<PAGE> 1
CONTESTABILITY - We will not contest insurance coverage on the life of any
Covered Child after the Issue Date of this Rider.
SUICIDE - If, within two years from the Issue Date of this Rider, the Insured
commits suicide, while sane or insane:
1. the amount payable will be limited to the charges paid for this Rider; and
2. We will have no other obligations under this Rider except as stated in the
Conversion provision of this Rider.
TERMINATION - This Rider will terminate on the earliest of:
1. Subject to the Grace Period provision of the policy, the date on which the
Cash Surrender Value is insufficient to pay the charges due for the
policy or this Rider; or
2. the Deduction Day next following Your request In Writing to terminate this
Rider; or
3. policy termination (subject to the 'Conversion' provision); or
4. the Expiry Date of this Rider as shown on the Policy Summary; or
5. with respect to each Covered Child, conversion of insurance on his or her
life; or
6. with respect to each Covered Child, his or her twenty-fifth birthday.
THE TRAVELERS LIFE AND ANNUITY COMPANY
[SIG]
President
<PAGE> 2
ACCIDENTAL DEATH BENEFIT RIDER
This Rider is made a part of the policy to which it is attached. Except where
this Rider provides otherwise, it is subject to all conditions of the policy.
BENEFIT
The Accidental Death Benefit is shown on the Policy Summary page for this
Rider. We will pay the Accidental Death Benefit if an accident that occurs
while this Rider is in force causes the Insured's death within ninety days
after the accident. The Insured's death must be due to bodily injuries which
are the direct and independent cause of death. Except in the case of drowning
or internal injury revealed by autopsy, an injury must be evidenced by a
visible wound or contusion.
EXCLUSIONS
We will not pay the Accidental Death Benefit if the Insured's death results
from, and/or is contributed to by:
1. any bodily or mental infirmity or disease; or
2. war, whether declared or not, or any act of war or international armed
conflict; or
3. operating, learning to operate or serving as a crew member of any aircraft
or aerial navigation device; or
4. suicide while sane or insane.
ISSUE DATE
The Issue Date of this Rider is the same as the Issue Date of the basic policy
unless otherwise shown on the Policy Summary.
CONTESTABILITY
When applied to this Rider, the contestability period will begin on this
Rider's Issue Date.
CHARGE
This Rider is issued in consideration of the application for it and the
deduction of the additional charge shown on the Policy Summary. The charge for
this Rider is deducted under the same conditions as the charge for the policy.
AUTOPSY
We reserve the right to make an autopsy if allowed by law.
TERMINATION
This Rider will terminate on the earliest of:
1. Subject to the Grace Period provision of the policy, the date on which the
Cash Surrender Value would not be enough to pay charges due for the policy
or this Rider; or
2. failure to pay any charges due for this Rider or the basic policy; or
3. the Deduction Day following Your request, In Writing, to terminate this
Rider; or
4. the Expiry Date of this Rider as shown on the Policy Summary; or
5. policy termination or maturity.
THE TRAVELERS LIFE AND ANNUITY COMPANY
[SIG]
President
<PAGE> 3
COST OF LIVING ADJUSTMENT RIDER
This Rider is made a part of the policy to which it is attached. Except where
this Rider provides otherwise, it is subject to all conditions and limitations
of the policy.
DEFINITION
Consumer Price Index (CPI) -means the Consumer Price Index for all Urban
Consumers published by the United States Department of Labor for the September
of the calendar year immediately preceding the effective date of the increase.
We may change to another index that We consider appropriate if:
a. publication of the CPI is discontinued, delayed or otherwise not available
for this use; or
b. any change in the composition, base or method of computation of the CPI
makes its continued use inappropriate, in Our opinion, for determining
cost of living increases.
BENEFIT
This Rider provides increases to the Stated Amount of the policy based on
changes in the CPI. We will determine the increased Stated Amount on each
Policy Anniversary.
We will determine the increase by multiplying the number of Cost of Living
Units shown on the Policy Summary by the ratio of a divided by b, where:
a is the change in the CPI between the current Policy Anniversary and
the later of the effective date of the last increase and the effective
date of this Rider; and
b is the CPI on the effective date of this Rider.
In no event will the Death Benefit be reduced due to this calculation. If the
increase as calculated above is less than the Minimum Increase Amount for this
Rider as shown on the Policy Summary, an increase will not be made.
The amount of any single increase made under this Rider will be limited to the
Maximum Increase Amount for this Rider as shown on the Policy Summary. The
total of increases provided by this Rider cannot exceed the Total Increase
Limit for this Rider as shown on the Policy Summary.
CHARGE - This Rider is issued in consideration of the application for it and
the deduction of the additional charge shown for this Rider on the Policy
Summary. The charge for this Rider is deducted under the same conditions as the
charge for the policy. The maximum guaranteed charge for the cost of living
increase will be based on the Insured's age and current rate class.
ISSUE DATE - The Issue Date of this Rider is the same as the Issue Date of the
policy unless otherwise shown for this Rider on the Policy Summary.
CONTESTABILITY - When applied to this Rider, the contestability period will
begin on this Rider's Issue Date.
SUICIDE - If, within two years from the Issue Date of this Rider, the Insured
commits suicide while sane or insane, the amount payable under this Rider will
be limited to the charges paid for this Rider.
TERMINATION - This Rider will terminate on the earliest of:
1. Subject to the Grace Period provision of the policy, the date on which the
Cash Surrender Value is insufficient to pay the charges due for the policy
or this Rider; or
2. failure to pay any charges due for this Rider or the basic policy; or
3. the Deduction Day next following Your request In Writing to terminate this
Rider; or
4. policy termination; or
5. the Expiry Date of this Rider as shown on the Policy Summary; or
6. the effective date of a decrease to the Stated Amount; or
7. the date on which the Total Increase Limit for this Rider (as shown on the
Policy Summary) is reached; or
8. Your rejection of an increase under this Rider; or
9. the effective date of the first benefit payment under the Waiver of
Deduction Amount Rider.
THE TRAVELERS LIFE AND ANNUITY COMPANY
[SIG]
President
<PAGE> 4
WAIVER OF DEDUCTION AMOUNT RIDER
This Rider is made a part of the policy to which it is attached. Except where
this Rider provides otherwise, it is subject to all conditions and limitations
of such policy.
DEFINITIONS
Disability - For the purposes of this Rider, a Disability must:
1. result from bodily injury or disease;
2. begin while the policy and Rider are in force;
3. exist for a period of not less than six consecutive months; and
4. prevent the Insured from being Employed as defined below.
If the Insured was Employed on the date Disability began, the Insured must be
unable to perform:
1. for the first twenty-four months of Disability, the substantial and
material duties of his or her own occupation as of the date of Disability;
and thereafter
2. Employment for which the Insured is or can become reasonably fitted by
education, training or experience.
If the Insured was not Employed (except if the sole occupation was that of a
student or managing a household) on the date Disability began, the Insured must
be unable to perform:
1. for the first twenty-four months of Disability, his or her reasonable and
customary activities as of the date of Disability; and thereafter
2. Employment for which he or she is or can become reasonably fitted by
education, training or experience.
If the Insured's sole occupation was that of student or managing a household on
the date Disability began, he or she must be unable to perform that occupation.
We will consider the Insured to be disabled, even if he or she is Employed,
upon the entire and permanent loss of:
1. sight in both eyes; or
2. the use of both hands or both feet; or
3. the use of one hand and one foot.
Employed/Employment - For the purposes of this Rider, Employed/Employment means
engaged or engagement in any occupation for wages or profit.
BENEFITS
The Deduction Amounts eligible for waiver are shown on the Policy Summary page
for this Rider. While this Rider is in effect and during the Disability of the
Insured, We will waive the eligible Deduction Amounts, and will restore to the
Cash Value any eligible Deduction Amount that was paid during the Disability.
If the Disability occurs before the Policy Anniversary on which the Insured is
age sixty, benefits will continue until the Maturity Date of the policy or the
end of the Insured's Disability, whichever is earlier.
If the Disability occurs on or after the Policy Anniversary on which the
Insured is age sixty, but before the Policy Anniversary on which he or she is
age sixty-five, benefits under this Rider will continue to the Policy
Anniversary on which the Insured is age sixty-five or the end of the Insured's
Disability, whichever is earlier.
If the Disability occurs on or after the Policy Anniversary on which the
Insured is age sixty-five, there will be no benefits under this Rider.
We will not waive or restore any Deduction Amount that was due more than one
year prior to notice of claim under this Rider.
The provisions, values and benefits of the basic policy will be the same as if
the Deduction Amounts were paid to Us. In any settlement under the policy, We
will not deduct any Deduction Amounts that were waived.
<PAGE> 5
DEATH BENEFIT OPTION
If You elected Death Benefit Option 1 under the basic policy, We will
automatically change it to Option 2 on the Deduction Day following the date the
Insured's Disability began. The new Stated Amount will be the Option 1 Stated
Amount on that Deduction Day, less the Cash Value on that Deduction Day. The
new Option 2 Stated Amount will continue unchanged until termination of the
policy.
CHANGES
If the policy is changed to another plan of insurance, the benefits provided by
this Rider will not be included as part of the new policy, unless evidence of
insurability satisfactory to Us is furnished at that time and if a similar
Rider is available with the new policy. If the policy is changed while We are
waiving the Deduction Amount, We will not waive the Deduction Amount on the new
policy.
NOTICE OF CLAIM
Notice of claim must be given to Us In Writing:
1. during the lifetime of the Insured; and
2. during the period of Disability; and
3. within one year after the start of Disability.
We will not deny or reduce a claim if it is shown that notice of claim was
given as soon as reasonably possible
PROOF OF LOSS
We may require proof of Disability no more than once a year. We will not waive
further Deduction Amounts if proof is not furnished or if Disability has
terminated.
END OF DISABILITY
The benefits for Disability will end if and when the Insured's Disability ends.
The Deduction Amounts due after that will not be waived.
CHARGE
This Rider is issued in consideration of the application for it and the
deduction of the additional charge for it. The rates and the method of
determining the Rider charge are described on the Policy Summary.
ISSUE DATE
The Issue Date of this Rider is the same as that of the policy unless otherwise
shown for the Rider on the Policy Summary.
CONTESTABILITY
When applied to this Rider, the contestability period will begin on this
Rider's Issue Date.
TERMINATION
This Rider will terminate on the earliest of:
1. Subject to the Grace Period provision of the Policy, the date on which the
Cash Surrender Value would not be enough to pay charges for the policy or
this Rider; or
2. failure to pay any charges due for this Rider or the basic policy; or
3. policy termination or maturity; or
4. the Deduction Day following Your request In Writing for termination of
this Rider; or
5. the Expiry Date of this Rider as shown on the Policy Summary, except with
respect to payment of benefits for a Disability that began prior to the
Policy Anniversary on which the Insured was age sixty as described in the
second paragraph of the "Benefits" provision of this Rider.
THE TRAVELERS LIFE AND ANNUITY COMPANY
[SIG]
President
<PAGE> 6
SPECIFIED AMOUNT PAYMENT RIDER
This Rider is made a part of the policy to which it is attached. Except where
this Rider provides otherwise, it is subject to all conditions and limitations
of the policy.
DEFINITIONS
Disability - For the purposes of this Rider, a Disability must:
1. result from bodily injury or disease;
2. begin while the policy and Rider are in force;
3. exist for a period of not less than six consecutive months; and
4. prevent the Insured from being Employed as defined below.
If the Insured was Employed on the date Disability began, the Insured must be
unable to perform:
1. for the first twenty-four months of Disability, the substantial and
material duties of his or her own occupation as of the date of Disability;
and thereafter
2. Employment for which the Insured is or can become reasonably fitted by
education, training or experience.
If the Insured was not Employed (except if the sole occupation was that of a
student or managing a household) on the date Disability began, the Insured must
be unable to perform:
1. for the first twenty-four months of Disability, his or her reasonable and
customary activities as of the date of Disability; and thereafter
2. Employment for which he or she is or can become reasonably fitted by
education, training or experience.
If the Insured's sole occupation was that of student or managing a household on
the date Disability began, he or she must be unable to perform that occupation.
We will consider the Insured to be disabled, even if he or she is Employed,
upon the entire and permanent loss of:
1. sight in both eyes; or
2. the use of both hands or both feet; or
3. the use of one hand and one foot.
Employed/Employment - For the purposes of this Rider, Employed/Employment means
engaged or engagement in any occupation for wages or profit.
Specified Amount - The amount that You have selected to be credited to the Cash
Value of the policy during the Insured's Disability. This amount is shown on
the Policy Summary for this Rider. You may request an increase to the Specified
Amount at any time while this Rider is in force. You may request a decrease to
the Specified Amount any time after the second Policy Anniversary and while
this Rider is in force. We reserve the right to decrease the Specified Amount
if You request a reduction to the benefits provided by the policy.
BENEFITS
While the policy and this Rider are in effect and during the Disability of the
Insured, We will credit the Specified Amount to the policy's Cash Value on each
Policy Anniversary. The first amount that We will credit will be equal to the
result of (a x b) divided by twelve, where:
a equals the Specified Amount; and b equals the number of months from the start
of the Disability to the first Policy Anniversary that follows the start of the
Disability.
If the Disability occurs before the Policy Anniversary on which the Insured is
age sixty, benefits will continue until the Maturity Date of the policy or the
end of the Insured's Disability, whichever is earlier. In no event will benefits
under this Rider be paid past the Maturity Date, regardless of whether the
policy coverage is extended beyond this date.
If the Disability occurs on or after the Policy Anniversary on which the
Insured is age sixty, but before the Policy Anniversary on which he or she is
age sixty-five, benefits under this Rider will continue to the Policy
Anniversary on which the Insured is age sixty-five or the end of the Insured's
Disability, whichever is earlier.
If the Disability occurs on or after the Policy Anniversary on which the
Insured is age sixty-five, there will be no benefits under this Rider.
<PAGE> 7
We will not credit any Specified Amount that was due to be paid more than one
year prior to notice of claim under this Rider. In any settlement under the
policy, We will not deduct from the proceeds any Specified Amounts that were
credited.
We will not credit any Specified Amount if payment would disqualify the policy
as life insurance.
CHANGES
If the policy is changed to another plan of insurance, the benefits provided by
this Rider will not be included as part of the new policy, unless evidence of
insurability satisfactory to Us is furnished at that time and if a similar
Rider is available under the new policy. If the policy is changed during the
Disability of the Insured, We will not credit the Specified Amount to the new
policy.
NOTICE OF CLAIM
Notice of claim must be given to Us In Writing:
1. during the lifetime of the Insured; and
2. during the period of Disability; and
3. within one year after the start of Disability.
We will not deny or reduce a claim if it is shown that notice of claim was
given as soon as reasonably possible
PROOF OF LOSS
We may require proof of Disability no more than once a year. We will not credit
further Specified Amounts if proof is not furnished or if Disability has
terminated.
END OF DISABILITY
The benefits for Disability as defined above will end if and when the
Disability of the Insured ceases. The Specified Amount will not be credited
after Disability has ended.
CHARGE
This Rider is issued in consideration of the application for it and the
deduction of the additional charge for it. The rates and the method of
determining the Rider charge are described on the Policy Summary.
ISSUE DATE
The Issue Date of this Rider is the same as that of the policy unless otherwise
shown for the Rider on the Policy Summary.
CONTESTABILITY
When applied to this Rider, the contestability period will begin on this
Rider's Issue Date.
TERMINATION
This Rider will terminate on the earliest of:
1. Subject to the Grace Period provision of the policy, the date on which the
Cash Surrender Value would not be enough to pay charges for the policy or
this Rider; or
2. failure to pay any charges due for this Rider or the basic policy; or
3. policy termination; or
4. the policy Maturity Date, regardless of whether the policy coverage is
extended beyond this date; or
5. the Deduction Day following Your request In Writing for termination of
this Rider; or
6. the Expiry Date of this Rider as shown on the Policy Summary, except with
respect to payment of benefits for a Disability that began prior to the
Policy Anniversary on which the Insured was age sixty as described in the
second paragraph of the "Benefits" provision of this Rider.
THE TRAVELERS LIFE AND ANNUITY COMPANY
[SIG]
President
<PAGE> 8
EXTENSION OF COVERAGE RIDER
This Rider is made a part of the policy on the date specified on the
supplemental Policy Summary. Except where this Rider provides otherwise, it is
subject to all conditions of the policy.
BENEFIT - One year prior to the Maturity Date and at any time in the twelve
calendar months thereafter, You may request that coverage be extended beyond
the Maturity Date. If We have received Your request In Writing prior to the
Maturity Date, and any past due Deduction Amounts have been paid, then We will
continue this policy in force beyond the Maturity Date. The policy will be
continued until the earlier of the Insured's death or the date that We receive
Your request for full surrender In Writing. All other riders and supplemental
benefits will terminate on the Maturity Date.
The Death Benefit after the Maturity Date will be equal to the Amount Insured
as of the date of the Insured's death, minus any Loan Account value and any
amounts payable under a collateral assignment of the policy. After the Maturity
Date, Deduction Amounts will not be charged, and additional premium payments
will not be accepted. Interest on loans will continue to accrue and will be
added to the total Loan Account value. Loan repayments will be accepted.
All other provisions of the policy relating to the payment of the Death Benefit
apply to the Death Benefit after the Maturity Date. The Death Benefit and
policy values are based on the experience of the Investment Options selected,
and are variable and not guaranteed.
TAXATION - The policy with which this Rider is used is intended to qualify as a
life insurance policy for Federal tax purposes. The amount payable under this
policy upon the death of the Insured is intended to qualify for the Federal
income tax exclusion. The provisions of the policy are to be interpreted to
ensure such tax qualification, not withstanding any other provision to the
contrary.
The policy may be surrendered prior to the Insured's death for its Cash
Surrender Value. Such a surrender will be treated as a taxable distribution.
THE COMPANY DOES NOT GIVE TAX ADVICE. NO LANGUAGE IN THIS RIDER SHOULD BE
CONSTRUED TO MEAN THAT THE DEATH BENEFIT AND CASH VALUE WILL BE EXEMPT FROM ANY
FUTURE TAX LIABILITY. THE TAX RESULTS OF ANY BENEFITS RECEIVED UNDER THIS RIDER
DEPEND UPON INTERPRETATION OF THE INTERNAL REVENUE CODE. YOU SHOULD CONSULT
WITH YOUR PERSONAL TAX ADVISOR PRIOR TO THE EXERCISE OF THIS OPTION TO ASSESS
ANY POTENTIAL TAX LIABILITY.
THE TRAVELERS LIFE AND ANNUITY COMPANY
[SIG]
President
