<PAGE> 1
'33 Act Registration No. 333-12333
'40 Act Registration No. 811-07819
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
PRE-EFFECTIVE AMENDMENT NO. 1
TO FORM S-6
FOR REGISTRATION UNDER THE SECURITIES ACT OF 1933 OF
SECURITIES OF UNIT INVESTMENT TRUSTS REGISTERED ON FORM N-8B-2
NATIONWIDE VL SEPARATE ACCOUNT-B
(EXACT NAME OF TRUST)
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
ONE NATIONWIDE PLAZA
COLUMBUS, OHIO 43216
(EXACT NAME AND ADDRESS OF DEPOSITOR AND REGISTRANT)
GORDON E. MCCUTCHAN
SECRETARY
ONE NATIONWIDE PLAZA
COLUMBUS, OHIO 43216
(NAME AND ADDRESS OF AGENT FOR SERVICE)
Title and amount of securities being registered: Flexible premium
variable universal life insurance policies. Such policies are not issued in
predetermined amounts or units.
The Registrant elects to register an indefinite number of securities by
this registration statement in accordance with Rule 24f-2 under the Investment
Company Act of 1940. Pursuant to Paragraph (a)(3) thereof, a non-refundable fee
in the amount of $500.00 accompanies this registration.
Approximate date of proposed public offering: (As soon as practicable
after the effective date of this Registration Statement - January 1, 1997
requested).
[ ] Check box if it is proposed that this filing will become effective on (date)
at (time) pursuant to Rule 487.
The Registrant hereby amends this Registration Statement on such date
or 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 therefore become effective in accordance with Section 8(a) of
the Securities Act of 1933 or until the Registration Statement shall become
effective on such dates as the Commission, acting pursuant to said Section 8(a),
may determine.
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CROSS REFERENCE TO ITEMS REQUIRED
BY FORM N-8B-2
N-8B-2 ITEM CAPTION IN PROSPECTUS
1................................ Nationwide Life and Annuity
Insurance Company
The Variable Account
2................................ Nationwide Life and Annuity
Insurance Company
3................................ Custodian of Assets
4................................ Distribution of The Policies
5................................ The Variable Account
6................................ Not Applicable
7................................ Not Applicable
8................................ Not Applicable
9................................ Legal Proceedings
10............................... Information About The Policies; How
The Cash Value Varies; Right to
Exchange for a Fixed Benefit Policy;
Reinstatement; Other Policy
Provisions
11............................... Investments of The Variable
Account
12............................... The Variable Account
13............................... Policy Charges
Reinstatement
14............................... Underwriting and Issuance -
Premium Payments
Minimum Requirements for
Issuance of a Policy
15............................... Investments of the Variable
Account; Premium Payments
16............................... Underwriting and Issuance -
Allocation of Cash Value
17............................... Surrendering The Policy for Cash
18............................... Reinvestment
19............................... Not Applicable
20............................... Not Applicable
21............................... Policy Loans
22............................... Not Applicable
23............................... Not Applicable
24............................... Not Applicable
25............................... Nationwide Life and Annuity
Insurance Company
26............................... Not Applicable
27............................... Nationwide Life and Annuity
Insurance Company
28............................... Company Management
29............................... Company Management
30............................... Not Applicable
31............................... Not Applicable
32............................... Not Applicable
33............................... Not Applicable
34............................... Not Applicable
35............................... Nationwide Life and Annuity
Insurance Company
36............................... Not Applicable
37............................... Not Applicable
38............................... Distribution of The Policies
39............................... Distribution of The Policies
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N-8B-2 ITEM CAPTION IN PROSPECTUS
40............................... Not Applicable
41(a)............................ Distribution of The Policies
42............................... Not Applicable
43............................... Not Applicable
44............................... How The Cash Value Varies
45............................... Not Applicable
46............................... How The Cash Value Varies
47............................... Not Applicable
48............................... Custodian of Assets
49............................... Not Applicable
50............................... Not Applicable
51............................... Summary of The Policies;
Information About The Policies
52............................... Substitution of Securities
53............................... Taxation of The Company
54............................... Not Applicable
55............................... Not Applicable
56............................... Not Applicable
57............................... Not Applicable
58............................... Not Applicable
59............................... Financial Statements
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NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
P.O. Box 182150
Columbus, Ohio 43218-2150
(800) 547-7548, TDD (800) 238-3035
FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE POLICIES
ISSUED BY NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
THROUGH ITS NATIONWIDE VL SEPARATE ACCOUNT-B
The Life Insurance Policies offered by this prospectus are variable life
insurance policies (collectively referred to as the "Policies"). The Policies
are designed to provide life insurance coverage and the flexibility to vary the
amount and frequency of premium payments. The Policies may also provide a Cash
Surrender Value if the Policy is terminated during the lifetime of the Insured.
The death benefit and Cash Value of the Policies may vary to reflect the
experience of the Nationwide VL Separate Account-B (the "Variable Account") to
which Cash Values are allocated.
The policies are expected to be issued on multiple lives in cases where the
insureds have a common employment or business relationship. The policies may be
owned individually or by a corporation, trust, association or similar entity.
The Owner will have all rights under the Policy. The Policies may be used for
such purposes as funding non-qualified executive deferred compensation or salary
continuance plans. These policies may be used by corporations as a means of
funding death benefit liabilities incurred under executive retirement plans or
as a source for funding cash flow obligations under such plans. These policies
are not designed to be used in an employer's pension or profit sharing plan.
The Policies described in this prospectus meet the definition of "life
insurance" under Section 7702 of the Internal Revenue Code (the "Code").
The Policy Owner may allocate Net Premiums and Cash Value to one or more of the
sub-accounts of the Variable Account. The assets of each sub-account will be
used to purchase, at net asset value, shares of a designated Underlying Mutual
Fund in the following series of the underlying variable account Mutual Fund
options:
FIDELITY VARIABLE INSURANCE PRODUCTS FUND
-Equity-Income Portfolio
-Overseas Portfolio
NATIONWIDE SEPARATE ACCOUNT TRUST
-Money Market Fund
-Total Return Fund
THE ONE(R) GROUP INVESTMENT TRUST
-Asset Allocation Fund
-Government Bond Fund
-Large Company Growth Fund
-Growth Opportunities Fund
Nationwide Life and Annuity Insurance Company (the "Company") guarantees that
the death benefit for a Policy will never be less than the Specified Amount
stated on the Policy data pages as long as the Policy is in force. There is no
guaranteed Cash Surrender Value. If the Cash Surrender Value is insufficient to
cover the charges under the Policy, the Policy will lapse without value.
1
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INVESTMENTS IN THESE CONTRACTS ARE NOT DEPOSITS OR OBLIGATIONS OF, AND ARE NOT
GUARANTEED OR ENDORSED BY, THE ADVISER OF ANY OF THE UNDERLYING MUTUAL FUNDS
IDENTIFIED ABOVE, THE U.S. GOVERNMENT, OR ANY BANK OR BANK AFFILIATE.
INVESTMENTS ARE NOT FEDERALLY INSURED BY THE FEDERAL DEPOSIT INSURANCE
CORPORATION, THE FEDERAL RESERVE BOARD, OR ANY OTHER GOVERNMENTAL AGENCY. ANY
INVESTMENT IN THE CONTRACT INVOLVES CERTAIN INVESTMENT RISK WHICH MAY INCLUDE
THE POSSIBLE LOSS OF PRINCIPAL.
THESE SECURITIES HAVE NOT BEEN APPROVED OR DISAPPROVED BY THE SECURITIES AND
EXCHANGE COMMISSION NOR HAS THE COMMISSION PASSED UPON THE ACCURACY OR ADEQUACY
OF THE PROSPECTUS. ANY REPRESENTATION TO THE CONTRARY IS A CRIMINAL OFFENSE.
THIS PROSPECTUS SHOULD BE READ AND RETAINED FOR FUTURE REFERENCE. A PROSPECTUS
FOR THE UNDERLYING MUTUAL FUND OPTION(S) BEING CONSIDERED MUST ACCOMPANY THIS
PROSPECTUS AND SHOULD BE READ IN CONJUNCTION HEREWITH.
The date of this prospectus is January 1, 1997
2
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GLOSSARY OF TERMS
ATTAINED AGE-The Insured's age on the Policy Date, plus the number of full years
since the Policy Date.
ACCUMULATION UNIT-An accounting unit of measure used to calculate the Variable
Account Cash Value.
BENEFICIARY-The person to whom the Death Proceeds are paid.
CASH VALUE-The sum of the Policy values in the Variable Account and any
associated value in the Policy Loan Account.
CASH SURRENDER VALUE-The Policy's Cash Value, less any Indebtedness under the
Policy.
CODE-The Internal Revenue Code of 1986, as amended.
COMPANY- Nationwide Life and Annuity Insurance Company.
DEATH PROCEEDS-Amount of money payable to the Beneficiary if the Insured dies
while the Policy is in force.
GUIDELINE LEVEL PREMIUM-The amount of level annual premium calculated in
accordance with the provisions of the Internal Revenue Code of 1986. It
represents the level annual premiums required to mature the Policy under
guaranteed mortality and expense charges, and an interest rate of 4%.
INDEBTEDNESS-Amounts owed the Company as a result of Policy loans including both
principal and accrued interest.
INITIAL PREMIUM-The Initial Premium is the premium required for coverage to
become effective on the Policy Date. It is shown on the Policy Data Page.
INSURED-The person whose life is covered by the Policy, and who is named on the
Policy Data Page.
MATURITY DATE-The Policy Anniversary on or following the Insured's 100th
birthday.
MONTHLY ANNIVERSARY DAY-The same day as the Policy Date for each succeeding
month.
NET ASSET VALUE-The worth of one share at the end of a market day or at the
close of the New York Stock Exchange. Net Asset Value is computed by adding the
value of all portfolio holdings plus other assets, deducting liabilities and
then dividing the result by the number of shares outstanding.
NET PREMIUMS-Net Premiums are equal to the actual premiums minus the percent of
premium charge. The percent of premium charges are shown on the Policy Data
Page.
POLICY ANNIVERSARY-The same day and month as the Policy Date for succeeding
years.
POLICY CHARGES-All deductions made from the value of the Variable Account, or
the Policy Cash Value.
POLICY DATE-The date the provisions of the Policy take effect, as shown on the
Policy Data Page.
POLICY LOAN ACCOUNT-The Portion of the Cash Value which results from Policy
Indebtedness.
POLICY OWNER-The person designated in the Policy application as the Owner.
POLICY YEAR-Each year commencing with the Policy Date and each Policy
Anniversary thereafter.
SCHEDULED PREMIUM-The Scheduled Premium is shown on the Policy Data Page.
SPECIFIED AMOUNT-A dollar amount used to determine the death benefit under a
Policy. It is shown on the Policy Data Page.
UNDERLYING MUTUAL FUNDS-The Underlying mutual funds which correspond to the
sub-accounts of the Variable Account.
VALUATION DATE-Each day the New York Stock Exchange and the Company's Home
Office are open for business or any other day during which there is sufficient
degree of trading that the current net asset value of the Accumulation Units
might be materially affected.
VALUATION PERIOD-A period commencing with the close of business on a Valuation
Date and ending at the close of business for the next succeeding Valuation Date.
VARIABLE ACCOUNT-A separate investment account of Nationwide Life and Annuity
Insurance Company.
3
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TABLE OF CONTENTS
GLOSSARY OF TERMS.................................................. 3
SUMMARY OF THE POLICIES............................................ 6
Variable Life Insurance................................... 6
The Variable Account and its Sub-Accounts................. 6
Charges and Fees.......................................... 6
Reduction of Charges...................................... 7
Premiums.................................................. 7
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY...................... 8
THE VARIABLE ACCOUNT............................................... 8
Investments of the Variable Account....................... 8
Fidelity Variable Insurance Products Fund................. 9
Nationwide Separate Account Trust......................... 9
The One(R) Group Investment Trust......................... 9
Reinvestment.............................................. 10
Transfers................................................. 10
Dollar Cost Averaging..................................... 10
Substitution of Securities................................ 10
Voting Rights............................................. 11
INFORMATION ABOUT THE POLICIES..................................... 11
Underwriting and Issuance................................. 11
-Minimum Requirements for Issuance of a Policy............ 11
-Premium Payments......................................... 12
Allocation of Cash Value.................................. 12
Short-Term Right to Cancel Policy......................... 12
POLICY CHARGES..................................................... 12
Deductions from Premiums.................................. 12
Deductions from Cash Value................................ 13
-Monthly Cost of Insurance................................ 13
-Monthly Administrative Charge............................ 13
-Monthly Mortality and Expense Risk Charge................ 13
Deductions from the Sub-Accounts.......................... 13
HOW THE CASH VALUE VARIES.......................................... 14
How the Investment Experience is Determined............... 14
Net Investment Factor..................................... 14
Valuation of Assets....................................... 14
Determining the Cash Value................................ 14
Valuation Periods and Valuation Dates..................... 15
SURRENDERING THE POLICY FOR CASH................................... 15
Right to Surrender........................................ 15
Cash Surrender Value...................................... 15
Partial Surrenders........................................ 15
Maturity Proceeds......................................... 15
Income Tax Withholding.................................... 15
POLICY LOANS....................................................... 16
Taking a Policy Loan...................................... 16
Effect on Investment Performance.......................... 16
Interest.................................................. 16
Effect on Death Benefit and Cash Value.................... 16
Repayment................................................. 17
HOW THE DEATH BENEFIT VARIES....................................... 17
Calculation of the Death Benefit.......................... 17
APPLICABLE PERCENTAGE OF CASH VALUE TABLE.......................... 17
Proceeds Payable on Death................................. 17
RIGHT TO EXCHANGE FOR A FIXED BENEFIT POLICY....................... 17
CHANGES OF INVESTMENT POLICY....................................... 18
GRACE PERIOD....................................................... 18
REINSTATEMENT...................................................... 18
CHANGES IN EXISTING INSURANCE COVERAGE............................. 19
Specified Amount Increases................................ 19
Specified Amount Decreases................................ 19
Changes in the Death Benefit Option....................... 19
4
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OTHER POLICY PROVISIONS......................................... 19
Policy Owner........................................... 19
Beneficiary............................................ 19
Assignment............................................. 20
Incontestability....................................... 20
Error in Age........................................... 20
Suicide................................................ 20
Nonparticipating Policies.............................. 20
DISTRIBUTION OF THE POLICIES.................................... 20
CUSTODIAN OF ASSETS............................................. 21
TAX MATTERS..................................................... 21
Policy Proceeds........................................ 21
Taxation of the Company................................ 22
Other Considerations................................... 22
THE COMPANY..................................................... 22
COMPANY MANAGEMENT.............................................. 22
Directors of the Company............................... 23
Executive Officers of the Company...................... 24
OTHER CONTRACTS ISSUED BY THE COMPANY........................... 24
STATE REGULATION................................................ 24
REPORTS TO POLICY OWNERS........................................ 24
ADVERTISING..................................................... 25
LEGAL PROCEEDINGS............................................... 25
EXPERTS......................................................... 25
REGISTRATION STATEMENT.......................................... 25
LEGAL OPINIONS.................................................. 25
APPENDIX 1...................................................... 26
FINANCIAL STATEMENTS............................................ 29
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.
5
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THE PURPOSE OF THE POLICIES IS TO PROVIDE LIFE INSURANCE PROTECTION FOR THE
BENEFICIARY NAMED IN THE POLICY. NO CLAIM IS MADE THAT THE POLICIES ARE IN ANY
WAY SIMILAR OR COMPARABLE TO A SYSTEMATIC INVESTMENT PLAN OF A MUTUAL FUND.
SUMMARY OF THE POLICIES
VARIABLE LIFE INSURANCE
The variable life insurance Policies offered by Nationwide Life and Annuity
Insurance Company (the "Company") are similar in many ways to fixed-benefit
whole life insurance. As with fixed-benefit whole life insurance, the Owner of
the Policy pays a premium for life insurance coverage on the person insured.
Also like fixed-benefit whole life insurance, the Policies may provide for a
Cash Surrender Value which is payable if the Policy is terminated during the
Insured's lifetime.
However, the Policies differ from fixed-benefit whole life insurance in several
respects. Unlike fixed-benefit whole life insurance, the death benefit and Cash
Value of the Policies may increase or decrease to reflect the investment
performance of the Variable Account sub-accounts to which Cash Values are
allocated (see "How the Death Benefit Varies"). There is no guaranteed Cash
Surrender Value (see "How the Cash Value Varies"). If the Cash Surrender Value
is insufficient to pay the Policy Charges, the Policy will lapse without value.
Under certain conditions, a Policy may become a modified endowment contract as a
result of a material change or a reduction in benefits as defined by the
Internal Revenue Code ("Code"). Excess premiums paid may also cause the Policy
to become a modified endowment contract. The Company will monitor premiums paid
and other policy transactions and will notify the Policy Owner when the Policy's
non-modified endowment contract status is in jeopardy (see "Tax Matters").
THE VARIABLE ACCOUNT AND ITS SUB-ACCOUNTS
The Company places the Policy's Net Premiums in the Variable Account at the time
the Policy is issued. The Policy Owner selects the sub-accounts of the Variable
Account into which the Cash Value will be allocated (see "Allocation of Cash
Value"). When the Policy is issued, the Net Premiums will be allocated to the
Nationwide Separate Account Trust Money Market Fund sub-account until the
expiration of the period in which the Policy Owner may exercise his or her
short-term right to cancel the Policy. Assets of each sub-account are invested
at net asset value in shares of a corresponding Underlying Mutual Fund. For a
description of the Underlying Mutual Fund options and their investment
objectives, see "Investments of the Variable Account."
CHARGES & FEES
The Company deducts certain charges from the premiums or the assets of the
Variable Account and the Cash Value of the Policy. These charges are made for
administrative and sales expenses, federal, state or local premium taxes,
providing life insurance protection and assuming the mortality and expense
risks. For a discussion of any charges imposed by the Underlying Mutual Fund
options, see the prospectuses of the respective Underlying Mutual Funds.
The Company deducts a sales load from each premium payment received not to
exceed 9% of each premium payment for years 1-7, and 5% in years 8 and after.
The Company also deducts a tax expense charge equal to 4% of all premium
payments.
The Company also deducts the following charges from the Policy's Cash Value on
the Policy Date and each subsequent Monthly Anniversary Day:
1. monthly cost of insurance; plus
2. monthly cost of any additional benefits provided by riders; plus
3. monthly administrative expense; plus
4. monthly mortality and expense risk.
Underlying Mutual Fund shares are purchased at net asset value, which reflects
the deduction of investment management fees and certain other expenses. The
management fees are charged by each Underlying Mutual Fund's investment adviser
for managing the Underlying Mutual Fund and selecting its portfolio of
securities. Other Underlying Mutual Fund expenses can include such items as
interest expense on loans and contracts with transfer agents, custodians, and
other companies that provide services to the Underlying Mutual Fund. The
management fees and other expenses for each Underlying Mutual Fund for its most
recently completed fiscal year, expressed as a percentage of the Underlying
Mutual Fund's average assets, are as follows:
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UNDERLYING MUTUAL FUND ANNUAL EXPENSES
(After Expense Reimbursement)
<TABLE>
<CAPTION>
- ---------------------------------------------------------------------------------------------------------------
Management Other Total Portfolio
Fees Expenses Company Expenses
<S> <C> <C> <C>
- ---------------------------------------------------------------------------------------------------------------
Fidelity Variable Insurance Products Fund-Equity 0.51% 0.10% 0.61%
Income Portfolio
- ---------------------------------------------------------------------------------------------------------------
Fidelity Variable Insurance Products Fund-Overseas 0.76% 0.15% 0.91%
Portfolio
- ---------------------------------------------------------------------------------------------------------------
NSAT-Money Market Fund 0.50% 0.02% 0.52%
- ---------------------------------------------------------------------------------------------------------------
NSAT-Total Return Fund 0.50% 0.01% 0.51%
- ---------------------------------------------------------------------------------------------------------------
The One(R) Group Investment Trust-Asset Allocation 0.70% 0.30% 1.00%
Fund
- ---------------------------------------------------------------------------------------------------------------
The One(R) Group Investment Trust-Government Bond 0.45% 0.30% 0.75%
Fund
- ---------------------------------------------------------------------------------------------------------------
The One(R) Group Investment Trust-Large Company 0.65% 0.25% 0.90%
Growth Fund
- ---------------------------------------------------------------------------------------------------------------
The One(R) Group Investment Trust-Growth 0.65% 0.25% 0.90%
Opportunities Fund
- ---------------------------------------------------------------------------------------------------------------
</TABLE>
The Mutual Fund expenses shown above are assessed at the Underlying Mutual Fund
level and are not direct charges against the Variable Account or reductions in
Cash Value. These Underlying Mutual Fund expenses are taken into consideration
in computing each Underlying Mutual Fund's net asset value, which is the share
price used to calculate the Variable Account's unit value. The above Underlying
Mutual Funds are not subject to 12b-1 fees. The following funds are subject to
the following fee waiver or expense reimbursement arrangements:
- ------------------------------ -------------------------------------------------
FUND EXPENSES WITHOUT REIMBURSEMENT OR WAIVER
- ------------------------------ -------------------------------------------------
Fidelity Variable Insurance The Fund may, from time to time,
Products Fund - Equity-Income agree to reimburse a fund for
Portfolio management fees and other expenses
above a specified limit. The Fund
retains the ability to be repaid if
expenses fall below the specified
limit prior to the end of the
fiscal year. Reimbursement
arrangements, which may be
terminated at any time, can
decrease the Fund's expense and
boost its performance.
- ------------------------------ ---------------------------------------------
Fidelity Variable Insurance The Fund may, from time to time,
Products Fund - Overseas agree to reimburse a fund for
Portfolio management fees and other expenses
above a specified limit. The Fund
retains the ability to be repaid if
expenses fall below the specified
limit prior to the end of the
fiscal year. Reimbursement
arrangements, which may be
terminated at any time, can
decrease the Fund's expense and
boost its performance.
- ------------------------------ ---------------------------------------------
The One(R) Group Investment The Adviser has voluntarily agreed
Trust-Asset Allocation Fund to waive all or part of its fees in
order to limit the Funds' operating
expenses to not more than 1.00% of
the average daily net assets.
- ------------------------------ ---------------------------------------------
The One(R) Group Investment The Adviser has voluntarily agreed
Trust-Government Bond Fund to waive all or part of its fees in
order to limit the Funds' operating
expenses to not more than .75% of
the average daily net assets.
- ------------------------------ ---------------------------------------------
The One(R) Group Investment The Adviser has voluntarily agreed
Trust-Large Company Growth to waive all or part of its fees in
Fund order to limit the Funds' operating
expenses to not more than 1.00% of
the average daily net assets.
- ------------------------------ ---------------------------------------------
The One(R) Group Investment The Adviser has voluntarily agreed
Trust-Growth Opportunities to waive all or part of its fees in
Fund order to limit the Funds' operating
expenses to not more than 1.10% of
the average daily net assets.
The information relating to the Underlying Mutual Fund expenses was provided by
the Underlying Mutual Fund and was not independently verified by the Company.
REDUCTION OF CHARGES
These policies are expected to be issued to corporations, trusts or other
sponsoring organizations on multiple lives. The Company reserves the right to
reduce premium loads or any other policy charges on certain multiple life sales
where it is expected that such sales will result in reduced sales, underwriting
or other administrative expenses. Eligibility for these reductions will be
determined by a number of factors including the number of lives to be insured,
total premiums expected to be paid or other factors the Company believes are
relevant. Any reductions will be on a uniform basis and will not be
discriminatory to any Policy Owner.
PREMIUMS
The Initial Premium is due and will be credited on the Policy Date. Any due and
unpaid monthly deductions will be subtracted from the Cash Value at this time.
Insurance will not be effective until the Initial Premium is paid. The Initial
Premium is shown on the Policy data page. Premiums other than the Initial
Premium may be paid at any time while the Policy is in force subject to the
limits described below.
For a limited time, the Policy Owner has the right to cancel the Policy and
receive a full refund of premiums paid (see "Short-Term Right to Cancel
Policy").
The Company will send Scheduled Premium payment reminder notices according to
the premium mode shown on the Policy data page.
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<PAGE> 11
The Initial Premium may be paid to the Company at its Home Office or to an
authorized agent. All premiums after the first are payable at the Company's Home
Office. Premium receipts will be furnished upon request.
The Company reserves the right to require satisfactory evidence of insurability
before accepting any additional premium payment which results in an increase in
the net amount at risk. Also, the Company will refund any portion of any premium
payment which is determined to be in excess of the premium limit established by
law to qualify the Policy as a contract for life insurance. Where permitted by
state law, the Company may also require that any existing Policy Indebtedness is
repaid prior to accepting any additional premium payments.
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
The Company is a stock life insurance company organized under the laws of the
State of Ohio and was established in February, 1981. The Company is a member of
the Nationwide Insurance Enterprise which includes Nationwide Life Insurance
Company, Nationwide Indemnity Company, Nationwide Mutual Insurance Company,
Nationwide Mutual Fire Insurance Company, Nationwide Property and Casualty
Insurance Company, National Casualty Company, West Coast Life Insurance Company,
Scottsdale Indemnity Company and Nationwide General Insurance Company. The
Company's Home Office is at One Nationwide Plaza, Columbus, Ohio 43216.
The Company offers a multiple line of products, including variable annuities and
variable life insurance policies. As of January 1, 1996, it is admitted to do
business in 43 states and the District of Columbia (for additional information,
see "The Company").
THE VARIABLE ACCOUNT
The Variable Account was established by a resolution of the Company's Board of
Directors, on August 9, 1996, pursuant to Ohio law. The Company has caused the
Variable Account to be registered with the Securities and Exchange Commission as
a unit investment trust pursuant to the provisions of the Investment Company Act
of 1940. Nationwide Life and Annuity Insurance Company, One Nationwide Plaza,
Columbus, Ohio 43216 serves as Trustee for the Trust. Nationwide Advisory
Services, Inc., One Nationwide Plaza, Columbus, Ohio 43216 serves as principal
underwriter for the Trust. Such registration does not involve supervision of the
management of the Variable Account or the Company by the Securities and Exchange
Commission.
The Variable Account is a separate investment account of the Company and as
such, is not chargeable with the liabilities arising out of any other business
the Company may conduct. The Company does not guarantee the investment
performance of the Variable Account. The death benefit and Cash Value under the
Policy may vary with the investment performance of the investments in the
Variable Account (see "How the Death Benefit Varies" and "How the Cash Value
Varies").
Net Premium payments and Cash Value are allocated within the Variable Account
among one or more sub-accounts (see "Tax Matters"). The assets of each
sub-account are used to purchase shares of the Underlying Mutual Fund options
designated by the Policy Owner. Thus, the investment performance of a Policy
depends upon the investment performance of the Underlying Mutual Fund options
designated by the Policy Owner.
INVESTMENTS OF THE VARIABLE ACCOUNT
At the time of application, the Policy Owner elects to have the Net Premiums
allocated among one or more of the Variable Account sub-accounts (see
"Allocation of Cash Value"). During the period in which the Policy Owner may
exercise his or her short-term right to cancel the Policy, all Net Premiums are
placed in the Nationwide Separate Account Trust Money Market Fund sub-account.
At the end of this period, the Cash Value in that sub-account will be
transferred to the Variable Account sub-accounts based on the Fund allocation
factors. Any subsequent Net Premiums received after this period will be
allocated based on the Fund allocation factors.
No less than 5% of Net Premiums may be allocated to any one sub-account. The
Policy Owner may change the allocation of Net Premiums or may transfer Cash
Value from one sub-account to another, subject to such terms and conditions as
may be imposed by each Underlying Mutual Fund option and as set forth in this
prospectus (see "Transfers", "Allocation of Cash Value" and "Short-Term Right to
Cancel Policy").
These Underlying Mutual Fund options are available only to serve as the
underlying investment for variable annuity and variable life contracts issued
through separate accounts of life insurance companies which may or may not be
affiliated, also known as "mixed and shared funding." There are certain risks
associated with mixed and shared funding, which is disclosed in the Underlying
Mutual Funds' prospectuses. A full description of the Underlying Mutual Funds,
their investment policies and restrictions, risks and charges are contained in
the prospectuses of the respective Underlying Mutual Funds.
8
<PAGE> 12
Additional Premium payments, upon acceptance, will be allocated to the
Nationwide Separate Account Money Market Fund unless the Policy Owner specifies
otherwise (see "Premium Payments").
Each of the Underlying Mutual Fund options is a registered investment company
which receives investment advice from a registered investment adviser:
1) Fidelity Variable Insurance Products Fund, managed by Fidelity
Management & Research Company;
2) Nationwide Separate Account Trust, managed by Nationwide
Advisory Services, Inc.; and
3) The One(R) Group Investment Trust, managed by Banc One
Investment Advisers Corporation.
A summary of investment objectives is contained in the description of each
Underlying Mutual Fund below. More detailed information may be found in the
current prospectus for each Underlying Mutual Fund option. A prospectus for the
Underlying Mutual Fund option(s) being considered must accompany this prospectus
and should be read in conjunction herewith.
FIDELITY VARIABLE INSURANCE PRODUCTS FUND
The Fidelity Variable Insurance Products Fund is an open-end, diversified
management investment company organized as a Massachusetts business trust on
November 13, 1981. The Fund's shares are purchased by insurance companies to
fund benefits under variable insurance and annuity policies. Fidelity Management
& Research Company ("FMR") is the Fund's manager.
-EQUITY-INCOME PORTFOLIO
Investment Objective: To seek reasonable income by investing primarily in
income-producing equity securities. In choosing these securities FMR also
will consider the potential for capital appreciation. The Portfolio's
goal is to achieve a yield which exceeds the composite yield on the
securities comprising the Standard & Poor's 500 Composite Stock Price
Index.
-OVERSEAS PORTFOLIO
Investment Objective: To seek long term growth of capital primarily
through investments in foreign securities. The Overseas Portfolio
provides a means for investors to diversify their own portfolios by
participating in companies and economies outside of the United States.
NATIONWIDE SEPARATE ACCOUNT TRUST
Nationwide Separate Account Trust is a diversified, open-end management
investment company created under the laws of Massachusetts. The Nationwide
Separate Account Trust offers shares under this Contract in the two Underlying
Mutual Funds listed below, each with its own investment objectives. Currently,
shares of the Nationwide Separate Account Trust will be sold only to life
insurance company separate accounts to fund the benefits under variable
insurance or annuity policies issued by life insurance companies. The assets of
the Nationwide Separate Account Trust are managed by Nationwide Advisory
Services, Inc. of One Nationwide Plaza, Columbus, Ohio 43216, a wholly-owned
subsidiary of Nationwide Life Insurance Company.
-MONEY MARKET FUND
Investment Objective: To seek as high a level of current income as is
considered consistent with the preservation of capital and liquidity by
investing primarily in money market instruments.
-TOTAL RETURN FUND
Investment Objective: To obtain a reasonable long-term total return
(i.e., earnings growth plus potential dividend yield) on invested
capital from a flexible combination of current return and capital gains
through investments in common stocks, convertible issues, money market
instruments and bonds with a primary emphasis on common stocks.
THE ONE(R) GROUP INVESTMENT TRUST
The One(R)Group Investment Trust is a diversified, open-end management
investment company organized under the laws of Massachusetts by a Declaration of
Trust, dated June 7, 1993. The One(R) Group Investment Trust offers shares in
the four separate mutual funds (the "Funds") shown below, each with its own
investment objective. The shares of the Funds are sold only to Nationwide Life
and Annuity Insurance Company to fund the benefits of The One(R) Investors
Annuity and certain other separate accounts funding variable annuity contracts
and variable life policies issued by other life insurance companies and
qualified pension and retirement plans. The assets of The One(R) Group
Investment Trust are managed by Banc One Investment Advisers Corporation.
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-GOVERNMENT BOND FUND
Investment Objective: To seek a high level of current income with
liquidity and safety of principal.
-ASSET ALLOCATION FUND
Investment Objective: To seek total return while preserving capital.
-GROWTH OPPORTUNITIES FUND
Investment Objective: To seek growth of capital and, secondarily,
current income, by investing primarily in equity securities. Issuers
will include medium sized companies with a history of above-average
growth or companies that are expected to enter periods of above-average
growth, and smaller companies which are positioned in emerging growth
industries.
-LARGE COMPANY GROWTH FUND
Investment Objective: To seek long-term capital appreciation and growth
of income by investing primarily in equity securities. The weighted
average capitalization of the companies in which the Fund invests will
always be in excess of the market median capitalization of the S & P
500 Index.
REINVESTMENT
The Funds described above have as a policy the distribution of dividends in the
form of additional shares (or fractions thereof) of the Underlying Mutual Funds.
The distribution of additional shares will not affect the number of Accumulation
Units attributable to a particular Policy (see "Allocation of Cash Value").
TRANSFERS
Transfers may be made either in writing or, in states allowing such transfers,
by telephone. In states allowing telephone transfers, and if the Policy Owner so
elects, the Company will also permit the Policy Owner to utilize the Telephone
Exchange Privilege for exchanging amounts among sub-account options. The Company
will employ reasonable procedures to confirm that instructions communicated by
telephone are genuine. Such procedures may include any or all of the following,
or such other procedures as the Company may, from time to time, deem reasonable:
requesting identifying information, such as name, contract number, Social
Security Number, and/or personal identification number; tape recording all
telephone transactions; and providing written confirmation thereof to both the
Policy Owner and any agent of record at the last address of record. Although
failure to follow reasonable procedures may result in the Company's liability
for any losses due to unauthorized or fraudulent telephone transfers, the
Company will not be liable for following instructions communicated by telephone
which it reasonably believes to be genuine. Any losses incurred pursuant to
actions taken by the Company in reliance on telephone instructions reasonably
believed to be genuine shall be borne by the Policy Owner. The Company may
determine to withdraw the Telephone Exchange Privilege, upon 30 days written
notice to Policy Owners.
DOLLAR COST AVERAGING
The Policy Owner may direct the Company to automatically transfer from the Money
Market sub-account to any other sub-account within the Variable Account on a
monthly basis. This service is intended to allow the Policy Owner to utilize
Dollar Cost Averaging, a long-term investment program which provides for
regular, level investments over time. The Company makes no guarantees that
Dollar Cost Averaging, will result in a profit or protect against loss in a
declining market. To qualify for Dollar Cost Averaging, there must be a minimum
total Cash Value, less Policy Indebtedness, of $15,000. Transfers for purposes
of Dollar Cost Averaging can only be made from the Money Market sub-account. The
minimum monthly Dollar Cost Averaging transfer is $100. A written election of
this service, on a form provided by the Company, must be completed by the Policy
Owner in order to begin transfers. Once elected, transfers from the Money Market
sub-account will be processed monthly until either the value in the Money Market
sub-account is completely depleted or the Policy Owner instructs the Company in
writing to cancel the monthly transfers.
The Company reserves the right to discontinue offering Dollar Cost Averaging
upon 30 days written notice to Policy Owners. However, any such discontinuation
would not affect Dollar Cost Averaging programs already commenced. Currently,
the Company does not assess a charge for this service, but reserves the right to
assess a charge up to an annual maximum of $10.00 for this service.
SUBSTITUTION OF SECURITIES
If shares of the Underlying Mutual Fund options should no longer be available
for investment by the Variable Account or, if in the judgment of the Company's
management further investment in such Underlying Mutual Funds should become
inappropriate in view of the purposes of the Policy, the Company may substitute
shares of another Underlying Mutual Fund for shares already purchased or to be
purchased in the future by Net Premium payments under the Policy. No
substitution of securities in the Variable Account may take place
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without prior approval of the Securities and Exchange Commission, and under such
requirements as it and any state insurance department may impose.
VOTING RIGHTS
Voting rights under the Policies apply only with respect to Cash Value allocated
to the sub-accounts of the Variable Account.
In accordance with its view of present applicable law, the Company will vote the
shares of the Underlying Mutual Funds held in the Variable Account at regular
and special meetings of the shareholders of the Underlying Mutual Funds in
accordance with instructions received from Policy Owners. However, if the
Investment Company Act of 1940 or any regulation thereunder should be amended or
if the present interpretation thereof should change, and as a result the Company
determines that it is permitted to vote the shares of the Underlying Mutual
Funds in its own right, the Company may elect to do so.
The Policy Owner shall have the voting interest under a Policy. The number of
shares in each sub-account for which the Policy Owner may give voting
instructions is determined by dividing any portion of the Policy's Cash Value
derived from participation in that Underlying Mutual Fund by the net asset value
of one share of that Underlying Mutual Fund.
The number of shares which a person has a right to vote will be determined as of
a date chosen by the Company, but not more than 90 days prior to the meeting of
the Underlying Mutual Fund. Voting instructions will be solicited by written
communication prior to such meeting.
The Company will vote Underlying Mutual Fund shares in accordance with
instructions received from the Policy Owners. Underlying Mutual Fund shares held
by the Company or by the Variable Account as to which no timely instructions are
received will be voted by the Company in the same proportion as the voting
instructions which are received.
Each person having a voting interest in the Variable Account will receive
periodic reports relating to investments of the Variable Account, the Underlying
Mutual Funds' proxy material and a form with which to give such voting
instructions.
Notwithstanding contrary Policy Owner voting instructions, the Company may vote
Underlying Mutual Fund shares in any manner necessary to enable the Underlying
Mutual Fund to: (1) make or refrain from making any change in the investments or
investment policies for any of the Underlying Mutual Funds, if required by an
insurance regulatory authority; (2) refrain from making any change in the
investment policies or any investment adviser or principal underwriter of any
portfolio which may be initiated by Policy Owners or the Underlying Mutual
Fund's Board of Directors, provided the Company's disapproval of the change is
reasonable and, in the case of a change in the investment policies or investment
adviser, based on a good faith determination that such change would be contrary
to state law or otherwise inappropriate in light of the portfolio's objective
and purposes; or (3) enter into or refrain from entering into any advisory
agreement or underwriting contract, if required by any insurance regulatory
authority.
INFORMATION ABOUT THE POLICIES
UNDERWRITING AND ISSUANCE
- -Minimum Requirements for Issuance of a Policy
The Policies are designed to provide life insurance coverage and the flexibility
to vary the amount and frequency of premium payments. At issue, the Policy Owner
selects the initial Specified Amount and premium. The minimum Specified Amount
is $50,000. Policies may be issued to Insureds with issue ages 80 or younger.
Before issuing any Policy, the Company requires satisfactory evidence of
insurability which may include a medical examination. For multiple life cases,
policies may be underwritten on either a guaranteed or simplified issue basis.
Policies may be issued on a guaranteed issue basis based upon the following
conditions: (i) the Participant is a full-time employee and has been working
continuously for a specified number of months prior to the date of application;
(ii) minimum participation levels among employees are met; and (iii) the amount
of coverage on any Participant must be specified, based upon the number of
participating lives. Currently, the maximum amount of insurance available under
a guaranteed issue is $500,000 per Participant.
If the criteria for guaranteed issue as set forth above are not met, policies
may be issued on a simplified issue basis based upon receipt of medical history
and other personal information, such as driving record, previous insurance
ratings or coverage denials with respect to any proposed insured. Further,
certain minimum participation levels among employees must be met in order to
qualify for simplified issue basis. Maximum issue amounts on a simplified
issue basis are determined based upon the number of participanting lives.
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The maximum available insurance for either a guaranteed issue basis or a
simplified issue basis will be reduced by any corresponding amounts of
employer-sponsored insurance currently in force.
- -Premium Payments
The Initial Premium for a Policy is payable in full at the Company's Home
Office. Upon payment of an initial premium, temporary insurance may be provided,
subject to a maximum amount. The effective date of permanent insurance coverage
is dependent upon completion of all underwriting requirements, payment of the
Initial Premium, and delivery of the Policy while the Insured is still living.
Premiums other than the Initial Premium may be paid at any time while the Policy
is in force subject to the limits described below.
The Company reserves the right to require satisfactory evidence of insurability
before accepting any additional premium payment which results in an increase in
the net amount at risk. Also, the Company will refund any portion of any premium
payment which is determined to be in excess of the premium limit established by
law to qualify the Policy as a contract for life insurance. The Company may also
require that any existing Policy Indebtedness is repaid prior to accepting any
additional premium payments. Additional premium payments or other changes to the
contract, may jeopardize the Policy's non-modified endowment status. The Company
will monitor premiums paid and other policy transactions and will notify the
Policy Owner when non-modified endowment contract status is in jeopardy (see
"Tax Matters").
ALLOCATION OF CASH VALUE
When the Policy is issued, the Net Premiums will be allocated to the Nationwide
Separate Account Trust Money Market Fund sub-account until the expiration of the
period in which the Policy Owner may exercise his or her short-term right to
cancel the Policy. At the expiration of the period in which the Policy Owner may
exercise his or her short term right to cancel the Policy, shares of the
Underlying Mutual Funds specified by the Policy Owner are purchased at net asset
value for the respective sub-account(s). The Policy Owner may change the
allocation of Net Premiums or may transfer Cash Value from one sub-account to
another, subject to such terms and conditions as may be imposed by each
Underlying Mutual Fund and as set forth in the prospectus.
The designation of investment allocations will be made by the prospective Policy
Owner at the time of application for a Policy. The Policy Owner may change the
way in which future Net Premiums are allocated by giving written notice to the
Company. All percentage allocations must be in whole numbers, and must be at
least 5%. The sum of allocations must equal 100%.
SHORT-TERM RIGHT TO CANCEL POLICY
A Policy may be returned for cancellation and a full refund of premium within 10
days after the Policy is received, within 45 days after the application for
insurance is signed, or within 10 days after the Company mails or delivers a
Notice of Right of Withdrawal, whichever is latest. The Policy can be mailed or
delivered to the registered representative who sold it, or to the Company.
Immediately after such mailing or delivery, the Policy will be deemed void from
the beginning. The Company will refund the total premiums paid within seven days
after it receives the Policy.
POLICY CHARGES
DEDUCTIONS FROM PREMIUMS
The Company deducts a sales load from each premium payment received not to
exceed 9% of each premium payment for years 1-7, and 5% in years 8 and after.
The Company also deducts a tax expense charge of 4% from all premium payments.
This charge reimburses the Company for premium taxes imposed by various state
and local jurisdictions and for federal taxes imposed under Section 848 of the
Code. This Charge includes a premium tax deduction rate of 2.5% and a federal
tax deduction rate of 1.5%.
The 2.5% premium tax deduction rate approximates the Company's average expense
for state and local premium tax. Premium taxes vary by jurisdiction ranging in
rate from zero to more than 4%. The premium tax deduction is made whether or not
any premium tax applies and the deduction may be higher or lower than the
premium tax imposed. The 1.5% federal tax deduction rate is designed to
reimburse the Company for expenses incurred from federal taxes imposed under
Section 848 of the Code (enacted by the Omnibus Budget Reconciliation Act of
1990). The federal tax deduction rate is a factor the Company must use when
computing the maximum sales load chargeable under SEC rules. The Company does
not expect to make a profit from the tax expense charge.
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DEDUCTIONS FROM CASH VALUE
The Company also deducts the following charges from the Policy's Cash Value on
the Policy Date and each subsequent Monthly Anniversary Day:
1. monthly cost of insurance; plus
2. monthly cost of any additional benefits provided by riders; plus
3. monthly administrative expense; plus
4. monthly mortality and expense risk.
These deductions will be charged proportionately to the Cash Value in each
Variable Account sub-account.
- -Monthly Cost of Insurance Charge
The monthly cost of insurance charge for each policy month is determined by
multiplying the monthly cost of insurance rate by the net amount at risk. The
net amount at risk is the difference between the death benefit and the Policy's
Cash Value, each calculated at the beginning of the policy month.
If death benefit Option 1 is in effect and there have been increases in the
Specified Amount, then the Cash Value shall first be considered a part of the
initial Specified Amount. If the Cash Value exceeds the initial Specified
Amount, it shall then be considered a part of the additional increases in
Specified Amount resulting from the increases in the order of the increases.
Monthly cost of insurance rates will not exceed those guaranteed in the Policy.
Guaranteed cost of insurance rates are based on the Blended 1980 Commissioners
Standard Ordinary Unisex Mortality Table B (80% Male/20% Female), Age Last
Birthday. Guaranteed cost of insurance rates for Policies issued on a
substandard basis are based on appropriate percentage multiples of the table for
the comparable standard risk. These mortality tables are not sex distinct. In
addition, separate mortality tables will be used for standard and non-tobacco.
The rate class of an Insured may affect the cost of insurance rate. The Company
currently places Insureds into both standard rate classes and substandard
classes that involve a higher mortality risk. In an otherwise identical Policy,
an Insured in the standard rate class will have a lower cost of insurance than
an Insured in a rate class with higher mortality risks. The Company may also
issue certain Policies on a Guaranteed or Simplified issue basis to certain
categories of individuals. Due to the underwriting criteria established for
Policies issued on a Guaranteed or Simplified issue basis, actual rates will be
higher than the current cost of insurance rates being charged under Policies are
subject to regular underwriting.
- -Monthly Administrative Charge
The Company deducts a monthly Administrative Expense Charge to reimburse it for
certain expenses related to maintenance of the Policies, accounting and record
keeping and periodic reporting to Policy Owners. This charge is designed only to
reimburse the Company for certain actual administrative expenses. The Company
does not expect to recover from this charge any amount in excess of aggregate
maintenance expenses. Currently, this charge is $15 per month in the first year,
$5 per month in renewal years. The Company may at its sole discretion increase
this charge. However, the Company guarantees that this charge will never exceed
$10.00 per month in renewal years.
- -Monthly Mortality and Expense Risk Charge
The Company assumes certain risks for guaranteeing the mortality and expense
charges. The mortality risk assumed under the Policies is that the Insured may
die sooner than expected. The expense risk assumed is that the actual expenses
incurred in issuing and administering the Policy may be greater than expected.
In addition, the Company assumes risks associated with the non-recovery of
policy issue, underwriting and other administrative expenses due to a Policy
which lapses or is surrendered in the early Policy Years.
To compensate the Company for assuming these risks associated with the Policy,
the Company deducts a mortality and expense risk charge at the beginning of each
policy month. The Mortality and Expense Risk Charge will apply solely to the
assets in the Variable Account. This charge will be deducted proportionately
from the assets in the Variable Account sub-accounts.
The Mortality and Expense Risk Charge is equivalent to an annual effective rate
of 0.65%.
DEDUCTIONS FROM THE SUB-ACCOUNTS
The Company does not currently assess any charge for income taxes incurred by
the Company as a result of the operations of the sub-accounts of the Variable
Account (see "Taxation of the Company"). The Company
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reserves the right to assess a charge for such taxes against the Variable
Account if the Company determines that such taxes will be incurred.
HOW THE CASH VALUE VARIES
On any date during the Policy Year, the Cash Value equals the Cash Value on the
preceding Valuation Date, plus any Net Premium applied since the previous
Valuation Date, minus any partial surrenders, plus or minus any investment
results, and less any Policy Charges.
There is no guaranteed Cash Value. The Cash Value will vary with the investment
experience of the Variable Account and/or Policy Loan Account depending on the
allocation of Cash Value by the Policy Owner.
HOW THE INVESTMENT EXPERIENCE IS DETERMINED
The Cash Value in each sub-account is converted to Accumulation Units of that
sub-account. The conversion is accomplished by dividing the amount of Cash Value
allocated to a sub-account by the value of an Accumulation Unit for the
sub-account of the Valuation Period during which the allocation occurs.
The value of an Accumulation Unit for each sub-account was arbitrarily set
initially at $10 when the Underlying Mutual Fund shares in that sub-account were
available for purchase. The value for any subsequent Valuation Period is
determined by multiplying the Accumulation Unit value for each sub-account for
the immediately preceding Valuation Period by the Net Investment Factor for the
sub-account during the subsequent Valuation Period. The value of an Accumulation
Unit may increase or decrease from Valuation Period to Valuation Period. The
number of Accumulation Units will not change as a result of investment
experience.
NET INVESTMENT FACTOR
The Net Investment Factor for any Valuation Period is determined by dividing (a)
by (b) where:
(a) is the net of:
(1) the net asset value per share of the Underlying Mutual Fund held
in the sub-account determined at the end of the current Valuation
Period, plus
(2) the per share amount of any dividend or capital gain distributions
made by the Underlying Mutual Fund held in the sub-account if the
"ex-dividend" date occurs during the current Valuation Period.
(b) is the net of:
(1) the net asset value per share of the Underlying Mutual Fund held
in the sub-account determined at the end of the immediately
preceding Valuation Period, plus or minus
(2) the per share charge or credit, if any, for any taxes reserved for
in the immediately preceding Valuation Period (see "Charge For Tax
Provisions").
For Underlying Mutual Fund options that credit dividends on a daily basis and
pay such dividends once a month, the Net Investment Factor allows for the
monthly reinvestment of these daily dividends.
The Net Investment Factor may be greater or less than one; therefore, the value
of an Accumulation Unit may increase or decrease. It should be noted that
changes in the Net Investment Factor may not be directly proportional to changes
in the net asset value of Underlying Mutual Fund shares, because of the
deduction for Mortality and Expense Risk Charge, and any charge or credit for
tax reserves.
VALUATION OF ASSETS
Underlying Mutual Fund shares in the Variable Account will be valued at their
net asset value.
DETERMINING THE CASH VALUE
The Cash Value is the sum of the value of all Variable Account Accumulation
Units and any amount in the Policy Loan Account attributable to the Policy. The
number of Accumulation Units credited per each sub-account is determined by
dividing the net amount allocated to the sub-account by the Accumulation Unit
Value for the sub-account for the Valuation Period during which the premium is
received by the Company. In the event part or all of the Cash Value is
surrendered or charges or deductions are made against the Cash Value, an
appropriate number of Accumulation Units from the Variable Account will be
deducted.
The Cash Value in the Policy Loan Account is credited with interest daily at an
effective annual rate which the Company periodically declares. The annual
effective rate will never be less than 4%. Upon request, the Company will inform
the Policy Owner of the then applicable rates for the Policy Loan Account.
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VALUATION PERIODS AND VALUATION DATES
A Valuation Period is the period commencing with the close of business on a
Valuation Date and ending at the close of business for the next succeeding
Valuation Date. A Valuation Date is each day that the New York Stock Exchange
and the Company's Home Office are open for business or any other day during
which there is sufficient degree of trading that the current net asset value of
the Accumulation Units might be materially affected.
SURRENDERING THE POLICY FOR CASH
RIGHT TO SURRENDER
The Policy Owner may surrender the Policy in full at any time while the Insured
is living and receive its Cash Surrender Value. The cancellation will be
effective as of the date the Company receives a proper written request for
cancellation and the Policy. Such written request must be signed and, where
permitted, the signature guaranteed by a member firm of the New York, American,
Boston, Midwest, Philadelphia or Pacific Stock Exchange, or by a Commercial Bank
or a Savings and Loan, which is a member of the Federal Deposit Insurance
Corporation. In some cases, the Company may require additional documentation of
a customary nature.
CASH SURRENDER VALUE
The Cash Surrender Value increases or decreases daily to reflect the investment
experience of the Variable Account and the daily crediting of interest in the
Policy Loan Account. The Cash Surrender Value equals the Policy's Cash Value,
next computed after the date the Company receives a proper written request for
surrender and the Policy, minus any charges, Indebtedness or other deductions
due on that date.
PARTIAL SURRENDERS
Partial Surrenders may be made at any time after the first Policy Anniversary.
Partial surrenders will be permitted only if they satisfy the following
requirements:
1. The minimum partial surrender is $500;
2. The partial surrender may not reduce the Specified Amount to
less than the Minimum Issue Amount ($50,000);
3. After the partial surrender, the Policy continues to qualify
as life insurance;
4. The maximum partial surrender is equal to the available Cash
Surrender Value less the greater of $500 and three monthly
deductions.
The Company reserves the right to limit the number of partial surrenders in each
Policy Year.
When a partial surrender is made, the Cash Value is reduced by the amount of the
partial surrender. Also, under death benefit Option 1, the Specified Amount is
reduced by the amount of the partial surrender. The Company reserves the right
to deduct a fee for each partial surrender of not more than the lesser of $25
and 2% of the amount of the partial surrender.
On a current basis, the Company does not deduct the above fee. Certain partial
surrenders may result in currently taxable income and tax penalties (see "Tax
Matters").
MATURITY PROCEEDS
The Maturity Date is the Policy Anniversary on or next following the Insured's
100th birthday. The maturity proceeds will be payable to the Policy Owner on the
Maturity Date provided the Policy is still in force. The Maturity Proceeds will
be equal to the amount of the Policy's Cash Value, less any Indebtedness.
INCOME TAX WITHHOLDING
Federal law requires the Company to withhold income tax from any portion of
surrender proceeds that is subject to tax, unless the Policy Owner advises the
Company, in writing, of his or her request not to withhold.
If the Policy Owner requests that the Company not withhold taxes, or if the
taxes withheld are insufficient, the Policy Owner may be liable for payment of
an estimated tax. The Policy Owner should consult his or her tax advisor.
In certain employer-sponsored life insurance arrangements, including equity
split dollar arrangements, participants may be required to report for income tax
purposes, one or more of the following: (1) the value each year of the life
insurance protection provided, (2) an amount equal to any employer-paid
premiums; or (3) some or all of the amount by which the current value exceeds
the employer's interest in the Contract. Participants
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should consult with the sponsor or the administrator of the Plan, and/or with
their personal tax or legal advisor, to determine the tax consequences, if any,
of their employer-sponsored life insurance arrangements.
POLICY LOANS
TAKING A POLICY LOAN
After the first Policy Year, the Policy Owner may take a Policy loan using the
Policy as security. Maximum Policy Indebtedness is limited to 90% of the Cash
Surrender Value. The Company will not grant a loan for an amount less than $200.
Should the Death Proceeds become payable, the Policy be surrendered, or the
Policy mature while a loan is outstanding, the amount of Policy Indebtedness
will be deducted from the death benefit, Cash Surrender Value or the maturity
value, respectively.
Any request for a Policy loan must be in written form satisfactory to the
Company. The request must be signed and, where permitted, the signature
guaranteed by a member firm of the New York, American, Boston, Midwest,
Philadelphia or Pacific Stock Exchange; or by a Commercial Bank or a Savings and
Loan which is a member of the Federal Deposit Insurance Corporation. Certain
policy loans may result in currently taxable income and tax penalties (see "Tax
Matters").
A Policy Owner considering the use of policy loans in connection with his or her
retirement income plan should consult his or her personal tax adviser regarding
potential tax consequences that may arise if necessary payments are not made to
keep the Policy from lapsing. The amount of such payments necessary to prevent
the Policy from lapsing would increase with age (see "Tax Matters").
EFFECT ON INVESTMENT PERFORMANCE
When a loan is made, an amount equal to the amount of the loan is transferred
from the Variable Account to the Policy Loan Account. If the assets relating to
a Policy are held in more than one sub-account, withdrawals from sub-accounts
will be made in proportion to the assets in each Variable sub-account at the
time of the loan. The amount taken out of the Variable Account will not be
affected by the Variable Account's investment experience while the loan is
outstanding.
INTEREST
On a current basis, policy loans are credited with an annual effective rate of
5.1% during policy years 1 through 10 and an annual effective rate of 6% during
the 11th and subsequent policy years. The rate is guaranteed never to be lower
than 4%. The Company may change the current interest crediting rate on policy
loans at any time at its sole discretion. The loan interest rate is 6% per year
for all Policy loans. In the event that it is determined that such loans will be
treated, as a result of the differential between the interest crediting rate and
the loan interest rate, as taxable distributions under any applicable ruling,
regulation, or court decision, the Company retains the right to increase the net
cost (by decreasing the interest crediting rate) on all subsequent policy loans
to an amount that would result in the transaction being treated as a loan under
Federal tax law. If this amount is not prescribed by such ruling, regulation, or
court decision, the amount will be that which the Company considers to be more
likely to result in the transaction being treated as a loan under Federal tax
law.
Amounts transferred to the Policy Loan Account will earn interest daily from the
date of transfer. The earned interest is transferred from the Policy Loan
Account to the Variable Account on each Policy Anniversary or at the time of
loan repayment. It will be allocated according to the Fund allocation factors in
effect at the time of the transfer.
Interest is charged daily and is payable at the end of each Policy Year or at
the time of loan repayment. Unpaid interest will be added to the existing Policy
Indebtedness as of the due date and will be charged interest at the same rate as
the rest of the Indebtedness.
Whenever the total Policy Indebtedness exceeds the Cash Value, the Company will
send a notice to the Policy Owner and the assignee, if any. The Policy will
terminate without value 61 days after the mailing of the notice unless a
sufficient repayment is made during that period. A repayment is sufficient if it
is large enough to reduce the total Policy Indebtedness to an amount equal to
the total Cash Value plus an amount sufficient to continue the Policy in force
for 3 months.
EFFECT ON DEATH BENEFIT AND CASH VALUE
A Policy loan, whether or not repaid, will have a permanent effect on the Death
Benefit and Cash Value because the investment results of the Variable Account
will apply only to the non-loaned portion of the Cash Value. The longer the loan
is outstanding, the greater the effect is likely to be. Depending on the
investment results of the Variable Account while the loan is outstanding, the
effect could be favorable or unfavorable.
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<PAGE> 20
REPAYMENT
All or part of the Indebtedness may be repaid at any time while the Policy is in
force during the Insured's lifetime. Any payment intended as a loan repayment,
rather than a premium payment, must be identified as such. Loan repayments will
be credited to the Variable sub-accounts in proportion to the Policy Owner's
Underlying Mutual Fund allocation factors in effect at the time of the
repayment. Each repayment may not be less than $50.
HOW THE DEATH BENEFIT VARIES
CALCULATION OF THE DEATH BENEFIT
At issue, the Policy Owner selects the Specified Amount. While the Policy is in
force, the death benefit will never be less than the Specified Amount. The death
benefit may vary with the Cash Value of the Policy, which depends on investment
performance.
The Policy Owner may choose one of two death benefit options. Under Option 1,
the death benefit will be the greater of the Specified Amount or the Applicable
Percentage of Cash Value. Under Option 1, the amount of the death benefit will
ordinarily not change for several years to reflect the investment performance
and may not change at all. If investment performance is favorable the amount of
death benefit may increase. To see how and when investment performance will
begin to affect death benefits, please see the illustrations. Under Option 2,
the death benefit will be the greater of the Specified Amount plus the Cash
Value, or the Applicable Percentage of Cash Value and will vary directly with
the investment performance.
The term "Applicable Percentage" means the percentage shown in the "Applicable
Percentage of Cash Value Table."
APPLICABLE PERCENTAGE OF CASH VALUE TABLE
<TABLE>
<CAPTION>
Attained Percentage Attained Percentage Attained Percentage
Age of Cash Value Age of Cash Value Age of Cash Value
--- ------------- --- ------------- --- -------------
<S> <C> <C> <C> <C> <C>
0-40 250% 60 130% 80 105%
41 243% 61 128% 81 105%
42 236% 62 126% 82 105%
43 229% 63 124% 83 105%
44 222% 64 122% 84 105%
45 215% 65 120% 85 105%
46 209% 66 119% 86 105%
47 203% 67 118% 87 105%
48 197% 68 117% 88 105%
49 191% 69 116% 89 105%
50 185% 70 115% 90 105%
51 178% 71 113% 91 104%
52 171% 72 111% 92 103%
53 164% 73 109% 93 102%
54 157% 74 107% 94 101%
55 150% 75 105% 95 101%
56 146% 76 105% 96 101%
57 142% 77 105% 97 101%
58 138% 78 105% 98 101%
59 134% 79 105% 99 101%
100 100%
</TABLE>
PROCEEDS PAYABLE ON DEATH
The actual Death Proceeds payable on the Insured's death will be the death
benefit as described above, less any Policy Indebtedness and less any unpaid
Policy Charges. Under certain circumstances, the Death Proceeds may be adjusted
(see "Incontestability", "Error in Age ", and "Suicide").
RIGHT TO EXCHANGE FOR A FIXED BENEFIT POLICY
The Policy Owner may exchange the Policy for a flexible premium adjustable life
insurance policy offered by the Company on the Policy Date. The benefits for the
new policy will not vary with the investment experience
17
<PAGE> 21
of a separate account. The exchange must be elected within 24 months from the
Policy Date. No evidence of insurability will be required.
The Policy Owner and Beneficiary under the new policy will be the same as those
under the exchanged Policy on the effective date of the exchange. The new policy
will have a death benefit on the exchange date not more than the death benefit
of the original Policy immediately prior to the exchange date. The new policy
will have the same Policy Date and issue age as the original Policy. The initial
Specified Amount and any increases in Specified Amount will have the same rate
class as those of the original Policy. Any indebtedness may be transferred to
the new policy.
The exchange may be subject to an equitable adjustment in rates and values to
reflect variances, if any, in the rates and values between the two Policies.
After adjustment, if any excess is owed the Policy Owner, the Company will pay
the excess to the Policy Owner in cash. The exchange may be subject to federal
income tax withholding (see "Income Tax Withholding").
CHANGES OF INVESTMENT POLICY
The Company may materially change the investment policy of the Variable Account.
The Company must inform the Policy Owners and obtain all necessary regulatory
approvals. Any change must be submitted to the various state insurance
departments which may disapprove it if deemed detrimental to the interests of
the Policy Owners or if it renders the Company's operations hazardous to the
public. If a Policy Owner objects, the Policy may be converted to a
substantially comparable General Account life insurance policy offered by the
Company on the life of the Insured. The Policy Owner has the later of 60 days (6
months in Pennsylvania) from the date of the investment policy change or 60 days
(6 months in Pennsylvania) from being informed of such change to make this
conversion. The Company will not require evidence of insurability for this
conversion.
The new policy will not be affected by the investment experience of any separate
account. The new policy will be for an amount of insurance not exceeding the
death benefit of the Policy converted on the date of such conversion.
GRACE PERIOD
If the Cash Surrender Value on a Monthly Anniversary Day is not sufficient to
cover the current Policy Charges, a Grace Period of 61 days from the Monthly
Anniversary Day will be allowed for the payment of sufficient premium to cover
the current Policy Charges due plus an amount equal to three times the current
monthly deduction. The Company will send such a notice at the start of the Grace
Period to the Policy Owner's last known address. If the Insured dies during the
Grace Period, the Company will pay the Death Proceeds.
REINSTATEMENT
If the Grace Period ends and the Policy Owner has neither paid the required
premium nor surrendered the Policy for its Cash Surrender Value, the Policy
Owner may reinstate the Policy by:
1. submitting a written request at any time within 3 years after
the end of the Grace Period and prior to the Maturity Date;
2. providing evidence of insurability satisfactory to the Company;
3. paying sufficient premium to cover all policy charges that were
due and unpaid during the Grace Period;
4. paying sufficient premium to keep the Policy in force for 3
months from the date of reinstatement; and
5. paying or reinstating any indebtedness against the Policy which
existed at the end of the Grace Period.
The effective date of a reinstated Policy will be the Monthly Anniversary Day on
or next following the date the application for reinstatement is approved by the
Company. If your Policy is reinstated, the Cash Value on the date of
reinstatement, but prior to applying any premiums or loan repayments received,
will be set equal to the Cash Value at the end of the Grace Period.
Unless the Policy Owner has provided otherwise, all amounts will be allocated
based on the Underlying Mutual Fund allocation factors in effect at the start of
the Grace Period.
18
<PAGE> 22
CHANGES IN EXISTING INSURANCE COVERAGE
The Policy Owner may request certain changes in the insurance coverage under the
Policy. Any request must be in writing and received at the Company's Home
Office. No change will take effect unless the Cash Surrender Value, after the
change, is sufficient to keep the Policy in force for at least 3 months.
SPECIFIED AMOUNT INCREASES
After the first Policy Year, the Policy Owner may request an increase to the
Specified Amount. Any increase will be subject to the following conditions:
1. satisfactory evidence of insurability must be provided;
2. the increase must be for a minimum of $10,000; and
3. age limits are the same as for a new issue.
Any approved increase will have an effective date of the Monthly Anniversary Day
on or next following the date the Company approves the supplemental application.
The Company reserves the right to limit the number of Specified Amount increases
to one each Policy Year.
SPECIFIED AMOUNT DECREASES
After the first Policy Year, the Policy Owner may also request a decrease to the
Specified Amount. Any approved decrease will be effective on the Monthly
Anniversary Day on or next following the date the Company receives the request.
Any such decrease shall reduce insurance in the following order:
1. against insurance provided by the most recent increase;
2. against the next most recent increases successively; and
3. against insurance provided under the original application.
The Company reserves the right to limit the number of Specified Amount decreases
to one each Policy Year. The Company will refuse a request for a decrease which
would:
1. reduce the Specified Amount to less than $50,000; or
2. disqualify the Policy as a contract for life insurance.
CHANGES IN THE DEATH BENEFIT OPTION
After the first Policy Year, the Policy Owner may change the death benefit
option under the Policy. If the change is from Option 1 to Option 2, the
Specified Amount will be decreased by the amount of the Cash Value. If the
change is from Option 2 to Option 1, the Specified Amount will be increased by
the amount of the Cash Value. Evidence of insurability is not required for a
change from Option 2 to Option 1. The Company reserves the right to require
evidence of insurability for a change from Option 1 to Option 2. The effective
date of the change will be the Monthly Anniversary Day on or next following the
date the Company approves the request for change. Only one change of option is
permitted per Policy Year. A change in death benefit option will not be
permitted if it results in the total premiums paid exceeding the then current
maximum premium limitations prescribed by the Internal Revenue Service to
qualify the Policy as a life insurance contract.
OTHER POLICY PROVISIONS
POLICY OWNER
While the Insured is living, all rights in this Policy are vested in the Policy
Owner named in the application or as subsequently changed, subject to
assignment, if any.
The Policy Owner may name a contingent Policy Owner or a new Policy Owner while
the Insured is living. Any change must be in a written form satisfactory to the
Company and recorded at the Company's Home Office. Once recorded, the change
will be effective when signed. The change will not affect any payment made or
action taken by the Company before it was recorded. The Company may require that
the Policy be submitted for endorsement before making a change.
If the Policy Owner is other than the Insured and names no contingent Policy
Owner, and dies before the Insured, the Policy Owner's rights in this Policy
belong to the Policy Owner's estate.
BENEFICIARY
The Beneficiary(ies) shall be as named in the application or as subsequently
changed, subject to assignment, if any.
The Policy Owner may name a new Beneficiary while the Insured is living. Any
change must be in a written form satisfactory to the Company and recorded at the
Company's Home Office. Once recorded, the change will be effective when signed.
The change will not affect any payment made or action taken by the Company
before it was recorded.
19
<PAGE> 23
If any Beneficiary predeceases the Insured, that Beneficiary's interest passes
to any surviving Beneficiary(ies), unless otherwise provided. Multiple
Beneficiaries will be paid in equal shares, unless otherwise provided. If no
named Beneficiary survives the Insureds, the Death Proceeds shall be paid to the
Policy Owner or the Policy Owner's estate.
ASSIGNMENT
While the Insured is living, the Policy Owner may assign his or her rights in
the Policy. The assignment must be in writing, signed by the Policy Owner and
recorded by the Company at its Home Office. Any assignment will not affect any
payments made or actions taken by the Company before it was recorded. The
Company is not responsible for any assignment not submitted for recording, nor
is the Company responsible for the sufficiency or validity of any assignment.
The assignment will be subject to any Indebtedness owed to the Company before it
was recorded.
INCONTESTABILITY
The Company will not contest payment of the Death Proceeds based on the initial
Specified Amount after the Policy has been in force during the Insured's
lifetime for 2 years from the Policy Date. For any increase in Specified Amount
requiring evidence of insurability, the Company will not contest payment of the
Death Proceeds based on such an increase after it has been in force during the
Insured's lifetime for 2 years from its effective date.
ERROR IN AGE
If the age of the Insured has been misstated, the affected benefits will be
adjusted. The amount of the death benefit will be 1. multiplied by 2. and
then the result added to 3., where:
1. is the amount of the death benefit at the time of the Insured's
death reduced by the amount of the Cash Value at the time of the
Insured's death;
2. is the ratio of the monthly cost of insurance applied in the
policy month of death and the monthly cost of insurance that
should have been applied at the true age in the policy month of
death; and
3. is the Cash Value at the time of the Insured's death.
SUICIDE
If the Insured dies by suicide, while sane or insane, within two years from the
Policy Date, the Company will pay no more than the sum of the premiums paid,
less any Indebtedness. If the Insured dies by suicide, while sane or insane,
within two years from the date an application is accepted for an increase in the
Specified Amount, the Company will pay no more than the amount paid for such
additional benefit.
NONPARTICIPATING POLICIES
These are nonparticipating Policies on which no dividends are payable. These
Policies do not share in the profits or surplus earnings of the Company.
DISTRIBUTION OF THE POLICIES
The Policies will be sold by licensed insurance agents in those states where the
Policies may lawfully be sold. Such agents will be registered representatives of
broker dealers registered under the Securities Exchange Act of 1934 who are
members of the National Association of Securities Dealers, Inc. (NASD). The
Policies will be distributed by the General Distributor, Nationwide Advisory
Services, Inc. (NAS), located at One Nationwide Plaza, Columbus, Ohio, 43216,
also serves as principal underwriter for the Trust. NAS acts as general
distributor for the Nationwide Multi-Flex Variable Account, Nationwide DC
Variable Account, Nationwide DCVA-II, Nationwide Variable Account-II, Nationwide
Variable Account-5, Nationwide Variable Account-8, Nationwide VA Separate
Account-A, Nationwide VA Separate Account-B, Nationwide VA Separate Account-C,
Nationwide VL Separate Account-A, Nationwide VL Separate Account - B, Nationwide
VLI Separate Account-2, Nationwide VLI Separate Account-3, NACo Variable Account
and the Nationwide Variable Account, all of which are separate investment
accounts of the Company or its parent company, Nationwide Life Insurance
Company. NAS is a wholly owned subsidiary of Nationwide Life Insurance Company.
NAS also acts as principal underwriter for the Nationwide Investing Foundation,
Nationwide Separate Account Trust, Financial Horizons Investment Trust, and
Nationwide Investing Foundation II, which are open-end management
investment companies.
20
<PAGE> 24
CUSTODIAN OF ASSETS
The Company, located at One Nationwide Plaza, Columbus, Ohio, 43216, serves as
the Custodian of the assets of the Variable Account. The Company also serves as
Trustee for the Trust (see Section entitled "The Variable Account").
TAX MATTERS
POLICY PROCEEDS
Section 7702 of the Code provides that if certain tests are met, a Policy will
be treated as a life insurance policy for federal tax purposes. The Company will
monitor compliance with these tests. The Policy should thus receive the same
federal income tax treatment as fixed benefit life insurance. As a result, the
Death Proceeds payable under a Policy are excludable from gross income of the
beneficiary under Section 101 of the Code.
Section 7702A of the Code defines modified endowment contracts as those policies
issued or materially changed on or after June 21, 1988 on which the total
premiums paid during the first seven years exceed the amount that would have
been paid if the policy provided for paid up benefits after seven level annual
premiums (see "Information about the Policies"). The Code provides for taxation
of surrenders, partial surrenders, loans, collateral assignments and other
pre-death distributions from modified endowment contracts in the same way
annuities are taxed. Modified endowment contract distributions are defined by
the Code as amounts not received as an annuity and are taxable to the extent the
cash value of the policy exceeds, at the time of distribution, the premiums paid
into the policy. A 10% tax penalty generally applies to the taxable portion of
such distributions unless the Policy Owner is an individual and is over age
59-1/2 or disabled.
The Policies offered by this prospectus may or may not be issued as modified
endowment contracts. The Company will monitor premiums paid and will notify the
Policy Owner when the policy's non-modified endowment status is in jeopardy. If
a policy is not a modified endowment contract, a cash distribution during the
first 15 years after a policy is issued which causes a reduction in death
benefits may still become fully or partially taxable to the Owner pursuant to
Section 7702(f)(7) of the Code. The Policy Owner should carefully consider this
potential effect and seek further information before initiating any changes in
the terms of the policy. Under certain conditions, a policy may become a
modified endowment as a result of a material change or a reduction in benefits
as defined by Section 7702A(c) of the Code.
In addition to meeting the tests required under Sections 7702, Section 817(h) of
the Code requires that the investments of separate accounts such as the Variable
Account be adequately diversified. Regulations under 817(h) provide that a
variable life policy failing to satisfy the diversification standards will not
be treated as life insurance unless such failure was inadvertent, is corrected,
and the Policy Owner or the Company pays an amount to the Internal Revenue
Service. The amount will be based on the tax that would have been paid by the
Policy Owner if the income, for the period the policy was not diversified, had
been received by the Policy Owner. If the failure to diversify is not corrected
in this manner, the Policy Owner will be deemed the owner of the underlying
securities and taxed on the earnings of his or her account.
Representatives of the Internal Revenue Service have suggested, from time to
time, that the number of Underlying Mutual Funds available or the number of
transfer opportunities available under a variable product may be relevant in
determining whether the product qualifies for the desired tax treatment. No
formal guidance has been issued in this area. Should the Secretary of the
Treasury issue additional rules or regulations limiting the number of Underlying
Mutual Funds, transfers between Underlying Mutual Funds, exchanges of Underlying
Mutual Funds or changes in investment objectives of Underlying Mutual Funds such
that the Policy would no longer qualify as life insurance under Section 7702 of
the Code, the Company will take whatever steps are available to remain in
compliance.
The Company will monitor compliance with these regulations and, to the extent
necessary, will change the objectives or assets of the sub-account investments
to remain in compliance.
A total surrender or cancellation of the Policy by lapse or the maturity of the
Policy on its Maturity Date may have adverse tax consequences. If the amount
received by the Policy Owner plus total Policy Indebtedness exceeds the premiums
paid into the Policy, the excess generally will be treated as taxable income,
regardless of whether or not the Policy is a modified endowment contract.
Generally the taxable portion of any distribution from a contract to a
nonresident alien of the United States is subject to tax withholding at a rate
equal to thirty percent (30%) of such amount or, if applicable, a lower treaty
rate. A payment may not be subject to withholding where the recipient
sufficiently establishes that such payment is effectively connected to the
recipient's conduct of a trade or business in the United States and such payment
is includable in the recipient's gross income.
21
<PAGE> 25
Federal estate and state and local estate, inheritance and other tax
consequences of ownership or receipt of Policy proceeds depend on the
circumstances of each Policy Owner or Beneficiary.
TAXATION OF THE COMPANY
The Company is taxed as a life insurance company under the Code. Since the
Variable Account is not a separate entity from the Company and its operations
form a part of the Company, it will not be taxed separately as a "regulated
investment company" under Sub-chapter M of the Code. Investment income and
realized capital gains on the assets of the Variable Account are reinvested and
taken into account in determining the value of Accumulation Units. As a result,
such investment income and realized capital gains are automatically applied to
increase reserves under the Policies.
The Company does not initially expect to incur any Federal income tax liability
that would be chargeable to the Variable Account. Based upon these expectations,
no charge is currently being made against the Variable Account for federal
income taxes. If, however, the Company determines that on a separate company
basis such taxes may be incurred, it reserves the right to assess a charge for
such taxes against the Variable Account.
The Company may also incur state and local taxes (in addition to premium taxes)
in several states. At present, these taxes are not significant. If they
increase, however, charges for such taxes may be made.
OTHER CONSIDERATIONS
The foregoing discussion is general and is not intended as tax advice. Counsel
and other competent advisors should be consulted for more complete information.
This discussion is based on the Company's understanding of Federal income tax
laws as they are currently interpreted by the Internal Revenue Service. No
representation is made as to the likelihood of continuation of these current
laws and interpretations.
THE COMPANY
The life insurance business, which includes product lines in health insurance
and annuities, is the only business in which the Company is engaged.
The Company markets its Policies through independent insurance brokers, general
agents, and registered representatives of registered NASD broker/dealer firms.
The Company serves as depositor for the Nationwide VA Separate Account-A,
Nationwide VA Separate Account-B, Nationwide VA Separate Account-C, Nationwide
VL Separate Account-A and Nationwide VL Separate Account-B, each of which is a
registered investment company, and each of which is a separate investment
account of the Company.
The Company, in common with other insurance companies, is subject to regulation
and supervision by the regulatory authorities of the states in which it is
licensed to do business. A license from the state insurance department is a
prerequisite to the transaction of insurance business in that state. In general,
all states have statutory administrative powers. Such regulation relates, among
other things, to licensing of insurers and their agents, the approval of policy
forms, the methods of computing reserves, the form and content of statutory
financial statements, the amount of policyholders' and stockholders' dividends,
and the type of distribution of investments permitted.
The Company operates in the highly competitive field of life insurance. There
are approximately 2,300 stock, mutual and other types of insurers in the life
insurance business in the United States, and a large number of them compete with
the registrant in the sale of insurance policies.
As is customary in insurance company groups, employees are shared with the other
insurance companies in the group. In addition to its direct salaried employees,
the Company shares employees with Nationwide Mutual Insurance Company and
Nationwide Mutual Fire Insurance Company.
The Company does not presently own or lease any materially important physical
properties when its property holdings are viewed in relation to its total
assets. The Company shares Home Office, other facilities and equipment with
Nationwide Mutual Insurance Company.
COMPANY MANAGEMENT
Nationwide Life and Annuity Insurance Company, together with Nationwide Mutual
Insurance Company, Nationwide Indemnity Company, Nationwide Mutual Fire
Insurance Company, Nationwide Life Insurance Company, Nationwide Property and
Casualty Insurance Company, National Casualty Company, West Coast Life Insurance
Company, Scottsdale Indemnity Company and Nationwide General Insurance Company
and their affiliate companies comprise the Nationwide Insurance Enterprise.
The companies comprising the Nationwide Insurance Enterprise have substantially
common boards of directors and officers. Nationwide Life Insurance Company is
the sole shareholder of Nationwide Life and Annuity Insurance Company.
22
<PAGE> 26
DIRECTORS OF THE COMPANY
<TABLE>
<CAPTION>
Director
Name Since Principal Occupation
---- ----- --------------------
<S> <C> <C>
Lewis J. Alphin 1993 Farm Owner and Operator (1)
Keith W. Eckel 1996 Partner and Manager, Fred W. Eckel Sons and Eckel Farms, Inc. (1)
Willard J. Engel 1994 General Manager Lyon County Cooperative Oil Company (1)
Fred C. Finney 1992 Owner and Operator, Moreland Fruit Farm; Operator, Melrose Orchard(1)
Charles L. Fuellgraf, Jr. *+ 1969 Chief Executive Officer, Fuellgraf Electric Company, Electrical
Construction and Engineering Services (1)
James J. Gasper *+ 1996 President and Chief Operating Officer, Nationwide Life Insurance
Company and Nationwide Life and Annuity Insurance Company (2)
Henry S. Holloway *+ 1986 Farm Owner and Operator (1)
D. Richard McFerson *+ 1988 Chairman and Chief Executive Officer; Nationwide Insurance
Enterprise (2)
David O. Miller *+ 1985 Farm Owner and Land Developer; President, Owen Potato Farm, Inc.;
Partner, M&M Enterprises (1)
C. Ray Noecker 1994 Farm Owner and Operator (1)
James F. Patterson 1989 Vice President, Pattersons, Inc.; President Patterson Farms, Inc. (1)
Arden L. Shisler *+ 1984 Partner and Manager, Sweetwater Beef Farms; President and Chief
Executive Officer, K&B Transport, Inc. (1)
Robert L. Stewart 1989 Farm Owner and Operator; Owner, Sunnydale Mining (1)
Nancy C. Thomas * 1986 Farm Owner and Operator, Da-Ma-Lor Farm (1)
Harold W. Weihl 1990 Farm Owner and Operator, Weihl Farm (1)
</TABLE>
- ----------------------------
*Member, Executive Committee +Member, Investment Committee
(1) Principal occupation for last five years.
(2) Prior to assuming this current position, Messrs. McFerson and Gasper held
other executive management positions with the companies.
Each of the directors is a director of the other major insurance affiliates of
the Nationwide Insurance Enterprise, except Mr. Gasper who is a director only of
the Company and Nationwide Life Insurance Company. Messrs. McFerson and Gasper
are directors of Nationwide Advisory Services, Inc., a registered broker-dealer.
Messrs. Gasper, Holloway, McFerson, Miller, Patterson and Shisler are
directors of Nationwide Corporation. Messrs. Fuellgraf, McFerson, Ms. Thomas
and Mr. Weihl are trustees of Nationwide Investing Foundation, a registered
investment company. Mr. McFerson is trustee of Nationwide Separate Account
Trust, Financial Horizons Investment Trust and Nationwide Investing Foundation
II, registered investment companies. Mr. Engel is a director of Western
Cooperative Transport.
23
<PAGE> 27
EXECUTIVE OFFICERS OF THE COMPANY
<TABLE>
<CAPTION>
NAME OFFICE HELD
<S> <C>
D. Richard McFerson Chairman and Chief Executive Officer-Nationwide Insurance Enterprise
Joseph J. Gasper President and Chief Operating Officer
Gordon E. McCutchan Executive Vice President, Law and Corporate Services and Secretary
Robert A. Oakley Executive Vice President-Chief Financial Officer
Robert J. Woodward, Jr. Executive Vice President - Chief Investment Officer
James E. Brock Senior Vice President - Life Company Operations
W. Sidney Druen Senior Vice President and General Counsel and Assistant Secretary
Harvey S. Galloway, Jr. Senior Vice President and Chief Actuary
Richard A. Karas Senior Vice President - Sales and Financial Services
Duane Campbell Vice President and Treasurer
</TABLE>
Mr. Gasper is also President and Chief Operating Officer of Nationwide Life
and Annuity Insurance Company. Mr. Galloway is also an officer of Nationwide
Mutual Insurance Company and Nationwide Life and Annuity Insurance Company.
Each of the other officers listed above is also an officer of each of the
companies comprising the Nationwide Insurance Enterprise.
OTHER CONTRACTS ISSUED BY THE COMPANY
The Company does presently and will, from time to time, offer variable contracts
and policies with benefits which vary in accordance with the investment
experience of a separate account of the Company.
STATE REGULATION
The Company is subject to the laws of Ohio governing insurance companies and to
regulation by the Ohio Insurance Department. An annual statement in a prescribed
form is filed with the Insurance Department each year covering the operation of
the Company for the preceding year and its financial condition as of the end of
such year. Regulation by the Insurance Department includes periodic examination
to determine the Company's contract liabilities and reserves so that the
Insurance Department may certify the items are correct. The Company's books and
accounts are subject to review by the Insurance Department at all times and a
full examination of its operations is conducted periodically by the National
Association of Insurance Commissioners. Such regulation does not, however,
involve any supervision of management or investment practices or policies. In
addition, the Company is subject to regulation under the insurance laws of other
jurisdictions in which it may operate.
REPORTS TO POLICY OWNERS
The Company will mail to the Policy Owner, at the last known address of record,
an annual statement showing the amount of the current death benefit, the Cash
Value, and Cash Surrender Value, premiums paid and monthly charges deducted
since the last report, the amounts invested in each sub-account of the Variable
Account, and any Policy Indebtedness.
Policy Owners will also be sent annual and semi-annual reports containing
financial statements for the Variable Account as required by the 1940 Act.
In addition, Policy Owners will receive statements of significant transactions,
such as changes in Specified Amount, changes in death benefit option, changes in
future premium allocation, transfers among sub-accounts, premium payments,
loans, loan repayments, reinstatement and termination.
24
<PAGE> 28
ADVERTISING
The Company is also ranked and rated by independent financial rating services,
including Moody's, Standard & Poor's and A.M. Best Company. The purpose of these
ratings is to reflect the financial strength or claims-paying ability of the
Company. The ratings are not intended to reflect the investment experience or
financial strength of the Variable Account. The Company may advertise these
ratings from time to time. In addition, the Company may include in certain
advertisements, endorsements in the form of a list of organizations, individuals
or other parties which recommend the Company or the Contracts. Furthermore, the
Company may occasionally include in advertisements comparisons of currently
taxable and tax deferred investment programs, based on selected tax brackets, or
discussions of alternative investment vehicles and general economic conditions.
LEGAL PROCEEDINGS
There are no material legal proceedings, other than ordinary routine litigation
incidental to the business to which the Company and the Variable Account are
parties or to which any of their property is the subject.
The General Distributor, Nationwide Advisory Services, Inc., is not engaged in
any material litigation of any nature.
EXPERTS
The financial statements included herein have been included in reliance upon the
reports of KPMG Peat Marwick LLP, independent certified public accountants, and
upon the authority of said firm as experts in accounting and auditing.
REGISTRATION STATEMENT
A Registration Statement has been filed with the Securities and Exchange
Commission under the Securities Act of 1933, as amended, with respect to the
Policies offered hereby. This prospectus does not contain all the information
set forth in the Registration Statement and amendments thereto and exhibits
filed as a part thereof, to all of which reference is hereby made for further
information concerning the Variable Account, the Company, and the Policies
offered hereby. Statements contained in this prospectus as to the content of
Policies and other legal instruments are summaries. For a complete statement of
the terms thereof, reference is made to such instruments as filed.
LEGAL OPINIONS
Legal matters in connection with the Policies described herein are being passed
upon by Druen, Rath & Dietrich, One Nationwide Plaza, Columbus, Ohio 43216. All
the members of such firm are employed by the Nationwide Mutual Insurance
Company.
25
<PAGE> 29
APPENDIX 1
ILLUSTRATIONS OF CASH VALUES,
CASH SURRENDER VALUES,
AND DEATH BENEFITS
The illustrations in this prospectus have been prepared to help show how values
under the Policies change with investment performance. The illustrations
illustrate how Cash Values, Cash Surrender Values and death benefits under a
Policy would vary over time if the hypothetical gross investment rates of return
were a uniform annual effective rate of either 0%, 6% or 12%. If the
hypothetical gross investment rate of return averages 0%, 6% or 12% over a
period of years, but fluctuates above or below those averages for individual
years, the Cash Values, Cash Surrender Values and death benefits may be
different. For a hypothetical return of 0%, the second illustration also
illustrates when the Policy would go into default, at which time additional
premium payments would be required to continue the Policy in force. The
illustrations also assume there is no Policy Indebtedness, no additional premium
payments are made, and there are no changes in the Specified Amount or death
benefit option.
The amounts shown for the Cash Value, Cash Surrender Value and death benefit as
of each Policy Anniversary reflect the fact that the net investment return on
the assets held in the sub-accounts is lower than the gross return. This is due
to the charges made against the assets of the sub-accounts for assuming
mortality and expense risks. The mortality and expense risk charges are
equivalent to an annual effective rate of 0.65% of the daily net asset value of
the Variable Account. In addition, the net investment returns also reflect the
deduction of Underlying Mutual Fund investment advisory fees and other expenses
which are equivalent to an annual effective rate of .75% of the daily net asset
value of the Variable Account. The Underlying Mutual Funds are subject to the
following fee waiver or expense reimbursement arrangements:
- ------------------------------ -------------------------------------------------
FUND EXPENSES WITHOUT REIMBURSEMENT OR WAIVER
- ------------------------------ -------------------------------------------------
Fidelity Variable Insurance The Fund may, from time to time,
Products Fund - Equity-Income agree to reimburse a fund for
Portfolio management fees and other expenses
above a specified limit. The Fund
retains the ability to be repaid if
expenses fall below the specified
limit prior to the end of the
fiscal year. Reimbursement
arrangements, which may be
terminated at any time, can
decrease the Fund's expense and
boost its performance.
- ------------------------------ -------------------------------------------------
Fidelity Variable Insurance The Fund may, from time to time,
Products Fund - Overseas agree to reimburse a fund for
Portfolio management fees and other expenses
above a specified limit. The Fund
retains the ability to be repaid if
expenses fall below the specified
limit prior to the end of the
fiscal year. Reimbursement
arrangements, which may be
terminated at any time, can
decrease the Fund's expense and
boost its performance.
- ------------------------------ -------------------------------------------------
The One(R) Group Investment The Adviser has voluntarily agreed
Trust-Asset Allocation Fund to waive all or part of its fees in
order to limit the Funds' operating
expenses to not more than 1.00% of
the average daily net assets.
- ------------------------------ -------------------------------------------------
The One(R) Group Investment The Adviser has voluntarily agreed
Trust-Government Bond Fund to waive all or part of its fees in
order to limit the Funds' operating
expenses to not more than .75% of
the average daily net assets.
- ------------------------------ -------------------------------------------------
The One(R) Group Investment The Adviser has voluntarily agreed
Trust-Large Company Growth to waive all or part of its fees in
Fund order to limit the Funds' operating
expenses to not more than 1.00% of
the average daily net assets.
- ------------------------------ -------------------------------------------------
The One(R) Group Investment The Adviser has voluntarily agreed
Trust-Growth Opportunities to waive all or part of its fees in
Fund order to limit the Funds' operating
expenses to not more than 1.10% of
the average daily net assets.
- ------------------------------ -------------------------------------------------
The illustrations also reflect the fact that the Company makes monthly charges
for providing insurance protection. Guaranteed values reflect the maximum cost
of insurance charges guaranteed in the Policy. The values shown are for Policies
which are issued as standard. Policies issued on a substandard basis would
result in lower Cash Values and Death benefits than those illustrated.
Guaranteed values in the illustrations also reflect the fact that the Company
deducts the following charges from premium payments:
<TABLE>
<CAPTION>
Years 1-7 Years 8+
--------- --------
<S> <C> <C>
Sales load 9% 5%
-
Tax expense charge 4% 4%
</TABLE>
In addition, the illustrations reflect the fact that the Company deducts a
monthly administrative charge at the beginning of each Policy Month. This
monthly administrative expense charge is $15 per month in the first year, $5 per
month in renewal years. Guaranteed values reflect the $10.00 maximum monthly
administrative charge under the Policy in renewal years. The illustrations also
reflect the fact that no charges for federal or state income taxes are currently
made against the Variable Account. If such a charge is made in the future, it
will require a higher gross investment return than illustrated in order to
produce the net after-tax returns shown in the illustrations.
Upon request, the Company will furnish a comparable illustration based on the
proposed Insured's age, sex, smoking classification, rating classification and
premium payment requested.
26
<PAGE> 30
DEATH BENEFIT OPTION 1
$6,000 ANNUAL PREMIUM: $250,000 SPECIFIED AMOUNT
UNISEX: NON-TOBACCO: NON-MEDICAL: AGE 45
GUARANTEED VALUES
<TABLE>
<CAPTION>
0% HYPOTHETICAL 6% HYPOTHETICAL 12% HYPOTHETICAL
GROSS INVESTMENT RETURN GROSS INVESTMENT RETURN GROSS INVESTMENT RETURN
----------------------- ----------------------- -----------------------
PREMIUMS
PAID PLUS CASH CASH CASH
POLICY INTEREST CASH SURR DEATH CASH SURR DEATH CASH SURR DEATH
YEAR AT 5% VALUE VALUE BENEFIT VALUE VALUE BENEFIT VALUE VALUE BENEFIT
---- ----- ----- ----- ------- ----- ----- ------- ----- ----- -------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 6,300 4,145 4,145 250,000 4,422 4,422 250,000 4,699 4,699 250,000
2 12,915 8,242 8,242 250,000 9,055 9,055 250,000 9,903 9,903 250,000
3 19,861 12,229 12,229 250,000 13,847 13,847 250,000 15,600 15,600 250,000
4 27,154 16,103 16,103 250,000 18,801 18,801 250,000 21,841 21,841 250,000
5 34,811 19,862 19,862 250,000 23,922 23,922 250,000 28,683 28,683 250,000
6 42,852 23,498 23,498 250,000 29,211 29,211 250,000 36,186 36,186 250,000
7 51,295 27,003 27,003 250,000 34,668 34,668 250,000 44,416 44,416 250,000
8 60,159 30,606 30,606 250,000 40,547 40,547 250,000 53,714 53,714 250,000
9 69,467 34,055 34,055 250,000 46,606 46,606 250,000 63,929 63,929 250,000
10 79,241 37,343 37,343 250,000 52,850 52,850 250,000 75,163 75,163 250,000
11 89,503 40,461 40,461 250,000 59,285 59,285 250,000 87,535 87,535 250,000
12 100,278 43,403 43,403 250,000 65,917 65,917 250,000 101,181 101,181 250,000
13 111,592 46,167 46,167 250,000 72,763 72,763 250,000 116,265 116,265 250,000
14 123,471 48,741 48,741 250,000 79,830 79,830 250,000 132,966 132,966 250,000
15 135,945 51,110 51,110 250,000 87,125 87,125 250,000 151,492 151,492 250,000
16 149,042 53,254 53,254 250,000 94,658 94,658 250,000 172,083 172,083 250,000
17 162,794 55,153 55,153 250,000 102,436 102,436 250,000 195,023 195,023 250,000
18 177,234 56,770 56,770 250,000 110,466 110,466 250,000 220,426 220,426 277,737
19 192,396 58,070 58,070 250,000 118,757 118,757 250,000 248,348 248,348 307,952
20 208,316 59,021 59,021 250,000 127,330 127,330 250,000 279,042 279,042 340,431
21 225,031 59,592 59,592 250,000 136,216 136,216 250,000 312,791 312,791 375,349
22 242,583 59,752 59,752 250,000 145,456 145,456 250,000 349,837 349,837 416,306
23 261,012 59,472 59,472 250,000 155,102 155,102 250,000 390,500 390,500 460,790
24 280,363 58,710 58,710 250,000 165,213 165,213 250,000 435,128 435,128 509,100
25 300,681 57,403 57,403 250,000 175,855 175,855 250,000 484,102 484,102 561,558
26 322,015 55,459 55,459 250,000 187,106 187,106 250,000 537,834 537,834 618,509
27 344,415 52,759 52,759 250,000 199,060 199,060 250,000 596,996 596,996 674,605
28 367,936 49,142 49,142 250,000 211,843 211,843 250,000 662,204 662,204 735,046
29 392,633 44,424 44,424 250,000 225,626 225,626 250,000 734,181 734,181 800,257
30 418,565 38,409 38,409 250,000 240,517 240,517 257,353 813,793 813,793 870,758
<FN>
(1) NO POLICY LOANS AND NO PARTIAL WITHDRAWALS HAVE BEEN MADE.
(2) GUARANTEED VALUES REFLECT CURRENT COST OF INSURANCE CHARGES AND A MONTHLY
$15 ADMINISTRATIVE EXPENSE CHARGE FOR THE FIRST POLICY YEAR AND $10
THEREAFTER. GUARANTEED VALUES REFLECT A 13% OF PREMIUM CHARGE ON ALL
PREMIUMS PAID IN THE FIRST SEVEN YEARS AND A 9% OF PREMIUM CHARGE ON ALL
PREMIUMS PAID THEREAFTER.
(3) NET INVESTMENT RETURNS ARE CALCULATED AS THE HYPOTHETICAL GROSS INVESTMENT
RETURN LESS ALL CHARGES AND DEDUCTIONS SHOWN IN THE PROSPECTUS APPENDIX.
(*) UNLESS ADDITIONAL PREMIUM IS PAID, THE POLICY WILL NOT STAY IN FORCE.
</TABLE>
THE HYPOTHETICAL INVESTMENT RATES OF RETURN SHOWN ABOVE AND ELSEWHERE IN THIS
PROSPECTUS 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, PREVAILING RATES AND RATES OF
INFLATION. THE DEATH BENEFIT AND CASH VALUE FOR A POLICY WOULD BE DIFFERENT FROM
THOSE SHOWN IF THE ACTUAL RATES OF RETURN AVERAGED 0%, 6%, AND 12% OVER A PERIOD
OF YEARS BUT ALSO FLUCTUATED ABOVE OR BELOW THOSE AVERAGES FOR INDIVIDUAL POLICY
YEARS. NO REPRESENTATION CAN BE MADE BY NATIONWIDE LIFE OR THE TRUST THAT THESE
HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY ONE YEAR OR SUSTAINED OVER
ANY PERIOD OF TIME.
27
<PAGE> 31
DEATH BENEFIT OPTION 1
$15,000 PREMIUM FOR 7 YEARS: $300,000 SPECIFIED AMOUNT
UNISEX: NON-TOBACCO: NON-MEDICAL: AGE 45
GUARANTEED VALUES
<TABLE>
<CAPTION>
0% HYPOTHETICAL 6% HYPOTHETICAL 12% HYPOTHETICAL
GROSS INVESTMENT RETURN GROSS INVESTMENT RETURN GROSS INVESTMENT RETURN
----------------------- ----------------------- -----------------------
PREMIUMS
PAID PLUS CASH CASH CASH
POLICY INTEREST CASH SURR DEATH CASH SURR DEATH CASH SURR DEATH
YEAR AT 5% VALUE VALUE BENEFIT VALUE VALUE BENEFIT VALUE VALUE BENEFIT
---- ----- ----- ----- ------- ----- ----- ------- ----- ----- -------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 15,750 11,724 11,724 300,000 12,461 12,461 300,000 13,198 13,198 300,000
2 32,288 23,311 23,311 300,000 25,516 25,516 300,000 27,810 27,810 300,000
3 49,652 34,703 34,703 300,000 39,136 39,136 300,000 43,929 43,929 300,000
4 67,884 45,903 45,903 300,000 53,349 53,349 300,000 61,723 61,723 300,000
5 87,029 56,912 56,912 300,000 68,187 68,187 300,000 81,378 81,378 300,000
6 107,130 67,728 67,728 300,000 83,682 83,682 300,000 103,103 103,103 300,000
7 128,237 78,351 78,351 300,000 99,867 99,867 300,000 127,133 127,133 300,000
8 134,648 75,830 75,830 300,000 103,057 103,057 300,000 139,236 139,236 300,000
9 141,381 73,199 73,199 300,000 106,295 106,295 300,000 152,586 152,586 300,000
10 148,450 70,442 70,442 300,000 109,575 109,575 300,000 167,332 167,332 300,000
11 155,872 67,540 67,540 300,000 112,889 112,889 300,000 183,640 183,640 300,000
12 163,666 64,476 64,476 300,000 116,235 116,235 300,000 201,706 201,706 300,000
13 171,849 61,238 61,238 300,000 119,611 119,611 300,000 221,726 221,726 314,851
14 180,442 57,801 57,801 300,000 123,009 123,009 300,000 243,801 243,801 336,446
15 189,464 54,135 54,135 300,000 126,419 126,419 300,000 268,107 268,107 359,263
16 198,937 50,201 50,201 300,000 129,824 129,824 300,000 294,882 294,882 383,347
17 208,884 45,957 45,957 300,000 133,210 133,210 300,000 324,311 324,311 415,118
18 219,328 41,337 41,337 300,000 136,547 136,547 300,000 356,651 356,651 449,380
19 230,295 36,274 36,274 300,000 139,807 139,807 300,000 392,189 392,189 486,315
20 241,809 30,697 30,697 300,000 142,966 142,966 300,000 431,249 431,249 526,124
21 253,900 24,536 24,536 300,000 146,001 146,001 300,000 474,196 474,196 569,035
22 266,595 17,717 17,717 300,000 148,891 148,891 300,000 521,321 521,321 620,372
23 279,924 10,163 10,163 300,000 151,617 151,617 300,000 573,032 573,032 676,178
24 293,921 1,775 1,775 300,000 154,153 154,153 300,000 629,773 629,773 736,835
25 308,617 * * * 156,455 156,455 300,000 692,026 692,026 802,750
26 324,048 * * * 158,461 158,461 300,000 760,314 760,314 874,361
27 340,250 * * * 160,088 160,088 300,000 835,518 835,518 944,135
28 357,262 * * * 161,228 161,228 300,000 918,427 918,427 1,019,454
29 375,126 * * * 161,756 161,756 300,000 1,009,975 1,009,975 1,100,873
30 393,882 * * * 161,540 161,540 300,000 1,111,275 1,111,275 1,189,065
<FN>
(1) NO POLICY LOANS AND NO PARTIAL WITHDRAWALS HAVE BEEN MADE.
(2) GUARANTEED VALUES REFLECT CURRENT COST OF INSURANCE CHARGES AND A MONTHLY
$15 ADMINISTRATIVE EXPENSE CHARGE FOR THE FIRST POLICY YEAR AND $10
THEREAFTER. GUARANTEED VALUES REFLECT A 13% OF PREMIUM CHARGE ON ALL
PREMIUMS PAID IN THE FIRST SEVEN YEARS AND A 9% OF PREMIUM CHARGE ON ALL
PREMIUMS PAID THEREAFTER.
(3) NET INVESTMENT RETURNS ARE CALCULATED AS THE HYPOTHETICAL GROSS INVESTMENT
RETURN LESS ALL CHARGES AND DEDUCTIONS SHOWN IN THE PROSPECTUS APPENDIX.
(*) UNLESS ADDITIONAL PREMIUM IS PAID, THE POLICY WILL NOT STAY IN FORCE.
</TABLE>
THE HYPOTHETICAL INVESTMENT RATES OF RETURN SHOWN ABOVE AND ELSEWHERE IN THIS
PROSPECTUS 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, PREVAILING RATES AND RATES OF
INFLATION. THE DEATH BENEFIT AND CASH VALUE FOR A POLICY WOULD BE DIFFERENT FROM
THOSE SHOWN IF THE ACTUAL RATES OF RETURN AVERAGED 0%, 6%, AND 12% OVER A PERIOD
OF YEARS BUT ALSO FLUCTUATED ABOVE OR BELOW THOSE AVERAGES FOR INDIVIDUAL POLICY
YEARS. NO REPRESENTATION CAN BE MADE BY NATIONWIDE LIFE OR THE TRUST THAT THESE
HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY ONE YEAR OR SUSTAINED OVER
ANY PERIOD OF TIME.
28
<PAGE> 32
<PAGE> 1
INDEPENDENT AUDITORS' REPORT
The Board of Directors
Nationwide Life and Annuity Insurance Company:
We have audited the accompanying balance sheets of Nationwide Life and
Annuity Insurance Company (formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company) as of December
31, 1995 and 1994, and the related statements of income, shareholder's equity
and cash flows for each of the years in the three-year 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 Nationwide Life and Annuity
Insurance Company as of December 31, 1995 and 1994, and the results of its
operations and its cash flows for each of the years in the three-year period
ended December 31, 1995, in conformity with generally accepted accounting
principles.
In 1994, the Company adopted the provisions of the Financial Accounting
Standards Board's Statement of Financial Accounting Standards (SFAS) No. 115,
Accounting for Certain Investments in Debt and Equity Securities.
In 1993, the Company adopted the provisions of SFAS No. 109, Accounting for
Income Taxes and SFAS No. 106, Employers' Accounting for Postretirement Benefits
Other Than Pensions.
KPMG Peat Marwick LLP
Columbus, Ohio
February 26, 1996
<PAGE> 2
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Balance Sheets
December 31, 1995 and 1994
(000's omitted)
<TABLE>
<CAPTION>
Assets 1995 1994
------ -------- --------
<S> <C> <C>
Investments (notes 5, 8 and 9):
Securities available-for-sale, at fair value:
Fixed maturities (cost $539,214 in 1995; $427,874 in 1994) $555,751 413,764
Equity securities (cost $10,256 in 1995; $9,543 in 1994) 11,407 9,411
Fixed maturities held-to-maturity, at amortized cost (fair value $78,690 in 1994) -- 82,631
Mortgage loans on real estate 104,736 95,281
Real estate 1,117 1,802
Policy loans 94 79
Short-term investments (note 13) 4,844 365
-------- --------
677,949 603,333
-------- --------
Accrued investment income 8,464 8,041
Deferred policy acquisition costs 23,405 41,540
Deferred Federal income tax -- 1,923
Other assets 208 270
Assets held in Separate Accounts (note 8) 257,556 177,933
-------- --------
$967,582 833,040
======== ========
Liabilities and Shareholder's Equity
------------------------------------
Future policy benefits and claims (notes 6 and 8) 621,280 583,188
Accrued Federal income tax (note 7):
Current 708 10
Deferred 2,830 --
-------- --------
3,538 10
-------- --------
Other liabilities 5,031 4,663
Liabilities related to Separate Accounts (note 8) 257,556 177,933
-------- --------
887,405 765,794
-------- --------
Shareholder's equity (notes 3, 4, 5 and 12):
Capital shares, $40 par value. Authorized, issued and outstanding 66 shares 2,640 2,640
Additional paid-in capital 52,960 52,960
Retained earnings 20,123 15,349
Unrealized gains (losses) on securities available-for-sale, net 4,454 (3,703)
-------- --------
80,177 67,246
-------- --------
Commitments (note 9)
$967,582 833,040
======== ========
</TABLE>
See accompanying notes to financial statements.
<PAGE> 3
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Statements of Income
Years ended December 31, 1995, 1994 and 1993
(000's omitted)
<TABLE>
<CAPTION>
1995 1994 1993
-------- -------- --------
<S> <C> <C> <C>
Revenues (note 14):
Traditional life insurance premiums $ 674 311 85
Universal life and investment product policy charges 4,322 3,601 2,345
Net investment income (note 5) 49,108 45,030 40,477
Realized (losses) gains on investments (note 5) (702) (625) 420
-------- -------- --------
53,402 48,317 43,327
-------- -------- --------
Benefits and expenses:
Benefits and claims 34,180 29,870 29,439
Amortization of deferred policy acquisition costs 5,508 6,940 4,128
Other operating costs and expenses 6,567 6,320 5,424
-------- -------- --------
46,255 43,130 38,991
-------- -------- --------
Income before Federal income tax expense and cumulative effect of
changes in accounting principles 7,147 5,187 4,336
-------- -------- --------
Federal income tax expense (benefit) (note 7):
Current 2,012 2,103 1,982
Deferred 361 (244) (630)
-------- -------- --------
2,373 1,859 1,352
-------- -------- --------
Income before cumulative effect of changes in accounting principles 4,774 3,328 2,984
Cumulative effect of changes in accounting principles, net (note 3) -- -- (514)
-------- -------- --------
Net income $ 4,774 3,328 2,470
======== ======== ========
</TABLE>
See accompanying notes to financial statements.
<PAGE> 4
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Statements of Shareholder's Equity
Years ended December 31, 1995, 1994 and 1993
(000's omitted)
<TABLE>
<CAPTION>
Unrealized
gains (losses)
Additional on securities Total
Capital paid-in Retained available-for- shareholder's
shares capital earnings sale, net equity
-------- ---------- --------- --------------- --------------
<S> <C> <C> <C> <C> <C>
1993:
Balance, beginning of year $ 2,640 43,960 9,551 21 56,172
Net income -- -- 2,470 -- 2,470
Unrealized gains on equity securities, net -- -- -- 17 17
------- ------- ------- ------
-------
Balance, end of year $ 2,640 43,960 12,021 38 58,659
======= ======= ======= ====== =======
1994:
Balance, beginning of year 2,640 43,960 12,021 38 58,659
Capital contribution -- 9,000 -- -- 9,000
Net income -- -- 3,328 -- 3,328
Adjustment for change in accounting for
certain investments in debt and equity
securities, net (note 3) -- -- -- 4,698 4,698
Unrealized losses on securities available-
for-sale, net -- -- -- (8,439) (8,439)
------- ------- ------- ------- -------
Balance, end of year $ 2,640 52,960 15,349 (3,703) 67,246
======= ======= ======= ======= =======
1995:
Balance, beginning of year 2,640 52,960 15,349 (3,703) 67,246
Net income -- -- 4,774 -- 4,774
Unrealized gains on securities available-
for-sale, net -- -- -- 8,157 8,157
------- ------- ------- ------- -------
Balance, end of year $ 2,640 52,960 20,123 4,454 80,177
======= ======= ======= ======= =======
</TABLE>
See accompanying notes to financial statements.
<PAGE> 5
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Statements of Cash Flows
Years ended December 31, 1995, 1994 and 1993
(000's omitted)
<TABLE>
<CAPTION>
1994 1994 1993
-------- -------- --------
<S> <C> <C> <C>
Cash flows from operating activities:
Net income $ 4,774 3,328 2,470
Adjustments to reconcile net income to net cash provided by
(used in) operating activities:
Capitalization of deferred policy acquisition costs (6,754) (7,283) (10,351)
Amortization of deferred policy acquisition costs 5,508 6,940 4,128
Amortization and depreciation 878 473 660
Realized losses (gains) on invested assets, net 702 625 (420)
Deferred Federal income tax expense (benefit) 361 (244) (784)
Increase in accrued investment income (423) (750) (1,078)
Decrease (increase) in other assets 62 (126) 326
Increase (decrease) in policy liabilities 627 926 (202)
Increase (decrease) in accrued Federal income tax payable 698 (254) 666
Increase (decrease) in other liabilities 368 (505) 2,843
-------- -------- --------
Net cash provided by (used in) operating activities 6,801 3,130 (1,742)
-------- -------- --------
Cash flows from investing activities:
Proceeds from maturity of securities available-for-sale 41,729 24,850 --
Proceeds from sale of securities available-for-sale 3,070 13,170 134
Proceeds from maturity of fixed maturities held-to-maturity 11,251 8,483 28,829
Proceeds from sale of fixed maturities -- -- 2,136
Proceeds from repayments of mortgage loans on real estate 8,673 5,733 3,804
Proceeds from sale of real estate 655 -- --
Proceeds from repayments of policy loans 50 2 2
Cost of securities available-for-sale acquired (79,140) (94,130) (661)
Cost of fixed maturities held-to maturity acquired (8,000) (15,544) (100,671)
Cost of mortgage loans on real estate acquired (18,000) (11,000) (31,200)
Cost of real estate acquired (10) (52) (2)
Policy loans issued (66) (80) (2)
-------- -------- --------
Net cash used in investing activities (39,788) (68,568) (97,631)
-------- -------- --------
Cash flows form financing activities:
Proceeds from capital contribution -- 9,000 --
Increase in universal life and investment product account balances 79,523 95,254 127,050
Decrease in universal life and investment product account balances (42,057) (40,223) (33,159)
-------- -------- --------
Net cash provided by financing activities 37,466 64,031 93,891
-------- -------- --------
Net increase (decrease) in cash and cash equivalents 4,479 (1,407) (5,482)
Cash and cash equivalents, beginning of year 365 1,772 7,254
-------- -------- --------
Cash and cash equivalents, end of year $ 4,844 365 1,772
======== ======== ========
</TABLE>
See accompanying notes to financial statements.
<PAGE> 6
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements
December 31, 1995, 1994 and 1993
(000's omitted)
(1) Organization and Description of Business
Nationwide Life and Annuity Insurance Company, formerly Financial
Horizons Life Insurance Company, (the Company) is a wholly owned
subsidiary of Nationwide Life Insurance Company (NLIC).
The Company is a life insurer licensed in 42 states and the District of
Columbia. The Company sells primarily fixed and variable rate annuities
through banks and other financial institutions. In addition, the
Company sells universal life and other interest-sensitive life
insurance products and is subject to competition from other insurers
throughout the United States. The Company is subject to regulation by
the Insurance Departments of states in which it is licensed, and
undergoes periodic examinations by those departments.
The following is a description of the most significant risks facing
life insurers and how the Company mitigates those risks:
Legal/Regulatory Risk is the risk that changes in the legal or
regulatory environment in which an insurer operates will create
additional expenses not anticipated by the insurer in pricing its
products. That is, regulatory initiatives designed to reduce
insurer profits, new legal theories or insurance company
insolvencies through guaranty fund assessments may create costs
for the insurer beyond those currently recorded in the financial
statements. The Company mitigates this risk by operating
throughout the United States, thus reducing its exposure to any
single jurisdiction, and also by employing underwriting practices
which identify and minimize the adverse impact of this risk.
Credit Risk is the risk that issuers of securities owned by the
Company or mortgagors on mortgage loans on real estate owned by
the Company will default. The Company minimizes this risk by
adhering to a conservative investment strategy, by maintaining
sound credit and collection policies and by providing for any
amounts deemed uncollectible.
Interest Rate Risk is the risk that interest rates will change and
cause a decrease in the value of an insurer's investments. This
change in rates may cause certain interest-sensitive products to
become uncompetitive or may cause disintermediation. The Company
mitigates this risk by charging fees for non-conformance with
certain policy provisions, by offering products that transfer this
risk to the purchaser, and/or by attempting to match the maturity
schedule of its assets with the expected payouts of its
liabilities. To the extent that liabilities come due more quickly
than assets mature, an insurer would have to borrow funds or sell
assets prior to maturity and potentially recognize a gain or loss.
(2) Summary of Significant Accounting Policies
The significant accounting policies followed by the Company that
materially affect financial reporting are summarized below. The
accompanying financial statements have been prepared in accordance with
generally accepted accounting principles (GAAP) which differ from
statutory accounting practices prescribed or permitted by regulatory
authorities. See note 4.
In preparing the financial statements, management is required to make
estimates and assumptions that affect the reported amounts of assets
and liabilities and the disclosures of contingent assets and
liabilities as of the date of the financial statements and the reported
amounts of revenues and expenses for the reporting period. Actual
results could differ significantly from those estimates.
The most significant estimates include those used in determining
deferred policy acquisition costs, valuation allowances for mortgage
loans on real estate and real estate investments and the liability for
future policy benefits and claims. Although some variability is
inherent in these estimates, management believes the amounts provided
are adequate.
<PAGE> 7
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
(a) Valuation of Investments and Related Gains and Losses
The Company is required to classify its fixed maturity securities
and equity securities as held-to-maturity, available-for-sale or
trading. Fixed maturity securities are classified as
held-to-maturity when the Company has the positive intent and
ability to hold the securities to maturity and are stated at
amortized cost. Fixed maturity securities not classified as
held-to-maturity and all equity securities are classified as
available-for-sale and are stated at fair value, with the
unrealized gains and losses, net of adjustments to deferred policy
acquisition costs and deferred Federal income tax, reported as a
separate component of shareholder's equity. The adjustment to
deferred policy acquisition costs represents the change in
amortization of deferred policy acquisition costs that would have
been required as a charge or credit to operations had such
unrealized amounts been realized. The Company has no fixed
maturity securities classified as held-to-maturity or trading as
of December 31, 1995.
Mortgage loans on real estate are carried at the unpaid principal
balance less valuation allowances. The Company provides valuation
allowances for impairments of mortgage loans on real estate based
on a review by portfolio managers. The measurement of impaired
loans is based on the present value of expected future cash flows
discounted at the loan's effective interest rate or, as a
practical expedient, at the fair value of the collateral, if the
loan is collateral dependent. Loans in foreclosure and loans
considered to be impaired are placed on non-accrual status.
Interest received on non-accrual status mortgage loans on real
estate are included in interest income in the period received.
Real estate is carried at cost less accumulated depreciation and
valuation allowances.
Realized gains and losses on the sale of investments are
determined on the basis of specific security identification.
Estimates for valuation allowances and other than temporary
declines are included in realized gains and losses on investments.
In March, 1995, the Financial Accounting Standards Board (FASB)
issued Statement of Financial Accounting Standards No. 121 -
Accounting for the Impairment of Long-Lived Assets and for
Long-Lived Assets to be Disposed Of (SFAS 121). SFAS 121 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 amount. SFAS 121 also addresses
the accounting for long-lived assets that are expected to be
disposed of. The statement is effective for fiscal years beginning
after December 15, 1995 and earlier application is permitted.
Previously issued financial statements shall not be restated. The
Company will adopt SFAS 121 in 1996 and the impact on the
financial statements is not expected to be material.
(b) Revenues and Benefits
Traditional Life Insurance Products: Traditional life insurance
products include those products with fixed and guaranteed premiums
and benefits and consist primarily of certain annuities with life
contingencies. Premiums for traditional life insurance products
are recognized as revenue when due. Benefits and expenses are
associated with earned premiums so as to result in recognition of
profits over the life of the contract. This association is
accomplished by the provision for future policy benefits.
Universal Life and Investment Products: Universal life products
include universal life, variable universal life and other
interest-sensitive life insurance policies. Investment products
consist primarily of individual deferred annuities and immediate
annuities without life contingencies. Revenues for universal life
and investment products consist of asset fees, cost of insurance,
policy administration and surrender charges that have been earned
and assessed against policy account balances during the period.
Policy benefits and claims that are charged to expense include
benefits and claims incurred in the period in excess of related
policy account balances and interest credited to policy account
balances.
<PAGE> 8
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
(c) Deferred Policy Acquisition Costs
The costs of acquiring new business, principally commissions,
certain expenses of the policy issue and underwriting department
and certain variable selling expenses have been deferred for
universal life and investment products. Deferred policy
acquisition costs are being amortized with interest over the lives
of the policies in relation to the present value of estimated
future gross profits from projected interest margins, asset fees,
cost of insurance, policy administration and surrender charges.
For years in which gross profits are negative, deferred policy
acquisition costs are amortized based on the present value of
gross revenues. Deferred policy acquisition costs are adjusted to
reflect the impact of unrealized gains and losses on fixed
maturity securities available-for-sale as described in note 2(a).
(d) Separate Accounts
Separate Account assets and liabilities represent contractholders'
funds which have been segregated into accounts with specific
investment objectives. The investment income and gains or losses
of these accounts accrue directly to the contractholders. The
activity of the Separate Accounts is not reflected in the
statements of income and cash flows except for the fees the
Company receives for administrative services and risks assumed.
(e) Future Policy Benefits
Future policy benefits for annuity policies in the accumulation
phase, universal life and variable universal life policies have
been calculated based on participants' contributions plus interest
credited less applicable contract charges.
(f) Federal Income Tax
The Company files a consolidated Federal income tax return with
Nationwide Mutual Insurance Company (NMIC).
In 1993, the Company adopted Statement of Financial Accounting
Standards No. 109 - Accounting for Income Taxes, which required a
change from the deferred method of accounting for income tax of
APB Opinion 11 to the asset and liability method of accounting for
income tax. Under the asset and liability method, deferred tax
assets and liabilities are recognized for the future tax
consequences attributable to differences between the financial
statement carrying amounts of existing assets and liabilities and
their respective tax bases and operating loss and tax credit
carryforwards. Deferred tax assets and liabilities are measured
using enacted tax rates expected to apply to taxable income in the
years in which those temporary differences are expected to be
recovered or settled. Under this method, the effect on deferred
tax assets and liabilities of a change in tax rates is recognized
in income in the period that includes the enactment date.
Valuation allowances are established when necessary to reduce the
deferred tax assets to the amounts expected to be realized.
The Company has reported the cumulative effect of the change in
method of accounting for income tax in the 1993 statement of
income. See note 3.
(g) Cash Equivalents
For purposes of the statements of cash flows, the Company
considers all short-term investments with original maturities of
three months or less to be cash equivalents.
<PAGE> 9
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
(h) Reclassification
Certain items in the 1994 and 1993 financial statements have been
reclassified to conform to the 1995 presentation.
(3) Changes in Accounting Principles
Effective January 1, 1994, the Company changed its method of accounting
for certain investments in debt and equity securities in connection
with the issuance of Statement of Financial Accounting Standards No.
115 - Accounting for Certain Investments in Debt and Equity Securities.
As of January 1, 1994, the Company classified fixed maturity securities
with amortized cost and fair value of $380,974 and $399,556,
respectively, as available-for-sale and recorded the securities at fair
value. Previously, these securities were recorded at amortized cost.
The effect as of January 1, 1994, has been recorded as a direct credit
to shareholder's equity as follows:
<TABLE>
<S> <C>
Excess of fair value over amortized cost of fixed maturity securities
available-for-sale $ 18,582
Adjustment to deferred policy acquisition costs (11,355)
Deferred Federal income tax (2,529)
--------
$ 4,698
========
</TABLE>
During 1993, the Company adopted accounting principles in connection
with the issuance of two accounting standards by the FASB. The effect
as of January 1, 1993, the date of adoption, has been recognized in the
1993 statement of income as the cumulative effect of changes in
accounting principles, as follows:
<TABLE>
<S> <C>
Asset/liability method of recognizing income tax (note 2(f)) $ (79)
Accrual method of recognizing postretirement benefits other than
pensions (net of tax benefit of $234) (note 11) (435)
-----
$(514)
=====
</TABLE>
(4) Basis of Presentation
The financial statements have been prepared in accordance with GAAP. An
Annual Statement, filed with the Department of Insurance of the State
of Ohio (the Department), is prepared on the basis of accounting
practices prescribed or permitted by such regulatory authority.
Prescribed statutory accounting practices include a variety of
publications of the National Association of Insurance Commissioners
(NAIC), as well as state laws, regulations and general administrative
rules. Permitted statutory accounting practices encompass all
accounting practices not so prescribed. The Company has no material
permitted statutory accounting practices.
The statutory capital shares and surplus of the Company as reported to
regulatory authorities as of December 31, 1995, 1994 and 1993 was
$54,978, $48,947 and $35,875, respectively. The statutory net income of
the Company as reported to regulatory authorities for the years ended
December 31, 1995, 1994 and 1993 was $8,023, $6,173 and $3,539,
respectively.
<PAGE> 10
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
(5) Investments
An analysis of investment income by investment type follows for the
years ended December 31:
<TABLE>
<CAPTION>
1995 1994 1993
------- ------- -------
<S> <C> <C> <C>
Gross investment income:
Securities available-for-sale:
Fixed maturities $35,093 36,720 --
Equity securities 713 16 13
Fixed maturities held-to-maturity 4,530 540 34,023
Mortgage loans on real estate 9,106 8,437 7,082
Real estate 273 175 167
Short-term investments 348 207 295
Other 41 19 --
------- ------- -------
Total investment income 50,104 46,114 41,580
Less: investment expenses 996 1,084 1,103
------- ------- -------
Net investment income $49,108 45,030 40,477
======= ======= =======
</TABLE>
An analysis of realized gains (losses) on investments, net of valuation
allowances, by investment type follows for the years ended December 31:
<TABLE>
<CAPTION>
1995 1994 1993
----- ----- -----
<S> <C> <C> <C>
Fixed maturity securities available-for-sale $(822) 260 --
Fixed maturities -- -- 856
Mortgage loans on real estate 110 (832) (246)
Real estate and other 10 (53) (190)
----- ----- -----
$(702) (625) 420
===== ===== =====
</TABLE>
The components of unrealized gains (losses) on securities
available-for-sale, net, were as follows as of December 31:
<TABLE>
<CAPTION>
1995 1994
-------- --------
<S> <C> <C>
Gross unrealized gains (losses) $ 17,688 (14,242)
Adjustment to deferred policy acquisition costs (10,836) 8,545
Deferred Federal income tax (2,398) 1,994
-------- --------
$ 4,454 (3,703)
======== ========
</TABLE>
An analysis of the change in gross unrealized gains (losses) on
securities available-for-sale and fixed maturities held-to-maturity
follows for the years ended December 31:
<TABLE>
<CAPTION>
1995 1994 1993
-------- -------- --------
<S> <C> <C> <C>
Securities available-for-sale:
Fixed maturities $ 30,647 (32,692) --
Equity securities 1,283 (190) 26
Fixed maturities held-to-maturity 3,941 (8,407) 5,710
-------- -------- --------
$ 35,871 (41,289) 5,736
======== ======== ========
</TABLE>
<PAGE> 11
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
The amortized cost and estimated fair value of securities
available-for-sale were as follow as of December 31, 1995:
<TABLE>
<CAPTION>
Gross Gross
Amortized unrealized unrealized Estimated
cost gains losses fair value
-------- -------- -------- --------
<S> <C> <C> <C> <C>
Fixed maturities:
U.S. Treasury securities and obligations of U.S.
government corporations and agencies $ 3,492 18 -- 3,510
Obligations of states and political subdivisions 271 -- (1) 270
Debt securities issued by foreign governments 6,177 301 -- 6,478
Corporate securities 332,425 10,116 (925) 341,616
Mortgage-backed securities 196,849 7,649 (621) 203,877
-------- -------- -------- --------
Total fixed maturities 539,214 18,084 (1,547) 555,751
Equity securities 10,256 1,151 -- 11,407
-------- -------- -------- --------
$549,470 19,235 (1,547) 567,158
======== ======== ======== ========
</TABLE>
The amortized cost and estimated fair value of securities
available-for-sale were as follow as of December 31, 1994:
<TABLE>
<CAPTION>
Gross Gross
Amortized unrealized unrealized Estimated
cost gains losses fair value
-------- -------- -------- --------
<S> <C> <C> <C> <C>
Fixed maturities:
U.S. Treasury securities and obligations of U.S.
government corporations and agencies $ 4,442 92 -- 4,534
Obligations of states and political subdivisions 273 -- (21) 252
Debt securities issued by foreign governments 8,517 15 (452) 8,080
Corporate securities 214,332 518 (7,903) 206,947
Mortgage-backed securities 200,310 1,291 (7,650) 193,951
-------- -------- -------- --------
Total fixed maturities 427,874 1,916 (16,026) 413,764
Equity securities 9,543 45 (177) 9,411
-------- -------- -------- --------
$437,417 1,961 (16,203) 423,175
======== ======== ======== ========
</TABLE>
The amortized cost and estimated fair value of fixed maturity corporate
securities held-to-maturity as of December 31, 1994 are $82,631 and
$78,690, respectively. Gross gains of $130 and gross losses of $4,071
were unrealized on those securities.
The amortized cost and estimated fair value of fixed maturity
securities available-for-sale as of December 31, 1995, by contractual
maturity, are shown below. 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>
Amortized Estimated
cost fair value
-------- --------
<S> <C> <C>
Due in one year or less $ 39,072 39,427
Due after one year through five years 224,262 231,200
Due after five years through ten years 75,380 77,726
Due after ten years 3,651 3,521
-------- --------
342,365 351,874
Mortgage-backed securities 196,849 203,877
-------- --------
$539,214 555,751
======== ========
</TABLE>
<PAGE> 12
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
Proceeds from the sale of securities available-for-sale during
1995 and 1994 were $3,070 and $13,170, respectively, while proceeds
from sales of investments in fixed maturity securities during 1993 were
$2,136. Gross gains of $64 ($373 in 1994 and $205 in 1993) and gross
losses of $6 ($73 1994 and none in 1993) were realized on those sales.
During 1995, the Company transferred fixed maturity securities
classified as held-to-maturity with amortized cost of $2,000 to
available-for-sale securities due to evidence of a significant
deterioration in the issuer's creditworthiness. The transfer of those
fixed maturity securities resulted in a gross unrealized loss of $600.
As permitted by the FASB's Special Report, A Guide to Implementation of
Statement 115 on Accounting for Certain Investments in Debt and Equity
Securities, issued in November, 1995, the Company transferred all of
its fixed maturity securities previously classified as held-to-maturity
to available-for-sale. As of December 14, 1995, the date of transfer,
the fixed maturity securities had amortized cost of $77,405, resulting
in a gross unrealized gain of $1,709.
Fixed maturity securities that were non-income producing for the twelve
month period preceding December 31, 1995 had a carrying value of $996
(none in 1994).
Real estate is presented at cost less accumulated depreciation of $81
in 1995 ($97 in 1994) and valuation allowances of $229 in 1995 ($472 in
1994).
As of December 31, 1995, the recorded investment of mortgage loans on
real estate considered to be impaired (under Statement of Financial
Accounting Standards No. 114, Accounting by Creditors for Impairment of
a Loan as amended by Statement of Financial Accounting Standards No.
118, Accounting by Creditors for Impairment of a Loan - Income
Recognition and Disclosure) was $966, for which there was no valuation
allowance. During 1995, the average recorded investment in impaired
mortgage loans on real estate was approximately $242 and no interest
income was recognized on those loans.
Activity in the valuation allowance account for mortgage loans on real
estate is summarized for the year ended December 31, 1995:
<TABLE>
<CAPTION>
1995
----
<S> <C>
Allowance, beginning of year $ 860
Reduction of the allowance credited to operations (110)
-----
Allowance, end of year $ 750
=====
</TABLE>
Foreclosures of mortgage loans on real estate were $631 in 1994. No
mortgage loans on real estate were in process of foreclosure or
in-substance foreclosed as of December 31, 1994 .
Fixed maturity securities with an amortized cost of $2,806 and $2,786
as of December 31, 1995 and 1994, respectively, were on deposit with
various regulatory agencies as required by law.
(6) Future Policy Benefits
The liability for future policy benefits for investment products has
been established based on policy terms, interest rates and various
contract provisions. The average interest rate credited on investment
product policies was approximately 5.6%, 5.3% and 6.0% for the years
ended December 31, 1995, 1994 and 1993, respectively.
<PAGE> 13
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
(7) Federal Income Tax
The tax effects of temporary differences that give rise to significant
components of the net deferred tax asset (liability) as of December 31,
1995 and 1994 are as follows:
<TABLE>
<CAPTION>
1995 1994
-------- --------
<S> <C> <C>
Deferred tax assets:
Future policy benefits $ 5,249 5,879
Securities available-for-sale -- 4,985
Liabilities in Separate Accounts 3,445 3,111
Mortgage loans on real estate and real estate 338 458
Other assets and other liabilities 708 101
-------- --------
Total gross deferred tax assets 9,740 14,534
-------- --------
Deferred tax liabilities:
Securities available-for-sale 6,308 --
Deferred policy acquisition costs 6,262 12,611
-------- --------
Total gross deferred tax liabilities 12,570 12,611
-------- --------
$ (2,830) 1,923
======== ========
</TABLE>
The Company has determined that valuation allowances are not necessary
as of December 31, 1995, 1994 and 1993 based on its analysis of future
deductible amounts. In assessing the realizability of deferred tax
assets, management considers whether it is more likely than not that
some portion of the total gross deferred tax assets will not be
realized. All future deductible amounts can be offset by future taxable
amounts or recovery of Federal income tax paid within the statutory
carryback period. In addition, for future deductible amounts for
securities available-for-sale, affiliates of the Company which are
included in the same consolidated Federal income tax return hold
investments that could be sold for capital gains that could offset
capital losses realized by the Company should securities
available-for-sale be sold at a loss.
Total Federal income tax expense for the years ended December 31, 1995,
1994 and 1993 differs from the amount computed by applying the U.S.
Federal income tax rate to income before tax as follows:
<TABLE>
<CAPTION>
1995 1994 1993
--------------------- --------------------- ---------------------
Amount % Amount % Amount %
------------ ------- ------------ ------- ------------- -------
<S> <C> <C> <C> <C> <C> <C>
Computed (expected) tax expense $ 2,501 35.0 $ 1,815 35.0 $ 1,518 35.0
Tax exempt interest and dividends
received deduction (150) (2.1) (50) (1.0) (206) (4.7)
Current year increase in U.S. Federal
income tax rate -- -- -- -- 36 0.8
Other, net 22 0.3 94 1.8 4 0.1
------- ---- ------- ---- ------- ----
Total (effective rate of each year $ 2,373 33.2 $ 1,859 35.8 $ 1,352 31.2
======= ==== ======= ==== ======= ====
</TABLE>
Total Federal income tax paid was $1,314, $2,357 and $1,316 during the
years ended December 31, 1995, 1994 and 1993, respectively.
<PAGE> 14
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
(8) Disclosures about Fair Value of Financial Instruments
Statement of Financial Accounting Standards No. 107 - Disclosures about
Fair Value of Financial Instruments (SFAS 107) requires disclosure of
fair value information about existing on and off-balance sheet
financial instruments. SFAS 107 defines the fair value of a financial
instrument as the amount at which the financial instrument could be
exchanged in a current transaction between willing parties. In cases
where quoted market prices are not available, fair value is based on
estimates using present value or other valuation techniques.
These techniques are significantly affected by the assumptions used,
including the discount rate and estimates of future cash flows.
Although fair value estimates are calculated using assumptions that
management believes are appropriate, changes in assumptions could cause
these estimates to vary materially. In that regard, the derived fair
value estimates cannot be substantiated by comparison to independent
markets and, in many cases, could not be realized in the immediate
settlement of the instruments. SFAS 107 excludes certain assets and
liabilities from its disclosure requirements. Accordingly, the
aggregate fair value amounts presented do not represent the underlying
value of the Company.
Although insurance contracts, other than policies such as annuities
that are classified as investment contracts, are specifically exempted
from SFAS 107 disclosures, estimated fair value of policy reserves on
life insurance contracts are provided to make the fair value
disclosures more meaningful.
The tax ramifications of the related unrealized gains and losses can
have a significant effect on fair value estimates and have not been
considered in the estimates.
The following methods and assumptions were used by the Company in
estimating its fair value disclosures:
Short-term investments and policy loans: The carrying amount
reported in the balance sheets for these instruments approximates
their fair value.
Fixed maturity and equity securities: Fair value for fixed
maturity securities is based on quoted market prices, where
available. For fixed maturity securities not actively traded, fair
value is estimated using values obtained from independent pricing
services or, in the case of private placements, is 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 value for equity securities is based on
quoted market prices.
Separate Account assets and liabilities: The fair value of assets
held in Separate Accounts is based on quoted market prices. The
fair value of liabilities related to Separate Accounts is the
amount payable on demand.
Mortgage loans on real estate: The fair value for mortgage loans
on real estate is estimated using discounted cash flow analyses,
using interest rates currently being offered for similar loans to
borrowers with similar credit ratings. Loans with similar
characteristics are aggregated for purposes of the calculations.
Fair value for mortgages in default is the estimated fair value of
the underlying collateral.
Investment contracts: Fair value for the Company's liabilities
under investment type contracts is disclosed using two methods.
For investment contracts without defined maturities, fair value is
the amount payable on demand. For investment contracts with known
or determined maturities, fair value is estimated using discounted
cash flow analysis. Interest rates used are similar to currently
offered contracts with maturities consistent with those remaining
for the contracts being valued.
<PAGE> 15
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
Policy reserves on life insurance contracts: The estimated
fair value is the amount payable on demand. Also included are
disclosures for the Company's limited payment policies, which the
Company has used discounted cash flow analyses similar to those
used for investment contracts with known maturities to estimate
fair value.
Carrying amount and estimated fair value of financial instruments
subject to SFAS 107 and policy reserves on life insurance contracts
were as follows as of December 31, 1995 and 1994:
<TABLE>
<CAPTION>
1995 1994
------------------------ ----------------------
Carrying Estimated Carrying Estimated
amount fair value amount fair value
------ ---------- ------ ----------
<S> <C> <C> <C> <C>
Assets
------
Investments:
Securities available-for-sale:
Fixed maturities $555,751 555,751 413,764 413,764
Equity securities 11,407 11,407 9,411 9,411
Fixed maturities held-to-maturity -- -- 82,631 78,690
Mortgage loans on real estate 104,736 111,501 95,281 92,340
Policy loans 94 94 79 79
Short-term investments 4,844 4,844 365 365
Assets held in Separate Accounts 257,556 257,556 177,933 177,933
Liabilities
-----------
Investment contracts 616,984 601,582 579,903 563,331
Policy reserves on life insurance contracts 4,296 4,520 3,285 3,141
Liabilities related to Separate Accounts 257,556 246,996 177,933 168,749
</TABLE>
(9) Additional Financial Instruments Disclosures
Financial Instruments with Off-Balance-Sheet Risk: The Company is a
party to financial instruments with off-balance-sheet risk in the
normal course of business through management of its investment
portfolio. These financial instruments include commitments to extend
credit in the form of loans. These instruments involve, to varying
degrees, elements of credit risk in excess of amounts recognized on the
balance sheets.
Commitments to fund fixed rate mortgage loans on real estate are
agreements to lend to a borrower, and are subject to conditions
established in the contract. Commitments generally have fixed
expiration dates or other termination clauses and may require payment
of a deposit. Commitments extended by the Company are based on
management's case-by-case credit evaluation of the borrower and the
borrower's loan collateral. The underlying mortgage property represents
the collateral if the commitment is funded. The Company's policy for
new mortgage loans on real estate is to lend no more than 80% of
collateral value. Should the commitment be funded, the Company's
exposure to credit loss in the event of nonperformance by the borrower
is represented by the contractual amounts of these commitments less the
net realizable value of the collateral. The contractual amounts also
represent the cash requirements for all unfunded commitments.
Commitments on mortgage loans on real estate of $8,500 extending into
1996 were outstanding as of December 31, 1995.
Significant Concentrations of Credit Risk: The Company grants mainly
commercial mortgage loans on real estate to customers throughout the
United States. The Company has a diversified portfolio with no more
than 28% (27% in 1994) in any geographic area and no more than 14.8%
(8.2% in 1994) with any one borrower.
<PAGE> 16
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
The summary below depicts loans by remaining principal balance as of
December 31, 1995 and 1994:
<TABLE>
<CAPTION>
Apartment
Office Warehouse Retail & other Total
------ --------- ------ ------- -----
<S> <C> <C> <C> <C> <C>
1995:
East North Central $ 1,854 878 8,263 3,940 14,935
East South Central -- -- 1,877 11,753 13,630
Mountain -- -- -- 1,964 1,964
Middle Atlantic 882 1,820 901 -- 3,603
New England -- 895 1,963 -- 2,858
Pacific 1,923 8,600 8,211 8,838 27,572
South Atlantic 3,953 -- 9,928 15,797 29,678
West North Central -- 1,500 -- -- 1,500
West South Central 3,881 969 -- 4,932 9,782
-------- -------- -------- -------- --------
$ 12,493 14,662 31,143 47,224 105,522
======== ======== ======== ======== ========
Less valuation allowances and unamortized discount 786
--------
Total mortgage loans on real estate, net $104,736
========
</TABLE>
<TABLE>
<CAPTION>
Apartment
Office Warehouse Retail & other Total
------ --------- ------ ------- -----
<S> <C> <C> <C> <C> <C>
1994:
East North Central $ 1,921 2,254 10,290 4,959 19,424
East South Central -- -- 1,921 9,876 11,797
Mountain -- -- -- 1,986 1,986
Middle Atlantic 882 1,872 1,909 -- 4,663
New England -- 921 1,983 -- 2,904
Pacific 1,952 6,873 6,310 4,910 20,045
South Atlantic 1,965 -- 10,049 13,970 25,984
West North Central -- 1,500 -- -- 1,500
West South Central 1,921 978 -- 4,973 7,872
------- ------ ------ ------ -------
$ 8,641 14,398 32,462 40,674 96,175
======= ====== ====== ======
Less valuation allowances and unamortized discount 894
-------
Total mortgage loans on real estate, net $95,281
=======
</TABLE>
(10) Pension Plan
The Company is a participant, together with other affiliated companies,
in a pension plan covering all employees who have completed at least
one thousand hours of service within a twelve-month period and who have
met certain age requirements. Benefits are based upon the highest
average annual salary of a specified number of consecutive years of the
last ten years of service. The Company funds an allocation of pension
costs accrued for employees of affiliates whose work efforts benefit
the Company.
Effective January 1, 1995, the plan was amended to provide enhanced
benefits for participants who met certain eligibility requirements and
elected early retirement no later than March 15, 1995. The entire cost
of the enhanced benefit was borne by NMIC and certain of its property
and casualty insurance company affiliates.
<PAGE> 17
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
Effective December 31, 1995, the Nationwide Insurance
Companies and Affiliates Retirement Plan was merged with the Farmland
Mutual Insurance Company Employees' Retirement Plan and the Wausau
Insurance Companies Pension Plan to form the Nationwide Insurance
Enterprise Retirement Plan. Immediately prior to the merger, the plans
were amended to provide consistent benefits for service after January
1, 1996. These amendments had no significant impact on the accumulated
benefit obligation or projected benefit obligation as of December 31,
1995.
Pension costs charged to operations by the Company during the years
ended December 31, 1995, 1994 and 1993 were $214, $265 and $131,
respectively.
The net periodic pension cost for the Nationwide Insurance Companies
and Affiliates Retirement Plan as a whole for the years ended December
31, 1995, 1994 and 1993 follows:
<TABLE>
<CAPTION>
1995 1994 1993
--------- --------- ---------
<S> <C> <C> <C>
Service cost (benefits earned during the period) $ 64,524 64,740 47,694
Interest cost on projected benefit obligation 95,283 73,951 70,543
Actual return on plan assets (249,294) (21,495) (105,002)
Net amortization and deferral 143,353 (62,150) 20,832
--------- --------- ---------
$ 53,866 55,046 34,067
========= ========= =========
</TABLE>
Basis for measurements, net periodic pension cost:
<TABLE>
<CAPTION>
1995 1994 1993
---- ---- ----
<S> <C> <C> <C>
Weighted average discount rate 7.50% 5.75% 6.75%
Rate of increase in future compensation levels 6.25% 4.50% 4.75%
Expected long-term rate of return on plan assets 8.75% 7.00% 7.50%
</TABLE>
Information regarding the funded status of the Nationwide Insurance
Enterprise Retirement Plan as a whole as of December 31, 1995
(post-merger) and the Nationwide Insurance Companies and Affiliates
Retirement Plan as of December 31, 1995 (pre-merger) and 1994 follows:
<TABLE>
<CAPTION>
Post-merger Pre-merger
1995 1995 1994
----------- ----------- -----------
<S> <C> <C> <C>
Accumulated benefit obligation:
Vested $ 1,236,730 1,002,079 914,850
Nonvested 26,503 8,998 7,570
----------- ----------- -----------
$ 1,263,233 1,011,077 922,420
=========== =========== ===========
Net accrued pension expense:
Projected benefit obligation for services rendered
to date $ 1,780,616 1,447,522 1,305,547
Plan assets at fair value 1,738,004 1,508,781 1,241,771
----------- ----------- -----------
Plan assets (less than) in excess of projected
benefit obligation (42,612) 61,259 (63,776)
Unrecognized prior service cost 42,845 42,850 46,201
Unrecognized net (gains) losses (63,130) (86,195) 39,408
Unrecognized net obligation (asset) at transition 41,305 (19,841) (21,994)
----------- ----------- -----------
$ (21,592) (1,927) (161)
=========== =========== ===========
</TABLE>
<PAGE> 18
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
Basis for measurements, funded status of plan:
<TABLE>
<CAPTION>
Post-merger Pre-merger
1995 1995 1994
-------------- -------------- --------------
<S> <C> <C> <C>
Weighted average discount rate 6.00% 6.00% 7.50%
Rate of increase in future compensation levels 4.25% 4.25% 6.25%
</TABLE>
Assets of the Nationwide Insurance Enterprise Retirement Plan are
invested in group annuity contracts of NLIC and Employers Life
Insurance Company of Wausau, a wholly owned subsidiary of NLIC. Prior
to the merger, the assets of the Nationwide Insurance Companies and
Affiliates Retirement Plan were invested in a group annuity contract of
NLIC.
(11) Postretirement Benefits Other Than Pensions
In addition to the defined benefit pension plan, the Company, together
with other affiliated companies, participates in life and health care
defined benefit plans for qualifying retirees. Postretirement life and
health care benefits are contributory and generally available to full
time employees who have attained age 55 and have accumulated 15 years
of service with the Company after reaching age 40. Postretirement
health care benefit contributions are adjusted annually and contain
cost-sharing features such as deductibles and coinsurance. In addition,
there are caps on the Company's portion of the per-participant cost of
the postretirement health care benefits. These caps can increase
annually, but not more than three percent. The Company's policy is to
fund the cost of health care benefits in amounts determined at the
discretion of management. Plan assets are invested primarily in group
annuity contracts of NLIC.
Effective January 1, 1993, the Company adopted the provisions of
Statement of Financial Accounting Standards No. 106 - Employers'
Accounting for Postretirement Benefits Other Than Pensions (SFAS 106),
which requires the accrual method of accounting for postretirement life
and health care insurance benefits based on actuarially determined
costs to be recognized over the period from the date of hire to the
full eligibility date of employees who are expected to qualify for such
benefits.
The Company elected to immediately recognize its estimated accumulated
postretirement benefit obligation as of January 1, 1993. Accordingly, a
noncash charge of $669 ($435 net of related income tax benefit) was
recorded in the 1993 statement of income as a cumulative effect of a
change in accounting principle. See note 3. The adoption of SFAS 106,
including the cumulative effect of the change in accounting principle,
increased the expense for postretirement benefits by $739 to $761 in
1993. Certain affiliated companies elected to amortize their initial
transition obligation over periods ranging from 10 to 20 years.
The Company's accrued postretirement benefit expense as of December 31,
1995 and 1994 was $808 and $771, respectively, and the net periodic
postretirement benefit cost (NPPBC) for 1995 and 1994 was $66 and $119,
respectively.
The amount of NPPBC for the plan as a whole for the years ended
December 31, 1995, 1994 and 1993 was as follows:
<TABLE>
<CAPTION>
1995 1994 1993
----------- ---------- ----------
<S> <C> <C> <C>
Service cost - benefits attributed to employee service during the year $ 6,235 8,586 7,090
Interest cost on accumulated postretirement benefit obligation 14,151 14,011 13,928
Actual return on plan assets (2,657) (1,622) --
Amortization of unrecognized transition obligation of affiliates 2,966 568 568
Net amortization and deferral (1,619) 1,622 --
-------- -------- --------
$ 19,076 23,165 21,586
======== ======== ========
</TABLE>
<PAGE> 19
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
Information regarding the funded status of the plan as a whole
as of December 31, 1995 and 1994 follows:
<TABLE>
<CAPTION>
1995 1994
--------- ---------
<S> <C> <C>
Accrued postretirement benefit expense:
Retirees $ 88,680 76,677
Fully eligible, active plan participants 28,793 22,013
Other active plan participants 90,375 59,089
--------- ---------
Accumulated postretirement benefit obligation (APBO) 207,848 157,779
Plan assets at fair value 54,325 49,012
--------- ---------
Plan assets less than accumulated postretirement benefit obligation (153,523) (108,767)
Unrecognized transition obligation of affiliates 1,827 6,577
Unrecognized net gains (1,038) (41,497)
--------- ---------
$(152,734) (143,687)
========= =========
</TABLE>
Actuarial assumptions used for the measurement of the APBO as of
December 31, 1995 and 1994 and the NPPBC for 1995, 1994 and 1993 were
as follows:
<TABLE>
<CAPTION>
1995 1995 1994 1994 1993
APBO NPPBC APBO NPPBC NPPBC
----------- ----------- ----------- ---------- ----------
<S> <C> <C> <C> <C> <C>
Discount rate 6.75% 8% 8% 7% 8%
Assumed health care cost trend rate:
Initial rate 11% 10% 11% 12% 14%
Ultimate rate 6% 6% 6% 6% 6%
Uniform declining period 12 Years 12 Years 12 Years 12 Years 12 Years
</TABLE>
The health care cost trend rate assumption has an effect on the amounts
reported. For the plan as a whole, a one percentage point increase in
the assumed health care cost trend rate would increase the APBO as of
December 31, 1995 by $641 and the NPPBC for the year ended December 31,
1995 by $107.
(12) Regulatory Risk-Based Capital and Dividend Restriction
Ohio, the Company's state of domicile, imposes minimum risk-based
capital requirements that were developed by the NAIC. The formulas for
determining the amount of risk-based capital specify various weighting
factors that are applied to financial balances or various levels of
activity based on the perceived degree of risk. Regulatory compliance
is determined by a ratio of the company's regulatory total adjusted
capital, as defined by the NAIC, to its authorized control level
risk-based capital, as defined by the NAIC. Companies below specific
trigger points or ratios are classified within certain levels, each of
which requires specified corrective action. The Company exceeds the
minimum risk-based capital requirements.
Ohio law limits the payment of dividends to shareholders. The maximum
dividend that may be paid by the Company without prior approval of the
Director of the Department is limited to the greater of statutory gain
from operations of the preceding calendar year or 10% of statutory
shareholder's surplus as of the prior December 31. Therefore, $70,034
of shareholder's equity, as presented in the accompanying financial
statements, is so restricted as to dividend payments in 1996.
<PAGE> 20
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
(formerly Financial Horizons Life Insurance Company)
(a wholly owned subsidiary of Nationwide Life Insurance Company)
Notes to Financial Statements, Continued
(13) Transactions With Affiliates
The Company shares home office, other facilities, equipment and common
management and administrative services with affiliates.
The Company and various affiliates entered into agreements with
Nationwide Cash Management Company (NCMC) and California Cash
Management Company (CCMC), both affiliates, under which NCMC and CCMC
act as common agents in handling the purchase and sale of short-term
securities for the respective accounts of the participants. Amounts on
deposit with NCMC and CCMC were $4,844 and $365 as of December 31, 1995
and 1994, respectively, and are included in short-term investments on
the accompanying balance sheets.
Certain annuity products are sold through an affiliated company, which
is a subsidiary of Nationwide Corporation. Total commissions paid to
the affiliate for the three years ended December 31, 1995 were $6,638,
$6,935 and $10,041, respectively.
(14) Segment Information
The Company operates in the long-term savings and life insurance lines
of business in the life insurance industry. Long-term savings
operations include both qualified and non-qualified individual annuity
contracts. Life insurance operations include universal life and
variable universal life issued to individuals. Corporate primarily
includes investments, and the related investment income, which are not
specifically allocated to one of the two operating segments. In
addition, realized gains and losses on all general account investments
are reported as a component of the corporate segment.
During 1995, the Company changed its reporting segments to better
reflect the way the businesses are managed. Prior periods have been
restated to reflect these changes.
The following table summarizes the revenues and income (loss) before
Federal income tax expense and cumulative effect of changes in
accounting principles for the years ended December 31, 1995, 1994 and
1993 and assets as of December 31, 1995, 1994 and 1993, by business
segment.
<TABLE>
<CAPTION>
1995 1994 1993
--------- --------- ---------
<S> <C> <C> <C>
Revenues:
Long-term savings $ 50,669 45,234 39,684
Life insurance 179 173 187
Corporate 2,554 2,910 3,456
--------- --------- ---------
$ 53,402 48,317 43,327
========= ========= =========
Income (loss) before Federal income tax expense and
cumulative effect of changes in accounting principles:
Long-term savings 4,514 3,739 2,134
Life insurance (387) (996) (1,254)
Corporate 3,020 2,444 3,456
--------- --------- ---------
$ 7,147 5,187 4,336
========= ========= =========
Assets:
Long-term savings 931,939 789,147 693,915
Life insurance 2,565 2,393 2,027
Corporate 33,078 41,500 30,097
--------- --------- ---------
$ 967,582 833,040 726,039
========= ========= =========
</TABLE>
<PAGE> 33
PART II - OTHER INFORMATION
CONTENTS OF REGISTRATION STATEMENT
This Registration Statement comprises the following papers and documents:
The facing sheet.
Cross-reference to items required by Form N-8B-2.
The prospectus consisting of 48 pages.
Representations and Undertakings.
The Signatures.
The following exhibits required by Forms N-8B-2 and S-6:
<TABLE>
<S> <C> <C>
1. Power of Attorney dated August 9, 1996 Filed with initial registration (File No. 333-12333) and is
hereby incorporated by reference.
2. Resolution of the Depositor's Board of Directors Filed with initial registration (File No. 333-12333) and is
authorizing the establishment of the Registrant, hereby incorporated by reference.
adopted
3. Distribution Contracts Underwriting or Distribution of contracts between the
Registrant and Principal Underwriter - Filed previously in
connection with Registration Statement (SEC File No.
33-86408) on November 14, 1994 and hereby incorporated by
reference.
4. Form of Security Attached hereto.
5. Articles of Incorporation of Depositor Attached hereto.
6. Application form of Security Attached hereto.
7. Opinion of Counsel Filed with initial registration (File No. 333-12333) and is
hereby incorporated by reference.
</TABLE>
<PAGE> 34
REPRESENTATIONS AND UNDERTAKINGS
The Registrant and the Company hereby make the following representations and
undertakings:
(a) This filing is made pursuant to Rules 6c-3 and 6e-3(T) under the Investment
Company Act of 1940 (the "Act"). The Registrant and the Company elect to be
governed by Rule 6e-3(T)(b)(13)(i)(A) under the Act with respect to the Policies
described in the prospectus. The Policies have been designed in such a way as to
qualify for the exemptive relief from various provisions of the Act afforded by
Rule 6e-3(T).
(b) Paragraph (b) (13) (iii) (F) of Rule 6e-3(T) is being relied on for the
deduction of the mortality and expense risk charges ("risk charges") assumed by
the Company under the Policies. The Company represents that the risk charges are
within the range of industry practice for comparable policies and reasonable in
relation to all of the risks assumed by the issuer under the Policies. Actuarial
memoranda demonstrating the reasonableness of these charges are maintained by
the Company, and will be made available to the Securities and Exchange
Commission (the "Commission") on request.
(c) That there is a reasonable likelihood that the distribution financing
arrangement of the separate account will benefit the separate account and the
contractholders and will keep and make available to the Commission on request a
memorandum setting forth the basis for this representation.
(d) That the separate 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.
(e) Subject to the terms and conditions of Section 15(d) of the Securities
Exchange Act of 1934, the Registrant hereby undertakes to file with the
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.
(f) That the fees and charges deducted under the Policy in the aggregate are
reasonable in relation to the services rendered, the expenses expected to be
incurred, and the risks assumed by the Company.
<PAGE> 35
SIGNATURES
Pursuant to the requirements of the Securities Act of 1933, the
Registrant, NATIONWIDE VL SEPARATE ACCOUNT-B, has caused this pre-effective
amendment to be signed on its behalf in the City of Columbus, and State of Ohio,
on this 10th day of December, 1996.
NATIONWIDE VL SEPARATE ACCOUNT-B
--------------------------------
(Registrant)
(Seal) NATIONWIDE LIFE AND ANNUITY
INSURANCE COMPANY
--------------------------------
Attest: (Sponsor)
W. SIDNEY DRUEN By: JOSEPH P. RATH
- ------------------------- --------------------------------
W. Sidney Druen Joseph P. Rath
Assistant Secretary Vice President and Associate
General Counsel
Pursuant to the requirements of the Securities Act of 1933, this Registration
Statement has been signed below by the following persons in the capacities
indicated on the 10th day of December, 1996.
<TABLE>
<CAPTION>
SIGNATURE TITLE
<S> <C>
LEWIS J. ALPHIN Director
- ------------------------------------------
Lewis J. Alphin
KEITH W. ECKEL Director
- ------------------------------------------
Keith W. Eckel
WILLARD J. ENGEL Director
- ------------------------------------------
Willard J. Engel
FRED C. FINNEY Director
- ------------------------------------------
Fred C. Finney
CHARLES L. FUELLGRAF, JR. Director
- ------------------------------------------
Charles L. Fuellgraf, Jr.
JOSEPH J. GASPER President/Chief Operating Officer and Director
- ------------------------------------------
Joseph J. Gasper
HENRY S. HOLLOWAY Chairman of the Board and Director
- -----------------------------------------
Henry S. Holloway
D. RICHARD MCFERSON Chairman and Chief Executive Officer - Nationwide
- ------------------------------------------ Insurance Enterprise and Director
D. Richard McFerson
DAVID O. MILLER Director
- ------------------------------------------
David O. Miller
C. RAY NOECKER Director
- ------------------------------------------
C. Ray Noecker
ROBERT A. OAKLEY Executive Vice President-Chief Financial Officer
- ------------------------------------------
Robert A. Oakley
JAMES F. PATTERSON Director By/s/JOSEPH P. RATH
- ------------------------------------------ ------------------------------------------
James F. Patterson Joseph P. Rath
Attorney-in-Fact
ARDEN L. SHISLER Director
- ------------------------------------------
Arden L. Shisler
ROBERT L. STEWART Director
- ------------------------------------------
Robert L. Stewart
NANCY C. THOMAS
- ------------------------------------------ Director
Nancy C. Thomas
HAROLD W. WEIHL Director
- ------------------------------------------
Harold W. Weihl
</TABLE>
<PAGE> 1
AMENDED ARTICLES OF INCORPORATION
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
* FIRST: The name of said Corporation shall be "NATIONWIDE LIFE AND
ANNUITY INSURANCE COMPANY."
SECOND: Said Corporation is to be located, and its principal offices
maintained, in the City of Columbus, County of Franklin, State
of Ohio.
THIRD: This Corporation is formed for the purpose of making insurance
upon the lives of individuals, and every type of insurance
appertaining thereto or connected therewith, and granting,
purchasing or disposing of annuities, as authorized by Section
3907.01, Ohio Revised Code, as it now exists or may hereafter
be amended.
FOURTH: The maximum number of shares which the Corporation is
authorized to have outstanding is Sixty-Six Thousand (66,000)
shares, all of which shall be with par value of Forty Dollars
($40.00) each.
FIFTH: The amount of capital with which the Corporation will begin
business is One Million Forty Thousand Dollars
($1,040,000.00).
SIXTH: The corporate powers and business of the Corporation shall be
exercised, conducted and controlled, and the corporate
property managed by a board of directors consisting of not
less than five (5), nor more than twenty-one (21), as may from
time to time be fixed by the Code of Regulations of the
Corporation. At the first election of directors one-third of
the directors shall be elected to serve until the next annual
meeting, one-third shall be elected to serve until the second
annual meeting, and one-third shall be elected to serve until
the third annual meeting; therefore all directors shall be
elected to serve for terms of three (3) years each, and until
their successors are elected and qualified. Vacancies in the
board of directors, arising from any cause, shall be filled by
the remaining directors.
The directors shall be elected at the annual meetings of the
stockholders by a majority of the stockholders present in
person or by proxy, provided that vacancies may be filled as
herein provided for.
The stockholders of the Corporation shall have the right,
subject to the statutes of the State of Ohio and these
Articles of Incorporation, to adopt a Code of Regulations
governing the transaction of the business and affairs of the
Corporation which may be altered, amended or repealed in a
manner provided by law.
* Amended effective January 30, 1995
<PAGE> 2
The board of directors shall elect from their own number a
Chairman of the Board of Directors, a General Chairman, and a
President. The board of directors shall also elect a Vice
President and a Secretary and a Treasurer, or a Secretary-
Treasurer. The board of directors may also elect or appoint
such additional vice presidents, assistant secretaries and
assistant treasurers as may be deemed advisable or necessary,
and may fix their duties. The board of directors may appoint
such other officers as may be provided in the Code of
Regulations. All officers, unless sooner removed by the board
of directors, shall hold office for one (1) year, or until
their successors are elected and qualified. Other than the
Chairman of the Board of Directors, the General Chairman and
the President, the officers need not be members of the board
of directors. Officers shall be elected at each annual
organization meeting of the board of directors, but elections
or appointments to fill vacancies may be had at any meeting of
the directors.
SEVENTH: The annual meeting of the stockholders of the Corporation
shall be held at such time as may be fixed in the Code of
Regulations of the Corporation. Any meeting of the
stockholders, annual or special, may be held in or outside the
State of Ohio. Reasonable notice of all meetings of
stockholders should be given, by mail or publication, or as
prescribed by the Code of Regulations or by law.
Amended effective January 30, 1995
<PAGE> 1
WELCOME TO
NATIONWIDE LIFE
AND ANNUITY
INSURANCE COMPANY
SPECIMEN COPY
NWLA-103 (11/96)
<PAGE> 2
PART I
[NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY LOGO]
NATIONWIDE(R) LIFE AND ANNUITY
<TABLE>
<CAPTION>
NATIONWIDE LIFE AND ANNUITY
INSURANCE COMPANY
EMPLOYER-SPONSORED P.O. BOX 182150
FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE COLUMBUS, OHIO 43218-2150
<S> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
1. EMPLOYER INFORMATION
- ------------------------------------------------------------------------------------------------------------------------------------
Employer Name Taxpayer ID Number
- ------------------------------------------------------------------------------------------------------------------------------------
Address (City, State, Zip Code)
- ------------------------------------------------------------------------------------------------------------------------------------
2. INSURED
- ------------------------------------------------------------------------------------------------------------------------------------
Name of Insured (First, Middle, Last) Home Telephone Business Telephone
( ) ( )
- ------------------------------------------------------------------------------- -------------------------- -------------------------
Social Security
Sex |_| M |_| F Age Date of Birth / / Birth Place Number - -
- -------------------- ------------ -------------------------- ------------------------- ---------------------------------------------
Street Address City State Zip Code County
- -------------------------------------------------------------- ---------------- ----------------- ---------------- -----------------
3. OWNER (If other than Employer)
- ------------------------------------------------------------------------------------------------------------------------------------
Full Name Date of Birth Relationship to Insured
- ------------------------------------------------------------------------------------------------------------------------------------
Address Social Sec or Tax ID Number
- -
- ------------------------------------------------------------------------------------------------- ----------------------------------
4. BENEFICIARY (If other than Employer)
- ------------------------------------------------------------------------------------------------------------------------------------
FULL NAME OF DATE OF RELATIONSHIP SOCIAL
BENEFICIARY ADDRESS BIRTH TO INSURED SECURITY #
____________________________ __________________________________ ______________ ________________ _______________
____________________________ __________________________________ ______________ ________________ _______________
____________________________ __________________________________ ______________ ________________ _______________
- ------------------------------------------------------------------------------------------------------------------------------------
5. SPECIFIED AMOUNT AND PREMIUM PLAN
- ------------------------------------------------------------------------------------------------------------------------------------
SPECIFIED AMOUNT PLANNED PREMIUM
|_| Employer List Bill $ __________________ |_|Annual $ _______________
|_| Monthly $ __________________ |_|Semi-Annual $ _______________
$ __________________________ (Electronic Funds Transfer) |_|Quarterly $ _______________
(Attach completed authorization |_|Other $ _______________
and void check)
- ----------------------------------- ------------------------------------------------------------------------------------------------
6. DEATH BENEFIT OPTION
- ------------------------------------------------------------------------------------------------------------------------------------
|_| OPTION 1 (The Specified Amount, or a multiple of the Contract Value, whichever is greater.)
|_| OPTION 2 (The Specified Amount, plus the Contract Value, or a multiple of the Contract
Value, whichever is greater.)
(IF NO OPTION IS SELECTED, OPTION 1 IS ELECTED.)
- ------------------------------------------------------------------------------------------------------------------------------------
7. OPTIONAL BENEFIT RIDERS
- ------------------------------------------------------------------------------------------------------------------------------------
|_| Change of Insured |_| Other ______________________________________
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
NWLA-103 (11/96)
<PAGE> 3
<TABLE>
<CAPTION>
<S> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
8. SUPPLEMENTAL INFORMATION
- ------------------------------------------------------------------------------------------------------------------------------------
a. Have you been actively at work daily on a full-time basis (minimum 30 hours per week) for the past 3 months? (Disregard
vacation days and absences that total less than 5 days.)
|_|Yes |_|No If No, explain and complete PART II ______________________________________________________________________
b. Have you used any tobacco products in the past 12 months?
|_|Yes |_|No If Yes, specify Type:___________________________________ Frequency:____________________________________
c. Will the insurance applied for replace existing Life Insurance or Annuities on any person here proposed for insurance?
|_|Yes |_|No If Yes, explain ________________________________________________________________________________________
________________________________________________________________________________________
(Complete and send replacement forms where applicable.)
- ------------------------------------------------------------------------------------------------------------------------------------
9. SUITABILITY
- ------------------------------------------------------------------------------------------------------------------------------------
YES NO
a. Do you understand that the Death Benefit and Surrender Value may increase or decrease depending
on the investment experience of the Variable Account?............................................................. |_| |_|
b. Do you believe that this policy will meet your insurance needs and financial objectives?.......................... |_| |_|
c. Have you received a current copy of the prospectus?............................................................... |_| |_|
- ------------------------------------------------------------------------------------------------------------------------------------
10. ALLOCATIONS
- ------------------------------------------------------------------------------------------------------------------------------------
ON ISSUED CONTRACTS, YOUR FULL NET PREMIUM WILL BE ALLOCATED TO THE NATIONWIDE SEPARATE ACCOUNT TRUST MONEY MARKET FUND UNTIL
THE END OF THE RIGHT TO CANCEL PERIOD. WHEN THIS PERIOD ENDS, YOUR CONTRACT VALUE WILL BE ALLOCATED TO THE SUBACCOUNT(S)
INDICATED BELOW. SELECTIONS MUST TOTAL 100%. MINIMUM INITIAL ALLOCATION TO ANY SINGLE SUBACCOUNT IS 5%. NO FRACTIONAL
PERCENTAGES. MAXIMUM OF 10 ACTIVE FUNDS. THESE PERCENTAGES WILL APPLY IN FUTURE YEARS BUT MAY BE CHANGED AT ANY TIME BY THE
POLICY OWNER. (IF NO ALLOCATION IS INDICATED, MONEY MARKET WILL BE AUTOMATICALLY SELECTED.)
- ------------------------------------------------------------------------------------------------------------------------------------
FIDELITY VARIABLE
INSURANCE PRODUCTS FUND
____% Equity Income Portfolio
____% Overseas Portfolio
NATIONWIDE SEPARATE
ACCOUNT FUND
____% Money Market Fund
____% Total Return Fund
THE ONE(R) GROUP
INVESTMENT TRUST
____% Asset Allocation Fund
____% Government Bond Fund
____% Large Company Growth Fund
____% Growth Opportunities Fund
OTHER AVAILABLE FUNDS
____% __________________
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
NWLA-103
<PAGE> 4
<TABLE>
<CAPTION>
<S> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
11. TAXPAYER IDENTIFICATION NUMBER
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Under the Interest and Dividend Compliance Act of 1983, persons owning insurance policies are required to provide the Company with
certification that their taxpayer identification number is correct. (For most individuals, this is their Social Security Number.)
If you do not provide us with certification of this number, you may be subject to a $50 penalty imposed by the Internal Revenue
Service. In addition, we will be forced to withhold 31% from interest and other payments we make to you (known as backup
withholding). It is not an additional tax, since the amount withheld will be applied against the tax you owe. If withholding
results in an overpayment of taxes, a refund may be obtained.
|_| Check this box if the Internal Revenue Service has notified you that you
are not subject to the provisions of this law. Otherwise, your signature
on this application is certification that the taxpayer identification
number on this application is true, correct, and complete.
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12. IMPORTANT NOTICE
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I UNDERSTAND THAT THE DEATH BENEFIT UNDER A VARIABLE LIFE INSURANCE POLICY MAY INCREASE OR DECREASE, DEPENDING ON THE
INVESTMENT RETURN OF THE SUBACCOUNT(S) I SELECT. REGARDLESS OF INVESTMENT RETURN, THE DEATH BENEFIT CAN NEVER BE LESS THAN
THE SPECIFIED AMOUNT, AS LONG AS THE POLICY IS IN FORCE. THE CONTRACT VALUE MAY INCREASE OR DECREASE ON ANY DAY, DEPENDING ON
THE INVESTMENT RETURN FOR THE POLICY. NO MINIMUM CONTRACT VALUE IS GUARANTEED. ON REQUEST, WE WILL FURNISH ILLUSTRATIONS OF
BENEFITS, INCLUDING DEATH BENEFITS AND CONTRACT VALUES FOR A VARIABLE LIFE INSURANCE POLICY AND A FIXED LIFE INSURANCE POLICY
FOR THE SAME PREMIUM.
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AGREEMENT, AUTHORIZATION AND SIGNATURES (If completing Part II, skip this section)
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I have read this application. I understand each of the questions. All of the answers and statements on this form are complete and
true to the best of my knowledge and belief. I understand and agree that:
1. This application and any amendments to it, will become a part of the Policy. They are the basis of any insurance issued upon
this application.
2. Any person who submits an application or a claim containing a false or deceptive statement, and does so with intent to
defraud or knowing that he/she is facilitating a fraud against an insurer, is guilty of insurance fraud.
3. No agent or other representative of Nationwide may accept risks or make or change any contract, or waive or change any of the
Company's rights or requirements.
4. No information will be considered as having been given to Nationwide unless it is written in this application.
5. Insurance will only take effect when all of the following conditions are met:
a. If a Policy is issued by Nationwide and is accepted by me; and
b. If the full first premium is paid; and
c. If all the answers and statements made on the application and amendments continue to be true to the best of my knowledge
and belief.
Signed at ___________________________________________, on _____________, 19__.
___________________________________________ __________________
Signature of Primary Insured (if over age 14) Signature of Owner
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I have truly and accurately recorded all Proposed Insured's answers on this application and have witnessed his/her/their
signature(s) hereon.
To the best of my knowledge, the insurance applied for |_| will |_| will not (CHECK ONE) replace any life insurance or annuity.
___________________________________________________ ______________________________________________
Licensed Resident Agent Signature Firm Agent's Name (Print) License ID Number
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</TABLE>
NWLA-103
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<TABLE>
PART II
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13. PERSONAL INFORMATION
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YES NO
a. Have you ever had any application for Life or Health Insurance (or for reinstatement of Life or Health
Insurance) declined, postponed, rated-up or limited?.............................................................. |_| |_|
(If "Yes", provide details below.)
b. Have you ever applied for or received disability payments for any illness or injury?.............................. |_| |_|
(If "Yes", provide details below.)
c. Have you ever had your driver's license suspended or revoked; or been convicted of driving while
impaired or intoxicated; or been convicted in the past three years of more than one moving violation?............. |_| |_|
(If "Yes", provide details, driver's license #, and state of issue below.)
d. Have you ever been convicted of a felony, misdemeanor, or any other crime?........................................ |_| |_|
(If "Yes", provide details below.)
e. In the past 3 years have you engaged in, or do you intend to engage in: flying as a pilot, student pilot,
or crew member; racing of an automobile, motorcycle, or any type of motor-powered vehicle; scuba
diving, mountain climbing, hang gliding, parachuting, sky diving, bungee jumping, or any type of
body-contact or life-threatening sport?........................................................................... |_| |_|
(If "Yes", complete an Aviation/Hazardous Activities Questionnaire.)
DETAILS: ______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
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14. MEDICAL QUESTIONS AND INFORMATION
(For each "yes" answer circle the appropriate item and provide details in #15 below.)
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YES NO
To the best of your knowledge and belief, in the past 10 years have you been
treated for or been diagnosed by a member of the medical profession as having:
a. Alcoholism, drug use other than as prescribed by a physician, nervous or mental disorder?......................... |_| |_|
b. High blood pressure, epilepsy or stroke, Alzheimer's disease, disease of the pancreas or lymph glands,
blood disorder?................................................................................................... |_| |_|
c. Chest pains, heart attack or other heart disorder, diabetes, kidney disorder, lung or respiratory disorder
or any cancer or malignancy?...................................................................................... |_| |_|
d. AIDS (Acquired Immune Deficiency Syndrome), ARC (AIDS-related complex), or any other AIDS-related.................
condition, or received a positive result of an HIV test?.......................................................... |_| |_|
e. Any chronic or persistent disease not mentioned previously?....................................................... |_| |_|
Within the past five years, have you:
f. Consulted, or been examined or treated by any physician, chiropractor, or other medical practitioner,
or by any hospital, clinic, or other medical facility not previously mentioned?................................... |_| |_|
g. Had any disease, disorder, injury, or operation not previously mentioned?......................................... |_| |_|
Within the past two years, have you:
h. Taken or do you currently take any prescription medication (If so, state name of drug, reason for taking
drug and frequency below)?........................................................................................ |_| |_|
i. Been advised to have any surgery, hospitalization, treatment or test that was not completed?...................... |_| |_|
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15. DETAILS OF MEDICAL HISTORY
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QUESTION NUMBER
& LETTER DATES DETAILS (BE SPECIFIC. GIVE FULL NAMES, ADDRESSES AND TELEPHONE
NUMBER, IF AVAILABLE, OF PHYSICIANS, HOSPITALS, ETC.)
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NWLA-103
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<TABLE>
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16. PERSONAL PHYSICIAN INFORMATION
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Name, address, and phone number of Personal Physician _____________________________________________________________________________
___________________________________________________________________________________________________________________________________
Date last consulted, reason and results ___________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Proposed Insured's Height: ________________________________________ Weight: ______________________________________________________
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17. INSURANCE INFORMATION
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List all Life Insurance now in force on Proposed Insured. If none, write "NONE".
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Year Accidental
Insurance Company Policy Number Amount Issued Death To Be Replaced?
<S> <C> <C> <C> <C> <C>
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18. SPECIAL INSTRUCTIONS
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AGREEMENT, AUTHORIZATION AND SIGNATURES
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I have read this application. I understand each of the questions. All of the answers and statements on this form are complete
and true to the best of my knowledge and belief. I understand and agree that:
1. This application and any amendments to it, and any related medical examinations will become a part of the Policy. They are
the basis of any insurance issued upon this application.
2. Any person who submits an application or a claim containing a false or deceptive statement, and does so with intent to
defraud or knowing that he/she is facilitating a fraud against an insurer, is guilty of insurance fraud.
3. No medical examiner or no agent or other representative of Nationwide may accept risks or make or change any contract, or
waive or change any of the Company's rights or requirements.
4. Insurance will only take effect when all of the following conditions are met:
a. If a Policy is issued by Nationwide and is accepted by me; and
b. If the full first premium is paid; and
c. If all the answers and statements made on the application and amendments continue to be true to the best of my knowledge
and belief.
I have received the pre-notice form of the Fair Credit Reporting Act of 1970. Also, the Medical Information Bureau disclosure form
has been given to me. I certify that the Social Security Number given is correct and complete.
I authorize: any licensed physician or medical practitioner; any hospital, clinic or other medical or medically related facility;
any insurance company; the Medical Information Bureau; or any other organization, institution or person who has knowledge of me;
to give that information to the Medical Director of the Nationwide Life and Annuity Insurance Company, or its reinsurers. This
authorization, or a copy of it, will be valid for a period of not more than one year from the date it was signed.
Signed at _____________________________________________________________, on__________________________________ , 19 _____________.
_____________________________________________________ ____________________________________________________
Signature of Primary Insured (if over age 14) Signature of Owner
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I have truly and accurately recorded all Proposed Insured's answers on this application and have witnessed his/her/their
signature(s) hereon.
To the best of my knowledge, the insurance applied for |_| will |_| will not (CHECK ONE) replace any life insurance or annuity.
_________________________________________________________ ____________________________________________________
Licensed Resident Agent Signature Firm Agent's Name (Print) License ID Number
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</TABLE>
NWLA-103
<PAGE> 7
PROVIDE TO PROPOSED INSURED ONLY IF PART II OF APPLICATION IS COMPLETED
IMPORTANT NOTICE
DETACH AND GIVE TO PROPOSED INSURED
PRE-NOTICE OF PROCEDURES AS REQUIRED BY THE FAIR CREDIT REPORTING ACT OF 1970
This notice is to inform you that as part of our normal underwriting procedures
in connection with an application for insurance:
An investigative consumer report may be made whereby information is obtained
through personal interviews with your neighbors, friends or others with whom you
are acquainted. This inquiry will include information as to character, general
reputation, personal characteristics and mode of living, except as may be
related directly or indirectly to your sexual orientation, with respect to you,
members of your family, and others having an interest in or closely connected
with the insurance transaction; and
Upon your written request, made within a reasonable time after you receive this
notice, additional information as to the nature and scope of the investigation,
if one is made, will be provided. Requests for additional information should be
addressed to Nationwide Life and Annuity Insurance Company, Box 182150,
Columbus, Ohio 43218-2150.
MEDICAL INFORMATION BUREAU DISCLOSURE NOTICE
Information regarding your insurability will be treated as confidential.
Nationwide Life and Annuity Insurance Company, or its reinsurer(s) may, however,
make a brief report thereon to the Medical Information Bureau, a non-profit
membership organization of life insurance companies, which operates an
information exchange on behalf of its members. If you apply to another Bureau
member company for life or health insurance coverage or a claim for benefits is
submitted to such a company, the Bureau, upon request, will supply such company
with the information in its file.
Upon receipt of a request from you, the Bureau will arrange disclosure of any
information it may have in your file. (Medical information will be disclosed
only to your attending physician.) If you question the accuracy of information
in the Bureau's file, you may contact the Bureau and seek a correction in
accordance with the procedures set forth in the Federal Fair Credit Reporting
Act. The address of the Bureau's information office is Post Office Box 105,
Essex Station, Boston Massachusetts, 02112, telephone number (617) 426-3660.
Nationwide Life and Annuity Insurance Company, or its reinsurer(s) may also
release information in its file to other life insurance companies to whom you
may apply for life or health insurance, or to whom a claim for benefits may be
submitted.
NWLA-103
<PAGE> 1
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[NATIONWIDE LIFE NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
AND ANNUITY
INSURANCE CO.
LOGO] Home Office: Two Nationwide Plaza
Columbus, Ohio 43218-2008
-------------------------------------------------------
PLEASE READ YOUR POLICY CAREFULLY
This Policy is a legal contract between the Owner (you, your) and Nationwide
Life and Annuity Insurance Company (we, our, us, the Company).
INSURING AGREEMENT:
We issue this Policy in consideration of your application and the payment of the
Initial Premium. We agree to pay the Death Proceeds to the Beneficiary upon
receiving proof that the Insured has died while this Policy is in force and
before the Maturity Date. We agree to pay the Maturity Proceeds to you if the
Insured is living on the Maturity Date.
You and we are bound by the conditions and provisions of this Policy.
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The Cash Surrender Value of this Policy will vary from day to day. It may
increase or decrease depending on the investment experience of the Policy. Refer
to the Nonforfeiture Provisions on page 10 for details. There is no guaranteed
Cash Surrender Value.
The amount or duration of the death benefit will be variable and depend on
the investment experience of the Policy. The death benefit will never be less
than the Specified Amount as long as your Policy is in force. Refer to the Death
Benefit Provisions on page 9 for details.
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You may return this Policy to us within (1) 10 days after you get it, or
(2) 45 days after you sign the application, or (3) 10 days after we mail or
deliver the Notice of Withdrawal Right, whichever is latest. The Policy, with a
written request for cancellation, must be mailed or delivered to our Home Office
or to the agent who sold it to you. The returned Policy will be treated as if we
never issued it and we will refund any premiums paid.
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If you have any questions about your Policy or need additional insurance
service, contact your agent or write to our Home Office.
Signed at our Home Office on the Policy Date.
/s/ illegible Secretary /s/ illegible President
- -------------------------- ---------------------------
FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE POLICY
-Adjustable Death Benefit -Flexible premiums payable during
Insured's lifetime until the Maturity Date
-Death Proceeds payable at Insured's death prior to the Maturity Date
-Maturity Proceeds payable on the Maturity Date
-Not eligible for dividends -Investment experience reflected in benefits
NWLA-19
<PAGE> 2
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CONTENTS
Page
Annual Report......................................................7
Assignment.........................................................7
Beneficiary........................................................7
Cash Surrender Value...............................................4
Cash Value........................................................10
Death Benefit......................................................9
Definitions........................................................4
Error in Age.......................................................6
Exchange of Policy................................................13
Grace Period.......................................................8
Incontestability...................................................6
Insured............................................................4
Insuring Agreement.................................................1
Loan..............................................................12
Monthly Cost of Insurance.........................................11
Nonforfeiture.....................................................10
Optional Modes of Settlement......................................16
Ownership..........................................................7
Partial Surrender.................................................12
Policy Data Page...................................................3
Premium............................................................8
Reinstatement......................................................8
Suicide............................................................6
Surrender.........................................................12
Termination........................................................6
Valuation of Assets...............................................14
Variable Account..................................................14
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2
<PAGE> 3
DEFINITIONS
AGE
ATTAINED AGE: Attained Age is the Issue Age plus the number of full years
since the Policy Date.
ISSUE AGE: Issue Age is the Insured's age on the last birthday on or before
the Policy Date. It is shown on the Policy Data Page.
BENEFICIARY: The Beneficiary is the person to whom the Death Proceeds are
paid when the Insured dies. The Beneficiary is named in the
application, unless changed.
CASH SURRENDER The Cash Surrender Value of your Policy on any date is equal to
VALUE: (1) minus (2) where:
1. is the Cash Value; and
2. is any Indebtedness.
CASH VALUE: Your Policy's Cash Value is the sum of the associated
values in any Variable Account and the Policy Loan Account.
Refer to the Nonforfeiture Provision for details.
COMPANY: The Company is the Nationwide Life and Annuity Insurance
Company. "We," "our", and "us" refer to the Company.
CONTINGENT The Contingent Beneficiary will become the Beneficiary
BENEFICIARY: if the named Beneficiary dies prior to the Insured.
The Contingent Beneficiary is named in the application, unless
changed.
CONTINGENT The Contingent Owner will become the Owner if the named Owner
OWNER: dies prior to the Insured. The Contingent Owner is named in the
application, unless changed.
DEATH The Death Proceeds are the amount of money payable to the
PROCEEDS: Beneficiary if the Insured dies while your Policy is in force
prior to the Maturity Date. Refer to the Death Benefit Provision
for details.
FUND: A Fund is the underlying mutual fund in which Subaccount assets
are invested. There is a Fund that corresponds to each
Subaccount in a Variable Account. The Funds are listed on the
Policy Data Page with the corresponding Subaccounts.
HOME The Home Office of the Company is at Two Nationwide Plaza,
OFFICE: Columbus, Ohio.
INDEBTEDNESS: Indebtedness is any amount you owe us as a result of a policy
loan. Indebtedness consists of principal amount plus accrued
interest.
INITIAL The Initial Investment Date is the later of the Policy Date or
INVESTMENT the date we receive the Initial Premium at our Home Office.
DATE:
INITIAL The Initial Premium is the premium required for coverage to
PREMIUM: become effective on the Policy Date. It is shown on the Policy
Data Page.
INSURED: The Insured is the person whose life is covered by this
insurance Policy and is named in the application.
MATURITY DATE: The Maturity Date is the Policy Anniversary on or next
following the Insured's 100th birthday.
MATURITY Maturity Proceeds are the amount of money payable to you on the
PROCEEDS: Maturity Date if your Policy is still in force. The Maturity
Proceeds will be equal to the amount of the Cash Value, less any
Indebtedness.
4
<PAGE> 4
MONTHLY The Monthly Anniversary Day is the same day as the Policy Date
ANNIVERSARY for each succeeding month.
DAY:
NET The Net Premium is equal to the actual premium minus the percent
PREMIUM: of premium charge. The percent of premium charge is shown on the
Policy Data Page. The Company may at its sole discretion apply a
lower percent of premium charge.
OWNER: The Owner has all rights under this Policy and is named in the
application unless later changed and endorsed on this Policy.
"You" or "your" refer to the Owner of this Policy.
POLICY The Policy Anniversary is the same day and month as the Policy
ANNIVERSARY: Date for each succeeding year.
POLICY DATE: The Policy Date is the date the provisions of this Policy take
effect. It is shown on the Policy Data Page. Policy years and
policy months are measured from the Policy Date.
POLICY LOAN The Policy Loan Account is that portion of the Contract
ACCOUNT: Value which results from policy loans.
PROCEEDS: The Proceeds are the amount payable on the Maturity Date, on the
surrender of this Policy prior to the Maturity Date, or on the
death of the Insured while this Policy is in force.
SEC: SEC is the Securities and Exchange Commission.
SPECIFIED The Specified Amount is a dollar amount used to determine the
AMOUNT: death benefit of your Policy. It is shown on the Policy Data
Page.
SUBACCOUNT: A Subaccount is a part of a Variable Account. The assets in each
Subaccount are invested exclusively in a specified Fund. The
Subaccounts are listed on the Policy Data Page.
VARIABLE One or more Variable Accounts are named on the Policy Data Page.
ACCOUNT: Each is a separate investment account of the Company.
VALUATION DAY: A Valuation Day is each day that the New York Stock
Exchange and the Company's home office are open for business or
any other day during which there is sufficient trading that the
net asset value of the Accumulation Units might be materially
affected.
VALUATION A Valuation Period is the period commencing at the close of
PERIOD: business on a Valuation Day and ending at the close of business
on the next Valuation Day.
GENERAL POLICY PROVISIONS
ENTIRE The entire contract consists of this Policy, any attached riders
CONTRACT: or endorsements, and the attached copy of any written
application, including any written supplemental applications. No
agent, registered representative, or other person may change
this Policy or waive any of its provisions. Any agreement to
alter this Policy must be in writing, signed by our President or
Secretary and attached to or endorsed on your Policy. We will
not be bound by any promise or representation made by any agent
or other person.
APPLICATION: All statements made in an application are considered
representations and not warranties. In issuing this Policy, we
have relied on the statements made in any application to be true
and complete. No such statement will be used to void the Policy
or to deny a claim unless that statement is a material
misrepresentation.
5
<PAGE> 5
INCONTEST- We will not contest payment of the Death Proceeds based on
ABILITY: the initial Specified Amount after this Policy has been in force
during the Insured's lifetime for 2 years from the Policy Date.
For any increase in Specified Amount requiring evidence of
insurability, we will not contest payment of the Death Proceeds
based on such an increase after it has been in force during the
Insured's lifetime for 2 years from its effective date.
SUICIDE: If the Insured commits suicide, while sane or insane, within 2
years from the Policy Date, we will not pay the Death Proceeds
normally payable on the Insured's death. Instead, we will pay
the Beneficiary an amount equal to all premiums paid prior to
the Insured's death, less any Indebtedness, and less any partial
surrenders.
For any increase in Specified Amount requiring evidence of
insurability, if the Insured commits suicide, while sane or
insane, within 2 years from the effective date of any such
increase, we will not pay the Death Proceeds associated with
such an increase. Instead, our liability with respect to such an
increase will be limited to its cost.
ERROR IN AGE: If the age of the Insured has been misstated, the
affected benefits will be adjusted. The amount of the adjusted
death benefit will be (1), multiplied by (2) and then the result
added to (3), where:
1. is the amount of the death benefit at the time of the
Insured's death reduced by the amount of the Cash Value at
the time of the Insured's death;
2. is the ratio of the monthly cost of insurance applied in the
policy month of death and the monthly cost of insurance that
should have been applied at the true age and sex in the
policy month of death; and
3. is the Cash Value at the time of the Insured's death.
PAYMENT Unless an optional mode of settlement is elected, the Death
OF PROCEEDS: Proceeds will be paid in one sum to the Beneficiary. Unless an
optional mode of settlement is elected, any Proceeds payable on
the Maturity Date or upon surrender of this Policy will be paid
in one sum to you.
POSTPONEMENT We will normally pay any amount payable on surrender or policy
OF PAYMENTS: loan within seven days after we receive your written request. We
will normally pay any Death Proceeds within seven days after we
receive proof of death and any other information we may
reasonably require to pay a claim.
However, such payments may be postponed if:
1. the New York Stock Exchange is closed (except for customary
holiday closings);
2. the SEC requires trading be restricted or declares an
emergency; or
3. the SEC lets us defer payments for the protection of our
Policy Owners.
EFFECTIVE DATE The effective date of coverage of any person insured under
OF COVERAGE: your Policy is as follows:
1. the Policy Date is the effective date for all coverage
provided in the original application;
2. for any increase or addition to coverage, the effective date
will be the Monthly Anniversary Day on or next following the
date we approve the supplemental application; and
3. for any insurance that has been reinstated, the effective
date is the Monthly Anniversary Day on or next following
the date we approve the application for reinstatement.
TERMINATION: All coverage under your Policy will terminate when any one of
the following events occurs:
1. you request in writing that the coverage terminate;
2. the Insured dies;
3. the Policy matures; or
4. the Grace Period ends.
6
<PAGE> 6
ANNUAL REPORT: We will send you a report at least once a year, which
shows the current Cash Value, Cash Surrender Value, amount of
insurance, premiums paid, all charges since the last report and
outstanding policy loans. The report will also include any other
information required by laws and regulations, both federal and
state. We will mail this report to you at your last known
address.
NONPARTICI- This is a nonparticipating Policy on which no dividends are
PATION: payable. Your Policy will not share in our profits or surplus
earnings.
ILLUSTRATION We will provide a projection of illustrative future benefits
OF BENEFITS and values under this Policy at any time. Your written request
AND VALUES: and payment of a service fee set by us at the time of the
request will be required.
OWNER, BENEFICIARY AND ASSIGNMENT PROVISIONS
OWNERSHIP: While the Insured is living, all rights in your Policy belong to
you. Your rights in your Policy belong to your estate if you die
before the Insured dies and there is no Contingent Owner.
You may name a Contingent Owner or a new Owner at any time while
the Insured is living. If a new Owner is named, any earlier
designation is automatically revoked. Any change must be in a
written form satisfactory to us and recorded at our Home Office.
Once recorded, the change will take effect as of the date you
signed it. It will not affect any payment made or any action
taken by us before it was recorded. We may require that you send
us your Policy for endorsement before making a change.
BENEFICIARY: The Beneficiary and Contingent Beneficiary on the Policy Date
are named in the application. More than one Beneficiary or
Contingent Beneficiary may be named. If more than one
Beneficiary is alive when the Insured dies, we will pay them in
equal shares, unless you have provided otherwise.
If any Beneficiary dies before the Insured, that Beneficiary's
interest will be paid to any surviving Beneficiaries or
Contingent Beneficiaries according to their respective
interests, unless you have provided otherwise. If no Beneficiary
is living at the Insured's death, we will consider you or your
estate to be the Beneficiary.
While the Insured is living, you may change any Beneficiary or
Contingent Beneficiary. Any change must be in a written form
satisfactory to us and recorded at our Home Office. Once
recorded, the change will take effect as of the date you signed
it. It will not affect any payment made or action taken by us
before it was recorded. We may require that you send us your
Policy for endorsement before making a change.
ASSIGNMENT: While the Insured is living, you may assign any or all rights
under your Policy. We will not be bound by any assignment unless
it is in a written form acceptable to us and is recorded at our
Home Office. An assignment will not affect any payments made or
actions taken by us before we record it. We will not be
responsible for the sufficiency or validity of any assignment.
The assignment will be subject to any Indebtedness owed to us
before it was recorded. The interest of any Beneficiary will be
subject to the rights of any assignee of record at our Home
Office.
7
<PAGE> 7
PREMIUM PROVISIONS
PREMIUM The Initial Premium is due on the Policy Date. It will
PAYMENTS: be credited on the Initial Investment Date. Any due and unpaid
monthly deductions will be subtracted from the Contract Value at
this time. Insurance will not be effective until the Initial
Premium is paid. The Initial Premium is shown on the Policy Data
Page.
Premiums, other than the Initial Premium may be made at any
time while your Policy is in force subject to the limits
described below.
We will send Planned Premium payment reminder notices to you.
We will send them according to the premium mode shown on the
Policy Data Page.
You may pay the Initial Premium to us at our Home Office or to
an authorized agent. All premiums after the first are payable
at our Home Office. Premium receipts will be furnished upon
request.
LIMITS: We reserve the right to require satisfactory evidence of
insurability before accepting any additional premium payment
which results in any increase in the net amount at risk. Also,
we will refund any portion of any premium payment which is
determined to be in excess of the premium limit established by
law to qualify your Policy as a contract for life insurance. We
may also require that any existing Policy Indebtedness is
repaid prior to accepting any additional premium payments.
GRACE PERIOD PROVISIONS
GRACE PERIOD: If the Surrender Value on a Monthly Anniversary Day is
not sufficient to cover the current monthly deduction, a Grace
Period of 61 days from the Monthly Anniversary Day will be
allowed for the payment of sufficient premium to cover the
current monthly deduction plus an amount equal to 3 times the
current monthly deduction.
We will send you a notice at the start of the Grace Period at
your last known address stating the amount of premium required.
The Grace Period will end 61 days after we mail you the notice.
If this amount is not paid by the end of the Grace Period, the
policy will terminate without value. If the Insured dies during
the Grace Period, we will pay the Death Proceeds.
REINSTATEMENT: If the Grace Period has ended and you have not paid the
required premium and have not surrendered your Policy for its
Surrender Value, you may reinstate your Policy if you:
1. submit a written request at any time within 3 years after the
end of the Grace Period and prior to the Maturity Date;
2. provide evidence of insurability satisfactory to us;
3. pay sufficient premium to cover all monthly deductions that
were due and unpaid during the Grace Period;
4. pay sufficient premium to keep the Policy in force for 3
months from the date of reinstatement; and
5. pay or reinstate any Indebtedness against the Policy which
existed at the end of the Grace Period.
The effective date of a reinstated Policy will be the Monthly
Anniversary Day on or next following the date the application
for reinstatement is approved by us.
If your Policy is reinstated, the Cash Value on the date of
reinstatement, but prior to applying any premiums received, will
be set equal to the Cash Value at the end of the Grace Period;
Unless you have provided otherwise, all amounts will be
allocated based on the Fund allocation factors in effect at the
start of the Grace Period.
8
<PAGE> 8
DEATH BENEFIT PROVISIONS
DEATH BENEFIT: If the Insured dies while the Policy is in force, your
Policy will provide a death benefit. The death benefit will be
determined in accordance with one of the following options,
whichever is in effect on the date of the Insured's death. The
current option in effect is shown on the Policy Data Page.
Option 1 The death benefit will be the greater of:
1. the Specified Amount on the date of death; or
2. the applicable percentage of the Contract Value on the date
of death.
Option 2 The death benefit will be the greater of:
1. the Specified Amount plus the Contract Value on the date of
death; or
2. the applicable percentage of the Contract Value on the date
of death.
The table below gives the "Applicable Percentage" for each
Attained Age.
<TABLE>
APPLICABLE PERCENTAGE OF CONTRACT VALUE TABLE
<CAPTION>
----------- -------------------- ----------- -------------------- ------------ --------------------
Attained Percentage of Attained Percentage of Attained Percentage of
Age Contract Value Age Contract Value Age Contract Value
----------- -------------------- ----------- -------------------- ------------ --------------------
<S> <C> <C> <C> <C> <C>
0-40 250% 60 130% 80 105%
41 243% 61 128% 81 105%
42 236% 62 126% 82 105%
43 229% 63 124% 83 105%
44 222% 64 122% 84 105%
45 215% 65 120% 85 105%
46 209% 66 119% 86 105%
47 203% 67 118% 87 105%
48 197% 68 117% 88 105%
49 191% 69 116% 89 105%
50 185% 70 115% 90 105%
51 178% 71 113% 91 104%
52 171% 72 111% 92 103%
53 164% 73 109% 93 102%
54 157% 74 107% 94 101%
55 150% 75 105% 95 101%
56 146% 76 105% 96 101%
57 142% 77 105% 97 101%
58 138% 78 105% 98 101%
59 134% 79 105% 99 101%
100 100%
----------- -------------------- ----------- -------------------- ------------ --------------------
</TABLE>
DEATH The actual amount of money payable to the Beneficiary if the
PROCEEDS: Insured dies while your Policy is in force is called the Death
Proceeds. The Death Proceeds equals:
1. the death benefit provided by your Policy; plus
2. any insurance on the Insured's life that may be provided by
riders to your Policy; minus
3. any Indebtedness; and minus
4. any due and unpaid monthly deductions accruing during a Grace
Period.
9
<PAGE> 9
We will pay the Death Proceeds to the Beneficiary after we
receive at our Home Office proof of death satisfactory to us
and such other information as we may reasonably require. The
Death Proceeds will be adjusted under certain conditions.
Refer to the Incontestability, Suicide, and Error in Age
Provisions.
DEATH BENEFIT After the first Policy year, you may change the death
OPTION benefit option under your Policy. If the change is from Option 1
CHANGES: to Option 2, the Specified Amount will be decreased by the
amount of the Cash Value. If the change is from Option 2 to
Option 1, the Specified Amount will be increased by the amount
of the Cash Value. We reserve the right to require evidence of
insurability for a change from Option 2 to Option 1. The
effective date of change will be the Monthly Anniversary Day on
or next following the date we approve the request for change.
Only one change of option is permitted in a policy year. We will
refuse a death benefit option change which would reduce the
Specified Amount to a level where the total premiums already
paid to date exceed the premium limit established by law to
qualify your Policy as a contract for life insurance. In order
for a death benefit option change to become effective, the Cash
Surrender Value, after the change, must be sufficient to keep
the Policy in force for at least 3 months.
SPECIFIED At any time after the first policy year, you may request an
AMOUNT increase in Specified Amount. Your request must be in writing to
INCREASES: our Home Office on our official forms. Any increase shall be
subject to the following conditions:
1. you must provide evidence of insurability satisfactory to us;
and
2. the Cash Surrender Value is sufficient to keep this Policy in
force for at least 3 months.
An approved increase will have an effective date of the Monthly
Anniversary Day on or next following the date we approve the
supplemental application. We reserve the right to limit the
number of increases in Specified Amount to one each policy year.
SPECIFIED At any time after the first policy year, you may request a
AMOUNT decrease in the Specified Amount. Any decrease will be
DECREASES: effective on the Monthly Anniversary Day on or next following
our receipt of your request. Any such decrease shall reduce
insurance in the following order:
1. against insurance provided by the most recent increase;
2. against the next most recent increases successively; and
3. against insurance provided under the original application.
We reserve the right to limit the number of decreases in the
Specified Amount to one each policy year. We will refuse a
request for a decrease which would:
1. reduce the Specified Amount to less than $50,000; or
2. disqualify this Policy as a contract for life insurance.
NONFORFEITURE PROVISIONS
CASH VALUE: The Cash Value of your Policy is the sum of the Cash
Value in each Subaccount and the Policy Loan Account. The Cash
Value in each Subaccount on the Initial Investment Date is equal
to the portion of the Net Premium allocated to the Subaccount
minus a pro-rata monthly deduction for the month following the
Policy Date.
The Cash Value in each Subaccount on each subsequent Valuation
Day is equal to (1) plus (2) plus (3) minus (4) minus (5) minus
(6) where:
1. is the Cash Value in the Subaccount on the preceding
Valuation Day multiplied by its net investment factor for the
current Valuation Period;
2. is any Net Premiums or other amounts allocated to the
Subaccount during the current Valuation Period;
3. is any amounts transferred to the Subaccount during the
current Valuation Period;
4. is any amounts transferred from the Subaccount during the
current Valuation Period;
5. is the portion of any monthly deductions which are due and
charged to the Subaccount during the current Valuation
Period; and
10
<PAGE> 10
6. is any partial surrender amounts allocated to the Subaccount
during the current Valuation Period.
The Cash Value in the Policy Loan Account is zero, unless you
take a policy loan. If you take a policy loan, then the Cash
Value in the Policy Loan Account on the loan date is equal to
the amount of the loan. The loan amount is transferred from a
Variable Account in proportion to the Cash Value in each
Subaccount on the date of the loan.
The Cash Value in the Policy Loan Account on each subsequent
Valuation Day is equal to (1) plus (2) plus (3) plus (4)
minus (5) minus (6) where:
1. is the Cash Value in the Policy Loan Account on the preceding
Valuation Day;
2. is guaranteed interest credited at an annual effective rate
of 4% during the current Valuation Period;
3. is any excess interest that is credited during the current
Valuation Period;
4. is any amounts transferred to the Policy Loan Account because
of additional policy loans and any due and unpaid loan
interest during the current Valuation Period;
5. is the amount of any loan repayments you make during the
current Valuation Period; and
6. is any amount of interest transferred from the Policy Loan
Account to a Variable Account during the current Valuation
Period.
MONTHLY The monthly deduction for each policy month shall be calculated
DEDUCTION: as:
1. the monthly cost of insurance; plus
2. the monthly cost of any additional benefits provided by
Riders; plus
3. the monthly expense charge. This charge will not exceed the
maximum monthly policy expense charge shown on the Policy
Data Page.
The monthly deduction will be charged proportionately to the
Cash Values in each Subaccount.
MONTHLY COST A deduction will be made on the Policy Date and each
OF INSURANCE Monthly Anniversary Day for the monthly cost of insurance. This
monthly deduction will be charged proportionately to the
Contract Values in each Subaccount. The monthly cost of
insurance for each policy month is determined by multiplying the
monthly cost of insurance rate by the net amount at risk. Net
amount at risk is the difference between the death benefit and
the Cash Value, each calculated at the beginning of the policy
month. The monthly cost of insurance rate is described under the
Cost of Insurance Rates Provision.
If the death benefit Option 1 is in effect, and there have been
increases in the Specified Amount, then the Cash Value shall be
first considered a part of the initial Specified Amount. If the
Cash Value exceeds the initial Specified Amount, it shall then
be considered a part of additional increases in Specified
Amounts resulting from increases in the order of the increases.
COST OF A separate monthly cost of insurance rate is used to
INSURANCE obtain the monthly cost of insurance for the Insured's initial
RATES: Specified Amount and each increase in Specified Amount. Each
rate is based on the Insured's sex and Attained Age. Each rate
is also based on the Insured's rate class at the time the
initial Specified Amount or increase took effect.
Monthly cost of insurance rates will be determined by us from
time to time, based on our expectations as to future experience.
Any change in cost of insurance rates will be on a uniform basis
for insureds of the same sex, Attained Age, rate class and rate
type whose policies have been in force for the same length of
time. These rates will never be greater than the Guaranteed
Maximum Monthly Cost of Insurance Rates shown on the Policy Data
Page. The basis for these guaranteed maximum cost of insurance
rates is shown in the Basis of Computation on the Policy Data
Pages.
INTEREST Any Cash Value allocated to the Policy Loan Account will be
CREDITING: credited interest daily. The guaranteed minimum annual effective
rate is 4%. Interest in excess of the minimum guaranteed rate
may be used.
11
<PAGE> 11
MINIMUM LEGAL The cash surrender, loan and other values in your Policy
VALUES: are at least as large as those set by law in the state where it
is delivered. Where required, we have given the insurance
regulator a detailed statement of how we compute values and
benefits.
CONTINUATION If the premium payments are not made, insurance coverage under
OF INSURANCE: this Policy and any benefits provided by Rider will be continued
in force. Such coverage will be continued as provided in the
Grace Period Provision. This provision will not continue the
Policy beyond the Maturity Date nor continue any Rider beyond
the date for its termination, as provided in the Rider.
COMPLETE Your Policy may be surrendered for its Cash Surrender Value at
SURRENDER: any time while it is in force. You must submit a written request
on a form acceptable to us. We may also require the return of
your Policy. The date of surrender will be the date we receive
your written request at our Home Office. The Cash Surrender
Value will be determined as of the end of the Valuation Period
during which your request is received. All coverage will end on
the date of surrender.
PARTIAL A partial surrender may be made at any time after the first
SURRENDER: policy year while this Policy is in force. You must submit a
written request. We may also require that this Policy be sent to
us. We reserve the right to deduct a fee from the partial
surrender amount. The maximum fee is shown on the Policy Data
Page.
When a partial surrender is made, we will reduce the Cash Value
by the partial surrender amount. We will also reduce the
Specified Amount by the amount of the partial surrender if death
benefit Option 1 is in effect. Any such decrease will reduce
insurance in the following order:
1. against the insurance provided by the most recent increase;
2. against the next most recent increase successively; and
3. against the insurance under the original application.
The amount of any partial surrender is subject to the following
conditions:
1. the minimum amount of a partial surrender must be at least
$500;
2. the maximum amount of a partial surrender is the Cash
Surrender Value less the greater of $500 and three monthly
deductions; and
3. a partial surrender may not reduce the Specified Amount to
less than $50,000.
In addition, the partial surrender will be allowed only if after
the surrender, this Policy continues to qualify as a contract
for life insurance. We reserve the right to limit the number of
partial surrenders in a policy year.
LOAN PROVISIONS
POLICY LOAN: After the first policy year, you may request a loan at any
time while your Policy is in force. The loan must be requested
in writing on a form acceptable to us. The amount of the loan
and all existing Indebtedness may not be more than the
maximum loan value as of the loan date. The loan date is the
date we process the loan. The minimum loan amount is $200.
The loan will be made upon the sole security of the Policy
and proper assignment of your Policy to us.
MAXIMUM LOAN The maximum loan value is equal to 90% of the Cash
VALUE: Surrender Value on the loan date.
LOAN The loan interest rate is 6% per year. Interest is
INTEREST: charged daily and payable at the end of each policy year. Unpaid
interest will be added to the existing Indebtedness as of the
due date and will be charged interest at the same rate as the
rest of the loan.
12
<PAGE> 12
LOAN All or part of a loan may be repaid to us at any time while your
REPAYMENT: Policy is in force during the Insured's lifetime. Any payment
intended as a loan repayment, rather than a premium payment,
must be identified as such.
Any Indebtedness that exists at the end of the Grace Period may
not be repaid unless this Policy is reinstated.
TERMINATION If the total Indebtedness ever equals or exceeds the Cash
OF POLICY: Value, your Policy will terminate without value, as described in
the Grace Period Provision.
EFFECT OF When you take a loan, we will transfer an amount equal
LOAN: to the policy loan from a Variable Subaccount to the Policy
Loan Account. Any loan interest that becomes due and unpaid
will also be so transferred. Amounts transferred to the
Policy Loan Account will earn interest daily from the date of
transfer. When you repay part or all of a loan, we will
transfer an amount equal to the amount you repay from the
Policy Loan Account to a Subaccount.
Unless otherwise specified, we will allocate loans among the
Subaccounts in proportion to the Cash Value in each Subaccount
as of the loan date. Any loan interest which becomes due and is
unpaid will be transferred to the Policy Loan Account in
proportion to the Cash Values in each Subaccount. Unless
specified, loan repayments will be allocated among the
Subaccounts using the Fund allocation factors in effect on the
date of the repayment subject to any other restrictions the
Company may impose.
Since the amount you borrow is removed from a Variable
Subaccount, a loan will have a permanent effect on any death
benefit and Surrender Value of this Policy. The effect may be
favorable or unfavorable. This is true whether you repay the
loan or not. If not repaid, Indebtedness will reduce the amount
of any Death Proceeds or Maturity Proceeds.
EXCHANGE OF POLICY PROVISIONS
RIGHT OF Within 24 months from the Policy Date, you may exchange this
EXCHANGE: Policy for a new policy on the life of the Insured. We will not
require evidence of insurability for this exchange. New policy
means the policy for which this Policy may be exchanged. The new
policy will not be affected by the investment experience of any
separate investment account.
CONDITIONS: Your right to make this exchange is subject to the following
conditions:
1. You must ask for the exchange in writing to our Home Office
on our official forms.
2. You must surrender this Policy to us.
3. We must have your written request and this Policy at our Home
Office while this Policy is in force and not in its Grace
Period.
4. You must pay us any money due on the exchange.
EXCHANGE The exchange date will be the later of:
DATE:
1. the date we receive this Policy and your written request at
our Home Office; or
2. the date we receive at our Home Office any sum due to be paid
for such an exchange.
The new policy will take effect on the exchange date only if the
Insured is then living. This Policy will terminate when the new
policy takes effect.
NEW POLICY: The new policy may be a Flexible Premium Adjustable Life
Policy offered by us on the Policy Date. The new policy will
have a death benefit on the exchange date not more than the
death benefit of this Policy immediately prior to the exchange
date. The new policy will have the same Policy Date and Issue
Age as this Policy. The initial Specified Amount and any
increase in Specified Amount will have the same rate class as
the one in this Policy. Any Indebtedness may be transferred to
the new policy.
13
<PAGE> 13
EXCHANGE AT After 24 months from the Policy Date, you may exchange this
OTHER TIMES: Policy for a new policy, subject to our approval. You must
furnish any evidence of insurability we require and pay all
costs associated with the exchange.
VALUATION OF ASSETS IN A VARIABLE ACCOUNT
DETERMINING The Cash Value will change with a change in the investment
INVESTMENT results of the Subaccounts. We use an index to measure changes
RESULTS: in a Subaccount's investment experience. This index is called an
accumulation unit value. Each Subaccount has its own
accumulation unit value.
For each Subaccount, the accumulation unit value was initially
set at $10.00. The accumulation unit value for a Subaccount in
each subsequent Valuation Period is equal to (1), multiplied by
(2), where:
1. is the Subaccount's accumulation unit value for the preceding
Valuation Period; and
2. is the Subaccount's net investment factor for the subsequent
Valuation Period.
A net investment factor is defined below.
Because the net investment factor may be greater than or less
than one, the accumulation unit value may increase or decrease
from one Valuation Period to the next; however, the accumulation
unit value remains constant throughout a Valuation Period.
NET The net investment factor for a Subaccount for a
INVESTMENT Valuation Period is obtained by dividing (1) by (2), where:
FACTOR:
1. is the net of:
(a) the net asset value per share of the Fund held in the
Subaccount at the end of the current Valuation Period;
plus
(b) the per share amount of any dividend and capital gains
distributions made by the Fund 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 taxes reserved for, if
any, which is determined by the Company to have resulted
from the investment operations of the Subaccount.
2. is the net of:
(a) the net asset value per share of the Fund held in the
Subaccount determined as of the end of the immediately
preceding Valuation Period; plus or minus
(b) the per share charge or credit for taxes reserved for in
the immediately preceding Valuation Period.
VARIABLE ACCOUNT PROVISIONS
VARIABLE A Variable Account is a separate investment account of the
ACCOUNT: Company. One or more are named on the Policy Data Page. A
Variable Account is also subject to the laws of Ohio.
We own the assets of any Variable Account; we keep them separate
from the assets of our General Account. We maintain assets which
are at least equal to the reserves and other liabilities of a
Variable Account. Such assets will not be charged with
liabilities that arise from any other business we conduct. We
may transfer to our General Account assets which exceed the
reserves and other liabilities of a Variable Account.
We will determine the value of the assets in a Variable Account
at the end of each Valuation Day.
SUBACCOUNTS: A Variable Account may have several Subaccounts. We list them on
the Policy Data Page. You determine, using Fund allocation
factors, how Net Premiums will be allocated among the
Subaccounts. You may choose to allocate nothing to a particular
Subaccount. But any
14
<PAGE> 14
allocation you make must be at least 10%; you may not choose a
fractional percent. The sum of the Fund allocation factors must
equal 100%.
During the "Right to Examine Policy" period, Net Premiums will
be allocated to the Subaccount that invests in a money market
Fund. At the end of this period, the Cash Value in that
Subaccount will be transferred to the Variable Subaccounts
according to your chosen Fund allocation factors. Also, any
subsequent Net Premiums will be allocated according to your
chosen factors. Fund allocation factors during and immediately
after the "Right to Examine Policy" period, are shown on the
Policy Data Page. After the "Right to Examine Policy" period has
expired, you may transfer amounts among the Subaccounts.
Transfers will take effect on the date your written request is
received at our Home Office, subject to any restrictions imposed
by a Fund.
You may change the allocation for future Net Premiums at any
time while your Policy is in force. To do so, you must notify us
in writing in a form that meets our approval. The change will
take effect on the date we receive your written request at our
Home Office.
Income and realized and unrealized gains and losses from assets
in each Subaccount are credited to, or charged against, the
Subaccount. This is without regard to income, gains, or losses
in our other Subaccounts, separate investment accounts, or our
General Account.
CHANGES A Fund might, in our judgment, become unsuitable for
OF FUND: investment by a Subaccount. This might happen because of a
change in investment policy, a change in the laws or
regulations, the shares are no longer available for investment,
or for some other reason. If that occurs, we have the right to
substitute another Fund. But we would first notify you and seek
approval from the SEC and the Superintendent of Insurance of the
State of Ohio. We would also get any other required approvals.
OTHER To the extent permitted by applicable laws and
CHANGES: regulations (including any order of the SEC), we may make
changes as follows:
1. A Variable Account may be operated as a management company
under the Investment Company Act of 1940, or in any other
form permitted by law, if we deem it to be in the best
interest of the Policy Owners.
2. A Variable Account may be deregistered under the Investment
Company Act of 1940 in the event registration is no longer
required.
3. A Variable Account may be combined with other separate
investment accounts.
4. The provisions of this and other policies may be modified to
comply with any other applicable federal or state laws.
In the event of such changes, we may make appropriate
endorsement on this and other policies having an interest in a
Variable Account and take other actions as may be necessary to
effect such a change.
OPTIONAL MODES OF SETTLEMENT PROVISIONS
Proceeds may be paid in a lump sum. Optional modes of settlement are also
available. After the Proceeds are applied under such optional modes, any amounts
payable are paid from our General Account and will not be affected by the
investment experience of any separate investment account.
One or a combination of settlement options may be chosen. A settlement option
may be chosen only if the total amount placed under the option is at least
$2,000.00 and each payment is at least $20.00.
A settlement option election may be changed at any time by proper written
request to our Home Office. Once recorded, it will become effective on the date
it was requested. We may require proof of the age and sex of any person to be
paid under a settlement option. While this Policy is in force, you may choose or
change settlement options at any time. If no settlement option has been chosen
prior to the Insured's death, the Beneficiary may choose one. A change of
Beneficiary automatically revokes any option in effect.
When Proceeds become payable under any option, a Settlement Contract is issued
in exchange for this Policy. The new contract's effective date is the date of
the Insured's death or the date this Policy is surrendered.
15
<PAGE> 15
Settlement option payments are not assignable. To the extent allowed by law,
settlement option payments are not subject to the claims of creditors or to
legal process.
Under Options 2, 3, 4, and 5, payments will be made at the beginning of each 12,
6, 3, or 1 month interval beginning on the effective date of the Settlement
Contract. Under Option 1 and 6, payments will be made at the end of every 12, 6,
3, or 1 month interval from the Settlement Contract's effective date.
Under Options 1, 2, and 4, withdrawal of any outstanding balance may be made by
written request to our Home Office. No amount left with us under Options 3, 5,
or 6 may be withdrawn.
Options 1, 2, 4, and the guaranteed period of Option 3, provide for payment of
interest at a guaranteed minimum interest rate of 21/2% per year, compounded
annually. Any interest to be paid in excess of this rate will be determined once
a year.
OPTION 1: The Proceeds remain with us to earn interest. This interest
INTEREST INCOME may be left to accumulate or be paid periodically as stated
above.
OPTION 2: Proceeds remaining with us will be paid over a
INCOME FOR A specified number of years (not exceeding 30 years). Each
FIXED PERIOD payment consists of a portion of the Proceeds plus a portion
of the interest credited on the outstanding balance. The
amount payable monthly for each $1,000 left with us will be at
least the amount shown in the Option 2 Table.
OPTION 3: Payments are made for a guaranteed period of 10, 15,
LIFE INCOME or 20 years, and thereafter for the remainder of a payee's
WITH PAYMENTS lifetime. The amount payable monthly for each $1,000 left with
GUARANTEED us is shown in the Option 3 Table, according to the payee's
sex and age on the effective date of the option.
OPTION 4: The Proceeds may be left on deposit with us at
FIXED INCOME FOR interest with payments of a fixed amount being paid at
VARYING PERIODS specified intervals until principal and interest have been
exhausted. The last payment will be for the balance only. The
total amount payable each year may not be less than 5% of the
original proceeds. (i.e., not less than $50 per annum of each
$1,000 of original proceeds.)
OPTION 5: Equal payments will be made for the longer of the lives of
JOINT AND two named payees. In other words, when one payee dies, the
SURVIVOR LIFE same payment continues to be paid for the remainder of the
INCOME surviving payee's life. We will furnish values for other age
combinations (than those shown in Option 5 Table) upon
request.
OPTION 6: We will use the Proceeds to purchase an annuity. The amount
ALTERNATE LIFE payable will be 102% of our current individual immediate
INCOME annuity purchase rate on the effective date of the Settlement
Contract. We reserve the right to change our current annuity
rates at any time. However, once this option has been selected
and the Settlement Contract issued, any revision in rates will
not affect payment to a payee or payees. Upon request, we will
quote the amount currently payable under this settlement
option.
16
<PAGE> 16
<TABLE>
TABLES FOR SETTLEMENT OPTIONS
Monthly Installments for each $1,000 of Proceeds
<CAPTION>
OPTION 2 Option 2 - Income for a Fixed Period
-------------------------- --------------------------- --------------------------- ---------------------------
Number of Years Specified Amount of Each Installment Number of Years Specified Amount of Each Installment
-------------------------- --------------------------- --------------------------- ---------------------------
<S> <C> <C> <C>
1 $84.28 16 $6.30
2 42.66 17 6.00
3 28.79 18 5.73
4 21.86 19 5.49
5 17.70 20 5.27
6 14.93 21 5.08
7 12.95 22 4.90
8 11.47 23 4.74
9 10.32 24 4.60
10 9.39 25 4.46
11 8.64 26 4.34
12 8.02 27 4.22
13 7.49 28 4.12
14 7.03 29 4.02
15 6.64 30 3.93
-------------------------- --------------------------- --------------------------- ---------------------------
--------------------------------------------------------------------------------------------------------------
Annual, semi-annual or quarterly payments are 11.865, 5.969 and 2.994 respectively times the monthly
installments.
------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
OPTION 3 Monthly Installments for each $1,000 of Proceeds
Option 3 - Life Income with Payments Guaranteed
---------------------------------------------------------------------------------------------------------------
GUARANTEED PERIOD GUARANTEED PERIOD GUARANTEED PERIOD
AGE OF PAYEE -------------------- AGE OF PAYEE ------------------- AGE OF PAYEE -------------------
LAST BIRTHDAY YEARS LAST BIRTHDAY YEARS LAST BIRTHDAY YEARS
---------------------------------------------------------------------------------------------------------------
MALE FEMALE 10 15 20 MALE FEMALE 10 15 20 MALE FEMALE 10 15 20
----------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
5 & 10 &
Under Under 2.54 2.54 2.53 30 35 3.11 3.10 3.09 55 60 4.78 4.62 4.39
6 11 2.55 2.55 2.55 31 36 3.15 3.14 3.12 56 61 4.90 4.71 4.45
7 12 2.57 2.56 2.56 32 37 3.18 3.18 3.16 57 62 5.01 4.80 4.52
8 13 2.58 2.58 2.58 33 38 3.23 3.22 3.20 58 63 5.14 4.90 4.59
9 14 2.60 2.59 2.59 34 39 3.27 3.26 3.24 59 64 5.26 5.00 4.65
10 15 2.61 2.61 2.61 35 40 3.31 3.30 3.28 60 65 5.40 5.10 4.71
11 16 2.63 2.63 2.62 36 41 3.36 3.35 3.32 61 66 5.54 5.20 4.77
12 17 2.65 2.64 2.64 37 42 3.41 3.39 3.36 62 67 5.68 5.30 4.83
13 18 2.66 2.66 2.66 38 43 3.46 3.44 3.41 63 68 5.83 5.40 4.89
14 19 2.68 2.68 2.68 39 44 3.51 3.49 3.46 64 69 5.99 5.50 4.94
15 20 2.70 2.70 2.70 40 45 3.57 3.54 3.50 65 70 6.16 5.61 4.99
16 21 2.72 2.72 2.72 41 46 3.63 3.60 3.55 66 71 6.33 5.71 5.03
17 22 2.74 2.74 2.74 42 47 3.69 3.66 3.60 67 72 6.50 5.81 5.07
18 23 2.77 2.76 2.76 43 48 3.76 3.72 3.66 68 73 6.68 5.90 5.11
19 24 2.79 2.79 2.78 44 49 3.82 3.78 3.71 69 74 6.86 5.99 5.14
20 25 2.81 2.81 2.80 45 50 3.89 3.84 3.77 70 75 7.05 6.08 5.17
21 26 2.84 2.83 2.83 46 51 3.97 3.91 3.82 71 76 7.23 6.16 5.19
22 27 2.86 2.86 2.85 47 52 4.04 3.98 3.88 72 77 7.42 6.24 5.21
23 28 2.89 2.88 2.88 48 53 4.12 4.05 3.94 73 78 7.61 6.30 5.23
24 29 2.92 2.91 2.91 49 54 4.21 4.12 4.00 74 79 7.79 6.37 5.24
25 30 2.94 2.94 2.93 50 55 4.29 4.20 4.07 75 80 7.97 6.42 5.25
26 31 2.97 2.97 2.96 51 56 4.38 4.28 4.13 76 81 8.14 6.47 5.26
27 32 3.01 3.00 2.99 52 57 4.48 4.36 4.19 77 82 8.31 6.51 5.26
28 33 3.04 3.03 3.02 53 58 4.57 4.44 4.26 78 83 8.46 6.54 5.27
29 34 3.07 3.07 3.06 54 59 4.68 4.53 4.32 79 84 8.61 6.57 5.27
80 & 85 &
Over Over 8.74 6.59 5.27
---------------------------------------------------------------------------------------------------------------
If the income payable for a specific guaranteed period is
equal to that for other guarantee periods the longer period
will be deemed to have been elected.
---------------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Monthly Installments for each $1,000 of Proceeds
OPTION 5 Option 5 - Joint & Survivor Life Income
---------------------------------------------------------------------------------------------------------------
Male Female 50 55 60 65 70
---------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C>
50 3.53 3.71 3.86 4.00 4.11
55 3.62 3.86 4.09 4.30 4.48
60 3.70 4.00 4.30 4.60 4.89
65 3.77 4.11 4.48 4.89 5.30
70 3.83 4.20 4.63 5.13 5.70
---------------------------------------------------------------------------------------------------------------
</TABLE>
17
<PAGE> 17
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
ENDORSEMENTS (Endorsements may be made only by the Company at the Home Office)
<PAGE> 18
[NATIONWIDE LIFE AND ANNUITY INSURANCE COMOPANY LOGO]
NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY
FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE POLICY
-Adjustable Death Benefit -Flexible premiums payable during Insured's lifetime
until the Maturity Date
-Death Proceeds payable at Insured's death prior to the Maturity Date
-Maturity Proceeds payable on the Maturity Date
-Not eligible for dividends -Investment experience reflected in benefits
