IDS Life Insurance Company of New York
20 Madison Avenue Extension
P.O. Box 5144
Albany, New York 12205
Flexible Premium Variable Life Insurance Policy
- Adjustable death benefit payable at insured's death prior to the maturity
date at age 100 anniversary.
- Cash surrender value payable on the maturity date at age 100 anniversary.
- Flexible premiums payable during the lifetime of the insured until the
maturity date at age 100 anniversary.
- No-lapse guarantee as described herein.
- This policy is nonparticipating. Dividends are not payable.
Insured: John Doe
Policy Date: January 15, 1999
This is a life insurance policy. It is a legal contract between you, as the
owner, and us, IDS Life Insurance Company of New York, a Stock Company. PLEASE
READ YOUR POLICY CAREFULLY.
In consideration of your application and payment of the initial premium, we
issue this policy and we promise: to pay the proceeds described in this policy
to the beneficiary if we receive proof satisfactory to us that the insured died
while this policy was in force; or to pay the proceeds to you if, on the
maturity date, the insured is living and this policy is in force.
The owner and beneficiary are as named in the application unless they are
changed as provided in this policy.
The amount and duration of the death benefit of this policy may increase or
decrease as described herein depending on the investment experience of the
subaccounts.
A No-lapse guarantee is provided until 5 years from the policy date if minimum
monthly premiums are paid as defined in this policy.
The policy value of this policy may increase or decrease daily depending on
the investment experience of the subaccounts. There is no guaranteed minimum
policy value.
Policy Number: 9790-1234 567
Initial Specified Amount: $100,000
NOTICE OF YOUR RIGHT TO EXAMINE THIS POLICY FOR 10 DAYS. If for any reason you
are not satisfied with this policy, return it to us or our representative
within 10 days after you receive it. We will then cancel this policy and refund
all premiums which you have paid. This policy will then be considered void
from its start.
Signed for and issued by IDS Life Insurance Company of New York, in Albany, New
York, as of the policy date shown above.
President:
/s/ Timothy V. Bechtold
Secretary:
/s/ Eric L. Marhoun
<PAGE>
GUIDE TO POLICY PROVISIONS
Rate Table Tables of Guaranteed Maximum Monthly
Cost of Insurance Rates/Page 4,5
Definitions Important words and meanings/Page 6
Insurance Contract Entire contract; Incontestability;
Suicide provision; Misstatement of
age or sex; Termination/Page 7
Owner and Beneficiary Owner's rights; Successor owner; Change of
ownership; Beneficiary designation; Change of
beneficiary; Assignment/Page 9
Premiums Payment of premiums; Premium allocations;
Grace period; No-lapse guarantee; Reinstatement/Page 10
Death Benefits Death benefit options 1 and 2/Page 12
Policy Change How to increase or decrease the specified amount
or to change the death benefit options/Page 13
Policy Values The policy's value and how it is determined; Monthly
deduction; Cost of insurance; Basis of policy
values/Page 14
Policy Loans How to request a loan; Interest rate;
Amount of loan; Loan repayment/Page 17
Policy Surrender Cash surrender value; Full and partial
surrenders/Page 18
Subaccounts The subaccounts; Net investment factor; Deductions
from the subaccounts; Transfer of values/Page 19
Payment of Policy How the proceeds are paid; Payment options/Page 21
Proceeds
<PAGE>
<TABLE>
<CAPTION>
<S> <C> <C> <C>
Insured: John Doe Initial Specified Amount: $100,000
Issue Age: 35 Minimum Specified Policy year 1 - $100,000;
Amount Allowed: years 2-5 - $ 80,000;
Risk Classification: Standard Non-Smoker years 6-10 - $ 60,000;
years 11-15 - $ 40,000
Type of Policy: Flexible Premium thereafter - $ 1,000
Variable Life
Initial Death Initial Premium: $100.00
Benefit Option: Option 1
Scheduled Premium: $1,200.00 per year
payable monthly
Policy Number: 9790-01234567 Minimum Monthly
(no-lapse guarantee)
Policy Date: January 15, 1999 Premium: $88.19 per month
Maturity Date: January 15, 2064
Monthly Date: 15 Premium Expense Charge: 3.5% of premium
Guaranteed Interest Policy Fee: $5.00 per month
Rate: 4% per year
Guaranteed Interest
Rate Factor: 1.0032737 Partial Surrender Fee: $25.00 or 2% of amount
surrendered, whichever is less
Current Loan
Interest Rate: Current Mortality and
First 10 policy years: 6% per year Expense Risk Charge:
All other First 10 policy years: .9% per year
policy years: 4% per year All other policy years: .45% per year
Guaranteed Loan Guaranteed Mortality and
Interest Rate: 6% per year Expense Risk Charge:
All policy years: .9% per year
No-lapse guarantee
period: 5 years from the policy
date.
</TABLE>
Table of Surrender Charges
Policy Year Beginning of year End of year
1-5 $901.00 $901.00
6 901.00 720.80
7 720.80 540.60
8 540.60 360.40
9 360.40 180.20
10 180.20 0.00
This table applies to the initial specified amount for the first 10 policy
years. After year 5, surrender charges decrease monthly. Additional charges will
apply to each increase in the specified amount for 10 years after the effective
date of the increase.
The premium payments shown above may not be sufficient to continue the policy
and coverage in force to the maturity date. The period for which the policy and
coverage will continue in force will depend on: 1) the amount, timing, and
frequency of premium payment; 2) changes in the specified amount and the death
benefit options; 3) change in the interest rates credited to the fixed account
and in the investment performance of the subaccounts; 4) changes in the monthly
cost of insurance deductions from the policy value for this policy and any
benefits provided by riders to this policy; and 5) loan and partial surrender
activity.
Cost of insurance rates may be changed based on our expectations as to expense,
persistency and investment earnings experience. Any change will apply to all
individuals in the same risk class and will be in accordance with procedures and
standards on file with the Insurance Department. The Cost of Insurance rates
will never exceed the Guaranteed Maximum Monthly Cost of Insurance Rates shown
in this policy on pages 4 and 5.
Payments allocated to the fixed account will receive the rate in effect when the
payment is received in the IDS Life of New York Home Office. The interest rate
will never be less than the guaranteed interest rate of 4.0%. Any interest rates
for the fixed account in excess of the guaranteed rate are not guaranteed and
may change. Any change will be based on our expectations as to future interest
rates and will be in accordance with procedures and standards on file with the
Insurance Department.
Any change in interest rates and cost of insurance rates may require more
premium to be paid than was illustrated or the policy values may be less than
those illustrated.
The interest rate applied to the portion of the policy value which equals any
indebtedness due us will be the Guaranteed Interest Rate.
<PAGE>
<TABLE>
<CAPTION>
Investment Options Initial Premium Allocations
<S> <C>
IDS Life of New York Fixed Account 0.0%
IDS Life of New York Account 8
Subaccounts that invest in portfolios ("the Portfolios") of the
IDS Life Series Fund, Inc.:
FIX IDS Life Fixed Account 100.0%
YEQ IDS Life Series Fund, Inc. Equity Portfolio 0.0%
YIN IDS Life Series Fund, Inc. Income Portfolio 0.0%
YMM IDS Life Series Fund, Inc. Money Market Portfolio 0.0%
YMA IDS Life Series Fund, Inc. Managed Portfolio 0.0%
YGS IDS Life Series Fund, Inc. Government Securities Portfolio 0.0%
YIT IDS Life Series Fund, Inc. International Equity Portfolio 0.0%
YEI IDS Life Series Fund, Inc. Equity Income Portfolio 0.0%
YBC AXP(SM) VP Blue Chip Advantage Fund 0.0%
YBD AXP(SM) VP Bond Fund 0.0%
YCR AXP(SM) VP Capital Resource Fund 0.0%
YCM AXP(SM) VP Cash Management Fund 0.0%
YDE AXP(SM) VP Diversified Equity Income Fund 0.0%
YEM AXP(SM) VP Emerging Markets Fund 0.0%
YEX AXP(SM) VP Extra Income Fund 0.0%
YFI AXP(SM) VP Federal Income Fund 0.0%
YGB AXP(SM) VP Global Bond Fund 0.0%
YGR AXP(SM) VP Growth Fund 0.0%
YIE AXP(SM) VP International Fund 0.0%
YMF AXP(SM) VP Managed Fund 0.0%
YND AXP(SM) VP New Dimensions Fund 0.0%
YIV AXP(SM) VP S&P 500 Index Fund 0.0%
YSM AXP(SM) VP Small Cap Advantage Fund 0.0%
YSA AXP(SM) VP Strategy Aggressive Fund 0.0%
YGI AIM V.I. Growth and Income Fund 0.0%
YCA AIM V.I. Capital Appreciation Fund 0.0%
YCD AIM V.I. Capital Development Fund 0.0%
YIR American Century VP International Fund 0.0%
YVL American Century VP Value Fund 0.0%
YSB Calvert Variable Series Social Balanced Portfolio 0.0%
YGC Fidelity VIP III Growth & Income Portfolio: Service Class 0.0%
YMP Fidelity VIP III Mid Cap Portfolio: Service Class 0.0%
YOS Fidelity VIP Overseas Portfolio: Service Class 0.0%
YRE FTVIPT Franklin Real Estate Fund Class 2 0.0%
YSV FTVIPT Franklin Value Securities Fund Class 2 0.0%
YIF FTVIPT Templeton International Securities Fund Class 2 0.0%
YIS FTVIPT Templeton International Smaller Companies Fund Class 2 0.0%
YSE Goldman Sachs VIT Core(SM) Small Cap Equity Fund 0.0%
YUE Goldman Sachs VIT Core(SM) US Equity Fund 0.0%
YMC Goldman Sachs VIT Mid Cap Value Fund 0.0%
YAG Janus Aspen Series Aggressive Growth - Service Shares 0.0%
YGT Janus Aspen Series Global Technology - Service Shares 0.0%
YIG Janus Aspen Series International Growth - Service Shares 0.0%
YIP Lazard Retirement International Equity Portfolio 0.0%
YGW MFS VIT Growth Series - Service Class 0.0%
YDS MFS VIT New Discovery Series - Service Class 0.0%
YPH Putnam VT High Yield Fund - Class IB Shares 0.0%
YNO Putnam VT New Opportunities Fund - Class IA Shares 0.0%
YIO Putnam VT International New Opportunities Fund -
Class IB Shares 0.0%
YVS Putnam VT Vista Fund - Class IB Shares 0.0%
YMI Royce Micro-Cap Portfolio 0.0%
YVA Third Avenue Value Portfolio 0.0%
YIC Wanger International Small Cap 0.0%
YSP Wanger U.S. Small Cap 0.0%
YEG Warburg Pincus Trust Emerging Growth Portfolio 0.0%
YSC Warburg Pincus Trust Small Company Growth Portfolio 0.0%
</TABLE>
<TABLE>
<CAPTION>
Schedule of Additional Benefits and Riders
<S> <C> <C> <C>
Monthly
Effective Date Expiration Date Cost of Insurance
Flexible Premium January 15, 1999 see policy form see policy form
Variable Life
Other Insured Rider See Policy Data Supplemental Page for information as to coverage, amounts,
and cost of insurance.
Waiver of Monthly January 15, 1999 January 15, 2024 see rider form
Deduction Rider
for Total Disability
</TABLE>
<PAGE>
Policy Data Supplemental Page
Other Insured Rider
Policy Number: 9790-12345678
Insured: Jane J. Doe
Issue Age: 35
Face Amount: $25,000
Minimum Face Amount: $25,000
Effective Date: January 15, 1999
Expiration Date: January 15, 2044
Monthly Cost of Insurance See rider form. The guaranteed monthly cost of
insurance rates are shown in the rider.
Risk Classification: Standard Non-Smoker
<PAGE>
<TABLE>
<CAPTION>
Male Rate Table
Guaranteed Maximum Monthly Cost of Insurance Rates per $1,000 for Insureds with a Standard Risk Classification
Standard Standard
Attained Attained Standard Non- Attained Standard Non-
Age Standard Age Smoker Smoker Age Smoker Smoker
<S> <C> <C> <C> <C> <C> <C> <C>
0 $0.2175 35 $0.2250 $0.1425 70 $ 4.8525 $ 3.0875
1 0.0850 36 0.2425 0.1500 71 5.2850 3.4275
2 0.0825 37 0.2625 0.1600 72 5.7775 3.8250
3 0.0800 38 0.2875 0.1725 73 6.3250 4.2725
4 0.0775 39 0.3125 0.1825 74 6.9300 4.7700
5 0.0725 40 0.3450 0.1975 75 7.5800 5.3050
6 0.0675 41 0.3775 0.2125 76 8.2500 5.8725
7 0.0650 42 0.4150 0.2275 77 8.9250 6.4675
8 0.0625 43 0.4550 0.2450 78 9.6150 7.0975
9 0.0600 44 0.5000 0.2650 79 10.3425 7.7825
10 0.0625 45 0.5450 0.2875 80 11.1325 8.5450
11 0.0675 46 0.5950 0.3100 81 12.0075 9.4075
12 0.0750 47 0.6475 0.3350 82 12.9875 10.3900
13 0.0875 48 0.7050 0.3625 83 14.0600 11.4925
14 0.1025 49 0.7675 0.3925 84 15.1925 12.6975
15 0.1175 50 0.8350 0.4275 85 16.3450 13.9800
16 0.1325 51 0.9150 0.4675 86 17.4900 15.3250
17 0.1425 52 1.0025 0.5125 87 18.6825 16.7175
18 0.1500 53 1.0250 0.5650 88 19.9400 18.1500
19 0.1550 54 1.2125 0.6225 89 21.2100 19.6475
55 1.3300 0.6875 90 22.5100 21.2325
56 1.4550 0.7575 91 23.8825 22.9475
Standard 57 1.5850 0.8325 92 25.5000 24.8700
Attained Standard Non- 58 1.7250 0.9150 93 27.6200 27.2000
Age Smoker Smoker 59 1.8725 1.0075 94 30.5957 30.4275
20 $0.1925 $0.1400 60 2.0400 1.1125 95 34.5957 34.5957
21 0.1925 0.1375 61 2.2275 1.2300 96 41.3950 41.3950
22 0.1900 0.1350 62 2.4375 1.3650 97 53.1975 53.1975
23 0.1850 0.1325 63 2.6750 1.5175 98 73.2725 73.2725
24 0.1800 0.1275 64 2.9375 1.6850 99 83.3325 83.3325
25 0.1750 0.1250 65 3.2125 1.8725
26 0.1725 0.1225 66 3.5050 2.0750
27 0.1700 0.1200 67 3.8050 2.2900
28 0.1700 0.1200 68 4.1225 2.5275
29 0.1725 0.1200 69 4.4700 2.7900
30 0.1775 0.1200
31 0.1825 0.1225
32 0.1900 0.1250
33 0.2000 0.1300
34 0.2125 0.1375
</TABLE>
For insureds with a preferred risk classification, the above standard
non-smoker guaranteed monthly cost of insurance rates will apply. For insureds
with other than a preferred or standard risk classification, the guaranteed
monthly cost of insurance rates are calculated by multiplying the above
monthly rates by the Special Class Risk Factor shown under Policy Data.
<PAGE>
<TABLE>
<CAPTION>
Female Rate Table
Guaranteed Maximum Monthly Cost of Insurance Rates per $1,000 for Insureds with a Standard Risk Classification
Standard Standard
Attained Attained Standard Non- Attained Standard Non-
Age Standard Age Smoker Smoker Age Smoker Smoker
<S> <C> <C> <C> <C> <C> <C> <C>
0 $0.1550 35 $0.1675 $0.1250 70 $ 2.4625 $ 1.8725
1 0.0700 36 0.1800 0.1325 71 2.7025 2.0775
2 0.0650 37 0.1975 0.1425 72 2.9975 2.3275
3 0.0650 38 0.2175 0.1550 73 3.3500 2.6275
4 0.0625 39 0.2375 0.1650 74 3.7525 2.9750
5 0.0625 40 0.2625 0.1800 75 4.1950 3.3625
6 0.0600 41 0.2900 0.1950 76 4.6675 3.7875
7 0.0575 42 0.3150 0.2100 77 5.1650 4.2425
8 0.0575 43 0.3425 0.2250 78 5.6925 4.7375
9 0.0575 44 0.3700 0.2400 79 6.2700 5.2900
10 0.0550 45 0.3975 0.2575 80 6.9225 5.9225
11 0.0575 46 0.4275 0.2750 81 7.6675 6.6550
12 0.0600 47 0.4575 0.2925 82 8.5225 7.5050
13 0.0625 48 0.4900 0.3125 83 9.5175 8.4775
14 0.0675 49 0.5250 0.3350 84 10.6125 9.5575
15 0.0725 50 0.5650 0.3600 85 11.7875 10.7425
16 0.0750 51 0.6050 0.3900 86 13.0400 12.0275
17 0.0800 52 0.6525 0.4200 87 14.3600 13.4100
18 0.0825 53 0.7050 0.4550 88 15.7550 14.9025
19 0.0850 54 0.7575 0.4925 89 17.2300 16.5150
55 0.8125 0.5300 90 18.8925 18.2725
56 0.8650 0.5700 91 20.7175 20.2225
Standard 57 0.9175 0.6075 92 22.7875 22.4525
Attained Standard Non- 58 0.9675 0.6450 93 25.2800 25.1475
Age Smoker Smoker 59 1.0200 0.6875 94 28.7350 28.7350
20 $0.0975 $0.0825 60 1.0825 0.7375 95 33.5325 33.5325
21 0.0975 0.0850 61 1.1625 0.8000 96 40.6975 40.6975
22 0.1000 0.0850 62 1.2650 0.8775 97 52.8275 52.8275
23 0.1025 0.0875 63 1.3875 0.9725 98 73.1550 73.1550
24 0.1050 0.0900 64 1.5275 1.0800 99 83.3325 83.3325
25 0.1075 0.0900 65 1.6750 1.1950
26 0.1125 0.0925` 66 1.8225 1.3150
27 0.1150 0.0950 67 1.9675 1.4375
28 0.1200 0.0975 68 2.1150 1.5650
29 0.1250 0.1000 69 2.2750 1.7075
30 0.1300 0.1025
31 0.1350 0.1075
32 0.1425 0.1100
33 0.1500 0.1150
34 0.1575 0.1200
</TABLE>
For insureds with a preferred risk classification, the above standard
non-smoker guaranteed monthly cost of insurance rates will apply. For insureds
with other than a preferred or standard risk classification, the guaranteed
monthly cost of insurance rates are calculated by multiplying the above
monthly rates by the Special Class Risk Factor shown under Policy Data.
<PAGE>
DEFINITIONS
The following words are often used in this policy. When we use these words,
this is what we mean:
accumulation unit
An accounting unit used to calculate the variable account value. It is a measure
of the net investment results of each of the subaccounts.
age anniversary
The policy anniversary on which the insured becomes a certain attained
insurance age.
cash surrender value
The policy proceeds if the policy is surrendered in full or matures. It is the
policy value minus indebtedness, minus surrender charges as shown under Policy
Data.
fixed account
Our general account. It is made up of our assets other than those in the
subaccounts and those in any other segregated asset account.
fixed account value
The portion of the policy value that is allocated to the fixed account,
including indebtedness.
in force
The insured's life remains insured under the terms of this policy.
indebtedness
All existing loans on this policy plus policy loan interest that has been
accrued or added to the policy loan.
insurance age
The insurance age of the insured on the policy date is the issue age shown
under Policy Data. It is the age of the insured on the date of application.
Attained insurance ages are determined from the policy date.
insured
The person whose life is insured by this policy.
maturity date
The date on which proceeds, as defined herein are payable if the insured is
living. The maturity date is shown under Policy Data.
monthly date
The same day each month as the policy date. If there is no monthly date in a
calendar month, the monthly date will be the first day of the next
calendar month.
net premium
The portion of a premium paid that is credited to the policy as described in the
Policy Values section. It is the premium paid minus the premium expense charge
shown under Policy Data.
policy anniversary
The same day and month as the policy date each year that the policy remains
in force.
policy date
The date from which policy anniversaries, policy years, and policy months
are determined. Your policy date is shown under Policy Data.
policy value
The sum of the fixed account value and the variable account value.
proceeds
The amount payable by this policy as follows:
1. upon death of the insured,
proceeds will be the death benefit under the option in effect as of the
date of the insured's death, minus any indebtedness;
2. on the maturity date, proceeds will be the cash surrender value;
3. on surrender of the policy, proceeds will be the cash surrender value.
pro-rata basis
Allocation to the fixed account and each of the subaccounts. It is proportionate
to the value (minus any indebtedness in the fixed account) that each bears
to the policy value, minus indebtedness.
<PAGE>
specified amount
An amount used to determine the death benefit and the proceeds payable upon
death. The initial specified amount is shown under Policy Data.
subaccounts
The subaccounts named under Policy Data. Each is an investment division of the
variable account and invests in a particular portfolio.
terminate
This policy is no longer in force. All insurance coverage under this policy
has stopped.
valuation date
Each day on which the New York Stock Exchange is open for trading, or any other
day on which there is a sufficient degree of trading in the investments of
the subaccounts such that the current value might be materially affected.
valuation period
The interval of time commencing at the close of business on each valuation date
and ending at the close of business on the next valuation date.
variable account value
The sum of the values of the subaccounts under this policy.
we, our, us
IDS Life Insurance Company of New York
written request
A request in writing signed by you.
you, your
The owner of this policy. The owner may be someone other than the insured.
The owner is shown in the application unless the owner has been changed as
provided in this policy.
<PAGE>
The Insurance Contract
What is the entire contract of Insurance?
This policy and the copy of the application attached to it and any endorsements
or riders added to the policy are the entire contract between you and us.
No one except one of our corporate officers (President, Vice President,
Secretary, or Assistant Secretary) can change or waive any of our rights or
requirements under this policy. That person must do so in writing. None of
our representatives or other persons have the authority to change or waive
any of our rights or requirements under this policy.
In issuing this policy, we have relied upon the application. The statements
contained in the application are considered, in the absence of fraud,
representations and not warranties. No statement made in connection with
the application will be used by us to void the policy or to deny a claim
unless that statement is part of the application.
When will the policy become incontestable?
After this policy has been in force during the insured's lifetime for two
years from the policy date, we cannot contest the policy except for
nonpayment of premiums.
Any additional specified amount, other than that resulting solely from a
change in death benefit option, issued after the policy date will be
incontestable only after such amount has been in force during the insured's
lifetime for two years from the effective date of such amount.
Is there a suicide exclusion?
Suicide by the insured within two years from the policy date is not
covered by this policy. In this event, the only amount payable by us to the
beneficiary will be the premium that you have paid, minus any indebtedness
and partial surrenders.
If the insured commits suicide within the two years after the effective
date of:
1. any additional specified amount other than that resulting solely
from a change in death benefit option; or
2. any rider attached to this policy;
the amount payable by us will be limited to the monthly deductions for such
additional amount or rider.
Can you exchange this policy?
Yes. Once during the first two policy years, you have the right to exchange
this policy for a flexible premium adjustable life policy that provides for
benefits that do not vary with the investment return of the subaccounts.
This is done by transferring, without charge, the entire policy value
to the fixed account.
You also have the right to exchange this policy for a flexible premium
adjustable life policy that provides for benefits that do not vary with the
investment return of the subaccounts in the event of a material change in
the investments of the subaccounts. The options to exchange is exercisable
within 60 days after
(a) the effective date of such change in the investment policy, or
(b) the receipt of the notice of the change in investments, whichever
is later.
The exchange is done by transferring, without charge, the entire policy
value to the fixed account.
Do you have voting rights?
All policy owners with variable account values will have voting rights. So
long as federal law requires, you may have the right to vote at the
meetings of the Variable Policy Owners. If you have voting rights, we will
send you a notice of the time and place of any such meetings. The notice
will also explain matters to be voted upon and how many votes you will
have.
<PAGE>
Do state laws apply?
Yes. This policy is governed by the law of the state in which it is
delivered. The values and benefits of this policy are at least equal to
those required by such state.
What if the insured's age or sex has been misstated?
If the insured's age or sex has been misstated, the proceeds payable upon
death will be:
1. the policy value on the date of death; plus
2. the amount of insurance that the cost of insurance on the
insured, which was deducted from the policy value for the policy
month during which such death occurred, would have been
purchased had the cost of the insurance been calculated using
the cost of insurance rates for the correct age and sex; minus
3. any indebtedness on the date of death.
When does this policy terminate?
This policy will terminate on the earliest of the following:
1. the date you request that coverage ends; or
2. the date you surrender the policy in full; or
3. the end of the grace period; or
4. the date of death of the insured; or
5. the maturity date.
Does this policy qualify for favorable tax treatment?
This policy is intended to qualify for treatment as a life insurance policy
under Sections 72, 101, and 7702 of the Internal Revenue Code as they now
exist or may later be amended.
We reserve the right to endorse this policy to comply with:
1. future changes in the Internal Revenue Code;
2. any regulations or rulings issued under the Code; and
3. any other requirements imposed by the Internal Revenue Service;
with respect to remaining qualified for treatment as a life insurance
policy under these Code sections.
We will provide the owner with a copy of any such endorsement.
<PAGE>
Owner and Beneficiary
What are your rights as owner of this policy?
As long as the insured is living and unless otherwise provided in this
policy, you may exercise all rights and privileges provided in this policy
or allowed by us.
How can you change ownership of this policy?
You can change the ownership of this policy by written request on a form
approved by us. The change must be made while the insured is living. Once
the change is received by us, it will take effect as of the date of your
request, subject to any action taken or payment made by us before receipt.
To whom are the proceeds paid on the insured's death?
We will pay the proceeds to the beneficiary or beneficiaries whom you have
named in the application unless you have since changed the beneficiary as
provided below. If the beneficiary has been changed, we will pay the
proceeds in accordance with your last change of beneficiary request.
If one or all of the beneficiaries die before the insured, to whom are the
proceeds payable?
Only those beneficiaries who survive the insured's death may share in the
proceeds. If no beneficiary survives the insured, we will pay the proceeds
to you, if living; otherwise, to your estate.
How do you change the beneficiary?
By making a satisfactory written request to us, you may change the
beneficiary anytime while the insured is living. Once we receive the
change, it will take effect as of the date of your request, subject to any
action taken or payment made by us before receipt.
Can you assign this policy as collateral?
Yes. While the insured is living, you can assign this policy or any
interest in it. Your interest and the interest of any beneficiary are
subject to the interest of the assignee. An assignment is not a change of
ownership and an assignee is not an owner as these terms are used in this
policy. We will pay any policy proceeds payable to the assignee in a single
sum.
You must give us a copy of any assignment. Any assignment is subject to any
action taken or payment made by us before the assignment was received at
our home office. We are not responsible for the validity of any assignment.
<PAGE>
Premiums
What are the premium payments for this policy?
Three types of premium payments apply to this policy. We call these:
1. the initial premium;
2. scheduled premiums; and
3. unscheduled premiums.
What is the initial premium?
The initial premium is the premium due on the policy date of this policy.
What is the scheduled premium? Can it be changed?
The scheduled premium is the premium shown under Policy Data. It is payable
at the stated interval that you selected in the application.
The scheduled premium will serve only as an indication of your intent as to
the frequency and amount of future premium payments. You may change the
amount or interval at any time by written request. You may also skip
scheduled premium payments. Any change in amount may be subject to
applicable tax laws and regulations.
Scheduled premiums may be paid annually, semi-annually, or quarterly.
Payment at any other interval must be approved by us. Scheduled premium
payments must be at least $25. We reserve the right to limit the amount of
any increase in scheduled premiums.
Can you make unscheduled premium payments?
Yes. You can make additional premium payments of at least $25 at any time
prior to the maturity date. We reserve the right to limit the number and
amount of these unscheduled premiums. This includes our right to refuse
such premiums if there is indebtedness on this policy.
How are premium payments allocated?
Premium payments applied to the fixed account and the subaccounts will be
allocated as specified in your application for this policy. You may choose
any whole percentage for each account from 0% to 100%. By written request,
you may change this allocation. The change will be effective for all
premiums received after our receipt of the change. Premiums received before
the policy date will be allocated initially to the fixed account. On the
policy date, the policy value in the fixed account will be transferred to
the subaccounts or remain in the fixed account in accordance with your
premium allocation percentages. For any premium received on or after the
policy date, the premium will be allocated in accordance with your premium
allocation percentages.
Can we restrict premium payments?
We reserve the right to refuse premiums and to return premiums with
interest if such premiums would disqualify your policy from
1. treatment as a life insurance policy under Code Sections
72, 101, and 7702; or
2. favorable tax treatment under Code Sections 72 and 101.
Is there a grace period for paying premiums?
Yes. If, on a monthly date, the cash surrender value is less than the
monthly deduction for the policy month following such monthly date, a
grace period of 61 days will begin.
The grace period will give you time to pay a premium sufficient to continue
your coverage. Within 30 days of the monthly date, we will mail to your
last known address, a notice as to the premium needed so that the estimated
cash surrender value will be sufficient to cover the next three monthly
deductions.
If such premium is not paid within the grace period, all coverage under
this policy will terminate without value at the end of the 61-day grace
period.
If a claim by death during the grace period becomes payable under the
policy, any overdue monthly deductions will be deducted from the proceeds.
If the no-lapse guarantee is in effect as described in the provision below,
the policy will not enter the grace period.
<PAGE>
What is the No-Lapse Guarantee?
During the no-lapse guarantee period, as shown under Policy Data, this
policy will not terminate even if the cash surrender value is insufficient
to cover the monthly deduction on a monthly date if (a)-(b)-(c) equals or
exceeds (d) where:
(a) is the total of all premiums paid;
(b) is any partial surrenders;
(c) is any indebtedness;
(d) is the sum of the minimum monthly premiums required to keep the
no-lapse guarantee in effect since the policy date.
The intial minimum monthly premium is shown under Policy Data.
If, during the no-lapse guarantee period the specified amount is increased
or decreased, or, riders are added, changed, or terminated, a new minimum
monthly premium will be established for the remainder of the no-lapse
guarantee period.
For any month in which the monthly deduction is being paid by a Waiver of
Monthly Deduction Rider, if applicable and attached to this policy, the
minimum monthly premium for that month will be zero.
If on a monthly date, sufficient premiums have not been paid to maintain
the no-lapse guarantee, the no-lapse guarantee period will be terminated.
The no-lapse guarantee period may be reinstated within 2 years of its
termination if the policy is in force. The amount needed to reinstate the
no-lapse guarantee period is an amount equal to (a)+(b)+(c)-(d) where:
(a) is the sum of minimum monthly premiums to the date of reinstatement
assuming the no-lapse guarantee was always in effect since the policy
date;
(b) is any partial surrenders that have been taken to the date of
reinstatement;
(c) is any indebtedness on the date of reinstatement;
(d) is the total of all premiums paid to the date of reinstatement.
Can you ever reinstate this policy?
This policy may be reinstated within 5 years after the end of the grace
period unless it was surrendered for cash. To do this, we will require all
of the following:
1. your written request to reinstate the policy;
2. evidence of insurability of the insured satisfactory to us;
3. payment of the required reinstatement premium;
4. payment or reinstatement of any indebtedness.
The required premium to reinstate the policy is an amount equal to
(a)+(b)+(c)-(d) where:
(a) is the surrender charge which will be reinstated;
(b) is an amount equal to the monthly deductions not taken during the grace
period;
(c) is an amount equal to the next 3 monthly deductions that will be taken
after reinstatement;
(d) is the policy value which will be reinstated.
The effective date of a reinstated policy will be the monthly date on or
next following the date on which we approve the application for
reinstatement.
The incontestability period will apply from the effective date of
reinstatement. We will have two years from the effective date of
reinstatement to contest the truth of statements or representations in the
reinstatement application.
<PAGE>
Death Benefits
What are the proceeds payable upon death of the insured by this policy?
The proceeds payable upon death will be the death benefit in effect on the
date of the insured's death, minus any indebtedness. The death benefit will
be calculated based on the death benefit option in effect as of the date of
the insured's death. One of two options will apply: Option 1 or 2. Both
options are described below. Any portion of the death benefit that is based
on the variable account value will be determined each valuation date, but
no less frequently than annually.
What is Option 1?
The death benefit under this option will be the greater of:
1. the specified amount; or
2. the percentage of policy value for the insured's attained age
shown in the table below.
Under this option, the policy value of this policy is part of the
specified amount. The initial specified amount is shown under Policy Data.
Such amount may be changed as explained in the Policy Change section. A
partial surrender will reduce the specified amount.
What is Option 2?
The death benefit under this option will be the greater of:
1. the policy value of this policy, plus the specified amount; or
2. the percentage of policy value for the insured's attained age
shown in the table below.
Under this option, the policy value is not a part of the specified amount.
The initial specified amount is shown under Policy Data. Such amount
may be changed as explained in the Policy Change section.
Insured's Applicable Insured's Applicable
Attained Age Percentage Attained Age Percentage
40 or less 250 61 128
41 243 62 126
42 236 63 124
43 229 64 122
44 222 65 120
45 215 66 119
46 209 67 118
47 203 68 117
48 197 69 116
49 191 70 115
50 185 71 113
51 178 72 111
52 171 73 109
53 164 74 107
54 157 75-95 105
55 150 96 104
56 146 97 103
57 142 98 102
58 138 99 101
59 134 100 100
60 130
The percentage is designed to ensure that the policy meets the provisions
of Federal tax law which require a minimum death benefit in relation to
policy value for the policy to qualify as life insurance.
Which death benefit option will apply?
You chose the death benefit option you wanted when you applied for this
policy. The initial death benefit option is shown under Policy Data. While
this policy is in force, you may change the option as explained in Policy
Change section.
<PAGE>
Policy Change
Can you request to change the benefits of this policy?
Yes. While this policy is in force, you may request to decrease or increase
the specified amount. You may also change the death benefit option from 1
to 2 or from 2 to 1. All such changes will be subject to the rules below.
What are the rules for changing the specified amount?
Decreases of the Specified Amount
You may decrease the specified amount once per policy year by written
request. A decrease may only be made after the first policy year and
is subject to the following rules.
1. Any decrease will be effective on the monthly date on or next
following our receipt of your written request. Any such decrease
will be applied in the following order:
(a) against the specified amount provided by the most recent
increase; then
(b) against the next most recent increases successively; then
(c) against the initial specified amount shown under Policy
Data.
2. The specified amount that remains in force after a requested
decrease may not be less than the minimum specified amount
allowed shown under Policy Data.
3. We reserve the right to decline to make any specified amount
decrease that we determine would cause this policy to fail to
qualify as life insurance under applicable tax laws.
Increases of the Specified amount
You may increase the specified amount at any time by written request.
The following rules apply to any increase in specified amount other
than that resulting solely from a change in death benefit option.
1. You must apply for an increase by written request on a form
satisfactory to us, and not later than the insured's age 75
anniversary.
2. You must furnish satisfactory evidence of insurability of the
insured.
3. Any increase will be subject to our issue rules and limits at
the time of increase.
4. The minimum increase in the specified amount is $10,000.
5. Any increase will be effective on the monthly date on or next
following the date your application is approved.
6. A new schedule of surrender charges will apply to the amount of
any increase in the specified amount.
7. An increase in specified amount will be assigned a risk
classification tha may be the same or different than the risk
classification assigned to the initial specified amount and any
other increases in specified amount.
How do you change the death benefit option?
You may change the death benefit option once per policy year by written
request. You do not need to provide additional evidence of insurability.
The change in option will be effective on the monthly date on or next
following the date we approve your request.
If the death benefit is Option 2, it may be changed to Option 1. The new
specified amount will be the Option 2 death benefit as of the effective
date of change.
If the death benefit is Option 1, it may be changed to Option 2. The new
specified amount will be the Option 1 death benefit, minus the policy value
as of the effective date of change.
The death benefit after a change may not be less than the minimum
specified amount allowed shown under Policy Data.
We reserve the right to decline to make any death benefit option change
that we determine would cause this policy to fail to qualify as life
insurance under applicable tax laws.
<PAGE>
Policy Values
What is the policy's value?
On a given date, the policy value is equal to the fixed account value plus
the variable account value. The policy value and cash surrender value will
be determined each valuation date, but no less frequently than monthly.
What is the fixed account value?
On the policy date, the fixed account value equals: 1) the portion of the
initial net premium allocated to the fixed account, plus any interest
credited on such portion before the policy date; minus 2) the portion of
the monthly deduction allocated to the fixed account for the first policy
month.
On any subsequent date, the fixed account value will be calculated as:
a + b + c - d - e - f
where:
(a) is the fixed account value on the preceding monthly date plus
interest thereon from the preceding monthly date to the date of
calculation;
(b) is the portion of net premiums allocated to the fixed account and
received since the preceding monthly date, plus interest on
such portions from the date such net premiums were received to the
date of calculation;
(c) is the amount of any transfers from the subaccounts, including loan
transfers, to the fixed account since the preceding monthly date,
plus interest on such transferred amounts from the effective dates
of such transfers to the date of calculation;
(d) is the amount of any transfers from the fixed account, including
loan repayment transfers, to the subaccounts since the preceding
monthly date, plus interest on such transferred amounts from the
effective dates of such transfers to the date of calculation;
(e) is the amount of any partial surrenders and partial surrender fees
allocated to the fixed account since the preceding monthly date, plus
interest on such surrendered mounts from the effective date of such
partial surrenders to the date of calculation; and
(f) if the date of calculation is a monthly date, the portion of the
monthly deduction allocated to the fixed account for the policy
month following the monthly date.
What is the variable account value?
The variable account value is the sum of the values of the subaccounts
under this policy as shown under Policy Data. The assets of the subaccounts
will be valued each valuation date, but no less frequently than monthly.
On the policy date, the value of each subaccount equals: 1) the portion of
the initial net premium allocated to the subaccount, plus any interest
credited on such portion before the policy date; minus 2) the portion of
the monthly deduction allocated to the subaccount for the first policy
month.
On any subsequent date, the value of each subaccount will be calculated as:
a + b + c - d - e - f
where:
(a) is the value of the subaccount on the preceding valuation date,
multiplied by the net investment factor for the current valuation
period;
(b) is the net premiums received and allocated to the subaccount during
the current valuation period;
(c) is the amount of any transfers from other subaccounts or the fixed
account, including loan repayment transfers, to the subaccount
during the current valuation period;
(d) is the amount of any transfers to other subaccounts or the fixed
account, including loan transfers, from the subaccount during the
current valuation period;
(e) is the amount of partial surrender and partial surrender fee
allocated to the subaccount during the current valuation period;
(f) is the portion of any monthly deduction during the current
valuation period allocated to the subaccount for the policy month
following the monthly date.
<PAGE>
What is the monthly deduction?
A deduction will be made each monthly date for the cost of insurance,
policy fee, and the cost of any riders, for the policy month following such
monthly date. The monthly deduction for a policy month will be calculated
as:
(a) + (b) + (c)
where:
(a) is the cost of insurance for the policy month;
(b) is the policy fee shown under Policy Data.
(c) is the cost of any policy riders for the policy month.
The monthly deduction will be taken from the fixed account and the
subaccounts with value according to the monthly deduction allocation
percentages specified in your application for this policy. You may choose
any whole percentage for each account from 0% to 100%. By written request,
you may change the percentages. Any change will be effective for monthly
deductions taken thereafter.
The monthly deduction will be taken from the fixed account and the
subaccounts with value on a prorata basis if: 1) the value in the fixed
account or in any subaccount is insufficient to pay the portion of the
monthly deduction so allocated; or 2) you do not specify the account or
subaccounts from which the monthly deduction is to be taken.
How is the cost of insurance calculated?
The cost of insurance for a policy month is calculated as:
a x (b-c) + d
--------------
1000
where:
(a) is the cost of insurance rate described below;
(b) is the death benefit on the monthly date divided by the guaranteed
interest rate factor shown under Policy Data;
(c) is the policy value at the beginning of the policy month. At this
point, the policy value has been reduced by the monthly deduction
except for the part of the monthly deduction that pays for the
cost of insurance; and
(d) is the amount of any flat extra insurance charges as shown under
Policy Data.
If there have been changes in the specified amount the policy value is
considered a pro-rata part of each specified amount. The part of the policy
value that applies to a segment of specified amount is the segment of
specified amount divided by the total specified amount. The cost of
insurance rate that applies to each segment of specified amount is based on
the risk classification for that segment of specified amount.
The inital specified amount and any increases in specified amount are each
segments of specified amount. Decreases in the specified amount are applied
against the segments of specified amount as described in the provision
entitled "Decreases of the Specified Amount" of the "Policy Change" section
of the policy.
What is the cost of insurance rate?
The cost of insurance rate is the rate applied to the insurance under this
policy to determine the monthly deduction. It is based on the sex, attained
age, and risk classification of the insured. "Attained Age" means age on
the prior policy anniversary.
<PAGE>
We may change monthly cost of insurance rates from time to time. Any change
in the cost of insurance rate will apply to all individuals of the same
risk class as the insured. Any change will be in accordance with procedures
and standards on file with the state insurance department. We will review
the cost of insurance rates for inforce policies whenever we change the
cost of insurance rates for new policies. This review will be done no more
than once each policy year but no less than once each five policy years.
Cost of insurance rates will be determined by us based on our expectations
as to expense, persistency and investment earnings experience.
The guaranteed maximum monthly cost of insurance rates shown in this
policy on pages 4 and 5, for ages 20 and over, are based on the 1980
Commissioners Standard Ordinary Smoker or Nonsmoker, Male or Female
Mortality Tables, Age Last Birthday.
The rates for ages under 20 do not distinguish between smokers and
nonsmokers and are based on the 1980 Standard Ordinary Mortality Table,
Male or Female, Age Last Birthday. Shortly before the Insured's becomes
age 20, we will send you a notice that we may begin charging smoker rates
upon the insured's age 20 policy anniversary. If you do not apply for
nonsmoker rates, or the insured does not qualify for nonsmoker rates, the
insured will be reclassified as a smoker, and the smoker guaranteed
maximum monthly cost of insurance rates will apply to the policy.
What interest rate is used to determine the fixed account value?
The guaranteed interest rate applied in the calculation of the fixed
account value is shown under Policy Data. Interest in excess of the
guaranteed interest rate shown under Policy Data may be applied in the
calculation of the fixed account value at such increased rates and in such
manner as we may determine.
Interest in excess of the guaranteed interest rate as shown under Policy
Data however, will not be applied to the portion of the policy value that
equals any indebtedness due us.
If we apply excess interest, it will be applied daily in the calculation of
the fixed account value and will result in additional fixed account value.
The excess interest rate will be applied to the fixed account value, net
premiums, transfers, partial surrender amounts and partial surrender fee as
used in the calculation of the fixed account value.
Any change in the excess interest rate will apply to all policies of the
same class. Excess rates will be determined by us based on our expectations
as to future interest rates.
For how long will the policy value continue your insurance?
If sufficient scheduled premium payments are not continued, insurance
coverage under this policy and any benefits provided by riders will be
continued until the cash surrender value is insufficient to cover the
monthly deduction, as provided in the Grace Period provision. This
provision will not continue the policy beyond the maturity date, nor will
it continue any rider beyond the date for its termination as provided in
the rider.
<PAGE>
What is the basis used for policy values?
Values and reserves are equal to or greater than those required by law.
Where required, a detailed statement of the method of computation of
values and reserves has been filed with the insurance department of the
state where this policy was delivered.
Will you receive information about the values of this policy?
Yes. At least once a year, we will send to your last known address, a
report that shows:
1. the currency policy value;
2. premiums paid since the last report;
3. all charges since the last report;
4. indebtedness on this policy;
5. the current cash surrender value;
6. the current death benefit; and
7. partial surrenders since the last report.
At any time, upon written request by you, we will provide a projection of
future death benefits and policy values. The projection will be based on
(1) assumptions as to the specified amount(s), type of coverage option and
future premium payments as are necessary and specified by us and/or you.
Is there a paid-up option?
Yes. By written request, the cash surrender value of this policy can be
used to purchase an amount of paid-up insurance. The request may be made in
the 30 days before any policy anniversary prior to the maturity date. If
you request this option, you will be forfeiting all rights to make future
premium payments. All riders will terminate. The paid-up insurance policy
will be effective as of the policy anniversary after your written request.
The insurance amount and the cash surrender value of the paid-up insurance
will be based on the cost of insurance rates guaranteed in the policy, with
4% interest. This policy's death benefit and policy value, both as of the
date of the paid-up policy's purchase, will also be used to compute the
paid-up policy's insurance amount. The paid-up policy's insurance amount,
minus its cash surrender value, cannot be greater than this policy's death
benefit, minus its policy value. The amount purchased will remain level and
will mature on the maturity date of this policy. Any cash surrender value
that is not used to purchase the paid-up insurance amount will be paid to
you. The amount of paid-up insurance will not be less than that required by
law.
At any time before the insured's death, you may surrender the paid-up
insurance for its cash surrender value.
<PAGE>
Policy Loans
Can you borrow money on this policy? How?
By written request, you may obtain a loan from us whenever this policy has
a loan value. You are advised to consult with a tax advisor before
obtaining a policy loan. The loan value of this policy is the only security
required for your loan. A loan must be for at least $200. We will pay
interest on the loaned amount at an annual rate as stated under Policy
Data. Loans may affect the no-lapse guarantee as described in the Premiums
section of this policy.
If you do not specify the accounts from which the loan is to be made, the
loan will be made from the fixed account and the subaccounts with value
on a pro-rata basis.
The amount of any loan and any loan interest from the subaccounts will be
transferred from the subaccounts to the fixed account.
Can we delay or suspend payment of a loan?
We will normally pay the portion of any loan from the subaccounts within
7 days after we receive your written request in our home office. We have
the right, however, to suspend or delay the date of any loan from the
subaccounts for any period:
1. when the New York Stock Exchange is closed; or
2. when trading on the New York Stock Exchange is restricted; or
3. when an emergency exists, and as a result:
(a) disposal of securities held in the subaccounts is not reasonably
practicable; or
(b) it is not reasonably practicable to fairly determine the value
of the assets of the subaccounts; or
4. during any other period when the Securities and Exchange Commission,
by order, so permits for the protection of security holders.
Rules and regulations of the Securities and Exchange Commission will
govern as to whether the conditions set forth in the above items 2 and 3
exist.
For any loans from the fixed account, we have the right to postpone the
loan for up to 6 months unless the loan is used to pay premiums on any
policies you have with us.
If we postpone payment more than 10 days, we will also pay you interest.
Interest will be paid on the loan amount request at the rate of 3% per year
compounded annually for the period of postponement.
What is the interest rate for a policy loan?
The current loan interest rate for policy loans is shown under Policy
Data. We reserve the right to increase the current loan interest rate
charge, but it will never exceed the guaranteed loan interest rate shown
under Policy Data.
Loan interest is charged daily and payable at the end of the policy year.
If loan interest is not paid when it is due, it will be added to your
indebtedness and charged the same interest rate as your loan. The
additional interest will be taken from the fixed account and the
subaccounts with value on a pro-rata basis.
Any loan interest taken from the fixed account will remain in the fixed
account but will then earn loan interest at the guaranteed interest rate
shown under Policy Data. The amount of any loan interest taken from the
subaccounts will be transferred from the subaccounts to the fixed account
and then earn interest at the guaranteed interest rate shown under Policy
Data.
Any change in the loan interest rate will apply to all policies of the same
class and duration.
Interest rates will be reviewed at least once every twelve months but not
more frequently than once in any three month period. The loan interest rate
will be based on our expectations as to expense, persistency and investment
earnings.
What is the maximum loan value of this policy?
You can borrow an amount up to 90% of the policy value minus surrender
charges. We calculate the policy value as of the date of the loan.
Interest to pay for the loan until the next policy anniversary will be
included in determining the maximum loan value.
<PAGE>
When can you repay your loan?
Your loan can be repaid in full or in part at any time before the insured's
death and while this policy is in force. A loan that exists at the end
of the grace period may not be repaid unless this policy is reinstated.
Repayments should be clearly marked as "loan repayments"; otherwise, they
will be credited to this policy as premiums. Loan repayments must be in
amounts of at least $25. Remaining loan amounts of less than $25 can be
paid in full. Loan repayments will be allocated to the fixed account and
the subaccounts according to the premium allocation percentages in effect
unless you tell us otherwise.
What if your loan is not repaid?
Failure to repay a loan or to pay loan interest will not terminate this
policy unless the cash surrender value is insufficient to cover the monthly
deduction, as provided in the Grace Period provision. This would happen
if indebtedness exceeded the policy value, minus surrender charges.
<PAGE>
Policy Surrender
Can you surrender this policy?
Yes. You may surrender this policy for its cash surrender value at any
time. Your request must be in writing. Upon surrender for the cash
surrender value, this policy will terminate.
The cash surrender value of this policy is:
1. the policy value at the time of surrender; minus
2. any indebtedness on this policy; minus
3. any applicable surrender charges as shown under Policy Data.
Surrender charges are shown under Policy Data.
Is a partial surrender possible?
Yes. By written request or other requests acceptable to us, you may
partially surrender this policy for an amount less than the cash surrender
value. Partial surrenders are subject to the rules below and payment of the
Partial Surrender Fee shown under Policy Data. We reserve the right to
limit the frequency of partial surrenders you may request to once per
policy year. Partial surrenders may affect the no-lapse guarantee as
described in the Premiums section of this policy.
If death benefit Option 1 is in effect, both the specified amount and the
policy value will be reduced by the amount of surrender and partial
surrender fee. If death benefit Option 2 is in effect, the policy value
will be reduced by the amount of surrender and the partial surrender fee.
Any decrease in specified amount will be applied in the following order:
(a) against the specified amount provided by the most recent increase;
then
(b) against the next most recent increases successively; then
(c) against the intial specified amount shown under Policy Data.
What are the rules for a partial surrender?
The following rules will apply to any partial surrender:
1. partial surrenders may not be made in the first policy year;
2. the minimum amount that may be surrendered is $500;
3. the partial surrender amount cannot exceed 90% of the full cash
surrender value;
4. the death benefit that remains in force may not be less than the
minimum specified amount allowed shown under Policy Data;
5. the partial surrender fee is as stated under Policy Data. The
surrender amount and partial surrender fee will be deducted from
the policy value at the time of each partial surrender; and
6. we reserve the right to decline a request for a partial surrender
that we determine would cause this policy to fail to qualify as
life insurance under applicable tax laws.
If you do not specify the accounts from which the surrender is to be made,
the surrender will be made from the fixed account and the subaccounts
with value on a pro-rata basis.
Can we delay or suspend payment of a surrender?
We will normally pay the portion of any surrendered amount from the
subaccounts within 7 days after we receive your written request in our
home office. We have the right, however, to suspend or delay the date of
any surrender payment from the subaccounts for any period:
1. when the New York Stock Exchange is closed; or
2. when trading on the New York Stock Exchange is restricted; or
3. when an emergency exists, and as a result:
(a) disposal of securities held in the subaccounts is not reasonably
practicable; or
(b) it is not reasonably practicable to fairly determine the value
of the assets of the subaccounts; or
4. during any other period when the Securities and Exchange Commission,
by order, so permits for the protection of security holders.
Rules and regulations of the Securities and Exchange Commission will
govern as to whether the conditions set forth in the above items 2 and 3
exist.
For any surrender request from the fixed account, we have the right to
postpone the payment for up to 6 months. If we postpone payment more than
10 days, we will also pay you interest. The interest will be paid at the
rate of 3% per year compounded annually based on the amount surrendered for
the period of postponement.
<PAGE>
Subaccounts
What are the subaccounts?
The subaccounts are separate investment accounts of ours. They are named
under Policy Data. We have allocated a part of our assets for this and
certain other policies to the subaccounts. Such assets remain our property.
They cannot be charged, however, with liabilities from any other business
in which we may take part.
What are the investments of the subaccounts?
Net premiums and transfers will be allocated as you specify. Each
subaccount will buy the investment shown for that subaccount under Policy
Data or as later added or changed.
How do we value the subaccounts?
The subaccount value is determined by multiplying the number of
accumulation units credited to the subaccount by the appropriate
accumulation unit values.
What are the subaccount accumulation units?
The number of accumulation units for each of the subaccounts is found by
dividing: (1) the amount allocated to the subaccount; by (2) the
subaccount's accumulation unit value for the valuation period in which we
received the premium payment, transfer request, or partial surrender
request.
What is the subaccount accumulation unit value?
The value of an accumulation unit for each of the subaccounts was
arbitrarily set at $1 when the first investments were bought.
The value for any later valuation period is found as follows: The
accumulation unit value for a subaccount for the last prior valuation
period is multiplied by such subaccount's net investment factor for
the following valuation period. The result is the accumulation unit value.
The value of an accumulation unit may increase or decrease from one
valuation period to the next.
What is the net investment factor? How is it determined?
The net investment factor is an index applied to measure the investment
performance of a subaccount from one valuation period to the next. The
net investment factor may be greater or less than one; therefore, the value
of an accumulation unit may increase or decrease.
To find the net investment factor of any such subaccount for any valuation
period, we divide (1) by (2), and subtract (3) from the result, where:
(1) is the net result of:
a. the net asset value per share of the portfolios or funds held in
the subaccount determined at the end of the current valuation
period; plus
b. the per-share amount of any dividend or capital gain
distributions made by the investment held in the subaccount, if
the "ex-dividend" date occurs during the current valuation
period; plus or minus
c. a per-share charge or credit for any taxes reserved for the
current valuation period that we determine to have resulted from
the investment operations of the subaccount;
(2) is the net result of:
a. the net asset value per share of the portfolios or funds held in
the subaccount, determined at the end of the last prior
valuation period; plus or minus
b. the per-share charge or credit for any taxes reserved for the
last prior valuation period; and
(3) is a factor representing the mortality and expense risk charge.
<PAGE>
What deductions are made from the subaccounts?
The mortality and expense risk charge compensates us for assuming the
mortality and expense risks under this policy. It is equal on an annual
basis to the percentage, as stated under Policy Data, of the daily value of
the subaccounts. The deduction will be (1) made from each subaccount with
value; and (2) computed on a daily basis. We will review the mortality and
expense risk charge for in force policies whenever we change the mortality
and expense risk charge for new policies. This review will be done no more
than once each policy year but no less than once each five policy years.
Mortality and expense risk charges will be determined by us based on our
expectations as to expense, persistency and investment earnings experience.
Can the investments of the subaccounts be changed?
This would happen if laws or regulations changed, the investment became
unavailable, or, in the judgment of IDS Life Insurance Company of New York,
the investments were no longer suitable for the subaccounts. If any of
these situations occurred, we would have the right to substitute
investments other than those shown under Policy Data. We would first seek
the approval of the Securities and Exchange Commission and the New York
Superintendent of Insurance.
Can transfers be made among your subaccounts and fixed account?
By written request or other requests acceptable to us, you may transfer all
or part of the value of a subaccount to one or more of the other
subaccounts or to the fixed account. The amount transferred, however, must
be at least: 1) $250; or 2) the total value in the subaccount, if less. We
reserve the right to limit such transfers to 5 per policy year. We may
suspend or modify this transfer privilege at any time with the necessary
approval of the Securities and Exchange Commission and the New York
Superintendent of Insurance.
You may also transfer from the fixed account to the subaccounts once a
year, but only on the policy anniversary or within 30 days after such
policy anniversary. If you make this transfer, you cannot transfer from the
subaccounts back into the fixed account until the next policy anniversary.
If we receive your written request within 30 days before the policy
anniversary date, the transfer from the fixed account to the subaccounts
will be effective on the anniversary date. If we receive your written
request within 30 days before the policy anniversary date, the transfer
from the fixed account to the subaccounts will be effective on the
anniversary date. If we receive your written request within 30 days after
the policy anniversary date, the transfer from the fixed account to the
subaccounts will be effective on the date we receive the request. The
miminum transfer amount is $250 or the fixed account value minus
indebtedness, if less. The maximum transfer amount is the fixed account
value, minus indebtedness. We may suspend or modify this transfer privilege
at any time with the necessary approval of the Securities and Exchange
Commission and the New York Superintendent of Insurance.
You may also transfer all or part of the value of a subaccount to one or
more of the other subaccounts or to the fixed account by automated
transfers. Only one automated transfer arrangement can be in effect at any
time. Policy values may be transferred to one or more subaccounts and to
the fixed account, but can be transferred from only one account. The
mimimun automated transfer amount is $50. Twelve automated transfers from
the fixed account may not exceed an amount that, if continued, would
deplete the fixed account within 12 months.
<PAGE>
Payment of Policy Proceeds
What proof is necessary to process a claim for the death benefit of this
policy?
Proof satisfactory to us of the insured's death is determined by our
receipt of a notarized death claim statement making claim to the insurance
provided by this policy and a certified death certificate. Additionally, a
physician's statement will be required for claims occurring within two
years from: (1) the policy date; (2) the effective date of reinstatement;
or, (3) any additional specified amount other than that resulting solely
from a change in death benefit option issued after the policy date.
How are the proceeds paid?
We will pay the proceeds in a single sum unless a payment option has been
selected. The date on which the proceeds are paid in a lump sum or first
placed under a payment option is the settlement date. All proceeds are
payable at our home office. We will pay interest at a rate then in effect,
on death proceeds from the date of the insured's death to the settlement
date.
What are the payment options other than a single sum?
During the insured's lifetime, you may request in writing that we pay the
proceeds under one or more of the payment options shown below, or that we
change a prior election. You may elect other payment options not shown if
we agree. Unless we agree otherwise, however, a payment option may be
selected only if the payments are to be made to a natural person in that
person's own right. Also, the amount of proceeds placed under a payment
option must be at least $5,000. The following payment options are based on
3% interest and the 1983 A Mortality Table with Projection Scale G.
Option A - Interest Payments
We will pay interest on proceeds placed under this option at the rate of 3%
per year compounded annually. We will make regular interest payments at
intervals and for a period that is agreeable to both you and us. At the end
of any payment interval, a withdrawal of proceeds may be made in the amount
of at least $100. At any time, all of the proceeds that remain may be
withdrawn or placed under a different payment option approved by us.
Option B - Payments for a Specified Period
We will make monthly payments for a specified number of years. The amount
of each monthly payment for each $1,000 placed under this option is shown
in the table below. Monthly payment amounts for years not shown will be
furnished upon request.
Option B Table
Number Monthly
of Years Payment/$1000
10 9.61
15 6.87
20 5.51
25 4.71
30 4.18
Option C - Lifetime Income
We will make monthly payments for the life of the person (the payee) who is
to receive the income. Payment will be guaranteed for either 10, 15, or 20
years. The amount of each monthly payment for each $1,000 placed under this
option will be based on our Table of Settlement Rates in effect at the time
of the first payment. The amounts will not be less than those shown in the
following table for the sex and age of the payee on the due date of the
first payment.
Monthly income amounts for any age not shown in the following table will be
furnished upon request.
<PAGE>
Option C Table M = Male F = Female
Age Beginning Life Income per $1,000 with
Payee In Year Payments Guaranteed for
------- ---------- ------------------------------
10 years 15 years 20 years
----------- ------------ ------------
M F M F M F
65 2005 5.16 4.63 4.96 4.54 4.69 4.41
2010 5.08 4.57 4.90 4.49 4.65 4.36
2015 5.01 4.51 4.84 4.43 4.61 4.32
2020 4.94 4.45 4.78 4.39 4.57 4.28
2025 4.87 4.40 4.73 4.34 4.53 4.25
2030 4.81 4.35 4.68 4.30 4.49 4.21
70 2005 5.88 5.26 5.49 5.07 5.03 4.79
2010 5.79 5.18 5.42 5.00 4.99 4.75
2015 5.70 5.10 5.36 4.94 4.96 4.71
2020 5.61 5.03 5.30 4.88 4.92 4.67
2025 5.53 4.96 5.24 4.83 4.89 4.63
2030 5.45 4.89 5.18 4.77 4.85 4.60
75 2005 6.74 6.09 6.01 5.67 5.29 5.15
2010 6.63 5.99 5.95 5.60 5.26 5.12
2015 6.52 5.89 5.90 5.54 5.24 5.08
2020 6.42 5.79 5.84 5.47 5.22 5.05
2025 6.32 5.71 5.78 5.41 5.19 5.02
2030 6.23 5.62 5.73 5.35 5.17 4.99
80 2005 7.67 7.10 6.44 6.23 5.45 5.39
2010 7.56 6.98 6.41 6.18 5.44 5.38
2015 7.45 6.87 6.37 6.13 5.43 5.36
2020 7.35 6.76 6.32 6.07 5.42 5.35
2025 7.24 6.65 6.28 6.02 5.41 5.34
2030 7.14 6.55 6.24 5.97 5.40 5.32
85 2005 8.52 8.14 6.73 6.64 5.50 5.49
2010 8.44 8.04 6.72 6.62 5.50 5.49
2015 8.36 7.93 6.70 6.59 5.50 5.49
2020 8.27 7.83 6.68 6.57 5.50 5.49
2025 8.19 7.74 6.67 6.54 5.50 5.49
2030 8.11 7.64 6.65 6.52 5.50 5.48
At certain ages, the monthly payment may be the same for the 10, 15, and 20 year
guaranteed periods. In this event, we will guarantee the maximum years possible
for the given monthly payment.
The table above is based on the "1983 Individual Annuitant Mortality Table A" at
3.00% with 100% Projection Scale G. Settlement rates for any year, age, or any
combination of year, age and sex not shown above, will be calculated on the same
basis as those rates shown in the table above. We will furnish such rates upon
request.
Will a supplemental contract be prepared if proceeds are placed under a
payment option?
If a payment option is requested, we will prepare an agreement stating the
terms under which payments will be made. The agreement will include
statements about withdrawal value, if any, and to whom remaining proceeds
will be paid if the payee dies.
Can a beneficiary request a payment option?
After the insured's death but before any proceeds are paid, the beneficiary
may select a payment option by written request to us. You may provide,
however, that the beneficiary will not be permitted to change the payment
option you have selected.
Are excess interest earnings payable by us?
On each anniversary of the settlement date, we will determine excess
interest, if any, on payment option deposits. Any such excess interest
will be paid under Option A or B.
<PAGE>
Flexible Premium Variable Life Insurance Policy
- Adjustable death benefit payable at insured's death prior to the maturity
date at age 100 anniversary.
- Flexible premiums payable during the lifetime of the insured until the
maturity at age 100 anniversary.
- Cash surrender value payable on the maturity date at age 100 anniversary.
- No-lapse guarantee as described herein.
- This policy is nonparticipating. Dividends are not payable.
IDS Life Insurance Company of New York
20 Madison Avenue Extension
P.O. Box 5144
Albany, New York 12205
