum sales surrender charge for each death
benefit segment is equal to 130% of one Target Premium (50% of one Target
Premium plus 40% of each of the next two Target Premiums) for the death benefit
segment.  The maximum sales surrender charge for each death benefit segment will
be shown in the schedule attached to your Policy.  Like the administrative
surrender charge, the maximum sales surrender charge for a death benefit segment
remains level for the first 9 years after the death benefit segment takes
effect, then decreases each year by one-sixth of the amount in effect at the end
of the 9th year after it takes effect until it reaches zero at the beginning of
the 15th year after it takes effect, or the year in which the Insured reaches
Age 98, whichever is earlier.      
    
In the first two Policy Years or first two years after an increase in Stated
Death Benefit, the sales surrender charge is capped at 26% of premiums paid up
to one Target Premium, plus 6% of premiums paid between one and two Target
Premiums, plus 5% of all other premiums for the death benefit segment.      
    
The entire amount of the sales surrender charge in effect on any Valuation Day
is taken into account when calculating the Cash Surrender Value payable on a
Surrender.  A portion of the sales surrender charge may be deducted upon a
decrease in Stated Death Benefit resulting from a requested decrease in Stated
Death Benefit or a Withdrawal, depending in part on whether premiums paid and
allocated to a death benefit segment are more or less than the Target Premium
for the segment.  The following rules explain when a sales surrender charge is
deducted on a decrease in Stated Death Benefit, how the amount deducted is
calculated, and how the remaining sales surrender charge is adjusted.      
    
 .  When the Stated Death Benefit is decreased, each death benefit segment and
   corresponding Target Premium is reduced in the same proportion that the
   Stated Death Benefit is decreased. A new sales surrender charge will be
   calculated based on the reduced Target Premiums for each death benefit
   segment, as reduced, and giving credit for the time the death benefit segment
   had been in effect before the reduction.      
    
 .  If the reduced Target Premium for each reduced death benefit segment is
   greater than or equal to the sum of premiums paid that were allocated to the
   segment before the reduction, no sales surrender charge will be deducted from
   your Accumulation Value.      
    
 .  If the reduced Target Premium for each death benefit segment is less than the
   sum of premiums paid that were allocated to the segment, a sales surrender
   charge will be deducted from your Accumulation Value. The amount of this
   charge is the difference between the sales surrender charge in effect
   immediately before the decrease in Stated Death Benefit and the new sales
   surrender charge calculated upon the decrease.      
    
An example of the calculation of surrender charges follows:      

                                     -49-
<PAGE>
 
    
If the Stated Death Benefit is $200,000 for an insured age 45 on the Policy Date
and the Target Premium on this Policy is $2,800, the surrender charge assuming
that a $2,500 premium is paid at the beginning of each Policy Year is shown in
the table below:      

<TABLE>    
<CAPTION>
 
Policy Year     Administrative    Sales Surrender Charge       Actual
               Surrender Charge                              Surrender
                                                              Charge
- --------------------------------------------------------------------------
<S>            <C>                <C>                     <C>
     1               800                     650              1450
     2               800                     860              1660
     3               800                    2250              3050
     4               800                    2250              3050
     5               800                    2250              3050
     6               800                    2250              3050
     7               800                    2250              3050
     8               800                    2250              3050
     9               800                    2250              3050
     10              800                    1875              2541
     11              666                    1500              2034
     12              400                    1125              1525
     13              266                     750              1016
     14              134                     375               509
     15               0                       0                 0
</TABLE>     

MONTHLY DEDUCTIONS FROM YOUR NET ACCUMULATION VALUE
    
The following charges are deducted from your Net Accumulation Value on each
Monthly Processing Date.  These deductions are taken from the Subaccounts of the
Variable Account and the Guaranteed Interest Account in the same proportion that
your Net Accumulation Value in each Subaccount and the Guaranteed Interest
Account bears to the total Net Accumulation Value as of the Monthly Processing
Date.      

Initial Policy Charge.  The initial Policy charge is $20 per month for the first
Policy Year.  This charge covers the costs of setting up your Policy, other than
sales expenses, such as application processing, medical examinations,
establishment of Policy records and insurance underwriting costs.  This charge
is designed to reimburse us for expenses and we do not expect to gain from it.

Monthly Administrative Charge.  The monthly administrative charge is $6 per
month and is guaranteed never to exceed $10 a month.  This charge is designed to
cover the ongoing costs of maintaining your Policy, such as premium billing and
collections, claim processing, Policy

- -50-
<PAGE>
 
transactions, record keeping, reporting and other communications with Owners,
and other expenses and overhead.  This charge is designed to reimburse us for
expenses and we do not expect to gain from it.  The initial amount of this
charge is not more than the average expected cost of the services to be provided
this year.
    
Cost of Insurance Charge.  The cost of insurance charge compensates us for the
anticipated cost of paying the amount of the Death Benefit that exceeds your
Accumulation Value upon the death of the Insured.  The cost of insurance charges
are calculated monthly, and depend on a number of variables.  The charge on a
Monthly Processing Date is equal to our current monthly cost of insurance rate
multiplied by the net amount at risk under the Policy for the Death Benefit.
Because the monthly rate and the net amount at risk vary, the charge varies from
month to month and from Policy to Policy.      
    
- -- Net Amount At Risk.  Generally, the net amount at risk is the difference
between the Accumulation Value and the Death Benefit.  If the Adjustable Term
Insurance Rider is in effect, the net amount at risk is determined separately
for the Base Death Benefit and for the insurance provided by the rider.  The net
amount at risk for the Base Death Benefit is equal to the difference between the
current Base Death Benefit and the amount of your Accumulation Value on the
Monthly Processing Date.  For this purpose, the amount of your Accumulation
Value is determined after deduction of administrative charges and other
supplemental benefit charges due on that date, but before deduction of the cost
of insurance charges for the Base Death Benefit and for any Adjustable Term
Insurance Rider.  The net amount at risk for the Adjustable Term Insurance Rider
is equal to the amount of the benefit provided.  If the Base Death Benefit of
your Policy consists of more than one death benefit segment because there has
been an increase in Stated Death Benefit (see "DEATH BENEFIT AND CHANGES IN
DEATH BENEFIT TYPE," page 41), the net amount at risk is allocated to each death
benefit segment in the same proportion that the death benefit segment bears to
the sum of all death benefit segments as of the Monthly Processing Date.     
    
If the Base Death Benefit at the beginning of the month is increased, for
example, due to the requirements of federal income tax law definition of life
insurance, the net amount at risk for the Base Death Benefit that month will
also increase, but the net amount at risk for any Adjustable Term Insurance
Rider may be reduced. Changes in the relative makeup of the death benefit may
affect the cost of insurance charge.    
    
- -- Cost of Insurance Rate.  The cost of insurance rate for your Policy (or for a
death benefit segment) is based on the Age, sex and risk class of the Insured.
Separate cost of insurance rates apply to the Base Death Benefit, the Adjustable
Term Insurance Rider (See, "ADDITIONAL BENEFITS," page 58.), and any additional
death benefit segments. We place the Insured in a risk class when we issue the
Policy, based on our underwriting of the application. This original risk class
applies to the initial Stated Death Benefit and any Adjustable Term Insurance
Rider then added to the Policy. When an increase in Stated Death Benefit is
requested, we conduct underwriting     
                                      -51-
<PAGE>
 
before approving the increase to determine whether a different risk class will
apply to the increase.  If the risk class for the increase has lower cost of
insurance rates than the original risk class, the risk class for the increase
also will be applied to the initial Stated Death Benefit.  If the risk class for
the increase has higher cost of insurance rates than the original risk class,
the risk class for the increase will apply only to the increase in Stated Death
Benefit, and the original risk class will continue to apply to the initial
Stated Death Benefit.  We currently place Insureds in the following risk
classes, based on our underwriting:  a smoker (tobacco) or nonsmoker (non-
tobacco) standard risk class or a risk class involving a higher mortality risk
(a "substandard class").
    
Cost of insurance rates may change from time to time, but they will never be
more than the guaranteed maximum rates set forth in your Policy.  The guaranteed
rates for standard risk classes are based on the 1980 Commissioners' Standard
Ordinary Mortality Tables, Age Nearest Birthday ("1980 CSO Tables"), sex-
distinct.  The guaranteed rates for substandard risk classes are based on
multiples or additives of the 1980 CSO Tables.  Unisex rates are used where
appropriate under applicable law, currently including the state of Montana and
any Policies purchased by employers and employee organizations in connection
with employment-related insurance or benefit programs.  Our current cost of
insurance rates may be less than the guaranteed rates.  In addition, current
rates are less for Policies with a Stated Death Benefit (or Target Death
Benefit, if any) that is at least $250,000 on the Policy Date.  Our current cost
of insurance rates will be determined based on our expectations as to future
mortality, investment, expense and persistency experience.      
    
Cost of insurance rates (whether guaranteed or current) for an Insured in a
nonsmoker standard risk class are lower than guaranteed rates for an Insured of
the same Age and sex in a smoker standard risk class.  Cost of insurance rates
(whether guaranteed or current) for an Insured in a nonsmoker or smoker standard
risk class are generally lower than guaranteed rates for an Insured of the same
Age and sex and smoking status in a substandard risk class.  Cost of insurance
rates (whether guaranteed or current) generally increase as the Age of the
Insured increases.      
    
Supplemental Benefit Charges.  If any additional benefits are added to your
Policy, charges for these benefits will be deducted monthly as part of the
monthly deduction.  See "ADDITIONAL BENEFITS," page 58.      

OTHER ADMINISTRATIVE CHARGES

The following describes other administrative charges that may be imposed on
certain transactions or requests.  We do not expect to earn a profit from these
charges.
    
Withdrawal Transaction Charge.  Prior to the Maturity Date and after the Free
Look Period, you may take one Withdrawal each Policy Year without a withdrawal
transaction charge.  We impose a withdrawal transaction charge equal to the
lesser of $25 or 2% of the amount requested      

                                      -52-
<PAGE>
 
on each additional Withdrawal in that Policy Year.  The withdrawal transaction
charge will be deducted from your Net Accumulation Value on the same basis as
the Withdrawal is taken.
    
Excess Transfer Charge.  We allow you 12 free transfers among and between the
Subaccounts and the Guaranteed Interest Account each Policy Year.  For each
additional transfer, we will charge you $25 at the time each such transfer is
processed.  The charge will be deducted from your Subaccount Accumulation Value
and Guaranteed Interest Account Accumulation Value in the same proportion as
amounts transferred from those values.  Any transfer(s) due to the election of
Dollar Cost Averaging will not be included in determining if the excess transfer
charge should apply.      
    
Change in Net Premium Allocation Percentages.  If you change your Net Premium
allocation percentages more than five times during a Policy Year, we may impose
an administrative charge of $25.  If imposed, this charge will be deducted
proportionally from your Subaccount Accumulation Values and Guaranteed Interest
Account Accumulation Value as of the Valuation Day the allocation change is
effective.      
    
Automatic Rebalancing Charge.  If you change the Automatic Rebalancing
allocation more than five times in a Policy Year, a $25 charge is deducted from
your Accumulation Value in proportion to the Subaccount Accumulation Values and
the Guaranteed Interest Account Accumulation Value as of the Valuation Day the
allocation change is effective.      

CHARGES DEDUCTED FROM THE SUBACCOUNTS
    
Mortality and Expense Risk Charge.  We deduct a daily charge from the assets in
the Subaccounts to compensate Southland for mortality and expense risks that we
assume under the Policy.  The daily charge is at the rate of 0.02466%
(equivalent to an annual rate of 0.90%) on the assets of the Variable Account.
The mortality and expense risk charge is not deducted from the Guaranteed
Interest Account.  If the mortality and expense risk charge is insufficient to
cover the cost of mortality and expense risks undertaken by Southland, the
Company will bear the shortfall.  Conversely, if the charge proves more than
sufficient, the excess will be profit to the Company and will be available for
any proper corporate purpose including, among other things, payment of sales
expenses.      

The mortality risk assumed is the risk that Insureds, as a group, will live for
a shorter period of time than estimated and, therefore, the cost of insurance
charges specified in the Policy will be insufficient to meet our actual claims.
The expense risk assumed is the risk that it will cost us more to issue and
administer the Policy and the Variable Account than we expected in setting
certain of the charge levels guaranteed in the Policy.

PORTFOLIO EXPENSES

                                      -53-
<PAGE>
 
There are fees and charges deducted from the Portfolios.  Please read the
prospectus for the Portfolios you are considering for complete details.
    
PERSISTENCY REFUND      
    
Southland currently intends to provide a persistency refund to long-term Owners
of the Policy.  Each month the Policy or a coverage segment of Stated Death
Benefit remains in force after the tenth Policy Anniversary, Southland will
credit the Net Accumulation Value with a refund equivalent to 0.35% on an
annualized basis (0.02917% monthly) of the Net Accumulation Value for that
segment.  The Net Accumulation Value will be allocated to each coverage segment
based upon the number of completed Policy Years that segment has been in force
and the size of the guideline annual premium as defined by the Federal income
tax law definition of life insurance.      
    
The persistency refund will be added to the Subaccounts of the Variable Account
in the same proportion that the Accumulation Value in each Subaccount bears to
the Net Accumulation Value in the Variable Account as of the Monthly Processing
Date.     
    
The following are examples of how the persistency refund affects a $10,000 Net
Accumulation Value each month if: (a) there is no Policy loan outstanding; and
(b) there is an outstanding Policy loan:      

Accumulation Value = $10,000 (all in the Variable Account)

Monthly persistency refund rate = .0002917
    
Persistency refund = 10,000 x .0002917 = $2.92      

<TABLE>
<CAPTION>
 
                                              Variable Account
                                              ----------------
      <S>                                     <C>

      Before Persistency Refund                  $10,000.00

      After Persistency Refund                   $10,002.92
</TABLE>

The following is an example of how the persistency refund affects the
Accumulation Value each month if the Policy has a loan:

Accumulation Value = $10,000
    
Accumulation Value in the Variable Account = $5,000      

Policy Loan Account Value = $5,000
 
Monthly persistency refund rate = .0002917

                                      -54-
<PAGE>
 
Persistency refund = 5,000 x .0002917 = $1.46

<TABLE>    
<CAPTION> 
                                           Variable Account    Loan Division
                                           ----------------    -------------
      <S>                                  <C>                 <C> 

      Before Persistency Refund                $5,000.00        $5,000.00

      After Persistency Refund                 $5,001.46        $5,000.00
</TABLE>     

GROUP OR SPONSORED ARRANGEMENTS
    
For certain group or sponsored arrangements, we may reduce any sales, surrender,
administrative, and mortality and expense risk charges.  We may also change the
minimum initial and additional premium requirements, or accept a lower minimum
initial Stated Death Benefit.  Group arrangements include those in which a
trustee or an employer, for example, purchases Policies covering a group of
individuals on a group basis.  Sponsored arrangements include those in which an
employer allows us to sell Policies to its employees on an individual basis. 
     

Our costs for sales, administration, and mortality generally vary with the size
and stability of the group among other factors.  We take all these factors into
account when reducing charges.  To qualify for reduced charges, a group or
sponsored arrangement must meet certain requirements, including our requirements
for size and number of years in existence.  Group or sponsored arrangements that
have been set up solely to buy Policies or that have been in existence less than
six months will not qualify for reduced charges.

We will make these and any similar reductions according to our rules in effect
when an application or enrollment form for a Policy is approved.  We may change
these rules from time to time.  Any variation in the administrative charge will
reflect differences in costs or services and will not be unfairly
discriminatory.

                         ADDITIONAL POLICY INFORMATION

THE OWNER
    
The original Owner is the person named as the Owner in the application.  You, as
Owner, can exercise all rights and receive the benefits during the Insured's
life before the Maturity Date.  All rights of the Owner are subject to the
rights of any assignee and any irrevocable Beneficiary.      

THE BENEFICIARY

The Beneficiary is the person to whom we pay the Death Proceeds upon the death
of the Insured prior to the Maturity Date.

                                      -55-
<PAGE>
 
The original Beneficiary and any Contingent Beneficiaries are named in the
application.  Contingent Beneficiaries are paid Death Proceeds only if no
Beneficiary survives.  If more than one Beneficiary in a class survives, they
will share the Death Proceeds equally, unless the Owner's designation provides
otherwise.  If there is no designated Beneficiary or Contingent Beneficiary
surviving, we will pay the Death Proceeds to the Owner's estate.  We will pay
the Death Proceeds to the most recent Beneficiary designation on file with us.

CHANGE OF OWNER OR BENEFICIARY

Prior to the Maturity Date and after the Free Look Period, you may transfer
ownership of the Policy subject to our published rules at the time of the
change.

The Owner may name a new Beneficiary unless an irrevocable Beneficiary has
previously been named.  When an irrevocable Beneficiary has been designated, the
Owner and the irrevocable Beneficiary must act together to make any Beneficiary
changes.
    
To make any of these changes, you must send us Written Notice.  The change will
take effect as of the day the notice is signed.  The change will not affect any
payment made or action taken by us before recording the change at our Customer
Service Center.  For possible tax consequences, see "FEDERAL TAX 
CONSIDERATIONS," page 61.     

RIGHT TO CONVERT POLICY
    
At any time within the first 24 Policy Months after issuance of the Policy or
after an increase in Stated Death Benefit, while the Policy is in force during
the life of the Insured, the Owner may convert the Policy without evidence of
insurability to a new Policy on the life of the Insured providing benefits which
do not vary with the investment experience of the Variable Account.  This
conversion is accomplished by the transfer of the entire amounts in the
Subaccounts of the Variable Account to the Guaranteed Interest Account and the
allocation of all future premium payments to the Guaranteed Interest Account.
This will, in effect, serve as a conversion of the Policy to the equivalent of a
flexible premium universal life insurance policy.  No charge will be imposed on
the transfer in exercising this exchange privilege.  The converted policy will
be on the flexible premium adjustable life insurance plan being issued by
Southland.  The converted policy will provide the same amount of death benefit
or the same net amount at risk to Southland as the Policy and will have the same
issue Age and date of issue as the Policy.  The cost of insurance rates for the
converted policy will be those applicable to flexible premium adjustable life
policies in the same risk classification as the Policy and issued on the same
date as the Policy.  All Policy Debt must be paid.  The contestable period,
suicide period, and surrender charge period of the converted policy will be
measured from the date of issue of the Policy.  The effective date of the
conversion will be the date Southland received a Written Request to convert at
its Customer Service Center.  When exercising your conversion right, you are
required to return the Policy to our Customer Service Center, and we will send
to you a new policy form which will not allow you to allocate future premiums to
Subaccounts of the Variable Account.      

                                      -56-
<PAGE>
 
REINSTATEMENT
    
If coverage ends because a sufficient premium is not paid during a grace period,
the Policy may be reinstated within five (5) years after the lapse, subject to
compliance with certain conditions, including the payment of a necessary premium
and submission of satisfactory evidence of insurability.  See your Policy for
further information.      
 
OTHER POLICY PROVISIONS
    
If an Age or sex given in the application is misstated, the amounts payable or
benefits provided by the Policy shall be those that the premium would have
bought at the correct Age or sex.      
    
We cannot contest this Policy after is has been in force for two years from the
Policy Date during the Insured's lifetime except for non-payment of premium.  No
benefits added to your Policy after the Policy Date can be contested after they
have been in force for two years from the effective date of such benefit, during
the Insured's lifetime except for non-payment of premium.      

We must receive any election, designation, change, assignment, or any other
change request you make in writing.  We may require a return of your Policy for
any Policy change or for paying Death Benefits.  If your Policy has been lost,
we will require that you complete and return a "Policy Replacement Form."  The
effective date of any change will be the date the request was signed.  Any
change will not affect payments made or action taken by us before the change is
recorded at our Customer Service Center.

You may assign this Policy as collateral security upon Written Notice to us.
Once it is recorded with us, the rights of the Owner and Beneficiary are subject
to the assignment.  It is your responsibility to make sure the assignment is
valid.

AUTHORITY TO CHANGE POLICY TERMS

Only the President, a Vice President, or the Secretary of the Company has
authority to agree on behalf of the Company to any alteration of the Policy or
to any waiver of the right or requirements of the Company.
    
This Policy is intended to qualify as a life insurance policy under the Code.
To that end, all terms and provisions of the Policy shall be interpreted or
implemented to ensure or maintain such qualification.      

We reserve the right to amend this Policy, to reflect any clarifications or
changes that may be needed or are appropriate, or to conform it to any
applicable changes in the tax requirements, in order to qualify the Policy as a
life insurance policy under the Code.  We will send you Written Notice of such
amendments.

                                      -57-
<PAGE>
 
                                 ADDITIONAL BENEFITS
    
Your Policy may include additional benefits, which are also attached to the
Policy by Rider.  A charge will be deducted monthly from your Accumulation Value
for each additional benefit you choose.  These benefits may be canceled at any
time.  More details will be included in your Policy if you choose any of these
benefits.  A Policy may not contain both the Waiver of Specified Premium Rider
and the Waiver of Cost of Insurance Rider at the same time.      
    
From time to time we may make available Riders other than those listed below.
Contact your registered representative for a complete list of the Riders
available.      

ACCIDENTAL DEATH BENEFIT RIDER

This Rider will pay the benefit amount selected by you if the Insured dies as a
result of an accident or if the Insured dies within 90 days of an injury
sustained in an accident and the death occurs prior to the Insured's Age 70.
The minimum amount of coverage is $5,000 and the maximum amount is the Stated
Death Benefit.

ADJUSTABLE TERM INSURANCE RIDER

The Death Proceeds may be increased by adding the Adjustable Term Insurance
Rider on the life of the Insured.  As the name suggests, the Adjustable Term
Insurance Rider adjusts over time.
    
At issue, you determine a schedule of death benefits called the Target Death
Benefit which you establish at levels to meet your projected needs in the
future.  You may set the Target Death Benefit to vary as often as each Policy
Year.  The Target Death Benefit will be listed in the schedule attached to the
Policy.      
    
Subject to our rules, the Target Death Benefit schedule may be changed after
issue.  See "DEATH BENEFIT AND CHANGES IN DEATH BENEFIT TYPE," page 41.      

The amount of Adjustable Term Insurance in force at any time is the amount
needed to fill the difference between the Target Death Benefit you have selected
and the Base Death Benefit then in effect.  The Adjustable Term Insurance Rider
is dynamic in that it adjusts daily for variations in the Base Death Benefit
under the Policy (i.e., changes resulting from the federal income tax law
definition of life insurance test you have chosen under option 1 or 2).

For example, assume the Base Death Benefit varies according to the following
schedule.  The Adjustable Term Insurance Rider will adjust to provide Death
Proceeds equal to the Target Death Benefit in each year:

                                      -58-
<PAGE>
 
<TABLE> 
<CAPTION> 
 
  Base Death Benefit     Target Death Benefit     Adjustable Term Insurance
                                                         Rider Amount
  <S>                    <C>                      <C>
       $201,500                 $250,000                   $48,500
       $202,500                 $250,000                   $47,500
       $202,250                 $250,000                   $47,750
</TABLE>
    
Since the Adjustable Term Insurance Rider is dynamic, it is possible that the
Term Rider amount may be eliminated entirely as a result of increases in the
Base Death Benefit under the Policy.  Using the example outlined above, if the
Base Death Benefit under the Policy grew to $250,000, the Adjustable Term
Insurance Rider amount would be reduced to zero.  (It can never be reduced below
zero.)  Even though the Adjustable Term Insurance Rider amount is reduced to
zero, the Rider will remain in effect until you choose to remove it from your
Policy.  Therefore, if the Base Death Benefit under the Policy is subsequently
reduced below the Target Death Benefit you have applied for, the Adjustable Term
Insurance Rider amount will reappear as needed to maintain the Target Death
Benefit at the requested level.  Withdrawals may reduce the amount of the Target
Death Benefit.  See "WITHDRAWALS," page 37.      

We generally restrict the amount of the Target Death Benefit to an amount not
more than 500% of the Stated Death Benefit.  For example, if the Stated Death
Benefit is $100,000 then the maximum amount of Target Death Benefit we will
allow will be $500,000.
    
Given the flexible nature of the Adjustable Term Insurance Rider, there is no
defined premium for the amount of coverage.  Instead, a cost of insurance charge
is deducted monthly from your Accumulation Value for the Adjustable Term
Insurance Rider amount in effect.  These cost of insurance charges may be lower
than the rates applicable to the Base Death Benefit in the early Policy Years,
and may be higher in the later Policy Years.  See "Cost of Insurance Charge,"
page 51.  Since there is no defined premium related to the Adjustable Term
Insurance Rider, there are no sales or Surrender Charges associated with this
coverage; therefore, any increase in the Target Death Benefit which does not
increase the Stated Death Benefit will not increase the total Surrender Charge
for your Policy; any decrease in the Adjustable Term Insurance Rider coverage
will not cause a Surrender Charge to be incurred.  See "DEATH BENEFIT AND
CHANGES IN DEATH BENEFIT TYPE," page 41.      

The Adjustable Term Insurance Rider provides life insurance coverage on the
Insured as long as the Cash Surrender Value is sufficient to pay all of the
deductions that are taken out of your Net Accumulation Value each month.

ADDITIONAL INSURED RIDER
    
This Rider allows you to provide for death benefits upon the death of immediate
family members of the Insured.  A maximum of nine Additional Insured Riders may
be added to your Policy.      

                                      -59-
<PAGE>
 
The minimum amount of coverage for each Rider is $10,000 and the maximum
coverage for all Additional Insured Riders combined equals five times the Stated
Death Benefit of your Policy.

CHILDREN'S INSURANCE RIDER
    
This Rider will allow you to add death benefit coverage on your children.  It
also provides that you may cover children upon birth or legal adoption without
presenting evidence of insurability to us.  The minimum amount of coverage is
$1,000 per child and the maximum amount of coverage is $10,000 per child.      

EXCHANGE OF INSURED RIDER
    
This Rider allows you to change the person insured under your Policy.  If you do
so, the cost of insurance charge may change, but we will not change the Policy
values or the Surrender Charge.  There is no charge for this Rider.  The
exercise of this Rider may have adverse tax consequences.  For federal tax
purposes, the exercise of this Rider is treated as a surrender of the Policy.
Consult your tax advisor.  See "FEDERAL TAX CONSIDERATIONS," page 61.      

GUARANTEED INSURABILITY RIDER

This Rider will allow you to increase your Stated Death Benefit without
providing us with evidence that the Insured remains insurable during the Policy.
Increases are limited in amount and timing.

WAIVER OF THE COST OF INSURANCE RIDER
    
This Rider provides that during the total disability of the Insured, while the
Policy remains in force, the monthly expense charges, cost of insurance charges
and Rider charges will be waived and therefore not deducted from your Net
Accumulation Value.      

WAIVER OF SPECIFIED PREMIUM RIDER

This Rider provides that during the total disability of the Insured, while the
Policy remains in force, a specified premium will be credited monthly to the
Policy.  In your application you select the amount of premium, within limits,
that will be waived.

                                      -60-
<PAGE>
 
                          FEDERAL TAX CONSIDERATIONS

                    The Following Discussion is General and
                         Is Not Intended as Tax Advice

Introduction
    
The following summary provides a general description of the federal income tax
considerations associated with your purchase of the Policy and does not purport
to be complete or to cover all situations.  Southland advises that counsel or
other competent tax advisors should be consulted for more complete information.
This discussion is based upon Southland's understanding of the present federal
income tax laws as they are currently interpreted by the Internal Revenue
Service (the "Service").  No representation is made as to the likelihood of
continuation of the present federal income tax laws or of the current
interpretations by the Service.      

Tax Status of the Policy
    
Code section 7702 sets forth the definition of a life insurance contract for
federal tax purposes.  The Secretary of the Treasury (the "Treasury") is
authorized to prescribe regulations implementing section 7702.  While proposed
regulations and other interim guidance has been issued, final regulations have
not been adopted.  In short, guidance as to how section 7702 is to be adopted is
limited.  If a Policy were determined not to be a life insurance contract for
purposes of section 7702, such Policy would not qualify for the favorable tax
treatment normally provided to a life insurance policy.      
    
With respect to a Policy issued on the basis of a standard rate class, Southland
believes (largely in reliance on IRS Notice 88-128 and the proposed regulations
under section 7702, issued on July 5, 1991) that such a Policy should meet the
section 7702 definition of a "life insurance contract."      

With respect to a Policy that is issued on a substandard basis (i.e., a premium
class involving higher than standard mortality risk), there is less guidance, in
particular as to how the mortality and other expense requirements of section
7702 should be applied in determining whether such a Policy meets the section
7702 definition of a life insurance contract.

If it is subsequently determined that a Policy does not satisfy section 7702,
Southland may take whatever steps are appropriate and necessary to attempt to
cause such a Policy to comply with section 7702.  For these reasons, Southland
reserves the right to restrict Policy transactions as necessary to attempt to
continue its qualification as a life insurance contract under section 7702.
    
In addition to the definitional test described above, section 817(h) mandates
that the investments of the Variable Account must be "adequately diversified" in
accordance with Treasury regulations in order for the Policy to qualify as a
life insurance contract under section 7702 of the      

                                      -61-
<PAGE>
 
Code.  The Variable Account, through the Portfolios, intends to comply with the
diversification requirements prescribed in Treas. Reg. (S)1.817-5, which affect
how the Portfolio's assets are to be invested.
    
In certain circumstances, owners of variable life insurance contracts may be
considered the owners, for federal income tax purposes, of the assets of the
separate account used to support their contracts.  In those circumstances,
income and gains from the separate account assets would be includable in the
variable contract owner's gross income.  The Service has stated in published
rulings that a variable contract owner will be considered the owner of separate
account assets if the contract owner possesses incidents of ownership in those
assets, such as the ability to exercise investment control over the assets.  The
Treasury also announced, in connection with the issuance of temporary
regulations concerning diversification, that those regulations "do not provide
guidance concerning the circumstances in which investor control of the
investments of a segregated asset account may cause the investor (i.e., the
Policyowner), rather than the insurance company, to be treated as the owner of
the assets in the account."  This announcement also stated that guidance would
be issued by way of regulations or rulings on the "extent to which policyholders
may direct their investments to particular subaccounts without being treated as
owners of the underlying assets."      
    
The ownership rights under the Policy are similar to, but different in certain
respects from, those described by the Service in rulings in which it was
determined that policy owners were not owners of separate account assets.  For
example, the Owner has additional flexibility in allocating premium payments and
policy values.  These differences could result in an Owner being treated as the
owner of a pro rata portion of the assets of the Variable Account.  In addition,
Southland does not know what standards will be set forth, if any, in the
regulations or rulings which the Treasury has stated it expects to issue.
Southland therefore reserves the right to modify the Policy as necessary to
attempt to prevent an Owner from being considered the owner of a pro rata share
of the assets of the Variable Account or to otherwise qualify the Policy for
favorable tax treatment.      
    
The Policies may be used in various arrangements, including nonqualified
deferred compensation or salary continuance plans, split dollar insurance plans,
executive bonus plans, retiree medical benefit plans and others.  The tax
consequences of such plans may vary depending on the particular facts and
circumstances of each individual arrangement.  Southland does not guarantee the 
tax treatment of any such arrangements. Therefore, if you are contemplating the
use of the Policies in any arrangement the value of which depends in part on its
tax consequences, you should be sure to consult a qualified tax advisor
regarding the tax attributes of the particular arrangement.     

The following discussion assumes that the Policy will qualify as a life
insurance contract for federal income tax purposes.

                                      -62-
<PAGE>
 
Tax Treatment of Policy Benefits

In General.  Southland believes that the proceeds and cash value increases of a
Policy should be treated in a manner consistent with a flexible-benefit life
insurance policy for federal income tax purposes.  Thus, the Death Benefit under
the Policy should be excludable from the gross income of the Beneficiary under
Code section 101(a)(1).
    
Depending on the circumstances, the exchange of a Policy, a change in the
Policy's Death Benefit Option (i.e., a change from Option A to Option B or vice
versa), a policy loan, a Withdrawal, a surrender, or an assignment of the Policy
may have federal income tax consequences.  In addition, federal, state and local
transfer, and other tax consequences of ownership or receipt of Policy proceeds
depend on the circumstances of each Owner or Beneficiary.      
    
Generally, the Owner will not be deemed to be in constructive receipt of the
Accumulation Value, including increments thereof, until there is a distribution.
The tax consequences of distributions from, and loans taken from or secured by a
Policy, depend on whether the Policy is classified as a "Modified Endowment
Contract."  Whether a Policy is or is not a modified endowment contract, upon a
complete surrender or lapse of a Policy, or when benefits are paid at such a
Policy's maturity, if the amounts received plus the amount of indebtedness
exceeds the total investment in the Policy the excess will generally be treated
as ordinary income subject to tax.      
    
Modified Endowment Contracts.  Code section 7702A establishes a class of life
insurance contracts designated as "Modified Endowment Contracts," which applies
to Policies entered into or materially changed after June 20, 1988.      
    
Due to the Policy's flexibility, classification as a Modified Endowment Contract
will depend on the individual circumstances of each Policy.  In general, a
Policy will be a Modified Endowment Contract if the accumulated premiums paid at
any time during the first seven Policy Years exceeds the sum of the net level
premiums which would have been paid on or before such time if the Policy
provided for paid-up future benefits after the payment of seven level annual
premiums.  The determination of whether a Policy will be a Modified Endowment
Contract after a material change generally depends upon the relationship of the
Death Benefit and Policy Value at the time of such change and the additional
premiums paid in the seven years following the material change.      

The rules relating to whether a Policy will be treated as a Modified Endowment
Contract are extremely complex and cannot be adequately described in the limited
confines of this summary.  Therefore, a current or prospective Owner should
consult with a competent advisor to determine whether a policy transaction will
cause the Policy to be treated as a Modified Endowment Contract.  Southland
will, however, monitor Policies and will attempt to notify an Owner on a timely
basis if his or her Policy is in jeopardy of becoming a Modified Endowment
Contract.

                                      -63-
<PAGE>
 
    
Distributions from Policies Classified as Modified Endowment Contracts.
Policies classified as Modified Endowment Contracts will be subject to the
following tax rules.  First, all distributions, including distributions upon
surrender and partial surrenders from such a Policy, are treated as ordinary
income subject to tax up to the amount equal to the excess (if any) of the
Accumulation Value immediately before the distribution over the investment in
the Policy (described below) at such time.  Second, loans taken from or secured
by, such a Policy are treated as distributions from such a Policy and taxed
accordingly.  Past due loan interest that is added to the loan amount will be
treated as a loan.  Third, a 10 percent additional income tax is included in
income except where the distribution or loan is made on or after the Owner
attains age 59 1/2, is attributable to the Owner's becoming disabled, or is part
of a series of substantially equal periodic payments for the life (or life
expectancy) of the Owner or the joint lives (or joint life expectancies) of the
Owner and the Owner's Beneficiary.      

If a Policy becomes a modified endowment contract after it is issued,
distributions that occur during the policy year it becomes a modified endowment
contract and any subsequent policy year will be taxed as distributions from a
modified endowment contract.  In addition, distributions from a Policy within
two years before it becomes a modified endowment contract will be taxed as
distributions from a modified endowment contract.
    
Distributions From Policies Not Classified as Modified Endowment Contracts.
Distributions from a Policy that is not a Modified Endowment Contract, are
generally treated as first recovering the investment in the Policy (described
below) and then, only after the return of all such investment in the Policy, as
distributing taxable income.  An exception to this general rule occurs in the
case of a decrease in the Policy's Death Benefit or any other change that
reduces benefits under the Policy in the first fifteen years after the Policy is
issued and that results in a cash distribution to the Owner in order for the
Policy to continue complying with the section 7702 definitional limits.  Such a
cash distribution will be taxed in whole or in part as ordinary income (to the
extent of any gain in the Policy) under rules prescribed in section 7702.      

Loans from, or secured by, a Policy that is not a Modified Endowment Contract
are not treated as distributions.  Instead, such loans generally are treated as
indebtedness of the Owner.

Finally, neither distributions (including distributions upon surrender) nor
loans from, or secured by, a Policy that is not Modified Endowment Contract are
subject to the 10 percent additional tax.

Policy Loans.  Generally, consumer interest paid on any loan under a Policy
which is owned by an individual is not deductible.  The deduction of interest on
Policy loans is further restricted by section 264 of the Code.  Before taking a
Policy loan, an Owner should consult a tax adviser as to the tax consequences of
such a loan.

Investment in the Policy.  Investment in the Policy means (i) the aggregate
amount of any premiums or other consideration paid for a Policy, minus (ii) the
aggregate amount received

                                      -64-
<PAGE>
 
under the Policy which is excluded from gross income of the Owner (except that
the amount of any loan from, or secured by, a Policy that is a Modified
Endowment Contract, to the extent such amount is excluded from gross income,
will be disregarded), plus (iii) the amount of any loan from, or secured by a
Policy that is a Modified Endowment Contract to the extent that such amount is
included in the gross income of the Owner.

Multiple Policies.  All Modified Endowment Contracts that are issued by
Southland (and its affiliates) to the same Owner during any calendar year are
treated as one Modified Endowment Contract for purposes of determining the
amount includable in the gross income under Code section 72(e).


                               OTHER INFORMATION

REPORTS TO OWNERS
    
Southland maintains records and accounts of all transactions involving the 
Policy, the Guaranteed Interest Account and the Variable Account.
Each year, we will send you a report that shows current information regarding
your Policy.  This report will show for the last Policy Year the current
Accumulation Value, Cash Surrender Value and Premiums paid since the last
report.  The report will also show the allocation of your Accumulation Value as
of the date of the report and the amounts added to or deducted from your
Subaccount Accumulation Values and Guaranteed Interest Account Accumulation
Value since the last report.  The report will include any other information that
may be currently required by the insurance supervisory official of the
jurisdiction in which the Policy is delivered.      

We will also send you copies of any shareholder reports of the Portfolios in
which the Subaccounts invest, as well as any other reports, notices or documents
required by law to be furnished to Policyowners.

DISTRIBUTION OF THE POLICIES

ING America Equities, Inc. is principal underwriter and distributor of the
Policies as well as of other contracts issued through the Variable Account and
other separate accounts of Southland.  ING America Equities, Inc. is an
affiliate of Southland.  It is a corporation organized under the laws of the
State of Colorado in 1993.  Its officers are located at 1290 Broadway, Denver,
Colorado, 80203-1290.  It is registered with the SEC as a broker-dealer and is a
member of the National Association of Securities Dealers, Inc. ("NASD").

ING America Equities, Inc. serves as underwriter/distributor for other separate
accounts registered with the SEC.  We pay ING America Equities, Inc. for acting
as principal underwriter under a distribution agreement.  The Policy will be
offered on a continuous basis and Southland does not anticipate discontinuing
the offer.

ING America Equities, Inc. will enter into sales agreements with broker-dealers
to solicit for the sale of the Policies through registered representatives who
are licensed to sell securities and

                                      -65-
<PAGE>
 
    
variable insurance products.  Registered representatives who sell the Policy
will be paid a maximum sales commission of approximately 85% of all premiums
paid in the first Policy Year up to one Target Premium, and 3% of premiums paid
in the first Policy Year in excess of one Target Premium.  An additional 3% is
paid on premiums received in Policy Years 2 through 10.  In addition, certain
bonuses and managerial compensation may be paid.      

VOTING PRIVILEGES
    
In accordance with its view of current applicable law, the Company will vote
Portfolio shares held in the Variable Account at regular and special shareholder
meetings of the Portfolios in accordance with instructions received from persons
having voting interests in the corresponding Subaccounts.  If, however, the 1940
Act or any regulation thereunder should be amended, or if the present
interpretation thereof should change, or the Company otherwise determines that
it is allowed to vote the shares in its own right, it may elect to do so.      

The number of votes that an Owner has the right to instruct will be calculated
separately for each Subaccount, and may include fractional votes.  An Owner
holds a voting interest in each Subaccount to which the Variable Accumulation
Value is allocated.

For each Owner, the number of votes attributable to a Subaccount will be
determined by dividing the Accumulation Value attributable to that Owner's
Policy in that Subaccount by the net asset value per share of the Portfolio in
which that Subaccount invests.

The number of votes available to an Owner will be determined as of the date
coincident with the date established by the Portfolio for determining
shareholders eligible to vote at the relevant meeting of the Portfolio's
shareholders.  Voting instructions will be solicited by written communication
prior to such meeting in accordance with procedures established for the
Portfolio.  Each Owner having a voting interest in a Subaccount will receive
proxy materials and reports relating to any meeting of shareholders of the
Portfolio in which that Subaccount invests.
    
Portfolio shares as to which no timely instructions are received and shares held
by the Company in a Subaccount as to which no Owner has a beneficial interest
will be voted in proportion to the voting instructions which are received with
respect to all Policies participating in that Subaccount.  Voting instructions
to abstain on any item to be voted upon will be applied to reduce the total
number of votes eligible to be cast on a matter.  Under the 1940 Act, certain
actions affecting the Variable Account (such as some of those described under
"CHANGES RELATING TO THE VARIABLE ACCOUNT," page 26) may require Owner
approval.  In that case, you will be entitled to vote in proportion to your
Variable Accumulation Value.      
    
We may, if required by state insurance officials, disregard Owner voting
instructions if such instructions would require shares to be voted so as to
cause a change in sub-classification or investment objectives of one or more of
the Portfolios, or to approve or disapprove an investment advisory agreement.
In addition, we may under certain circumstances disregard voting      

                                      -66-
<PAGE>
 
instructions that would require changes in the investment policy or investment
adviser of one or more of the Portfolios, provided that we reasonably disapprove
of such changes in accordance with applicable federal regulations.  If we ever
disregard voting instructions, we will advise Owners of that action and of our
reasons for such action in the next semiannual report.  Finally, we reserve the
right to modify the manner in which we calculate the weight to be given to pass-
through voting instructions where such a change is necessary to comply with
current federal regulations or the current interpretation thereof.

LEGAL PROCEEDINGS
    
There are no legal or administrative proceedings to which the Variable Account
is a party or to which the assets of the Variable Account are subject.
Southland, as an insurance company, is ordinarily involved in litigation.  We do
not believe that any current litigation or administrative proceeding is material
to Southland's ability to meet its obligations under the Policy or to the
Variable Account nor do we expect to incur significant losses from such actions.
ING America Equities, Inc. is not involved in any legal or administrative
proceedings that are material with respect to the Variable Account or the
Variable Account's assets.      

                                      -67-
<PAGE>
 
SOUTHLAND'S DIRECTORS AND OFFICERS

Southland Life Insurance Company is managed by a board of directors.  The
following table sets forth the name, address and principal occupations during
the past five years of each of Southland's directors.

                               Position with    Principal Occupation During the
 Name and Address              Southland Life   Past Five Years
- --------------------------------------------------------------------------------
 R. Glenn Hilliard             Chairman         Director, Life of Georgia (since
 5780 Powers Ferry Road, N.W.                   1994); President & Chief
 Atlanta, GA 30327-4390                         Executive Officer, ING North
                                                America Insurance Corp. (since
                                                1993); Chief Executive Officer &
                                                Director, ING America Life Corp.
                                                (since 1993); Chairman of the
                                                Board and Chief Executive
                                                Officer, Southland Life (since
                                                1993); Chief Executive Officer,
                                                ING America Life Corp. (1993);
                                                Chief Executive Officer &
                                                Director, Security Life and
                                                Denver Insurance Company (since
                                                1989).
- --------------------------------------------------------------------------------
 Robert J. St. Jacques         Vice             Chief Executive Officer,
 5780 Power Ferry Road, N.W.   Chairman         Southland Life Insurance Company
 Atlanta, GA 30327-4390                         (since 1995); President & Chief
                                                Executive Officer, ING America
                                                Life Corporation (since 1994);
                                                President & Chief Executive
                                                Officer, The Laurentian Group
                                                (1990 - 1994); Chairman & Chief
                                                Executive Officer, The Imperial
                                                Life Insurance Co. of Canada
                                                (1990-1994).
- --------------------------------------------------------------------------------
 Michael W. Cunningham         Director         Executive Vice President, Chief
 5780 Powers Ferry Road, N.W.                   Financial Officer, ING North
 Atlanta, GA 30327-4390                         America Insurance Corporation
                                                (since June, 1991); Executive
                                                Vice President, Chief Financial
                                                Officer, American Income Life
                                                (1991); Senior Vice President,
                                                Chief Financial Officer, Integon
                                                Corporation (1987-1991).
- --------------------------------------------------------------------------------

                                      -68-
<PAGE>
 
                               Position with    Principal Occupation During the
 Name and Address              Southland Life   Past Five Years
- --------------------------------------------------------------------------------
 Linda B. Emory                Director         Executive Vice President, ING
 5780 Powers Ferry Road, N.W.                   North America Insurance
 Atlanta, GA 30327-4390                         Corporation (since 1994);
                                                Director, Life of Georgia (since
                                                1991); Senior Vice President,
                                                Life of Georgia (1990-1994).
- --------------------------------------------------------------------------------
 James D. Thompson             Director         President & Chief Operating
 5780 Powers Ferry Road, N.W.                   Officer, Southland Life 
 Atlanta, GA 30327-4390                         Insurance Company (since 1995);
                                                Executive Vice President & Chief
                                                Financial Officer, ING America
                                                Life Corporation (1993-1995);
                                                Vice President, ITT Corporation
                                                (1992-1993); Executive Vice
                                                President, ITT Corporation 
                                                (1990-1993).
- --------------------------------------------------------------------------------
 P. Randall Lowery             Director         Senior Vice President &
 5780 Powers Ferry Road, N.W.                   Corporate Actuary, ING America
 Atlanta, GA 30327-4390                         Life Corporation (since 1994);
                                                Vice President & Actuary,
                                                Southland Life Insurance Company
                                                (1990-1994).
- --------------------------------------------------------------------------------
 Francis J. Mulcahy            Director         Vice President, General Counsel
 5780 Powers Ferry Road, N.W.                   & Secretary, Life of Georgia
 Atlanta, GA 30327-4390                         (since 1995); Vice President,
                                                General Counsel & Secretary,
                                                Southland Life Insurance Company
                                                (since 1995); Vice President &
                                                Secretary, Life Insurance
                                                Company of Georgia (since 1994);
                                                Vice President & Secretary,
                                                Southland Life Insurance Company
                                                (since 1994); General Counsel,
                                                Southland Life Insurance Company
                                                (1989-1994); Associate General
                                                Counsel, Southland Life
                                                Insurance Company (1989-1994);
                                                Associate General Counsel, Life
                                                Insurance Company of Georgia
                                                (1983-1994).


                                      -69-
<PAGE>
 
The following table sets forth the names, addresses and principal occupations
during the last five years of the senior officers of Southland (other than
officers who are members of Southland's board of directors).
 
                                Position with   Principal Occupation During
 Name and Address               Southland Life  the Past Five Years
- --------------------------------------------------------------------------------
 John R. Barmeyer               Senior Vice     Director, Life of Georgia
 5780 Powers Ferry Road, N.W.   President,      (since 1992); General Counsel,
 Atlanta, GA 30327-4390         Chief Legal     ING America Life Insurance
                                Officer         Corporation, and Senior Vice
                                                President, General Counsel &
                                                Secretary, Life of Georgia
                                                (since 1992); Vice President,
                                                General Counsel & Secretary,
                                                Life of Georgia (1990-1992).
- --------------------------------------------------------------------------------
 P. Thomas Chester             Senior Vice      Senior Vice President, 
 5780 Powers Ferry Road, N.W.  President &      Marketing, (since 1994);
 Atlanta, GA 30327-4390        Chief            President, Diversified 
                               Marketing        (1991-1994); President & Senior
                               Officer          Vice President, Marketing, 
                                                Surety Life Insurance Company
- --------------------------------------------------------------------------------
      
 Alan Jeglinski                Senior Vice      Senior Vice President,
 5780 Powers Ferry Road, N.W.  President -      Operations (since 1995); Vice
 Atlanta, GA 30327-4320        Operations       President -Administration
                                                (1994-1995); Vice President,
                                                Property and Casualty
                                                (1993-1994); General Manager,
                                                Orion Insurance, PLC
                                                (1985-1993)      
- --------------------------------------------------------------------------------
     
 Pamela Crane                  Senior Vice      Senior Vice President -
 5780 Powers Ferry Road, N.W.  President -      Actuarial (since 1995); Vice
 Atlanta, GA 30327-4390        Actuarial        President - BIO (1994 - 1995);
                                                Consultant, Tillinghast
                                                (1988-1994)      
- --------------------------------------------------------------------------------

A fidelity bond in the amount of $6 million in Guilders covering Southland's
officers and employees has been issued by NN Reinsurance Company, N.V.


EXPERTS
    
The financial statements of Southland Life Insurance Company at 
December 31, 1995 and 1994, and for each of the three years in the period ended
December 31, 1995, appearing in this Prospectus and Registration Statement have
been audited by Ernst & Young, LLP independent auditors, as set forth in their
report thereon appearing elsewhere herein, and are included in     

                                      -70-
<PAGE>
 
reliance upon such report given upon the authority of such firm as experts in
accounting and auditing.
    
Actuarial matters in this prospectus have been examined by Pamela M. Crane, who
is Senior Vice President - Finance/Actuarial of Southland Life Insurance
Company.  Her opinion on actuarial matters is filed as an exhibit to the
Registration Statement we filed with the SEC.      

LEGAL MATTERS
    
The legal matters in connection with the Policy described in this Prospectus
have been passed on by Francis J. Mulcahy, Vice President, Secretary and General
Counsel of Southland.  Sutherland, Asbill & Brennan of Washington, D.C. has
provided advice on certain matters relating to the federal securities laws. 
     

FINANCIAL STATEMENTS
    
The audited financial statements of Southland Life Insurance Company at 
December 31, 1995 and 1994, and for each of the three years in the period ended
December 31, 1995, (as well as the auditors' report thereon) are included
beginning on the next page.      
    
This prospectus does not contain financial statements for the Southland Separate
Account L1 because it has not yet commenced operations, has no assets or
liabilities and has received no income nor incurred any expenses as of the date
of this prospectus.      

                                      -71-
<PAGE>
 
                             Financial Statements

                       Southland Life Insurance Company

                 Years ended December 31, 1995, 1994 and 1993
                 --------------------------------------------
                      with Report of Independent Auditors
                      -----------------------------------
<PAGE>
 
                       Southland Life Insurance Company

                             Financial Statements

                 Years ended December 31, 1995, 1994 and 1993


                                   CONTENTS

Report of Independent Auditors............................. l

Audited Financial Statements

Balance Sheets............................................. 2
Statements of Income....................................... 4
Statements of Stockholder's Equity......................... 5
Statements of Cash Flows................................... 6
Notes to Financial Statements.............................. 8
 
<PAGE>

                [LETTERHEAD OF ERNST & YOUNG LLP APPEARS HERE]
 
                        Report of Independent Auditors
 
Board of Directors
Southland Life Insurance Company
 
We have audited the accompanying balance sheets of Southland Life Insurance
Company as of December 31, 1995 and 1994, and the related statements of
income, stockholder's equity, and cash flows for each of the three years in
the period ended December 31, 1995. These financial statements are the
responsibility of the Company's management. Our responsibility is to express
an opinion on these financial statements based on our audits.
 
We conducted our audits in accordance with generally accepted auditing
standards. Those standards require that we plan and perform the audit to
obtain reasonable assurance about whether the financial statements are free of
material misstatement. An audit includes examining, on a test basis, evidence
supporting the amounts and disclosures in the financial statements. An audit
also includes assessing the accounting principles used and significant
estimates made by management, as well as evaluating the overall financial
statement presentation. We believe that our audits provide a reasonable basis
for our opinion.
 
In our opinion, the financial statements referred to above present fairly, in
all material respects, the financial position of Southland Life Insurance
Company at December 31, 1995 and 1994, and the results of its operations and
its cash flows for each of the three years in the period ended December 31,
1995, in conformity with generally accepted accounting principles.
 
As discussed in Note 1 to the financial statements, in 1994 and 1993 the
Company changed its method of accounting for investments in debt and equity
securities and income taxes, respectively.
 
                                          /s/ ERNST & YOUNG LLP
 
Atlanta, Georgia
April 5, 1996

                                      1
<PAGE>

 
                        Southland Life Insurance Company

                                Balance Sheets
<TABLE>
<CAPTION>
 
                                                                         DECEMBER 31
                                                                      1995          1994
                                                                 --------------------------
                                                                        (In Thousands)
<S>                                                              <C>             <C>
ASSETS
Investments (Notes 1, 2, 3 and 4):
 Fixed maturities:
   A vailable-for-sale, at fair value (amortized cost:  1995-
    $793,055; 1994 - $645,554)                                      $  871,637   $  623,831
 
   Held-to-maturity, at amortized cost (fair value:  1994 -
    $201,704)                                                                -      200,554
 
 Equity securities, at fair value (cost:  1995 - $614; 1994 -
   $1,532)                                                                 764        1,602
 
 Mortgage loans on real estate                                         300,671      231,406
 Investment real estate, at cost, less accumulated
  depreciation (1995 - $10; 1994 - $6)                                     190          515
 Policy loans                                                           80,164       79,437
 Other long-term investments                                                 -           59
                                                                    -----------------------
Total investments                                                    1,253,426    1,137,404
 
Cash                                                                     1,268       10,831
Accrued investment income                                               15,951       16,728
Reinsurance recoverable:
 Paid benefits                                                           8,886          188
 Unpaid benefits and IBNR                                               16,400        2,614
Prepaid reinsurance premiums                                           282,943      240,824
Deferred policy acquisition costs                                      145,431      133,543
Present value of future profits less accumulated
 amortization (1995 - $163,605; 1994 - $145,535)                        78,204      100,602
Goodwill less accumulated amortization (1995 - $9,540;
 1994 - $7,999)                                                         50,921       52,462
Property and equipment, at cost, less accumulated
 depreciation (1994 - $105)                                                  -          626
Current federal income taxes (Note 8)                                        -        1,797
Other assets                                                             5,841        6,634
                                                                    -----------------------
Total assets                                                        $1,859,271   $1,704,253
                                                                    =======================
 
</TABLE>

                                       2
<PAGE>
 
<TABLE>
<CAPTION>
                                                            DECEMBER 31
                                                          1995          1994
                                                     --------------------------
                                                            (In Thousands,
                                                         Except Share Amounts)
<S>                                                  <C>             <C>  
LIABILITIES AND STOCKHOLDER'S EQUITY
Liabilities:
 Future policy benefits:
  Life and annuity reserves                              $1,052,649  $   944,710
  Accident and health reserves                               10,473       10,996
  Guaranteed investment contracts                           276,365      233,691
  Policyholders' funds                                        2,890        3,292
  Advance premiums                                               83           91
  Accrued dividends and dividends on deposit                    764          808
  Unpaid claims                                              30,383       11,001
                                                         -----------------------
Total future policy benefits                              1,373,607    1,204,589
 
Accounts payable and accrued expenses                         5,383        3,987
Indebtedness to related parties                              5,9 39       11,200
Other liabilities                                            27,146       31,946
Federal income taxes payable (Note 8):
 Current                                                      5,816            -
 Deferred                                                    55,236       29,130
                                                         -----------------------
Total liabilities                                         1,473,127    1,280,852
 
Stockholder's equity (Note 9):
 Common stock, $3 par value:
  Authorized-2,550,000 shares
  Issued and outstanding-2,500,000 shares                     7,500        7,500
 Additional paid-in capital                                 254,353      366,536
 Net unrealized investment gains (losses) (Note 1)           37,906       (8,874)
 Retained earnings                                           86,385       58,239
                                                         -----------------------
Total stockholder's equity                                  386,144      423,401
                                                         -----------------------
Total liabilities and stockholder's equity               $1,859,271   $1,704,253
                                                         =======================
</TABLE>
See accompanying notes.

                                       3
<PAGE>
 
                         Southland Life Insurance Company

                              Statements of Income
<TABLE>
<CAPTION>
                                                               YEAR ENDED DECEMBER 31
                                                              1995       1994       1993
                                                          -------------------------------- 
                                                                   (In Thousands)
                                                                   --------------
<S>                                                         <C>        <C>        <C>
Revenues:
  Traditional life insurance premiums                         $ 39,182   $ 36,116   $ 38,343
  Health insurance premiums                                     60,318     18,495     10,002
  Universal life and investment product charges                67,073     56,735     45,184
  Reinsurance assumed                                             201      1,740      1,519
                                                          ----------------------------------- 
                                                               166,774    113,086     95,048
  Reinsurance ceded premiums                                   (45,419)   (17,501)   (10,669)
                                                          ----------------------------------- 
                                                               121,355     95,585     84,379
  Net investment income                                        103,279     93,802     89,169
  Net realized gains (losses) on investments                     2,880     (1,345)     6,254
  Other revenues                                                   797      2,148      1,923
                                                          ----------------------------------- 
Total revenues                                                 228,311    190,190    181,725
 
Benefits and expenses:
  Insurance claims and benefits incurred:
    Traditional life insurance:
      Death benefits                                            24,305     24,124     26,634
      Other benefits                                            21,661     21,830     22,444
    Universal life and investment contracts:
      Interest credited to account balances                     31,465     25,181     21,462
      Death benefit incurred in excess of account balances      33,902     12,690     13,697
    Health benefits                                             28,883      8,841      6,730
    Increase in policy reserves and other funds                     94      3,757         57
    Reinsurance recoveries                                     (39,883)    (9,489)    (8,092)
                                                          ----------------------------------- 
                                                               100,427     86,934     82,932
 
Commissions                                                     15,229      8,178      6,457
Insurance operating expenses (Note 11)                          20,924     18,945     19,273
                              -------
Amortization of goodwill                                         1,541      1,541      1,361
Amortization of present value of future profits, net of
 accrued interest                                               10,155     10,414     11,253
 
Amortization of deferred policy acquisition costs               13,326     10,060      8,595
                                                          ----------------------------------- 
                                                               161,602    136,072    129,871
                                                          ----------------------------------- 
 
Income before federal income taxes and the cumulative
 effect of changes in accounting methods                        66,709     54,118     51,854 
Federal income taxes (Note 8)                                   23,828     18,722     12,551
                      -----
                                                          ----------------------------------- 
Net income before the cumulative effect of the changes
 in accounting methods                                          42,881     35,396     39,303 
Cumulative effect of the changes in accounting
 methods (Note 1)                                                    -          -     (7,823)
         -------
                                                          ----------------------------------- 
 Net income                                                  $  42,881   $ 35,396   $ 31,480
                                                          =================================== 
</TABLE>
See accompanying notes.
- ----------------------
                                           4
<PAGE>
 
                        Southland Life Insurance Company

                       Statements of Stockholder's Equity
<TABLE>
<CAPTION>
                                                                YEAR ENDED DECEMBER 31
                                                            1995          1994       1993
                                                          ----------------------------------- 
                                                                    (In Thousands)
                                                                     ------------
<S>                                                          <C>           <C>         <C>
Common stock:
  Balance at beginning and end of year                      $    7,500    $  7,500   $  7,500
                                                          =================================== 
Additional paid-in capital:
  Balance at beginning of year                              $  366,536    $366,536   $366,536
  Return of capital to stockholder                            (112,183)        -         -
                                                          ----------------------------------- 
  Balance at end of year                                    $  254,353    $366,536   $366,536
                                                          =================================== 
Net unrealized investment gains (losses) on securities:
  Balance at beginning of year                              $   (8,874)   $    (23)  $    328
  Adjustment to beginning balance for adoption of SFAS
   115, net of income taxes of $20,440 and effect on
   DPAC and PVFP of $14,692 (net of income taxes of
   $7,911) (Note 1)                                                   -     23,268         -
           ------
  Change in net unrealized investment gains (losses),
   net of tax                                                   65,248     (52,010)      (351)
  Effect on DPAC and PVFP of unrealized gains
   (losses) on fixed maturities, net of tax                    (18,468)     19,891          -
                                                          ----------------------------------- 
Balance at end of year                                      $   37,906    $ (8,874)  $    (23)
                                                          =================================== 
Retained earnings:
  Balance at beginning of year                              $   58,239    $ 51,543   $ 36,663
  Net income                                                    42,881      35,396     31,480
  Dividends to stockholder                                     (14,735)    (28,700)   (16,600)
                                                          ----------------------------------- 
  Balance at end of year                                    $   86,385    $ 58,239   $ 51,543
                                                          =================================== 
Total stockholder's equity                                  $  386,144    $423,401   $425,556
 
 </TABLE>

See accompanying notes.
- ----------------------
                                               5
<PAGE>
 
                        Southland Life Insurance Company

                            Statements of Cash Flows
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31
 
                                                              1995       1994       1993
                                                           ----------------------------------- 
                                                                    (In Thousands)
                                                                      -----------
<S>                                                         <C>           <C>        <C>
OPERATING ACTIVITIES
Net income                                                 $ 42,881   $  35,396   $  31,480
Adjustments to reconcile net income to net cash
 provided by operating activities:
  Increase in future policy benefits                         92,996     189,867      96,138
  Net increase (decrease) in federal income taxes             8,528      (5,682)      1,946
  Increase (decrease) in accounts payable and accrued
   expenses and other liabilities                            (3,404)      3,967      (3,186)
  (Increase) decrease in accrued investment income              777      (2,092)        584
  Net realized investment (gains) losses                     (2,880)      1,345      (6,254)
  (Increase) decrease in reinsurance recoverable            (22,484)        197         907
  Increase in prepaid reinsurance premiums                  (42,119)   (161,654)    (71,341)
  Depreciation and amortization expense                      11,708      12,001      12,722
  Policy acquisition costs deferred                         (41,581)    (38,423)    (41,439)
  Amortization of deferred policy acquisition costs          13,326      10,060       8,594
  Cumulative effect of accounting changes                         -           -       7,823
  Other, net                                                 (1,057)     (7,313)      5,485
                                                           --------------------------------
Net cash provided by operating activities                    56,691      37,669      43,459
 
INVESTING ACTIVITIES
Securities available-for-sale:
 Sales:
  Fixed maturities                                          118,212      34,553      27,952
  Equity securities                                           1,105      50,485      60,641
 Maturities - fixed maturities                               36,740      38,925      67,554
 Purchases:
  Fixed maturities                                         (201,698)   (143,013)   (132,809)
  Equity securities                                            (186)    (43,893)    (55,893)
Securities held-to-maturity:
  Maturities - fixed maturities                              19,202      40,114           -
  Purchases - fixed maturities                                    -     (43,000)          -
Sale, maturity or repayment of investments:
  Mortgage loans on real estate                              16,613      22,069      20,975
  Investment real estate                                        450       3,068       2,937
  Other long-term investments                                     -         250           -
</TABLE>
                                           6
<PAGE>
 
                        Southland Life Insurance Company

                      Statements of Cash Flows (continued)
<TABLE>
<CAPTION>
                                                                YEAR ENDED DECEMBER 31
                                                             1995         1994        1993
                                                         ---------------------------------- 
                                                                     (In Thousands)
                                                                     --------------
<S>                                                      <C>           <C>           <C>  
INVESTING ACTIVITIES (CONTINUED)
Purchase or issuance of investments:
Mortgage loans on real estate                              (85,580)     (76,403)    (50,928)
 Investment real estate                                          -         (462)       (374)
Policy loans, net                                             (727)       2,812       1,945
Short-term investments, net                                      -       14,600     (11,400)
Additions to property and equipment                            (62)          (9)        (12)
Disposal of property and equipment                             780          206          75
                                                         -----------------------------------
Net cash used by investing  activities                     (95,151)     (99,490)    (69,337)

FINANCING ACTIVITIES
(Decrease) increase in indebtedness to related parties      (5,261)       3,968       4,410
Receipts from interest sensitive products credited to      101,462       81,927      75,635
 policyholder account balances
Return of policyholder account balances on interest
 sensitive policies                                        (25,244)     (16,305)    (15,295)  
Return of capital and dividends paid to stockholder        (42,060)     (23,700)    (16,600)  
                                                         -----------------------------------
Net cash provided by financing activities                   28,897       45,890     48 ,150
                                                         -----------------------------------

Net (decrease) increase in cash                             (9,563)     (15,931)     22,272 
Cash at beginning of year                                   10,831       26,762       4,490
                                                         -----------------------------------
Cash at end of year                                       $  1,268    $  10,831   $  26,762
                                                         ===================================

</TABLE>
SIGNIFICANT NONCASH TRANSACTIONS

During 1995, the Company transferred fixed maturity securities having a fair
value plus accrued interest of $92,305,000 and $27,325,000 of cash to the parent
company as a return of capital.  This transaction was approved by state
regulatory authorities and is reflected in the accompanying statement of
stockholder's equity as a reduction to additional paid-in capital and unrealized
investment gains on securities.

Held-to-maturity fixed maturity securities having an amortized cost value of
$182,430,000 and a fair value of $199,206,000 were transferred to the available-
for-sale category on December 26, 1995.

The Company declared a $5,000,000 dividend to its parent company during 1994
which was unpaid as of December 31, 1994 and was presented as indebtedness to
related parties in the accompanying balance sheet.  The dividend was paid in
cash by the Company in January 1995.

See accompanying notes.
- -----------------------
                                     7
<PAGE>
 
                        Southland Life Insurance Company

                         Notes to Financial Statements

                               December 31, 1995

1. SIGNIFICANT ACCOUNTING POLICIES

BASIS OF FINANCIAL STATEMENTS

Southland Life Insurance Company (the Company) is a wholly-owned subsidiary of
Internationale Nederlanden America Life Corporation (America Life), an indirect,
wholly-owned subsidiary of Internationale Nederlanden Groep.  The accompanying
financial statements have been prepared on the basis of generally accepted
accounting principles.

NATURE OF OPERATIONS

The Company's market focus is on the middle-income consumer.  The life insurance
products offered address retirement accumulation, wealth transfer and estate
planning, and death protection needs.  Products include universal life,
survivorship and traditional life.  The Company also provides stop-loss coverage
on group health insurance.  Operations are conducted through independent
producers.  The Company is presently licensed in forty-eight states (all states
except for New York and Vermont), the District of Columbia, and Puerto Rico.

The significant accounting policies followed by the Company that materially
affect the financial statements are summarized below:

BASIS OF PRESENTATION

The accompanying financial statements have been prepared in accordance with
generally accepted accounting principles.

The preparation of financial statements in conformity with generally accepted
accounting principles requires management to make estimates and assumptions that
affect the reported amounts of assets and liabilities and disclosure of
contingent assets and liabilities at the date of the financial statements and
the reported amounts of revenues and expenses during the reporting period.
Actual results could differ from those estimates.

                                       8
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


1. SIGNIFICANT ACCOUNTING  POLICIES (CONTINUED)

ACCOUNTING CHANGES

Effective January 1, 1993, the Company adopted Financial Accounting Standards
Board (FASB) Statement No. 109, Accounting for Income Taxes.  Prior to 1993, the
Company accounted for income taxes under the provisions of APB Opinion No. 11,
Accounting for Income Taxes. As permitted under the new rules, prior years'
financial statements have not been restated.  The cumulative effect of adopting
FASB Statement 109 as of January 1, 1993 was to decrease net income by
$7,800,000.

In 1993 the Company adopted FASB Statement No. 113,  Accounting and Reporting
for Reinsurance of Short-Duration and Long-Duration Contracts.  This statement
eliminates the practice of reporting amounts for reinsured contracts net of the
effects of reinsurance.  The statement requires that reinsurance receivables and
prepaid reinsurance premiums are to be reported as assets.  The statement
establishes conditions required for a contract with a reinsurer to qualify for
reinsurance accounting.  Contacts that do not result in the possibility that the
reinsurer may realize significant gain or loss from the insurance risk assumed
would be accounted for as deposits.  The adoption of this statement had no
effect on income before the cumulative effect of accounting changes or net
income.

In May 1993, the Financial Accounting Standards Board issued FASB Statement No.
115, Accounting for Certain Investments in Debt and Equity Securities.  The
Company adopted the provisions of the new standard for investments held as of or
acquired after January 1, 1994.  In accordance with the statement, prior period
financial statements have not been restated to reflect the change in accounting
principle.  The cumulative effect as of January 1, 1994 of adopting Statement
115 had no impact on income.  The opening balance of stockholder's equity was
increased by $37,960,000 (net of tax of $20,440,000) to reflect the net
unrealized holding gains on securities classified as available-for-sale
previously carried at amortized cost less an adjustment for $14,692,000 (net of
tax of $7,911,000) to deferred policy acquisition costs and present value of
future profits (PVFP) for the change in expected future gross profits.

In 1994, the Company  adopted the provisions of  FASB Statement No. 119,
Disclosures about Derivative Financial Instruments and Fair Value of Financial
Instruments, which  require disclosures about derivative financial instruments
such as futures, forwards,

                                       9
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


1. SIGNIFICANT ACCOUNTING  POLICIES (CONTINUED)

ACCOUNTING CHANGES (CONTINUED)

swaps and options and other financial instruments with similar characteristics.
The statement also amends existing disclosure requirements of FASB Statement No.
105, Disclosure of Information about Financial Instruments with Off-Balance
Sheet Risk and No. 107, Disclosures about Fair Value of Financial Instruments.

Beginning in 1995, the Company adopted FASB Statement No. 114, Accounting by
Creditors for Impairment of a Loan, and FASB Statement No. 118, Accounting by
Creditors for Impairment of a Loan - Income Recognition and Disclosures, which
amends Statement No. 114.  Under the amended statement, the 1995 allowance for
credit losses related to loans that are identified for evaluation in accordance
with Statement 114 is based on discounted cash flows using the loan's initial
effective interest rate or the fair value of the collateral for certain
collateral dependent loans.  Adoption of this standard had no impact on net
income or stockholder's equity.

INVESTMENTS

Investments are shown on the following bases:

The carrying value of fixed maturities depends on the classification of the
security: securities held-to-maturity, securities available-for-sale, and
trading securities.  Management determines the appropriate classification of
debt securities at the time of purchase and reevaluates such designation as of
each balance sheet date.  Debt securities are classified as held-to-maturity
when the Company has the positive intent and ability to hold the securities to
maturity.  Held-to-maturity securities are stated at amortized cost.

Debt securities not classified as held-to-maturity and marketable equity
securities are classified as available-for-sale. Available-for-sale securities
are stated at fair value, with the unrealized gains and losses, net of tax, and
deferred acquisition cost and present value of future profit adjustments,
reported in a separate component of stockholder's equity.

The Company does not hold trading securities.

                                       10
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


1. SIGNIFICANT ACCOUNTING  POLICIES (CONTINUED)

INVESTMENTS (CONTINUED)

The amortized cost of debt securities classified as held-to-maturity or
available-for-sale is adjusted for amortization of premiums and accretion of
discounts to maturity, or in the case of mortgage-backed securities, over the
estimated life of the security.  Such amortization is included in interest
income from investments.  Interest and dividends are included in net investment
income as earned.

Equity securities are reported at fair value.  Mortgage loans are carried at the
unpaid balances.  Investment real estate is carried at cost, less accumulated
depreciation.  Investment real estate is depreciated on a straight line basis
over the estimated useful life of the respective properties.  Policy loans are
carried at unpaid balances.  Short-term investments are carried at cost, which
approximates fair value.  Derivatives are accounted for on the same basis as the
asset hedged.

Realized gains and losses, and declines in value judged to be other-than-
temporary are included in net realized gains (losses) on investments.  The cost
of securities sold is based on the specific identification method.

RECOGNITION OF PREMIUM REVENUES AND COSTS

For life and annuity contracts other than universal life or investment-type
contracts, premiums are recognized as revenues over the premium-paying period,
with valuation reserves for future benefits established on a pro-rata basis from
such premiums.

Revenues for universal life and investment-type contracts consist of policy
charges for the cost of insurance and policy administration and surrender
charges assessed during the period.  Expenses include interest credited to
policy account balances and benefits incurred in excess of policy account
balances.  Certain profits on limited-payment policies are deferred and
recognized over the policy term.

For accident and health policies, gross premiums are prorated over the contract
term of the policies with the unearned premium included in the policy reserves.
Anticipated investment income is considered in determining if a premium
deficiency related to short-term contracts exists.

                                       11
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


1. SIGNIFICANT ACCOUNTING  POLICIES (CONTINUED)

DEFERRED POLICY ACQUISITION COSTS

Commissions and other costs of acquiring traditional life insurance, universal
life insurance (including interest sensitive products) and investment products
that vary with and are primarily related to the production of new and renewal
business have been deferred.  Traditional life insurance acquisition costs are
being amortized over the premium-paying period of the related policies using
assumptions consistent with those used in computing policy benefit reserves.
For universal life insurance and investment products, acquisition costs are
being amortized generally in proportion to the present value (using the assumed
crediting rate) of expected gross profits from surrender charges and investment,
mortality, and expense margins.  This amortization is adjusted retrospectively
when estimates of current or future gross profits to be realized from a group of
products are revised.

Deferred policy acquisition costs are adjusted to reflect changes that would
have been necessary if unrealized investment gains and losses related to
available-for-sale securities had been realized.  The Company has reflected
those adjustments in the asset balance with the offset as a direct adjustment to
stockholder's equity.

FUTURE POLICY BENEFITS

Benefit reserves, with the exception of reserves for universal life-type
policies and investment products, are computed using a net level premium method
including assumptions as to investment yields, mortality, withdrawals and other
assumptions based on the Company's and industry experience, modified as
necessary to reflect anticipated trends to include provisions for possible
unfavorable deviations.  Reserve interest assumptions are those deemed
appropriate at the time of policy issue, and range from 2.5% to 5%.  Policy
benefit claims are charged to expense in the year that the claims are incurred.
Health reserves consist principally of unearned premiums and claim reserves.

Benefit reserves for interest sensitive products (including universal life-type
policies)  and investment products are computed under a retrospective deposit
method and represent policy account balances before applicable surrender
charges.  Policy benefits and claims that are charged to expense include benefit
claims incurred during the year in

                                       12
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


1. SIGNIFICANT ACCOUNTING  POLICIES (CONTINUED)

FUTURE POLICY BENEFITS (CONTINUED)

excess of related policy account balances.  Interest crediting rates for
universal life and investment products range from 4.5% to 8.18% during 1995 and
1994, and 5% to 8.75% during 1993.

Included in life and annuity reserves is an unearned revenue reserve that
reflects the unamortized balance of excess first year policy service fees over
renewal period policy service fees on universal life and investment products.
These excess fees have been deferred and are being recognized in income over the
periods benefited, using the same assumptions and factors used to amortize
deferred policy acquisition costs.

UNPAID CLAIMS

The liabilities for unpaid claims include estimates of amounts due on reported
claims and claims that have been incurred but were not reported as of December
31.  Such estimates are based on actuarial projections applied to historical
claim payment data.  Such liabilities are reasonable and adequate to discharge
the Company's obligations for claims incurred but unpaid as of December 31.

GOODWILL

The excess cost of acquired subsidiaries over the sum of amounts assigned to
identifiable assets at acquisition, less liabilities assumed, is recorded as
goodwill.  Generally, goodwill is amortized using the straight-line method over
forty years.

PRESENT VALUE OF FUTURE PROFITS

The present value of future profits (PVFP) represents the profits to be realized
from future premiums on insurance in-force (at the date of acquisition) from
businesses acquired. The PVFP arises from the acquisition of the Company by
America Life.

                                       13
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


1. SIGNIFICANT ACCOUNTING  POLICIES (CONTINUED)

PRESENT VALUE OF FUTURE PROFITS (CONTINUED)

The PVFP is being amortized over the years that it is anticipated such profits
will be received.  In general, this value is determined using the same
assumptions applied to compute benefit reserves and deferred policy acquisition
costs, discounted to provide an appropriate rate of return.  Interest for
traditional life business is accrued at a rate of 8.45% and 9% in 1995 and 1994,
respectively, grading down to 6% over the next 14 years.  Interest for universal
life business is amortized based on the credited rate.

An analysis of the PVFP for the years ended December 31 follows:
<TABLE>
<CAPTION>
                                                                1995       1994       1993
                                                              ------------------------------ 
                                                                     (In Thousands)
<S>                                                          <C>         <C>        <C>
Balance at beginning of year                                  $100,602   $107,318   $118,571
Interest accrued on unamortized balance                          7,915      8,882     10,381
Amortization                                                   (18,070)   (19,296)   (21,634)
FAS 115 adjustment                                             (12,243)     3,698          -
                                                              ------------------------------ 
Balance at end of year                                        $ 78,204   $100,602   $107,318
                                                              ============================== 
 
The estimated amount to be amortized during each of the next five years is shown below (in
 thousands):

                                          AMORTIZATION OF
                                               PVFP
                                          ---------------
                                           (In Thousands)
 
                 1996                          $16,552
                 1997                           14,746
                 1998                           13,051
                 1999                           11,579
                 2000                           10,103
 
</TABLE>

                                       14
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


1. SIGNIFICANT ACCOUNTING  POLICIES (CONTINUED)

PROPERTY AND EQUIPMENT

Property and equipment are carried at cost less accumulated depreciation.
Depreciation for major classes of assets is calculated on a straight-line basis
over the estimated useful lives of the respective assets.

FEDERAL INCOME TAXES

Deferred federal income taxes have been provided or credited to reflect
significant temporary differences between income reported for tax and financial
reporting purposes using reasonable assumptions.

CASH FLOW INFORMATION

Cash includes cash on hand and demand deposits.

PENDING ACCOUNTING STANDARDS

In March 1995, the FASB issued Statement No. 121, Accounting for the Impairment
of Long-Lived Assets and for Long-Lived Assets to Be Disposed Of, which requires
impairment losses to be recorded on long-lived assets used in operations when
indicators of impairment are present and the undiscounted cash flows estimated
to be generated by those assets are less than the assets' carrying amounts.
Statement No. 121 also addresses the accounting for long-lived assets that are
expected to be disposed of.  The Company will adopt Statement No. 121 in the
first quarter of 1996, and based on current circumstances, management does not
believe the effect of adoption will be material.

RECLASSIFICATIONS

Certain amounts in the 1993 and 1994 financial statements have been reclassified
to conform to the 1995  presentation.

                                       15
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


2. FAIR VALUES OF FINANCIAL INSTRUMENTS

The carrying amounts and fair values of the Company's financial instruments at
December 31, 1995 and 1994 are summarized below:
<TABLE>
<CAPTION>
 
                                      DECEMBER 31, 1995      DECEMBER 31, 1994
                                      CARRYING      FAIR     CARRYING      FAIR
                                       AMOUNT      VALUE      AMOUNT      VALUE
                                     --------------------------------------------
                                         (In Thousands)         (In Thousands)
<S>                                   <C>         <C>       <C>          <C>
ASSETS
Fixed maturities:
 Available-for-sale                    $871,637   $871,637   $62 3,831   $623,831
 Held-to-maturity                             -          -     200,554    201,704
Equity securities                           764        764       1,602      1,602
Commercial mortgages                    300,445    331,584     231,171    231,068
Residential mortgages                       226        226         235        235
Policy loans                             80,164     69,383      79,437     67,279
 
LIABILITIES
Supplemental contracts without
 life contingencies                         934        934         966        966
Other policyholder funds left on
 deposit                                  2,992      2,992       3,208      3,208
Individual and group annuities,
 net of reinsurance                      22,452     22,220      26,032     25,690
 
</TABLE>
The following methods and assumptions were used by the Company in estimating the
fair value disclosures for financial instruments:

FIXED MATURITIES AND EQUITY SECURITIES:  The fair values for fixed maturities
(including redeemable preferred stocks) are based on quoted market prices, where
available.  For fixed maturities not actively traded, fair values are estimated
using values obtained from independent pricing services or, in the case of
private placements and collateralized mortgage obligations and other mortgage
derivative investments, are estimated by discounting expected future cash flows
using a current market rate applicable to the yield, credit quality, and
maturity of the investments. The fair values of equity securities are based on
quoted market prices.

                                       16
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


2. FAIR VALUES OF FINANCIAL INSTRUMENTS (CONTINUED)

MORTGAGE LOANS ON REAL ESTATE:  Estimated  fair values for commercial real
estate loans  are generated using a discounted cash flow approach.  Loans in
good standing are discounted using interest rates determined by U.S. Treasury
yields on December 31 and spreads  required on new loans with similar
characteristics.  The amortizing features of all loans are incorporated in the
valuation.  Where data on options features is available, option values are
determined using a binomial valuation method and are incorporated into the
mortgage valuation.  Restructured loans are valued in the same manner; however,
these are discounted at a greater spread to reflect increased risk.  Fair values
for residential loans are based on discounted cash flows and approximate
carrying value.

POLICY LOANS:  The fair values for policy loans are estimated by discounting
cash flows at the interest rates charged on policy loans of similar policies
currently being issued.  Loans with similar characteristics are aggregated for
purposes of the calculations.

DERIVATIVE FINANCIAL INSTRUMENTS:  Fair values for on-balance-sheet derivative
financial instruments (swaps hedging fixed maturities) are based on
broker/dealer valuations or on internal discounted cash flow pricing models
taking into account current cash flow assumptions and the counterparties' credit
standing.  Swaps with a fair value of $1,544,000 at December 31, 1995 and
$(4,690,000) at December 31, 1994 represent asset hedges and are reported as a
component of fixed maturity securities on the accompanying balance sheets.

OTHER INVESTMENT-TYPE INSURANCE CONTRACTS:  The fair values of the Company's
deferred annuity contracts and supplemental contracts without life contingencies
are estimated based on the cash surrender value.  The carrying values of other
liabilities including immediate annuities, dividend accumulations, and premium
deposits approximate their fair values.

                                       17
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


3. INVESTMENTS

The amortized cost and estimated fair value of investments in fixed maturities
and equity securities are as follows at December 31, 1995:
<TABLE>
<CAPTION>
 
                                          COST OR          GROSS                GROSS         ESTIMATED 
                                         AMORTIZED    UNREALIZED GAINS    UNREALIZED LOSSES     FAIR
                                           COST                                                 VALUE
                                          ------------------------------------------------------------- 
                                                             (In Thousands)
<S>                                       <C>          <C>                 <C>                <C>
Available-for-sale:
 U.S. Treasury securities and
  obligations of U.S. government
  corporations and agencies               $ 41,415              $ 8,310         $   -         $  49,725
States, municipalities and political
 subdivisions                                6,208                  232             -             6,440
 
 Public utilities securities                48,451                6,217             -            54,668
 Corporate securities                      418,769               47,814            64           466,519
 Mortgage-backed securities                239,419               12,677           397           251,699
 Other asset-backed securities              38,793                2,284            35            41,042
 Derivatives hedging fixed maturities            -                1,774           230             1,544
                                          ------------------------------------------------------------- 
Total fixed maturities                     793,055               79,308           726           871,637
 
Preferred stocks                               530                   73            12               591
Common stocks                                   84                  108            19               173
                                          ------------------------------------------------------------- 
Total                                     $793,669              $79,489          $757          $872,401
                                          ============================================================= 
</TABLE>

                                       18
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


3.  INVESTMENTS (CONTINUED)

The amortized cost and estimated fair value of investments in fixed maturities
and equity securities are as follows at December 31, 1994:
<TABLE>
<CAPTION>
 
                                          COST OR                                             ESTIMATED 
                                         AMORTIZED         GROSS                GROSS           FAIR
                                           COST       UNREALIZED GAINS    UNREALIZED LOSSES     VALUE
                                          ------------------------------------------------------------  
                                                             (In Thousands)
<S>                                       <C>          <C>                 <C>                <C>
Available-for-sale:
U.S. Treasury securities and
 obligations of U.S. government
 corporations and agencies                $ 43,654              $ 1,159        $    298      $  44,515
Public utilities securities                 29,493                  801             658         29,636
Corporate securities                       326,240                3,385          11,658        317,967
Mortgage-backed securities                 227,008                4,514          13,171        218,351
Other asset-backed securities               19,159                  116           1,223         18,052
Derivatives hedging fixed maturities             -                    -           4,690         (4,690)
                                          ------------------------------------------------------------  
Total fixed maturities                     645,554                9,975          31,698        623,831
 
Preferred stocks (nonredeemable)             1,532                    7              18          1,521
Common stocks                                    -                   81               -             81
                                          ------------------------------------------------------------  
Total                                     $647,086              $10,063         $31,716       $625,433
                                          ============================================================  
 
Held-to -maturity:
Public utilities securities               $ 23,391              $ 1,008         $     -       $ 24,399
Corporate securities                       168,229                3,881           3,537        168,573
Other asset-backed securities                8,934                   56             258          8,732
                                          ------------------------------------------------------------  
Total                                     $200,554              $ 4,945         $ 3,795       $201,704
                                          ============================================================  

</TABLE>

                                       19
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)

 
3. INVESTMENTS (CONTINUED)

Held-to-maturity fixed maturity securities having an amortized cost of
$182,430,000 and a fair value of $199,206,000 were transferred to the available-
for-sale category on December 26, 1995, resulting in a net unrealized gain of
$10,904,000 (net of $5,872,000 of deferred taxes).  The Company reassessed the
appropriateness of its classification of securities as held-to-maturity upon
reviewing the interpretive guidance provided in the FASB publication A Guide to
Implementation of Statement 115 on Accounting for Certain Investments in Debt
and Equity Securities.

The amortized cost and estimated fair value of debt securities by contractual
maturity and marketable equity securities at December 31, 1995 are shown in the
following table.  Expected maturities will differ from contractual maturities
because borrowers may have the right to call or prepay obligations with or
without call or prepayment penalties.
<TABLE>
<CAPTION>
 
                                                                      ESTIMATED
                                                         AMORTIZED      FAIR
                                                           COST         VALUE
                                                         ----------------------
                                                             (In Thousands)
<S>                                                     <C>           <C>
Available-for-sale:
 Due in one year or less                                 $  3,989      $  4,098
 Due after one year through five years                     94,604       102,648              
 Due after five years through ten years                   231,262       253,977                                
 Due after ten years                                      184,988       218,173                                
                                                         ----------------------
                                                          514,843       578,896                                
 Mortgage-backed securities                               239,419       251,699                                
 Other asset-backed securities                             38,793        41,042                                
 Equity securities                                            614           764                                
                                                         ----------------------
Total available-for-sale                                 $793,669      $872,401                                
                                                         ======================
</TABLE>

                                       20
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


3. INVESTMENTS (CONTINUED)

Changes in unrealized gains (losses) on investments in available-for-sale
securities for the years ended December 31, 1995 and 1994 are summarized as
follows:

                                                DECEMBER 31, 1995
                                            FIXED      EQUITY    TOTAL
                                           ----------------------------
                                                   (In Thousands)
Gross unrealized gains                     $ 79,308     $181   $ 79,489
Gross unrealized losses                         726       31        757
                                           ----------------------------
Net unrealized gains                         78,582      150     78,732
Deferred income tax expense                 (27,504)     (53)   (27,557)
                                           ----------------------------
Net unrealized gains after taxes             51,078       97     51,175
Less:
 Balance at beginning of year               (14,120)      47    (14,073)
                                           ----------------------------
Change in net unrealized gains             $ 65,198     $ 50   $ 65,248
                                           ============================
 
 
 
                                                DECEMBER 31, 1994
                                            FIXED      EQUITY    TOTAL
                                           ----------------------------
                                                   (In Thousands)
Gross unrealized gains                     $  9,975     $ 88   $ 10,063
Gross unrealized losses                      31,698       18     31,716
                                           ----------------------------
Net unrealized gains (losses)               (21,723)      70    (21,653)
Deferred income tax benefit
   (expense)                                  7,603      (23)     7,580
                                           ----------------------------
Net unrealized gains (losses) after
    taxes                                   (14,120)      47    (14,073)
Less:
 Balance at beginning of year                     -      (23)       (23)
 Adjustments for change in
   accounting method                         37,960        -     37,960
                                           ----------------------------
Change in net unrealized gains
    (losses)                               $(52,080)    $ 70   $(52,010)
                                           ============================

                                       21
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)

 
3. INVESTMENTS (CONTINUED)

As part of its overall investment management strategy, the Company has entered
into agreements to purchase securities as follows:

                                         DECEMBER 31
                                        1995       1994
                                       ----------------- 
                                         (In Thousands)

Investment purchase commitments        $21,865   $12,340
 
 
Major categories of investment income for the years ended December 31 are 
summarized as follows:
 
                                             1995          1994      1993
                                           --------------------------------
                                                     (In Thousands)

Fixed maturities                           $ 74,911       $69,031   $67,570
Equity securities                                73             -         -
Mortgage loans on real estate                23,851        19,139    15,848
Policy loans                                  4,775         4,735     4,821
Other investments                             1,457         2,986     2,839
                                           --------------------------------
                                            105,067        95,891    91,078
Investment expenses                          (1,788)       (2,089)    1,909
                                           --------------------------------
Net investment income                      $103,279       $93,802   $89,169
                                           ================================
 

                                       22
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


3. INVESTMENTS (CONTINUED)

Net realized gains (losses) on investments for the years ended December 31 are
summarized as follows:

                                                  1995     1994      1993
                                                 --------------------------
                                                     (In Thousands)

Fixed maturities                                 $2,824   $ 1,248   $ 1,820
Equity securities                                     -    (2,577)   (1,066)
Real estate and other                                56       (16)    5,500
                                                 --------------------------
Net realized gain (losses) on investments        $2,880   $(1,345)  $ 6,254
                                                 ==========================
 
During 1995 and 1994, debt and marketable equity securities available-for-sale
were sold with a fair value at the date of sale of $119,317,000 and $85,038,000,
respectively.  Gross gains of $3,494,000 and $1,940,000 and gross losses of
$670,000 and $3,269,000 were realized on those sales in 1995 and 1994,
respectively.  Proceeds from sales of investments in fixed maturities during
1993 were $27,952,000.  Gross gains of $5,085,000 and  gross losses of
$3,265,000 were realized on those sales.

4. DERIVATIVE FINANCIAL INSTRUMENTS HELD FOR PURPOSES OTHER THAN TRADING

The Company enters into interest rate contracts to reduce and manage interest
rate risk associated with individual assets and liabilities and its overall
aggregate portfolio.

Interest rate swap agreements generally involve the exchange of fixed and
floating interest payments over the life of the agreement without an exchange of
the underlying principal amount.  The differential to be paid or received is
accrued as interest rates change and is recognized as an adjustment to interest
expense or income.  The related amount payable to or receivable from
counterparties is included in other liabilities or assets.

                                       23
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


4. DERIVATIVE FINANCIAL INSTRUMENTS HELD FOR PURPOSES OTHER THAN TRADING
   (CONTINUED)

The Company manages the potential credit exposure from interest rate contracts
through careful evaluation of the counterparty credit standing and master
netting agreements.  The Company is exposed to credit loss in the event of
nonperformance by counterparties on interest rate contracts; however, the
Company does not anticipate nonperformance by any of these counterparties.  The
amount of such exposure is generally the unrealized gains in such contracts.

The table below summarizes the Company's interest rate contracts at December 31,
1995 and 1994:
 
                                            DECEMBER 31, 1995
 
                              NOTIONAL    AMORTIZED     FAIR         BALANCE
                               AMOUNT       COST        VALUE         SHEET
                             -------------------------------------------------
Interest rate contracts:
Swaps                        $28,000,000    $  -     $ 1,774,425   $ 1,774,425
Swaps-affiliates              25,000,000       -        (230,300)     (230,300)
                             -------------------------------------------------
Total swaps                  $53,000,000    $  -     $ 1,544,125   $ 1,544,125
                             =================================================
 
 
                                            DECEMBER 31, 1994
 
                              NOTIONAL    AMORTIZED     FAIR         BALANCE
                               AMOUNT       COST        VALUE         SHEET
                             -------------------------------------------------
Interest rate contracts:
Swaps                        $28,000,000    $  -     $(1,866,315)  $(1,866,315)
Swaps-affiliates              25,000,000       -      (2,823,186)   (2,823,186)
                             -------------------------------------------------
Total swaps                  $53,000,000    $  -     $(4,689,501)  $(4,689,501)
                             =================================================
 

                                       24
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


5. CONCENTRATIONS OF CREDIT RISK

At December 31, 1995, the Company held less-than-investment-grade bonds
classified as available-for-sale with a carrying value of $11,625,000 and a fair
value of $11,826,000.  These holdings amounted to 1.4% of the Company's
investment in bonds and less than 1% of total assets.  The holdings of less-
than-investment-grade bonds are widely diversified and of satisfactory quality
based on the Company's investment policies and credit standards.

At December 31, 1995, the Company's  commercial mortgages involved a
concentration of properties located in Florida (23%), Pennsylvania (12%) and
Georgia (11%).  The remaining commercial mortgages relate to properties located
in 22 other states.  The portfolio is well diversified, covering many different
types of income-producing properties on which the Company has first mortgage
liens.  The maximum mortgage outstanding on any individual property is
$6,900,000.

6. EMPLOYEE BENEFIT PLANS

The Company does not sponsor an employee retirement plan.  Home office and field
office services are provided to the Company by employees of Life Insurance
Company of Georgia (Life of Georgia), an affiliated insurer.  The Company
reimburses Life of Georgia for the actual cost of salaries and fringe benefits
of employees utilized in providing administrative services to the Company.

The Company does not sponsor a deferred compensation plan, but reimburses Life
of Georgia for the actual cost of fringe benefits for employees providing
administrative services to the Company.  The Company has an unfunded
noncontributory, nonqualified deferred compensation plan covering certain agents
in the General Agency Sales Division.

7. REINSURANCE

The Company is involved in both ceded and assumed reinsurance with other
companies for the purpose of diversifying risk and limiting exposure on larger
risks. Substantially all of the guaranteed investment contracts and the
associated prepaid reinsurance premiums are ceded under a reinsurance agreement
with an affiliate. As of

                                       25
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


7. REINSURANCE (CONTINUED)

December 31, 1995, the Company's retention limit for acceptance of risk on life
insurance policies had been set at various levels up to $250,000.  Reinsurance
premiums, commissions, expense reimbursements, and reserves related to reinsured
business are accounted for on bases consistent with those used in accounting for
the original policies issued and the terms of the reinsurance contacts.

To the extent that the assuming companies become unable to meet their
obligations under these treaties, the Company remains contingently liable to its
policyholders for the portion reinsured.  Consequently, allowances are
established for amounts deemed uncollectible.  To minimize its exposure to
significant losses from reinsurer insolvencies, the Company evaluates the
financial condition of its reinsurers and monitors concentrations of credit risk
arising from similar geographic regions, activities, or economic characteristics
of the reinsurer.

The carrying values of amounts recoverable from reinsurers approximate their
fair value.

                                       26
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


7. REINSURANCE (CONTINUED)

Additional information regarding the Company's reinsurance activity for the
years ended December 31, 1995, 1994 and 1993 is as follows:
<TABLE>
<CAPTION>
 
                                                                                         PERCENTAGE OF
                                               CEDED TO         ASSUMED                     AMOUNT
                              GROSS              OTHER         FROM OTHER        NET       ASSUMED TO
                              AMOUNT           COMPANIES        COMPANIES       AMOUNT         NET
                             --------------------------------------------------------------------------
                                                         (In Thousands)
<S>                   <C>                  <C>                <C>           <C>          <C>
1995
Life insurance in
  force                      $18,048,076         $4,138,717      $  809        $13,910,168      0.01%
                             ==========================================================================
Premiums:
  Life insurance             $    39,182         $    8,073      $  201        $    31,310      0.64%
  Health insurance                60,318             37,346          -              22,972      0.00%
                             --------------------------------------------------------------------------
Total premiums               $    99,500         $   45,419      $  201        $    54,282      0.37%
                             ==========================================================================
1994
Life insurance in
  force                      $15,284,670         $3,396,943      $2,307        $11,890,034      0.02%
                             ==========================================================================
Premiums:
  Life insurance             $    36,116         $    7,356      $1,740        $    30,500      5.70%
  Health insurance                18,495             10,145          -               8,350      0.00%
                             --------------------------------------------------------------------------
Total premiums               $    54,611         $   17,501      $1,740        $    38,850      4.48%
                             ==========================================================================
1993
Life insurance in
  force                      $13,952,869         $2,405,218      $1,078        $11,548,729      0.01%
                             ==========================================================================
Premiums:
  Life insurance             $    38,343         $    7,660      $1,519        $    32,202      4.72%
  Health insurance                10,002              3,009          -               6,993      0.00%
                             --------------------------------------------------------------------------
Total premiums               $    48,345         $   10,669      $1,519        $    39,195      3.87%
                             ==========================================================================

</TABLE>
 
8. INCOME TAXES

The Company, which was acquired by America Life in 1989, filed a separate
federal income tax return for years prior to 1995 due to consolidated return
eligibility regulations.

The Company will file a consolidated federal income tax return in 1995 with
Internationale Nederlanden U.S. Insurance Holdings (the direct parent of America
Life) and other U.S. affiliates and subsidiaries, with the exception of First
ING Life Insurance Company of New York. The affiliated companies that join in
the filing of the consolidated federal return have entered into a tax sharing
agreement which provides for an allocation of taxes among life and nonlife
members. Under the agreement, a life member may not receive the full benefit of
a taxable loss in the year the loss is incurred. The agreement provides that a
loss member will receive at least 50% of the loss utilized by other members and
that any remaining benefit will be fully repaid when the loss member could have
used the loss had they filed a separate federal income tax return. The deferred
payments or receipts for the use of losses are accounted for as a component of
the Company's deferred tax liability.

The current tax liability of $5,816,000 is payable to the parent company,
America Life, under the terms of the tax sharing agreement.

                                       27
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


8. INCOME TAXES (CONTINUED)

Deferred income taxes reflect the net tax effects of temporary differences
between the carrying amounts of assets and liabilities for financial reporting
purposes and the amounts used for income tax purposes.  Significant components
of the Company's deferred tax assets and liabilities are as follows:
 
                                                       DECEMBER 31
                                                      1995     1994
                                                    -----------------
                                                     (In Thousands)
Deferred income tax liability:
 Deferred policy acquisition costs                  $34,700   $33,400
 PVFP                                                 7,500    5,60 0
 Deferred investment gains                            2,300         -
 Unrealized investment gains and losses              24,800         -
 Reserves                                                 -     3,400
 Bond/mortgage loans market discount                    700       900
 Other reserves                                       2,100     2,300
                                                    -----------------
Total deferred income tax liability                  72,100    45,600
 
Deferred income tax asset:
 Unrealized investment gains and losses                   -     8,200
 Reinsurance liability                                    -    5,3 00
 Benefit reserves                                    14,100         -
 Other assets                                         2,764     1,900
 Other liabilities                                        -     1,070
                                                    -----------------
Total deferred income tax asset                      16,864    16,470
Valuation allowance for deferred tax asset                -         -
                                                    -----------------
Deferred income tax asset after allowance            16,864    16,470
                                                    -----------------
Net deferred income tax liability                   $55,236   $29,130
                                                    =================
 

                                       28
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


8. INCOME TAXES (CONTINUED)

A reconciliation of the income tax attributable to continuing operations
computed at U.S. federal statutory tax rates to the income tax expense included
in the accompanying statements of income follows:
<TABLE>
<CAPTION>
 
                                                        YEAR ENDED DECEMBER 31
                                                       1995      1994      1993
                                                      --------------------------
<S>                                                    <C>       <C>       <C>
Statutory federal income tax rate                      35.0%     35.0%     35.0%
Tax-preferred investment income                           -       (.1)      (.1)
Goodwill                                                 .7       1.0        .9
Change in deferred liability due to tax settlement        -         -      (7.2)
Other items, net                                          -      (1.3)     (4.4)
                                                      --------------------------
Effective tax rate                                     35.7%     34.6%     24.2%
                                                      ==========================

The components of federal income tax expense consist of the following:
 
                                                        YEAR ENDED DECEMBER 31
                                                       1995       1994      1993
                                                      ----------------------------
<S>                                                    <C>       <C>       <C>
Current                                                $22,913   $13,768   $11,649
Deferred                                                   915     4,954       902
                                                      ----------------------------
Federal income tax expense                             $23,828   $18,722   $12,551
                                                      ============================
 
</TABLE>

The Company made net income tax payments of $16,254,000 during 1995, $22,585,000
during 1994, and $10,604,000 during 1993 for current income taxes and
settlements of prior year returns.

9. STATUTORY ACCOUNTING INFORMATION AND PRACTICES

Statutory capital and surplus was $78,992,000 and $159,223,000 at December 31,
1995 and 1994, respectively.  Statutory net income was $42,182,000, $36,539,000,
and $36,871,000 for the years ended December 31, 1995, 1994, and 1993,
respectively.

                                       29
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


9. STATUTORY ACCOUNTING INFORMATION AND PRACTICES (CONTINUED)

The Company exceeded its minimum statutory capital and surplus requirements at
December 31, 1995.  Additionally, the amount of dividends which can be paid by
the Company to its stockholder without prior approval of the state insurance
department is generally limited to the greater of 10% of statutory surplus or
the statutory net gain from operations.

The Company, which is domiciled in Texas, prepares its statutory-basis financial
statements in accordance with accounting principles and practices prescribed or
permitted by the state of Texas.  "Prescribed" statutory accounting practices
include state laws, regulations and general administrative rules, as well as a
variety of publications of the National Association of Insurance Commissioners
(NAIC).  "Permitted" statutory accounting practices encompass all accounting
practices that are not prescribed; such practices may differ from state to
state, from company to company within the state, and may change in the future.
The NAIC is currently in the process of codifying statutory accounting
practices, the result of which is expected to constitute the only source of
"prescribed" statutory accounting practices.  Accordingly, that project, which
is expected to be completed in 1997, will likely change, to some extent,
prescribed statutory accounting practices, and may result in changes to the
accounting practices that insurance companies use to prepare their statutory
financial statements. The Company does not currently apply permitted statutory
practices which differ from prescribed accounting practices.

During 1992 and 1993, the NAIC approved certain Risk-Based Capital (RBC)
requirements for life/health insurance companies.  Those requirements were
effective in 1993 and require that the amount of capital maintained by an
insurance company is to be determined based on the various risk factors related
to it.  At December 31, 1995, the Company met RBC requirements.

At December 31, 1995 and 1994, bonds with an amortized cost of $8,376,000 and
$7,634,000 , respectively, were on deposit with various state insurance
departments to meet regulatory requirements.

                                       30
<PAGE>
 
                        Southland Life Insurance Company

                   Notes to Financial Statements (continued)


10. COMMITMENTS AND CONTINGENT LIABILITIES

The increase in the number of insurance companies that are under regulatory
supervision has resulted, and is expected to continue to result, in increased
assessments by state guaranty funds to cover losses to policyholders of
insolvent or rehabilitated insurance companies.  Those mandatory assessments may
be partially recovered through a reduction in future premium taxes in certain
states.  The Company has accrued for estimated future assessments net of future
premium tax deductions.

11. SERVICE AGREEMENT WITH AFFILIATE

The Company has a service agreement with Life of Georgia whereby this affiliate
provides personnel, certain services and facilities for the conduct of the
Company's operations in return for payment representing the costs incurred in
providing such services and facilities.  Substantially all insurance operating
expenses and employment taxes are incurred under the terms of this service
agreement.  During 1995, 1994, and 1993, the Company reimbursed Life of Georgia
$24,573,000, $28,000,000, and $27,843,000, respectively, under this agreement.
The Company has a payable to Life of Georgia of  $5,894,000 and $6,200,000 at
December 31, 1995 and 1994, respectively, related to this agreement.  This
payable is included within indebtedness to related parties in the accompanying
balance sheets.

12. FINANCING ARRANGEMENTS

The Company has a revolving line of credit totaling $40,000,000 which matures 30
days from the date of advancement. This line of credit expires February 29,
1996.  Interest rates on these borrowings are tied to the Federal Funds rate
plus .25%.  Outstanding borrowings under this agreement were $0 at December 31,
1995 and 1994.

                                       31
<PAGE>
 
                          UNDERTAKING TO FILE REPORTS

     Subject to the terms and conditions of Section 15(d) of the Securities
Exchange Act of 1934, the undersigned Registrant hereby undertakes to file with
the Securities and Exchange Commission such supplementary and periodic
information, documents and reports as may be prescribed by any rule or
regulation of the Commission heretofore or hereafter duly adopted pursuant to
authority conferred in that section.

                              RULE 484 UNDERTAKING

     Insofar as indemnification for liability arising under the Securities Act
of 1933 (the "Act") may be permitted to directors, officers and controlling
persons of the Registrant pursuant to the foregoing provisions, or otherwise,
the Registrant has been advised that in the opinion of the Securities and
Exchange Commission such indemnification is against public policy as expressed
in the Act and is, therefore, unenforceable.  In the event that a claim for
indemnification against such liabilities (other than the payment by the
Registrant of expenses incurred or paid by a director, officer or controlling
person of the Registrant in the successful defense of any action, suit or
proceeding) is asserted by such director, officer or controlling person in
connection with the securities being registered, the Registrant will, unless in
the opinion of its counsel the matter has been settled by controlling precedent,
submit to a court of appropriate jurisdiction the question whether such
indemnification by it is against public policy as expressed in the Act and will
be governed by the final adjudication of such issue.

     Texas Business Corporations Act Article 2.02-1 is a comprehensive provision
that defines the power of Texas corporations to provide for the indemnification
of its directors, officers, employees and agents.  This Article also grants to
corporations the power to purchase director and officer insurance.

Article XXVIII of the Southland Life Insurance Company Bylaws provides as
follows:


                                 ARTICLE XXVIII


INDEMNIFICATION OF DIRECTORS, OFFICERS AND OTHERS


     SECTION 1.  Authorization for indemnification of Directors and officers in
actions by or in the right of a company to procure a judgment in its favor.

     (a)  Any person made party to an action by or in the right of the Company
to procure a judgment in its favor by reason of the fact that he, his testator
or intestate, is or was a Director or officer of the Company, shall be
indemnified against the reasonable expenses, including attorneys' fees, actually
and necessarily incurred by him in connection with the defense

                                       1
<PAGE>
 
of such action, or in connection with an appeal therein, except in relation to
matters as to which such Director or officer is adjudged to have breached his
duty to the Company.

     (b)  The indemnification authorized under paragraph (a) shall in no case
include:

           (1)  Amounts paid in settling or otherwise disposing of a threatened
or a pending action with or without court approval; or

           (2)  Expenses incurred in defending a threatened action or a pending
action which is settled or otherwise disposed of without court approval.

     SECTION 2.  Authorization for indemnification of Directors and officers in
actions or proceedings other than by or in the right of a company to procure a
judgment in its favor.

     (a)  Any person made, or threatened to be made, a party in an action or
proceeding other than one by or in the right of the company to procure a
judgment in its favor, whether civil, criminal or administrative, including an
action by or in the right of any other company of any type or kind, domestic or
foreign, which any Director or officer of the Company, served in any capacity at
the request of the Company, by reason of the fact that he, his testator or
intestate, was a Director or officer of the Company, or served such other
company in any capacity, shall be indemnified against judgments, fines, amounts
paid in settlement and reasonable expenses, including attorneys' fees actually
and necessarily incurred as a result of such action or proceeding, or any appeal
therein, if such Director or officer acted, in good faith, for a purpose which
he reasonably believed to be in the best interests of the Company and, in
criminal actions or proceedings, in addition, had no reasonable cause to believe
that his conduct was unlawful.

     (b)  The termination of any such civil or criminal action or proceeding by
judgment, settlement, conviction or upon a plea of nolo contendere, or its
equivalent, shall not in itself create a presumption that any such Director or
officer did not act in good faith for a purpose which he reasonably believed to
be in the best interests of the Company or that he had reasonable cause to
believe that this conduct was unlawful.

     SECTION 3.  Payment of indemnification other than by court award.

     (a)  A person who has been wholly successful, on the merits or otherwise,
in the defense of a civil, criminal, or administrative action or proceeding of
the character described in Section 1 or Section 2 above shall be entitled to
indemnification as authorized in such Section 1 or Section 2.

     (b)  Except as provided in Paragraph (a) of this Section 3, any
indemnification under Section 1 or Section 2 above, unless ordered by a court,
shall be made by the Company only if authorized in the specific case:

                                       2
<PAGE>
 
           (1)  By the Board of Directors acting by a quorum consisting of
Directors who are not parties to such action or proceeding upon a finding that
the Director or officer has met the standard of conduct set forth in Section 1
or Section 2, as the case may be; or

           (2)  If a quorum of the Board of Directors is not obtainable with due
diligence:

                 (A)  By the Board of Directors upon the opinion in writing of
independent legal counsel that indemnification is proper in the circumstances
because the applicable standard of conduct set forth in Section 1 or Section 2
above has been met by such Director or officer, or

                 (B)  By the stockholder (excluding the director or officer)
upon a finding that the Director or officer has met the applicable standard of
conduct set forth in Section 1 or Section 2 above.

     (c)  Reasonable expenses incurred in defending a civil, criminal or
administrative action or proceeding may be paid by the Company in advance of the
final disposition of such action or proceeding if authorized under paragraph (b)
of this Section 3 and if the Director or officer submits a written affirmation
that he meets the standards necessary for indemnification and if the facts known
to those making the determination would not preclude indemnification, but
subject to a written undertaking of repayment if ultimately found not to be
entitled to indemnification under the provisions hereof.

     SECTION 4.  General

     The foregoing provisions of this Article XXVIII shall be deemed to be a
contract between the Company and each Director and officer who serves in such
capacity at any time while this bylaw is in effect, and any repeal or
modification thereof shall not affect any rights or obligations then existing
with respect to any state of facts then or therefore existing or any action,
suit or proceeding theretofore or thereafter brought based in whole or in part
upon any such state of facts.

     The foregoing rights of indemnification shall not be deemed exclusive of
any other rights to which any Director or officer may be entitled apart from the
provisions of this Article XXVIII.

     The Board of Directors in its discretion shall have the power on behalf of
the Company to indemnify any person, other than a Director or officer, made a
party to any action, suit or proceeding by reason of the fact that he, his
testator or intestate, is or was an employee of the company.  Such
indemnification shall be to the same extent and subject to the same standards as
indemnification for a director or officer.

                                       3
<PAGE>
 
     SECTION 5.  Liability Insurance

     The company and/or the Board of Directors may purchase and maintain
insurance on behalf of any person who is or was a director, officer, employee,
or agent of the company or who is or was serving at the request of the company
as a director, officer, partner, venturer, proprietor, trustee, employee, agent,
or similar functionary of another foreign or domestic corporation, partnership,
joint venture, sole proprietorship, trust, other enterprise or employee benefit
plan, against any and all liability asserted against him and/or incurred by him
in such capacity or arising out of his status as such a person, whether or not
such person would be subject to or eligible for indemnification under the other
provisions of this Article XXVIII.


                    REPRESENTATIONS PURSUANT TO RULE 6e-3(T)

     This filing is made pursuant to Rule 6e-3(T) under the Investment Company
Act of 1940.

     Registrant elects to be governed by Rule 6e-3(T)(b)(13)(i)(A) under the
Investment Company Act of 1940 with respect to the policies described in the
Prospectus.

     Registrant makes the following representations:

     (1) Rule 6e-3(T)(b)(13)(iii)(F) has been relied upon.

     (2) The level of the mortality and expense risk charge is within the range
         of industry practice for comparable flexible or scheduled contracts.

     (3) Registrant has concluded that there is a reasonable likelihood that the
         distribution financing arrangement of the Variable Account will benefit
         the Variable Account and Policy owners and will keep and make available
         to the Commission on request a memorandum setting forth the basis for
         this representation.

     (4) The Variable Account will invest only in management investment
         companies which have undertaken to have a board of directors, a
         majority of whom are not interested persons of the company, formulate
         and approve any plan under Rule 12b-1 to finance distribution expenses.

     The methodology used to support the representation made in paragraph (2)
above is based on an analysis of the mortality and expense risk charge contained
in other variable life insurance contracts.  Registrant undertakes to keep and
make available to the Commission on request the documents used to support the
representation in paragraph (2) above.

                                       4
<PAGE>

 
                      CONTENTS OF REGISTRATION STATEMENT

This Registration Statement comprises the following papers and documents:
     
     The facing sheet.
     The prospectus consisting of 105 pages.
     Undertaking to file reports.
     Rule 484 undertaking.
     Representations pursuant to Rule 6e-3(T).
     The signatures.
     Written consents of the following persons: Francis J. Mulcahy, Esquire;
     Pamela Crane, Senior Vice President - Finance/Actuarial, Southland
     Life Insurance Company; Ernst & Young LLP; and Sutherland, Asbill &
     Brennan.     

The following exhibits, corresponding to those required by paragraph A of the
instructions as to exhibits in Form N-8B-2:

1.
     A.
     (1)  Resolution of the Board of Directors of Southland Life Insurance
          Company establishing Southland Separate Account L1 *
     (2)  Not Applicable
     (3)  (a)  Form of Underwriting Agreement between Southland Life Insurance
               Company and ING America Equities, Inc. **
          (b)  Form of Distribution Agreement ***
          (c)  Schedule of Sales Commissions
     (4)  Not applicable
     (5)  (a)  Specimen Flexible Premium Adjustable Combination Fixed and
               Variable Life Insurance Policy
          (b)  Adjustable Term Insurance Rider
          (c)  Accidental Death Benefit Rider
          (d)  Additional Insured Rider
          (e)  Children's Insurance Rider
          (f)  Exchange of Insured Rider
          (g)  Guaranteed Insurability Rider
          (h)  Waiver of the Cost of Insurance Rider
          (i)  Waiver of Specified Premium Rider
     (6)  (a)  Amended and restated Articles of Incorporation of Southland Life
               Insurance Company ***                                  
          (b)  By-laws of Southland Life Insurance Company **
     (7)  Not applicable
     (8)  (a)  Form of participation/distribution agreement between The Alger
               American Fund and the Company ***

                                       5
<PAGE>
 
           (b)  Form of participation/distribution agreement between Fidelity
                Variable Insurance Products Fund and the Company ***
           (c)  Form of participation/distribution agreement between Fidelity
                Variable Insurance Products Fund II and the Company ***
           (d)  Form of participation/distribution agreement between INVESCO
                Variable Investment Funds, Inc. and the Company ***
           (e)  Form of participation/distribution agreement between Janus Aspen
                Series and the Company ***
     (9)   Not applicable
     (10)  Application form
     (11)  Description of issuance, transfer and redemption procedures

     B.    Not applicable

     C.    Not applicable

2.   Opinion and Consent of Francis J. Mulcahy, Esquire

3.   Not applicable

4.   Not applicable

5.   Not applicable
    
6.   Opinion and Consent of Pamela M. Crane, Senior Vice President -
     Finance/Actuarial of Southland Life Insurance Company, as to actuarial
     matters pertaining to the securities being registered     
    
7.   (a)  Consent of Ernst & Young LLP     
     (b)  Consent of Sutherland, Asbill & Brennan

- -----------------------------
*    Incorporated by reference to the Registration Statement on Form S-6 for
     Southland Separate Account L1 (File No. 33-97852) filed with the Commission
     on October 6, 1995.
**   Incorporated by reference to the Registration Statement on Form N-4 for
     Southland Separate Account A1 (File No. 33-89574) filed with the Commission
     on February 17, 1995.
***  Incorporated by reference to Pre-Effective Amendment No. 1 to the
     Registration Statement on Form N-4 for Southland Separate Account A1 (File
     No. 33-89574) filed with the Commission on September 29, 1995.


                                       6
<PAGE>
 
                                  SIGNATURES

Pursuant to the requirements of the Securities Act of 1933 and the Investment
Company Act of 1940, the Registrant, Southland Separate Account L1, has duly
caused this Pre-effective Amendment No. 2 to be signed on its behalf by the
undersigned thereunto duly authorized, and its seal to be thereunto affixed and
attested, all in the County of Fulton, State of Georgia, this 8th day of May,
1996.

                                             Southland Separate Account L1
[SEAL APPEARS HERE]                          Southland Life Insurance Company
                                                    (Depositor)

Attest: /s/ Francis J. Mulcahy             By: /s/ James D. Thompson
       -----------------------------          ----------------------------------
        Francis J. Mulcahy, Vice President,       James D. Thompson, President &
                Secretary & General Counsel             Chief Operating Officer
 

Pursuant to the requirements of the Securities Act of 1933, Southland Life
Insurance Company has duly caused this Pre-effective Amendment No. 2 to be
signed on its behalf by the undersigned persons in their capacities with
Southland Life Insurance Company thereunto authorized, and its seal to be
thereunto affixed and attested, all in the County of Fulton, State of Georgia,
this 8th day of May, 1996.

[SEAL APPEARS HERE]                          Southland Life Insurance Company


Attest: /s/ Francis J. Muicahy             By: /s/ James D. Thompson
       -----------------------------          ----------------------------------
        Francis J. Mulcahy, Vice President,       James D. Thompson, President &
                Secretary & General Counsel             Chief Operating Officer


Pursuant to the requirements of the Securities Act of 1933, this Pre-effective
Amendment No. 2 has been signed below by the following persons in the capacities
indicated on the date(s) set forth below.
 
Principal Officers
 
Signature                       Title                           Date
- ---------                       -----                           ----       
                                                         
/s/ James D. Thompson           President &                     May 8, 1996
- ----------------------------    Chief Operating               
James D. Thompson               Officer                  
                                                         
/s/ Robert J. St. Jacques       Chief Executive Officer         May 8, 1996
- ----------------------------                             
Robert J. St. Jacques                                    
                                                         
/s/ Francis J. Mulcahy          Vice President,                 May 8, 1996
- ----------------------------    Secretary                     
Francis J. Mulcahy              & General Counsel

                                       7
<PAGE>
 
Board of Directors
 
 
Signature                       Title                           Date
- ---------                       -----                           ----       


/s/ R. Glenn Hilliard           Chairman of the Board           May 8, 1996
- -----------------------------
R. Glenn Hilliard

/s/ Robert J. St. Jacques       Vice Chairman                   May 8, 1996
- -----------------------------
Robert J. St. Jacques

/s/ Michael W. Cunningham       Director                        May 8, 1996
- -----------------------------
Michael W. Cunningham

/s/ Linda B. Emory              Director                        May 8, 1996
- -----------------------------
Linda B. Emory

/s/ James D. Thompson           Director                        May 8, 1996
- -----------------------------
James D. Thompson

/s/ P. Randall Lowery           Director                        May 8, 1996
- -----------------------------
P. Randall Lowery

/s/ Francis J. Mulcahy          Director                        May 8, 1996
- -----------------------------
Francis J. Mulcahy

                                       8
<PAGE>
 
Exhibit Index

    
1.A.(3)(c)    Schedule of Sales Commissions
1.A.(5)(a)    Specimen Flexible Premium Adjustable Combination Fixed and
              Variable Life Insurance Policy
1.A.(5)(b)    Adjustable Term Insurance Rider
1.A.(5)(c)    Accidental Death Benefit Rider
1.A.(5)(d)    Additional Insured Rider
1.A.(5)(e)    Children's Insurance Rider
1.A.(5)(f)    Exchange of Insured Rider
1.A.(5)(g)    Guaranteed Insurability Rider
1.A.(5)(h)    Waiver of the Cost of Insurance Rider
1.A.(5)(i)    Waiver of Specified Premium Benefit Rider
1.A.(10)      Application form
1.A.(11)      Description of issuance, transfer and redemption procedures
2.            Opinion and Consent of Francis J. Mulcahy, Esquire
6.            Opinion and Consent of Pamela M. Crane, Senior Vice President -
              Finance/Actuarial of Southland Life Insurance Company, as to
              actuarial matters pertaining to the securities being registered
7.(a)         Consent of Ernst & Young
7.(b)         Consent of Sutherland, Asbill & Brennan     

<PAGE>
                                                              Exhibit 1.A.(3)(c)
 
                                Southland Life



                      General Agent's Commission Schedule
                            Commission Percentages
<TABLE>
<CAPTION>
 
- -------------------------------------------------------------------------------
Plan                                         First Year         Renewal 

- --------------------------------------------------------------------------------
                                                              2-5     6-10
- --------------------------------------------------------------------------------
<S>                                            <C>            <C>     <C>
Future Dimensions Variable Universal Life
Total Target Premium or Less/(1)/              85.0           3.0     3.0
Excess Over Total Target Premium                3.0           3.0     3.0
- --------------------------------------------------------------------------------
</TABLE>


Effective May 1, 1996

/(1)/  The "Total Target Premium" is defined to mean the Annual Target Premium
       Per Thousand as shown on the rate card times the number of thousands of
       Specified Amount, plus the total of all first-year term charges for (a)
       any supplemental benefits and (b) any substandard extras applicable for
       ten years or more. No first-year commissions will be paid for any
       substandard extras applicable for less than 10 years.

       The commission on any form of policy not herein specified shall be
       determined by the Company. The commission rates shown on this schedule
       may be changed upon written notice.

                                       1

<PAGE>
 
                                                                Exhibit 1A(5)(a)

                       SOUTHLAND LIFE INSURANCE COMPANY
                             (A TEXAS CORPORATION)
          5780 POWERS FERRY ROAD, N. W., ATLANTA, GEORGIA 30327-4390
                                MAILING ADDRESS
                P. O. BOX 105006, ATLANTA, GEORGIA  30348-5006
                      A STOCK COMPANY - ESTABLISHED 1908

                                 [JOHN Q. DOE]    

               [12-3456789-0]                     [$100,000]

                 Agreement by Southland Life Insurance Company

Southland Life Insurance Company will pay the benefits described in this Policy
in accordance with the terms of this Policy.

                     Consideration for Issuing This Policy

This Policy is issued in consideration of:
     1.  the application; and
     2.  payment of the first premium.

                       Please Read Your Policy Carefully

This Policy is a legal contract between the Policyowner and the Company.

                               Free Look Period

You have the right to examine and return this Policy.  This Policy may be
returned to the agent or the Company within 20 days of receipt, 45 days after
you sign the application or 10 days after we mail the Notice of Withdrawal
Right, whichever is latest.  The Policy will be deemed to be received by you 15
days after it is mailed from our Customer Service Center.  The Policy may be
returned by mail or other delivery to our Customer Service Center or to our
authorized agent who sold it.  It will then be void from the beginning.  Upon
return of the Policy, we will refund all Premiums paid.

This Policy is signed for Southland Life Insurance Company by

              James D. Thompson               Francis J. Mulcahy
                   President                       Secretary

                FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE POLICY
    
Death benefits and other values provided by this Policy, when based on the
investment experience of a separate account, are variable.  These values may
increase or decrease based on investment experience and are not guaranteed as to
a fixed dollar amount.  Death benefits are payable by us to the Beneficiary upon
the death of the Insured prior to maturity.  The Net Accumulation Value, if any,
is payable by us if the Insured is living upon maturity.  Flexible premiums are
payable by the Owner during the lifetime of the Insured until maturity.     
                                
                            Customer Service Center
                                P.O. Box 173789
                             Denver, CO 80217-3789
                                (800) 224-3035           

                                       1
<PAGE>
 
                               TABLE OF CONTENTS
<TABLE>
<CAPTION>
<S>                                               <C>
POLICY SCHEDULE.................................   3
 
DEFINITIONS.....................................   7
 
OWNERSHIP AND BENEFICIARY PROVISIONS............  10
 
PAYMENT OF PREMIUMS.............................  10
 
DEATH BENEFITS..................................  12
 
POLICY CHANGES..................................  14
 
VARIABLE ACCOUNT................................  15
 
GUARANTEED INTEREST ACCOUNT.....................  16
 
ACCUMULATION UNIT VALUE.........................  16
 
ACCUMULATION EXPERIENCE FACTOR..................  16
     
SUBACCOUNT ACCUMULATION VALUE...................  17     
     
GUARANTEED INTEREST ACCOUNT ACCUMULATION VALUE..  17     
 
TRANSFERS.......................................  18
 
POLICY SURRENDER AND WITHDRAWALS................  20
 
POLICY LOANS....................................  21
 
POLICY CHARGES..................................  22
 
REPORTS.........................................  26
 
GENERAL POLICY PROVISIONS.......................  27
 
CONVERSION OF POLICY............................  28
 
HOW BENEFITS ARE PAID...........................  29
</TABLE>

                                       2
<PAGE>
 
<TABLE> 
<CAPTION> 
                                POLICY SCHEDULE
<S>                                       <C>
 
POLICY NUMBER                             [                    ]
                                           --------------------

INSURED PERSON                            [JOHN Q. DOE]

ISSUE AGE                                 [35]

INSURED PERSON'S SEX                      [MALE]

RATING CLASS                              [STANDARD SMOKER]

RATING FACTOR                             [1.00]

STATED DEATH BENEFIT                      [$100,000]

MINIMUM STATED DEATH BENEFIT              [$50,000]

ADDITIONAL TERM INSURANCE AMOUNT

TOTAL DEATH BENEFIT AT ISSUE              [$100,000]

POLICY DATE                               [JUNE 1, 1995]

MONTHLY PROCESSING DATE                   1ST

DEATH BENEFIT TYPE                        [A]

BENEFICIARY NAME                          [MARY J. DOE]

BENEFICIARY RELATIONSHIP                  [SPOUSE]

FIRST PREMIUM                             [      ]
                                           ------

PLANNED PERIODIC PREMIUM                  [         ]
                                           ---------

MODE AT ISSUE                             ANNUAL

MINIMUM MONTHLY PREMIUM                   [         ]
                                           --------- 

OWNER                                     [JOHN Q. DOE]
</TABLE>

                                       3
<PAGE>
 
                         ALLOCATION OF INITIAL PREMIUM
<TABLE>
<CAPTION>
 
<S>                                                   <C>
[Alger American Small Capitalization Subaccount]      0.00%

[Alger American MidCap Growth Subaccount]             0.00%

[Alger American Leveraged AllCap Subaccount]          0.00%

[Alger American Growth Subaccount]                    0.00%

 
[Fidelity VIP II Asset Manager Subaccount]            0.00%

[Fidelity VIP Growth Subaccount]                      0.00%

[Fidelity VIP Overseas Subaccount]                    0.00%

[Fidelity VIP Money Market Subaccount]                0.00%

[Fidelity VIP II Index 500 Subaccount]                0.00%

[Fidelity VIP Equity-Income Subaccount]               0.00%

[Fidelity VIP High Income Subaccount]                 0.00%

[Fidelity VIP II Contrafund Subaccount]               0.00%

[Fidelity VIP II Investment Grade Bond Subaccount]    0.00%
 

[Janus Growth Subaccount]                             0.00%

[Janus Aggressive Growth Subaccount]                  0.00%

[Janus Worldwide Growth Subaccount]                   0.00%

Janus International Growth Subaccount]                0.00%

Janus Balanced Subaccount]                            0.00%

Janus Short-Term Bond Subaccount]                     0.00%

 
[INVESCO Industrial Income Subaccount]                0.00%

[INVESCO Utilities Subaccount]                        0.00%

 
Guaranteed Interest Account                           0.00%

 
</TABLE>

If you elect to invest in a particular investment option, at least 5% of your
Premiums must be allocated to that option.  All percentage allocations must be
in whole numbers.

                                       4
<PAGE>
 
                                POLICY SCHEDULE

               Planned Premium at Issue on Other Available Modes
<TABLE>
<CAPTION>
<S>                                                   <C> 
Annual                                                Quarterly

Semi-Annual                                           Special Monthly

Monthly Administrative Charge of:

Percent of Premium Expense Charge:

Per Thousand Expense Charge:
</TABLE> 
<TABLE> 
<CAPTION> 
 
                      Table of Surrender Charges at Issue
          <S>          <C>                   <C>                <C>  
          Policy         Amount              Policy              Amount
           Year         of Charge             Year              of Charge 
            1                                   9
            2                                  10
            3                                  11
            4                                  12
            5                                  13
            6                                  14
            7                                  15
            8
 
</TABLE> 
<TABLE> 
<CAPTION> 

    Table of Factors for Surrender Charges for Stated Death Benefit Changes
          <S>           <C>                  <C>               <C> 
          Policy        Surrender            Policy            Surrender
           Year           Factor              Year               Factor
            1                                   9           
            2                                  10
            3                                  11
            4                                  12
            5                                  13
            6                                  14
            7                                  15
            8
</TABLE>
A Stated Death Benefit decrease may result in a charge to the Accumulation
Value.  See the "Decrease in Stated Death Benefit" and Surrender Charge
provisions of this Policy.

                                       5
<PAGE>
 
<TABLE>
<CAPTION>
                                POLICY SCHEDULE
 
                              Summary of Benefits
<S>                                          <C>                   <C>
                                             Minimum Monthly       Years of
                                                 Premium            Benefit
LIFE INSURANCE

 
ANY ADDITIONAL BENEFITS OR RIDERS
 
 
 
 
 
TOTAL MINIMUM MONTHLY PREMIUM AT ISSUE
</TABLE>

                                       6
<PAGE>
 
                                  DEFINITIONS

Accumulation Value:  The "Accumulation Value" is the combined value of your
Policy in all of the Subaccounts of the Variable Account, Guaranteed Interest
Account and the values held in the General Account to secure policy loans.

Adjustable Term Insurance Rider: The "Adjustable Term Insurance Rider" is
available to add death benefit coverage to your Policy. The amount of death
benefit coverage provided under this rider is the difference between the Base
Death Benefit and the Target Death Benefit.

Age: The Insured's "Age" at any time is his or her age on the birthday nearest
the Policy Date increased by the number of Policy Years elapsed since the Policy
Date.

Base Death Benefit: The "Base Death Benefit" depends on the death benefit type
you choose. Under Type A, the Base Death Benefit is the greater of Stated Death
Benefit or a multiple of the Accumulation Value on the date of the Insured's
death. Under Type B, the Base Death Benefit is the greater of the Stated Death
Benefit plus the Accumulation Value on the date of the Insured's death, or a
multiple of the Accumulation Value, on the date of the Insured's death.

Beneficiary: The "Beneficiary" is the person to whom the death benefit (payable
on the death of an Insured) is paid.

Cash Surrender Value: The "Cash Surrender Value" of the Policy on any Valuation
Day is the Net Accumulation Value minus any Surrender Charge that would apply
that day.

Code:  The "Code" is the Internal Revenue Code of 1986, as amended.

Customer Service Center: The Southland "Customer Service Center" is the
Company's offices at P.O. Box 173789, Denver, CO 80217-3789. For overnight
delivery, the address is 8515 East Orchard Road, 9T2, Denver, CO 80111.

Death Benefit: The "Death Benefit" is the Base Death Benefit plus any additional
life insurance proceeds provided by any riders. If the Adjustable Term Insurance
Rider is in effect, the Death Benefit is equal to the Target Death Benefit plus
any additional life insurance proceeds provided by any other riders.
    
Death Benefit Proceeds: The "Death Benefit Proceeds" are the proceeds payable to
the Beneficiary by us upon due proof of death of the Insured while the Policy is
in force equal to: [1] the Death Benefit; minus [2] any outstanding Policy Debt;
minus [3] any monthly deductions not yet deducted.     

Free Look Period: The "Free Look Period" is the period during which you may
return the Policy and receive a refund of all premiums paid.

General Account: The "General Account" represents our corporate assets other
than those segregated in any separate account established by us.

Gross Withdrawal: A "Gross Withdrawal" is a Withdrawal plus any applicable
Withdrawal Transaction Charge and any applicable Surrender Charge.

Guaranteed Interest Account: The "Guaranteed Interest Account" is a part of our
General Account, to which a portion of the Accumulation Value may be allocated
and which provides guarantees of principal and interest.

                                       7
<PAGE>
 
Guaranteed Interest Account Accumulation Value: The "Guaranteed Interest Account
Accumulation Value" is the value under the Policy in the Guaranteed Interest
Account.

Insured: The "Insured" means the person upon whose life the Policy is issued.
    
Monthly Deduction: The "Monthly Deduction" or "Monthly Deduction" is the total
amount of deduction taken from the Accumulation Value on each Monthly Processing
Date and includes the initial Policy charge, the monthly administrative charge,
the cost of insurance charge and any changes for additional benefits provided by
riders.     

Monthly Processing Date: The "Monthly Processing Date" is the date each month on
which the monthly deductions from the Accumulation Value are deducted. The first
Monthly Processing Date will be the Policy Date or the date on which the initial
Net Premium is allocated to your Policy, if later. Subsequent Monthly Processing
Dates will be the same date as the Policy Date each month thereafter unless this
is not a Valuation Day, in which case the Monthly Processing Date occurs on the
next Valuation Day.

Net Accumulation Value: The "Net Accumulation Value" on any Valuation Day is the
Accumulation Value on that day less policy loans (and interest thereon) and if
other than the Monthly Processing Date, the monthly deduction that would be
deducted on the next Monthly Processing Date.
    
Net Premium: The "Net Premium" is the premium amount paid less any sales and tax
charges. These charges are deducted from each premium before the premium is
applied to your Accumulation Value.     

No-Lapse Premium: The "No-Lapse Premium" is a benchmark monthly premium
calculated for each Policy based on the Age, sex and rate class of the Insured,
the requested Stated Death Benefit and any supplemental benefits. It is used for
purposes of the No-Lapse Guarantee.
    
No-Lapse Guarantee: The "No-Lapse Guarantee" refers to our guarantee to keep the
Policy in force during the first three Policy Years, regardless of the
sufficiency of the Cash Surrender Value, so long as total premiums paid, less
Withdrawals and Policy Debt, is at least equal to cumulative amount of No-Lapse
Premiums for the Policy months the Policy has been in force.     

Owner:  The "Owner" is the person(s) who owns the Policy and who is entitled to
exercise all rights and privileges provided in the Policy.

Policy Anniversary:  The "Policy Anniversary" is the first day of each Policy
Year.

Policy Date:  The "Policy Date" is shown on the Schedule and is the date the
Policy becomes effective.

Policy Debt: The "Policy Debt" is equal to unrepaid policy loans (including
unpaid interest added to the loan) plus accrued interest not yet due.
    
Policy Loan Account:  The "Policy Loan Account" is described in the "Policy
Loans" section of this Policy.     

Policy Year:  Each "Policy Year" starts on the same day and month as the Policy
Date.

Portfolio:  A "Portfolio" refers to a division of an underlying mutual fund in
which assets of a corresponding Subaccount are invested.

SEC:  The "SEC" is the Securities and Exchange Commission.

                                       8
<PAGE>
 
    
Stated Death Benefit: The "Stated Death Benefit" is a dollar amount used to
determine the death benefit under the Policy and is shown in the Policy
Schedule.     

Subaccount:  A Subaccount is a subdivision of the Variable Account, the assets
of which are invested in a corresponding Portfolio.

Subaccount Accumulation Value:  The "Subaccount Accumulation Value" is the value
under a Policy in a particular Subaccount.

Surrender:  A "Surrender" is a written request for the Cash Surrender Value
which terminates the Policy.
    
Target Death Benefit: The "Target Death Benefit" is the death benefit specified
by the Owner when an Adjustable Term Insurance Rider is added to the Policy.
    
    
Target Premium: The "Target Premium" refers to a premium amount we use to
calculate the sales charge, the sales surrender charge and the cost of insurance
charge. A Target Premium is determined for the initial Stated Death Benefit on
the Policy Date, and an additional Target Premium is determined for each
increase in Stated Death Benefit. The Target Premium generally is less than
planned premiums for a Policy Year. It may be more or less than the No-Lapse
Premium for a Policy Year, depending on the supplemental benefits added to the
Policy.     

Valuation Day: For each Subaccount, a "Valuation Day" is each day on which the
New York Stock Exchange and Southland's Customer Service Center are both open
for business except for a day that a Subaccount's corresponding Portfolio does
not value its shares. The New York Stock Exchange is currently closed on
weekends and on the following holidays: New Year's Day, Presidents' Day, Good
Friday, Memorial Day, July Fourth, Labor Day, Thanksgiving Day and Christmas
Day. Southland's Customer Service Center is normally not open on the following
days: the Monday before New Year's Day, July Fourth or Christmas Day, if any of
these holidays falls on a Tuesday; the Friday after New Year's Day, July Fourth
or Christmas Day, if any of these holidays falls on a Thursday; and the Friday
after Thanksgiving.

Valuation Period: A "Valuation Period" begins at 4:00 p.m. Eastern time on a
Valuation Day and ends at 4:00 p.m. Eastern time on the next succeeding
Valuation Day.

We, us, our, Southland and the Company:  "We," "us," "our," "Southland" and "the
Company" refer to Southland Life Insurance Company.

Withdrawal:  A "Withdrawal" refers to the surrender of a portion of the Net
Accumulation Value.

Written Notice or Written Request: A written notice or written request in a form
satisfactory to the Company which is signed by the Owner and received at the
Customer Service Center.

You and your:  "You" and "your" refer to the Owner of this Policy.

                                       9
<PAGE>
 
OWNERSHIP AND BENEFICIARY PROVISIONS

Ownership
    
The original Owner is the person named as the Owner in the application. You, as
Owner, can exercise all rights and receive the benefits during the Insured's
life before maturity. All rights of the Owner are subject to the rights of any
assignee and any irrevocable Beneficiary.     

Beneficiary
The Beneficiary will receive any death benefits of this policy, subject to any
assignment you have made. Unless otherwise provided, the interest of any
Beneficiary who dies before the Insured, will be paid in equal shares to any
surviving Beneficiaries. If no Beneficiary is living at the Insured's death,
payment will be made to the Owner's estate.

The Beneficiary may be changed by Written Request. After we record receipt of
your request, the change will take effect as of the date the request is signed,
but will not affect any action already taken. The rights of the former
Beneficiary will cease at the same time. We may require return of the Policy to
record the change.

If you give up the right to change a Beneficiary, that Beneficiary's written
consent will be needed along with your Written Request to make any change in
this Policy.

Assignment
We will not honor an assignment of this Policy unless it is in writing and filed
with the Company. You must provide the form of assignment. Conditions of the
assignment take priority over any conflicting ownership or beneficiary
provisions. It is up to you to make sure it is valid. All assignments are
subject to Policy Debt(s).

PAYMENT OF PREMIUM

Premiums
Premiums must be paid to the Company. A receipt will be furnished on request.
The first premium is due on the Policy Date. The Policy will not take effect
until it has been delivered and the first premium paid while the Insured is
alive and prior to any change in health as shown in the application.
    
The planned periodic premium and the mode of payment are shown on the Policy
Schedule. We will send reminder notices to you for the planned periodic premium
that you have selected. You may select to receive notices either annually,
semiannually or quarterly. You may also arrange for payment of premiums on a
monthly basis through an authorized special payment facility. All payment modes
are subject to our minimum requirements for the payment mode selected. Changes
in frequency and increases or decreases in the amount of planned premiums may be
made by you, subject to our current administrative rules and minimum limits on
premiums.     
    
Additional unplanned premiums may be made at any time during the Insured's
lifetime subject to certain limits. The premiums must be at least $100 and must
be sent to our Customer Service Center. We reserve the right to require evidence
of insurability prior to accepting any premium that would increase the
difference between the Accumulation Value and the Death Benefit. We reserve the
right to limit total premiums paid in a Policy Year to the planned premiums
selected. No premium will be accepted after maturity.     

                                       10
<PAGE>
 
If you have Policy Debt outstanding, any payment submitted will be treated as a
loan repayment unless you indicate otherwise when submitting the payment. If no
Policy Debt is outstanding, any payment submitted by you is treated as a premium
payment.

Excess Premium
It is possible that total premiums paid may reach a level that could cause an
adverse effect on the tax status of the Policy. Under the Code, there is a limit
on aggregate premiums for the Policy to be considered a "life insurance
contract." Code section 7702 provides for that exclusion. The portion of any
premium received in excess of that limit will be refunded. This provision is
subject to interpretations of and changes in the federal income tax laws and
regulations.
    
Three-Year Guarantee
We guarantee that a Policy will remain in force during the first three Policy
Years, regardless of the sufficiency of the Cash Surrender Value, if the total
premiums paid less any Withdrawals, Policy Debt, and accrued interest are
greater than the No-Lapse Premium multiplied by the number of months the Policy
has been in force. The No-Lapse Premium for your Policy generally will be less
than the monthly amount of planned premiums you select to pay. The above
referred test of premiums is made on each Monthly Processing Date. As long as
this test is satisfied, the Net Accumulation Value is less than or equal to
zero, the charges will be temporarily waived. Whenever the net Accumulation
Value becomes positive, a portion of all of the charges waived will be deducted
from the Accumulation Value. This process will continue until the end of the
Three-Year Guarantee period. If there is a balance of waived charges at the end
of this period and there is not sufficient Accumulation Value to pay them, the
Policy will enter its grace period. The Three-Year Guarantee will not prevent
the termination of the Policy if the Cash Surrender Value becomes insufficient
because of excessive Policy Debt.     

Allocation of Net Premium
During the Free Look Period, the portion of your Net Premium which you elected
to invest in a Subaccount of the Variable Account will be invested in the money
market Subaccount shown on Page 4. The portion of your Net Premium which you
elected to invest in the Guaranteed Interest Account will be allocated to that
Account. After the Free Look Period, the balance of your assets in the money
market Subaccount will be reallocated as directed by the Owner in the
application for this Policy. Subject to and in accordance with the provisions of
this Policy, subsequent Net Premiums will be allocated as directed by the Owner
to the Subaccounts of the Variable Account or the Guaranteed Interest Account.
The Owner may change the allocation of future premiums at any time by sending
Written Notice. Our administrative rules as in effect from time to time may
impose minimum allocation requirements or limit allocations to whole percentages
(e.g., 33%, not 33 1/3).
                               
Continuation of Insurance
If all premiums cease, the insurance provided under this Policy, including
additional benefits provided by any supplemental agreements attached to this
Policy, will continue in accordance with the provisions of this Policy and any
such supplemental agreements for as long as the Cash Surrender Value of this
Policy is sufficient to keep it in force.     
    
Grace Period
A grace period of sixty-one (61) days is allowed to pay each premium after the
first premium. If the Cash Surrender Value on a Monthly Processing Date will not
cover the monthly deduction due, a sufficient premium must be paid in the grace
period to cover past due changes plus amount sufficient to keep the policy in
force for two (2) months following receipt.     

                                       11
<PAGE>
 
 Notice of the amount of premium required to be paid to keep the Policy from
 lapsing will be mailed to you and to any assignee at the last known address.
 The grace period will begin on the date the notice is mailed. If the premium is
 not paid, the Policy will terminate without value at the end of the grace
 period.

 Reinstatement
 If coverage ends because a sufficient premium is not paid in a grace period,
 this Policy may be reinstated within five (5) years after the lapse. We would
 require:
     
       1.   satisfactory proof that the Insured is insurable;
       2.   payment of premiums sufficient to keep the Policy (and applicable
            riders) in force from the date of lapse to the date of the expired
            grace period and for two months following the date of reinstatement;
            plus
       3.   repayment or the continuance of any Policy Debt which existed when
            coverage ended.
     
At reinstatement, the Accumulation Value will be:
    
       1.   the Accumulation Value at the date of lapse; plus
       2.   your payments on reinstatement; less
       3.   the difference in surrender charges as of the lapse date and as of
            the reinstatement date based on the table of surrender charges.
     
The reinstatement will be effective on the date of our approval.

If the Policy has been surrendered, we will not reinstate this Policy.

DEATH BENEFITS

Proceeds Payable at Death Prior to Age 100
We will pay the Death Benefit Proceeds of this Policy to the Beneficiary on
receipt of proof that the Insured died while this Policy was in force.  These
proceeds will equal:
    
       1.   the Base Death Benefit; plus
       2.   amounts payable from any additional benefits provided by any rider;
            minus
       3.   any monthly deductions due in the grace period, if applicable; minus
       4.   any Policy Debt.
     
    
Payment of Death Proceeds is subject to the "Age and Sex Misstatement," "Policy
Incontestability" and "Suicide" provisions of this Policy.     


Payment will be in a lump sum unless you request an alternate form of payment by
Written Request (See "How Benefits Are Paid").  Interest will be paid on this
lump sum from the date we determine the Death Benefit Proceeds to the date of
payment, or until another payment option is selected.  Interest will be at the
rate we declare, or at any higher rate required by law.
    
Death Benefit
If death benefit type A is shown on the Policy Schedule, the Base Death Benefit
equals the larger of:

       1.   the Stated Death Benefit; or
       2.   a multiple of the Accumulation Value on the date of death.
     

                                       12
<PAGE>
 
    
If death benefit type B is shown on the Policy Schedule, the Base Death Benefit
equals the larger of:

       1.   the Stated Death Benefit plus the Accumulation Value on the date of
            death; or
       2.   a multiple of the Accumulation Value on the date of death.     
    
In both cases, the multiple in (2) depends on the Insured's Age at death.  The
table of multiples in effect as of the Policy Date is shown below.  If the table
becomes inconsistent with any federal income tax laws and regulations, we
reserve the right to change it.     
<TABLE>
<CAPTION>
 
- --------------------------------------------------------------------------------
                            Death Benefit Multiples
- --------------------------------------------------------------------------------
             Multiple of              Multiple of              Multiple of
 Attained   Accumulation   Attained  Accumulation   Attained  Accumulation
   Age         Value         Age        Value         Age        Value
- --------------------------------------------------------------------------------
  <S>          <C>           <C>        <C>            <C>       <C>
  0 - 40       2.50          54         1.57           68        1.17
    41         2.43          55         1.50           69        1.16
    42         2.36          56         1.46           70        1.15       
    43         2.29          57         1.42           71        1.13       
    44         2.22          58         1.38           72        1.11       
    45         2.15          59         1.34           73        1.09       
    46         2.09          60         1.30           74        1.07       
    47         2.03          61         1.28      75 - 90        1.05       
    48         1.97          62         1.26           91        1.04       
    49         1.91          63         1.24           92        1.03       
    50         1.85          64         1.22           93        1.02       
    51         1.78          65         1.20           94        1.01       
    52         1.71          66         1.19     95 - 100        1.00       
    53         1.64          67         1.18       
- ---------------------------------------------------------------------------
</TABLE>

Maturity At Age 100
If the Insured is living at attained age 100 and this Policy is in force, we
will pay you the Policy's Net Accumulation Value and the Policy will terminate.

It is possible that the coverage will terminate prior to age 100 if premiums are
not paid regularly or are insufficient to cover monthly deductions.  Coverage
may be affected also by changes in interest rates and monthly deductions.
    
Optional Continuance Beyond Age 100
You may make a Written Request that we defer payment of proceeds and continue
the Policy in force. We must receive your Written Request at least one year
before maturity.    

During continuance, the death benefit at any time will be the Net Accumulation
Value.  The Accumulation Value will be increased with interest from date of
death to payment in the same manner as prior to maturity.  No further monthly
deductions will apply.  No more premiums may be paid after continuance.

                                       13
<PAGE>
 
POLICY CHANGES
    
Right to Make Change
At any time this Policy is in force after the first Policy Year, the Owner may
make any of the following changes by Written Request.  An increase or decrease
in Stated Death Benefit can be requested only during the thirty day period
preceding a Policy Anniversary.  A change in Death Benefit type can only be made
on a Policy Anniversary.  No change will be permitted that would result in the
failure of this Policy to be a "life insurance contract" by virtue of not
satisfying the requirements of section 7702 of the Code or as set forth in any
applicable successor provision thereto.  In addition, each change is subject to
the conditions stated.     

Increase in Stated Death Benefit
Any increase in the Stated Death Benefit must be at least $10,000 and must be
applied for on a written application. Evidence of insurability satisfactory to
the Company must be submitted. An increase will become effective as of the
Policy Anniversary after we have approved your application for increase. You
will receive a new Schedule to show the effective date of the increase. If the
increase becomes effective during the first three Policy Years, the Three-Year
Guarantee will be extended for three years from the effective date of the
increase. A Target Premium will be established for the increase, and the portion
of premiums paid thereafter allocated to the increase will be subject to a 4%
sales charge until an amount equal to 10 Target Premiums for the increase has
been paid.
    
Decrease in Stated Death Benefit
A decrease in the Stated Death Benefit may only be made after the second Policy
Year.  Any decrease in the Stated Death Benefit must be at least $10,000 or
less.  The Stated Death Benefit may not be decreased to less than $50,000.  No
decrease may be made until at lease two years following the effective date of an
increase in the Stated Death Benefit.     

Any decrease in the Stated Death Benefit will become effective as of the Policy
Anniversary on or following the receipt by the Company of the Written Request.
If increases in the initial Stated Death Benefit are in effect, a decrease in
the Stated Death Benefit will be allocated to each segment of the Stated Death
Benefit in the same proportion as the Target Premium for each segment bears to
the total Target Premiums for the Policy.

If a decrease in Stated Death Benefit occurs during the first 14 Policy Years,
or during the first 14 years following an increase in Stated Death Benefit, a
Surrender Charge may apply.
    
Change of Death Benefit Type
If type A is in effect, you can request that it be changed to type B.  This will
decrease the Stated Death Benefit by the amount of Accumulation Value.  The new
Stated Death Benefit cannot be less than the minimum Stated Death Benefit shown
on the Policy Schedule.     
    
If type B is in effect, you can request that it be changed to type A.  This will
increase the Stated Death Benefit by the amount of the Accumulation Value.     
    
The effective date of the change will be the Monthly Processing Date that
coincides with or follows the Valuation Day after we approve the Written Request
for the changes.     

Change of Benefits Option
You may add or drop any additional benefits by sending us a Written Request.

                                       14
<PAGE>
 
Proof of insurability may be required by us to add a benefit.  We may require
this Policy to be returned to us to make the change.  The amounts and types of
benefits allowed to be added must be in accordance with our rules as of the date
of your request.

VARIABLE ACCOUNT

The Variable Account is an account established by us pursuant to the laws of the
State of Texas, to separate the assets funding the variable benefits for the
class of Policies to which this Policy belongs from the other assets of
Southland Life Insurance Company.

The Variable Account is registered with the SEC as a unit investment trust under
the Investment Company Act of 1940 (the "1940 Act").  All income, gains and
losses, whether or not realized, from assets allocated to the Variable Account
are credited to or charged against the Variable Account without regard to
income, gains or losses of the Company.  The assets of the Variable Account are
our property, but are separate from our General Account and any other separate
account maintained by us.  That portion of the assets of the Variable Account
which is equal to the reserves and other Policy liabilities with respect to the
Variable Account is not chargeable with liabilities arising out of any other
business we may conduct.

We reserve the right to transfer to our General Account any assets that are in
excess of such reserves and other liabilities.

The Variable Account is divided into Subaccounts, each of which invests in a
corresponding Portfolio designed to meet the objectives of the Subaccount.  The
current Subaccounts are shown on the Policy Schedule.  We may, from time to
time, make the following changes to the Variable Account, subject to review by
the SEC and other regulatory authorities:

       (1) create new separate accounts for the Policy;

       (2) combine separate accounts, including the Variable Account;


       (3) add new Subaccounts to or remove existing Subaccounts from the
           Variable Account or combine Subaccounts;

       (4) make new Subaccounts or other Subaccounts available to such classes
           of Policies or contracts as we may determine;

       (5) add new Portfolios or remove existing Portfolios;

       (6) if shares of a Portfolio are no longer available for investment or if
           we determine that investment in a Portfolio is no longer appropriate
           in light of the purposes of the Variable Account, substitute a
           different Portfolio for any existing Portfolio;

       (7) deregister the Variable Account under the 1940 Act if such
           registration is no longer required;

       (8) operate the Variable Account as a management investment company under
           the 1940 Act or as any other form permitted by law; and
       (9) make any changes to the Variable Account or its operations as may be
           required by the 1940 Act or other applicable law or regulations.

We reserve the right to limit the number of Subaccounts in which you may invest.

                                       15
<PAGE>
 
GUARANTEED INTEREST ACCOUNT
    
The Guaranteed Interest Account is another account to which you may allocate Net
Premiums or make transfers.   It is part of our general account assets.
Interest is credited at the guaranteed annual effective interest rate shown on
the Policy Schedule or may be credited at a higher rate.     
    
We pay a declared interest rate on all amounts that you have in the Guaranteed
Interest Account.  These interest rates will never be less than the minimum
guaranteed effective annual interest rate of 3.5%.  When a Net Premium is
received or an amount is transferred into the Guaranteed Interest Account, an
interest rate will be credited to that amount.  The rate will be guaranteed for
a twelve-month period.  Thereafter, interest rates credited to that amount (and
amounts earned on that amount) will be similarly guaranteed for successive
periods of at least twelve-months at the then current interest rate.  Therefore,
different interest rates may apply to different amounts in the Guaranteed
Interest Account, depending on when and how the amount was initially allocated.
For purposes of crediting interest, amounts deducted, transferred or withdrawn
from the Guaranteed Interest Account are accounted for on a first-in-first-out
basis.  Interest at the guaranteed minimum rate or such higher rate as Southland
may determine will be paid regardless of the actual investment experience of the
General Account.  We bear the full amount of the investment risk for the amount
allocated to the Guaranteed Interest Account while the Owner assumes the risk
that interest credited may not exceed the guaranteed minimum rate.     

ACCUMULATION UNIT VALUE
    
Net Premiums allocated to a Subaccount or amounts transferred to a Subaccount
are converted into Accumulation Units, a unit of measure used to calculate
Subaccount Accumulation Value.  For any Subaccount, the number of Accumulation
Units credited is determined by dividing the dollar amount directed to the
Subaccount by the value of the Accumulation Unit for that Subaccount for the
Valuation Period on which the Net Premium is received or the transfer is
effective.  In this manner, an increase in Subaccount Accumulation Value under a
policy occurs by the addition of Accumulation Units of that Subaccount.     

The Accumulation Unit Value for each Subaccount was arbitrarily set initially at
$10 when the Subaccount was established.  Thereafter, for any Subaccount, the
Accumulation Unit Value for a Valuation Period equals the Accumulation Unit
Value for the preceding Valuation Period multiplied by the Accumulation
Experience Factor (described below) for the current Valuation Period.  Decreases
in Subaccount Accumulation Value under a Policy are effected by the cancellation
of an appropriate number of Accumulation Units of a Subaccount.   Accumulation
Units are canceled as of the end of the Valuation Period in which the Company
received notice of or instructions regarding the event.

ACCUMULATION EXPERIENCE FACTOR

For each Subaccount of the Variable Account, the Accumulation Experience Factor
reflects the investment experience of the Portfolio in which that Subaccount
invests and the charges assessed against that Subaccount for a Valuation Period.
The Accumulation Experience Factor is calculated by dividing

(1) by (2) and subtracting (3) from the result, where:

       (1)  is the result of:

            a. the net asset value per share of the Portfolio held in the
               Subaccount, determined at the end of the current Valuation 
               Period; plus

                                       16
<PAGE>
 
            b. the per share amount of any dividend or capital gains
               distributions made by the Portfolio held in the Subaccount, if
               the "ex-dividend" date occurs during the current Valuation
               Period; plus or minus

            c. a per share charge or credit for any taxes reserved for, which is
               determined by the Company to have resulted from the operations of
               the Subaccount.

       (2) is the net asset value per share of the Portfolio held in the
           Subaccount, determined at the end of the last prior Valuation Period.

            
       (3) is the daily factor representing the mortality and expense risk
           charge and the administrative charge deducted from the Subaccount
           adjusted for the number of days in the Valuation Period.     

SUBACCOUNT ACCUMULATION VALUE

The Subaccount Accumulation Value for any Subaccount as of the Policy Date is
equal to the amount of the initial Net Premium allocated to that Subaccount .

On subsequent Valuation Days, the amount of the Subaccount Accumulation Value is
calculated as follows:

       1.    The number of Accumulation Units in that Subaccount as of the
             beginning of the current Valuation Period multiplied by that
             Subaccount's Accumulation Unit value for the current Valuation
             Period; plus
       2.    Any additional Net Premiums allocated to that Subaccount during the
             current Valuation Period; plus
       3.    Any Accumulation Value transferred to the Subaccount during the
             current Valuation Period (including any amounts released from the
             Policy Loan Account and allocated to that Subaccount during the
             current Valuation Period); minus
       4.    Any Accumulation Value transferred from the Subaccount during the
             current Valuation Period (including any amounts transferred to the
             Policy Loan Account) and; the portion of any Excess Transfer Charge
             allocated to the Subaccount during the current Valuation Period;
             minus
       5.    The portion of any Gross Withdrawals allocated to that Subaccount
             during the current Valuation Period (including the portion of the
             Surrender Charge resulting from a decrease in Stated Death Benefit
             allocated to the Subaccount during the current Valuation Period);
             minus
       6.    The portion of the monthly deduction allocated to such Subaccount,
             if a Monthly Processing Date occurs during the current Valuation
             Period.

GUARANTEED INTEREST ACCOUNT ACCUMULATION VALUE

The Guaranteed Interest Account Accumulation Value as of the Policy Date is
equal to the amount of the initial Net Premium allocated to the Guaranteed
Interest Account.

On subsequent Valuation Days, the Guaranteed Interest Account Accumulation Value
is calculated as follows:

                                       17
<PAGE>
 
       1.    The Guaranteed Interest Account Accumulation Value as of the end of
             the preceding Valuation Period plus any interest earned during the
             Valuation Period; plus
           
       2.    Any additional Net Premiums allocated to the Guaranteed Interest
             Account plus interest credited to those premiums during the current
             Valuation Period; plus     

       3.    Any Accumulation Value transferred to the Guaranteed Interest
             Account during the current Valuation Period (including any amounts
             released from the Policy Loan Account and allocated to the
             Guaranteed Interest Account during the current Valuation Period);
             minus

       4.    Any Accumulation Value transferred from the Guaranteed Interest
             Account during the current Valuation Period (including any amounts
             transferred to the Policy Loan Account) and the portion of any
             Excess Transfer Charge allocated to the Guaranteed Interest Account
             during the current Valuation Period; minus

       5.    The portion of any Gross Withdrawals allocated to the Guaranteed
             Interest Account during the current Valuation Period (including the
             portion of any Surrender Charges resulting from a decrease in
             Stated Death Benefit allocated to the Guaranteed Interest Account
             during the current Valuation Period); minus

       6.    The portion of the monthly deduction allocated to the Guaranteed
             Interest Account, if a Monthly Processing Date occurs during the
             current Valuation Period.
    
Interest Credits
We guarantee that the Accumulation Value in the Guaranteed Interest Account will
be credited with an effective annual interest rate of at least 3.5%.  We may, at
our discretion, credit a higher current rate of interest.     

TRANSFERS

You may transfer amounts among Subaccounts and the Guaranteed Interest Account.
Transfers may be made based upon instructions given by Written Notice or by
telephone.  Any such transfer will take effect at the end of the Valuation
Period during which we receive such notice at our Customer Service Center, or
such later date as you may specify in your Written Notice or telephone request.
    
Each transfer must be for a minimum of $100 or the balance in the Subaccount or
the Guaranteed Interest Account, if less.  The minimum amount which can remain
in a Subaccount or in the Guaranteed Interest Account as a result of a transfer
is $100.00.  Any amount below this minimum must be included in the amount
transferred.     

Once during the first 30 days of each Policy Year, you may transfer amounts to
or from the Guaranteed Interest Account.  Transfer requests received within 30
days prior to the Policy Anniversary will be considered requests to transfer on
the Policy Anniversary.  A request to transfer to or from the Guaranteed
Interest Account that is received on the Policy Anniversary or within the
following 30 days will be processed if it is the first such transfer request
received during the 30 day period.  Requests for transfer to or from the
Guaranteed Interest Account received at any other times will not be processed.

The maximum transfer amount from the Guaranteed Interest Account to the
Subaccounts of the Variable Account in any Policy Year is the greater of:

                                       18
<PAGE>
 
           
       a. 25% of the Guaranteed Interest Account Accumulation Value immediately
          prior to the first transfer or Withdrawal in that Policy Year from the
          Guaranteed Interest Account;
       b. $100; or
       c. the sum of the amounts that were transferred out of and withdrawn
          from the Guaranteed Interest Account in the prior Policy Year.     
    
Excess Transfer Charge
The first 12 transfers per Policy Year will be allowed free of charge.
Thereafter, a $10.00 transfer charge may be deducted from the amount
transferred.  All transfers effected during a single Valuation Period will be
counted as one transfer for purposes of the transfer charge.  Transfers due to
the operation of Dollar Cost Averaging or Automatic Rebalancing are not included
in determining the limit on the number of transfers allowed without a charge.
The charge will be deducted from your Subaccount Accumulation Value and
Guaranteed Interest Account Accumulation Value in the same proportion as amounts
transferred from those values.     
    
Dollar Cost Averaging Facility
If you have at least $10,000 of Accumulation Value in the Money Market
Subaccount shown on the Schedule, you may choose to transfer a specified dollar
amount each month from this Subaccount and have a percentage of that amount
transferred to other Subaccounts of the Variable Account.  Dollar Cost Averaging
transfers may not be made to the Guaranteed Interest Account.  You may elect the
Dollar Cost Averaging transfer option at any time prior to maturity by Written
Notice.     

The minimum amount that you may elect to transfer each month is $100.  The
maximum amount that you may transfer is equal to the Subaccount Accumulation
Value (when the election is made) of the Subaccount from which the transfer is
taken divided by twelve.
    
The percentage to be transferred to the other Subaccounts must be designated in
whole number percentages.  No specific dollar designation may be made to the
Subaccounts.  If you elect to transfer to a particular Subaccount, the minimum
percentage that may be transferred to that Subaccount is 5% of the total amount
transferred.  Transfers for Dollar Cost Averaging will be effected on the
Monthly Processing Dates.  If, on any transfer date, the Accumulation Value in
the selected Subaccount is equal to or less than the amount you have elected to
have transferred, the entire amount will be transferred, and this option will
end.  If still in effect, Dollar Cost Averaging will end as of the Valuation Day
immediately preceding maturity.     

You may change the transfer amount or the Subaccount to which transfers are to
be made once each Policy Year. You may cancel this election by Written Notice at
least seven days before the next transfer date. Any transfer under this option
will not be included for purposes of computing the transfer charge .
    
Automatic Rebalancing
Automatic Rebalancing allows you to match your Accumulation Value in each
Subaccount to your allocation percentage for new premiums.  Automatic
Rebalancing can be elected in your application or by completing the Automatic
Rebalancing form and returning it to our Customer Service Center.  As of the
first Valuation Date of each calendar quarter thereafter we will reallocate your
Net Accumulation Value so that the amount in each Subaccount matches your most
recent premium allocation.  Automatic Rebalancing may not begin until the
Monthly Processing Date following the end of the Free Look Period.  Automatic
Rebalancing will continue until we receive Written Notice or a telephone request
at our Customer Service Center to terminate.     

While this feature is in effect, we require that you allocate no more than 35%
of your premiums to any one Subaccount, and you must allocate your premiums to
at least five Subaccounts.  If at any time during the

                                       19
<PAGE>
 
operation of the Automatic Rebalancing feature you request a change in premium
allocation which does not meet these requirements, we will notify you that your
allocation must be changed.  We will not process such a request unless you also
request that the Automatic Rebalancing feature be discontinued.

When you request a change in premium allocation that meets these requirements,
your net Accumulation Value will be reallocated as of the Valuation Date that we
receive your written allocation instructions.  Amounts will be transferred among
the Subaccounts to match the allocation for new Premiums.

During the operation of Automatic Rebalancing, you may not change your
allocation percentage to the Guaranteed Interest Account by more than 25% of the
percentage previously allocated to the Guaranteed Interest Account.
    
If you change your Premium allocation more than five (5) times per Policy Year,
there will be a $25 charge taken from your Accumulation Value.  This charge will
be deducted from each of the Subaccounts of the Variable Account and the
Guaranteed Interest Account in the same proportion that your Accumulation Value
in each Subaccount and Guaranteed Interest Account bears to your Net
Accumulation Value as of the Valuation Day the allocation change is effective.
     
    
You may elect either Dollar Cost Averaging or Automatic Rebalancing, but not
both. Other transfers may not be made during Automatic Rebalancing.     

POLICY SURRENDER AND WITHDRAWALS

Policy Surrender
You may surrender this Policy for its Cash Surrender Value by Written Notice.
We must receive the Policy and your request during the Insured's lifetime.  We
will pay the Cash Surrender Value within seven days following receipt of the
Written Notice.  The Policy will be canceled on the date of receipt of the
Written Notice.

Withdrawals
You may withdraw part of the Cash Surrender Value after the first Policy Year by
Written Notice or request by telephone.  We must receive the request during the
Insured's lifetime.
    
The maximum Withdrawal is the amount which will leave $500 as Cash Surrender
Value for the Policy.  The amount withdrawn from the Guaranteed Interest Account
may not be greater than the total Withdrawal times the ratio of the Accumulation
Value in the Guaranteed Interest Account to the total unborrowed Accumulation
Value immediately prior to the Withdrawal.  It cannot cause the Stated Death
Benefit to reduce below the minimum Stated Death Benefit of $50,000.  The
minimum Withdrawal amount, the maximum number of Withdrawals per Policy Year and
the Withdrawal Transaction Charge are shown below:     
<TABLE> 
    
       <S>                                               <C>   
       Minimum Withdrawal amount:                        $500
       Maximum number of Withdrawals per Policy Year     12
       Withdrawal Transaction Charge:                    the lesser of $ 25 or
                                                         2% of the amount 
                                                         requested
</TABLE>      
    
If death benefit type A is in effect, a Withdrawal will reduce the Accumulation
Value and the Stated Death Benefit.  However, if the Withdrawal is the first
Withdrawal of that Policy Year, the Insured's attained age is less than 81 at
the time of the Withdrawal, and the Withdrawal occurs less than 16 years
following the date of issue, then the Withdrawal will not reduce the Stated
Death Benefit if the amount of the Withdrawal is less than 5% of the Stated
Death Benefit.  If the above conditions are met and the amount of the     

                                       20
<PAGE>
 
    
Withdrawal exceeds the greater of 10% of the Accumulation Value immediately
prior to the Withdrawal and 5% of the Stated Death Benefit, the Stated Death
Benefit will only be reduced by the amount by which the Withdrawal exceeds the
greater of 10% of the Accumulation Value immediately prior to the Withdrawal and
5% of the Stated Death Benefit.  The Stated Death Benefit will be reduced in
proportion to the reduction in Accumulation Value caused by the Gross
Withdrawal.  The decrease in Accumulation Value will occur on the day we process
the Withdrawal; however, the decrease in Stated Death Benefit will be effective
as of the next Monthly Processing Date.  If the Withdrawal occurs during the
first 14 Policy Years or first 14 years following an increase in Stated Death
Benefit, a Surrender Charge will be assessed.     

If death benefit type B is in effect, a Withdrawal will reduce the Accumulation
Value but the Stated Death Benefit will not be reduced as the Accumulation Value
reflects the decrease.
    
You may tell us how to allocate the Gross Withdrawal among the Subaccounts and
the Guaranteed Interest Account.  If you do not,  the  Withdrawal will be
allocated among the Subaccounts and the Guaranteed Interest Account on a pro
rata basis.     

We will pay a withdrawal request within seven days following our receipt of the
request.
    
Withdrawal Transaction Charge
A Withdrawal Transaction Charge of the lesser of $25 or 2% of the amount
requested will be deducted from the requested Withdrawal amount on any
Withdrawal made during a Policy Year after the first Withdrawal.  The Withdrawal
Transaction Charge will be deducted from your Net Accumulation Value on the same
basis as the Withdrawal is taken.     

POLICY LOANS

Loan Benefits
This Policy has loan benefits that are described below.  Any outstanding Policy
Debt will be deducted from proceeds payable at the Insured's death, on maturity
or on Surrender.
    
Making a Policy Loan
After the first Policy Anniversary, you may obtain a policy loan from us by
submitting a Written Request or telephone request to our Customer Service
Center.  This Policy is the only security required.  The available loan amount
at any time is the maximum loan amount less any outstanding Policy Debt.  The
maximum loan amount is equal to 90% of the Policy's Cash Surrender Value at the
time of the loan.  The minimum amount you may borrow is $100.     

Certain loan amounts taken after the earlier of:

     1. the tenth Policy Anniversary, or
     2  the fifth Policy Anniversary if the Insured's attained Age is 60 or
        greater,

will be considered preferred loan amounts as described below.

During each Policy Year of preferred loan eligibility amounts, the first loan
made during that year will be considered a preferred loan amount up to a maximum
of 10% of the Net Accumulation Value.  Any amount loaned later in that Policy
Year will not be considered a preferred loan amount.

If the preferred loan amount made during any Policy Year is less than the
maximum allowed, the balance may not be carried over to increase the eligible
preferred loan amount of any subsequent Policy Year.

                                       21
<PAGE>
 
Beginning with the 21st Policy Year, all loan balances will be considered to be
preferred loan amounts.

The amount of any Accumulation Value in the Guaranteed Interest Account equal to
any preferred loan amount on this policy will be credited with interest at the
rate of 4%.

Interest
The maximum interest rate on any loan is 6% per year.  We have the option of
charging a lower rate.  Interest accrues daily and becomes a part of the
Outstanding Policy Debt if not paid when due.  Interest payments are due on each
Policy Anniversary.  If interest is not paid when due, it will be added to the
Policy Debt and will be charged interest at the rate then being charged on the
loan.

Other Borrowing Rules
When a policy loan is made, or when interest is not paid when due, an amount of
Accumulation Value sufficient to secure the Policy Debt is transferred out of
the Variable Account and the Guaranteed Interest Account and into the Policy
Loan Account of our General Account.  You may tell us how to allocate the
remaining Accumulation Value among the Subaccounts and the Guaranteed Interest
Account provided that the amount remaining in the Subaccount or the Guaranteed
Interest Account as a result of the allocation is at least $100.  Otherwise, the
Accumulation Value will be allocated among the Subaccounts and the Guaranteed
Interest Account in the same proportion that the Policy's Accumulation Value in
each Subaccount and the Guaranteed Interest Account bears to the total
Accumulation Value in all Subaccounts and the Guaranteed Interest Account on the
date we make the loan.
    
Accumulation Value in the Policy Loan Account of the General Account will be
credited with 4% interest annually.  The interest earned will be allocated to
the Subaccounts and the Guaranteed Interest Account in the same proportion that
Net Premiums are being allocated and will be transferred on each Policy
Anniversary.     

If the outstanding Policy Debt exceeds the Accumulation Value less any Surrender
Charge and the Monthly Deduction, the Policy will be in default.  We will send
you a notice of the amount you must pay.  If you do not pay this amount within
61 days after we send notice, the Policy will terminate without value.  We will
send the notice to you and to any assignee of record at our Customer Service
Center.

Any loan transaction will permanently affect the values of this Policy.
    
Repaying a Policy Debt
You can repay a Policy Debt in part or in full anytime during the Insured's life
prior to maturity while this policy is in force.  If there is an outstanding
Policy loan, any payment which is not a scheduled premium received before
maturity is considered loan repayment unless otherwise indicated.  When a loan
repayment is made, Accumulation Value in the General Account related to that
payment will be transferred into the Subaccounts and the Guaranteed Interest
Account in the same proportion that net premiums are then being allocated unless
you provide other instructions.     

POLICY CHARGES

State Premium Tax Charge.  All states levy taxes on life insurance premium
payments.  The amount of these taxes vary from state to state, and may vary from
jurisdiction to jurisdiction within a state.  We currently deduct an amount
equal to 2.5% of each premium to pay applicable premium taxes.  The 2.5% rate
approximates the average tax rate we expect to pay on premiums from all states.

                                       22
<PAGE>
 
DAC Tax Charge.  A charge currently equal to 1.5% of each premium payment is
deducted to cover our estimated cost for the Federal income tax treatment of
deferred acquisition costs determined solely by the amount of life insurance
premiums we receive.

We reserve the right to increase or decrease the premium expense charge for
taxes due to any change in tax law.  We further reserve the right to increase or
decrease the premium expense charge for the federal income tax treatment of
deferred acquisition costs due to any change in the cost to us.

Sales Charge. A charge equal to 4.0% of each premium paid up to an aggregate
amount equal to ten Target Premiums for your Policy, or to ten Target Premiums
for an increase after an increase in Stated Death Benefit is deducted to
compensate us for a portion of the cost of selling the Policy.

The sales charge covers the cost of distribution, costs of preparing our sales
literature, other promotional expenses, and other direct and indirect expenses.
The amount of this charge cannot be specifically related to sales expenses in a
particular year since we recover these costs over the period the Policies remain
in effect.  We pay the sales expenses from our own resources, including this
sales charge, any sales Surrender Charge we may collect and any profit we may
earn on the mortality and expense risk charge deducted under the Policy.  The
sales charge may be reduced or waived for certain group or sponsored
arrangements or corporate purchasers.

Surrender Charge
We assess a surrender charge against your Accumulation Value upon a Surrender,
reduction in Stated Death Benefit or lapse of your Policy in the first fourteen
Policy years, or the fourteen Policy years following an increase in Stated Death
Benefit (herein referred to as an addition of a new coverage segment of Stated
Death Benefit).  The surrender charge is designed to recover our expenses in
issuing and distributing Policies.  The surrender charge consists of two
charges:  an administrative surrender charge and a sales surrender charge.

During the first fourteen years of the Policy or within 14 years of an increase
in the Stated Death Benefit, if you request a decrease to the Stated Death
Benefit of your Policy or take a Withdrawal which decreases the Stated Death
Benefit, we will deduct a portion of the surrender charge from your Net
Accumulation Value.  The amount of the surrender charge which will be deducted
from your Net Accumulation Value on the decrease will equal the surrender charge
in effect before the reduction minus the surrender charge in effect after the
reduction.

Decreases as a result of a change to your death benefit option do not result in
a surrender charge deduction from your Net Accumulation Value and future
surrender charges will not be reduced.

Increases in the Stated Death Benefit as a result of changes in death benefit
option do not result in an increase in the maximum sales surrender charge.  All
other increases in Stated Death Benefit will increase the maximum surrender
charges.

Administrative Surrender Charge
The administrative surrender charge is equal to four dollars ($4.00) per $1,000
of Stated Death Benefit.

The administrative surrender charge remains level for the first nine years
following issuance of the Policy or the effective date of a coverage segment,
then decreases by one-sixth of the amount in effect at the end of the 9th Policy
year until it reaches zero at the beginning of the fifteenth year, or the year
in which the Insured reaches Age 98, whichever is earlier.

                                       23
<PAGE>
 
During the first 14 Policy years or within 14 years of an increase in the Stated
Death Benefit, if you request a decrease to the Stated Death Benefit or take a
Withdrawal which causes the Stated Death Benefit to decrease, your
administrative surrender charge will decrease in the same proportion that the
Stated Death Benefit decreases.

The administrative surrender charge is designed to partially cover the
administrative expenses associated with setting up your Policy (other than sales
expenses), such as application processing, establishment of Policy records and
insurance underwriting costs.  It also includes costs associated with the
development and operation of our systems for administering the policies.  We do
not expect to profit from the administrative surrender charge.
    
Sales Surrender Charge
The sales surrender charge is equal to 50.0% of actual premiums paid up to one
Target Premium plus 40% of any additional premiums paid up to two Target
Premiums.  However, in the first two Policy Years or the first two years
following an increase in Stated Death Benefit, the sales surrender charge is
capped at 26% of premiums paid up to one Target Premium, plus 6% of premiums
paid between one and two Target Premiums, plus 5% of all other premiums.  Target
Premiums are not based on the planned premium you determine when you purchase
the Policy.  Target Premiums are actuarially determined based on the Age, sex
and risk class of the Insured.  The Target Premium for your Policy and any
Stated Death Benefit coverage segments added since the Policy Date will be
listed in the Schedule to your Policy.  Upon a decrease in the Stated Death
Benefit the Target Premium for each segment will be reduced in the same
proportion that the Stated Death Benefit is reduced.     
    
The maximum sales surrender charge for the Stated Death Benefit will be shown in
the Policy Schedule.     
    
The maximum sales surrender charge for a Stated Death Benefit remains level for
the first nine Policy Years or for the first nine years following an increase in
a Stated Death Benefit segment, then decreases by 15% of the amount in effect at
the end of the 9th year each Policy year until it reaches zero at the beginning
of the fifteenth year, or the year in which the Insured reaches Age 98,
whichever is earlier.     

Upon a decrease in the Stated Death Benefit other than due to a change in death
benefit option, the Target Premium for each segment will be reduced in the same
proportion that the Stated Death Benefit is reduced.  The following rules
explain when a sales surrender charge is deducted on a decrease in Stated Death
Benefit, and how future sales surrender charges are adjusted.  If the new target
Premium for each Stated Death Benefit segment is greater than or equal to the
sum of your paid Premiums which are allocated to the segment, the maximum sales
surrender charge you may pay in the future will be reduced, but a sales
surrender charge will not be deducted from your Accumulation Value.  If the new
Target Premium for each Stated Death Benefit segment is less than the sum of
your paid Premiums which are allocated to the segment, your maximum sales
surrender charge you may pay in the future will be reduced and a sales surrender
charge will be deducted from your Accumulation Value.  The new sales surrender
charge will be recalculated as if the new Target Premium was always in effect
for the segment.  A deduction equal to the difference between the sales
surrender charge as calculated before and after the decrease will be taken from
your Accumulation Value.

If you request a decrease to the Stated Death Benefit or take a Withdrawal which
causes the Stated Death Benefit to be reduced, more than nine years following
the Policy date or the date of an increase to the Stated Death Benefit,
whichever is applicable, the maximum sales surrender charge you could pay in the
future will be reduced in the same proportion that the Stated Death Benefit is
reduced.

                                       24
<PAGE>
 
The amount of the sales surrender charge in a Policy year is not necessarily
related to our actual sales expenses in that year.  To the extent sales expenses
are not covered by the sales surrender charge, we will cover them from other
funds.

Initial Policy Charge.  The initial Policy charge is $20 per month for the first
Policy Year.  This charge covers the costs of setting up your Policy, other than
sales expenses, such as application processing, medical examinations,
establishment of Policy records and insurance underwriting costs.  This charge
is designed to reimburse us for expenses and we do not expect to gain from it.

Monthly Administrative Charge.  The monthly administrative charge is $6 per
month and is guaranteed never to exceed $10 a month.  This charge is designed to
cover the ongoing costs of maintaining your Policy, such as premium billing and
collections, claim processing, Policy transactions, record keeping, reporting
and other communications with Owners, and other expenses and overhead.

Cost of Insurance Charge.  The cost of insurance charge compensates us for the
anticipated cost of paying the amount of the Death Benefit that exceeds your
Accumulation Value upon the death of the Insured.  The cost of insurance charges
are calculated monthly, and depend on a number of variables.  The charge varies
from Policy to Policy and from month to month.

The charge is equal to our current monthly cost of insurance rate multiplied by
the net amount at risk under the Policy for Death Benefit.  The net amount at
risk for the Base Death Benefit is equal to the difference between the current
Base Death Benefit and the amount of your Accumulation Value on the Monthly
Processing Date.  For this purpose, the amount of your Accumulation Value is
determined after deduction of administrative charges and other supplemental
benefit charges due on that date, but before deduction of the cost of insurance
charges for the Base Death Benefit, and any Adjustable Term Insurance Rider on
the Adjustable Term Insurance Rider.  The net amount at risk for the Adjustable
Term Insurance Rider is equal to the amount of the benefit provided.  If the
Base Death Benefit at the beginning of the month is increased, for example, due
to the requirements of Federal income tax law definition of life insurance, net
amount at risk for the Base Death Benefit that month will also increase, but the
net amount at risk for any Adjustable Term Insurance Rider may be reduced.
Therefore, the amount of the cost of insurance charges will vary from month to
month with changes in the net amount at risk, changes in the relative makeup of
the death benefit, and with increasing Age of the Insured.
    
If the Death Benefit of your Policy consists of more than one segment because
there has been an increase in Stated Death Benefit, the charge is calculated
separately for each segment.  The cost of insurance charge for each segment is
equal to our current monthly cost of insurance rate for each segment times the
net amount at risk for that segment of the Death Benefit.  Net Amount at Risk
for each segment of the Death Benefit is calculated on the Monthly Processing
Date.  Net amount at risk is allocated to each Stated Death Benefit segment in
the same proportion that the Stated Death Benefit of each segment bears to the
sum of the Stated Death Benefit for all coverage segments as of the Monthly
Processing Date.     

The cost of insurance rate for a Policy or for a segment is based on the
Attained Age, sex and rate class of the Insured, and therefore varies from time
to time.  We currently place Insureds in the following rate classes, based on
our underwriting:  a smoker or nonsmoker standard rate class or a rate class
involving a higher mortality risk (a "substandard class").

We place the insured in a rate class when we issue the Policy, based on our
underwriting of the application.  This original rate class applies to the
Initial Stated Death Benefit and any Adjustable Term Insurance Rider when added
to the Policy.  When an increase in Stated Death Benefit is requested, we
conduct underwriting before approving the increase to determine whether a
different rate class will apply

                                       25
<PAGE>
 
to the increase.  If the rate class for the increase has lower cost of insurance
rates than the original rate class, the rate class for the increase also will be
applied to the Initial Stated Death Benefit.  If the rate class for the increase
has higher cost of insurance rates than the original rate class, the rate class
for the increase will apply only to the increase in Stated Death Benefit, and
the original rate class will continue to apply to the Initial Stated Death
Benefit.

Our current cost of insurance rates may be less than the guaranteed rates.  In
addition, current rates are greater for Policies with Stated Death Benefit (or
Target Death Benefit, if any) that is less than $250,000 on the Policy Date.
Our current cost of insurance rates will be determined based on our expectations
as to future mortality, investment expense and persistency experience.  The
rates may change from time to time, but they will never be more than the
guaranteed maximum rates set forth in your Policy.

The guaranteed rates for standard classes are based on the 1980 Commissioners'
Standard Ordinary Mortality Tables, Age Nearest Birthday ("1980 CSO Tables")
sex-distinct.  The guaranteed rates for substandard classes are based on
multiples or additives of the 1980 CSO Tables.
    
Cost of insurance rates (whether guaranteed or current) of an Insured in a
nonsmoker standard class are lower than guaranteed rates for an Insured of the
same age and sex in a smoker standard class.     
    
Mortality and Expense Risk Charge.  We will deduct a daily charge from the
assets in the Subaccounts to compensate Southland for mortality and expense
risks that we assume under the Policy.  The daily charge is at the rate of
0.02466% (equivalent to an annual rate of 0.90%) on the assets of the Variable
Account.  The mortality and expense risk charge is not deducted from the
Guaranteed Interest Account.     

The mortality risk assumed is the risk that Insureds, as a group, will live for
a shorter period of time than estimated and, therefore, the cost of insurance
charges specified in the Policy will be insufficient to meet our actual claims.
The expense risk assumed is the risk that it will cost us more to issue and
administer the Policy and the Variable Account than we expected in setting
certain of the charge levels guaranteed in the Policy.

Portfolio Expenses
There are fees and charges deducted from the Portfolios.  Please read the
prospectus for the Portfolios you are considering for complete details.
    
Persistency Refund
Each month your Policy or a coverage segment of Stated Death Benefit remains in
force after its tenth Policy Anniversary, we will credit the Accumulation Value
in the Subaccounts with a persistency refund equivalent to 0.35% of the
Accumulation Value in the Subaccounts on an annual basis for that segment
(0.02917% monthly).  The persistency refund will be added to the Subaccounts in
the same proportion that your Accumulation Value in each Subaccount bears to the
total of Accumulation Value in the Subaccounts on the Monthly Processing Date.
     
    
REPORTS     
    
Annual Report
Each year, the Owner will be mailed an annual report that shows the progress of
the Policy.  This report will show for the last Policy Year the current
Accumulation Value, Cash Surrender Value and premiums paid since the last
report.  The report will also show the allocation of your Accumulation Value as
of the date of the report and the amounts added to or deducted from your
Subaccount Accumulation Values and Guaranteed Interest Account Accumulation
Value since the last report.  The report will include any other     

                                       26
<PAGE>
 
information that may be currently required by the insurance supervisory official
of the jurisdiction in which the policy is delivered.

Other Reports
The Owner may request a report illustrating future values of the policy under
both guaranteed and current assumptions.  A reasonable fee not to exceed $50 may
be charged for this report.

GENERAL POLICY PROVISIONS
    
This Policy, the attached application, any additional riders or endorsements,
and any supplemental applications make up the entire contract between you and
us.  In the absence of fraud, statements in the application will be considered
representations and not warranties.  No statement will void this Policy or be
used in defense of a claim unless contained in the application.     
    
Policy Incontestability
We cannot contest this Policy after it has been in force for two years from the
issue date, during the Insured's lifetime except for non-payment of premium.  No
benefits added to your Policy after the issue date can be contested after two
years from the effective date of such benefit, during the Insured's lifetime
except for non-payment of premium.     

Termination
All coverage under this Policy will terminate on the first to occur of one of
these events:
        1. you request that coverage terminate; or
        2. the Insured dies; or
        3. this Policy matures; or
        4  the grace period ends; or
        5. this Policy is surrendered.

On termination of this Policy, we will make any payment that may be applicable.

Age and Sex Misstatement
The amount of insurance under this Policy is based on the Insured person's sex
and age nearest birthday on the Policy Date.  If either the sex or age shown on
Page 3 is wrong, the Stated Death Benefit will be adjusted.  The adjusted death
benefit will be that which would be purchased by the most recent cost of
insurance charge at the correct age and sex.

Legal Action
No legal action can be brought against us until 60 days after written proof of
death or other loss is given to us.  No such action can be brought more than
three years after such proof is furnished to us.

Suicide
If the Insured commits suicide during the first two years from the Policy Date,
instead of paying the Policy proceeds, we will make a limited payment of:
        1. all premiums paid; less
        2  any Policy Debt; less
        3. any Withdrawals.

If the Insured commits suicide within two years from the effective date of any
increase in Stated Death Benefit or benefits provided by any rider, we will pay:
        1. proceeds from this Policy and any benefits that have been in force
           at least two years from their respective effective dates; plus

                                       27
<PAGE>
 
        2. the cost of insurance for any increase or additional benefits that
           have been in effect less than two years from their respective
           effective dates; less
        3. any Policy Debt; less
        4. any Withdrawals.

The payment will be made to the Beneficiary.

Modifications
No agent is allowed to make any changes in this Policy.  Changes can only be
made by our President, a Vice President, or the Secretary.

Delay of Payment by Law
Payments of Withdrawals, Surrenders or Death Benefit Proceeds from the
Subaccounts will usually be made within seven days of receipt of the request at
our Customer Service Center.  However, we may postpone the processing of any
such transactions for any of the following reasons:

a)   When the New York Stock Exchange ("NYSE") is closed for trading other than
     for customary holiday or weekend closings, or trading on the NYSE is
     otherwise restricted, as determined by the SEC;

b)   When the SEC determines that an emergency exists that would make the
     disposal of securities held in the Variable Account or the determination of
     the value of the Variable Account's assets not reasonably practicable; or

c)   When the SEC by order permits a delay for the protection of Policyowners.

We may defer up to six months the payment of any Withdrawal or proceeds from the
Guaranteed Interest Account.  Interest will be credited at the currently
declared rate of interest for the Guaranteed Interest Account until payment is
made.

CONVERSION OF POLICY

At any time within the first 24 Policy months after issuance of the Policy or
after an increase in Stated Death Benefit while this Policy is in force during
the life of the Insured, the Owner may convert this Policy without evidence of
insurability for a new Policy on the life of the Insured providing benefits
which do not vary with the investment experience of the Variable Account.  This
conversion is accomplished by the transfer of the entire amount in the
Subaccounts of the Variable Account to the Guaranteed Interest Account and the
allocation of all future premium payments to the Guaranteed Interest Account.
This will, in effect, serve as a conversion of the Policy to the equivalent of a
flexible premium universal life insurance policy. No charge will be imposed on
the transfer in exercising this exchange privilege.  The exchange will be
subject to the following conditions:

       (1) The new Policy will be on the flexible premium adjustable life
           insurance plan that was being issued by Southland on the date of
           issue of this Policy.
    
       (2) The new Policy will provide the same amount of death benefit or the
           same net amount at risk to Southland as this Policy and will have the
           same Policy Issue Date and issue Age as this Policy.      
       (3) The cost of insurance rates for the new Policy will be those
           applicable to flexible premium adjustable life policies in the same
           risk classification as this Policy and issued on the same date as the
           Policy.
       (4) All Policy Debt under this Policy must be paid.

                                       28
<PAGE>
 
The contestable period, suicide period, and surrender charge period of the new
Policy will be measured from the Policy Date.  The Accumulation Value of this
Policy will be transferred to the new Policy as of the effective date of the
conversion.  The effective date of the conversion will be the date Southland
received Written Request for conversion at its Customer Service Center.  When
exercising your conversion right, you are required to return the Policy to our
Customer Service Center, and we will send to you a new policy form which will
not allow you to allocate future premiums to Portfolios of the Variable Account.

HOW BENEFITS ARE PAID

Any payment of proceeds of this Policy will be made in a lump sum payment unless
you request an alternate method.  You may request any of the alternate payment
options listed below if you prefer.

Selecting an Optional Payment
To select an option, send Written Notice to our Customer Service Center.
Payment under any option must be at least $20.  Payment under these options to
any assignee, executor, administrator, trustee, corporation or association
cannot be made without our consent.

If you die while receiving payments, any remaining payments will be paid as a
lump sum to your estate.  If payments are being made to the beneficiary and he
or she dies, any remaining payments will be paid as a lump sum to the
beneficiary's estate.

- --Option 1:  Fixed Period - Equal payments for a fixed period of up to 25 years.
The longer the period, the lower the payments.  Monthly payments per $1,000 are
shown in Table 1.

- --Option 2:  Life Income - Equal payments for life.  The longer the certain
period, if any, the lower the payments.  Monthly payments per $1,000 are shown
in Table 2.

- --Option 3:  Interest Only - Equal payments of 4% interest on the amount left
with us.  That amount must be at least $1,000.

- --Option 4:  Fixed installments - Equal payments totaling at least $60 per year
for each $1,000.  The larger the amount, the shorter the period of payments.

Additional and more favorable forms of payment may be available at the time an
option is selected.

Provisions Relating to Options 1, 3, and 4
Payments made under this option are based on guaranteed compound interest at a
rate of 4% per year.  They will be increased during any certain or guaranteed
periods by any excess interest earnings we declare.  If death occurs during a
certain or guaranteed period, the lump sum payable to the deceased's estate will
be equal to the value of the remaining guaranteed payments reduced by compound
interest at 4% per year.

                                       29
<PAGE>
 
<TABLE>
<CAPTION>
                           SETTLEMENT OPTION TABLE I
 
                         (Per $1,000 of Net Proceeds)
 
No. of Years              Monthly         No. of Years        Monthly
 Payable                Installments        Payable         Installments
<S>                        <C>                 <C>              <C>
    1                      $84.47              16               6.53
    2                       42.86              17               6.23
    3                       28.99              18               5.96
    4                       22.06              19               5.73
    5                       17.91              20               5.51
 
    6                       15.14              21               5.32
    7                       13.16              22               5.15
    8                       11.68              23               4.99
    9                       10.53              24               4.84
   10                        9.61              25               4.71
 
   11                        8.86              26               4.59
   12                        8.24              27               4.47
   13                        7.71              28               4.37
   14                        7.26              29               4.27
   15                        6.87              30               4.18
</TABLE>

                                       30
<PAGE>
 
<TABLE>
<CAPTION>
                                                    SETTLEMENT OPTION TABLE II
                                                                                                                    
                                                   (Per $1,000 of Net Proceeds)                                     
                                                                                                                    
                                                                                                                    
                                                             Age of                                                 
                                                              Payee                                                 
    Age of Payee                                             Nearest                                                
  Nearest Birthday                                           Birthday                                               
    When  First                                             When First                                              
    Installment                                             Installment                                             
    is Payable               Monthly Installment             is Payable           Monthly Installments              
                                                                                                                    
                                  10       15         20                                 10        15       20                      
                     5 Years    Years     Years     Years                    5 Years    Years     Years    Years                   
Male        Female   Certain    Certain   Certain   Certain  Male   Female   Certain   Certain   Certain  Certain                 
<S>          <C>     <C>        <C>       <C>       <C>       <C>     <C>     <C>       <C>      <C>      <C>                     
15           20      2.94       2.94      2.94      2.93      33      38      3.36      3.35     3.34     3.33                 

16           21      2.96       2.95      2.95      2.95      34      39      3.39      3.39     3.38     3.36                 

17           22      2.97       2.97      2.97      2.96      35      40      3.43      3.42     3.41     3.40                 

18           23      2.99       2.99      2.99      2.98      36      41      3.46      3.46     3.45     3.43                 

19           24      3.01       3.01      3.00      3.00      37      42      3.50      3.50     3.48     3.47                 

20           25      3.03       3.02      3.02      3.02      38      43      3.54      3.54     3.52     3.50                 

21           26      3.05       3.04      3.04      3.04      39      44      3.59      3.58     3.56     3.54                 

22           27      3.07       3.06      3.06      3.06      40      45      3.63      3.62     3.61     3.58                 

23           28      3.09       3.08      3.08      3.08      41      46      3.58      3.67     3.65     3.62                 

24           29      3.11       3.11      3.10      3.10      42      47      3.73      3.72     3.70     3.66                 

25           30      3.13       3.13      3.13      3.12      43      48      3.78      3.77     3.74     3.71                 

26           31      3.16       3.15      3.15      3.14      44      49      3.84      3.82     3.79     3.75                 

27           32      3.18       3.18      3.17      3.17      45      50      3.89      3.88     3.84     3.80                 

28           33      3.21       3.20      3.20      3.19      46      51      3.95      3.93     3.90     3.85                 

29           34      3.23       3.23      3.23      3.22      47      52      4.01      3.99     3.95     3.90                 

30           35      3.26       3.26      3.25      3.25      48      53      4.08      4.05     4.01     3.95                 

31           36      3.29       3.29      3.28      3.27      49      54      4.15      4.12     4.07     4.00                 

32           37      3.32       3.32      3.31      3.30      50      55      4.22      4.19     4.13     4.06                 
</TABLE>

                                       31
<PAGE>
 
<TABLE>
<CAPTION>
                                                    SETTLEMENT OPTION TABLE II
                                                            (Continued)

                                                   (Per $1,000 of Net Proceeds)                                    
                                                                                                                   
                                                             Age of                                                
                                                              Payee                                                
    Age of Payee                                             Nearest                                               
  Nearest Birthday                                           Birthday                                              
    When  First                                             When First                                             
    Installment                                             Installment                                            
    is Payable               Monthly Installment             is Payable           Monthly Installments             
                                                                                                                   
                                  10       15         20                                 10        15       20      
                     5 Years    Years     Years     Years                    5 Years    Years     Years    Years    
Male        Female   Certain    Certain   Certain   Certain  Male   Female   Certain   Certain   Certain  Certain   
<S>          <C>     <C>        <C>       <C>       <C>       <C>     <C>     <C>       <C>      <C>      <C>       
51           56      4.29       4.26      4.20      4.11      69      74      6.70      6.35     5.81     5.21                    

52           57      4.37       4.33      4.27      4.17      70      75      6.93      6.52     5.91     5.25                     

53           58      4.45       4.41      4.34      4.23      71      76      7.16      6.69     6.01     5.29                      

54           59      4.54       4.49      4.41      4.29      72      77      7.41      6.86     6.10     5.33                      

55           60      4.63       4.58      4.49      4.36      73      78      7.67      7.04     6.19     5.36                      

56           61      4.73       4.67      4.57      4.42      74      79      7.95      7.22     6.27     5.38                      

57           62      4.83       4.76      4.65      4.48      75      80      8.24      7.39     6.34     5.41                      

58           63      4.94       4.87      4.74      4.55      76      81      8.55      7.57     6.42     5.43                      

59           64      5.05       4.97      4.82      4.61      77      82      8.87      7.74     6.48     5.45                      

60           65      5.18       5.08      4.92      4.68      78      83      9.20      7.91     6.54     5.46                      

61           66      5.31       5.20      5.01      4.75      79      84      9.54      8.08     6.59     5.47                      

62           67      5.45       5.32      5.11      4.81      80      85      9.90      8.24     6.64     5.48                      

63           68      5.60       5.45      5.21      4.87      81             10.27      8.39     6.68     5.49                      

64           69      5.76       5.59      5.31      4.94      85             10.64      8.53     6.72     5.50                      

65           70      5.92       5.73      5.41      5.00      83             11.02      8.66     6.75     5.50                      

66           71      6.10       5.88      5.51      5.05      84             11.41      8.79     6.77     5.51                      

67           72      6.29       6.03      5.61      5.11      85             11.79      8.90     6.80     5.51                      

68           73      6.49       6.19      5.71      5.16                     
</TABLE>

                                       32

<PAGE>
 
                                                                Exhibit 1A(5)(b)

                        ADJUSTABLE TERM INSURANCE RIDER



This Rider is a part of the Policy to which it is attached if this Rider is
shown in the Schedule.  This Rider must be read with all Policy provisions.
This Rider does not participate in our surplus earnings.  This Rider has no loan
provision or Cash Surrender Value.  This Rider starts as of the Policy Date or,
if added later, the Monthly Processing Date as of or next following the date
your application for this Rider is approved by us.

THE DEATH BENEFIT

Subject to all the Rider's terms and upon receipt of due proof that the Insured
died while this Rider was in force, we will determine the benefit payable to the
Beneficiary which will provide the Target Death Benefit.

The amount of the term death benefit is the difference, at the time of the
determination of Death Proceeds, between the Target Death Benefit and the Base
Death Benefit provided by the Policy.  In no event will this benefit be less
than zero.  It is not increased or decreased by Policy Loan activity.  For
example, if the Target Death Benefit is $100,000 at the time of determination
and the Base Death Benefit is $60,000 at the time of determination, this Rider's
death benefit is $40,000.

The Target Death Benefit is shown in the Schedule attached to your Policy.  It
may be a constant amount or it may change at the beginning of a Policy Year.
The maximum amount of Target Death Benefit at issue is equal to five times the
Stated Death Benefit of your Policy.  The Target Death Benefit may be reduced if
there is a Withdrawal.  If a Withdrawal reduces the Base Death Benefit of your
Policy, the Target Death Benefit for the current year and all future years will
be reduced by an amount equal to the reduction to the Base Death Benefit and you
will receive a new Schedule reflecting the new Target Death Benefit.  See your
Policy for details.

The Base Death Benefit provided by your Policy is defined in your Policy.

DEFINITIONS

The Insured means the person Insured under the Policy to which this Rider is
attached.

SURRENDER CHARGE

There is no Surrender Charge applicable to this Rider.
<PAGE>
 
COST OF INSURANCE

The cost of insurance for each coverage segment of this Rider is determined on a
monthly basis. The cost is added to the Policy's monthly deduction from the
Accumulation Value as of each Monthly Processing Date until this Rider
terminates. The cost of insurance rates will be determined by us from time to
time. They will be based on the issue Age and Premium Class of the Insured for
the segment, as well as the duration since the Policy Date or since the coverage
began. The cost of insurance for each Rider segment is calculated as the monthly
cost of insurance rate applicable to the segment multiplied by the death benefit
for the segment.

The monthly guaranteed maximum cost of insurance rates per $1,000 for this Rider
are shown in the Schedule on the Target Death Benefit Schedule attached to your
Policy.

OWNER

The Owner of the Policy is the Owner of this Rider.

INCONTESTABILITY

After this Rider has been in force during the Insured's life for two years from
the Policy Date, we will not contest the statements in the application for this
Rider attached at the time the Rider is issued.

After this Rider has been in force during the Insured's life for two years from
the effective date of any increase in the amount of insurance, we will not
contest the statements in the application for the increase.

After this Rider has been in force during the Insured's life for two years from
the effective date of any reinstatement of the Rider, we will not contest the
statements regarding the Insured in the application for such reinstatement of
this Rider.

SUICIDE EXCLUSION

If the Insured commits suicide, while sane or insane, within two years of the
Rider effective date, we will make a limited payment to the Beneficiary. We will
pay in one sum the amount of the cost of insurance for this Rider which was
deducted from the Accumulation Value. If the Insured commits suicide, while sane
or insane, within two years of the effective date of any increase in the amount
of insurance under this Rider, we will make a limited payment to the Beneficiary
for the increase. This payment will equal the cost of insurance which was
deducted from the Accumulation Value for the Increased portion of the death
benefit.

MISSTATEMENT OF AGE

                                       2
<PAGE>
 
If the Insured's Age has been misstated, any amount payable by us will be
adjusted. The amount payable will be that which the cost of insurance which was
deducted from the Accumulation Value as of the last Monthly Processing Date
prior to the death of the Insured would have purchased for the Insured's correct
Age.

CHANGE IN AMOUNT OF COVERAGE

On any Policy Anniversary after the first Rider anniversary, the Target Death
Benefit under this Rider may be changed. The Target Death Benefit may be
increased or decreased by sending a Written Request to our Customer Service
Center. Any request for increased death benefits will automatically be an
increase to the Stated Death Benefit as well as to the Target Death Benefit
unless you specifically request an increase to only the Target Death Benefit.
You may increase or decrease the Target Death Benefit only during the 30-day
period preceding a Policy Anniversary. You may not increase insurance coverage
provided by this Rider after the Insured is Age 76. Any change in coverage may
not be for an amount less than $10,000. Such change is subject to the following
conditions:

     a)  Any decrease will reduce the insurance under this Rider in the
         following order:

         i)    against insurance provided by the most recent increase;
         ii)   against the next most recent increase successively; and
         iii)  against insurance provided under the original application.

     b)  Any request for an increase must be applied for on a supplemental
         application. The increase is subject to evidence satisfactory to us
         that the Insured is still insurable according to our normal rules of
         underwriting for this type of Policy. An increase will also be subject
         to the existence of sufficient Net Cash Surrender Value to cover the
         monthly deduction for the next two months. The maximum amount of Target
         Death Benefit after an increase is equal to 5 times the Stated Death
         Benefit of your Policy.

     c)  For any increase or addition to coverage, the effective date will be
         the Policy anniversary that falls on or next follows the date the
         supplemental application is approved by us. For any decrease in
         coverage, the effective date will be the Policy anniversary that falls
         on or next follows receipt of the Written Request to reduce coverage.
         For any change in coverage, a supplemental Schedule will be issued.

     d)  Any increase to the Target Death Benefit will create a new coverage
         segment of Adjustable Term Insurance Rider. The new segment will be
         equal to the new Target Death Benefit, minus the Base Death Benefit,
         minus the amount of Adjustable Term Insurance Rider attributable to the
         Target Death Benefit prior to the increase. The new segment will no
         event be less than zero. Each coverage

                                       3
<PAGE>
 
         segment will have a unique cost of insurance rate based on the
         Insured's Age and Premium Class and smoker status at the time of the
         increase, the Insured's sex, and the duration since the increase.

TERMINATION

This Rider will terminate on the earliest of the following dates:

1.  the termination of the Policy;
2.  Written Request from you to cancel this Rider;
3.  the Policy Anniversary nearest the 100th birthday of the Insured.

Any deduction for the cost of insurance after termination of this Rider will not
be considered a reinstatement of this Rider nor a waiver by us of the
termination. Any such deduction will be credited to the Accumulation Value of
the Policy as of the date of the deduction.

REINSTATEMENT

If you reinstate your Policy under the reinstatement provisions provided in the
Policy, this Rider will be reinstated.

Signed for the Company at Atlanta, Georgia.

SOUTHLAND LIFE INSURANCE COMPANY



SECRETARY

                                       4

<PAGE>
 
                                                                Exhibit 1A(5)(c)

                        ACCIDENTAL DEATH BENEFIT RIDER


Benefit
This benefit is part of your Policy.  It provides that, if the Insured dies as
the result of an accident, we will pay the accidental death amount then in
effect.  This benefit takes effect on the date shown on your Policy Schedule.
Except as provided below, this benefit is subject to all the terms of your
Policy.

This benefit will end on the first to occur of:
     1.  the Policy Anniversary nearest the Insured's 70th birthday;
     2.  Policy maturity;
     3.  Policy termination; or
     4.  receipt by us of proper Written Request.


Description
If we receive proof of the Insured's accidental death, we will pay the
accidental death amount in effect on that date to the beneficiary.  The amount
in effect on the effective date is shown on your Policy Schedule.

The accidental death amount may be increased, subject to proof of insurability,
or decreased on any Monthly Processing Date.  The change in the accidental death
amount must be for an amount at least $5,000 and the accidental death amount may
not fall below $5,000.

The accidental death amount cannot be more than the Stated Death Benefit.  If
the Stated Death Benefit is decreased below the accidental death amount, we will
automatically reduce the accidental death amount to the same level.

Accidental death is death directly and solely resulting from a bodily injury
caused by external accidental means.  This injury must be evidenced by a visible
wound or bruise except in the case of drowning or internal injuries revealed by
an autopsy.

This benefit has no loan or cash values.


Limitations and Exclusions
Death must occur within 6 months of the injury and before the Policy Anniversary
on or nearest the insured person's 70th birthday.  We will not pay an accidental
death benefit if death is in any way the result of:

     1.  disease or infirmity, or its treatment;
     2.  suicide or attempted suicide;
     3.  sensitivity to or overdose of drugs or taking poison;
     4.  war, declared or undeclared, including acts of aggression by any
         country;
     5.  committing an assault or felony;
     6.  infection, other than of a wound caused by accidental means;

                                       1
<PAGE>
 
     7.  flight or travel in, or descent from, any military or naval aircraft,
         flight training, or any flight where the Insured was a pilot or crew
         member.

We shall have the right and opportunity to examine the body if a claim is made.
We may also wish to make an autopsy if allowed by law.  No autopsy will be made
unless we notify the claimant within 30 days after receipt of the claim notice.

Cost of This Benefit
The cost of this benefit is deducted as part of the cost of insurance for your
Policy.  It is included in the monthly deduction for extra benefits.

The maximum amount of this benefit's cost included in that deduction is the
factor shown in the following table of Guaranteed Accidental Death Factors
multiplied by the accidental death amount as of that Policy month.
<TABLE>
<CAPTION>
 
- --------------------------------------------------------------------------------
                      Guaranteed Accidental Death Factors
                  (for determining maximum cost of insurance)
                      Standard or Preferred Rating Class
- --------------------------------------------------------------------------------
     Attained           Monthly           Attained               Monthly
       Age              Factor              Age                  Factor
<S>                   <C>                 <C>                   <C>
- --------------------------------------------------------------------------------
       5-18              .08                53-56                 .11
- --------------------------------------------------------------------------------
      19-28              .09                57-60                 .12
- --------------------------------------------------------------------------------
      29-36              .08                61-64                 .13
- --------------------------------------------------------------------------------
      37-46              .09                65-67                 .14
- --------------------------------------------------------------------------------
      47-52              .10                68-69                 .15
- --------------------------------------------------------------------------------
</TABLE>

(The maximum monthly cost of insurance for this benefit is the appropriate
factor from above times the Insured's rating factor for this benefit times the
number of $1,000's of accidental death benefit amount.)

Signed for the Company at Atlanta, Georgia.

SOUTHLAND LIFE INSURANCE COMPANY



SECRETARY

                                       2

<PAGE>
                                                                Exhibit 1A(5)(d)

                       ADDITIONAL INSURED BENEFIT RIDER

Person insured by this Rider       [                ]

Benefit
This benefit is part of your Policy.  Except as provided below, this benefit is
subject to all the terms of your Policy.  It provides additional term insurance
on the person shown above.  This benefit takes effect on the effective date
shown on your Policy Schedule.

This benefit will terminate on the first to occur of:
     1.  the Policy Anniversary nearest the 100th birthday of the Insured;
     2.  the Policy Anniversary nearest the 100th birthday of the additional
         insured;
     3.  the Valuation Day on which the conversion option is exercised; or
     4.  Policy termination.

No extra benefits apply to the Insured under this benefit.

Description
We will pay to the Beneficiary the additional term insurance amount applicable
to the person covered under this benefit upon receipt of proof that the person
died while coverage was in force.

Payment of proceeds will be increased by any interest in the same manner as
provided by your Policy.  We may deduct from the payment any monthly deduction
for this benefit that is unpaid in the grace period.

This benefit has no loan or cash value.

Cost of This Benefit
The cost of this benefit is deducted as part of the cost of insurance for your
Policy.  It is included in the monthly deduction for extra benefits.

The maximum amount of this benefit's cost included in the monthly deduction is
the maximum cost of insurance for the person covered.  The person's cost is the
term amount multiplied by the cost of insurance rate.  The maximum cost of
insurance rate is that defined in your Policy for the sex, attained age and
rating class of the covered person for the term amount at issue and for each
increase in term amount.

Changes in Insurance Coverage
Coverage under this benefit may be increased or decreased by your Written
Request subject to the following:
     1.  Any change in coverage under this benefit must be for an amount of at
         least $5,000.
     2.  Any decrease will become effective on the Monthly Processing Date
         on or next following the date we receive the request.  The new term
         amount cannot be less than the minimum

                                       1
<PAGE>
 
         amount for this benefit shown on the Policy Schedule.  The decrease
         shall reduce insurance in the following order: 

           a.  insurance provided by the most recent increase;
           b. the next most recent increase in succession; and
           c. insurance provided under the original application.

     3.  Any request for an increase must be applied for on a supplemental
         application. The term amount cannot be more than the Stated Death
         Benefit in effect on the Insured under your Policy. An increase shall
         be subject to proof of insurability satisfactory to us. Any benefit
         increase will be effective on the Monthly Processing Date after our
         approval.

If the Stated Death Benefit of the Insured is decreased below the term amount in
effect for this benefit, we will automatically reduce that term amount to the
level of the new Stated Death Benefit.

Conversion Privilege before Age 65
This benefit may be converted to a new policy on any Monthly Processing Date
prior to attained age 70 of the additional insured or within 30 days following
the death of the Insured.  Conversion may be to any plan of fixed or variable
life insurance that we offer for sale at that time.  Proof of insurability is
not required unless the amount of coverage on the new policy exceeds the
coverage provided by this benefit, or if the additional insured adds a Rider to
the new Policy.

The Stated Death Benefit of a person's new policy may be any amount up to the
term amount.  The Stated Death Benefit cannot be less than our required minimum
Stated Death Benefit on the new policy's issue date.  The issue age will be the
person's age nearest birthday on that date.

During the conversion period, the insurance that is to terminate will continue
in effect.  All coverage under this benefit will end at the end of the
conversion period and any new policy will become effective then.

The premium rating class of the new policy will be based on the person's rating
class for this benefit.  The actual premium will be from the schedule of premium
rates then in effect.

No Riders may be included in the new policy without our consent.

Suicide
If the person covered under this benefit commits suicide within the first two
Policy Years from the effective date of this benefit, our total liability for
that person will be the cost of insurance for that person.

If the covered person commits suicide within two years from the effective date
of any increase in coverage, our total liability with respect to the increase
will be the cost of such increase.

                                       2
<PAGE>
 
Incontestability
We cannot contest the person's coverage under this benefit after the coverage
has been in force two full Policy Years, during that person's lifetime.  We
cannot contest any increase in coverage after that increase has been in force
two full Policy Years during that person's lifetime.

Reinstatement
This benefit may be reinstated according to the same rules we require for your
Policy.  We require satisfactory proof that the person covered is insurable.

Age and Sex Misstatement
The amount of the person's insurance under this benefit is based on that
person's age nearest birthday and sex on the effective date of coverage under
this benefit.  If the age or sex shown for this benefit is wrong, the amount of
insurance will be adjusted.  The adjusted death benefit will be that which would
be purchased by the most recent cost of insurance charge at the correct age and
sex.

Beneficiary
The beneficiary of proceeds payable upon the death of the person covered under
this benefit is named on the Policy Schedule in the section which describes this
benefit.  Unless otherwise provided, the interest of any beneficiary who dies
before the covered insured person will be paid in equal shares to the surviving
beneficiaries.

Proceeds payable on a person's death will be paid to his or her estate if no
beneficiary of this benefit survives.  The beneficiary may be changed as
permitted by your Policy.

Signed for the Company at Atlanta, Georgia.

SOUTHLAND LIFE INSURANCE COMPANY


SECRETARY

                                       3

<PAGE>
 
                                                                Exhibit 1A(5)(e)

                      CHILDREN'S INSURANCE BENEFIT RIDER

Benefit
This benefit is part of your Policy.  It provides term insurance as shown on the
Policy Schedule on an insured child as defined below.  Except as provided below,
this benefit is subject to all the terms of your Policy.

This benefit takes effect on the effective date shown on your Policy Schedule.
This benefit will end on the Policy Anniversary nearest the Insured's 65th
birthday.

Each child's coverage terminates on the Policy Anniversary nearest his or her
22nd birthday unless this benefit has terminated.

Description
We will pay the insured child's term amount to the beneficiary upon receipt of
proof that the insured child died while this benefit is in force. We may deduct
from the payment any monthly deduction due for this benefit that is unpaid in
the grace period.

Each insured child's term amount is shown on your Policy Schedule.

Payment of proceeds will be increased by any interest in the same manner as
provided by your Policy.

This benefit has no loan or cash values.

Cost of This Benefit
The cost of this benefit is deducted as part of the cost of insurance for this
Policy. It is part of the monthly deduction for extra benefits.

The maximum monthly term cost of this benefit is $1.00 per unit times this
benefit's rating factor shown on the Policy Schedule.

Definition of Insured Child
"Insured Child" means the following:

     1.  a child, born to or adopted child by the Insured who is named in the
         application for this Rider.  On the date of the application, such child
         must be older than 7 days of age and less than 18 years of age;

     2.  any child born to or adopted by the Insured who was living at the time
         of the application, but not yet 8 days of age. The child will be
         insured upon attaining the age of 8 days.

     3.  any child born to or adopted by the Insured after the Rider effective
         date. The child will be insured upon attaining the age of 8 days.
<PAGE>
 
Automatic Paid-up Term Policies
If the Insured dies while this benefit is in force, we will issue paid-up term
policies in exchange for this benefit to insure each insured child covered at
the Insured's death. The amount of insurance will be the same as would have been
provided under this benefit.

Each insured child's coverage under the paid-up policies will end on the first
to occur of:
          1.  the Policy Anniversary nearest age 22; or
          2.  the Policy Anniversary nearest the Insured's 65th birthday
          (assuming the Insured had survived).

After the paid-up term policy is issued, any applicable cash value information
will be available upon Written Request.

Conversion Privilege
Each insured child may convert this benefit's coverage to fixed or variable life
coverage without proof of insurability. This benefit must be in force with no
monthly deduction past due.

The premium class of the converted policy will be based on the rating class of
this benefit. The premium will be our rate in effect for the plan and amount of
the new policy on its issue date.

The converted policy may be any fixed or variable plan of life insurance that we
offer for sale. The request must be dated on or after such child's 18th birthday
and not later than 31 days after his or her 22nd birthday.  The request and
first premium must be received by the Company during the insured child's
lifetime.  The issue date of the converted policy will be the date we receive
the application and premium.  The issue age will be the insured child's age
nearest birthday on the new Policy's issue date.  The owner of the Policy will
be the insured child.  The Stated Death Benefit of the converted policy can be
up to five times the insured child's term amount.  The Stated Death Benefit  of
the new policy cannot be less than the minimum required for that Policy.  No
additional Riders can be added to the new policy.

An insured child who converts prior to the 22nd birthday will continue to be
covered under this benefit until that birthday, while this benefit is in force.
This conversion privilege also applies to the paid-up term insurance described
above.

Reinstatement
This benefit may be reinstated according to the same rules as we require for
your Policy.  We require satisfactory proof that each insured child is insurable
as well as the Insured under your Policy.

Age and Sex Misstatement
If this benefit is based on any wrong age or sex, the insurance amount will be
changed to what would have been issued based on the correct age and sex.

Incontestability and Suicide
We cannot contest this benefit after it has been in force for two full years:
<PAGE>
 
          1.  unless the Insured dies within the two years; or

          2.  unless any insured child dies within the two years from the
              effective date of the Policy, in which case only the insurance of
              the deceased child can be contested after the two years.

If the insured person commits suicide within the two years, any liability is as
stated in the Policy.  We will have no obligation under this benefit under
either the "Automatic Paid-up Term Policies" or "Conversion Privilege"
provisions.

The two year period begins on the effective date of this benefit.

Beneficiary
The beneficiary of proceeds of this benefit is the Insured, if living.
Otherwise, proceeds will be paid to the insured child's estate.  The beneficiary
may be changed as permitted by your Policy.

Signed for the Company at Atlanta, Georgia.

SOUTHLAND LIFE INSURANCE COMPANY

SECRETARY

<PAGE>
 
                                                  Exhibit 1A(5)(F)


                           EXCHANGE OF INSURED RIDER

Benefit
This Rider and the benefit it provides is a part of the Policy to which it is
attached if the Rider is shown in the Schedule.  It must be read with all Policy
provisions.  This Rider does not participate in our surplus earnings.  This
Rider has no loan or Cash Surrender Value.  This Rider effective date is the
Policy Date or, if added later, the Policy Anniversary on or next following the
date the application for this Rider is approved by us.

Description
While this Rider is in force, you may elect to exchange the current named
Insured under the Policy for a new Insured.  The Policy will be continued on the
life of the new Insured.

Requirements for Exchange
Before exchange takes place, we must have all of the following:

1.   An application for insurance signed by you and the new Insured;

2.   The Policy returned by you for the appropriate changes;

3.   Evidence that you have an insurable interest in the new Insured;

4.   Evidence of the new Insured's insurability satisfactory to us;

5.   Evidence of the release of any collateral assignment, or written
     approval of the exchange by an assignee, plus other papers we may need;
     and,

6.   Payment of any applicable exchange charges.

Effective Date of Change
The Date of Exchange will be the Monthly Processing Date which coincides with or
next follows the date our requirements are met.  Coverage on the current named
Insured will end on the day before the Date of Exchange.  Coverage on the new
Insured will begin on the Date of Exchange.

Policy Date
The Policy date of the Policy will not change unless the new Insured was born
after the Policy's current Policy Date.  In that event, the new Policy Date will
be the first anniversary of the Policy next following the birth date of the new
Insured.

Taxation
Under current federal tax law, the exercise of this rider is taxed as if the
policy was surrendered in full for cash.  The Owner may realize taxable income
in such event.

                                       1
<PAGE>
 
Stated Death Benefit of New Policy
The Stated Death Benefit of the Policy will remain the same unless increased or
decreased as provided in the Change in Requested Insurance Coverage provision of
the Policy.  On and after the Date of Exchange, the minimum Death Benefit amount
as stated in the Death Benefit provision of the Policy will apply to the new
Insured.

Cost of Insurance Deductions
After the Date of Exchange, the cost of insurance for the Policy will be based
on the Policy year and the new Insured's sex, attained age, rate class, and the
cost of insurance rates described in the Policy.  No cost of insurance deduction
is made for this Rider.  If any other riders are attached to the Policy on or
after the Date of Exchange, the cost of insurance for the other riders will be
as described in the riders.

Account Values And Policy Loans
The Account Value of the Policy at the time of exchange will remain the same
unless withdrawn as provided in the Policy.  Any Policy loan on the Policy at
the time of exchange will be continued unchanged.

Owner, Beneficiary, and Collateral Assignments
The Owner and Beneficiary of the Policy will remain the same unless changed as
provided in the Policy.  The Policy will remain subject to any existing
collateral assignments.

Riders
Any Riders attached to the Policy will terminate on the day before the Date of
Exchange.  The addition of any riders on or after the Date of Exchange will be
subject to our approval and such terms as we determine.

Incontestability
The incontestable provision stated in the Policy will be applicable to the
Policy for two years from the Date of Exchange as to any representatives which
induced as to make the exchange.  On and after the Date of Exchange, the phrase
"Policy Date" in the incontestability provision of the Policy will be construed
to mean "Date of Exchange."

Suicide Exclusion
The suicide exclusion provision stated in the Policy will be applicable to the
Policy for two years from the Date of Exchange.  On and after the Date of
Exchange, the phrase "Effective Date" in the Suicide Exclusion provision of the
Policy will be construed to mean "Date of Exchange."

Termination
This Rider will terminate on the earliest of the following events:

1.   The termination or surrender of the Policy;

                                       2
<PAGE>
 
2.   The Policy matures;

3.   The right to exchange is exercised; or

4.   The receipt by us of a Written Request from you to cancel this Rider on
     any Monthly Processing Date.

     Signed for the Company at Atlanta, Georgia.

     SOUTHLAND LIFE INSURANCE COMPANY


     SECRETARY

                                       3

<PAGE>
 
                                                                Exhibit 1A(5)(g)


                     GUARANTEED INSURABILITY BENEFIT RIDER

Benefit
This benefit is part of your Policy.  It takes effect on the date shown on your
Policy Schedule.  Except as provided below, this benefit is subject to all the
terms of your Policy.

This benefit will end on the first to occur of:

          1.  the Policy Anniversary nearest the Insured's 40th birthday;
          2.  Policy maturity;
          3.  Policy termination; or
          4.  receipt by us of proper Written Request to terminate this benefit.

Description

You may increase the Stated Death Benefit of your Policy on the regular or
special option dates as defined below. These increases may be made regardless
of the Insured's health and occupation. An option date must occur after the
effective date of this benefit.

The effective date of any increase will be the option date.  The premium rating
class of the increase will be the same as your Policy.

If premiums or the cost of insurance are being waived on an option date under
another Rider, we will continue to waive the premium or cost of insurance until
they are no longer waived under the waiver Rider.

This benefit has no loan or cash values.

Regular Option Dates
A regular option date occurs on the Policy Anniversary nearest the Insured's
22nd, 25th, 28th, 31st, 34th, 37th, and 40th birthdays.

In addition, you may take an additional regular option date on your first or
second Policy Anniversary, but not both.

Special Option Dates
A special option date will occur on:
          1.  the date of the Insured's first marriage;
          2.  the date of birth of each child born to the Insured; and
          3.  the date of adoption of each child adopted by the Insured.

Multiples of maximum amounts of insurance will be available for multiple births.
If you exercise a special option, the next regular option date will be canceled.
If you exercise another special option, the next following regular option that
has not been canceled will be canceled.  If multiple option dates are exercised
due to multiple births, the corresponding multiple future option dates will be
canceled.
<PAGE>
 
Exercising an Option

To exercise an option you must send us written application.  If the option is a
regular option date, we must receive the application within a period of 60 days
before and 30 days after the regular option date.  If the option is a special
option date, we must receive the application within 30 days after the special
option date along with proof of the marriage, birth or adoption.  Written
application must reach the Company during the Insured's lifetime.

The amount of each increase in Stated Death Benefit cannot be less than $10,000
or more than the insurability amount shown for this benefit.  If the Stated
Death Benefit under this Policy is decreased below the insurability amount, we
will automatically reduce the insurability amount to the same level.

Limitations and Exclusions
We will not issue an increase under this benefit unless:
          1.  the Insured gives consent; and
          2.  you have an insurable interest in the Insured.

Cost of this Benefit
The cost of this benefit is deducted as part of the cost of insurance for your
Policy.  It is included in the monthly deduction for extra benefits.

The maximum amount of this benefit's cost included in that deduction is the
factor in the following table of Guaranteed Insurability Factors multiplied by
the insurability amount.
<TABLE>
<CAPTION>
 
                        Guaranteed Insurability Factors
                  (for determining maximum cost of insurance)
Attained Age      Monthly Factor       Attained Age       Monthly Factor
<S>               <C>                  <C>                <C>
    0-4                 .04                29-30               .11
    5-8                 .04                31-32               .12
    9-12                .05                33-34               .13
   13-15                .05                35-36               .14
   16-18                .07                 37                 .15
   19-23                .08                 38                 .17
   24-26                .09                 39                 .19
   27-28                .10
</TABLE>

(The maximum monthly cost of insurance for this benefit is the appropriate
factor from above times the number of $1,000's of insurability amount.)

Signed for the Company at Atlanta, Georgia.

SOUTHLAND LIFE INSURANCE COMPANY


SECRETARY

                                       2

<PAGE>
 
                                           Exhibit 1A(5)(h)


                   WAIVER OF COST OF INSURANCE BENEFIT RIDER

Benefit
This benefit is part of your Policy.  It provides that, if the Insured becomes
totally disabled, each month we will waive the monthly deductions for your
Policy and treat it as if you had paid this amount to us.  This benefit takes
effect on the date shown your Policy Schedule.  Except as provided below, this
benefit is subject to all the terms of your Policy.
 
This benefit will end on the first to occur of:
     1.  the Policy Anniversary on or nearest the Insured's 60th birthday;
     2.  Policy maturity;
     3.  Policy termination; or
     4.  receipt by us of proper Written Request.

Description
We will waive the monthly deductions described in your Policy when we receive
proof of the Insured's total disability.  Monthly deductions will be waived only
if the total disability:
     1.  occurs before the Policy Anniversary on or nearest the Insured's 60th
         birthday; and
     2.  lasts continuously for at least 6 months.

We will waive the monthly deductions from the first Monthly Processing Date
after the disability started.  We will not waive the monthly deduction that
applies to any increase in coverage that occurs or to any benefits added during
disability.  If monthly deductions are being waived under this benefit on the
Policy Anniversary on or nearest the Insured's 60th birthday, monthly deductions
will continue to be waived.

Policy Accumulation Value after a waiver begins will be the same as if the
amount waived had been paid each month as a premium and the same amount also
deducted as a monthly cost.  Any cost of insurance deducted after a waiver is in
effect will be credited to the Accumulation Value of the Policy.

This benefit has no loan or cash values.

Proceeds at death will not include any monthly deductions waived after the
Policy month of death.

Definition of Total Disability
Total Disability means the complete incapacity of the Insured to earn any income
or do any work for which he or she is reasonably fitted by education, training
or experience.  It must be caused by bodily injury or disease.

                                       1
<PAGE>
 
The Insured will also be considered totally disabled on:
     1.  severance of 2 limbs at or above the wrist or ankle; or
     2.  complete and permanent loss of all sight in both eyes due to injury or
         disease.

Exclusions
We will not waive the monthly deduction if total disability results in any way
from:
     1.  injury occurring or disease first manifested before this benefit was in
         force;
     2.  intentionally self-inflicted injury;
     3.  war or act of war, declared or undeclared;

Notice and Proof of Total Disability
Unless it is not possible to send proof earlier, we must receive proof of 
disability:
     1.  within one year after onset of total disability;
     2.  during the lifetime of the Insured; and
     3.  during the continuance of total disability.

Proof of Continuance of Total Disability
We will need regular proof from the Insured that he or she is still totally
disabled.  Proof may include medical exams by doctors we choose.  Waiver of the
monthly deduction will stop if:

     1.  proof is not sent when requested; or
     2.  the Insured becomes able to earn any income or do any work for which he
         or she is reasonably fitted by education, training or experience.

Notice of Recovery from Total Disability
You must give Written Notice to us if and when the Insured recovers.  This
Written Notice must be given as soon as the Insured recovers.

Cost of This Benefit
The cost of this benefit is deducted as part of the cost of insurance for your
Policy.  It is included in the monthly deduction for extra benefits.

The maximum amount of this benefit's cost included in that deduction is the
factor shown in the following table of Guaranteed Waiver of Benefit Factors
multiplied by the Policy's total monthly deduction.  The Policy's total monthly
deduction is the sum of all monthly deductions for the policy month for all
benefits except the part for this benefit.

                                       2
<PAGE>
 
<TABLE>
<CAPTION>
                                                            
         --------------------------------------------------------         
                   Guaranteed Waiver of Benefit Factors                   
                    Standard or Preferred Rating Class                    
         --------------------------------------------------------         
                     Monthly Factor              Monthly Factor           
          Attained  ----------------  Attained  -----------------         
            Age      Male    Female      Age     Male    Female           
         --------------------------------------------------------         
         <S>         <C>     <C>         <C>     <C>      <C>             
          -------------------------------------------------------         
             5       3.20%   4.80%       33      4.78%    7.17%           
          -------------------------------------------------------         
             6       3.20    4.80        34      4.88     7.33            
          -------------------------------------------------------         
             7       3.20    4.80        35      5.00     7.50            
          -------------------------------------------------------         
             8       3.20    4.80        36      5.14     7.67            
          -------------------------------------------------------         
             9       3.20    4.80        37      5.28     7.83            
          -------------------------------------------------------         
             10      3.20    4.80        38      5.44     8.01            
          -------------------------------------------------------         
             11      3.20    4.80        39      5.62     8.19            
          -------------------------------------------------------         
             12      3.20    4.80        40      5.80     8.40            
          -------------------------------------------------------         
             13      3.20    4.80        41      5.95     8.58            
          -------------------------------------------------------         
             14      3.20    4.80        42      6.09     8.75            
          -------------------------------------------------------         
             15      3.20    4.80        43      6.26     8.96            
          -------------------------------------------------------         
             16      3.26    4.88        44      6.52     9.26            
          -------------------------------------------------------         
             17      3.33    5.00        45      6.90     9.70            
          -------------------------------------------------------         
             18      3.42    5.13        46      7.43    10.34            
          -------------------------------------------------------         
             19      3.51    5.27        47      8.07    11.12            
          -------------------------------------------------------         
             20      3.60    5.40        48      8.82    11.99            
          -------------------------------------------------------         
             21      3.68    5.52        49      9.66    12.89            
          -------------------------------------------------------         
             22      3.76    5.64        50     10.60    13.80            
          -------------------------------------------------------         
             23      3.83    5.75        51     11.72    14.66            
          -------------------------------------------------------         
             24      3.91    5.87        52     12.99    15.54            
          -------------------------------------------------------         
             25      4.00    6.00        53     14.31    16.44            
          -------------------------------------------------------         
             26      4.09    6.13        54     15.61    17.39            
          -------------------------------------------------------         
             27      4.19    6.27        55     16.80    18.40            
          -------------------------------------------------------         
             28      4.30    6.41        56     17.97    19.46            
          -------------------------------------------------------         
             29      4.40    6.55        57     19.08    20.58            
          -------------------------------------------------------         
             30      4.50    6.70        58     20.04    21.77            
          -------------------------------------------------------         
             31      4.59    6.85        59     20.81    23.04            
         --------------------------------------------------------         
             32      4.69     7.0                                         
         ----------------------------                                     
</TABLE> 

(The maximum monthly cost of insurance for this benefit is the appropriate
factor from above times the Insured's rating factor for this benefit times the
Policy's total monthly deduction.)

Signed for the Company at Atlanta, Georgia.

SOUTHLAND LIFE INSURANCE COMPANY


SECRETARY

                                       3

<PAGE>
                                                                Exhibit 1A(5)(i)

                   WAIVER OF SPECIFIED PREMIUM BENEFIT RIDER

Benefit

This benefit is part of your Policy.  It provides that, if the Insured becomes
totally disabled, each month we will waive a specified amount of premium and
treat it as if you had paid this amount to us.  This benefit takes effect on the
date shown on your Policy Schedule.  Except as provided below, this benefit is
subject to all the terms of your Policy.

This benefit will end on the first to occur of:
          1.  the Policy Anniversary on or nearest the Insured's 60th birthday;
          2.  Policy maturity;
          3.  Policy termination; or
          4.  receipt by us of proper Written Request.

Description

We will waive the specified waiver amount, shown on your Policy Schedule, when
we receive proof of the Insured's total disability.  The specified amount will
be waived only if the total disability:

          1.  occurs before the Policy Anniversary on or nearest the Insured's
              60th birthday; and
          2.  lasts continuously for at least 6 months.

We will waive the specified amount from the first Monthly Processing Date after
the disability started.  If amounts are being waived under this benefit on the
Policy Anniversary on or nearest the Insured's 60th birthday, the waiver will
continue.

During any period when the specified amount is being waived, no change in
coverage may be made except as provided under any Guaranteed Insurability
Benefit.

Policy accumulation values after a waiver begins will be the same as if the
amount waived had been paid in cash each month as a premium.  Any premiums paid
in after a waiver is in effect will be credited to the Accumulation Value of
this Policy.

This benefit has no loan or cash values.

Proceeds at death will not include any amounts waived after the date of death.

Definition of Total Disability

"Total Disability" means the complete incapacity of the Insured to earn any
income or do any work for which he or she is reasonably fitted by education,
training or experience.  It must be caused by bodily injury or disease.

The applicant will also be considered totally disabled on:
          1.  severance of two limbs at or above the wrist or ankle; or
<PAGE>
 
          2.  complete and permanent loss of all sight in both eyes due to
          injury or disease.

Exclusions

Total disability which results from injury occurring or disease first manifested
before this benefit was in force, war or act of war, declared or undeclared, or
from intentionally self-inflicted injury is not covered.

Notice and Proof of Total Disability

Unless it is not possible to send proof earlier, we must receive proof of
disability:
          1.  within one year after onset of total disability;
          2.  during the lifetime of the Insured; and
          3.  during the continuance of total disability.

Proof of Continuance of Total Disability

We will need regular proof from the Insured that he or she is still totally
disabled.  Proof may include medical exams by doctors we choose.  Waiver of the
specified amount will stop if:

          1.  proof is not sent when requested; or
          2.  the Insured becomes able to earn any income or do any work for
              which he or she is reasonably fitted by education, training or
              experience.

Notice of Recovery from Total Disability

You must give Written Notice to us if and when the Insured recovers.  This
Written Notice must be given as soon as the Insured recovers.

Cost of This Benefit

The cost of this benefit is deducted as part of the cost of insurance for your
Policy.  It is included in the monthly deduction for extra benefits.

The maximum amount of this benefit's cost included in that deduction is the
factor shown on the following table of Guaranteed Waiver Benefit Factors
multiplied by the number of thousands of Stated Death Benefit shown on the
Policy Schedule.

 
                       Guaranteed Waiver Benefit Factors
                  (for determining maximum cost of insurance)
                      Monthly Waiver of Premium COI Rates
<TABLE>
<CAPTION>

             Monthly Factor                                          Monthly Factor

            Preferred &a Non-      Standard                          Preferred & Non-       Standard
Attained     Tobacco Male &        Male &           Attained         Tobacco Male &         Male &
 Age            Female             Female             Age                Female             Female
<S>              <C>                <C>               <C>                 <C>                <C>
18-30            .032               .040               43                 .082               .110
31               .035               .044               44                 .089               .120
</TABLE> 

                                       2
<PAGE>
 
<TABLE> 
<CAPTION> 
<S>              <C>                <C>               <C>                 <C>                <C>
32               .037               .049               45                 .098               .130
33               .040               .053               46                 .107               .142
34               .042               .057               47                 .120               .159
35               .044               .061               48                 .134               .179
36               .049               .066               49                 .151               .204
37               .053               .072               50                 .171               .228
38               .057               .078               51                 .191               .253
39               .061               .084               52                 .210               .277
40               .065               .089               53                 .230               .302
41               .070               .095               54                 .249               .334
42               .075               .102               55                 .269               .367
</TABLE>

(The maximum monthly cost of insurance for this benefit is the appropriate
factor from above times the number of thousands of Stated Death Benefit shown on
the Policy Schedule.)

Signed for the Company at Atlanta, Georgia.

SOUTHLAND LIFE INSURANCE COMPANY


SECRETARY

                                       3


<PAGE>
                                                                  Exhibit 1A(10)

                                             Southland Life Insurance Company
                                             Customer Service Center
                                             P. O. Box 173789
                                             Denver, CO 80217-3789
                                             1-800-224-3035

              FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE APPLICATION

                                  INSTRUCTIONS

- --------------------------------------------------------------------------------
FOR ALL APPLICATIONS         
 .  Use dark ink to complete the application. 
 .  Print LEGIBLY to avoid errors.                     
 .  Attach a complete illustration and all schedules associated with this 
   application to expedite policy issue process and ensure that the policy 
   is issued accordingly.                
 .  Incomplete applications may require an amendment to be signed upon           
   delivery, or may be returned, which will delay the issue process.    
 .  The issue state will be determined by the state in which the application    
   was signed unless otherwise directed on the Agent's Report.             
                             
SIGNATURES REQUIRED          
 .  The signature of all proposed insureds (parent or guardian of the          
   proposed insured if below age 15).                    
 .  The signature(s) of the owner.  If a corporation is the owner, one           
   officer, other than the proposed insured, should sign and indicate name 
   of corporation and title of signing officer.            
 .  The signature of the agent/registered representative.             
                             
                         APPLICATION - PART I         
SECTION A:        General Information                 
A-3:  Exercise Exchange of Insured Rider - complete this box to 
      identify policy to be exchanged and return the policy along with 
      the application and medical information on the new proposed 
      insured.
A-4:  If the application is employer sponsored, and the policy will be
      corporate owned, this question should be answered "No".
 
SECTION B:        Proposed Insured Information
B-1:  The legal name of the insured will appear on the policy as
      indicated in this space. If the applicant desires a different name 
      to appear on the policy, it must be shown in Special
      Instructions, Section M.
B-4:  Insurance age is calculated age nearest birthday.
 
SECTION C AND SECTION D:              Owner and Beneficiary
                                      Designations
 .  If you are designating more than one owner or beneficiary, use Special
   Instructions, Section O, and indicate the percentage of the split. For 
   example:
         John Doe, Husband, 70%
         Mary Doe, Mother, 30%
 
 .  If you are designating a trust as the owner or beneficiary, include the
   name of the Trustee, the name of the Trust and the date of the Trust.  
   For example:
     John Doe, Trustee, of the Revocable Life Insurance Trust of James 
     Doe, dated November 1, 1991.

SECTION C AND SECTION D (continued):              
 .  When you are designating more than one owner,  
   include the social security number or tax       
   identification number for each respective owner in
   Special Instructions, Section B.                  
 .  If you have children as owners or              
   beneficiaries, please refer to the brochure       
   entitled "Your Minor Child".                      
                                                  
SECTION F:  Special Dating Requested              
 .  This section provides an option for indicating 
   a specific age and date on which the policy       
   applied for will be issued.  This date is the     
   POLICY DATE only, and may differ from the         
   INVESTMENT DATE.                                  
                                                  
SECTION I:  Premium Information                   
I-1:  Consult your Administrator's Guide for List 
      Bill and EFT guidelines.                          
I-2:  Electronic Funds Transfer (EFT) is a premium
      payment method which the payor may elect.  If     
      selected, the premium will automatically be       
      drafted from the payor's checking account.        
                                                  
SECTION J:  Fund Transfers                        
J-1:  You must have at least $10,000 of           
      Accumulation Value in the Fidelity Money Market  
      Subaccount or the Janus Short-Term Bond          
      Subaccount to exercise this option.  The minimum  
      transfer amount each month is $100.  The maximum  
      transfer amount is equal to the Accumulation Value
      in the Subaccount from which the transfer         
      originates when the election is made, divided by  
      12.                                               
                                                  
SECTION K:  1035 Exchange Information             
K-4:  For purposes of 1035 Exchanges, this        
      information is required to carry over the correct 
      cost basis and loan amount.                       
                                                  
SECTION O:  Special Instructions                  
 .  Used for any additional information, alternate 
   or additional policy requests and continuing your 
   answers for owner and beneficiary designations.   
 .  If you are requesting child rider(s) and need  
   to request beneficiary(ies) other than shown in   
   Section D, please indicate here.  Include name(s) 
   of beneficiary(ies) and relationship.             
 .  May be used to continue answers to question    
   K-12, if necessary.                               
                                                  
APPLICATION - PART II   Medical Information       
   This part of the application must be completed for
   each person proposed for coverage unless the      
   person is medically examined.                      
<PAGE>
 
                                              Southland Life Insurance Company
                                              Customer Service Center
                                              P. O. Box 173789
                                              Denver, CO 80217- 3789
                                              1-800-224-3035

   Application for Flexible Premium Variable Life Insurance to Southland Life
                               Insurance Company
 
- --------------------------------------------------------------------------------
 
- --------------------------------------------------------------------------------
Please Print All Information Using Dark Ink
- --------------------------------------------------------------------------------
SECTION A - General Information (Complete for all cases)
A1  [ ]  Check here if insurance is for PENSION or similar tax qualified ERISA
         plan.

A2  If above statement checked, list plan type
                                               _________________________________
                           (Example: Profit-Sharing, Defined Contribution, Etc.)

A3  [ ]  Exercise Right of Exchange Rider 

                                     A4 Employer Sponsored Plans check one:

Name of Insured under Policy to be Exchanged           Policy #

                                       Employee Owned?     [ ] Yes      [ ] No
_________________________________________
- --------------------------------------------------------------------------------
SECTION B -  Proposed Insured (Complete for all cases.  To apply for additional
             insureds, complete Section G)
B1  [ ]  Name (Print full name, include suffix - if name to appear differently
         on policy, indicate in Section O)
 
         (First, Middle, Last, Suffix)

___________________________________________________________________________
B2  Sex        B3  Birthdate      B4  Insurance Age        B5  Birthplace

[ ]  Male    Month      Day      Year    (Age Nearest Birthday)    (State)

[ ]  Female  ____       ___      ____           _______             _______

B6  Social Security Number     B7  Telephone Number    B8  Height ___________

   ______ - ___ - ________  _____-_____-___________    B9  Weight ___________

B10  Address
(Street, Apt. No.)

_______________________________________________________________________________
(City)                        (State)                            (Zip Code)

______________________________________________  ______________  _______________
B11  Occupation                           B12   Describe Duties

_____________________________________    ______________________________________
B13  Employer Name                                                 Month  Year

____________________________________________  B14  Employment date:______  ____
 
- --------------------------------------------------------------------------------
SECTION C - OWNER (Complete only if other than Proposed Insured)
 
C1  Owner Name (Print full name, include suffix--if name to appear differently
    on policy, indicate in Section O)
    (First, Middle, Last, Suffix)

_______________________________________________________________________________
C2  Relationship to Proposed Insured    C3 Social Security Number or  Tax I.D.
                                           No. (include any hyphens)

_____________________________                           _______________________
C4  Owner Address
(Street, Apt. No.)

_______________________________________________________________________________
(City)                              (State)                        (Zip Code)

______________________________________    ____________  _______________________
 
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
SECTION D -- Beneficiaries (Complete for all cases)
D1  Primary Beneficiary(ies) (Print Full Names)    Relationship to Proposed
                                                   Insured  Birthdate

______________________________________________  ____________________________  

Contingent Beneficiary(ies) (Print Full Names)    Relationship to Proposed
                                                  Insured  Birthdate

______________________________________________  ____________________________  
- --------------------------------------------------------------------------------
SECTION E - Plan Information (Complete for all cases)
E1  Flexible Premium Variable Policy
    a.  Product Plan Name

__________________________________________________________
    b.  Stated Death Benefit ________________________________________
    c.  Scheduled Periodic Premium $_____________________ (If premium varies 
        from  year to year, attach schedule)
    d.  [ ]  Option A (Stated Death Benefit.  If no option selected, Option A 
        will apply.)
        [ ]  Option B (Stated Death Benefit plus Account Value)
    e.  First Year Pour-In (if any) $__________________________
    f.  Riders
    [ ]  Adjustable Term Rider $___________________  [ ]  Additional Insured
    $_____________________
    (Attach Schedule of Target Death Benefits)      (Complete Section G)
    [ ]  Accidental Death $________________________  [ ]  Children's Insurance
    Rider (# of Units) _____
    [ ]  Exchange of Insured        (Complete Section H)
    [ ]  Waiver of Cost of Insurance      [ ]  Guaranteed Insurability Rider
    [ ]  Waiver of Specified Premium $______________
    [ ]  Other
              ---------------------------------------------------------------
- --------------------------------------------------------------------------------
SECTION F-Special Dating Requested   (If neither box checked below, policy
                                     will be issued at age nearest birthday as 
                                     of issue date.) Mo.    Day       Year

F1  [ ]  Date to Save Age            F2  Specific Date -----  -----     -----

    Specify Requested Age  ________    
- --------------------------------------------------------------------------------
SECTION G - Additional Insured Rider
G1  Name of Proposed Additional Insured  (If more than one additional insured,
                                         specify details in Special 
                                         Instructions, Section O.)
(First, Middle, Last, Suffix)

- --------------------------------------------------------------------------------
G2  Relationship to proposed insured
                                    ---------------------------------------
               Month      Day     Year
G3  Birthdate  ______     _____  _____  G4  Height ___________ G5  Weight  _____
G6  Show beneficiary for additional insured if different from  G7  Insurance
 Age (Age nearest birthday) ________
beneficiary named in Section D.
Name _____________________________        Relationship _______________
 Birthdate ____________________
- --------------------------------------------------------------------------------
SECTION H - Children's Insurance Rider
                                         Birthdate (Mo./Day/Yr.)  Height  Weight
H1  Child
         -----------------------------------------------------------------------
H2  Child
         -----------------------------------------------------------------------
H3  Child
         -----------------------------------------------------------------------
H4  Child
         -----------------------------------------------------------------------
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
SECTION I - Premium Information
I1  Premium Mode (If no option selected, premium   I2  Payment Method
                 mode will be quarterly)
    [ ]  Annual           [ ]  Direct Bill (not available for monthly)
    [ ]  Quarterly        [ ]  Single Premium
    [ ]  Semi-Annual      [ ]  List Bill   Existing List Bill Number __________
    [ ]  Monthly (only    [ ]  Authorized Withdrawal  (Complete Authorized
         available for         Withdrawal/EFT Form)         
         List Bill and
         Authorized 
         Withdrawal/EFT)
 
I3  Premium collected with application NOTE: The agent is not authorized to
    collect any premium (including Authorized Withdrawal/EFT Form) before
    delivering a policy unless the Biding Limited Life Insurance Coverage form
    has been completed and signed by the agent, applicant and proposed insured
    and a copy given to the applicant. There is no coverage before delivery of
    the policy except as provided by that form.
    Yes  No
    [ ]  [ ]  a.  Has agent collected any premium (including any Authorized
                  Withdrawal/EFT Form) with this application? If yes, total
                  premium (including any pour-in) collected
                  $_____________________

    [ ]  [ ]  b.  If answer to (a) is "Yes", has agent complied with the Binding
                  Limited Life Insurance Coverage requirements?
 
    [ ]  [ ]  c.  Has the applicant signed and received a Binding Limited Life
                  Insurance Coverage form in connection with this application?
                  Attach signed copy of Binding Limited Life Insurance 
                  Coverage form.
 
I4  Initial Premium Allocation.  Please allocate your Initial Premium to the
    Guaranteed Interest Account and/or among the Variable Account Subaccounts.
    Please use whole number percentages.  The total must equal 100%.
 
    GUARANTEED INTEREST ACCOUNT __________%
 
    VARIABLE ACCOUNT SUBACCOUNTS
    ----------------------------
Fidelity               Alger                       Janus
_____% Asset Manager   _____% Growth               _____% Aggressive Growth
_____% Contrafund      _____% Leveraged AllCap     _____% Balanced
_____% Equity-Income   _____% MidCap Growth        _____% Growth
_____% Growth          _____% Small Capitalization _____% International Growth
_____% High Income                                 _____% Short-Term Bond
_____% Index 500       INVESCO                     _____% Worldwide Growth
_____% Investment Grade Bond
_____% Money Market    _____% Industrial Income
_____% Overseas        _____% Utilities
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
SECTION J - Fund Transfers           Check each option you wish to select.
 
J1  [ ] Dollar Cost Averaging
    Please transfer $_____________ from (check one only) my 
                                          [ ] Fidelity  Money Market Subaccount
                                          [ ] Janus Short-Term Bond Subaccount
 
    into the Subaccounts selected below. (Note: Please use whole number
    percentages for each Subaccounts selected.) You must allocate a minimum of
    1% to each Subaccount in which you elect to invest. The total must equal
    100%.

Fidelity                Alger                        Janus
_____% Asset Manager    _____% Growth                _____% Aggressive Growth
_____% Contrafund       _____% Leveraged AllCap      _____% Balanced
_____% Equity-Income    _____% MidCap Growth         _____% Growth
_____% Growth           _____% Small Capitalization  _____% International Growth
_____% High Income                                   _____% Short-Term Bond
_____% Index 500        INVESCO                      _____% Worldwide Growth
_____% Investment Grade 
       Bond
_____% Money Market     _____% Industrial Income
_____% Overseas         _____% Utilities
 
 
J2  Automatic Rebalancing
    [ ] Automatic Rebalancing 
    Note: If you elect this feature, each quarter we will transfer amounts among
    the Subaccounts and the Guaranteed Interest Account so that the percentages
    of your unborrowed Account Value in the Guaranteed Interest Account and in
    each Subaccount match your most recent premium allocation. To qualify for
    this feature you must allocate your premium to at least five Subaccounts (or
    four Subaccounts and the Guaranteed Interest Account) with no more than 35%
    of the premium allocated to the Guaranteed Interest Account or to any one
    Subaccount.

J3  Telephone Transfer, Partial Withdrawal and Loan Authorization
    [ ] Telephone Authorization (Check if you wish to select this option.) 
    I/We hereby authorize and direct the Customer Service Center of Southland
    Life Insurance Company to accept telephone instructions from either the
    Owner or ______________________________ (insert name of your Registered
    Representative if you wish the representative to have telephone transfer
    authority) to reallocate my Accumulation Value among the Guaranteed Interest
    Account and Subaccounts available or request a policy loan or partial
    withdrawal. I/We agree to hold harmless and indemnify Southland Life for any
    losses arising from such instructions. I/We further authorize Southland Life
    and its Customer Service Center to record telephone conversations with
    me/us. (Initials of Owner _____)
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
SECTION K - Personal Information
 
K1  List life insurance policies on all persons proposed for coverage (1) now in
    force or (2) applied for within the last 12 months, or (3) pending now. If
    NONE, Check this box [ ]
<TABLE> 
<CAPTION> 
    Name of                       Year                 A.D.     Business or     Indicate if in force  
Proposed Insured      Company    Issued     Amount    Amount      Personal     Applied for or Pending 
<S>                   <C>        <C>        <C>       <C>       <C>            <C> 
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
</TABLE> 
                                                                        Yes  No
K2  Has any proposed insured ever been declined for insurance (or
    reinstatement) or been offered insurance with restricted benefits 
    or at other than standard rates? (Do Not Answer This Question if 
    You Reside in Missouri.)  (If "Yes" give details in Section K-12)   [ ]  [ ]
K3  Is this insurance to replace, or will it cause any change in, any 
    insurance or annuity on any person proposed for coverage?  (If 
    "Yes" submit a completed replacement form with this application.)   [ ]  [ ]
K4  a.  Is this insurance intended to be a tax free exchange - 
        1035 Exchange?                                                  [ ]  [ ]
    b.  If "Yes" will any policy loan be carried over?                  [ ]  [ ]
K5  Has any person proposed for coverage:
    a.  ever smoked cigarettes?  (If "Yes", give name and details in 
        section K-12)                                                   [ ]  [ ]
    b.  ever used tobacco in any form other than cigarettes? (If 
        "Yes" give name and details in Section K-12)                    [ ]  [ ]
    c.  ever stopped smoking cigarettes?  (If "Yes" give name 
        and date last smoked in Section K12)                            [ ]  [ ]
    d.  ever stopped using tobacco in any form other than 
        cigarettes?  (If "Yes" give name, type and date last used in 
        section K-12)                                                   [ ]  [ ]
K6  Within the last 3 years or within the next 12 months, has any 
    person proposed for coverage:
    a.  flown (or planned to fly) other than as a passenger on a 
        regularly scheduled airline?
        (If "Yes" complete Aviation Supplement.)                        [ ]  [ ]
    b.  had a driver's license denied, revoked, or suspended; had 
        three or more moving violations;  been convicted of an 
        alcohol or drug related driving offense; been involved in
        two or more auto accidents? (If "Yes" give details in Section 
        K-12)                                                           [ ]  [ ]
    c.  participated in (or intend to participate in) vehicle racing 
        (on land or water), ballooning, bobsledding, hang gliding, 
        ultralight aviation, horse racing, mountaineering, rodeo,
        scuba/skin diving, skydiving/parachuting, or bungee cord 
        jumping?  (If "Yes" complete Avocation Supplement)              [ ]  [ ]
K7  List Driver's License No. here _____________________________  
    State ___________________
K8  Does any person proposed for coverage contemplate traveling or 
    residing outside the U.S.A. or Canada within the next 12 months?
    (If "Yes" give details in Section K-12.)                            [ ]  [ ]
K9  Has any person proposed for coverage been convicted of a felony 
    within the last 5 years?                                            [ ]  [ ]
    (If "Yes" give details in Section K-12.)
K10 Has any person proposed for coverage:
    a.  ever had, or now have, any type of heart disease, cancer, 
        leukemia, or malignant tumor?        
        (If "Yes" give details in Section K-12.)                        [ ]  [ ]
    b.  ever been diagnosed by a licensed member of the medical 
        profession as having Acquired Immune Deficiency Syndrome 
        (AIDS) or any immune deficiency or disorder? (Do Not 
        Answer This Question if You Reside In Nevada.)  
        (If "Yes" give details in Section K-12.)                        [ ]  [ ]
K11  Does any person proposed for coverage now participate in 
     any regular physical exercise program?                             [ ]  [ ]
K12  Details of "YES" Answers to Questions K-2 through K-11
     _____________________________________________________________________
     _____________________________________________________________________
     _____________________________________________________________________
     _____________________________________________________________________
- --------------------------------------------------------------------------------
 
<PAGE>
 
- --------------------------------------------------------------------------------
SECTION L - Medical Exam Certificate (Complete when submitting medical
 examination of another insurance company.)
L1  The attached examination is on the life of:
 _____________________________________________________________
L2  Name of insurance company for which examination was made and date of
 examination:
            Company            Date of Examination
_______________________________________________________________________________
                                                                        Yes  No
L3  To the best of the proposed insured's knowledge and belief, 
    are the statements in the examination true as of today? 
    (If "No", explain in Section L5)                                    [ ]  [ ]
L4  Has the proposed insured consulted a doctor or other 
    practitioner or received medical or surgical advice since 
    the date of the examination? (If "Yes", explain in
    Section L5)                                                         [ ]  [ ]
L5  Remarks to No. L3 and L4

    ________________________________________________________________________

    ________________________________________________________________________

    ________________________________________________________________________

- -------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
SECTION M - Financial Information (Must be completed where the face amount
 exceeds (1) $200,000 for business insurance, (2) $300,000 for an insured 65
 and under, or (3) $100,000 for an insured over 65.)
M1  What is the purpose of the insurance applied for?__________________________
    If the insurance applied for is personal, what is the proposed insured's:
    Annual Earned Income  $______________  Total Assets      $_________________
    Annual Interest 
    & Other Income        $______________  Total Liabilities $_________________
                                           Total Net Worth   $_________________
 
M1&2  If Business Insurance:                              Last Year  
  a.  Annual net profit (before taxes, past two years)    $_______________
        2 Years Ago 
      $_______________
  b.  Business reason for insurance (check at least one box and furnish details)
      [ ] Key Person        [ ] Stock Redemption/Buy and Sell     [ ] Other
      ________________________________________
  c.  If Key Person insurance:
                                                                Yes   No
      (1)  Are all partners or key people to be covered?        [ ]  [ ]
           If "No", explain)
           _____________________________________________________
           _____________________________________________________
      (2)  Does proposed insured have an ownership interest in 
           the business                                         [ ]  [ ]
           If "Yes", what is proposed insured's percent of 
           ownership?   _________%
      (3)  What is the proposed insured's annual income?
           $____________________________
d.   If to fund stock redemption, is there a written 
     agreement?                                                 [ ]  [ ]
     (1)  What is the book value of the business?
     $___________________________________
     (2)  What is the market value of the business
     $___________________________________
     (3)  How was the value determined?  _______________________
                                                                Yes  No
M3  Is this insurance to guarantee a loan?                      [ ]  [ ]
    a.  If "Yes", is the lender requiring this insurance?       [ ]  [ ]
    b.  Is the loan finalized?                                  [ ]  [ ]
    c.  What is the term of the loan? (Months)  _______________
    d.  Name of lender: _______________________________________
    e.  Amount of loan: _______________________________________
    f.  Purpose of loan: ______________________________________
    g.  Are others being insured for the same purpose?          [ ]  [ ]
        If "Yes", who and for what amount:
        ___________________________________  Amount $__________
        ___________________________________  Amount $__________
M4  Additional remarks about purpose of the insurance and how the amount of
    insurance was determined.
Remarks to Section M
    _________________________________________________________________________
    _________________________________________________________________________
    _________________________________________________________________________
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
SECTION N - Suitability
  a.  Have you the Proposed Insured and the Owner, if other than the Proposed
      Insured, received a current Prospectus for the policy applied for and for
      each designated fund? [ ] Yes [ ] No
  b.  Do you understand that under the policy applied for the amount or duration
      of the death benefit may vary under specified conditions; policy values
      may increase or decrease in accordance with the investment experience of
      our Separate Account and may increase in accordance with the interest
      credited in the Guaranteed Interest Account; and the amount payable at the
      Final Policy Date is not guaranteed but is dependent on the amount then in
      the Policy Account?     [ ] Yes      [ ] No
  c.  Do you understand that any personalized illustrations received are based
      on hypothetical interest assumptions which may not be indicative of actual
      future investment experience of our Separate Account or of actual interest
      credited in our Guaranteed Interest Account?     [ ] Yes    [ ] No
  d.  With this in mind, is the policy in accord with your insurance objectives
      and your anticipated financial needs?     [ ] Yes  [ ] No
- --------------------------------------------------------------------------------
SECTION O -- Special Instructions









- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
Please Print All Information Using Dark Ink
Part II must be completed for each person proposed for coverage unless the
person is medically examined.
- --------------------------------------------------------------------------------
SECTION A -- Personal Physicians
A1  For each person proposed for coverage, give the name and address of the
    personal physicians and the date and reason the physician was last seen.
    If NONE, check here [ ]
Proposed Insured's             Name and Address         Date and Reason 
     Name                        of Physician              Last Seen
_______________________________________________________________________________
                               ________________________________________________
                               ________________________________________________
                               ________________________________________________
_______________________________________________________________________________
                               ________________________________________________
                               ________________________________________________
                               ________________________________________________
_______________________________________________________________________________
                               ________________________________________________
                               ________________________________________________
                               ________________________________________________
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
SECTION B -- Medical Information (Complete for each person proposed for
 coverage.)  (For all of Section B, circle each specific condition and give
 details to all "Yes" answers in the Details Section following question B-11.
 Give name of disease, symptoms, etc; the date of onset; the duration; number
 of attacks; and name and addresses of medical professional or hospital
 providing services.)
B1  Has any person proposed for coverage ever been treated for, 
    or been told, by a member of the medical profession that 
    the person has:                                                  Yes  No
    a.  pain, pressure, or discomfort in the chest or arms,  
        high blood pressure, heart murmur, irregular heartbeat, 
        or any other disease or disorder of the heart?               [ ]  [ ]
    b.  anemia, leukemia, or any other disorder of the blood, 
        veins or arteries?                                           [ ]  [ ]
    c.  asthma, bronchitis, pneumonia, tuberculosis, emphysema, 
        shortness of breath, chronic cough, or any other 
        disorder of the lungs or respiratory system?                 [ ]  [ ]
    d.  mental or emotional disorder, nervous breakdown, 
        epilepsy, convulsions, chronic fatigue, fainting spells, 
        paralysis, stroke, or any other disorder of the brain or
        nervous system?                                              [ ]  [ ]
    e.  significant weight loss, ulcer, colitis, diverticulitis, 
        hepatitis, cirrhosis, persistent diarrhea, or other 
        disease of the liver, gall bladder, pancreas, stomach 
        or intestines?                                               [ ]  [ ]
    f.  diabetes, thyroid, recurrent enlarged glands, or 
        other glandular disease or disorder?                         [ ]  [ ]
    g.  arthritis, gout, or any bone, joint, muscle, or skin 
        disorder?                                                    [ ]  [ ]
    h.  polyp, tumor, or cancer?                                     [ ]  [ ]
    i.  disorder of the urinary tract or kidneys, urethritis, 
        cystitis, sugar, albumin, or blood in the urine?             [ ]  [ ]
    j.  prostate or testicular disease, venereal disease, 
        herpes, or disease of the uterus, ovaries or breasts?        [ ]  [ ]
    k.  any disorder of the eyes, ears, nose, or throat?             [ ]  [ ]
    l.  any other health impairment or medically or surgically 
        treated condition within the last 5 years not mentioned 
        above?                                                       [ ]  [ ]
 
B2  Has any person proposed for coverage ever been treated for, 
    or been told, by a licensed member of the medical profession 
    that the person has Acquired Immune Deficiency Syndrome 
    (AIDS) or any disorder or deficiency of the Immune System?  
    (Do Not  Answer This Question If You Reside In Nevada.)          [ ]  [ ]
 
B3  Within the past 10 years, has any person proposed for coverage:
    a.  tested positive in a test to detect antibodies to the AIDS 
        virus (Human T-cell Lymphotrophic Virus T type III; 
        HTLV-III, Human Immunodeficiency Virus [HIV]?  
        (Do Not Answer This Question If You Reside In Connecticut 
        or Maine.)                                                   [ ]  [ ]
    b.  had a blood transfusion?                                     [ ]  [ ]
 
B4  Within the past 5 years, has any person proposed for coverage 
    been a patient in or had treatment at a hospital, clinic, 
    sanitarium or other medical facility?                            [ ]  [ ]
 
B5  Is any person proposed for coverage now under regular medical 
    observation by, or taking treatment from, a member of the 
    medical profession?                                              [ ]  [ ]
 
B6  Other than as stated in the answers above, has any person 
    proposed for coverage, within the last 5 years:
    a.  had a checkup or consultation with a member of the 
        medical profession?                                          [ ]  [ ]
    b.  had an electrocardiogram, x-ray, blood test or other test?   [ ]  [ ]
    c.  been advised by a member of the medical profession to 
        have any diagnostic test, hospitalization, or surgery 
        which was not completed?                                     [ ]  [ ]
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
                                                                     Yes   No
B7  Does any person proposed for coverage have a deformity or 
    an amputation?                                                   [ ]  [ ]
 
B8  Does any person proposed for coverage now take any 
    medicine prescribed by a member of the medical profession?       [ ]  [ ]
 
B9  Except as legally prescribed by a physician, has any 
    person proposed for coverage ever used narcotics, 
    cocaine, marijuana, or any hallucinatory or mind altering
    substances in the past 10 years?                                 [ ]  [ ]
 
B10 In the last 5 years, has any person proposed for coverage 
    received treatment for or joined an organization because 
    of the alcoholism or drug addiction of that person?              [ ]  [ ]
 
B11 Has any parent, brother, or sister of any person proposed 
    for coverage ever had cancer, diabetes, high blood 
    pressure, heart or kidney disease, nervous or mental
    disorder, tuberculosis, or hereditary disorder?                  [ ]  [ ]
 
Details of "Yes" answers to questions B-1 through B-11
Ques                Name of
 No.            Proposed Insured       Complete Details
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

_______________________________________________________________________________
SECTION C - Family History
                        Living             Deceased
Family Member  Age  State of Health    Age at Death/Cause
Father_________________________________________________________________________

Mother_________________________________________________________________________

Brothers_______________________________________________________________________

 ______________________________________________________________________________

Sisters________________________________________________________________________
 ______________________________________________________________________________

- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
                                  AGREEMENTS
- --------------------------------------------------------------------------------

All statements and answers in this application (which includes Part I, Part II,
 and supplements and amendments) are true and complete to the best of my
 knowledge and belief. I also agree that:

1. The statements and answers in this application will be relied upon and form
 the basis of any insurance.
                             
2. No information will be considered as having been given to Southland Life
 unless it is written in this application. (This paragraph does not apply in the
 states of Maine, Missouri, Oregon, South Carolina, and South Dakota.) 

3. No agent or any other unauthorized person can make or change any insurance
 contract or give up any of Southland Life's rights or requirements. Any change
 must be in writing and signed by an officer of Southland Life.
 
4. Southland Life may amend this application by an appropriate notation in the
 space designated "Home Office Corrections" in order to correct errors or
 omissions or to conform the application with any policy that may be issued. The
 acceptance of the policy constitutes a ratification of such amendments.
 
In those states, including Maryland, where change in amount, classification,
plan, premium, or benefit requires the written consent of the applicant, no
change may be ratified except by a written acceptance. We reserve the right to
make any changes required by law.

5. Insurance Under Policy Applied For - Except as may be provided in any Binding
Limited Life Insurance Coverage, no policy of insurance will be in force until
(1) the first policy premium is paid and (2) the policy is delivered while the
facts and health condition of the proposed insured(s) are as represented in this
application. When these conditions are satisfied, the policy as delivered will
then take effect.

6. Binding Limited Life Insurance Coverage - Any pre-delivery insurance coverage
is provided in the Binding Limited Life Insurance Coverage form. That coverage
is available only if: a premium is accepted by the agent; the agent has
authority to accept premium as set out in that form; and the form is completed
and signed by the agent, applicant, and proposed insured.

7. If the contract applied for is for a pension, profit-sharing, HR-10, or other
tax qualified plan, any policy issued shall not be transferable other than to
the Insurer, except as directed by the Plan Administrator. Other applicable
provisions may be added to the contract.

8. I certify, under penalty of perjury, that my social security/tax
identification number(s) is shown and is correct and that I am not subject to
backup withholding.

- --------------------------------------------------------------------------------
               AUTHORIZATION TO OBTAIN AND DISCLOSE INFORMATION
- --------------------------------------------------------------------------------

Southland Life Insurance Company ("Southland Life") may obtain information about
me or my minor children from any physician, medical practitioner, hospital,
clinic or other medical facility, employer, other insurance companies or
institutions, consumer reporting agency, or Medical Information Bureau, Inc.
(MIB, Inc.). The purpose is to evaluate my application for insurance or
benefits. Southland Life may obtain an investigative consumer report and any
records or other information available as to diagnosis, treatment and prognosis
of any physical or mental condition.
 
Southland Life may obtain any drug, physician and mental health, and alcohol-
related information which may be protected by Federal or State laws and
regulations. As it pertains to alcohol and drug information covered by Federal
regulation, this authorization may be revoked at any time by written notice to
Southland Life, but any action taken before my written revocation is received by
Southland Life will not be affected.
 
Southland Life may make a brief report about me or my children to MIB, Inc.
Southland Life may disclose information to its reinsurers, those who perform
services for Southland Life on my application for insurance or benefits, or
those companies to which I have applied or may apply for life or health
insurance or benefits. Disclosure may be made when required or permitted by law.

This is valid for two and one-half years from the date below. An original or
copy may be used by Southland Life or its authorized representatives to obtain
information. I have read and received a copy of this authorization. I also have
a copy of the Notice of Information Procedures. It includes the MIB, Inc. and
Fair Credit Reporting Notices.
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
NOTICE: Any person who knowingly and with intent to injure, defraud, or deceive
any insurance company, files an application, statement or claim containing any
false, incomplete, or misleading information is guilty of insurance fraud.
 
Signature of
Proposed Insured _______________________________________________________ 
Date _________________________
(If below age 15, signature of parent or guardian)
 
Signed at City ___________________________________________________  
State ______________________________
 
Signature of
 Spouse/_______________________________________________________________________

Additional Insured(s) (if proposed for coverage)

 ___________________________________________________________
 
Owner Signature (if other than proposed insured)

 _________________________________________________________
 
OR (if applicable) Corporate Owner Signature

 ___________________________________________________________
 (If a firm or corporation is to be owner, the signature and title of an
  officer other than the proposed insured is required.)
Except for any medical exam form, I certify that I have asked and recorded
 completely and accurately the answers to all questions on this application.  I
 know of nothing else affecting the risk.
 
Signature of Agent/Registered Rep. _____________________________
Reg. Rep. Number _____________
 
__________________________________________  ___________________________________
Name of Broker/Dealer/Branch                              Address of
                                                     Broker/Dealer/Branch
- --------------------------------------------------------------------------------
    HOME OFFICE
    CORRECTIONS
(FOR HOME OFFICE
     USE ONLY)
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
 
                                Agent's Report
              (Must be completed and signed for every application)
- --------------------------------------------------------------------------------
                                                             
1.  In what state was the application taken?  ___________    
                                                               Yes  No 
2.  Do you have knowledge or reason to believe that 
    replacement of existing insurance or annuity may   
    be involved?                                               [ ]  [ ]    
3.  How long have you known the proposed insured?  
    ________ years   
    Are you related?                                           [ ]  [ ] 
    If so, how? ________________________  
4.  Does the proposed insured speak English?                   [ ]  [ ]
    Was the application interpreted for and       
    understood by the proposed insured?                        [ ]  [ ]        
    Are all persons proposed for coverage              
    U.S. citizens?                                             [ ]  [ ] 
    If not, how long in U.S.?  _______Mos. ________Yrs.  

5.  Did proposed insured approach you for this insurance       [ ]  [ ]
6.  What is the amount of insurance in force on the spouse 
    of the proposed insured? $_____________________         
7.  If any proposed insured is a minor, what is the amount 
    of insurance on:                    
      Father    $__________ Mother  $___________    
      Brothers  $__________ Sisters $___________   
8.  Will the applicant accept this policy if it is a 
    "Modified Endowment" at issue?                             [ ]  [ ]
9.  If a medical exam is required, has it been ordered?        [ ]  [ ]
10. What is the source of the first premium payment?                     
    [ ] Applicant check               
    [ ] Other (specify): __________________     
- --------------------------------------------------------------------------------
11. Print interest of all agents:
Agent Name  _________________________________________ 
Agent No.   __________________  % __________
Agent Name  _________________________________________ 
Agent No.   __________________  % __________
Agent Name  _________________________________________ 
Agent No.   __________________  % __________
Agent (Sign)_________________________________________  No. ____________  
Date        ___________________
- --------------------------------------------------------------------------------
12.  General Agent (Print)  ___________________________________________________
__________________________ Agent Number
 
General Agent (Sign)  ______________________________________________________
 Date _______________
- --------------------------------------------------------------------------------
13.  What was the PRIMARY purpose of the insurance?
<TABLE> 
<S>                            <C>                            <C>                           <C> 
     PERSONAL PLANNING         E  [ ]  Gift/Charitable        BUSINESS PLANNING             M  [ ]  Buy-Sell
A  [ ]  Estate/Death Tax       F  [ ]  Retirement Maximizer   J  [ ]  Executive Bonus       N  [ ]  Key Executive
B  [ ]  Family Protection      G  [ ]  IRP/PPP/PRO            K  [ ]  Qualified Plan        O  [ ]  Employee Benefit
C  [ ]  Mortgage Protection    H  [ ]  Savings                L  [ ]  Deferred              P  [ ]  Other _________
D  [ ]  College Funding        I  [ ]  Other ______________           Compensation
</TABLE> 
- --------------------------------------------------------------------------------
14.  Who was the PRIMARY decision-maker involved?
<TABLE> 
<S>                         <C>                           <C>                        <C> 
PERSONAL PLANNING           D  [ ]  Grandparent           BUSINESS PLANNING          J  [ ]  Board of
A  [ ]  Insured             E  [ ]  Child(ren)            G  [ ]  Business Owner             Directors
B  [ ]  Insured and Spouse  F  [ ]  Other_____________    H  [ ]  Attorney           K  [ ]  Trustee
C  [ ]  Parent                                            I  [ ]  Accountant         L  [ ]  Other _________
</TABLE> 
- --------------------------------------------------------------------------------
15.  Did the Home Office or Regional Staff assist you?     [ ] Yes      [ ] No
     (If yes, check all that apply)
<TABLE> 
<S>                       <C>                        <C>                           <C> 
A  [ ]  Illustration      D  [ ]  Template design    G  [ ]  Family Asset Review   J  [ ]  Other__________
B  [ ]  Case design       E  [ ]  Estate Analysis    H  [ ]  Competition Services
C  [ ]  Sample Documents  F  [ ]  Business Analysis  I  [ ]  Legal Consultation
</TABLE> 
- --------------------------------------------------------------------------------
<PAGE>
 
                        (Detach and give to Applicant)
                                  AGREEMENTS
- --------------------------------------------------------------------------------
All statements and answers in this application (which includes Part I, Part II,
and supplements and amendments) are true and complete to the best of my
knowledge and belief. I also agree that:
1.  The statements and answers in this application will be relied upon and form
    the basis of any insurance.
2.  No information will be considered as having been given to Southland Life
    unless it is written in this application. (This paragraph does not apply in
    the states of Maine, Missouri, Oregon, South Carolina, and South Dakota.)
3.  No agent or any other unauthorized person can make or change any insurance
    contract or give up any of Southland Life's rights or requirements. Any
    change must be in writing and signed by an officer of Southland Life.
4.  Southland Life may amend this application by an appropriate notation in the
    space designated "Home Office Corrections" in order to correct errors or
    omissions or to conform the application with any policy that may be issued.
    The acceptance of the policy constitutes a ratification of such amendments.
    In those states, including Maryland, where change in amount, classification,
    plan, premium, or benefit requires the written consent of the applicant, no
    change may be ratified except by a written acceptance. We reserve the right
    to make any changes required by law.
5.  Insurance Under Policy applied For - Except as may be provided in any
    Binding Limited Life Insurance Coverage, no policy of insurance will be in
    force until (1) the first policy premium is paid and (2) the policy is
    delivered while the facts and health condition of the proposed insured(s)
    are as represented in this application. When these conditions are satisfied,
    the policy as delivered will then take effect.
6.  Binding Limited Life Insurance Coverage - Any pre-delivery insurance
    coverage is provided in the Binding Limited Life Insurance Coverage form.
    That coverage is available only if a premium is accepted by the agent, the
    agent has authority to accept premium as set out in that form, and the form
    is completed and signed by the agent, applicant, and proposed insured.
7.  If the contract applied for is for a pension, profit-sharing, HR-10, or
    other tax qualified plan, any policy issued shall not be transferable other
    than to the Insurer, except as directed by the Plan Administrator. Other
    applicable provisions may be added to the contract.
8.  I certify, under penalty of perjury, that my social security/tax
    identification number(s) is shown and is correct and that I am not subject
    to backup withholding.
- --------------------------------------------------------------------------------
<PAGE>
 
- --------------------------------------------------------------------------------
                       NOTICE OF INFORMATION PROCEDURES
- --------------------------------------------------------------------------------

OUR UNDERWRITING PROCESS    
This process is an evaluation of information about you. It is to see if you
qualify for the insurance requested. The information we review may vary with the
insurance applied for. We look at information about you such as: your age;
occupation; health; mode of living; avocation; and other personal information.
                            
Answers on the application are the principal source of information. We may
contact other people or institutions personally, by phone, or by letter. The
purpose is to confirm or add to information you have provided. For example, we
may obtain information from your doctor, clinic, hospital, or other insurers. In
some cases, your Southland Life agent may obtain information on our behalf. A
medical examination or laboratory tests may be requested.

NOTICE                      
Any person who knowingly and with intent to injure, defraud, or deceive any
insurance company, files an application, statement or claim containing any
false, incomplete, or misleading information is guilty of insurance fraud.

MIB, INC.                   
Medical Information Bureau, Inc. ("MIB, Inc.") may provide Southland Life with a
brief report about you. This is a nonprofit organization of life insurance
companies which has an information exchange for its members. Information that is
sent to MIB, Inc. by one member may be given to their member companies who have
a business need for it.
 
Upon your written request, MIB, Inc. will arrange for disclosure of any
information it may have in your file. If you question the accuracy of MIB's
information, you may request a correction according to the procedures in the
Federal Fair Credit Reporting Act. MIB's address is: P. O. Box 105, Essex
Station, Boston, Massachusetts 02112, telephone 617-426-3660.
 
CONSUMER REPORTS
In some cases, a Southland Life representative may prepare a consumer report or
investigative consumer report about you, or Southland Life may ask an
independent agency to prepare a consumer report or an investigative consumer
report about you. These reports may include information on your character,
general reputation, personal characteristics such as health, finances, and job,
and mode of living except as may be related directly or indirectly to your
sexual orientation. Any information obtained by the agency may be kept in its
file and later given to others who have a business need for it. If an
investigative consumer report is ordered by Southland Life, the report will
include information obtained through interviews with your neighbors, friends, or
others you know. You may request a personal interview. The agency will make a
reasonable attempt to talk to you. It will include that information in its
report. The Federal Fair Credit Reporting Act gives you the right to make a
written request within a reasonable period of time, to receive additional
information from Southland Life about the nature and scope of an investigation,
if one is made. We will provide the name, address, and phone number of any
agency we ask to prepare such a report. You may contact the agency directly to
learn about the contents of the report.
                                                    
DISCLOSURE OF INFORMATION                          
Information we obtain about you is confidential. As permitted by law, we may
disclose information without further authorization to others such as: consumer
reporting agencies hired to prepare investigative reports; insurance companies
to which you have applied for coverage or benefits; those providing services for
us; those conducting bona fide actuarial, marketing, or scientific studies or
audits; and your attending doctor.
                                                    
Upon written request, we will give you more information about these procedures.
                                                    
YOUR RIGHT TO REVIEW INFORMATION                   
These are procedures by which you can make a written request to review personal
information in our policy file. However, Southland Life will not disclose
information to you that was prepared for any anticipated claim or any civil or
criminal proceeding. We also have procedures by which you may request
correction, amendment, or deletion of any information in our files which you
believe to be inaccurate or irrelevant. Upon written request, we will provide
you with further information about these procedures.
                                                     
We hope this notice helps explain our underwriting process. If you have any
additional questions, discuss them with your agent or contact us directly.
                                                    
                       Southland Life Insurance Company
                            Customer Service Center
                               P. O. Box 173789
                             Denver, CO 80217-3789
                                1-800-224-3035
- --------------------------------------------------------------------------------

<PAGE>
 
                                                                  EXHIBIT 1.A.11

                                                                    May 10, 1996


                            DESCRIPTION OF ISSUANCE,
                       TRANSFER AND REDEMPTION PROCEDURES
                      PURSUANT TO RULE 6E-3(T)(B)(12)(III)
               FOR FLEXIBLE PREMIUM ADJUSTABLE COMBINATION FIXED
                      AND VARIABLE LIFE INSURANCE POLICIES
                                   ISSUED BY
                        SOUTHLAND LIFE INSURANCE COMPANY


          This document sets forth the administrative procedures that will be
followed by Southland Life Insurance Company (the "Company") in connection with
the issuance of its flexible premium adjustable combination fixed and variable
life insurance policy ("Policy" or "Policies"), the transfer of assets held
thereunder, and the redemption by Policy owners ("Owners") of their interests in
those Policies.  Capitalized terms used herein have the same definition as in
the prospectus for the Policy that is included in the current registration
statement on Form S-6 for the Policy (File No. 33-97852) as filed with the
Securities and Exchange Commission ("Commission" or "SEC").


I.  PROCEDURES RELATING TO PURCHASE AND ISSUANCE OF THE POLICIES AND ACCEPTANCE
    ---------------------------------------------------------------------------
    OF PREMIUMS
    -----------

    A.  OFFER OF THE POLICIES, APPLICATION, INITIAL PREMIUMS, AND ISSUANCE
        ------------------------------------------------------------------

        1.  Offer of the Policies.  The Policies are offered and sold for
            ---------------------                                        
premiums pursuant to underwriting standards in accordance with state insurance
laws. Premiums for the Policies and related insurance charges are not the same
for all Owners selecting the same Stated Death Benefit.  Insurance is based on
the principle of pooling and distribution of mortality risks, which assumes that
each Owner pays a premium and related insurance charges commensurate with the
Insured's mortality risk as actuarially determined utilizing factors such as
Age, sex, and risk class of the Insured.  Uniform premium and insurance charges
for all Insureds would discriminate unfairly in favor of those Insureds
representing greater risk.  Although there is no uniform insurance charge for
all Insureds, there is a uniform insurance rate for all Insureds of the same
rate class.  Appendix A to this memorandum describes the monthly deductions
under the Policy, which include initial Policy charges, monthly administrative
charges, cost of insurance charges, and supplemental benefit charges.

       2.  Application.  Persons wishing to purchase a Policy must complete an
           -----------                                                        
application and submit it to the Company through an authorized agent. The appli-
cation must specify the Insured and provide certain required information about
<PAGE>
 
the Insured. The application also must specify a premium payment plan, which is
level premiums at specified intervals, e.g., monthly, quarterly, semi-annually,
or annually, designate net premium allocation percentages, and select the
initial Stated Death Benefit. An Owner may arrange with the Company to pay
planned premiums by pre-authorized checking account deductions. An application
will not be deemed to be complete unless all required information, including
without limitation Age, sex, and medical and other background information for
the Insured, has been provided in the application.

       3.  Minimum Initial Premium. An applicant must pay a minimum initial
           -----------------------
premium which, if not submitted with the application or during the underwriting
period, must be submitted when the Policy is delivered. Policy coverage does not
become effective until the initial premium is received in good order at the
Company's Customer Service Center. The Company may specify the form in which a
premium payment must be made in order for the premium to be in "good order."
Ordinarily, a check will be deemed to be in good order upon receipt, although
the Company may require that the check first be converted into federal funds. In
addition, for a premium to be received in good order, it must be accompanied by
all required supporting documentation, in whatever form required.

          The minimum initial premium depends on a number of factors, such as
the Insured's Age, sex, and risk class, the requested Stated Death Benefit, any
supplemental benefits, and the planned premiums the applicant proposes to make.
The initial premium is at least equal to two No-Lapse Premiums for a Policy
covering the proposed Insured for the requested Stated Death Benefit.  The No-
Lapse Premium is a benchmark monthly premium used to determine the No-Lapse
Guarantee.  The No-Lapse Guarantee is used for purposes of determining whether,
during the first three Policy Years, regardless of the sufficiency of the Cash
Surrender Value under certain circumstances, the Policy will not lapse.  It is
based in part on the sex, Age, and risk class of the Insured, the requested
Stated Death Benefit, and any supplemental benefits.

       4.  Minimum Stated Death Benefit.  The minimum initial Stated Death 
           -----------------------------
Benefit for which the Company will issue a Policy is $100,000.

       5.  Receipt of Application and Underwriting.  Upon receipt of a completed
           ---------------------------------------                              
application in good order from an applicant, the Company will follow certain
insurance underwriting procedures designed to determine whether the proposed
Insured is insurable.  This process may involve such verification procedures as

                                      -2-
<PAGE>
 
medical examinations and may require that further information be provided about
the proposed Insured before a determination can be made.

          The underwriting process determines the rate class to which the
Insured is assigned.  This original rate class applies to the initial Stated
Death Benefit.  The rate class may change upon an increase in Stated Death
Benefit.

          The Company also will determine whether the proposed planned premium
schedule will be sufficient to cover the charges to be imposed under the Policy.

          A Policy cannot be issued until the initial underwriting procedure has
been completed.  The Policy Date is the date on which coverage becomes
effective.  It is the date by which all of the following have occurred:  the
application has been accepted; the minimum initial premium has been received;
and the Company has generated a printed Policy that is delivered to an Owner
while the Insured is alive and before any change in health as shown in the
application.

          The Company reserves the right to reject an application for any reason
permitted by law.  If an application is rejected, any premium received will be
returned, without interest.

       6. Acceptance of Application and Policy Date. If an application is
          -----------------------------------------
accepted, premium is received, and the Policy is delivered, insurance coverage
under the Policy is effective as of the Policy Date, which is set forth in the
Policy. The Policy Date is used to determine Policy Years and Monthly Processing
Dates, as well as to measure suicide and contestability periods.

   B.  ADDITIONAL PREMIUMS
       -------------------

       1.  Additional Premiums Permitted.  Additional, unscheduled premiums
           -----------------------------                                   
may be paid in any amount, and at any time, subject to the following limits:

           .  A premium must be at least $100 and must be sent to the Customer
Service Center.  The Company may require satisfactory evidence of insurability
before accepting any premium that would result in an increase in the difference
between the Accumulation Value and the Death Benefit.

           .  The Company may limit total premiums paid in a Policy Year to the
planned premiums selected.

                                      -3-
<PAGE>
 
           .  Total premiums paid in a Policy Year also may not exceed guideline
premium limitations for life insurance set forth in the Internal Revenue Code.

           .  No premium will be accepted after the Maturity Date.

           .  The Company will monitor Policies and will attempt to notify an
Owner on a timely basis if the Owner's Policy is in jeopardy of becoming a
modified endowment contract under the Internal Revenue Code.

           .  A payment submitted when a Policy loan is outstanding will be
treated as a loan repayment unless the Owner specifies otherwise.

       2.  Refund of Excess Premium Amounts.  If at any time a premium is paid
           --------------------------------                                   
that would result in total premiums exceeding limits established by law to
qualify a Policy as a life insurance policy, the Company will only accept that
portion of the premium that would make total premiums equal the maximum amount
that may be paid under the Policy.  The excess premium will be refunded plus any
gain attributable to the excess premium.

       3. Planned Premiums. At the time of application, each Owner will select a
          ----------------
plan for paying level premiums at specified intervals, based on a periodic
billing mode of monthly, quarterly, semi-annual, or annual payments. The Company
will send reminder notices for planned premiums, unless an Owner arranges to pay
planned premiums by pre-authorized checking account deductions. The Owner may
change the planned premium frequency and amount by sending a Written Request to
the Customer Service Center. Any such change will be subject to the premium
limits discussed above.

       4. Crediting Premiums
          ------------------

          a.  Initial Premium.  The initial premium net of any sales and tax
              ---------------                                               
charges will be credited to the Policy as of the Policy Date.  If the initial
premium is submitted with the application or before the Policy is issued, the
premium will be allocated to the Money Market Subaccount (defined below) until
the Policy becomes effective.  At that time, the Accumulation value in the Money
Market Subaccount will be credited to the Subaccounts or the Guaranteed Interest
Account, as specified in the application.

          b.  Premiums Not Requiring Additional Underwriting.  Planned premiums
              ----------------------------------------------                   
and unplanned premiums not requiring additional underwriting will be credited to

                                      -4-
<PAGE>
 
the Policy and the resulting Net Premiums will be invested as requested on the
Valuation Day that the premium is received by the Customer Service Center.

          c.  Premiums Requiring Additional Underwriting.  Any premium requiring
              ------------------------------------------                        
additional underwriting will be allocated to the Money Market Subaccount
(defined below) until underwriting has been completed and the premium has been
accepted.  When accepted, the Accumulation Value in the Money Market Subaccount
attributable to the resulting Net Premium will be credited to the Policy and
allocated to the Subaccounts and/or Guaranteed Interest Account as requested.
If an additional premium is rejected, the Company will return the premium,
without any adjustment for investment experience.

   C. OVERPAYMENTS AND UNDERPAYMENTS  In accordance with industry practice, the
      ------------------------------                                           
Company will establish procedures to handle errors in initial and additional
premium payments to refund overpayments and collect underpayments, except for 
de minimis amounts (amounts under $5.00).
- -- -------                               

   D. PREMIUMS UPON INCREASE IN STATED DEATH BENEFIT, PREMIUMS DURING A GRACE 
      -----------------------------------------------------------------------
      PERIOD, AND PREMIUMS UPON REINSTATEMENT
      ---------------------------------------

      1.  Premiums Upon Increase in Stated Death Benefit.  Generally, no
          ----------------------------------------------                
premium is required for an increase in Stated Death Benefit.  However, depending
on the Accumulation Value at the time of an increase in the Stated Death Benefit
and the amount of the increase requested, an additional premium or change in the
amount of planned premiums may be advisable.  The Company will notify the Owner
if a premium is necessary or a change appropriate.

       2.  Premiums During a Grace Period.  If the Cash Surrender Value on a
           ------------------------------                                   
Monthly Processing Date is less than the amount of the monthly deduction to be
deducted on that date, and the Three-Year Guarantee (described below) is not in
effect, the Policy will be in default and a grace period will begin.  During the
Three-Year Guarantee, the Policy will remain in force during the first three
Policy Years, regardless of the sufficiency of the Cash Surrender Value, if the
total premiums paid less any withdrawals is greater than or equal to the No-
Lapse Premium multiplied by the number of months the Policy has been in force.

          .  The grace period is a 61-day period that is measured from the date
on which a grace period notice is sent by the Company.  The Policy does not
lapse, and the insurance coverage continues, until the expiration of this grace
period.

                                      -5-
<PAGE>
 
          .  In order to prevent lapse, the Owner must, during the grace period,
make a premium payment sufficient to cover the monthly deduction.  The amount
required to be paid will be identified in the grace period notice.

          .  Failure to make a sufficient payment within the grace period will
result in lapse of the Policy without value or benefits payable.

       3. Premiums Upon Reinstatement. A Policy that lapses without value may be
          ---------------------------
reinstated at any time within five years of the beginning of the grace period
(or longer period required in a particular state after the beginning of the
grace period) by submitting: evidence of the Insured's insurability satisfactory
to the Company; payment of any minimum monthly premiums due and unpaid during
the last five Policy Years plus, if reinstatement is later, a sum sufficient to
keep the Policy in force for two months; and repayment or the continuance of any
Policy loan that existed when coverage ended, with any loan interest. The
effective date of the reinstatement will be the date of the Company's approval.

          .  Upon reinstatement, the Accumulation Value will be the Accumulation
Value at the date of lapse, plus any payments on reinstatement, minus the
difference in surrender charges as of the lapse date and as of the reinstatement
date based on the table of surrender charges.

  E.  ALLOCATIONS OF NET PREMIUMS AMONG THE ACCOUNTS
      ----------------------------------------------

       1. The Variable Account and Guaranteed Interest Account.  An Owner may
          ----------------------------------------------------               
allocate Net Premiums to one or more of the Subaccounts of Southland Separate
Account L1 (the "Variable Account").  The Variable Account currently consists of
21 Subaccounts, the assets of which are used to purchase shares of a designated
corresponding mutual fund Portfolio that is part of one of the following mutual
funds:  the Alger American Fund, Fidelity Variable Insurance Products Fund,
Fidelity Variable Insurance Products Fund II, Janus Aspen Series, and INVESCO
Variable Investment Funds, Inc.  Each mutual fund is registered under the
Investment Company Act of 1940 as an open-end management investment company.
Additional Subaccounts may be added from time to time to invest in any of the
Portfolios of the above-referenced mutual funds or any other investment company.
Owners also may allocate Net Premiums to the Guaranteed Interest Account, which
guarantees a minimum fixed rate of interest.

       2. Allocations Among the Accounts.  Net Premiums and Accumulation
          ------------------------------                                
Value are allocated to the Subaccounts and the Guaranteed Interest Account in
accordance with the following procedures.

                                      -6-
<PAGE>
 
          a. General.  The Net Premium equals the premium paid less any sales
             -------                                                         
and tax charges.  In the application for the Policy, the Owner will indicate how
Net Premiums should be allocated among the Subaccounts of the Variable Account
and/or the Guaranteed Interest Account.  Such allocations may be changed at any
time by the Owner by Written Notice to the Customer Service Center.  The
percentage of each Net Premium that may be allocated to any Subaccount or the
Guaranteed Interest Account must be a whole number not less than 5%, and the sum
of the allocation percentages must be 100%.

          b. Net Premiums.  Any portion of the initial Net Premium allocated to
             ------------                                                      
a Subaccount will be invested in the Fidelity Variable Insurance Products Fund
Money Market Portfolio (the "Money Market Subaccount") until the Free Look
Period expires.  The Free Look Period is a period expiring at the latest of 20
days after an Owner receives a Policy, 45 days after the application is signed,
or 10 days after the Company mails or delivers a notice of withdrawal right,
during which an Owner may cancel the Policy and receive a refund of premiums
paid.  At the end of the Free Look Period, the Accumulation Value in the Money
Market Subaccount is transferred to and allocated to the Subaccounts based on
the allocation percentages in the Policy application.  Any Net Premium directed
to be invested in the Guaranteed Interest Account will be allocated to that
Account upon receipt by the Company.

          c. Additional Premiums.  Additional Net Premiums not requiring
             -------------------                                        
underwriting will be credited to the Policy and allocated to the Subaccounts or
Guaranteed Interest Account in accordance with the allocation percentages in
effect on the Valuation Day that the premium is received at the Customer Service
Center, unless other instructions by Written Notice accompany the premium, in
which case the Net Premium will be allocated in accordance with those
instructions, provided such instructions comply with the Company's allocation
rules.  Premiums requiring additional underwriting will be allocated to the
Money Market Subaccount until underwriting has been completed and the premium
has been accepted.  When accepted, the Accumulation Value in the Money Market
Subaccount attributable to the Net Premium will be credited to the Policy and
allocated to the Subaccounts and Guaranteed Interest Account as requested.

                                      -7-
<PAGE>
 
    F. LOAN REPAYMENTS AND INTEREST PAYMENTS
       -------------------------------------

       1.  Repaying Policy Debt.  The Owner may repay all or part of the
           --------------------                                         
Policy Debt at any time prior to the Maturity Date while Policy is in force and
the Insured is living.  Policy Debt is equal to all outstanding Policy loans and
any accrued and unpaid interest on those loans.  Loan repay  ments must be sent
to the Customer Service Center and will be credited as of the date received.  If
the Death Benefit becomes payable while a Policy loan is outstanding, the Policy
Debt will be deducted in calculating the Death Benefit.

       2.  Allocation for Repayment of Policy Loans.  When a loan is repaid,
           ----------------------------------------                         
an amount equal to the repayment will be transferred from the Policy Loan
Account to the Subaccounts and the Guaranteed Interest Account and allo  cated
as directed by the Owner when submitting the repayment.  If no direction is
provided, the amount will be allocated in accordance with the Owner's current
Net Premium allocation percentages.

       3.  Interest on Policy Loan Account.  The amount in the Policy Loan
           -------------------------------                                
Account will be credited with interest at a minimum guaranteed annual rate of
4%.  The interest earned will be allocated to the Subaccounts and the Guaranteed
Interest Account in the same proportion that Net Premiums are then allocated.

       4.  Notice of Excessive Policy Debt.  If the Policy Debt exceeds the
           -------------------------------                                 
Accumulation Value less any Surrender Charges on any Valuation Day, the Policy
will be in default.  The Company will send Owners and any assignee of record,
notice of the default.  The notice will specify the amount that must be repaid
to prevent termination.  This amount must be submitted within a 61-day grace
period to avoid termination.  A Policy that terminates due to excessive Policy
Debt cannot be reinstated.

II.  TRANSFERS
     ---------

     A.  TRANSFERS AMONG THE SUBACCOUNTS AND THE GUARANTEED INTEREST ACCOUNT
         -------------------------------------------------------------------

          After the Free Look Period, by Written Notice or telephone, the Owner
may transfer Net Accumulation Value between and among the Subaccounts of the
Variable Account and, subject to certain special rules, to and from the
Guaranteed Interest Account.

                                      -8-
<PAGE>
 
          In any Policy Year, the Owner may make an unlimited number of
transfers; however, the Company imposes an excess transfer charge of $25 for
each transfer in excess of 12 during any Policy Year.  All transfers effected
during a single Valuation Period will be counted as one transfer for purposes of
the transfer charge.  Transfers due to the operation of Dollar Cost Averaging or
Automatic Rebalancing (each described below) are not included in determining the
limit on the number of transfers allowed without an excess transfer charge.

          The minimum amount that may be transferred from each Subaccount or the
Guaranteed Interest Account is $100 or the balance in the Subaccount or the
Guaranteed Interest Account, if less.  The minimum amount that can remain in a
Subaccount or the Guaranteed Interest Account following a transfer is $100.  Any
amount below $100 must be included in the amount transferred.  If a transfer
request does not conform to this provision the request will not be effected.

          Transfers to or from the Guaranteed Interest Account are permitted
only during the first 30 days of each Policy Year, and only one such transfer
may be made in a Policy Year.  The maximum transfer amount from the Guaranteed
Interest Account to the Subaccounts in any Policy Year is the greatest of:  (a)
25% of the Guaranteed Interest Account Accumulation Value immediately prior to
the first transfer or Withdrawal in that Policy Year from the Guaranteed
Interest Account; (b) $100; or (c) the sum of the amounts transferred out of or
withdrawn from the Guaranteed Interest Account in the prior Policy Year.

          For any class of Policies, the Company reserves the right to modify,
restrict, suspend, or eliminate the transfer privileges at any time and for any
reason.

     B.  DOLLAR COST AVERAGING FACILITY
         ------------------------------

          Dollar Cost Averaging permits an Owner to systematically transfer
specified dollar amounts, on a monthly basis, from the Money Market Subaccount
to any of the other Subaccounts.

          1.  Election of Dollar Cost Averaging.  Owners may elect Dollar Cost
              ---------------------------------                               
Averaging only if their Subaccount Accumulation Value in the Money Market
Subaccount is at least $10,000 at the time of election.

          2.  Operation of the Dollar Cost Averaging Facility.  If Dollar Cost
              -----------------------------------------------                 
Averaging is elected, each month on the Monthly Processing Date the amount to be
transferred will be taken from the Money Market Subaccount and transferred to
the Subaccount or Subaccounts designated to receive the funds.  Once elected,

                                      -9-
<PAGE>
 
Dollar Cost Averaging remains in effect for a Policy until either the Subaccount
Accumulation Value in the Subaccount from which transfers are made is depleted,
the Maturity Date occurs, or until the Owner cancels the election by Written
Notice at least seven days in advance of the next transfer date.  Once each
Policy Year, an Owner may change the transfer amount or the Subaccounts to which
transfers are to be made.

          The minimum transfer amount from the appropriate Subaccount for Dollar
Cost Averaging is $100 per month.  The maximum transfer amount for Dollar Cost
Averaging is the Subaccount Accumulation Value in the Money Market Subaccount at
the time of election, divided by 12.

          Dollar Cost Averaging transfers may be made to more than one
Subaccount, provided that the Owner designates whole number percentage
allocations of the transfer amount.  If transfers to more than one Subaccount
are elected, the minimum percentage that may be transferred to any Subaccount is
5% of the total amount transferred.

          There is no additional charge for using Dollar Cost Averaging.
Transfers under Dollar Cost Averaging are not included for purposes of computing
the excess transfer charge.

      C.  AUTOMATIC REBALANCING
          ---------------------

          Automatic Rebalancing permits an Owner to automatically rebalance the
value in the Subaccounts on a quarterly basis, based on the Owner's premium
allocation percentages in effect at the time of the rebalancing.

          1.  Election of Automatic Rebalancing.  Automatic Rebalancing may be
              ---------------------------------                               
elected when applying for the Policy or at a later date by completing the
Automatic Rebalancing form and returning it to the Customer Service Center.

          2.  Operation of Automatic Rebalancing.  If Automatic Rebalancing is
              ----------------------------------                              
selected, an Owner must allocate premiums to at least five Subaccounts and must
allocate no more than 35% of premiums to any one Subaccount.  As of the first
Valuation Day of each calendar quarter, the Company will transfer Accumulation
Value among the Subaccounts to the extent necessary to return the allocation to
the Owner's specifications.  Automatic Rebalancing may not begin until the
Monthly Processing Date following the end of the Free Look Period.  Automatic
Rebalancing will continue until the Company receives a written or telephone
termination request at the Customer Service Center.

                                      -10-
<PAGE>
 
          During Automatic Rebalancing, an Owner may not change the allocation
percentage to the Guaranteed Interest Account by more than 25% of the percentage
previously allocated to the Guaranteed Interest Account.  If a premium
allocation is changed more than twice in a Policy Year, the Company will deduct
$25 proportionately from the Subaccount Accumulation Values and Guaranteed
Interest Account Accumulation Value as of the Valuation Day the allocation
change is effective.

      D.  TRANSFER ERRORS
          ---------------

          In accordance with industry practice, the Company will establish
procedures to address and to correct errors in amounts transferred among the
Subaccounts and the Guaranteed Interest Account, except for de minimis amounts
                                                            -- -------        
(amounts under $5.00).


III. "REDEMPTION" PROCEDURES: FREE LOOK RIGHTS, SURRENDERS, WITHDRAWALS, LAPSES,
     ---------------------------------------------------------------------------
     MONTHLY DEDUCTIONS, DEATH BENEFITS, AND POLICY LOANS
     ----------------------------------------------------

     A.  "FREE LOOK" RIGHTS
         ------------------

          1.  Initial Free Look Right.  The Policy provides for an initial Free
              -----------------------                                          
Look Right during which an Owner may cancel the Policy by returning it to the
Company or to an agent of the Company before the latest of:  (a) 20 days after
the Owner receives the Policy; (b) 45 days after the application for the Policy
is signed; or (c) 10 days after the Company mails a notice of withdrawal right
to the Owner.  Upon returning the Policy to the Customer Service Center or to an
authorized agent, the Policy will be deemed void from the beginning.  Within
seven days after the Customer Service Center receives the cancellation request
and Policy, the Company will pay a refund equal to the premiums received.  Upon
issuance of a Policy, the Company will send to the Owner by first class mail or
personal delivery a written document containing information comparable to that
required by Form N-27I-2: (i) notifying the Owner of the right to return the
Policy for cancellation and receive a full refund of all premiums paid; (ii)
containing, if appropriate, a statement of Policy fees and other charges and an
illustration of guideline annual premiums, death benefits, and cash surrender
values applicable to the Age, sex, and rate class of the Insured; and (iii)
providing a form of request for refund of gross premiums paid on the Policy
setting forth (a) instructions as to the manner in which a refund may be
obtained, including the address to which the request form should be mailed, and
(b) spaces necessary to indicate the date of such request, the Policy number,
and the signature of the Owner.

                                      -11-
<PAGE>
 
          2.  Free Look Right on Increases in Stated Death Benefit.  Upon an
              ----------------------------------------------------          
increase in Stated Death Benefit, an Owner is provided with a free look right
for the increase during which he may cancel the increase.  This free look right
expires after the latest of 20 days after the Owner receives a new Policy
schedule reflecting the increase, 45 days after the application for the increase
is signed, or 10 days after the Company mails or delivers a notice of withdrawal
right to the Owner.  If the Owner cancels the increase, the Company will refund
to the Accumulation Value any charges deducted that are attributable to the
increase.

     B.  24-MONTH RIGHT TO SURRENDER AND RECEIVE REFUND
         ----------------------------------------------

          The Policy provides for a 24-month surrender right pursuant to which
the Cash Surrender Value payable upon surrender during this period will be
calculated based on a sales surrender charge that is capped at 26% of premiums
paid up to one Target Premium, plus 6% of premiums paid between one and two
Target premiums, plus 5% of all other premiums.  Upon issuance of the Policy,
the Company will send to the Owner by first class mail or personal delivery a
written document containing information comparable to that required by Form N-
27I-1, providing notice of the right to return the Policy for cancellation at
any time within 24 months after issuance of the Policy and to receive a refund
of the Cash Surrender Value based on the "capped" sales surrender charge.  Such
Cash Surrender Value will be calculated on any Valuation Day based on the Net
Accumulation Value on the Valuation Day that the Company receives the surrender
request and the amount calculated will be paid within seven days.

    C. SURRENDERS
       ----------

       1.  Requests for Cash Surrender Value.  At any time during the
           ---------------------------------                         
Insured's lifetime, the Owner may surrender the Policy for its Cash Surrender
Value.  The Cash Surrender Value on any Valuation Day is the Accumulation Value
minus any Policy loan and accrued interest less any applicable Surrender Charge
and, if on any Valuation Day other than the Monthly Processing Date, minus the
monthly deduction applicable on the next Monthly Processing Date.  The Cash
Surrender Value will be determined by the Company on the Valuation Day it
receives a satisfactory Written Request signed by the Owner and the Policy
contract or an affidavit of lost policy.  The Company provides appropriate forms
for such Written Requests.  The Company will cancel the Policy as of the date of
the Written Request and will pay the Cash Surrender Value within seven days
following receipt of the Written Request.

       2. Surrender of Policy -- Surrender Charges. A surrender charge, which
          ----------------------------------------
consists of an administrative surrender charge and a sales surrender charge, is

                                      -12-
<PAGE>
 
imposed upon a surrender, reduction in Stated Death Benefit, or lapse of the
Policy within either the first 14 Policy Years or the 14 years following an
increase in Stated Death Benefit. This surrender charge is designed partially to
compensate the Company for the cost of issuing and distributing the Policy. The
surrender charges are described in Appendix B to this memorandum.

    D. WITHDRAWALS
       -----------

       1. When Withdrawals are Permitted. At any time during the Insured's
          ------------------------------
lifetime and after the first Policy Year, the Owner may, by Written Request,
withdraw a portion of the Policy's Cash Surrender Value subject to the following
conditions:

         .  The minimum amount that may be withdrawn is $500.

         .  The amount withdrawn must be less than the then-current Cash
Surrender Value.

         .  The amount withdrawn cannot cause the Stated Death Benefit to be
reduced below $50,000.

         .  No more than 12 withdrawals may be made during a Policy Year.

         .  A withdrawal transaction charge equal to the lesser of 2% of the
withdrawal amount requested or $25 will be assessed on each withdrawal made
during a Policy Year after the first withdrawal.

         .  The Owner may direct how the withdrawal amount requested, plus any
withdrawal transaction charge and any surrender charge (collectively, the "Gross
Withdrawal") will be deducted from the Accumulation Value in the Subaccounts and
the Guaranteed Interest Account.  If no directions are provided, the Gross
Withdrawal will be deducted from the Accumulation Value in the Subaccounts and
the Guaranteed Interest Account on a pro rata basis.

          .  The Company generally will pay a withdrawal request within seven
days following the Valuation Day it receives the request.

          .  If death benefit type A is in effect, a Withdrawal may reduce the
Accumulation Value and the Stated Death Benefit.  However, if the Withdrawal is
the first Withdrawal of that Policy Year, the Insured's attained age is less

                                      -13-
<PAGE>
 
than 81 at the time of the Withdrawal, and the Withdrawal occurs less than 16
years following the date of issue, then the Withdrawal will not reduce the
Stated Death Benefit if the amount of the Withdrawal is less than 5% of the
Stated Death Benefit.  If the above conditions are met and the amount of the
Withdrawal exceeds the greater of 10% of the Accumulation Value immediately
prior to the Withdrawal and 5% of the Stated Death Benefit, the Stated Death
Benefit will only be reduced by the amount by which the Withdrawal exceeds the
greater of 10% of the Accumulation Value immediately prior to the Withdrawal and
5% of the Stated Death Benefit.  Otherwise, the Accumulation Value will be
reduced, dollar for dollar, by the Gross Withdrawal amount.  The Stated Death
Benefit will be reduced in proportion to the reduction in Accumulation Value
caused by the Withdrawal.  The decrease in Accumulation Value will occur on the
day we process the Withdrawal; however, the decrease in Stated Death Benefit
will be effective as of the next Monthly Processing Date.   If the reduction
occurs while the surrender charge is in effect (generally, during the first 14
Policy Years and the first 14 years after an increase in Stated Death Benefit),
a portion of the sales surrender charge may be assessed.

          .  If death benefit type B is in effect, a withdrawal will reduce the
Accumulation Value dollar for dollar but the Stated Death Benefit will not be
reduced as the Accumulation Value reflects the decrease.

      E.  LAPSES
          ------

          If the Cash Surrender Value on a Monthly Processing Date is less than
the amount of the monthly deduction to be deducted on that date and the Three-
Year Guarantee is not in effect, the Policy will be in default and a grace
period will begin.  A Policy will lapse on the 61st day after a grace period
notice in sent unless a premium sufficient to cover the monthly deduction is
paid during the grace period.

     F.  MONTHLY DEDUCTIONS
         ------------------

          On each Monthly Processing Date, redemptions in the form of deductions
will be made from Accumulation Value for the monthly deduction, which is a
charge compensating the Company for administrative expenses and for the
insurance coverage provided by the Policy.  The monthly deduction consists of
four components:  (a) the initial Policy charge; (b) the monthly administrative
charge; (c) the cost of insurance charge; and (d) supplemental benefit charges.
The monthly deduction will be deducted from the Subaccounts of the Variable
Account and the Guaranteed Interest Account in the same proportion that the
Owner's Net Accumulation Value in each Subaccount and the Guaranteed Interest
Account bears to the total Net Accumulation Value as of the Monthly Processing
Date.

                                      -14-
<PAGE>
 
       1.  Initial Policy Charge.  The initial Policy charge is $20 per month
           ---------------------                                             
for the first Policy Year.  This charge is designed to reimburse the Company for
the costs of setting up a Policy, other than sales expenses, such as application
processing, medical examinations, establishment of Policy records and insurance
underwriting costs.

       2. Monthly Administrative Charge. The monthly administrative charge is $6
          -----------------------------
per month and is guaranteed never to exceed $10 a month. This charge is designed
to reimburse the Company for expenses necessary to cover the ongoing costs of
maintaining a Policy, such as premium billing and collections, claim processing,
Policy transactions, record keeping, reporting and other communications with
Owners, and other expenses and overhead.

        3.  Cost of Insurance Charge.  The cost of insurance charge is
            ------------------------                                  
intended to compensate the Company for the anticipated cost of paying the amount
of the Death Benefit that exceeds an Owner's Accumulation Value upon the death
of the Insured.  The cost of insurance charges are calculated monthly, and
depend on a number of variables, including the Age, sex and risk class(es) of
the Insured.  The charge varies from Policy to Policy and from month to month.

        4.  Supplemental Benefit Charges.  An Owner may add supplemental
            ----------------------------                                
benefits to the Policy.  Such benefits are made available by the Company through
riders to the Policy.  If any additional benefits are added to a Policy, charges
for these benefits will be deducted monthly as part of the monthly deduction.

        5.  Persistency Refund.  Southland currently intends to provide a
            ------------------                                           
persistency refund to long-term Owners of the Policy.  Each month the Policy or
a coverage segment of Stated Death Benefit remains in force after the tenth
Policy Anniversary, Southland will credit the Net Accumulation Value with a
refund equivalent to 0.35% on an annualized basis (0.02917% monthly) of the Net
Accumulation Value for that segment.  The Net Accumulation Value will be
allocated to each coverage segment based upon the number of completed Policy
Years that segment has been in force and the size of the guideline annual
premium as defined by the federal income tax law definition of life insurance.
The persistency refund will be added to the Subaccounts of the Variable Account
and the Guaranteed Interest Account in the same proportion that the Accumulation
Value in each Account bears to the Net Accumulation Value as of the Monthly
Processing Date.

                                      -15-
<PAGE>
 
    G.  DEATH BENEFITS
        --------------

        1. Payment of Death Proceeds. As long as the Policy remains in force,
           -------------------------
the Company will pay the Death Proceeds to the Beneficiary after receiving
satisfactory proof of the Insured's death. The Death Proceeds is equal to the
sum of the Base Death Benefit on the date of the Insured's death, plus any extra
benefits provided by rider, minus any Policy Debt on that date and, if the death
occurred during a grace period, minus the past due monthly deductions. The Death
Proceeds will be paid to the Beneficiary in a lump sum generally within seven
days after the Valuation Day by which the Company has received at the Customer
Service Center all materials necessary to constitute satisfactory proof of
death. If a payment option is elected, the Death Proceeds will be applied to the
option within seven days after the Valuation Day by which the Company received
satisfactory proof of death and payments will begin under that option when
provided by the option.

          2.  Base Death Benefit and Death Benefit Types.  The Policy provides
              ------------------------------------------                      
two Death Benefit Types:  Death Benefit Type A and Death Benefit Type B.  Under
Death Benefit Type A, the Base Death Benefit is the greater of the Stated Death
Benefit or a multiple of the Accumulation Value on the date of the Insured's
death.  Under Death Benefit Type B, the Base Death Benefit is the greater of the
Stated Death Benefit plus the Accumulation Value, or a multiple of the
Accumulation Value, on the date of the Insured's death.

          If investment performance is favorable, the amount of the Base Death
Benefit may increase.  However, under Death Benefit Type A, the Base Death
Benefit ordinarily will not change for several years as a result of any
favorable investment performance and may not change at all, whereas under Death
Benefit Type B, the Base Death Benefit will vary directly with the investment
performance of the Accumulation Value.

          In both cases, the multiple of the Accumulation Value depends on the
Insured's attained Age at death.  The table of multiples in effect as of the
issue date is set forth in the Policy.  The Company reserves the right to change
the table if the table becomes inconsistent with any federal income tax laws
and/or regulations.

       3. Changes in Death Benefit Type. The Death Benefit Type is selected in
          -----------------------------
the application for the Policy. After the first Policy Year, the Owner, by
Written Request, may change the Death Benefit Type on the Policy subject to the
following rules:

                                      -16-
<PAGE>
 
          . After any change, the Stated Death Benefit must be at least $50,000;

          .  The effective date of the change will be the Policy Anniversary
after the Company approves the Written Request for the change;

          .  When a change from Death Benefit Type A to Death Benefit Type B is
made, the Stated Death Benefit after the change will be equal to the Stated
Death Benefit before the change minus the Accumulation Value on the effective
date of the change.

          .  When a change from Death Benefit Type B to Death Benefit Type A is
made, the Stated Death Benefit after the change will be equal to the Stated
Death Benefit before the change plus the Accumulation Value on the effective
date of the change.

          .  The Company may require evidence of insurability in the event of a
change from Type A to Type B.

       4.  Changes in Stated Death Benefit.  The initial Stated Death Benefit
           -------------------------------                                   
is set at the time the Policy is issued.  The minimum initial Stated Death
Benefit is $100,000.  The Owner, by Written Request, may increase or decrease
the initial Stated Death Benefit from time to time, subject to the following
conditions:

          .  No change will be permitted that would result in the Policy not
satisfying the requirements of section 7702 of the Internal Revenue Code.

          .  An increase or decrease can be requested only during the 30-day
period preceding a Policy Anniversary.

          Increases
          ---------

          .  Any increase in the Stated Death Benefit must be at least $10,000
and an application must be submitted, along with evidence of insurability
satisfactory to the Company.

          .  The Company will employ its standard underwriting procedures to
determine whether the Insured is insurable for the increase, and to which rate
class the Insured should be assigned for the increase.

          .  An increase in Stated Death Benefit will become effective as of the
Policy Anniversary on or following the date the increase is approved.

                                      -17-
<PAGE>
 
          .  The Policy must be returned by the Owner so that the Company can
Policy to reflect the increase.  The amended Policy will be promptly returned to
the Owner.

          .  If the increase becomes effective during the first three Policy
Years, the Three-Year Guarantee will be extended for three years from the
effective date of the increase.

          .  A Target Premium will be established for the increase, and the
portion of premiums paid thereafter allocated to the increase will be subject to
a 4% sales charge until an amount equal to 10 Target Premiums for the increase
has been paid.  Premiums paid are allocated to the increase in Stated Death
Benefit in the same proportion that the Target Premium for each portion of the
Stated Death Benefit bears to the total Target Premium for the Policy after the
increase is taken into account.

          Decreases
          ---------

          .  Any decrease in the Stated Death Benefit must be at least $10,000,
and the Stated Death Benefit after the decrease must be at least $50,000.

          .  No decrease may be made in the first year following the effective
date of an increase in Stated Death Benefit.

          .  A decrease in Stated Death Benefit will become effective as of the
Policy Anniversary on or following the Company's receipt of the Written Request.

          .  If increases in the initial Stated Death Benefit are in effect, a
decrease in Stated Death Benefit will be allocated to each segment of the Stated
Death Benefit in the same proportion as the Target Premium for each segment
bears to the total Target Premiums for the Policy.

          .  If a decrease in Stated Death Benefit occurs during the first 14
Policy Years, or during the first 14 years following an increase in Stated Death
Benefit, a Surrender Charge will apply.

    H. POLICY LOANS
       ------------

       1.  Obtaining Policy Loans.  The Owner may obtain a Policy loan from
           ----------------------                                          
the Company at any time after the first Policy Anniversary by submitting a
Written Request to the Customer Service Center.  The minimum amount that the

                                      -18-
<PAGE>
 
Owner may borrow is $100.  The maximum loan amount is 90% of the Policy's Cash
Surrender Value on the Valuation Day that the Company receives the loan request.
Outstanding Policy loans reduce the amount available for new loans. Policy loans
will be processed as of the Valuation Day the Written Request is received and
loan proceeds generally will be sent to the Owner within seven days thereafter.

          2.  Interest on Policy Loans.  The Company charges interest daily on
              ------------------------                                        
any outstanding Policy loan at a maximum annual interest rate of 6%.  Interest
is due and payable on each Policy Anniversary while a Policy loan is
outstanding.  If interest is not paid when due, the amount of the interest is
added to the loan and becomes part of the outstanding Policy loan.

          3.  Collateral for Policy Loans.  When a Policy loan is made (or when
              ---------------------------                                      
interest is not paid when due), an amount equal to the loan proceeds (or due and
unpaid interest) is withdrawn from the Accumulation Value in the Subaccounts or
Guaranteed Interest Account.  This withdrawal is made pro rata on the basis of
Accumulation Value in each Subaccount and the Guaranteed Interest Account unless
the Owner directs a different allocation when requesting the loan and as long as
at least $100 remains in the Subaccount or Guaranteed Interest Account after the
allocation.  The amount withdrawn is then transferred to the Policy Loan Account
in the General Account.

          4.  Preferred Policy Loans.  Certain loan amounts taken after the
              ----------------------                                       
earlier of the tenth Policy Anniversary, or the fifth Policy Anniversary if the
Insured's Age is 60 or greater, will be considered preferred loan amounts.
During each Policy Year of preferred loan eligibility, the first loan made
during that year will be considered a preferred loan amount up to a maximum of
10% of the Net Accumulation Value. Any amount loaned later in that Policy Year
will not be considered a preferred loan amount.  If the preferred loan amount
made during any Policy Year is less than the maximum allowed, the balance may
not be carried over to increase the eligible preferred loan amount of any
subsequent Policy Year.  Beginning with the 21st Policy Year, all loan balances
will be considered to be preferred loan amounts.  The amount of any Guaranteed
Interest Account Accumulation Value equal to any preferred loan amount on the
Policy will be credited with interest at the rate of 4%.

          5.  Effects of Policy Loans.  A Policy loan, whether or not repaid,
              -----------------------                                        
will have a permanent effect on the Death Benefit and Accumulation Values
because the investment results of the Subaccounts of the Variable Account and
current interest rates credited on the Guaranteed Interest Account Accumulation
Value will apply only to the non-loaned portion of the Accumulation Value.  The

                                      -19-
<PAGE>
 
longer the loan is outstanding, the greater the effect is likely to be.  The
effect could be favorable or unfavorable, depending on the investment results of
the Subaccounts or credited interest rates for the Guaranteed Interest Account
while the Policy loan is outstanding.  Policy loans may increase the potential
for lapse if investment results of the Subaccounts are less than anticipated.
In addition, Policy loans could, particularly if not repaid, make it more likely
than otherwise for a Policy to terminate.

    I. MATURITY BENEFIT
       ----------------

          If the Insured is living at Age 100 and the Policy is in force, the
Company will pay the Owner the Net Accumulation Value and the Policy will
terminate unless the Owner exercise his or her right to continue the Policy.

    J. PAYMENT OPTIONS
       ---------------

          The Policy offers a wide variety of optional ways of receiving
proceeds payable under the Policy, such as on surrender, death or maturity,
other than in a lump sum.  None of these options vary with the investment
performance of a separate account because they are all forms of fixed-benefit
annuities.

    K. PAYMENTS BY THE COMPANY
       -----------------------

          Lump sum payments of withdrawals, surrenders or Death Proceeds from
the Subaccounts will usually be made within seven days of the Valuation Day on
which the Company receives the request and all required documentation at the
Customer Service Center.  If proceeds from a withdrawal, surrender or Death
Proceeds are to be applied to a payment option, the proceeds will usually be
applied within seven days of the Valuation Day on which the Company receives the
request and all required documentation at the Customer Service Center.  The
Company may postpone the processing of any such transactions for any of the
following reasons:

       1.  When the New York Stock Exchange ("NYSE") is closed for trading other
than for customary holiday or weekend closings, or trading on the NYSE is
otherwise restricted, as determined by the Securities and Exchange Commission
("SEC");

       2.  When the SEC determines that an emergency exists that would make the
disposal of securities held in the Variable Account or the determination of the
value of the Variable Account's assets not reasonably practicable; or

                                      -20-
<PAGE>
 
       3.  When the SEC by order permits a delay for the protection of Owners.

          The Company may defer up to six months the payment of any withdrawal
or proceeds from the Guaranteed Interest Account.  Interest will be credited at
the currently declared rate of interest for the Guaranteed Interest Account
until payment is made.

    L. RIGHT TO CONVERT THE POLICY
       ---------------------------

          At any time within the first 24 Policy Months after issuance of the
Policy or after an increase in Stated Death Benefit, while the Policy is in
force during the life of the Insured, the Owner may convert the Policy without
evidence of insurability to a new Policy on the life of the Insured providing
benefits that do not vary with the investment experience of the Variable
Account.  This conversion is accomplished by the transfer of the entire amounts
in the Subaccounts to the Guaranteed Interest Account and the allocation of all
future premium payments to the Guaranteed Interest Account.  This will, in
effect, serve as a conversion of the Policy to the equivalent of a flexible
premium universal life insurance policy.  No charge will be imposed on the
transfer in exercising this exchange privilege.

          The converted policy will be on the flexible premium adjustable life
insurance plan being issued by the Company.  The converted Policy will provide
the same amount of death benefit or the same net amount at risk to the Company
as the Policy and will have the same issue Age and date of issue as the Policy.
The cost of insurance rates for the converted Policy will be those applicable to
flexible premium adjustable life policies in the same risk classification as the
Policy and issued on the same date as the Policy.  All Policy Debt must be paid
at the time of conversion.  The contestable period, suicide period, and
surrender charge period of the converted Policy will be measured from the date
of issue of the Policy.  The effective date of the conversion will be the
Valuation Day the Company received a Written Request to convert at its Customer
Service Center. When exercising the conversion right, the Owner is required to
return the Policy to the Customer Service Center, and the Company will send the
Owner a new Policy form which will not allow the allocation of future premiums
to Subaccounts of the Variable Account.

    M. REDEMPTION ERRORS
       -----------------

          In accordance with industry practice, the Company will establish
procedures to address and to correct errors in amounts redeemed from the
Subaccounts and the Guaranteed Interest Account, except for de minimis amounts
                                                            -- -------        
(amounts under $5.00).

                                      -21-
<PAGE>
 
                                  APPENDIX A

          Charges will be deducted from the Net Accumulation Value on each
Monthly Processing Date to compensate the Company for administrative expenses
and for the insurance coverage provided by the Policy.  The monthly deduction
consists of four components:  (a) the initial Policy charge, (b) monthly
administrative charge, (c) the cost of insurance charge, and (d) supplemental
benefit charges.  Because portions of the monthly deduction, such as the cost of
insurance charge, can vary from month to month, the monthly deduction may vary
in amount from Policy to Policy and from month to month.  The monthly deduction
will be deducted from the Subaccounts of the Variable Account and the Guaranteed
Interest Account in the same proportion that the Owner's Net Accumulation Value
in each Subaccount and the Guaranteed Interest Account bears to the total Net
Accumulation Value as of the Monthly Processing Date.

          (a)  INITIAL POLICY CHARGE.  The initial Policy charge is $20 per
               ---------------------                                       
month for the first Policy Year.  This charge is designed to reimburse the
Company for expenses and covers the costs of setting up each Owner's Policy,
other than sales expenses, such as application processing, medical examinations,
establishment of Policy records and insurance underwriting costs.

          (b)  MONTHLY ADMINISTRATIVE CHARGE.  The monthly administrative charge
               -----------------------------                                    
is $6 per month and is guaranteed never to exceed $10 a month.  This charge is
designed to reimburse the Company for expenses incurred in covering the ongoing
costs of maintaining each Owner's Policy, such as premium billing and
collections, claim processing, Policy transactions, record keeping, reporting
and other communications with Owners, and other expenses and overhead. The
initial amount of this charge is not more than the average expected cost of the
services to be provided this year.

          (c)  COST OF INSURANCE CHARGE.  The cost of insurance charge
               ------------------------                               
compensates the Company for the anticipated cost of paying the amount of the
Death Benefit that exceeds the Owner's Accumulation Value upon the death of the
Insured.  The cost of insurance charges are calculated monthly, and depend on a
number of variables.  The charge varies from Policy to Policy and from month to
month.

          The cost of insurance charge is equal to the Company's current monthly
cost of insurance rate multiplied by the net amount at risk under the Policy for
the Death Benefit.  The net amount at risk for the Base Death Benefit is equal
to the difference between the current Base Death Benefit and the amount of the
Owner's Accumulation Value on the Monthly Processing Date.  For this purpose,
the amount of the Owner's Accumulation Value is determined after deduction of
administrative charges and other supplemental benefit charges due on that date,
but before deduction of the cost of insurance charges for the Base Death
Benefit, and for any Adjustable Term Insurance Rider.  The net amount at risk
for the Adjustable Term Insurance Rider is equal to the amount of the benefit
provided.  The amount of the cost of insurance charges will vary from month to
month with changes in the net amount at risk, changes in the relative makeup of
the death benefit, and with increasing Age of the Insured.
<PAGE>
 
          If the Base Death Benefit of an Owner's Policy consists of more than
one segment because there has been an increase in Stated Death Benefit, then the
charge is calculated separately for each segment.  The cost of insurance charge
for each segment is equal to the Company's current monthly cost of insurance
rate for each segment multiplied by the net amount at risk for that segment of
the Death Benefit.  Net amount at risk for each segment of the Death Benefit is
calculated on the Monthly Processing Date.  Net amount at risk is allocated to
each Stated Death Benefit segment in the same proportion that the Stated Death
Benefit of each segment bears to the sum of the Stated Death Benefit for all
segments as of the Monthly Processing Date.

          The cost of insurance rate for a Policy (or for a segment) is based on
the Age, sex and risk class of the Insured, and therefore varies from time to
time.  The Company currently places Insureds in the following risk classes,
based on the Company's underwriting:  a smoker or nonsmoker standard risk class
or a risk class involving a higher mortality risk (a "substandard class").

          The Company's current cost of insurance rates may be less than the
guaranteed rates.  In addition, current rates are greater for Policies with
Stated Death Benefit (or Target Death Benefit, if any) that is less than
$250,000 on the Policy Date.  Current cost of insurance rates will be determined
based on the Company's expectations as to future mortality, investment, expense
and persistency experience.  These rates may change from time to time, but they
will never be more than the guaranteed maximum rates set forth in the Owner's
Policy.  The guaranteed rates for standard risk classes are based on the 1980
Commissioners' Standard Ordinary Mortality Tables, Age Nearest Birthday ("1980
CSO Tables"), sex-distinct.  The guaranteed rates for substandard risk classes
are based on multiples or additives of the 1980 CSO Tables.

          (d)  SUPPLEMENTAL BENEFIT CHARGES.  If any additional benefits are
               ----------------------------                                 
added to an Owner's Policy, applicable charges for each additional benefit will
be deducted monthly from the Owner's Accumulation Value as part of the monthly
deduction.  Additional benefits are provided through riders attached to the
Policy.  The Company may cancel these additional benefits at any time.
Currently, the Company offers the following additional benefit riders:

          (1)  The Accidental Death Benefit Rider will pay the benefit amount
selected by the Owner if the Insured dies as a result of an accident or if the
Insured dies within 90 days of an injury sustained in an accident and the death
occurs prior to the Insured's Age 70.  The minimum amount of coverage is $5,000
and the maximum amount is the Stated Death Benefit;

          (2)  The Adjustable Term Insurance Rider allows the Death Proceeds to
be increased.  The amount of this rider adjusts daily to represent the amount of
any difference between the Target Death Benefit selected by the Owner and the
Base Death Benefit currently in effect;

                                     A-ii
<PAGE>
 
          (3)  The Additional Insured Rider allows the Owner to provide for
death benefits upon the death of immediate family members of the Insured.  A
maximum of nine Additional Insured Riders may be added to the Owner's Policy.
The minimum amount of coverage for each Rider is $10,000 and the maximum
coverage for all Additional Insured Riders combined equals five times the Stated
Death Benefit of the Owner's Policy;

          (4)  The Children's Insurance Rider allows an Owner to add death
benefit coverage on his or her children.  Children may be covered upon birth or
legal adoption without the Owner presenting evidence of insurability to the
Company.  The minimum amount of coverage is $1,000 per child and the maximum
amount of coverage is $10,000 per child;

          (5)  The Exchange of Insured Rider allows the Owner to change the
Insured. Changing the Insured may cause the cost of insurance charge to change;
however, the Company will not change the Policy values or the surrender charge.
The Company assesses no charge to add this Rider to a Policy;

          (6)  The Guaranteed Insurability Rider allows the Owner to increase
the Stated Death Benefit without providing the Company with evidence that the
Insured remains insurable during the Policy;

          (7)  The Waiver of the Cost of Insurance and Monthly Expense Charges
Rider provides that during the total disability of the Insured, while the Policy
remains in force, the monthly expense charges, cost of insurance charges and
Rider charges will be waived and therefore not deducted from Owner's Net
Accumulation Value; and

          (8)  The Waiver of Specified Premium Rider provides that during the
total disability of the Insured, while the Policy remains in force, a specified
premium will be credited monthly to the Policy.  In the Policy application, the
Owner selects the amount of premium, within limits, that will be waived.

                                     A-iii
<PAGE>
 
                                  APPENDIX B

          The Company will assess a surrender charge against the Owner's
Accumulation Value upon a Surrender, reduction in Stated Death Benefit or lapse
of the Policy during the first 14 Policy Years, or the 14 years following an
increase in Stated Death Benefit (also referred to as an addition of a new
coverage segment of Stated Death Benefit).  The surrender charge consists of two
charges:  an administrative surrender charge and a sales surrender charge.

ADMINISTRATIVE SURRENDER CHARGE
- -------------------------------

          The administrative surrender charge is equal to $4.00 per $1,000 of
Stated Death Benefit.

          The administrative surrender charge is calculated separately for the
initial Stated Death Benefit and for each increase in Stated Death Benefit (the
initial Stated Death Benefit and each increase is referred to as a death benefit
segment).  The charge is equal to $4.00 per $1,000 of Stated Death Benefit for
each death benefit segment.  The administrative surrender charge in effect on
any Valuation Day is taken into account when calculating the Cash Surrender
Value payable on a Surrender.  The administrative surrender charge is not
deducted on a reduction in Stated Death Benefit.  The administrative surrender
charge remains level for the first 9 Policy Years or 9 years after an increase
in Stated Death Benefit, then decreases by one-sixth of the amount in effect at
the end of the 9th Policy Year until it reaches zero at the beginning of the
15th year, or the year in which the Insured reaches Age 98, whichever is
earlier.

The administrative surrender charge is designed to partially cover the
administrative expenses associated with setting up a Policy (other than sales
expenses), such as application processing, establishment of Policy records and
insurance underwriting costs.  It also includes costs associated with the
development and operation of the Company's systems for administering the
Policies.

SALES SURRENDER CHARGE
- ----------------------

          The sales surrender charge is equal to 50% of actual premiums paid up
to one Target Premium plus 40% of any additional premiums paid up to two Target
Premiums. However, in the first two Policy Years, the sales surrender charge is
capped at 26% of premiums paid up to one Target Premium, plus 6% of premiums
paid between one and two Target Premiums, plus 5% of all other premiums.  Target
Premiums are actuarially determined based on the Age, sex and risk class of the
Insured, and are not based on the planned premium determined when the Policy is
                 ---                                                           
purchased.

          The maximum sales surrender charge for a Stated Death Benefit remains
level for the first nine Policy Years or for the first nine years following an
increase in a Stated Death Benefit segment, then decreases by one-sixth of the
amount in effect at the end of the 9th year each Policy Year until it reaches
zero at the beginning of the 15th year, or the year in which the Insured reaches
Age 98, whichever is earlier.
<PAGE>
 
          A sales surrender charge is deducted on a decrease in Stated Death
Benefit, and future sales surrender charges are adjusted based on the following
rules.  If the new Target Premium for each Stated Death Benefit segment is
greater than or equal to the sum of the Owner's paid premiums that are allocated
to the segment, the maximum sales surrender charge the Owner may pay in the
future will be reduced, but a sales surrender charge will not be deducted from
the Accumulation Value.  If the new Target Premium for each Stated Death Benefit
segment is less than the sum of the Owner's paid premiums that are allocated to
the segment, the maximum sales surrender charge the Owner may pay in the future
will be reduced and a sales surrender charge will be deducted from the
Accumulation Value.  The new sales surrender charge will be recalculated as if
the new Target Premium was always in effect for the segment.  A deduction equal
to the difference between the sales surrender charge as calculated before and
after the decrease will be taken from the Accumulation Value.

          If the Owner requests a decrease to the Stated Death Benefit or take a
Withdrawal that causes the Stated Death Benefit to be reduced, more than nine
years following the Policy Date or the date of an increase to the Stated Death
Benefit, whichever is applicable, the maximum sales surrender charge the Owner
could pay in the future will be reduced in the same proportion that the Stated
Death Benefit is reduced.

                                     B-ii

<PAGE>
 
                                                                     Exhibit 2 
[LETTERHEAD OF SOUTHLAND LIFE
ING GROUP APPEARS HERE]

May 8, 1996



Southland Life Insurance Company
5780 Powers Ferry Road, N.W.
Atlanta, Georgia 30327-4390

Dear Sir or Madam:

     This opinion is furnished in connection with the Form S-6 Registration
Statement being filed by Southland Life Insurance Company ("Southland") under
the Securities Act of 1933, as amended (the "Act"), for the offering of
interests ("Interests") in Southland Separate Account L1 ("Separate Account L1")
under the Flexible Premium Variable Universal Life Insurance Policies
("Policies") to be issued by Southland.  The securities being registered under
the Act are to be offered in the manner described in the Registration Statement.

     I have examined or supervised the examination of all such corporate records
of Securities Life and such other documents and such laws as I consider
appropriate as a basis for the opinion hereinafter expressed.  On the basis of
such examination, it is my opinion that:

1.   Southland is a corporation duly organized and validly existing under
     the laws of the State of Texas.

2.   Separate Account L1 was duly created as a separate investment account
     of Southland pursuant to the laws of the State of Texas.

3.   The assets of Separate Account L1 will be owned by Southland.  Under
     Texas law and the provisions of the Policies, the income, gains and losses,
     whether or not realized, from assets allocated to Separate Account L1 must
     be credited to or charged against such Account, without regard to the other
     income, gains or losses of Southland.

4.   The Policies provide that the assets of Separate Account L1 may not be
     charged with liabilities arising out of any other business Southland may
     conduct, except to the extent that assets of Separate Account L1 exceed its
     liabilities arising under the Policies.

5.   The Policies and the Interests in Separate Account L1 to be issued
     under the Policies have been duly authorized by Southland; and the
     Policies, including the Interests therein, when issued and delivered, will
     constitute validly issued and binding obligations of Southland in
     accordance with their terms.
<PAGE>
 
I hereby consent to the filing of this opinion as an exhibit to the Registration
Statement and to the use of my name under the caption "Legal Matters" in the
Prospectus contained in the Registration Statement.

                                              Sincerely,

                                           /S/Francis J. Mulcahy    

                                              Francis J. Mulcahy
                                              Secretary, Vice President
                                              and General Counsel

FJM/jnc

<PAGE>
 
                                                                       Exhibit 6

[LETTERHEAD OF SOUTHLAND LIFE APPEARS HERE]

May 8, 1996

Board of Directors
Southland Life Insurance Company
5780 Powers Ferry Road
Atlanta, Georgia 30327-4390

      RE:  Statement of Opinion regarding Aspects of Southland Life Insurance
           Company Filing of an Individual Flexible Premium Adjustable
           Combination Fixed and Variable Life Insurance Policy (S.E.C.
           Registration Number 33-97852)


To the Board of Directors:

This opinion is furnished in connection with the filing of a Registration
Statement on Form S-6 (the "Registration Statement") covering certain flexible
premium adjustable combination fixed and variable life insurance policies (a
"Policy" or the "Policies") proposed to be issued by Southland Life Insurance
Company (the "Company").

The Prospectus included in the Registration Statement describes the Policies.
The Policy forms were reviewed under my direction and I am familiar with the
Registration Statement and the Exhibits thereto.  In my opinion:

1.  The sales load, as defined in paragraph (c)(4) of Rule 6e-3T under the
Investment Company Act of 1940 will not exceed nine percent (9%) of the sum of
the guideline annual premiums that would be paid during the period equal to the
lesser of 20 years or the life expectancy based on the appropriate 1980
Commissioners Standard Ordinary Mortality Table.

2.  The illustrations of Policy values, surrender values, death benefits and
accumulated premiums in the Prospectus included in the Registration Statement
and based on the assumptions stated in the illustrations are consistent with
provisions of the Policy.  The rate structure of the Policies have not been
designed so as to make the relationship between premiums and benefits, as shown
in the illustrations, appear to be more favorable to prospective non-smoker
purchasers at age 45 than to prospective purchasers of Policies, for males or
females, smokers or non-smokers, at other issues ages.

3. The information contained in the Prospectus included in the Registration
Statement describing  premiums, surrender charges and other charges described in
the Registration Statement are consistent with the provisions of the Policy.

I hereby consent to the use of this opinion as an exhibit to the Registration
Statement and to the use of my name relating to actuarial matters under the
heading "Experts" in the Prospectus.

/s/ Pamela M. Crane

Pamela M. Crane, F.S.A., M.A.A.A.
Senior Vice President - Finance/Actuarial
Southland Life Insurance Company


                       Southland Life Insurance Company

            5780 Powers Ferry Road, NW . Atlanta, GA 30327-4390  
                    Phone: 404-980-5100 . Fax: 404-980-5800

<PAGE>
 
                                  EXHIBIT 7(a)


                        CONSENT OF INDEPENDENT AUDITORS



We consent to the reference to our firm under the captions "Experts" and
"Financial Statements" and to the use of our report dated April 5, 1996, in Pre-
Effective Amendment No. 2 to the Registration Statement (Form S-6 No. 33-97852)
and related Prospectus of Southland Separate Account L1 (dated May 14, 1996).



                                                 ERNST & YOUNG LLP



Atlanta, Georgia
May 8, 1996

<PAGE>
 
                  [Letterhead of Sutherland, Asbill & Brennan]

                                                                    Exhibit 7(b)
                                        

                                 May 8, 1996



Southland Life Insurance Company
5780 Powers Ferry Road, N.W.
Atlanta, GA 30340

Gentlemen:

     We hereby consent to the reference to our name under the caption "Legal
Matters" in the prospectus filed as part of the Pre-Effective Amendment No. 2 to
Form S-6 for Southland Separate Account L1 (File No. 33-97852).  In giving this
consent, we do not admit that we are in the category of persons whose consent is
required under Section 7 of the Securities Act of 1933.

                                 Sincerely,

                                 SUTHERLAND, ASBILL & BRENNAN



                                 By: /s/ Stephen E. Roth
                                    --------------------------
                                     Stephen E. Roth, Esq.


LFB


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