<PAGE>
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Registration No. _________
Form S-6
REGISTRATION STATEMENT UNDER THE SECURITIES
ACT OF 1933 OF SECURITIES OF
UNIT INVESTMENT TRUSTS REGISTERED
ON FORM N-8B-2
A. Exact name of Trust: C.M. Life Variable Life Separate Account I
B. Name of Depositor: C.M. Life Insurance Company
C. Complete address of 140 Garden Street
Depositor's principal Hartford, CT 06154
executive offices:
APPROXIMATE DATE OF PROPOSED PUBLIC OFFERING: As soon as possible after the
effective date of this Registration Statement.
Pursuant to Rule 24-F-2 of the Investment Company Act of 1940, the Registrant
hereby declares that an indefinite amount of its securities is being registered
under the Securities Act of 1933.
Registrant hereby amends this Registration Statement on such date or dates as
may be necessary to delay its effective date until Registrant shall file a
further amendment which specifically states that this Registration Statement
shall become effective in accordance with Section 8(a) of the Securities Act of
1933 or until this Registration Statement shall become effective on such date as
the Commission, acting pursuant to said section, may determine.
- ---------------------
STATEMENT PURSUANT TO RULE 24F-2
The Registrant registers an indefinite number or amount of its variable life
insurance contracts under the Securities Act of 1933 pursuant to Rule 24F-2
under the Investment Company Act of 1940. The Rule 24F-2 notice for Registrant's
fiscal year ending December 31, 1997 was filed on March 20, 1998.
<PAGE>
CROSS REFERENCE TO ITEMS REQUIRED
BY FORM N-8B-2
Item No. of
Form N-8B-2 Caption
- ----------- -------
1 Cover Page; Definition of Terms; The Separate Account
2 Cover Page; C.M. Life and the Separate Account
3 Cover Page; C.M. Life and the Separate Account
4 Sales and Other Agreements
5 C.M. Life and the Separate Account
6 C.M. Life and the Separate Account
7 Not Applicable
8 Appendix F. Financial Statement
9 Legal Proceedings
10 Cover Page; Introduction; Detailed Information about the Policy;
Transfers; Surrender Charges; Withdrawals; Death Benefit; Voting
Rights; Free Look Provision
11 C.M. Life and the Separate Account
12 C.M. Life and the Separate Account; Sales and Other Agreements
13 C.M. Life and the Separate Account; Charges and Deductions
14 Introduction; C.M. Life and the Separate Account; Detailed
Information About the Policy; The Investment Advisors and
Portfolio Managers; C.M. Life and the Separate Account; Surrender
Charges; Other Charges; Sales and Other Agreements
15 Introduction; Detailed Information About the Policy; Exhibit
99(11)
16 Introduction; C.M. Life and the Separate Account
17 Introduction; Account Value and Net Surrender Value; Withdrawal
Fee; Exhibit 99(11)
18 C.M. Life and the Separate Account
19 Records and Reports
20 Not Applicable
21 Introduction; Policy Loan Privilege
22 Assignment
23 Bonding Arrangement
24 Detailed Information About the Policy; C.M. Life and the Separate
Account
25 C.M. Life and the Separate Account
26 C.M. Life and MassMutual; The Investment Advisers
27 Detailed Information About the Policy; C.M. Life and the Separate
Account
28 Appendix C; Directors and Executive Officers of C.M. Life
29 C.M. Life and the Separate Account
30 C.M. Life and MassMutual
<PAGE>
CROSS REFERENCE TO ITEMS REQUIRED
BY FORM N-8B-2
Item No. of
Form N-8B-2 Caption
- ----------- -------
31 Not Applicable
32 Not Applicable
33 Not Applicable
34 Not Applicable
35 Detailed Information about the Policy; Sales and Other Agreements
36 Not Applicable
37 Not Applicable
38 Sales and Other Agreements
39 Sales and Other Agreements
40 Sales and Other Agreements
41 Sales and Other Agreements
42 Not Applicable
43 Sales and Other Agreements
44 Detailed Information About the Policy; C.M. Life and the Separate
Account; Charges for Federal Taxes;
45 Not Applicable
46 Account Values; C.M. Life and the Separate Account
47 C.M. Life and the Separate Account
48 C.M. Life and the Separate Account
49 Detailed Information About the Policy
50 C.M. Life and the Separate Account
51 Cover Page; Detailed Information About the Policy; Additional
Information
52 C.M. Life and the Separate Account; Reservation of Rights
53 Federal Income Tax Considerations
54 Not Applicable
55 Not Applicable
56 Not Applicable
57 Not Applicable
58 Not Applicable
59 Appendix F (to be filed)
<PAGE>
FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICIES*
ISSUED BY C.M. LIFE INSURANCE COMPANY
This Prospectus describes a flexible premium adjustable variable life insurance
policy (the "Policy") offered by C.M. Life Insurance Company ("C.M. Life"). The
Policy, for as long as it remains in force, provides lifetime insurance
protection on the Insured named in the Policy, and pays a Death Benefit at the
death of the Insured. The minimum Initial Face Amount which may be purchased is
$50,000 currently. The Policy is designed to provide flexibility of premium
payments and Death Benefits by permitting the Owner, subject to certain
restrictions, to vary the frequency and amount of premium payments and to
increase or decrease the Death Benefit payable under the Policy. This
flexibility allows an Owner to provide for changing insurance needs under a
single insurance policy. A Policy also may be surrendered for its Net Surrender
Value.
The Owner may allocate Net Premiums and Account Value among the divisions (the
"Divisions") of the designated segment of C.M. Life Variable Life Separate
Account I (the "Separate Account") and a Guaranteed Principal Account (the
"GPA"). The assets of each Division will be used to purchase, at net asset
value, shares of a designated investment fund. Currently, the available funds
include six funds of MML Series Investment Fund (the "MML Trust"), four funds of
Oppenheimer Variable Account Funds (the "Oppenheimer Trust"), one fund of the
Variable Insurance Products Fund II (VIP II, managed by Fidelity Management &
Research Company), one fund of the T. Rowe Price Equity Series, Inc., and one
fund of American Century Variable Portfolios, Inc. The individual funds are as
follow.
<TABLE>
<CAPTION>
MML TRUST OPPENHEIMER TRUST VARIABLE INSURANCE PRODUCTS FUND II
- --------- ----------------- -----------------------------------
<S> <C> <C>
MML Equity Fund Oppenheimer Aggressive Growth Fund VIP II Contrafund Portfolio
MML Money Market Fund Oppenheimer Global Securities Fund
MML Managed Bond Fund Oppenheimer Growth Fund T. ROWE PRICE EQUITY SERIES, INC.
--------------------------------------
MML Blend Fund Oppenheimer Strategic Bond Fund T. Rowe Price Mid-Cap Growth Portfolio
MML Equity Index Fund
MML Small Cap Value Equity Fund AMERICAN CENTURY VARIABLE PORTFOLIOS, INC
-----------------------------------------
American Century VP Income & Growth
</TABLE>
The Owner bears the investment risk of any Account Value allocated to the
Separate Account. The Death Benefit may, and the Net Surrender Value will, vary
depending on the investment performance of the Divisions. While there is no
guaranteed minimum Net Surrender Value for funds invested in the Separate
Account, as long as a Policy is in force, the Policy's Death Benefit will never
be less than the Face Amount less any Policy Debt and any unpaid premiums.
Furthermore, the Policy will not terminate if the Policy Value is sufficient
available to pay the Monthly Charges or if the Safety Test has been met during a
Guarantee Period.
All Policies are serviced through C.M. Life's Administrative Office, located at
1295 State Street, Springfield, Massachusetts 01111-0001. The telephone number
is (413) 788-8411. C.M. Life's Home Office is located in Hartford, Connecticut.
THESE SECURITIES HAVE NOT BEEN APPROVED OR DISAPPROVED BY THE SECURITIES AND
EXCHANGE COMMISSION OR ANY STATE SECURITIES COMMISSION NOR HAS THE SECURITIES
AND EXCHANGE COMMISSION OR ANY STATE SECURITIES COMMISSION PASSED UPON THE
ACCURACY OR ADEQUACY OF THIS PROSPECTUS. ANY REPRESENTATION TO THE CONTRARY IS
A CRIMINAL OFFENSE. THIS PROSPECTUS IS VALID ONLY WHEN ACCOMPANIED BY THE
PROSPECTUSES FOR MML TRUST INVESTMENT FUND AND OPPENHEIMER VARIABLE ACCOUNT
FUNDS.
THIS PROSPECTUS SHOULD BE READ AND RETAINED FOR FURTHER REFERENCE.
THE PURPOSE OF THE POLICY WE ARE OFFERING IS TO PROVIDE INSURANCE PROTECTION.
WE DO NOT CLAIM THE POLICY IS IN ANY WAY SIMILAR TO OR COMPARABLE WITH A MUTUAL
FUND'S SYSTEMATIC INVESTMENT PLAN. REPLACING EXISTING INSURANCE WITH THE POLICY
DESCRIBED IN THIS PROSPECTUS MAY NOT BE TO YOUR ADVANTAGE.
MAY 1, 1998
This Prospectus does not constitute an offer or solicitation to acquire any
interest or participation in the survivorship flexible premium adjustable
variable life insurance policies offered by this Prospectus in any jurisdiction
to anyone to whom it is unlawful to make such an offer or solicitation in such
jurisdiction.
*Title may vary in some jurisdictions
<PAGE>
TABLE OF CONTENTS
<TABLE>
<S> <C> <C>
I. INTRODUCTION 3
II. DETAILED DESCRIPTION OF THE POLICY
Availability of Policy 4
Death Benefit 4
Premiums 6
Transfers 7
Policy Termination and Reinstatement 7
Charges and Deductions 8
Deductions from Premiums 9
Monthly Charges Against the Account Value 9
Daily Charges Against the Separate Account 9
Surrender Charges 9
Other Charges 10
Account Value and Net Surrender Value 10
Policy Loan Privilege 10
Free Look Provision 11
The Guaranteed Principal Account 11
When We Pay Proceeds 12
Federal Income Tax Considerations 12
Your Voting Rights 14
Reservation of Rights 15
Additional Benefits You Can Get by Rider 15
Payment Options 16
Beneficiary 16
Assignment 16
Limits on Our Right to Challenge the Policy 17
Error of Age or Sex 17
Suicide 17
Sales and Other Agreements 17
Compensation 18
Service Agreement 18
Bonding Arrangement 18
Legal Proceedings 18
Experts 18
III. ADDITIONAL INFORMATION
C.M. Life and MassMutual 18
Records and Reports 19
The Separate Account 19
MML Trust and Oppenheimer Trust 20
Variable Insurance Products Fund II 20
T. Rowe Price Equity Series, Inc. 20
American Century Variable Portfolios 20
The Investment Advisers 22
APPENDIX A
Definition of Terms 24
APPENDIX B
Examples of Death Benefit Option Changes 26
APPENDIX C
Rates of Return 27
APPENDIX D
Illustration of Death Benefits, Net Surrender Values, and Accumulated Premiums 31
APPENDIX E
Directors of C.M. Life 44
Principals 44
APPENDIX F
Financials (to be filed) 45
</TABLE>
2
<PAGE>
I. INTRODUCTION
NOTE: PLEASE REFER TO APPENDIX A, GLOSSARY FOR DEFINITIONS OF THE TERMS
CONTAINED IN THIS PROSPECTUS.
You should consult Your Policy for further understanding of its term and
conditions, and for any state-specific provisions and variances that may apply
to Your Policy.
The Policy is a life insurance contract providing a Death Benefit, an Account
Value, surrender rights, policy loan privileges, and other features
traditionally associated with life insurance. The Policy is a "flexible
premium" policy because there is no fixed schedule of premium payments.
Although the Owner may establish a schedule of premium payments ("Planned
Premium Payments"), failure to make a Planned Premium Payment will not
necessarily cause a Policy to terminate nor will making the Planned Premium
payments guarantee a Policy will remain in force. The flexibility of premium
payment timing and amount allows an Owner to match premium payments to income
flows or other financial decisions.
The Policy is "adjustable" because the Owner may choose to increase or decrease
the Death Benefit and to change the Death Benefit Option under the Policy. The
Policy is "variable" because the Death Benefit may, and the Net Surrender Value
will, vary in relation to the investment experience of the Divisions of the
Separate Account to which an Owner has allocated Net Premiums. Additionally,
the GPA's crediting interest rate may be adjusted periodically, although it
will not drop below 3%.
The following diagram summarizes the elements of this Policy, and how the
Policy works.
<TABLE>
<CAPTION>
HOW THE POLICY WORKS
------------------------------------------
PREMIUM PAYMENT
A Premium Expense Charge is deducted from
each Premium Payment (graphic arrow to
"Net Premium")
------------------------------------------
NET PREMIUM
Net Premium and Account Value are
allocated among the Divisions of the
Separate Account and the GPA (graphic
arrow to "Account Value")
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C>
INVESTMENT EARNINGS ACCOUNT VALUE CHARGES
Investment earnings of the Divisions of Monthly deductions for administrative,
the Separate Account less fund Insurance, and rider expenses are
investment management fees and separate ACCOUNT VALUE deducted each month
account fees are credited/ debited daily The Account Value is allocated among the
available investment options.
Interest is credited on values in the (graphic arrows to "Account Value OWNER ACCESSS TO ACCOUNT VALUE
Guaranteed Principal Account Charges", "Owner Access to Account You may access Account Values through
Value", "Death Benefit" and "Policy loans and withdrawals
(graphic arrow to "Account Value") Surrender")
- ------------------------------------------------------------------------------------------------------------------------------------
DEATH BENEFIT POLICY SURRENDER
A choice of 3 Death Benefit Options is In the first 10 years of coverage, if
available. The Option chosen may be coverage is surrendered, a surrender
changed at a later date charge will be deducted from the
surrender proceeds
</TABLE>
3
<PAGE>
II. DETAILED DESCRIPTION OF THE POLICY
AVAILABILITY OF THE POLICY
Individuals wishing to purchase a Policy must send a completed application to
C.M. Life's Administrative Office. Under our current rules, which can be
changed at our sole discretion, the minimum Initial Face Amount of a Policy is
$50,000. The Policy can be issued to an Insured between the ages of 18 and 85
inclusive. Before issuing a Policy, C.M. Life will require satisfactory
evidence of insurability, which usually will include a medical examination.
The Policy is available to individuals who are purchasing a Policy in connection
with employee benefit plans that qualify for tax benefits under the Internal
Revenue Code (the "qualified market") and to other individuals (the
"nonqualified market").
UNISEX Policies issued in states requiring "unisex" policies (currently only
Montana) provide policy values that do not vary by the sex of the Insured. In
addition, Policies issued in conjunction with employee benefit plans provide
policy values that do not vary by sex. Thus, references in the Prospectus to
sex-distinct policy values are not applicable to Policies issued in Montana or
issued in conjunction with employee benefit plans. Illustrations showing the
effect of these unisex rates on premiums, Net Surrender Values and Death
Benefits are available from C.M. Life on request.
DEATH BENEFIT
As long as the Policy remains in force, C.M. Life will, upon due proof of the
death of the Insured, pay the Death Benefit of the Policy to the named
Beneficiary. Although C.M. Life normally will pay the Death Benefit within
seven days of receiving satisfactory proof of the Insured's death, the Company
may delay payments under certain circumstances. All or part of the Death
Benefit can be paid in cash or under one or more of the payment options set
forth in the Policy.
MINIMUM DEATH BENEFIT. In order to qualify as life insurance pursuant to I.R.C.
Section 7702, the Policy has a Minimum Death Benefit. The Minimum Death Benefit
is determined using one of two allowable Death Benefit Compliance Tests. The
applicable Test is chosen at the time of application and cannot be changed after
the Policy is issued. Under one of the tests, the Cash Value Test, the Minimum
Death Benefit is equal to an applicable percentage of the Account Value. The
applicable percentage depends on the sex (male, female, unisex), tobacco
classification, and Attained Age of the Insured. Under the other test, the
Guideline Premium Test, the Minimum Death Benefit also is equal to an applicable
percentage of the Account Value, but the percentage varies only by the Attained
Age of the Insured. The applicable percentages are set forth in the Policy.
The choice of the Guideline Premium Test or the Cash Value Test will depend on
how You intend to pay premiums. In general, if You intend to pay premiums in
early policy years only, the Cash Value Test may be more appropriate. If You
intend to pay level premiums over a long period of years, the Guideline Premium
Test may be more appropriate. It is important You see policy illustrations of
both approaches to determine how the policy works under each approach, and which
is best for You.
DEATH BENEFIT OPTIONS. The Death Benefit is the amount of the benefit provided
under the Death Benefit Option in effect on the date of death, less any
outstanding Policy Debt and less any unpaid premium needed to avoid policy
termination under the grace period provision. (See POLICY TERMINATION AND
REINSTATEMENT) The Owner may choose one of three Death Benefit Options: Option
1 (a level amount option) or Options 2 or 3 (variable amount options). The Death
Benefit Option is chosen in the application and subsequently may be changed
subject to certain restrictions described in CHANGES IN THE DEATH BENEFIT
OPTION.
Options 1, 2 and 3 provide the following benefits.
OPTION 1 - Under Option 1, the benefit provided is the greater of: (a) the Face
Amount on the date of death; and (b) the Minimum Death Benefit on the date of
death.
OPTION 2 - Under Option 2, the benefit provided is the greater of: (a) the Face
Amount plus the Account Value on the date of death; and (b) the Minimum Death
Benefit on the date of death.
OPTION 3 - Under Option 3, the benefit provided is the greater of: (a) the Face
Amount plus the premiums paid less any premiums refunded (See PREMIUM
LIMITATIONS) under the Policy to the date of death; and (b) the Minimum Death
Benefit on the date of death.
The following examples illustrate how changes in the Account Value and the
amount of premiums paid may affect the Death Benefits under Options 1, 2, and 3.
EXAMPLE I
Under Option 1, the Death Benefit will remain at the Face Amount, in this
example $1,000,000, unless the Minimum Death Benefit exceeds the Face Amount.
Assume the Owner has selected Option 1 with a Face Amount of $1,000,000. The
Account Value is $50,000. The Death Benefit in this case is $1,000,000. The
Minimum Death Benefit is $219,000. If the Account Value increases to $80,000,
the Minimum Death Benefit increases to $350,400, but the Death Benefit remains
at $1,000,000. If the Account Value decreases to $30,000, the Minimum
4
<PAGE>
Death Benefit decreases to $131,400 and the Death Benefit still remains at
$1,000,000.
EXAMPLE II
Under Option 2, the Death Benefit will be the Face Amount plus the Account Value
unless the Minimum Death Benefit exceeds the sum of the Face Amount plus the
Account Value.
Assume the Owner has selected Option 2 with a Face Amount of $1,000,000. The
Account Value is $50,000, and the Minimum Death Benefit is $219,000. The Death
Benefit in this case is $1,050,000 (Face Amount plus Account Value). If the
Account Value increases to $80,000, the Minimum Death Benefit will increase to
$350,400, and the Death Benefit will increase to $1,080,000. If the Account
Value decreases to $30,000, the Minimum Death Benefit will decrease to $131,400,
and the Death Benefit will decrease to $1,030,000.
EXAMPLE III
Under Option 3, the Death Benefit will be the Face Amount plus the premiums paid
under the Policy, less any premium refunds, unless the Minimum Death Benefit
exceeds the sum of the Face Amount plus the premiums paid.
Assume the Owner has selected Option 3 with a Face Amount of $1,000,000. The
Account Value is $50,000, the Minimum Death Benefit is $219,000 and premiums
paid under the Policy to-date total $40,000. The Death Benefit in this case is
$1,040,000. If an additional $30,000 of premium is paid into the Policy and the
Account Value increases to $80,000, the Minimum Death Benefit will increase to
$350,400, and the Death Benefit will increase to $1,070,000.
CHANGES IN DEATH BENEFIT OPTION. After the first Policy Year, the Owner may
change the Death Benefit Option. Any changes of Death Benefit Option may require
a written application and satisfactory evidence of insurability. The effective
date of any change will be the Monthly Charge Date that is on or precedes the
date C.M. Life approves the change. A change in the Death Benefit Option will
not in and of itself result in an immediate change in the amount of a Policy's
Death Benefit. The Policy Face Amount will be increased or decreased to give the
same Death Benefit under the new Death Benefit Option.
A change in Death Benefit Option will not be allowed if it would result in a
Face Amount of less than $50,000 after the change, if the insured is older than
Attained Age 85.
An increase or decrease in Face Amount resulting from a change in the Death
Benefit Option will affect the Monthly Charges, as they depend in part on the
Face Amount. The charge for certain additional benefits also may be affected.
The Surrender Charge, however, will not be affected by an increase or decrease
in Face Amount resulting from a change in the Death Benefit Option.
For examples of Death Benefit Option changes and their impacts on the contract,
see APPENDIX B.
CHANGES IN FACE AMOUNT. The Owner may request an increase or decrease in the
Face Amount subject to certain requirements. Any request for an increase or
decrease must be submitted in writing to C.M. Life's Administrative Office. It
will become effective on the Monthly Charge Date that is on or precedes C.M.
Life's acceptance of the request.
INCREASES IN FACE AMOUNT. For an increase in the Face Amount, C.M. Life requires
a written application and satisfactory evidence of insurability. An increase
may not be less than $15,000, and no increase will be permitted after the
younger Insured reaches Attained Age 85.
An increase in Face Amount will affect the Monthly Charges. The Face Amount
Charge and the Insurance Charges will increase.
DECREASES IN FACE AMOUNT. Decreases in coverage are allowed after the first
Policy Year or one year after a Face Amount increase by written request. A
decrease will not be permitted if the Face Amount would fall below $50,000.
A decrease may result in the deduction of Surrender Charges from the Account
Value. (For a discussion of the Surrender Charges associated with a decrease,
see SURRENDER CHARGES.) Any Surrender Charges applicable to a decrease will be
deducted from the Division(s) of the Separate Account and from the GPA in
proportion to the non-loaned values in each.
A decrease will reduce the Face Amount in the following order: (a) the Face
Amount provided by the most recent increase; (b) the Face Amounts provided by
the next most recent increases successively; and finally (c) the Initial Face
Amount. As a result, a decrease in Face Amount will affect the Monthly Charges
deducted from the Account Value.
A decrease may result in the Policy becoming a "modified endowment contract".
(See POLICY PROCEEDS, PREMIUMS AND LOANS.)
PREMIUMS
Subject to certain limitations, the Owner has flexibility in determining the
frequency and amount of premium payments.
PREMIUM FLEXIBILITY. Unlike traditional insurance policies, this Policy frees
the Owner from required premium payments and a rigid premium schedule. Instead,
C.M. Life requires an Owner to pay only a minimum initial premium at the time of
application or at any time before delivery of
5
<PAGE>
the Policy. After the first premium has been paid, subject to certain
limitations, premiums may be paid in any amount and at any interval.
The minimum initial premium depends on the planned frequency of premium
payments, and the Issue Age, sex, and rating class of the Insured, as well as
the initial Death Benefit Option and Initial Face Amount of the Policy.
PLANNED ANNUAL PREMIUM. When applying for a Policy, the Owner will select a
planned annual premium and payment frequency (annual, semiannual, quarterly, or
monthly check service). The planned premium at the payment frequency chosen is
shown on the schedule page of the Policy. C.M. Life will send premium notices
for the planned premium according to the amount and frequency selected. The
Owner may change the amount and frequency of planned premiums at any time by
sending written notice to C.M. Life's Administrative Office.
An Owner may elect to pay premiums by means of a pre-authorized check procedure.
Under this procedure, premium payments are deducted automatically on a monthly
basis from a designated bank account. An Owner does not receive a "bill" for
these payments.
There is no penalty if the planned premium is not paid, nor does payment of this
amount guarantee coverage for any period of time. Instead, the duration of the
Policy depends on maintaining a sufficient Policy Value, or meeting the Safety
Test ( See POLICY TERMINATION section.). The Policy Value is equal to the
Account Value less any outstanding Policy Debt during the first three Policy
Years. It is equal to the Net Surrender Value in years four and later. Even if
planned premiums are paid, if the Safety Test is not met, the Policy terminates
when the Policy Value becomes insufficient to pay the Monthly Charges and the
grace period expires without sufficient payment.
PREMIUM LIMITATIONS. After the first premium is paid, the minimum premium
payment is $20. If the Cash Value Test has been chosen as the Death Benefit
Compliance Test, the maximum premium that may be paid in any Policy Year without
evidence of insurability is the greatest of: (a) the premium that will not
increase the net amount at risk under the Policy; (b) twice the Policy's Target
Premium plus $100; and (c) the annual premium paid in the preceding Policy year.
If the Guideline Premium Test has been chosen, the maximum premium is equal to
the lesser of the maximum premium as determined above and the Guideline Premium
Test premium limitation. We have the right to refund any premium amount that
exceeds these limitations. Premium payments should be sent either to C.M.
Life's Administrative Office or to the address indicated on the billing notice.
ALLOCATION OF NET PREMIUM PAYMENTS. The Net Premium equals the premium paid
less the Premium Expense Charge. (See DEDUCTIONS FROM PREMIUMS.) At the time
of Application, the Owner indicates how Net Premiums are to be allocated among
the Divisions of the Separate Account and the GPA. The allocation percentages
must be in whole numbers and the sum of the allocation percentages must equal
100%.
The allocation percentages may be changed without charge at any time by
providing written notice to C.M. Life's Administrative Office. The maximum
number of different Divisions that may be used during the life of the Policy is
16.
Any Initial Net Premium received with an application will be deposited to C.M.
Life's General Account and earn interest at the rate set by C.M. Life from the
Policy Date to the date the Policy is issued. Once the Policy has been issued,
the Net Premium plus interest earnings, less any Monthly Charges will be
allocated either in accordance with the allocation percentages in the
Application, or to the Money Market Division of the Separate Account on the next
business day following the Issue Date. If under the Free Look Provision, the
Owner receives (i) any premium paid for this Policy plus (ii) interest credited
to this Policy under the Guaranteed Principal Account, plus or minus (iii) an
amount reflecting the investment experience of the investment divisions of the
Separate Account under this Policy to the date the Policy is received by us,
minus (iv) any amounts withdrawn and any Policy Debt, this amount will be
allocated to the GPA and the Divisions of the Separate Account based on the
allocation percentages in the Application. If under the Free Look Provision,
the Owner receives the total of all premiums paid for the Policy, reduced by any
amounts borrowed or withdrawn, this amount will be allocated to the Money Market
Division of the Separate Account.
If the Initial Net Premium plus interest earnings, less any Monthly Charges is
allocated to the Money Market Division of the Separate Account, Subsequent Net
Premiums received during the Free Look Period also will be allocated to the
Money Market Division of the Separate Account at the price next determined after
receipt in good order at our Administrative Office, or at the address indicated
on the billing notice. At the end of the Free Look Period, the Money Market
account balance will be transferred to the GPA and the Separate Accounts in
accordance with the allocation percentages in the Application.
If the Initial Net Premium plus interest earnings, less any Monthly Charges is
allocated in accordance with the allocation percentages in the Application,
Subsequent Net Premiums will be deposited on the Valuation Date on or next
following the date We receive the Subsequent Net Premiums in good order at our
Administrative Office, or at the address indicated on the billing notice.
Transfers from one Division to another will be credited on the Valuation Date
the Transfer Request is received in good order.
6
<PAGE>
TRANSFERS
By written request, the Owner may transfer all or part of the Account Value of a
Division of the Separate Account to any other Division or to the GPA. Although
C.M. Life currently imposes no limitation on the right of the Owner to make
transfers, we reserve the right to limit transfers to no more than one every 90
days in connection with compliance with Section 404(c) of ERISA. Any limitation
would not apply to a transfer of all funds in the Separate Account to the GPA or
to automated transfers made in connection with any program C.M. Life has in
place.
Transfers of values from the GPA to the Separate Account are limited to one each
Policy Year. Any transfer from the GPA cannot exceed 25% of the Fixed Account
Value (less any Policy Debt) at the time of the transfer. If 25% of the Fixed
Account Value has been transferred from the GPA each year for three consecutive
Policy Years, and no value has been transferred into the GPA, nor premiums
allocated to the GPA, during this time, the remainder of the Fixed Account Value
(less any Policy Debt) may be transferred, in one transaction, out of the GPA in
the succeeding Policy Year.
Any transfer is effective on the Valuation Date at the price next determined
after receipt of the request in good order at our Administrative Office. There
are no charges for transfers.
POLICY TERMINATION AND REINSTATEMENT
POLICY TERMINATION. This Policy will not terminate for failure to pay premiums
since premium payments, other than the Initial Premium Payment, are not
specifically required. Rather, if in the first three Policy Years the Account
Value less any Policy Debt is not enough to cover the Monthly Charges on a
Monthly Charge Date, or if in subsequent Policy Years the Net Surrender Value is
not enough to cover the Monthly Charges on a Monthly Charge Date, the Policy
will enter a 61-day grace period unless the Safety Test has been met.
At the beginning of the grace period, C.M. Life will mail a notice to the
Owner's last known address stating the amount of premium needed to cover the
shortfall. During the grace period, the Policy remains in force. If the
required premium is not paid within 61 days after the Monthly Charge Date (or,
if later, within 30 days after we mail the written notice), the Policy
terminates without value.
If the Account Value less Policy Debt in the first three Policy Years or the Net
Surrender Value in subsequent years is insufficient to pay the Monthly Charges
on a particular Monthly Charge Date and the Safety Test (as described below) has
been met on that date, the Monthly Charges for that Date will be reduced to an
amount equal to the Account Value less any Policy Debt.
The Safety Test can be met only during a Guarantee Period. There are two
Guarantee Periods. One Period is the lesser of 20 years or to the Insured's age
90. The other is to the Insured's age 100. Each Guarantee Period has a
Guarantee premium associated with it. These premiums vary depending on the
issue age, sex, and issue classification of the Insured and the Death Benefit
Option in effect. The Guarantee premiums for Your Policy are shown in the
Policy. On any day during a Guarantee Period, the Safety Test is met if the
premiums paid less amounts withdrawn accumulated with interest to that day,
equal or exceed the Guarantee premium accumulated with interest to that date.
The effective annual rate of interest used to accumulate these amounts is 3%.
The Guarantee Period in effect is determined by the Guarantee premium paid. The
Guarantee Periods available and the Safety Test may vary depending on the
contract state of Your Policy. Consult Your Policy for the Guarantee Periods
available to You.
REINSTATEMENT. For a period of five years after a Policy terminates, the Owner
can request that We reinstate the Policy provided the Insured has not died since
the Policy termination. However, the Policy cannot be reinstated if it has been
surrendered for its Net Surrender Value. Please note a termination or
reinstatement may cause the Policy to become a modified endowment contract. (See
MODIFIED ENDOWMENT CONTRACTS.)
Before We will reinstate the Policy, We must receive the following:
(a) Evidence of insurability satisfactory to C.M. Life;
(b) A premium payment sufficient to keep the policy in force for three months
following reinstatement;
(c) Where applicable, a signed acknowledgement the Policy has become a modified
endowment contract.
If We reinstate the Policy, the Face Amount for the reinstated Policy will be
the same as it would have been if the Policy had not terminated. The premium
payment will be allocated based on the allocation requested at the time of
reinstatement effective on the Monthly Charge Date on which the Policy is
reinstated. The Account Value at the time of reinstatement will be the net
amount of the premium paid at the time of reinstatement, less any Monthly
Charges taken at that time.
CHARGES AND DEDUCTIONS
Charges will be deducted in connection with the Policy to compensate C.M. Life
for: (a) providing the insurance
7
<PAGE>
benefits under the Policy (including any riders); (b) administering the Policy;
(c) assuming certain risks in connection with the Policy (including any riders);
and (d) expenses incurred in selling and distributing the Policy. Additionally,
certain expenses are deducted from the underlying funds. For more information
about these expenses, see the individual fund prospectuses. A summary of the
product and separate account charges is as follows.
<TABLE>
<CAPTION>
CURRENT RATE GUARANTEED RATE
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C>
Premium Expense Charge Coverage Years 1-10:13% of premium up to All Coverage Years: 13% of premium up to
Expense Premium; 3% of premium over Expense Expense Premium; 3% of premium over Expense
Premium Premium
Coverage Years 11+: 3% of all premium
Administrative Charge Policy Years 1-10: $12 per month per policy All Coverage Years: $12 per month per policy
Policy Years 11+: $6 per month per policy
Face Amount Charge Coverage Years 1-10: $0.13 per month per Coverage Years 1-10: $0.13 per month per
$1,000 of Face Amount $1,000 of Face Amount
Coverage Years 11+: $0.0 Coverage Years 11+: $0.0
Insurance Charges A per thousand rate multiplied by the For standard risks, the guaranteed cost of
amount at risk each month. The rate varies insurance rates are based on 1980
by the sex, issue age, and risk Commissioners Standard Ordinary (CSO)
classification of the Insured, and the Year Mortality Tables.
of Coverage.
Mortality and Expense Risk Charge All Policy Years: 0.25% on an annual basis All Policy Years: 0.90% on an annual basis
of daily net asset value of the Separate of daily net asset value of the Separate
Account Account
Loan Rate Expense Charge Policy Years 1-10: 0.50% of loaned amount All Policy Years: 2.0% of loaned amount
Policy Years 11+: 0.25% of loaned amount
Withdrawal Fee $25 $25
Surrender Charges First coverage year: the lesser of 100% of First coverage year: the lesser of 100% of
the Target Premium or $60 per thousand of the Target Premium or $60 per thousand of
Face Amount. Face Amount.
Coverage years 2-10: the prior year Coverage years 2-10: the prior year
Surrender Charge reduced by 10% of the Surrender Charge reduced by 10% of the
first year Surrender Charge first year Surrender Charge
- ----------------------------------------------------------------------------------------------------------------------------------
</TABLE>
DEDUCTIONS FROM PREMIUMS
A Premium Expense Charge is deducted from each premium payment made prior to the
allocation of the payment to the Divisions of the Separate Account and the GPA.
The Premium Expense Charge distinguishes between premium payments up to the
Expense Premium, and premium payments over the Expense Premium. The Expense
Premium is based on the issue age, sex, and risk classification of the Insured.
Premiums are allocated to the Initial Face Amount and any subsequent increases
based on the ratio of the Expense Premium for each segment to the total of the
Expense Premiums for all segments
8
<PAGE>
MONTHLY CHARGES AGAINST THE ACCOUNT VALUE
Charges will be deducted from the Account Value on each Monthly Charge Date. The
Monthly Charges consist of: (a) an Administrative Charge; (b) a Face Amount
Charge; (c) an Insurance Charge; and (d) a rider charge for any additional
benefits provided by rider. The Monthly Charges will be deducted from the
Division(s) of the Separate Account and the GPA in proportion to the non-loaned
values of the Policy in the Division(s) and the GPA.
ADMINISTRATIVE CHARGE AND FACE AMOUNT CHARGE. The monthly Administrative Charge
and Face Amount Charge reimburse C.M. Life for expenses incurred in issuing and
administering the Policy, and for such activities as processing claims,
maintaining records and communicating with Owners.
INSURANCE CHARGES. The monthly Insurance Charge for a Policy is equal to the
"amount at risk" under the Policy, multiplied by the monthly Insurance Charge
rate for that Policy month. The amount at risk is determined on the first day
of each Policy month and is the amount by which the Death Benefit (discounted at
the monthly equivalent of 3% per year) exceeds the Account Value.
Insurance rates will be based on the sex, Issue Age, and risk class of the
Insured, and the Year of Coverage. C.M. Life currently places Insureds into the
following three standard rate classes: Select-Preferred Nontobacco, Preferred
Nontobacco, and Preferred Tobacco; as well as substandard rate classes involving
higher mortality risks. In an otherwise identical Policy, the monthly insurance
rate is higher for tobacco users than for those who do not use tobacco and
higher for Preferred Nontobacco Insureds than for Select-Preferred Nontobacco
Insureds.
RIDER CHARGE. The monthly rider charge will include charges for any additional
benefits provided by rider.
DAILY CHARGES AGAINST THE SEPARATE ACCOUNT
MORTALITY AND EXPENSE RISK CHARGE. C.M. Life assesses a daily charge against
the net asset value of the Separate Account for mortality and expense risks.
This charge is not deducted from the assets in the GPA.
The mortality risk We assume is that the group of lives insured under our
Policies may, on average, live for shorter periods of time than we estimated.
The expense risk We assume is that our costs of issuing and administering
Policies may be more than We estimated.
If not all the money C.M. Life collects from this charge is needed to cover
death benefits and expenses, it will be our gain and will be used for any proper
purpose, including payment of sales commissions. Conversely, even if the money
We collect is insufficient, We will provide for all Death Benefits and expenses.
INVESTMENT MANAGEMENT FEE AND OTHER EXPENSES. Because the Divisions of the
Separate Account purchase shares of MML Trust, Oppenheimer Trust, (Fidelity)
Variable Insurance Products Fund II, T. Rowe Price Equity Series, Inc., or
American Century Variable Portfolios, Inc., the value of Accumulation Units of
the Divisions will reflect the investment management fee and other expenses
incurred by these entities. The prospectuses for these funds contain additional
information concerning such fees and expenses.
SURRENDER CHARGES
During the first 10 Years of Coverage under the Initial Face Amount, and during
the first 10 Years of Coverage under any increase in Face Amount, C.M. Life will
impose a Surrender Charge against the Account Value if the Owner surrenders the
Policy or decreases the Face Amount under the Policy. The Surrender Charge in
the first Year of Coverage is the lesser of 100% of the Target Premium or $60
per thousand of Face Amount. The Target Premium is used to determine the
maximum premium limitation, Surrender Charges and agent commissions. The Target
Premium is based on the issue age, sex, and risk classification of the Insured.
The Surrender Charge is decreased by 10% of the first year Surrender Charge in
each of the next nine years of coverage, and is zero in the eleventh year.
Surrender Charges are calculated separately for the Initial Face Amount and for
each increase in the Face Amount.
SURRENDER CHARGE UPON DECREASE IN SELECTED FACE AMOUNT. Elected decreases in
Face Amount--that is, decreases resulting from other than a withdrawal or a
change in the Death Benefit Option-- result in canceling all or a part of
previously issued Face Amount segments. A partial Surrender Charge is assessed
and deducted from the Account Value. The partial Surrender Charge is equal to
the Surrender Charge associated with each canceled Face Amount segment. If the
partial Surrender Charge for a decreased or canceled Face Amount segment would
be greater than the Account Value of the policy, the partial Surrender Charge
for that decrease is set equal to the Account Value on the date of the
surrender.
The Surrender Charge after the decrease equals the Surrender Charge prior to the
decrease less the partial Surrender Charge taken.
9
<PAGE>
OTHER CHARGES
WITHDRAWAL FEE. For each Withdrawal, a charge of $25 will be deducted from the
amount withdrawn. This fee is guaranteed not to increase for the duration of
the Policy.
LOAN INTEREST RATE EXPENSE CHARGE. This charge reimburses C.M. Life for
expenses incurred in administering loans.
ACCOUNT VALUE AND NET SURRENDER VALUE
ACCOUNT VALUE. The Account Value of the Policy is the sum of all Net Premium
payments adjusted by periodic charges and credits and by Withdrawals. Following
the Free Look Period, this amount is allocated among the Separate Account
Divisions and the GPA according to the net premium allocation requested at the
time of Application (See ALLOCATION OF NET PREMIUM PAYMENTS section for more
details.).
INVESTMENT RETURN. The investment return of a Policy is based on:
(a) The Account Value held for the Policy in each Division of the Separate
Account;
(b) The investment experience of each Division as measured by its actual net
rate of return; and
(c) The interest credited on Account Values held in the GPA.
The investment experience of a Division reflects increases and decreases in the
net asset value of the shares of the underlying Fund, any dividend or capital
gains distributions declared by the Fund, and any charges assessed against
assets of the Division. The investment experience is determined each day the
net asset value of the underlying Fund is determined -- that is, on each
Valuation Date. The actual net rate of return for a Division measures the net
investment experience from the end of one Valuation Date to the end of the next
Valuation Date.
NET SURRENDER VALUE. The Policy may be fully surrendered for its Net Surrender
Value at any time while the Insured is living. The Net Surrender Value is equal
to the Account Value less any applicable Surrender Charges and less any Policy
Debt as of the date the Company receives the request to surrender in good order.
The surrender will be processed within 14 days.
An Owner may surrender the Policy by sending a written request together with the
Policy to C.M. Life's Administrative Office. The proceeds will be determined as
of the end of the Valuation Date on which the request for surrender is received
in good order.
WITHDRAWALS. After the first Policy Year, the Owner may, subject to certain
restrictions, withdraw up to 75% of the Net Surrender Value. For each
Withdrawal, a fee of $25 is deducted from the amount withdrawn. The minimum
amount of a Withdrawal is $100 (before deducting the Withdrawal fee). We
reserve the right to prohibit Withdrawals that would result in a reduction of
the Face Amount to less than $50,000.
The Withdrawal amount will be made on a pro rata basis from the Divisions of the
Separate Account and the GPA based on the non-loaned Account Value of the
Divisions and the GPA at the price next determined after receipt in good order
of the Withdrawal request, and will be processed within seven days. The
Withdrawal amount attributable to a Division of the Separate Account or to the
GPA may not exceed the non-loaned Account Value of the Division or GPA. If
Death Benefit Option 1 or 3 is in effect, C.M. Life will reduce the Face Amount
by the amount of the Withdrawal unless satisfactory evidence of insurability is
provided. A Surrender Charge is not assessed for a Withdrawal.
POLICY LOAN PRIVILEGE
GENERAL. After the first Policy Year, the Owner may obtain a loan from the
Policy as long as the Account Value exceeds the total of any Surrender Charges.
The Policy must be assigned to C.M. Life as collateral for the loan. The
maximum amount that can be borrowed at any time is 90% of the Policy's Account
Value less any Surrender Charge. This is reduced by any outstanding Policy
Debt, which includes accrued interest.
SOURCE OF LOAN. The Policy loan amount requested is taken from the Divisions of
the Separate Account and the GPA in proportion to the Account Value of each
Division and the GPA (excluding any outstanding loans) on the date of the loan.
Loaned amounts are taken from the Divisions by liquidating units and the
resulting dollar amounts are transferred to the loaned portion of the GPA. We
may delay the granting of any loan taken from the GPA for up to six months. We
also may delay the granting of any loan from the Divisions of the Separate
Account during any period that: (i) the New York Stock Exchange is closed (other
than customary weekend and holiday closings); (ii) trading is restricted; (iii)
the SEC determines a state of emergency exists; or (iv) the Securities and
Exchange Commission permits C.M. Life to delay payment for the protection of our
Owners.
Whenever total Policy Debt (which includes accrued interest) equals or exceeds
the Account Value less Surrender Charges, C.M. Life will send a notice to the
10
<PAGE>
Owner. This notice will state the amount necessary to bring the Policy Debt
back within the limit. If We do not receive payment of that amount plus a
premium payment sufficient to keep the policy in force for three months, within
31 days after the date we mailed the notice, and if Policy Debt exceeds the
Account Value less any Surrender Charges at the end of those 31 days, the Policy
terminates without value.
LOAN INTEREST CHARGED. At the time of Application, the Owner may select a loan
interest rate of 5% or (in all jurisdictions except Arkansas) an adjustable loan
rate. Each year C.M. Life will set the adjustable rate that will apply for the
next Policy Year. The maximum loan rate is based on the Monthly Average
Corporate yield on seasoned corporate bonds as published by Moody's Investors
Service, Inc., or, if it is no longer published, a substantially similar
average. The maximum rate is the published monthly average for the calendar
month ending two months before the Policy Year begins, or 4%, whichever is
higher. If the maximum limit is not at least 1/2% higher than the rate in
effect for the previous year, we will not increase the rate. If the maximum
limit is at least 1/2% lower than the rate in effect for the previous
year, we will decrease the rate.
Interest on Policy loans accrues daily and becomes part of the Policy Debt as it
accrues. It is due on each Policy Anniversary. If not paid when due, the
interest will be added to the loan and, as part of the loan, will bear interest
at the same rate. Any interest capitalized on a Policy Anniversary will be
treated the same as a new loan and will be taken from the Divisions and the GPA
in proportion to the non-loaned Account Value in each.
REPAYMENT. All or part of any Policy Debt may be repaid at any time while the
Insured is living and while the Policy is in force. Any loan repayment made
within 30 days of the Policy Anniversary date pays policy loan interest due.
Any other loan repayment first will be allocated to the GPA until the Owner has
repaid all loan amounts that originated from the GPA. Additional loan repayments
will be allocated according to the premium allocation factors in effect. Loan
repayments must be clearly identified as such; otherwise they will be considered
premium payments.
Any outstanding Policy Debt will be deducted from the proceeds payable at death
or the surrender of the Policy.
INTEREST ON LOANED VALUE. Any loaned amount is held in the GPA and earns
interest at a rate determined by C.M. Life, equal to the greater of 3% and the
Policy loan rate less the Loan Interest Rate Expense Charge. This Charge is 2%
on a guaranteed basis and 0.50% in Policy Years one through 10 and 0.25% in
Policy Years 11 and later on a current basis.
EFFECT OF LOAN. A Policy loan affects the Policy since the Death Benefit and
Net Surrender Value under a Policy are reduced by the amount of the loan.
Repayment of the loan increases the Death Benefit and Net Surrender Value under
the Policy by the amount of the repayment. Taking a Policy loan could have tax
consequences. (See POLICY PROCEEDS, PREMIUMS AND LOANS.)
As long as a loan is outstanding, a portion of the Policy Account Value equal to
the loan is held in the GPA. This amount is not affected by the Separate
Account investment performance. The Account Value may be impacted since the
portion of the Account Value equal to the Policy loan is credited with an
interest rate declared by C.M. Life rather than a rate of return reflecting the
investment performance of the Division(s) of the Separate Account from which the
loan was taken.
FREE LOOK PROVISION
The Owner may cancel the Policy within 10 days (This period may be longer in
some states.)
The Owner should mail or deliver the Policy and Policy delivery receipt either
to C.M. Life's Administrative Office or to the agent who sold the Policy or to
one of our agency offices. If the Policy is canceled in this fashion, a refund
will be made to the Owner. The refund may be equal to the sum of: (i) any
premium paid for this Policy plus (ii) interest credited to this Policy under
the Guaranteed Principal Account, plus or minus (iii) an amount reflecting the
investment experience of the investment divisions of the Separate Account under
this Policy to the date the Policy is received by us, minus (iv) any amounts
withdrawn and any Policy Debt. Or, the refund may be equal to the total of all
premiums paid for the Policy, reduced by any amounts borrowed or withdrawn.
Check Your contract to determine which refund is applicable under Your Policy.
THE GUARANTEED PRINCIPAL ACCOUNT
An Owner may allocate some or all of the Net Premiums and transfer some or all
of the Account Value in the Divisions of the Separate Account, to the Guaranteed
Principal Account ("GPA"). Because of exemptive and exclusionary provisions,
interests in C.M. Life's General Account (which include interests in the
Guaranteed Principal Account) are not registered under the Securities Act of
1933 and the General Account is not registered as an investment company under
the Investment Company Act of 1940. Accordingly, neither the General Account
nor any interests therein are subject to the provisions of these Acts, and C.M.
Life has been advised that the staff of the Securities and Exchange Commission
has not reviewed the disclosures in the Prospectus relating to the General
Account. Disclosures regarding the General Account may, however, be subject to
certain generally applicable
11
<PAGE>
provisions of the federal securities laws relating to the accuracy and
completeness of statements made in prospectuses.
Amounts allocated to the Guaranteed Principal Account become part of the General
Account of C.M. Life, which consists of all assets owned by C.M. Life other than
those in the Separate Account and other separate accounts of C.M. Life. Subject
to applicable law, C.M. Life has sole discretion over the investment of the
assets of its General Account.
C.M. Life guarantees those amounts allocated to the GPA in excess of any Policy
Debt (which includes accrued interest) will accrue interest daily at an
effective annual rate at least equal to 3%. For amounts in the GPA equal to any
Policy Debt, the guaranteed minimum interest rate is an effective annual rate of
3% or, if greater, the Policy loan rate less the Loan Interest Rate Expense
Charge. This charge will not be greater than 2% per year. Such interest will be
paid regardless of the actual investment experience of the GPA. Although C.M.
Life is not obligated to credit interest at a rate higher than the guaranteed
minimum, it may declare a higher rate applicable for such periods as it deems
appropriate.
WHEN WE PAY PROCEEDS
If the Policy has not terminated, payment of the Net Surrender Value is made
within 14 days, and payment of loan proceeds or the Death Benefit are made
within seven days after We receive all required documents in a form satisfactory
to us at our Administrative Office. But We can delay payment of the Net
Surrender Value or any Withdrawal from the Separate Account or any loan proceeds
attributable to the Separate Account during any period when: (i) it is not
reasonably practical to determine the amount because the New York Stock Exchange
is closed (other than customary week-end and holiday closings); or (ii) trading
is restricted by the SEC; or (iii) the SEC declares an emergency exists; or (iv)
the SEC, by order, permits us to delay payment in order to protect our Owners.
We may delay paying any Net Surrender Value, any Withdrawal, or any loan
proceeds based on the GPA for up to six months from the date the request is
received at our Administrative Office.
We can delay payment of the entire Death Benefit if payment is contested. We
investigate all death claims arising within the two-year contestable period. We
may investigate death claims arising beyond the two-year contestable period.
Upon receiving the information from a completed investigation, We generally make
a determination within five days as to whether the claim should be authorized
for payment. Payments are made promptly after authorization.
If payment of a Net Surrender or Withdrawal is delayed for 30 days or more, We
add interest to the date of payment at the same rate it is paid under the
interest payment option. Interest is paid on the Death Benefit from the date of
death to the date of payment.
FEDERAL INCOME TAX CONSIDERATIONS
POLICY PROCEEDS, PREMIUMS AND LOANS C.M. Life believes the Policy meets the
statutory definition of life insurance under Code Section 7702 and hence
receives the same tax treatment as that accorded to fixed benefit life
insurance. Thus, the Death Benefit under the Policy is generally excludible
from the gross income of the Beneficiary under Section 101(a)(1) of the Code.
As an exception to this general rule, where a Policy has been transferred for
value, only the portion of the Death Benefit that is equal to the total
consideration paid for the Policy may be excluded from gross income. The Owner
is not deemed to be in constructive receipt of the cash values, including
increments thereon, under the Policy until a full surrender or partial
Withdrawal is made (unless the Policy is a "modified endowment contract," as
discussed below).
Decreases in Face Amount and Withdrawals may be taxable depending on the
circumstances. Code Section 7702(f)(7) provides that where a reduction of future
benefits occurs during the first 15 years after a Policy is issued and where
there is a cash distribution associated with that reduction, the Owner may be
taxed on all or a part of the amount distributed. Where the provisions of Code
Section 7702(f) do not cause a taxable event, a Withdrawal is taxable only to
the extent it exceeds the Owner's unrecovered premiums. After 15 years, such
cash distributions are not subject to federal income tax, except to the extent
they exceed the total amount of premiums paid but not previously recovered.
C.M. Life suggests You consult with your tax adviser in advance of a proposed
decrease in Face Amount or Withdrawal as to the portion, if any, which would be
subject to federal income tax.
A change of the Owner or the Insured or an exchange or assignment of the Policy
may have tax consequences depending on the circumstances.
C.M. Life also believes that under current law any loan received under the
Policy will be treated as Policy Debt of an Owner, and that no part of any loan
under a Policy will constitute income to the Owner unless the Policy has become
a "modified endowment contract." If the Policy is a modified endowment contract
under Code Section 7702A, loans will be fully taxable to the extent of any
income in the Policy and could be subject to an additional 10 percent tax. In
general, income in the policy is defined as the excess of the Account Value
(both loaned and unloaned) over
12
<PAGE>
previously unrecovered premiums paid. See the discussion on modified endowment
contracts below. Under the "personal" interest limitation provisions of the Tax
Reform Act of 1986, interest on Policy loans used for personal purposes, which
otherwise meet the requirements of Code Section 264, will no longer be tax-
deductible. However, other rules may apply to allow all or part of the interest
expense as a deduction if the loan proceeds are used for "trade or business" or
"investment" purposes. See your tax adviser for further guidance.
If the Policy Owner is a business or corporation, the 1986 Act may impose
additional restrictions. The Act limits the interest deduction available for
loans against a business-owned Policy. It imposes an indirect tax on the gain
in corporate-owned life insurance policies by way of the corporate alternative
minimum tax for those corporations subject to the alternative minimum tax. The
corporate alternative minimum tax also could apply to a portion of the amount by
which Death Benefits received exceed the Policy's date-of-death Net Surrender
Value.
Federal estate and gift and state and local estate and other tax consequences of
ownership or receipt of Policy proceeds depend on the circumstances of each
Owner or Beneficiary.
C.M. Life cannot make any guarantee regarding the future tax treatment of any
Policy. For complete information on the impact of changes with respect to the
Policy and federal and state tax considerations, a qualified tax adviser should
be consulted.
The ultimate effect of federal income taxes on values under this Policy and on
the economic benefit to the Owner or Beneficiary depends on C.M. Life's tax
status and on the tax status of the individual concerned. The discussion
contained herein is general in nature and is not an exhaustive discussion of all
tax questions that might arise under the Policy, and is not intended as tax
advice. Moreover, no representation is made as to the likelihood of
continuation of current federal income tax laws and Treasury Regulations or of
the current interpretations of the Internal Revenue Service. C.M. Life reserves
the right to make changes in the Policy to assure that it continues to qualify
as life insurance for tax purposes. For complete information on federal and
state tax law considerations, You should consult a qualified tax adviser. No
attempt is made herein to consider any applicable state or other tax laws.
CHARGES FOR FEDERAL TAXES. C.M. Life currently does not make any charge against
the Separate Account for federal income taxes. We may make such a charge
eventually in order to provide for the future federal income tax liability of
the Separate Account.
Upon a full surrender of a Policy for its Net Surrender Value, the Owner may
recognize ordinary income for federal income tax purposes. Ordinary income is
computed to be the amount by which the Account Value, unreduced by any
outstanding Policy Debt but less any Surrender Charges assessed, exceeds the
premiums paid but not previously recovered and any other consideration paid for
the Policy.
MODIFIED ENDOWMENT CONTRACTS. Contrary to the rules described above, loans,
collateral assignments, and other amounts distributed under a "modified
endowment contract" are taxable to the extent of any accumulated income in the
Policy. In general, the amount that may be subject to taxation is the excess of
the Account Value (both loaned and unloaned) over the previously unrecovered
premiums paid. Death benefits paid under a modified endowment contract,
however, are not taxed any differently than death benefits payable under other
life insurance contracts.
A Policy is a modified endowment contract if it satisfies the definition of life
insurance in the Internal Revenue Code but fails the additional "7-pay test." A
Policy fails this test if the accumulated amount paid under the contract at any
time during the first seven contract years exceeds the total premiums that would
have been payable under a policy providing guaranteed benefits upon the payment
of seven level annual premiums. Also, a Policy that would otherwise satisfy the
7-pay test will be taxed as a modified endowment contract if it is received in
exchange for a modified endowment contract.
Certain changes will require a Policy to be retested to determine whether it has
become a modified endowment contract. For example, a reduction in death benefits
during the first seven contract years will cause the Policy to be re-tested as
if it originally had been issued with the reduced death benefit. If the
premiums actually paid into the Policy exceed the limits under the 7-pay test
for a policy with the reduced death benefit, the Policy will become a modified
endowment contract. This classification change is effective retroactively to
the Policy Year in which the actual premiums paid exceed the new 7-pay limits.
In addition, a "material change" occurring at any time while the Policy is in
force will require the Policy to be retested to determine whether it continues
to meet the 7-pay test. A material change starts a new 7-pay test period. The
term "material change" includes many increases in death benefits. A material
change does not include an increase in death benefit attributable to the payment
of premiums necessary to fund the lowest level of death benefit payable during
the first seven contract years, or which is attributable to the crediting of
interest with respect to such premiums.
Since the Policy provides for flexible premium payments, the Company has
instituted procedures to monitor whether increases in death benefits or
additional premium payments cause either the start of a new seven-year test
period or the taxation of distributions and loans.
If any amount is taxable as a distribution of income under a modified endowment
contract, it also will be subject to a 10% penalty tax. Limited exceptions from
the additional
13
<PAGE>
penalty tax are available for individual Owners. The penalty tax will not apply
to distributions: (i) made on or after the date the taxpayer attains age 59 1/2;
or (ii) attributable to the taxpayer becoming disabled; or (iii) made as part of
a series of substantially equal periodic payments (made at least annually) made
for the life or life expectancy of the taxpayer. For complete information about
modified endowment contract status, a qualified tax adviser should be consulted.
Once a Policy fails the 7-pay test, loans and distributions occurring in the
year of failure and thereafter become subject to the rules for modified
endowment contracts. In addition, a recapture provision applies to loans and
distributions received in anticipation of failing the 7-pay test. Any
distribution or loan made within two years prior to failing the 7-pay test is
considered to have been made in anticipation of the failure.
Under certain circumstances, a loan, collateral assignment, or other
distribution under a modified endowment contract may be taxable even though it
exceeds the amount of income accumulated in the Policy. For purposes of
determining the amount of income received from a modified endowment contract,
the law requires the aggregation of all modified endowment contracts issued to
the same Owner by an insurer and its affiliates within the same calendar year.
Therefore, loans, collateral assignments, and distributions from any one such
Policy are taxable to the extent of the income accumulated in all the Policies
required to be aggregated.
QUALIFIED PLANS. The Policy may be used in conjunction with certain tax-
qualified employee benefit plans. Since the rules governing such use are
complex, a purchaser should not use the Policy in conjunction with any such
qualified plan until a competent tax adviser has been consulted. The Policy may
not be used in conjunction with an Individual Retirement Account (IRA).
DIVERSIFICATION STANDARDS. To comply with final regulations under Code Section
817(h) ("Final Regulations"), each Fund of the Trusts is required to diversify
its investments. The Final Regulations generally require that on the last day
of each quarter of a calendar year no more than 55% of the value of a Fund's
assets is represented by any one investment, no more than 70% is represented by
any two investments, no more than 80% is represented by any three investments,
and no more than 90% is represented by any four investments. A "look-through"
rule applies to treat a pro rata portion of each asset of a Fund as an asset of
the Separate Account. All securities of the same issuer are treated as a single
investment. However, each government agency or instrumentality is treated as a
separate issuer.
With respect to variable life insurance contracts, the general diversification
requirements are modified if any of the assets of the Separate Account are
direct obligations of the United States Treasury. In this case, there is no
limit on the investment that may be made in United States Treasury securities;
and for purposes of determining whether assets other than United States Treasury
securities are adequately diversified, the generally applicable percentage
limitations are increased based on the value of the Separate Account's
investment in United States Treasury securities. Notwithstanding this
modification of the general diversification requirements, the Funds of the
Trusts will be structured to comply with the general diversification standards
because they serve as an investment vehicle for certain variable annuity
contracts that must comply with the general standards.
In connection with the issuance of the temporary regulations prior to the Final
Regulations, the Treasury announced that such temporary regulations did not
provide guidance concerning the extent to which Owners may direct their
investments to particular Divisions of a separate account. Regulations in this
regard were not issued in connection with the Final Regulations, however. It is
not clear, at this time, what future regulations might provide. It is possible,
if future regulations are issued, the Policy may need to be modified to comply
with such regulations. For these reasons, C.M. Life reserves the right to
modify the Policy, as necessary, to prevent the Owner from being considered the
owner of the assets of the Separate Account.
C. M. Life intends to comply with the Final Regulations to assure the Policy
continues to qualify as life insurance for federal income tax purposes.
YOUR VOTING RIGHTS
As long as the Separate Account continues to operate as a unit investment trust
under the Investment Company Act of 1940, the Owner is entitled to give C.M.
Life instructions as to how shares of the Funds held in the Separate Account (or
other securities held in lieu of such shares) deemed attributable to the Policy
shall be voted at meetings of shareholders of the Funds of the Trusts. Those
persons entitled to give voting instructions are determined as of the record
date for the meeting.
The number of shares of the Funds held in the Separate Account deemed
attributable to the Policy during the lifetime of the Insured is determined by
dividing the Policy's Account Value held in each Division of the Separate
Account, if any, by $100. Fractional votes are counted.
Owners receive proxy material and a form on which Owner instructions may be
given. Shares of the Funds held by the Separate Account for which no effective
Owner instructions have been received are voted for or against any proposition
in the same proportion as the shares for which instructions have been received.
14
<PAGE>
RESERVATION OF RIGHTS
We reserve the right to take certain actions in connection with our operations
and the operations of the Separate Account. These actions will be taken in
accordance with applicable laws (including obtaining any required approval of
the Securities and Exchange Commission). If necessary, we will seek approval by
Owners.
Specifically, we reserve the right to:
. Create new Divisions of the Separate Account;
. Create new Separate Accounts;
. Combine any two or more Separate Accounts;
. Make available additional Divisions of the Separate Account investing in
additional investment companies;
. Invest the assets of the Separate Account in securities other than shares of
the Funds as a substitute for such shares already purchased or as the
securities to be purchased in the future;
. Operate the Separate Account as a management investment company under the
Investment Company Act of 1940 or in any other form permitted by law; and
. De-register the Separate Account under the Investment Company Act of 1940 in
the event such registration is no longer required;
. Substitute one or more Funds for other funds with similar investment
objectives;
. Delete Funds.
C.M. Life also reserves the right to change the name of the Separate Account.
We have reserved all rights to the name C.M. Life Insurance Company or any part
of it. We may allow the Separate Account and other entities to use our name or
part of it, but we also may withdraw this right.
ADDITIONAL BENEFITS YOU CAN GET BY RIDER
At the Owner's request, the Policy can include additional benefits We approve
based on our standards and limits for issuing insurance and classifying risks.
An additional benefit is provided by rider and is subject to the terms of both
the rider and the Policy. The cost of any rider is deducted as part of the
Monthly Charges. Subject to state availability, the following riders are
available.
SUBSTITUTE OF INSURED RIDER. This rider allows the Owner to substitute a new
insured in place of the current Insured under the Policy. A substitute of
Insured is allowed if the Policy is in force, the Owner has an insurable
interest in the life of the substitute insured, the substitute insured is age 80
or younger on the date of substitution, and the age of the substitute insured on
the Policy Date is within the issue age range allowed for this Policy on the
Policy Date.
An application and evidence of insurability satisfactory to us is required for
the substitute insured.
All monthly charges after the substitution of insured will be based on the life
and risk class of the substitute insured.
The rider terminates on the current Insured's Attained Age 75, at the time of
the exercise of the rider, if this Policy is changed to a different policy under
which this rider is not available, or this Policy terminates.
This rider is attached automatically at issue. There is no charge for the
rider.
OTHER INSURED RIDER. This rider provides level term insurance on the life of one
or more other insureds. The rider is convertible for a limited amount of time.
While the other insured is living and prior to the other insured's attained age
70, the rider may be fully or partially converted to a flexible premium
adjustable variable life policy offered at the time of conversion. The cost for
the new policy will be based on the other insured's attained age at the time of
conversion. No evidence of insurability is required to convert the rider
coverage.
There is a monthly charge for this rider. It is a rate per $1,000 of face
amount under the rider for each other insured.
GUARANTEED INSURABILITY RIDER. This rider provides the right to increase the
face amount of this Policy without evidence of insurability on certain option
dates as defined in the rider.
The rider terminates after the last option date as defined in the rider, if the
face amount of this Policy is decreased for any reason, if this Policy is
changed to another policy under which this rider is not available, or if the
Policy terminates.
There is a monthly charge for this rider. It is a rate per $1,000 of rider
option amount.
DISABILITY BENEFIT RIDER. This rider provides a disability benefit if the
Insured becomes totally disabled as defined in the rider. The rider provides
the following benefits if the Insured becomes disabled.
. We will credit an amount to the Account Value equal to the specified monthly
amount shown on the policy specification page for this rider. This amount
will be treated as a Net Premium.
. We will waive the monthly charges due for this Policy.
The benefits will be provided after the Insured has been totally disabled for
four months and all conditions of the rider have been met.
15
<PAGE>
The benefits under the rider end once the Insured is no longer totally disabled,
satisfactory proof of continued disability is not provided to us as required, or
the day before the Insured's Attained Age 65, unless total disability began
before the Insured's Attained Age 60 in which case the waiver of monthly charges
will continue while the Insured remains disabled.
There is a monthly charge for this rider based on both the specified amount
waived and the waiver of monthly charges. The charge varies by the Attained Age
of the Insured and the benefit provided.
WAIVER OF MONTHLY CHARGES RIDER. Under this rider, We will waive the monthly
charges due for the Policy if the Insured becomes totally disabled as defined in
the rider.
The benefit will be provided once the Insured has been totally disabled for four
months and all the provisions of the rider have been met. The benefits will end
when the Insured is no longer totally disabled, satisfactory proof of continued
total disability is not given to us as required, or the day before the Insured's
Attained Age 65 if the disability began when the Insured was Attained Age 60 or
older.
There is a monthly charge for this rider. It is a rate based on the Insured's
Attained Age and multiplied by the sum of the Policy monthly charges for the
month, excluding the rider charge for this rider.
PAYMENT OPTIONS
The Policy proceeds (the Death Benefit or the Net Surrender Value) can be paid
in cash, or if elected, all or part of these proceeds can be placed under one or
more of the following payment options. The minimum amount that can be applied
under a payment option is $2,000. If the periodic payment under any option is
less than $20, we reserve the right to make payments at less-frequent intervals.
None of these benefits depends on the performance of the Separate Account or the
GPA. For additional information concerning these options, see the Policy. The
following payment options are currently available.
<TABLE>
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
Installments for a Specified Period Equal monthly payments will be made for any period selected, up to 30 years. The
amount of each payment depends on the total amount applied, the period selected, and
the monthly income rates We are using when the first payment is due.
- -----------------------------------------------------------------------------------------------------------------------------------
Life Income Equal monthly payments will be based on the life of a named person. Payments will
continue for the lifetime of that person. Income with or without a minimum payment
period may be elected.
- ------------------------------------------------------------------------------------------------------------------------------------
Interest We will hold any amount applied under this option. Interest on the amount will be paid
at an effective annual rate determined by us. This rate will not be less than 3%.
- -----------------------------------------------------------------------------------------------------------------------------------
Installments of Specified Amount Each payment will be made for an agreed fixed amount. The total amount paid during the
first year must be at least 6% of the total amount applied. Interest will be credited
each month on the unpaid balance and added to it. This interest will be an effective
annual rate determined by us, but not less than 3%. Payments continue until the
balance we hold is reduced to less than the agreed fixed amount. The last payment will
be for the balance only.
- -----------------------------------------------------------------------------------------------------------------------------------
Life Income with Payments Guaranteed for Equal monthly payments will be based on the life of a named person. Payments will be
Amount Applied made until the total amount paid equals the amount applied, and as long thereafter
as the named person lives.
- -----------------------------------------------------------------------------------------------------------------------------------
Joint Lifetime Income with Reduced Monthly payments will be based on the lives of two named persons. Payments at the
Payments to Survivor initial level will continue while both are living, or for 10 years if longer. When one
dies (but not before the 10 years has elapsed), payments are reduced by one-third and
will continue at that level for the lifetime of the other. After the 10 years has
elapsed, payments stop when both named persons have died.
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
WITHDRAWAL RIGHTS UNDER PAYMENT OPTIONS. If provided in the payment option
election, all or part of the unpaid balance under the Fixed Amount or Interest
Payment Option may be withdrawn or applied under any other option. No part of
the payments under the Fixed Time Payment Option or payments that are based on a
named person's life may be withdrawn.
BENEFICIARY
A Beneficiary is any person named on our records to receive insurance proceeds
at the Insured's death. The Beneficiary is named in the application for the
Policy. There may be different classes of beneficiaries, such as primary and
secondary. These classes set the order of payment. There may be more than one
Beneficiary in a class.
16
<PAGE>
Any Beneficiary may be named an Irrevocable Beneficiary. An Irrevocable
Beneficiary is one whose consent is needed to change that Beneficiary. The
consent of any Irrevocable Beneficiary is needed to exercise any Policy right
except the rights to change the frequency of Planned Premiums and Reinstate the
Policy after termination.
The Owner may change the Beneficiary during the Insured's lifetime by writing to
our Administrative Office. Generally, the change will take effect as of the
date of the request. If no Beneficiary is living at the time of the Insured's
death, unless provided otherwise, the Death Benefit is paid to the Owner or, if
deceased, to the Owner's estate.
ASSIGNMENT
The Policy may be assigned as collateral for a loan or other obligation. For
any assignment to be binding on C.M. Life, however, We must receive a signed
copy of it at our Administrative Office. We are not responsible for the
validity of any assignment.
LIMITS ON OUR RIGHT TO CHALLENGE THE POLICY
Except for any policy change or reinstatement requiring evidence of
insurability, we cannot contest the validity of the policy with respect to any
material misrepresentation in the application regarding the insurability of the
Insured once the policy has been in force for two years after the Issue Date.
For any policy change or reinstatement requiring evidence of insurability, We
cannot contest the validity of the change or reinstatement with respect to the
Insured after the change has been in effect for two years.
ERROR OF AGE OR SEX
If the Insured's age or sex is misstated in the Policy application, the Death
Benefit payable under the Policy will be adjusted based on what the Policy would
provide based on the most recent Monthly Charge for the correct date of birth
and correct sex.
SUICIDE
Suicide within two years of the Policy Date is not covered by the Policy. If
the Insured dies by suicide, while sane or insane, within two years from the
Issue Date or Reinstatement Date, the Policy will terminate. We will refund the
amount of all premiums paid, less any Withdrawals and Policy Debt. If the
Insured, while sane or insane, dies by suicide within two years after the
effective date of any increase in the Face Amount, the increase will terminate
and We will refund the Monthly Charges for that increase. However, if a refund
was payable as the result of suicide during the first two years following the
Issue Date or the Reinstatement Date of the Policy, there is no additional
refund for any Face Amount increase.
SALES AND OTHER AGREEMENTS
MML Distributors, LLC ("MML Distributors"), 1414 Main Street, Springfield, MA
01144-1013, is the principal underwriter of the Policy pursuant to an
Underwriting and Servicing Agreement to which MML Distributors, C.M. Life and
the Separate Account are parties. MML Investors Services, Inc. ("MMLISI"), also
located at 1414 Main Street, Springfield, MA 01144-1013, serves as the co-
underwriter of the Policy. Both MML Distributors and MMLISI are registered with
the Securities and Exchange Commission (the "SEC") as broker-dealers under the
Securities Exchange Act of 1934 and are members of the National Association of
Securities Dealers, Inc. (the "NASD").
MML Distributors may enter into selling agreements with other broker-dealers
that are registered with the SEC and are members of the NASD ("selling
brokers"). C.M. Life sells the Policy through agents who are licensed by state
insurance officials to sell the Policy. These agents also are registered
representatives of selling brokers or of MMLISI. The Policy is offered in all
states where C.M. Life is authorized to sell variable life insurance.
The Company also may contract with independent third party broker-dealers who
may act as wholesalers by assisting the Company in finding Broker-dealers to
offer and sell the Policies. These parties also may provide training, marketing
and other sales related functions for the Company and other broker-dealers and
may provide certain administrative services to the Company in connection with
the Policies. The Company may pay such parties compensation based on premium
payments for the Policies purchased through broker-dealers selected by the
wholesaler. In addition, some sales personnel may receive various types of non-
cash compensation as special sales incentives, including trips and educational
and/ or business seminars.
When an application for the Policy is completed, it is submitted to C.M. Life.
Under a service agreement between C.M. Life and MassMutual (described below
under Service Agreement), MassMutual performs suitability and insurance
underwriting and determines whether to accept or reject the application for the
Policy and the Insured's risk classification. If the application is not
accepted, C.M. Life will refund any premium paid.
17
<PAGE>
Pursuant to the Underwriting and Servicing Agreement, both MML Distributors and
MMLISI will receive compensation for their activities as underwriters of the
Policy.
MML Distributors does business under different variations of its name; including
the name MML Distributors, L.L.C. in the states of Illinois, Michigan, Oklahoma,
South Dakota and Washington; and the name MML Distributors, Limited Liability
Company in the states of Maine, Ohio and West Virginia.
COMPENSATION
Writing agents will receive commissions based on a commission schedule and
rules. Some commissions are paid as a percentage of the premium paid in each
Policy Year. These commissions distinguish between premiums up to the Target
Premium and premiums paid in excess of the Target Premium. The Target Premium
is based on the issue age, sex, and risk classification of the Insured.
Commissions also are paid as a percentage of the average monthly Account Value
in each Policy Year. The maximum commission percentages are as follow:
PREMIUM-BASED COMMISSIONS
<TABLE>
<CAPTION>
<S> <C>
COVERAGE YEAR 1 50% of premium paid up to the
Target Premium
3% of premium paid over the
Target Premium
COVERAGE YEARS 2-5 5% of premium paid up to the
Target Premium
3% of premium paid over the
Target Premium
COVERAGE YEARS 6-10 3% of all premium paid
COVERAGE YEARS 11 AND 1% of all premium paid
BEYOND
- -----------------------------------------------------------
</TABLE>
ASSET-BASED COMMISSIONS
<TABLE>
<CAPTION>
- -------------------------------------------------------------
<S> <C>
POLICY YEARS 2 AND BEYOND 0.15% of the average monthly
Account Value in each Policy
Year
- -------------------------------------------------------------
</TABLE>
Agents under financing agreements with a general agent of MassMutual may be
compensated differently. Agents who meet certain productivity and persistency
standards in selling C.M. Life and MassMutual policies are eligible for
additional compensation. General agents and district managers who are registered
representatives of MMLISI also may receive commission overrides, allowances and
other compensation.
While the compensation payable to broker/dealers for sales of Policies may vary
with the sales agreement and level of production, they generally are expected to
be comparable to the aggregate compensation paid to Company agents and general
agents.
SERVICE AGREEMENT
In addition to acting as an investment manager for the funds underlying the
Divisions of the Separate Account, MassMutual performs certain investment and
administrative duties for C.M. Life. MassMutual does this according to a
written agreement. The agreement is renewed automatically each year, unless
either party terminates it. Under this agreement, C.M. Life pays MassMutual for
salary costs and other services and an amount for indirect costs incurred
through C.M. Life's use of MassMutual's personnel and facilities.
BONDING ARRANGEMENT
An insurance company blanket bond is maintained providing $50,000,000 coverage
for officers and employees of MassMutual and C.M. Life (subject to a $350,000
deductible) and $50,000,000 for MassMutual's general agents and agents (also
subject to a $350,000 deductible).
LEGAL PROCEEDINGS
We are not currently involved in any legal proceedings that would have a
material impact on the Policy.
EXPERTS
The audited financial statements of C.M. Life included in this Prospectus have
been included herein in reliance on the reports of Coopers & Lybrand L.L.P.,
Springfield, Massachusetts 01101, independent accountants, given on the
authority of that firm as experts in accounting and auditing.
Actuarial matters in the Prospectus have been examined by Craig Waddington, FSA,
MAAA. An opinion on actuarial matters is filed as an exhibit to the
registration statements We filed with the SEC.
18
<PAGE>
III. ADDITIONAL INFORMATION
C.M. LIFE AND MASSMUTUAL
C.M. Life is a stock life insurance company located at 140 Garden Street,
Hartford, CT 06154. It was chartered by a Special Act of the Connecticut
General Assembly on April 25, 1980. C.M. Life is engaged principally in the
sale of life insurance policies and annuity contracts, and is licensed to sell
such products in all states except New York. C.M. Life is a wholly owned
subsidiary of Massachusetts Mutual Life Insurance Company ("MassMutual"). As of
December 5, 1997, C.M. Life is licensed to transact variable life insurance
business in all jurisdictions in the United States, including Puerto Rico, other
than New York and California.
MassMutual is a mutual life insurance company chartered in 1851 under the laws
of Massachusetts. Its Home Office is located in Springfield, Massachusetts.
MassMutual is licensed to transact life, accident, and health business in all
fifty states of the United States, the District of Columbia, Puerto Rico, and
certain provinces of Canada. As of December 31, 1996, MassMutual had total
contingency reserves in excess of $2.6 billion and consolidated assets of $55.8
billion.
C.M. LIFE'S TAX STATUS. C.M. Life is taxed as a life insurance company under
Subchapter L of the Internal Revenue Code of 1986 (the "Code"). The Segment and
the Separate Account are not separate entities from C.M. Life and its operations
form a part of C.M. Life.
Investment income and realized capital gains on the assets of the Segment are
reinvested and taken into account in determining Account Value. The investment
income and realized capital gains are applied automatically to increase book
reserves associated with the Policy. Under existing federal income tax law, the
Segment's investment income, including net capital gains, is not taxed to C.M.
Life to the extent it is applied to increase reserves associated with the
Policy. The reserve items taken into account at the close of the taxable year
for purposes of determining net increases and net decreases must be adjusted for
tax purposes by subtracting any amount attributable to appreciation in the value
of assets and by adding any amount attributable to depreciation. C.M. Life's
basis in the Policy's share of the assets underlying the Segment will be
adjusted for appreciation or depreciation, to the extent the reserves are
adjusted. Thus, corporate-level capital gains and losses, and the tax effect
thereof, are eliminated.
Due to C.M. Life's current tax status, no charge is made to the Segment for C.M.
Life's federal income taxes that may be attributable to the Segment.
Periodically, C.M. Life reviews the question of a charge to the Segment for C.M.
Life's federal income taxes. A charge may be made for any federal income taxes
incurred by C.M. Life and attributable to the Segment. Depending on the method
of calculating interest on Policy values allocated to the Guaranteed Principal
Account (see preceding section), a charge may be imposed for the Policy's share
of C.M. Life's federal income taxes attributable to that account.
Under current laws, C.M. Life may incur state or local taxes (in addition to
premium taxes) in several states. At present, these taxes are not significant.
If there is a material change in applicable state or local tax laws, C.M. Life
reserves the right to charge the Separate Account for taxes, if any,
attributable to the Separate Account.
RECORDS AND REPORTS
All records and accounts relating to the Separate Account and the GPA are
maintained by MassMutual or C.M. Life. Each year within the 30 days following
the Policy anniversary, C.M. Life will mail You a report showing the Account
Value at the beginning of the previous Policy Year, all premiums paid since that
time, all additions to and deductions from the Account Value during the year,
and the Account Value, Death Benefit, Net Surrender Value and Policy Debt as of
the last Policy Anniversary. This report contains any additional information
required by any applicable law or regulation.
THE SEPARATE ACCOUNT
The Separate Account was established on February 2, 1995, as a separate
investment account of C.M. Life by C.M. Life's Board of Directors in accordance
with the laws of the State of Connecticut. The Separate Account is registered
with the Securities and Exchange Commission as a unit investment trust pursuant
to the provisions of the Investment Company Act of 1940, and meets the
definition of a "separate account" in that statute. Registration does not
involve supervision of the management or investment practices of either the
Separate Account or of C.M. Life. A separate segment for the Policies (the
"Segment") was established on xx/xx/xx and has been divided into 13 Divisions.
Each Division invests in a corresponding series of shares of a designated Fund
of MML Trust, Oppenheimer Trust, Variable Insurance Products Fund II (managed by
Fidelity Management & Research Company), T. Rowe Price Equity Series, Inc., or
American Century Variable Portfolios, Inc. C.M. Life may establish additional
divisions within the Separate Account in the future, which may invest in other
investment funds, including those of MML Trust, Oppenheimer Trust, (Fidelity)
Variable Insurance Products Fund II, T. Rowe Price Equity Series, Inc., or
American Century Variable Portfolios, Inc., or in
19
<PAGE>
any other investment fund C.M. Life deems to be appropriate.
C.M. Life owns the assets in the Separate Account and is required to maintain
sufficient assets in the Separate Account to meet anticipated obligations of the
Policies funded by the Separate Account. The income, gains, or losses, realized
or unrealized, of the Separate Account are credited to or charged against the
assets held in the Separate Account without regard to the other income, gains,
or losses of C.M. Life. Assets in the Separate Account attributable to the
reserves and other liabilities under the Policies are not chargeable with
liabilities arising from any other business conducted by C.M. Life. C.M. Life
may transfer to its General Account; however, any assets that exceed anticipated
obligations of the Separate Account. All obligations arising under the Policy
are general corporate obligations of C.M. Life. C.M. Life may accumulate in the
Separate Account proceeds from various Policy charges and investment results
applicable to those assets.
MML TRUST AND OPPENHEIMER TRUST
The MML Trust is a no-load, open-end, management investment company registered
under the Investment Company Act of 1940. The Oppenheimer Trust is an open-end,
diversified, management investment company registered under the Investment
Company Act of 1940.
Both the MML Trust and the Oppenheimer Trust provide an investment vehicle for
the separate investment accounts of variable life and variable annuity contracts
offered by companies such as MassMutual. Shares of the MML Trust and the
Oppenheimer Trust are not offered to the general public.
The assets of certain variable annuity separate accounts for which MassMutual or
an affiliate is the depositor are invested in shares of the MML Trust's and
Oppenheimer Trust's Funds. Because these separate accounts are invested in the
same underlying Funds, it is possible material irreconcilable conflicts could
arise between Policy Owners and owners of the variable annuity contracts.
Possible conflicts could arise if: (i) state insurance regulators should
disapprove or require changes in investment policies, investment advisers or
principal underwriters or if C.M. Life should be permitted to act contrary to
actions approved by holders of the Policies under rules of the Securities and
Exchange Commission; (ii) adverse tax treatment of the Policies or the variable
annuity contracts would result from utilizing the same underlying funds; (iii)
different investment strategies would be more suitable for the variable annuity
contracts than for the Policies; or (iv) state insurance laws or regulations or
other applicable laws would prohibit the funding of both the Separate Account
and other investment accounts by the same Funds. The Board of Trustees of each
Trust will follow monitoring procedures that have been developed to determine
whether material conflicts have arisen. If it is determined a conflict exists,
the Trustees will notify MassMutual, C.M. Life and OppenheimerFunds and
appropriate action will be taken to eliminate such irreconcilable conflicts.
C.M. Life purchases the shares of each Fund for the corresponding Division at
net asset value. All dividends and capital gain distributions received from a
Fund are automatically reinvested in that Fund at net asset value, unless C.M.
Life, on behalf of the Separate Account, elects otherwise. Shares of the MML
Trust and the Oppenheimer Trust will be redeemed by C.M. Life at their net asset
values to the extent necessary to make payments under the Policies.
VARIABLE INSURANCE PRODUCTS FUND II
Variable Insurance Products Fund II ("Fidelity VIP II"), managed by Fidelity
Management & Research Company (FMR), is an open-end diversified management
investment company organized as a Massachusetts business trust on March 21, 1988
and is registered with the SEC under the 1940 Act. One of its investment
portfolios, the VIP II Contrafund Portfolio, is available under this Policy.
T. ROWE PRICE EQUITY SERIES, INC.
The T. Rowe Price Equity Series, Inc. (the "Corporation") was incorporated in
Maryland in 1994, and is a diversified, open-end investment company, or mutual
fund. Currently, the corporation consists of four series, each representing a
separate class of shares having different objectives and investment policies.
One of the series, the Mid-Cap Growth Portfolio, is available under this Policy.
AMERICAN CENTURY VARIABLE PORTFOLIOS, INC.
American Century Variable Portfolios, Inc. is part of American Century
Investments, a family of funds that includes nearly 70 no-load mutual funds
covering a variety of investment opportunities. Variable Portfolios offers its
shares only to insurance companies to fund the benefits of variable annuity or
variable life insurance contracts. One of the funds, VP Income and Growth, is
offered under this Policy.
Following is a chart illustrating the risk profiles of the investment options
available under this Policy, and a summary of the investment objectives of each
fund. Please note there can be no assurance any fund will achieve its
objectives. More detailed information concerning these investment objectives is
contained in the accompanying prospectuses, including information on the risks
associated with the investments, the investment techniques of each of the funds,
and the deduction of expenses applicable to each of the funds.
20
<PAGE>
INVESTMENT PREFERENCE CHART
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------
<S> <C>
Oppenheimer Global Securities Fund
VIP II Contrafund Portfolio
Oppenheimer Aggressive Growth Fund
MML Small Cap Value Equity Fund
T. Rowe Price Mid-Cap Growth Portfolio
Oppenheimer Growth Fund
American Century VP Income & Growth
MML Equity Fund
MML Equity Index Fund
MML Blend Fund
Oppenheimer Strategic Bond Fund
MML Managed Bond Fund
MML Money Market Fund
Guaranteed Principal Account
- --------------------------------------------------------------------------------
</TABLE>
CONSERVATIVE LESS CONSERVATIVE MODERATE AGGRESSIVE MORE AGGRESSIVE
CONSERVATIVE: Investment goal is preservation of principal, while incurring
little or no risk.
LESS CONSERVATIVE: Investment goal is primarily preservation of principal, with
some desire for growth.
MODERATE: Investment goal is growth, while seeking some preservation of
principal.
AGGRESSIVE: Investment goal is growth, with more tolerance for risk.
MORE AGGRESSIVE: Investment goal is significant growth over the long-term, with
short-term fluctuations in value expected.
MML MONEY MARKET FUND
MML Money Market Fund seeks to achieve high current income, while preserving
capital, and liquidity. This Fund invests in short-term debt instruments,
including but not limited to commercial paper, certificates of deposit, bankers'
acceptances, and obligations of the United States government, its agencies and
instrumentalities.
MML MANAGED BOND FUND
MML Managed Bond Fund seeks to achieve as high a total rate of return on an
annual basis as is considered consistent with the preservation of capital
values. This Fund invests primarily in publicly issued, readily marketable,
fixed income securities of maturities MassMutual deems appropriate from time to
time in light of market conditions and prospects.
OPPENHEIMER STRATEGIC BOND FUND
Oppenheimer Strategic Bond Fund seeks a high level of current income principally
derived from interest on debt securities; and seeks to enhance such income by
writing covered call options on debt securities. The Fund invests principally
in: (i) foreign government and corporate debt securities; (ii) U.S. Government
securities; and (iii) lower-rated, high-risk high-yield debt securities. This
Fund's investments may be considered speculative.
For information concerning the risks associated with this Fund's investments,
please refer to the accompanying prospectus for the Oppenheimer Trust.
MML BLEND FUND
MML Blend Fund seeks to achieve as high a level of total rate of return over an
extended period of time as is considered consistent with prudent investment risk
and the preservation of capital values. This Fund invests in a portfolio of
common stocks and other equity-type securities, bonds and other debt securities
with maturities generally exceeding one year, and money market instruments and
other debt securities with maturities generally not exceeding one year.
21
<PAGE>
MML EQUITY INDEX FUND
MML Equity Index Fund seeks to provide investment results that correspond to the
price and yield performance of the publicly traded common stocks in the
aggregate, as represented by the Standard & Poor's 500 Composite Stock Price
Index. ("Standard & Poor's 500" and "S&P 500/(R)/" are trademarks of The
McGraw-Hill Companies, Inc. and have been licensed for use. The Fund is not
sponsored, endorsed, sold or promoted by Standard & Poor's or the McGraw-Hill
Companies, Inc.)
MML EQUITY FUND
MML Equity Fund seeks to achieve a superior total rate of return over an
extended period of time from both capital appreciation and current income. A
secondary objective is the preservation of capital when business and economic
conditions indicate investing for defensive purposes is appropriate. The assets
of this Fund are expected to be invested primarily in common stocks and other
equity-type securities.
AMERICAN CENTURY VP INCOME & GROWTH
The investment objective of VP Income & Growth is dividend growth, current
income and capital appreciation. The Fund will seek to achieve its investment
objective by investing in common stocks.
OPPENHEIMER GROWTH FUND
Oppenheimer Growth Fund seeks to achieve capital appreciation by investing in
securities of well-known established companies. Such securities generally have
a history of earnings and dividends, and are issued by seasoned companies,
namely those having an operating history of at least five years, including
predecessors. The type of securities in which this Fund invests will be
primarily common stocks, as well as securities having the investment
characteristics of common stocks, such as convertible preferred stock and
convertible bonds.
T. ROWE PRICE MID-CAP GROWTH PORTFOLIO
The Mid-Cap Growth Portfolio seeks to provide long-term capital appreciation by
investing primarily in common stocks of medium-sized (mid-cap) growth companies.
The Fund focuses on companies with superior earnings growth potential that are
no longer considered new or emerging, but may still be in the dynamic phase of
their life cycles.
MML SMALL CAP VALUE EQUITY FUND
This Fund seeks to earn a high rate of return over an extended period. The Fund
invests primarily in stocks of smaller capitalization companies with some unique
product, market position, or operating characteristic which, in the portfolio
manager's opinion distinguishes them and will result in above-average returns.
OPPENHEIMER AGGRESSIVE GROWTH FUND
Oppenheimer Capital Appreciation Fund seeks capital appreciation. The type of
securities in which this Fund invests will be primarily common stocks, as well
as securities having the investment characteristics of common stocks, such as
convertible preferred stock and convertible bonds. In seeking this objective
the Fund will emphasize investment in securities of "growth-type" companies.
Such companies are believed to have relatively favorable long-term prospects for
an increased demand for the particular company's products or services.
VIP II CONTRAFUND PORTFOLIO
This Fund seeks capital appreciation by investing in the securities of companies
whose value FMR believes is not fully recognized by the public. This Fund may
be appropriate for policyowners who are willing to ride out stock market
fluctuations in pursuit of potentially high long-term returns. The Fund is
designed for those who are looking for an investment approach that follows a
contrarian philosophy.
OPPENHEIMER GLOBAL SECURITIES FUND
Oppenheimer Global Securities Fund seeks long-term capital appreciation through
investing a substantial portion of its invested assets in securities of foreign
issuers, growth-type companies and special investment opportunities, such as
anticipated acquisitions, mergers or other unusual developments, which are
considered by OFI, in its capacity as investment manager of the Funds, to have
appreciation possibilities. The type of securities in which this Fund invests
will be primarily common stocks, as well as securities having the investment
characteristics of common stocks, such as convertible preferred stock,
convertible bonds and American Depository Receipts. Current income is not an
investment objective of the Oppenheimer Global Securities Fund.
THE INVESTMENT ADVISERS
MassMutual serves as investment manager of each of the MML Funds pursuant to
investment management agreements. Concert Capital Management, Inc. ("Concert")
served as the investment sub-adviser to MML Equity Fund and the Equity Sector of
the MML Blend Fund from 1993-1996. Concert merged with and into David L. Babson
& Company, Inc. ("Babson") effective December 31, 1996. Both Concert and Babson
are wholly-owned subsidiaries of Babson Acquisition Corporation, which is a
controlled subsidiary of MassMutual. Effective January 1, 1997, Babson became
the investment sub-adviser to MML Equity Fund and the Equity Sector of the MML
Blend Fund. Babson also is the sub-adviser to the MML Small Cap Value Equity
Fund. Both MassMutual and Babson are registered investment advisers under the
Investment Advisers Act of 1940.
MassMutual entered into a sub-advisory agreement with Mellon Equity whereby
Mellon Equity manages the
22
<PAGE>
investment and reinvestment of the assets of the MML Equity Index Fund.
OppenheimerFunds, Inc. ("OFI") is an investment adviser organized under the laws
of Colorado as a corporation; it was originally organized in 1959. It (including
a subsidiary) has assets aggregating over $62 billion as of December 31, 1996,
and over three million shareholder accounts. OFI is owned by Oppenheimer
Acquisition Corporation, a holding company owned in part by senior management of
OFI and ultimately controlled by MassMutual. OFI serves as investment adviser to
the Oppenheimer Trust. OFI is registered as an investment adviser under the
Investment Advisers Act of 1940. OFI serves as Investment Adviser to the
Oppenheimer Funds.
Citibank N.A., with its home office located at 111 Wall Street, New York, NY,
10005, acts as custodian for the MML Trust. Bank of New York, with its home
office at One Wall Street, New York, NY 10015, acts as custodian for the
Oppenheimer Trust.
MassMutual is also the investment adviser to MassMutual Corporate Investors and
MassMutual Participation Investors, closed-end investment companies, certain
wholly-owned subsidiaries of MassMutual, and various employee benefit plans.
MassMutual is the investment sub-adviser to Oppenheimer Investment Grade Bond
Fund and Oppenheimer Value Stock Fund, open-end management investment companies.
Fidelity Management & Research Company (FMR) is the investment adviser to the
VIP II Contrafund Portfolio. FMR is the management arm of Fidelity
Investments(R), which was established in 1946. Fidelity Investments(R) has its
principal business address at 82 Devonshire Street, Boston, Massachusetts. FMR
handles the VIP II Contrafund business affairs and, with the assistance of
affiliates, chooses the Fund's investments. Fidelity Management & Research
(U.K.) Inc, in London, England, and Fidelity Management & Research (Far East)
Inc, serve as sub-advisers for the VIP II Contrafund Portfolio.
T. Rowe Price Associates, Inc (T. Rowe Price) is the investment adviser to the
T. Rowe Price Mid-Cap Growth Portfolio. T. Rowe Price was founded in 1937. The
T. Rowe Price Equity Series, Inc. (the Corporation) was incorporated in Maryland
in 1994, and is a diversified, open-end investment company. The Corporation is
governed by a Board of Directors that meets regularly to review the Fund's
investments, performance, expenses, and other business affairs. The policy of
the Corporation is that a majority of Board members will be independent of T.
Rowe Price.
American Century Investment Management, Inc. is the investment adviser to the
American Century VP Income & Growth Fund. Under the laws of the state of
Maryland, the Board of Directors is responsible for managing the business and
affairs of the Fund. Acting pursuant to an investment management agreement
entered into with the Fund, American Century Investment Management, Inc. serves
as the manager of the Fund. Its principal place of business is American Century
Tower, 4500 Main Street, Kansas City, Missouri. The manager has been providing
investment advisory services to investment companies and institutional investors
since it was founded in 1958.
23
<PAGE>
APPENDIX A
DEFINITION OF TERMS
ACCOUNT VALUE: The sum of the Variable Account Value and the Fixed Account Value
of the Policy.
ADMINISTRATIVE OFFICE: C.M. Life's Administrative Office is located at 1295
State Street, Springfield, Massachusetts 01111-0001.
ATTAINED AGE: The Issue Age of the Insured plus the number of completed Policy
Years.
BENEFICIARY(IES): The person or persons specified by the Owner to receive some
or all of the Death Benefit at the Insured's death.
DEATH BENEFIT: The amount paid following receipt of due proof of the death of
the Insured. The amount is equal to the benefit provided by the Death Benefit
Option in effect on the date of death less any Policy Debt outstanding and any
unpaid premium.
DEATH BENEFIT OPTION: The Policy offers three Death Benefit Options for
determination of the amount of the Death Benefit. The Death Benefit Option is
elected at time of application and, subject to certain requirements, may be
changed at a later date.
EXPENSE PREMIUM: The level of premium payment used to determine the Premium
Expense Charges. The Expense Premium is based on the Issue Age, sex, and risk
classifications of the Insured in effect at the time of any Premium payment.
FIXED ACCOUNT VALUE: The current Account Value that is allocated to the
Guaranteed Principal Account.
FREE LOOK PERIOD: The Period during which an Owner may return the Policy for
cancellation and refund.
GUARANTEED PRINCIPAL ACCOUNT ("GPA"): Part of our General Account, the GPA is a
fixed account to and from which the Owner may make allocations and transfers.
INITIAL FACE AMOUNT: The amount of insurance coverage issued under the Policy.
Subject to certain limitations, the Owner may change the Face Amount after
issue.
INITIAL NET PREMIUM: The premium received before or at delivery of the Policy,
reduced by the Premium Expense Charge.
INSURED: The person whose life this Policy insures.
ISSUE AGE: The age of the Insured at his or her birthday nearest the Policy
Date.
ISSUE DATE: The date on which the suicide and contestability periods begin.
MINIMUM DEATH BENEFIT: The Death Benefit determined in accordance with the
applicable Death Benefit Compliance Test. The applicable Test is either the
Cash Value Test or the Guideline Premium Test, as chosen at the time of
application.
MONTHLY CHARGE DATE: The monthly date on which the Monthly Charges for the
Policy are deducted from the Account Value. The first Monthly Charge Date is
the Policy Date, and subsequent Monthly Charge Dates are on the same day of each
succeeding calendar month.
MONTHLY CHARGES: The charges assessed against the Policy Account Value on each
Monthly Charge Date.
NET PREMIUM: The premium payment less the Premium Expense Charge we deduct.
NET SURRENDER VALUE: The amount payable to an Owner upon surrender of the
Policy. It is equal to the Account Value less any surrender charges that apply
and less any Policy Debt.
OWNER: The person or entity that owns the Policy.
POLICY: The flexible premium adjustable variable life insurance policy offered
by C.M. Life and described in this Prospectus.
POLICY ANNIVERSARY DATE: An anniversary of the Policy Date.
POLICY DATE: The date shown on the Policy that is the starting point for
determining Policy Anniversary Dates, Policy Years, and Monthly Charge Dates.
POLICY DEBT: All outstanding Policy loans plus accrued loan interest.
POLICY VALUE: The Account Value less any outstanding Policy Debt during the
first three Policy Years. It is equal to the Net Surrender Value in years four
and later.
POLICY YEAR: A twelve-month period commencing with the Policy Date or a Policy
Anniversary Date.
SAFETY TEST: On any day during the Guarantee Periods as shown on the Policy
Specifications page of Your Policy, the Safety Test is met if the result of
premiums paid less amounts withdrawn, accumulated with interest to that day,
equals or exceeds the Guarantee Period premium requirement as shown on the
Policy Specification page of Your Policy accumulated with interest to that date.
SEPARATE ACCOUNT: The Policies' designated segment of the "C. M. Life Variable
Life Separate Account I" established by C. M. Life under the laws of Connecticut
and registered as a unit investment trust with the Securities and Exchange
24
<PAGE>
Commission pursuant to the Investment Company Act of 1940, as amended ("1940
Act"). The Separate Account is used to receive and invest Net Premiums for this
Policy.
SUBSEQUENT NET PREMIUM: Any premium received after the Policy is delivered,
reduced by the Premium Expense Charge.
TARGET PREMIUM: The level of premium payments used to determine commission
payments and surrender charges. The Target Premium is based on the Issue Age,
sex, and risk classification of the Insured.
VALUATION DATE: A date on which the net asset value of the shares of each
Division of the Separate Account is determined. Generally, this will be any
date on which the New York Stock Exchange (or its successor) is open for
trading.
VALUATION PERIOD: The period, consisting of one or more days, from one Valuation
Date to the next succeeding Valuation Date.
VALUATION TIME: The time of the close of the New York Stock Exchange (currently
4:00 p.m. eastern time) on a Valuation Date. All actions which are to be
performed on a Valuation Date will be performed as of the Valuation Time.
VARIABLE ACCOUNT VALUE: The total of the values of the Accumulation Units
credited to the Policy in each Division of the Separate Account multiplied by
the Owner's number of units in that Division.
WE: Refers to C.M. Life.
YEAR OF COVERAGE: For the Initial Face Amount, each Policy Year is a Year of
Coverage. For any increase in the Face Amount, each Year of Coverage is
measured from the effective date of the increase.
YOU: Refers to the Owner.
25
<PAGE>
APPENDIX B
EXAMPLES OF DEATH BENEFIT OPTION CHANGES
EXAMPLE I - CHANGE FROM OPTION 2 TO OPTION 1
For a change from Option 2 to Option 1, the Face Amount is increased by the
amount of the Account Value on the effective date of the change. For example,
if the Policy has a Face Amount of $500,000 and an Account Value of $25,000,
the Death Benefit under Option 2 is equal to the Face Amount plus the Account
Value, or $525,000. If the Owner changes from Option 2 to Option 1, the Death
Benefit under Option 1 is equal to the Policy Face Amount. Since the Death
Benefit under a Policy does not change as the result of a Death Benefit Option
change, the Face Amount will be increased from $500,000 under Option 2 to
$525,000 under Option 1.
EXAMPLE II - CHANGE FROM OPTION 3 TO OPTION 1
For a change from Option 3 to Option 1, the Face Amount is increased by the
amount of the premiums paid to the effective date of the change. For example, if
a Policy has a Face Amount of $500,000, and premium payments of $12,000 have
been made to-date, the Policy Death Benefit under Option 3 is equal to the Face
Amount plus the premiums paid, or $512,000. If the Owner changes from Option 3
to Option 1, the Death Benefit under Option 1 is equal to the Policy Face
Amount. Since the Death Benefit under a Policy does not change as the result of
a Death Benefit Option change, the Face Amount will be increased from $500,000
under Option 3 to $512,000 under Option 1.
EXAMPLE III- CHANGE FROM OPTION 1 TO OPTION 2
For a change from Option 1 to Option 2, the Face Amount will be decreased by the
amount of the Account Value on the effective date of the change. For example, if
the Policy has a Face Amount of $700,000 and an Account Value of $25,000, under
Option 1 the Death Benefit is equal to the Face Amount, or $700,000. If the
Owner changes from Option 1 to Option 2, the Death Benefit under Option 2 is
equal to the Face Amount plus the Account Value. Since the Death Benefit does
not change as the result of a Death Benefit Option change, the Face Amount will
be decreased by $25,000 to $675,000, and the Death Benefit under Option 2 after
the change will remain $700,000.
EXAMPLE IV - CHANGE FROM OPTION 1 TO OPTION 3
For a change from Option 1 to Option 3, the Face Amount will be decreased by the
amount of the premiums paid to the effective date of the change. For example, if
the Policy has a Face Amount of $700,000 and premiums paid to-date are $30,000,
the Death Benefit under Option 1 is equal to the Face Amount, or $700,000. If
the Owner changes from Option 1 to Option 3, the Death Benefit under Option 3 is
equal to the Face Amount plus the premiums paid to-date. Since the Death Benefit
under a Policy does not change as the result of a Death Benefit Option change,
the Face Amount will be decreased from $700,000 under Option 1 to $670,000 under
Option 3.
EXAMPLE V - CHANGE FROM OPTION 2 TO OPTION 3, OR FROM OPTION 3 TO OPTION 2
For a change from Option 2 to Option 3 or from Option 3 to Option 2, the Face
Amount is changed (increased or decreased) by the difference between the Account
Value and the premiums paid less any premium refunds. For example, if the Policy
has a Face Amount of $1,000,000, and an Account Value of $70,000, and premiums
paid of $25,000, the Death Benefit under Option 2 is equal to the Account Value
plus the Face Amount, or $1,070,000. If the Owner changes from Option 2 to
Option 3, the Death Benefit under Option 3 is equal to the Face Amount plus the
premiums paid less any premium refunds. Since the Death Benefit under a Policy
does not immediately change as the result of a Death Benefit Option change, the
Face Amount will be increased by the difference between the Account Value and
the premiums paid, or $45,000, to $1,045,000 under Option 3, maintaining a Death
Benefit of $1,070,000.
A similar type of change would be made for a change from Option 3 to Option 2.
26
<PAGE>
APPENDIX C
RATES OF RETURN
From time to time, the Company may report different types of historical
performance for the Divisions of the Separate Account available under the
Policy. The Company may report the average annual total returns of the funds
over various time periods. Such returns will reflect an annual reduction for
investment management fees and fund expenses, but not deductions at the Separate
Account or Policy level for Mortality and Expense Risk Charges and Policy
expenses, which, if included, would reduce performance.
The Company will accompany the returns of the funds with at least one of the
following: (i) returns, for the same periods as shown for the funds, which
include deductions under the Separate Account for the Mortality and Expense Risk
Charge, in addition to the deduction of investment management fees and fund
expenses, but does not include other charges under the Policy; or (ii) an
illustration of Account Values and Net Surrender Values as of the performance
reporting date for hypothetical Insureds of given ages, sexes, risk
classifications, premium level and Initial Face Amounts. Each illustration will
assume 100% of each Net Premium was allocated to the Division of the Separate
Account illustrated. The Net Surrender Value figures will assume all fund
charges, the Mortality and Expense Risk Charge, and all other Policy charges are
deducted. The Account Value figures will assume all charges except the Surrender
Charge are deducted.
We also may distribute sales literature comparing the percentage change in the
net asset values of the funds or in the Accumulation Unit Values for any of the
Divisions of the Separate Account to established market indices, such as the
Standard & Poor's 500 Stock Index and the Dow Jones Industrial Average. We also
may make comparisons to the percentage change in values of other mutual funds
with investment objectives similar to those of the Divisions of the Separate
Account being compared.
Tables 1 and 2 show the Effective Annual Rates of Return and One Year Total
Returns, respectively, of the funds based on the actual investment performance
(after deduction of investment management fees and direct operating expenses)
underlying each Division of the Separate Account. Table 1 shows figures for
periods ended December 31, 1997, while Table 2 shows December 31 annualized
figures. These rates do not reflect the Mortality and Expense Risk Charges
assessed against the Separate Account. Tables 1 and 2 do not reflect deductions
from premiums or Monthly Charges assessed against the Account Value of the
Policies, nor do they reflect the Policy's Surrender Charges. (For a discussion
of these charges, please see CHARGES AND DEDUCTIONS.) Therefore, these rates are
not illustrative of how actual investment performance will affect the benefits
under the Policy (see, however, PERFORMANCE ILLUSTRATION). The rates of return
shown are not necessarily indicative of future performance. These rates of
return may be considered, however, in assessing the competence and performance
of the investment advisers.
27
<PAGE>
TABLE 1
EFFECTIVE ANNUAL RATES OF RETURN
AS OF DECEMBER 31, 1997
<TABLE>
<CAPTION>
FUND Since 15 Years 10 Years 5 Years 1 Year
Inception
- --------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C>
MML Equity 14.78% 16.19% 16.44% 18.25% 28.59
MML Blend 13.67% --- 13.68% 13.81% 20.89%
MML Managed Bond 10.37% 9.73% 9.08% 7.79% 9.91%
MML Money Market 6.73% 6.44% 5.63% 4.47% 5.18%
MML Small Cap Value Equity --- 17.15% 16.99% 36.36%
MML Equity Index --- --- ---
Oppenheimer Global Securities 12.26% --- --- 18.81% 22.42
Oppenheimer Aggressive Growth 15.31% --- 16.23% 15.92% 11.67%
Oppenheimer Growth 15.43% --- 16.67% 18.61% 26.68%
Oppenheimer Strategic Bond 7.64% --- --- --- 8.71%
VIP II Contrafund Portfolio 28.11% --- --- --- 24.41%
Mid-Cap Growth Portfolio
VP Income & Growth 7.8% --- --- 21.8% 7.8%*
</TABLE>
The figures show in this Table do not reflect any charges at the Separate
Account or the Policy level.
*since inception.
<TABLE>
<S> <C>
Dates of inception:
MML Equity Fund-9/15/71 MML Blend Fund-2/3/84
Managed Bond Fund- 12/16/81 MML Small Cap Value Equity Fund-6/X/98
MML Money Market Fund-11/12/90 MML Equity Index Fund -4/30/97
Oppenheimer Global Securities Fund-11/12/90 Oppenheimer Aggressive Growth Fund -8/15/86
Oppenheimer Growth Fund - 4/3/85 Oppenheimer Strategic Bond Fund - 5/3/93
VIP II Contrafund Portfolio - January 3, 1995 Mid-Cap Growth Portfolio - XXX
VP Income & Growth - 10/30/97
</TABLE>
Performance for MML Small Cap Value Equity Fund for years prior to 1998 are
returns of a substantially identical fund which commenced operations x/x/xx.
Performance of VP Income & Growth for years prior to 1997 are the returns of AC
Income & Growth fund, a substantially identical fund which commenced
operations12/17/90
28
<PAGE>
TABLE 2
ONE YEAR TOTAL RETURNS
<TABLE>
<CAPTION>
YEAR MML EQUITY MML MONEY MARKET MML BOND MML BLEND MML SMALL CAP OPPENHEIMER
ENDED VALUE EQUITY GROWTH
<S> <C> <C> <C> <C> <C> <C>
1997 28.59% 5.18% 9.91% 20.89% 36.36% 26.68%
1996 20.25% 5.01% 3.25% 13.95% 22.82% 25.20%
1995 31.13% 5.58% 19.14% 23.28% 20.01% 36.65%
1994 4.10% 3.84% (3.76%) 2.48% (4.43%) 0.98%
1993 9.52% 2.75% 11.81% 9.70% 14.08% 7.25%
1992 10.48% 3.48% 7.31% 9.36% 17.10% 14.53%
1991 25.56% 6.01% 16.66% 24.00% 29.34% 25.54%
1990 (0.51%) 8.12% 8.38% 2.37% (5.42%) (8.21%)
1989 23.04% 9.16% 12.83% 19.96% 18.33% 23.59%
1988 16.68% 7.39% 7.13% 13.40% 31.06% 22.09%
1987 2.10% 6.49% 2.60% 3.12% 5.78% 3.32%
1986 20.15% 6.60% 14.46% 18.30% 11.69% 17.76%
1985 30.54% 8.03% 19.94% 24.88% 18.33% 9.50%*
1984 5.40% 10.39% 11.69% 8.24%* ---
1983 22.85% 8.97% 7.26% --- ---
1982 25.67% 11.12%* 22.79%* --- ---
1981 6.67% --- --- --- ---
1980 27.62% --- --- --- ---
1979 19.54% --- --- --- ---
1978 3.71% --- --- --- ---
1977 (0.52%) --- --- --- ---
1976 24.77% --- --- --- ---
1975 32.85% --- --- --- ---
1974 (17.61%)* --- --- --- ---
</TABLE>
The figures show in this Table do not reflect any charges at the Separate
Account or the Policy level.
*since inception.
<TABLE>
<CAPTION>
<S> <C>
Dates of inception:
MML Equity Fund-9/15/71 MML Blend Fund-2/3/84
Managed Bond Fund- 12/16/81 MML Small Cap Value Equity Fund-6/X/98
MML Money Market Fund-11/12/90 MML Equity Index Fund -4/30/97
Oppenheimer Global Securities Fund-11/12/90 Oppenheimer Aggressive Growth Fund -8/15/86
Oppenheimer Growth Fund - 4/3/85 Oppenheimer Strategic Bond Fund - 5/3/93
VIP II Contrafund Portfolio- January 3, 1995 Mid-Cap Growth Portfolio - XXX
VP Income & Growth - 10/30/97
</TABLE>
Performance for MML Small Cap Value Equity Fund for years prior to 1998 are
returns of a substantially identical fund which commenced operations x/x/xx.
Performance of VP Income & Growth for years prior to 1997 are the returns of AC
Income & Growth fund, a substantially identical fund which commenced operations
12/17/90.
29
<PAGE>
TABLE 2
ONE YEAR TOTAL RETURNS
<TABLE>
<CAPTION>
YEAR OPPENHEIMER OPPENHEIMER OPPENHEIMER VIP II MID CAP VP INCOME &
ENDED STRATEGIC BOND AGGRESSIVE GLOBAL CONTRA-FUND GROWTH GROWTH
GROWTH SECURITIES PORTFIKUI PORTFOLIO
<C> <S> <C> <C> <C> <C> <C>
1997 8.71% 11.67% 22.42% 24.14%
1996 12.07% 20.16% 17.80% 21.22%
1995 15.33% 32.52% 2.24% 39.72%
1994 (5.85%) (7.50%) (5.72%) ---
1993 4.25%* 27.32% 70.32% ---
1992 --- 15.42% (7.11%) ---
1991 --- 54.72% 3.39% ---
1990 --- (16.32%) 0.40% ---
1989 --- 27.39% --- ---
1988 --- 13.41% --- ---
1987 --- 14.34% --- ---
1986 --- (1.65%)* --- ---
1985 --- --- --- ---
1984 --- --- --- ---
1983 --- --- --- ---
1982 --- --- --- ---
1981 --- --- --- ---
1980 --- --- --- ---
1979 --- --- --- ---
1978 --- --- --- ---
1977 --- --- --- ---
1976 --- --- --- ---
1975 --- --- --- ---
1974 --- --- --- ---
</TABLE>
The figures show in this Table do not reflect any charges at the Separate
Account or the Policy level.
*since inception.
<TABLE>
<S> <C>
Dates of inception:
MML Equity Fund-9/15/71 MML Blend Fund-2/3/84
Managed Bond Fund- 12/16/81 MML Small Cap Value Equity Fund-6/X/98
MML Money Market Fund-11/12/90 MML Equity Index Fund -4/30/97
Oppenheimer Global Securities Fund-11/12/90 Oppenheimer Aggressive Growth Fund -8/15/86
Oppenheimer Growth Fund - 4/3/85 Oppenheimer Strategic Bond Fund - 5/3/93
VIP II Contrafund Portfolio - January 3, 1995 Mid-Cap Growth Portfolio - XXX
VP Income & Growth - 10/30/97
</TABLE>
Performance for MML Small Cap Value Equity Fund for years prior to 1998 are
returns of a substantially identical fund which commenced operations x/x/xx.
Performance of VP Income & Growth for years prior to 1997 are the returns of AC
Income & Growth fund, a substantially identical fund which commenced
operations 12/17/90
30
<PAGE>
APPENDIX D
ILLUSTRATION OF DEATH BENEFITS, NET SURRENDER VALUES, AND ACCUMULATED PREMIUMS
The following tables illustrate the way in which a Policy operates. They show
how the Death Benefit and Net Surrender Value could vary over an extended period
of time assuming the funds experience hypothetical gross rates of investment
return (i.e., investment income and capital gains and losses, realized or
unrealized), equivalent to constant gross annual rates of 0%, 6%, and 12%. The
tables are based on annual premium payments of $5,000 for a Select-Preferred
Male age 35 and for a Select-Preferred Female age 35. Select-Preferred is C.M.
Life's best risk classification. Separate tables are shown for the current and
guaranteed schedules of charges. These tables will assist in the comparison of
Death Benefits and Net Surrender Values for the Policy with those of other
variable life policies.
The Death Benefits and Net Surrender Values for a Policy would be different from
the amounts shown if the rates of return averaged 0%, 6%, and 12% over a period
of years, but varied above and below that average in individual Policy Years.
They also would differ if any Policy loan were made during the period of time
illustrated. They also would be different depending on the allocation of
investment value to each Division. They would be different depending on the
allocation of investment value to each Division if the rates of return for all
funds averaged 0%, 6%, and 12% but varied above or below that average for
particular funds.
The Death Benefits and Net Surrender Values shown in Tables 1,2,3,7,8, and 9
reflect the following current charges:
. Administrative Charges of $12 per month per Policy in Policy Years 1-10, and
$6 per month in Policy Years 11 and beyond.
. Face Amount Charges of $0.13 per month per $1,000 of Face Amount in Coverage
Years 1-10.
. Insurance Charges based on the current rates being charged by the Company for
Select-Preferred, fully underwritten risks.
. Mortality and Expense Risk Charges of 0.25% on an annual basis of the daily
net asset value of the Separate Account in all Policy Years.
. Fund level expenses of 0.66% on an annual basis of the net asset value of the
Separate Account. These expenses represent the unweighted average of all fund
expenses.
The Death Benefits and Net Surrender Values shown in Tables 4,5,6,10,11, and 12
reflect the following guaranteed maximum charges as well as the current fund
level expenses.
. Administrative Charges equal to $12 per month per policy in all years.
. Face Amount Charge of $0.13 per month per $1,000 of Face Amount in Coverage
Years 1-10.
. Insurance Charges based on the 1980 CSO Mortality Table.
. Mortality and Expense Risk Charges equal to 0.90% on an annual basis of the
daily net asset value of the Separate Account in all years.
Net Surrender Values shown in the Tables reflect the deduction of Surrender
Charges in the first 10 Policy Years. The Surrender Charge in the first year is
the Target Premium or $60 per $1,000 of Face Amount if less. In each of Years
two through 10, the Surrender Charge is equal to the Surrender Charge in the
prior year reduced by 10% of the Surrender Charge in the first year.
Taking the current Mortality and Expense Risk Charge and the fund level expenses
into account, the gross rates of 0%, 6%, and 12% are -0.91%, 5.09%, and 11.09%
respectively on a net basis.
31
<PAGE>
TABLE 1
<TABLE>
<CAPTION>
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 1 $1 million Initial Face Amount
Current Schedule of Charges Guideline Premium Test
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
- ---------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest
Year Per Year 0% 6% 12% 0% 6% 12
- ---------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,000,000 1,000,000 1,000,000 334 538 743
2 10,763 1,000,000 1,000,000 1,000,000 3,150 3,723 4,323
3 16,551 1,000,000 1,000,000 1,000,000 5,940 7,055 8,270
4 22,628 1,000,000 1,000,000 1,000,000 8,704 10,542 12,622
5 29,010 1,000,000 1,000,000 1,000,000 11,443 14,189 17,425
6 35,710 1,000,000 1,000,000 1,000,000 14,157 18,007 22,728
7 42,746 1,000,000 1,000,000 1,000,000 16,848 22,005 28,588
8 50,133 1,000,000 1,000,000 1,000,000 19,514 26,191 35,063
9 57,889 1,000,000 1,000,000 1,000,000 22,157 30,576 42,226
10 66,034 1,000,000 1,000,000 1,000,000 24,779 35,170 50,150
15 113,287 1,000,000 1,000,000 1,000,000 47,009 72,878 117,711
20 173,596 1,000,000 1,000,000 1,000,000 67,862 120,623 230,920
25 250,567 1,000,000 1,000,000 1,000,000 87,352 181,233 421,210
30 348,804 1,000,000 1,000,000 1,000,000 104,787 257,624 741,206
35 474,182 1,000,000 1,000,000 1,484,488 117,746 352,205 1,279,731
40 634,199 1,000,000 1,000,000 2,337,618 122,088 467,775 2,184,690
45 838,426 1,000,000 1,000,000 3,890,699 106,292 606,183 3,705,428
50 1,099,077 1,000,000 1,000,000 6,558,856 42,156 771,911 6,246,530
- ---------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- -----------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- -----------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,614 2,818 3,023
2 5,202 5,775 6,375
3 7,764 8,879 10,094
4 10,300 12,138 14,218
5 12,811 15,557 18,793
6 15,297 19,147 23,868
7 17,760 22,917 29,500
8 20,198 26,875 35,747
9 22,613 31,032 42,682
10 25,007 35,398 50,378
15 47,009 72,878 117,711
- -----------------------------------------------------------------------------------
</TABLE>
32
<PAGE>
TABLE 2
<TABLE>
<CAPTION>
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 2 $1 million Initial Face Amount
Current Schedule of Charges Guideline Premium Test
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
- -------------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest
Year Per Year 0% 6% 12% 0% 6% 12%
- -------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,025,207 1,026,766 1,028,327 22,927 24,486 26,047
2 10,763 1,050,183 1,054,880 1,059,764 48,131 52,828 57,712
3 16,551 1,074,931 1,084,407 1,094,652 73,107 82,583 92,828
4 22,628 1,099,452 1,115,421 1,133,370 97,856 113,825 131,774
5 29,010 1,123,749 1,147,995 1,176,340 122,381 146,627 174,972
6 35,710 1,147,823 1,182,208 1,224,027 146,683 181,068 222,887
7 42,746 1,171,679 1,218,145 1,276,953 170,767 217,233 276,041
8 50,133 1,195,315 1,255,891 1,335,690 194,631 255,207 335,006
9 57,889 1,218,738 1,295,539 1,400,881 218,282 295,083 400,425
10 66,034 1,241,949 1,337,185 1,473,234 241,721 336,957 473,006
15 113,287 1,366,570 1,592,801 1,989,232 366,570 592,801 989,232
20 173,596 1,485,466 1,919,454 2,916,967 485,466 919,454 1,857,941
25 250,567 1,598,595 2,336,611 4,449,072 598,595 1,336,611 3,320,203
30 348,804 1,705,361 2,868,533 7,052,392 705,361 1,868,533 5,780,649
35 474,182 1,803,169 3,543,951 11,502,713 803,169 2,543,951 9,916,132
40 634,199 1,887,417 4,397,231 18,045,368 887,417 3,397,231 16,864,830
45 838,426 1,945,472 5,463,132 29,967,618 945,472 4,463,132 28,540,589
50 1,099,077 1,949,525 6,768,468 50,453,846 949,525 5,768,468 48,051,282
- -------------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- --------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- --------------------------------------------------------------------------
<S> <C> <C> <C>
1 25,207 26,766 28,327
2 50,183 54,880 59,764
3 74,931 84,407 94,652
4 99,452 115,421 133,370
5 123,749 147,995 176,340
6 147,823 182,208 224,027
7 171,679 218,145 276,953
8 195,315 255,891 335,690
9 218,738 295,539 400,881
10 241,949 337,185 473,234
15 366,570 592,801 989,232
- --------------------------------------------------------------------------
</TABLE>
33
<PAGE>
TABLE 3
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 3 $1 million Initial Face Amount
Current Schedule of Charges Guideline Premium Test
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- --------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,005,000 1,005,000 1,005,000 334 538 743
2 10,763 1,010,000 1,010,000 1,010,000 3,150 3,723 4,323
3 16,551 1,015,000 1,015,000 1,015,000 5,939 7,055 8,269
4 22,628 1,020,000 1,020,000 1,020,000 8,704 10,541 12,622
5 29,010 1,025,000 1,025,000 1,025,000 11,443 14,189 17,424
6 35,710 1,030,000 1,030,000 1,030,000 14,156 18,006 22,727
7 42,746 1,035,000 1,035,000 1,035,000 16,846 22,004 28,586
8 50,133 1,040,000 1,040,000 1,040,000 19,511 26,188 35,061
9 57,889 1,045,000 1,045,000 1,045,000 22,155 30,572 42,222
10 66,034 1,050,000 1,050,000 1,050,000 24,776 35,166 50,145
15 113,287 1,075,000 1,075,000 1,075,000 46,996 72,862 117,691
20 173,596 1,100,000 1,100,000 1,100,000 67,820 120,568 230,847
25 250,567 1,125,000 1,125,000 1,125,000 87,217 181,057 420,967
30 348,804 1,150,000 1,150,000 1,150,000 104,354 257,054 740,405
35 474,182 1,175,000 1,175,000 1,675,412 116,263 350,261 1,277,941
40 634,199 1,200,000 1,200,000 2,534,397 117,630 461,822 2,181,680
45 838,426 1,225,000 1,225,000 4,110,386 93,436 588,687 3,700,368
50 1,099,077 1,250,000 1,250,000 6,799,947 6,016 721,521 6,238,045
- --------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
End of Policy Year
0% 6% 12%
- ----------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,614 2,818 3,023
2 5,202 5,775 6,375
3 7,763 8,897 10,093
4 10,300 12,137 14,218
5 12,811 15,557 18,792
6 15,296 19,146 23,867
7 17,758 22,916 29,498
8 20,195 26,872 35,745
9 22,611 31,028 42,678
10 25,004 35,394 50,373
15 46,996 72,862 117,691
- ----------------------------------------------------------------------------------
</TABLE>
34
<PAGE>
TABLE 4
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 1 $1 million Initial Face Amount
Guaranteed Schedules of Guideline Premium Test
Mortality and Expense Charges
and Current Fund Level Charges
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- ------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,000,000 1,000,000 1,000,000 0 0 0
2 10,763 1,000,000 1,000,000 1,000,000 1,093 1,666 2,266
3 16,551 1,000,000 1,000,000 1,000,000 4,103 5,218 6,431
4 22,628 1,000,000 1,000,000 1,000,000 7,082 8,918 10,996
5 29,010 1,000,000 1,000,000 1,000,000 10,030 12,772 16,003
6 35,710 1,000,000 1,000,000 1,000,000 12,944 16,786 21,498
7 42,746 1,000,000 1,000,000 1,000,000 15,822 20,966 27,533
8 50,133 1,000,000 1,000,000 1,000,000 18,663 25,317 34,164
9 57,889 1,000,000 1,000,000 1,000,000 21,463 29,845 41,454
10 66,034 1,000,000 1,000,000 1,000,000 24,220 34,557 49,473
15 113,287 1,000,000 1,000,000 1,000,000 43,028 68,091 111,942
20 173,596 1,000,000 1,000,000 1,000,000 59,112 108,823 214,797
25 250,567 1,000,000 1,000,000 1,000,000 71,149 157,479 385,159
30 348,804 1,000,000 1,000,000 1,000,000 75,246 212,620 668,893
35 474,182 1,000,000 1,000,000 1,330,487 60,952 267,213 1,146,972
40 634,199 1,000,000 1,000,000 2,081,623 4,635 304,180 1,945,442
45 838,426 0 1,000,000 3,441,960 0 273,274 3,278,057
50 1,099,077 0 1,000,000 5,728,265 0 34,778 5,455,490
- ------------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- ----------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- ----------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,613 2,817 3,022
2 5,197 5,770 6,370
3 7,751 8,866 10,079
4 10,274 12,110 14,188
5 12,766 15,508 18,739
6 15,224 19,066 23,778
7 17,646 22,790 29,357
8 20,031 26,685 35,532
9 22,375 30,757 42,366
10 24,676 35,013 49,929
15 43,028 68,091 111,942
- ----------------------------------------------------------------------------------
</TABLE>
35
<PAGE>
TABLE 5
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 2 $1 million Initial Face Amount
Guaranteed Schedules of Mortality Guideline Premium Test
and Expense Charges
and Current Fund Level Charges
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- --------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,002,613 1,002,817 1,003,022 0 0 0
2 10,763 1,005,197 1,005,770 1,006,370 1,093 1,666 2,266
3 16,551 1,007,750 1,008,865 1,010,079 4,102 5,217 6,431
4 22,628 1,010,274 1,012,109 1,014,187 7,082 8,917 10,995
5 29,010 1,012,765 1,015,507 1,018,737 10,029 12,771 16,001
6 35,710 1,015,223 1,019,064 1,023,776 12,943 16,784 21,496
7 42,746 1,017,644 1,022,787 1,029,352 15,820 20,963 27,528
8 50,133 1,020,026 1,026,679 1,035,524 18,658 25,311 34,156
9 57,889 1,022,369 1,030,749 1,042,353 21,457 29,837 41,441
10 66,034 1,024,667 1,035,000 1,049,909 24,211 34,544 49,453
15 113,287 1,042,980 1,068,008 1,111,797 42,980 68,008 111,797
20 173,596 1,058,923 1,108,445 1,214,001 58,923 108,445 214,001
25 250,567 1,070,542 1,156,025 1,381,409 70,542 156,025 381,409
30 348,804 1,073,567 1,207,675 1,652,888 73,567 207,675 652,888
35 474,182 1,056,923 1,251,441 2,084,731 56,923 251,441 1,084,731
40 634,199 0 1,258,378 2,756,462 0 258,378 1,756,462
45 838,426 0 1,154,806 3,760,494 0 154,806 2,760,494
50 1,099,077 0 0 5,211,472 0 0 4,211,472
- --------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
---------------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
---------------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,613 2,817 3,022
2 5,197 5,770 6,370
3 7,750 8,865 10,079
4 10,274 12,109 14,187
5 12,765 15,507 18,737
6 15,223 19,064 23,776
7 17,644 22,787 29,352
8 20,026 26,679 35,524
9 22,369 30,749 42,353
10 24,667 35,000 49,909
15 42,980 68,008 111,797
---------------------------------------------------------------------------------------
</TABLE>
36
<PAGE>
TABLE 6
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 3 $1 million Initial Face Amount
Guaranteed Schedules of Mortality Guideline Premium Test
and Expense Charges
and Current Fund Level Charges
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- -------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- -------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,005,000 1,005,000 1,005,000 0 0 0
2 10,763 1,010,000 1,010,000 1,010,000 1,093 1,666 2,266
3 16,551 1,015,000 1,015,000 1,015,000 4,102 5,217 6,431
4 22,628 1,020,000 1,020,000 1,020,000 7,082 8,917 10,995
5 29,010 1,025,000 1,025,000 1,025,000 10,028 12,770 16,001
6 35,710 1,030,000 1,030,000 1,030,000 12,941 16,783 21,495
7 42,746 1,035,000 1,035,000 1,035,000 15,818 20,961 27,527
8 50,133 1,040,000 1,040,000 1,040,000 18,655 25,308 34,154
9 57,889 1,045,000 1,045,000 1,045,000 21,451 29,832 41,439
10 66,034 1,050,000 1,050,000 1,050,000 24,203 34,537 49,450
15 113,287 1,075,000 1,075,000 1,075,000 42,941 67,986 111,814
20 173,596 1,100,000 1,100,000 1,100,000 58,789 108,417 214,275
25 250,567 1,125,000 1,125,000 1,125,000 70,109 156,130 383,334
30 348,804 1,150,000 1,150,000 1,150,000 72,195 208,550 663,145
35 474,182 1,175,000 1,175,000 1,489,323 52,198 255,299 1,133,037
40 634,199 0 1,200,000 2,256,710 0 270,255 1,922,159
45 838,426 0 1,225,000 3,626,131 0 173,984 3,239,172
50 1,099,077 0 0 5,910,674 0 0 5,391,118
- -------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- -------------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- ------------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,613 2,817 3,022
2 5,197 5,770 6,370
3 7,750 8,865 10,079
4 10,274 12,109 14,187
5 12,764 15,506 18,737
6 15,221 19,063 23,775
7 17,642 22,785 29,351
8 20,023 26,676 35,522
9 22,363 30,744 42,351
10 24,659 34,993 49,906
15 42,941 67,986 111,814
- ------------------------------------------------------------------------------------
</TABLE>
37
<PAGE>
TABLE 7
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 1 $1 million Initial Face Amount
Current Schedule of Charges Cash Value Test
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- ---------------------------------------------------------------------------------------------------------
End of Premiums
Policy Year Accumulated at
5% Interest Per
Year 0% 6% 12% 0% 6% 12%
- ---------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,000,000 1,000,000 1,000,000 0 0 0
2 10,763 1,000,000 1,000,000 1,000,000 1,098 1,671 2,271
3 16,551 1,000,000 1,000,000 1,000,000 4,116 5,231 6,446
4 22,628 1,000,000 1,000,000 1,000,000 7,108 8,946 11,026
5 29,010 1,000,000 1,000,000 1,000,000 10,075 12,821 16,057
6 35,710 1,000,000 1,000,000 1,000,000 13,017 16,867 21,588
7 42,746 1,000,000 1,000,000 1,000,000 15,936 21,093 27,676
8 50,133 1,000,000 1,000,000 1,000,000 18,830 25,507 34,379
9 57,889 1,000,000 1,000,000 1,000,000 21,701 30,120 41,770
10 66,034 1,000,000 1,000,000 1,000,000 24,551 34,942 49,922
15 113,287 1,000,000 1,000,000 1,000,000 47,009 72,878 117,711
20 173,596 1,000,000 1,000,000 1,000,000 67,862 120,623 230,920
25 250,567 1,000,000 1,000,000 1,099,249 87,352 181,233 421,200
30 348,804 1,000,000 1,000,000 1,613,848 104,787 257,624 740,258
35 474,182 1,000,000 1,000,000 2,343,307 117,746 352,205 1,271,896
40 634,199 1,000,000 1,000,000 3,405,858 122,088 467,775 2,152,330
45 838,426 1,000,000 1,000,000 5,009,398 106,292 606,183 3,594,668
50 1,099,077 1,000,000 1,000,000 7,471,496 42,156 771,911 5,922,666
- ---------------------------------------------------------------------------------------------------------
</TABLE>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
<TABLE>
End of Policy Year
0% 6% 12%
- ------------------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,614 2,818 3,023
2 5,202 5,775 6,375
3 7,764 8,879 10,094
4 10,300 12,138 14,218
5 12,811 15,557 18,793
6 15,297 19,147 23,868
7 17,760 22,917 29,500
8 20,198 26,875 35,747
9 22,613 31,032 42,682
10 25,007 35,398 50,378
15 47,009 72,878 117,711
- ------------------------------------------------------------------------------------------
</TABLE>
38
<PAGE>
TABLE 8
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 2 $1 million Initial Face Amount
Current Schedule of Charges Cash Value Test
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- ---------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- ---------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,002,614 1,002,818 1,003,023 0 0 0
2 10,763 1,005,202 1,005,775 1,006,375 1,098 1,671 2,271
3 16,551 1,007,763 1,008,879 1,010,093 4,115 5,231 6,445
4 22,628 1,010,300 1,012,137 1,014,218 7,108 8,945 11,026
5 29,010 1,012,811 1,015,557 1,018,792 10,075 12,821 16,056
6 35,710 1,015,297 1,019,147 1,023,867 13,017 16,867 21,587
7 42,746 1,017,759 1,022,916 1,029,498 15,935 21,092 27,674
8 50,133 1,020,196 1,026,873 1,035,745 18,828 25,505 34,377
9 57,889 1,022,612 1,031,029 1,042,679 21,700 30,117 41,767
10 66,034 1,025,005 1,035,395 1,050,374 24,549 34,939 49,918
15 113,287 1,047,002 1,072,865 1,117,689 47,002 72,865 117,689
20 173,596 1,067,835 1,120,569 1,230,808 67,835 120,569 230,808
25 250,567 1,087,260 1,181,022 1,420,684 87,260 181,022 420,684
30 348,804 1,104,485 1,256,808 1,738,719 104,485 256,808 738,719
35 474,182 1,116,723 1,348,914 2,337,610 116,723 348,914 1,268,804
40 634,199 1,119,178 1,456,178 3,397,704 119,178 456,178 2,147,178
45 838,426 1,099,003 1,567,747 4,997,514 99,003 567,747 3,586,141
50 1,099,077 1,028,123 1,651,595 7,453,869 28,123 651,595 5,908,693
- ---------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- ---------------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- ---------------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,614 2,818 3,023
2 5,202 5,775 6,375
3 7,763 8,879 10,093
4 10,300 12,137 14,218
5 12,811 15,557 18,792
6 15,297 19,147 23,867
7 17,759 22,916 29,498
8 20,196 26,873 35,745
9 22,612 31,029 42,679
10 25,005 35,395 50,374
15 47,002 72,865 117,689
- ---------------------------------------------------------------------------------------
</TABLE>
39
<PAGE>
TABLE 9
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 3 $1 million Initial Face Amount
Current Schedule of Charges Cash Value Test
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- ---------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- ---------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,005,000 1,005,000 1,005,000 0 0 0
2 10,763 1,010,000 1,010,000 1,010,000 1,098 1,671 2,271
3 16,551 1,015,000 1,015,000 1,015,000 4,115 5,231 6,445
4 22,628 1,020,000 1,020,000 1,020,000 7,108 8,945 11,026
5 29,010 1,025,000 1,025,000 1,025,000 10,075 12,821 16,056
6 35,710 1,030,000 1,030,000 1,030,000 13,016 16,866 21,587
7 42,746 1,035,000 1,035,000 1,035,000 15,934 21,092 27,674
8 50,133 1,040,000 1,040,000 1,040,000 18,827 25,504 34,377
9 57,889 1,045,000 1,045,000 1,045,000 21,699 30,116 41,766
10 66,034 1,050,000 1,050,000 1,050,000 24,548 34,938 49,917
15 113,287 1,075,000 1,075,000 1,075,000 46,996 72,862 117,691
20 173,596 1,100,000 1,100,000 1,100,000 67,820 120,568 230,847
25 250,567 1,125,000 1,125,000 1,223,640 87,217 181,057 420,967
30 348,804 1,150,000 1,150,000 1,762,975 104,354 257,054 739,858
35 474,182 1,175,000 1,175,000 2,517,072 116,263 350,261 1,271,226
40 634,199 1,200,000 1,200,000 3,604,091 117,630 461,822 2,151,214
45 838,426 1,225,000 1,225,000 5,231,822 93,436 588,687 3,592,820
50 1,099,077 1,250,000 1,250,000 7,717,676 6,016 721,521 5,919,637
- ---------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- ---------------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- ---------------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,614 2,818 3,023
2 5,202 5,775 6,375
3 7,763 8,879 10,093
4 10,300 12,137 14,218
5 12,811 15,557 18,792
6 15,296 19,146 23,867
7 17,758 22,916 29,498
8 20,195 26,872 35,745
9 22,611 31,028 42,678
10 25,004 35,394 50,373
15 46,996 72,862 117,691
- ---------------------------------------------------------------------------------------
</TABLE>
40
<PAGE>
TABLE 10
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 1 $1 million Initial Face Amount
Guaranteed Schedules of Mortality
and Expense Charges Cash Value Test
and Current Fund Level Charges
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- --------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,000,000 1,000,000 1,000,000 0 0 0
2 10,763 1,000,000 1,000,000 1,000,000 1,093 1,666 2,266
3 16,551 1,000,000 1,000,000 1,000,000 4,103 5,218 6,431
4 22,628 1,000,000 1,000,000 1,000,000 7,082 8,918 10,996
5 29,010 1,000,000 1,000,000 1,000,000 10,030 12,772 16,003
6 35,710 1,000,000 1,000,000 1,000,000 12,944 16,786 21,498
7 42,746 1,000,000 1,000,000 1,000,000 15,822 20,966 27,533
8 50,133 1,000,000 1,000,000 1,000,000 18,663 25,317 34,164
9 57,889 1,000,000 1,000,000 1,000,000 21,463 29,845 41,454
10 66,034 1,000,000 1,000,000 1,000,000 24,220 34,557 49,473
15 113,287 1,000,000 1,000,000 1,000,000 43,028 68,091 111,942
20 173,596 1,000,000 1,000,000 1,000,000 59,112 108,823 214,797
25 250,567 1,000,000 1,000,000 1,005,187 71,149 157,479 385,159
30 348,804 1,000,000 1,000,000 1,449,851 75,246 212,620 665,034
35 474,182 1,000,000 1,000,000 2,049,471 60,952 267,213 1,112,408
40 634,199 1,000,000 1,000,000 2,859,131 4,635 304,180 1,806,827
45 838,426 0 1,000,000 3,951,080 0 273,274 2,835,236
50 1,099,077 0 1,000,000 5,426,570 0 34,778 4,301,650
- --------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- -------------------------------------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- -------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,613 2,817 3,022
2 5,197 5,770 6,370
3 7,751 8,866 10,079
4 10,274 12,110 14,188
5 12,766 15,508 18,739
6 15,224 19,066 23,778
7 17,646 22,790 29,357
8 20,031 26,685 35,532
9 22,375 30,757 42,366
10 24,676 35,013 49,929
15 43,028 68,091 111,942
- -------------------------------------------------------------------------------------------------------------
</TABLE>
41
<PAGE>
TABLE 11
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 2 $1 million Initial Face Amount
Guaranteed Schedules of Mortality Cash Value Test
and Expense Charges
and Current Fund Level Charges
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- ---------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- ---------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,002,613 1,002,817 1,003,022 0 0 0
2 10,763 1,005,197 1,005,770 1,006,370 1,093 1,666 2,266
3 16,551 1,007,750 1,008,865 1,010,079 4,102 5,217 6,431
4 22,628 1,010,274 1,012,109 1,014,187 7,082 8,917 10,995
5 29,010 1,012,765 1,015,507 1,018,737 10,029 12,771 16,001
6 35,710 1,015,223 1,019,064 1,023,776 12,943 16,784 21,496
7 42,746 1,017,644 1,022,787 1,029,352 15,820 20,963 27,528
8 50,133 1,020,026 1,026,679 1,035,524 18,658 25,311 34,156
9 57,889 1,022,369 1,030,749 1,042,353 21,457 29,837 41,441
10 66,034 1,024,667 1,035,000 1,049,909 24,211 34,544 49,453
15 113,287 1,042,980 1,068,008 1,111,797 42,980 68,008 111,797
20 173,596 1,058,923 1,108,445 1,214,001 58,923 108,445 214,001
25 250,567 1,070,542 1,156,025 1,381,409 70,542 156,025 381,409
30 348,804 1,073,567 1,207,675 1,652,888 73,567 207,675 652,888
35 474,182 1,056,923 1,251,441 2,084,731 56,923 251,441 1,084,731
40 634,199 0 1,258,378 2,779,369 0 258,378 1,756,421
45 838,426 0 1,154,806 3,840,057 0 154,806 2,755,567
50 1,099,077 0 0 5,275,045 0 0 4,181,536
- ---------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- ----------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- ----------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,613 2,817 3,022
2 5,197 5,770 6,370
3 7,750 8,865 10,079
4 10,274 12,109 14,187
5 12,765 15,507 18,737
6 15,223 19,064 23,776
7 17,644 22,787 29,352
8 20,026 26,679 35,524
9 22,369 30,749 42,353
10 24,667 35,000 49,909
15 42,980 68,008 111,797
- ----------------------------------------------------------------------------------
</TABLE>
42
<PAGE>
TABLE 12
SURVIVORSHIP FLEXIBLE PREMIUM ADJUSTABLE VARIABLE LIFE INSURANCE POLICY
Male Issue Age 35, Select-Preferred $5,000 Annual Premium
Death Benefit Option 3 $1 million Initial Face Amount
Guaranteed Schedules of Mortality Cash Value Test
and Expense Charges
and Current Fund Level Charges
Death Benefit Assuming Net Surrender Value Assuming
Hypothetical Gross Annual Hypothetical Gross Annual
Investment Return Of: Investment Return Of:
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------------------------
Premiums
End of Accumulated at
Policy 5% Interest Per
Year Year 0% 6% 12% 0% 6% 12%
- --------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 5,250 1,005,000 1,005,000 1,005,000 0 0 0
2 10,763 1,010,000 1,010,000 1,010,000 1,093 1,666 2,266
3 16,551 1,015,000 1,015,000 1,015,000 4,102 5,217 6,431
4 22,628 1,020,000 1,020,000 1,020,000 7,082 8,917 10,995
5 29,010 1,025,000 1,025,000 1,025,000 10,028 12,770 16,001
6 35,710 1,030,000 1,030,000 1,030,000 12,941 16,783 21,495
7 42,746 1,035,000 1,035,000 1,035,000 15,818 20,961 27,527
8 50,133 1,040,000 1,040,000 1,040,000 18,655 25,308 34,154
9 57,889 1,045,000 1,045,000 1,045,000 21,451 29,832 41,439
10 66,034 1,050,000 1,050,000 1,050,000 24,203 34,537 49,450
15 113,287 1,075,000 1,075,000 1,075,000 42,941 67,986 111,814
20 173,596 1,100,000 1,100,000 1,100,000 58,789 108,417 214,275
25 250,567 1,125,000 1,125,000 1,125,426 70,109 156,130 383,334
30 348,804 1,150,000 1,150,000 1,592,259 72,195 208,550 661,552
35 474,182 1,175,000 1,175,000 2,214,013 52,198 255,299 1,106,732
40 634,199 0 1,200,000 3,044,769 0 270,255 1,797,751
45 838,426 0 1,225,000 4,156,426 0 173,984 2,821,133
50 1,099,077 0 0 5,649,746 0 0 4,280,386
- --------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<CAPTION>
Account Value Assuming Hypothetical Gross
Annual Investment Return Of:
- ---------------------------------------------------------------------------------
End of Policy Year
0% 6% 12%
- ---------------------------------------------------------------------------------
<S> <C> <C> <C>
1 2,613 2,817 3,022
2 5,197 5,770 6,370
3 7,750 8,865 10,079
4 10,274 12,109 14,187
5 12,764 15,506 18,737
6 15,221 19,063 23,775
7 17,642 22,785 29,351
8 20,023 26,676 35,522
9 22,363 30,744 42,351
10 24,659 34,993 49,906
15 42,941 67,986 111,814
- ---------------------------------------------------------------------------------
</TABLE>
43
<PAGE>
APPENDIX E
DIRECTORS OF C.M. LIFE
LAWRENCE V. BURKETT, JR., DIRECTOR, PRESIDENT AND CHIEF EXECUTIVE OFFICER
Director, President and Chief Executive Officer, C.M. Life, since 1996;
Executive Vice President and General Counsel, MassMutual, since 1993; Senior
Vice President and Deputy General Counsel, MassMutual, 1992-1993.
JOHN B. DAVIES, DIRECTOR
Director, C.M. Life, since 1996; Executive Vice President, MassMutual since
1994; Associate Executive Vice President, 1994; General Agent, MassMutual,
1982-1993.
STUART H. REESE, DIRECTOR AND SENIOR VICE PRESIDENT - INVESTMENTS
Director and Senior Vice President-Investments, C.M. Life, since 1996; Senior
Vice President, MassMutual, since 1993; Investment Manager, Aetna Life and
Casualty and Affiliates, 1979-1993.
PRINCIPALS (OTHER THAN THOSE WHO ALSO ARE DIRECTORS):
PAUL D. ADORNATO
Senior Vice President, C.M. Life since, 1996; Senior Vice President,
MassMutual, since 1986.
ANNE MELISSA DOWLING
Senior Vice President - Large Corporate Marketing, C.M. Life, since 1996;
Senior Vice President, MassMutual, since 1996; Chief Investment Officer,
Connecticut Mutual Life Insurance Company, 1994-1996; Senior Vice President -
International, Travelers Insurance Co., 1987-1993.
MAUREEN R. FORD
Senior Vice President - Annuity Marketing, C.M. Life, since 1996; Senior Vice
President, MassMutual, since 1996; Marketing Officer, Connecticut Mutual Life
Insurance Company, 1989-1996.
ISADORE JERMYN
Chief Actuary, MassMutual since 1997; Senior Vice President and Actuary, C.M.
Life, since 1996; Senior Vice President and Actuary, MassMutual 1995-1997; Vice
President and Actuary, MassMutual, 1980-1995.
EDWARD M. KLINE
Treasurer, C.M. Life since 1997, Vice President since 1989 and Treasurer since
1997, MassMutual.
ANN F. LOMELI
Secretary, C.M. Life, since 1988; Vice President, Associate Secretary and
Associate General Counsel, MassMutual, since 1996; Corporate Secretary and
Counsel, Connecticut Mutual Life Insurance Company, 1988-1996.
44
<PAGE>
PART II
INFORMATION NOT REQUIRED IN PROSPECTUS
UNDERTAKING TO FILE REPORTS
Subject to the terms and conditions of Section 15(d) of the Securities Exchange
Act of 1934, the undersigned registrant hereby undertakes to file with the
Securities and Exchange Commission (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.
RULE 484 UNDERTAKING
The Bylaws of C.M. Life provide for indemnification of directors and officers as
follows:
C.M. Life directors and officers are indemnified under its by-laws. No
indemnification is provided with respect to any liability to any entity which is
registered as an investment company under the Investment Company Act of 1940 or
to the security holders thereof, where the basis for such liability is willful
misfeasance, bad faith, gross negligence or reckless disregard of the duties
involved in the conduct of office.
Insofar as indemnification for liabilities arising under the Securities Act of
1933 may be permitted to directors, officers and controlling persons of C.M.
Life pursuant to the foregoing provisions, or otherwise, C.M. Life has been
advised that in the opinion of the Securities and Exchange Commission such
indemnification is against public policy as expressed in the Securities Act of
1933, and is, therefore unenforceable. In the event that a claim for
indemnification against such liabilities (other than the payment by C.M. Life of
expenses incurred or paid by a director, officer or controlling person of C.M.
Life in the successful defense of any action, suit or proceeding) is asserted by
such director, officer or controlling person in connection with the securities
being registered, C.M. Life will, unless in the opinion of its counsel the
matter has been settled by controlling precedent, submit to a court of
appropriate jurisdiction the question whether such indemnification by it is
against public policy as expressed in the Securities Act of 1933 and will be
governed by the final adjudication of such issue.
REPRESENTATION UNDER SECTION 26(e)(2)(A) OF
THE INVESTMENT COMPANY ACT OF 1940
C.M. Life hereby represents that the fees and charges deducted under the
flexible premium adjustable variable life insurance policies described in this
Registration Statement in the aggregate, are reasonable in relation to the
services rendered, the expenses expected to be incurred, and the risks assumed
by C.M. Life.
<PAGE>
CONTENTS OF FILING
This Registration Statement is comprised of the following documents:
The Facing Sheet.
cross-reference to items required by Form N-8B-2.
The Prospectus consisting of 43 pages.
The Undertaking to File Reports.
The Undertaking pursuant to Rule 484 under the Securities Act of
1933.
Representation under Section 26(e)(2)(a) of the Investment
Company Act of 1940.
The Signatures.
Written Consents of the Following Persons:
1. To be filed: Coopers & Lybrand, L.L.P., independent
accountants;
2. Counsel opining as to the legality of securities being
registered;
3. Opinion and consent of Craig Waddington, FSA, MAAA,
opining as to actuarial matters contained in the
Registration Statement.
The following Exhibits:
99. The following Exhibits correspond to those required by
Paragraph A of the instructions as to Exhibits in Form N-8B-
2:
A. 1. Form of Resolution of the Board of Directors
establishing the VUL segment of the Separate Account.
2. Not Applicable.
3. Form of Distribution Agreements:
a. Form of Distribution Servicing Agreement between MML
Distributors, LLC and C.M. Life./1/
b. Form of Co-Underwriting Agreement between MML
Investors Services, Inc. and C.M. Life./1/
4. Not applicable
5. Form of Flexible Premium Adjustable Variable Life
Policy.
<PAGE>
6. a. Certificate of Incorporation of C.M. Life./2/
b. By-Laws of C.M. Life./2/
7. Not Applicable.
8. Participation Agreement./3/
9. Not Applicable.
10. Form of Application for a Flexible Premium Adjustable
Variable Life insurance policy.
11. To be filed: Memorandum describing C.M. Life issuance,
transfer, and redemption procedures for the Policy.
99.B Opinion and Consent of Counsel as to the legality of the
securities being registered.
99.C No financial statement will be omitted from the Prospectus
pursuant to Instruction 1(b) or (c) of Part I.
99.D Not Applicable.
99.E. To be filed: Consent of Coopers & Lybrand L.L.P.
99.F. Opinion and consent of Craig Waddington, FSA, MAAA, as to
actuarial matters pertaining to the securities being registered.
99.G. Powers of Attorney/4/
27. Not Applicable
/1/ Incorporated by reference to Pre-Effective Amendment No. 1 to Registration
Statement No. 33-91072.
/2/ Incorporated by reference to Post-Effective Amendment No. 3 to Registration
Statement No. 33-91072.
/3/ Incorporated by reference to Initial Registration Statement of the Separate
Account filed with the Commission on February 28, 1997. (Registration No.
333-22557)
/4/ Incorporated by reference to Post-Effective Amendment No. 4 to Registration
Statement No. 333-2347.
<PAGE>
SIGNATURES
Pursuant to the requirements of the Securities Act of 1933, the Registrant has
caused this Registration Statement to be signed on its behalf by the undersigned
thereunto duly authorized, all in the city of Hartford and the state of
Connecticut, on the 3rd day of April, 1998.
C.M. LIFE VARIABLE LIFE SEPARATE ACCOUNT I
C.M. LIFE INSURANCE COMPANY
(Depositor)
By: /s/ Lawrence V. Burkett, Jr.*
------------------------------------------
Lawrence V. Burkett, Jr.,
President and Chief Executive Officer
C.M. Life Insurance Company
/s/ Richard M. Howe On April 3, 1998, as Attorney-in-Fact pursuant to
- -------------------- owers of attorney incorporated by reference.
*Richard M. Howe
As required by the Securities Act of 1933, this Registration Statement has been
signed by the following persons in the capacities and on the duties indicated.
<TABLE>
<CAPTION>
Signature Title Date
--------- ----- ----
<S> <C> <C>
/s/ Lawrence V. Burkett, Jr.*
- ------------------------------- Director, President and Chief April 3, 1998
Lawrence V. Burkett, Jr. Executive Officer
/s/ John Miller, Jr.*
- ------------------------------- Second Vice President and Comptroller April 3, 1998
John Miller, Jr. (Principal Accounting Officer)
/s/ John B. Davies*
- ------------------------------- Director April 3, 1998
John B. Davies
/s/ Stuart H. Reese*
- ------------------------------- Director April 3, 1998
Stuart H. Reese
/s/ Richard M. Howe
- ------------------------------- On April 3, 1998, as Attorney-in-Fact
*Richard M. Howe pursuant to powers of attorney.
</TABLE>
<PAGE>
EXHIBIT LIST
99.A.1. Form of Resolution of the Board of Directors establishing the VUL
segment of the Separate Account
99.A.5. Form of Flexible Premium Adjustable Variable Life Policy.
99.A.10. Form of Application for flexible premium adjustable variable life
insurance policy.
99.B. Opinion and Consent of Richard M. Howe, Esq.
99.F. Form of Opinion and Consent of Craig Waddington, FSA, MAAA
<PAGE>
EXHIBIT 99.A.1.
The undersigned hereby certifies that she is the Secretary of C.M. Life
Insurance Company (the "Company"); that the following vote was adopted by means
of an instrument of unanimous written consent of the Board of Directors of the
Company dated ; and that the said vote has been neither
rescinded nor modified, but remains in full force and effect:
VOTED:
That in connection with the development of a new variable universal
life insurance product (the "VUL Policy"), the Company establish a
segment of C.M. Life Variable Life Separate Account I (the "Separate
Account") in order to invest contributions received under the VUL Policy;
that the appropriate officers of the Company be, and each acting singly
hereby is, authorized to execute all documents or take any other action
which said officer deems necessary or advisable in order to permit the
sale of the VUL Policy, including the filing of registration statements
or amendments thereto with the United States Securities and Exchange
Commission or other appropriate regulatory authorities; and that the
chief executive officer or the chief operating officer of the Company be,
and each acting singly hereby is, authorized to establish additional
segments of the Separate Account or further divide any segment of the
Separate Account into additional divisions, as such officer in his
discretion deems necessary or appropriate.
IN WITNESS WHEREOF, I have hereunto affixed my hand and the seal of the Company
this day of
Secretary
<PAGE>
C.M. Life Insurance Company C.M. Life Insurance Company
A STOCK COMPANY Home Office: Hartford, Connecticut
Administrative Office: Springfield,
Massachusetts
Flexible Premium Adjustable Variable Life Insurance Policy
- --------------------------------------------------------------------------------
INSURED JOHN A. DOE
POLICY DATE JULY 1, 1998 POLICY NUMBER 123456789
ISSUE DATE JULY 1, 1998 INITIAL FACE AMOUNT $500,000
- --------------------------------------------------------------------------------
Dear Policy Owner:
READ YOUR POLICY CAREFULLY. It has been written in readable language to help
you understand its terms. We have used examples to explain some of its
provisions. These examples do not reflect the actual amounts or status of this
policy. As you read through the policy, remember the words "we," "us," and "our"
refer to C.M. Life Insurance Company.
We will, subject to the terms of this policy, pay the death benefit to the
Beneficiary when due proof of the Insured's death is received at our
Administrative Office.
The terms of this policy are contained on this and the following pages. For
service and information on this policy, contact the agent who sold the policy,
any of our agency offices, or our Administrative Office.
YOU HAVE THE RIGHT TO RETURN THIS POLICY. If you decide not to keep this policy,
return it within 10 days after you receive it. It may be returned by delivering
or mailing it to our Administrative Office, to any of our agency offices, or to
the agent who sold the policy. Then, the policy will be as though it had never
been issued. We will promptly refund (a) any premium paid for this policy, plus
(b) interest credited to this policy under the Guaranteed Principal Account,
plus or minus (c) an amount that reflects the investment experience of the
investment divisions of the Separate Account under this policy to the date the
policy is received by us, minus (d) any amounts withdrawn and any policy debt.
Signed for C.M. Life Insurance Company.
Sincerely yours,
/s/ [SIGNATURE APPEARS HERE] /s/ Ann F. Lomeli
PRESIDENT SECRETARY
This Policy provides that: A death benefit is payable when the Insured dies.
Within specified limits, flexible premiums may be
paid during the Insured's lifetime.
No dividends will be paid.
The amount of death benefit and the duration of insurance coverage may be fixed
or variable as described in Parts 3 and 5.
The variable account value of the policy may increase or decrease in accordance
with the experience of the Separate Account. There are no minimum guarantees as
to the variable account value. The fixed account value of the policy earns
interest at a rate not less than the minimum described in the Interest On Fixed
Account Value provision.
<PAGE>
Policy Summary
This Summary briefly describes some of the major policy provisions. Since it
does not go into detail, the actual provisions will prevail. See the provisions
for full information and any limits that may apply. The "Table Of Contents"
shows where the provisions may be found.
This is a variable universal life insurance policy. We will pay a death benefit
if the Insured dies while the policy is in force. "In force" means that the
insurance has not terminated. "Variable" means that values depend on the
investment performance of the Separate Account shown in the Policy
Specifications and are not guaranteed as to dollar amount. "Universal life"
means that, subject to the limits and conditions stated in the policy, the
amount of insurance may be adjusted and flexible premium payments may be made.
Premiums for this policy are flexible. After the first premium has been paid,
there is no requirement that any specific amount of premium be paid on any date.
Instead, within the limits stated in the policy, any amount may be paid on any
date during the lifetime of the Insured.
Premiums are applied to increase the value of this policy. Monthly charges are
deducted from the value of this policy each month. If the value cannot cover the
monthly charges for a month and premiums paid do not meet certain requirements,
the policy may terminate at the end of 62 days. There is, however, a right to
reinstate the policy.
Other rights available while the Insured is living include the rights to:
. Change the Owner or any Beneficiary;
. Assign this policy;
. Change the Face Amount;
. Change the Death Benefit Option;
. Make loans;
. Make withdrawals;
. Surrender this policy;
. Allocate net premiums among the Guaranteed Principal Account and
the divisions of the Separate Account; and
. Transfer values between the Guaranteed Principal Account and the
divisions of the Separate Account.
This policy also includes a number of Payment Options. They provide alternate
ways for us to pay the death benefit or the amount payable upon surrender of the
policy.
<PAGE>
TABLE OF CONTENTS
Policy Specifications
Page No.
-------
Part 1. - The Basics Of This Policy................................... 1
The Parties Involved - Owner, Insured, Beneficiary,
Irrevocable Beneficiary......................................... 1
Dates - Policy Date, Policy Anniversary Date, Policy Year,
Monthly Charge Date, Issue Date, Valuation Date, Valuation
Period, Valuation Time, Register Date........................... 2
Policy A Legal Contract........................................... 2
Policy Is Not Participating....................................... 2
Representations And Contestability................................ 3
Misstatement Of Age Or Gender..................................... 3
Death By Suicide.................................................. 3
Meaning Of In Force............................................... 4
Face Amount....................................................... 4
Year Of Coverage.................................................. 4
Ages - Issue Age, Attained Age.................................... 4
Written Request................................................... 4
Currency.......................................................... 4
Administrative Office............................................. 4
Part 2. - Premium Payments............................................ 4
The First Premium................................................. 4
Planned Premiums.................................................. 5
Premium Flexibility And Premium Notices........................... 5
Where To Pay Premiums............................................. 5
Right To Refund Premiums.......................................... 5
Net Premium....................................................... 5
Allocation Of Net Premiums........................................ 6
Part 3. - Accounts, Values, And Charges............................... 6
The Separate Account And The Guaranteed Principal Account........... 7
The Separate Account.............................................. 7
Changes In The Separate Account................................... 7
Accumulation Units................................................ 7
Purchase And Sale Of Accumulation Units........................... 7
The Guaranteed Principal Account.................................. 8
Values Of This Policy............................................... 8
Account Value Of Policy........................................... 8
Variable Account Value Of Policy.................................. 8
Fixed Account Value Of Policy..................................... 9
Interest On Fixed Account Value................................... 9
Monthly Policy Charges.............................................. 9
Monthly Charges................................................... 9
Administrative Charge............................................. 10
Face Amount Charge................................................ 10
Insurance Charge................................................. 10
Rider Charge..................................................... 11
Grace Period And Termination..................................... 11
Safety Test...................................................... 12
Part 4. - Life Benefits.............................................. 13
Policy Ownership................................................... 13
Rights Of Owner.................................................. 13
Changing The Owner Or Beneficiary................................ 13
Transfers Of Values.............................................. 13
Assigning This Policy............................................ 14
Right To Change The Face Amount.................................... 14
Increases In The Face Amount..................................... 14
Decreases In The Face Amount..................................... 15
Evidence Of Changes.............................................. 15
Borrowing Against This Policy...................................... 15
Right To Make Loans.............................................. 15
Effect Of Loan................................................... 15
Maximum Loan Available........................................... 16
Interest On Loans................................................ 16
Policy Debt Limit................................................ 17
Repayment Of Policy Debt......................................... 17
Other Borrowing Rules............................................ 17
Surrendering This Policy And Making Withdrawals.................... 18
Right To Surrender............................................... 18
Net Surrender Value.............................................. 18
Making Withdrawals............................................... 18
How We Pay....................................................... 19
Reinstating This Policy............................................ 19
When Reinstatement Can Be Made................................... 19
Requirements To Reinstate........................................ 20
Policy After Reinstatement....................................... 20
Reports to Owner................................................... 20
Annual Report.................................................... 20
Part 5. - The Death Benefit.......................................... 20
Amount Of Death Benefit.......................................... 20
Death Benefit Options............................................ 21
Minimum Death Benefit............................................ 21
Changes In The Death Benefit Option.............................. 21
When We Pay...................................................... 22
Interest On Death Benefit........................................ 22
Part 6. - Payment Options............................................ 22
Availability Of Options.......................................... 22
Minimum Amounts.................................................. 23
Description Of Options........................................... 23
<PAGE>
TABLE OF CONTENTS (continued)
Options 1, 2, 3, 4, 5, 6......................................... 23
Alternate Life Income............................................ 24
Electing A Payment Option........................................ 24
Effective Date And Payment Dates................................. 24
Withdrawals And Changes.......................................... 24
Income Protection................................................ 24
Other Payment Option Rules....................................... 24
Part 7. - Notes On Our Computations................................. 25
Net Investment Factor........................................... 25
Accumulation Unit Value......................................... 25
Adjustment Of Units And Values.................................. 26
Basis Of Computation............................................ 26
Method Of Computing Values...................................... 26
Payment Option Rates Tables......................................... 27-33
Any riders and endorsements, and a copy of the application for the policy,
follow page 33.
- --------------------------------------------------------------------------------
For additional important terms used in this policy, see the following
provisions:
<TABLE>
<CAPTION>
Term Provision Page No.
- ---- --------- --------
<S> <C> <C>
Death Benefit Factor Minimum Death Benefit 21
Expense Premium Net Premium 5
Guarantee Periods Safety Test 12
Guarantee Premiums Safety Test 12
Insurance Risk Insurance Charge 10
Loan Interest Rate Expense Charge Interest On Fixed Account Value 9
Minimum Annual Interest Rate For The Interest On Fixed Account Value 9
Guaranteed Principal Account
Borrowing Against This Policy Right To Make Loans 15
Premium Expense Charge Net Premium 5
Separate Account Charge For Mortality Net Investment Factor 25
And Expense Risk
Surrender Charges Net Surrender Value 18
Withdrawal Fee Making Withdrawals 18
</TABLE>
<PAGE>
Part 1. The Basics Of This Policy
In this Part, we discuss some definitions and insurance concepts necessary to
understand this policy. The words "we," "us," and "our" refer to C.M. Life
Insurance Company.
The Parties The Owner is the person who owns this policy, as
Involved - shown in our records. The Owner has the right to
Owner, Insured, exercise rights and privileges and to receive
Beneficiary, benefits under the terms of this policy during the
Irrevocable lifetime of the Insured. If the Owner designated
Beneficiary under the terms of this policy is not living and if
the policy does not provide otherwise, the Owner will
be the estate of the last Owner to die.
For more information about the rights and benefits
available to the Owner, see the "Policy Ownership"
section in Part 4.
The Insured is the person whose life this policy
insures. The Insured may be the Owner of this policy,
or someone else may be the Owner.
Example: You buy a policy that insures your own
life and name yourself as Owner. In
this case, you are both the Insured and
the Owner. If you buy a policy that
insures your son and name yourself as
Owner, then the Insured and the Owner
are different people.
A Beneficiary is any person named in our records to
receive the death benefit after the Insured dies.
There may be different classes of Beneficiaries, such
as primary and secondary. These classes set the order
of payment. There may be more than one Beneficiary in
a class.
Example: Elizabeth is named as primary (first)
Beneficiary. Rachel and David are named
as Beneficiaries in the secondary
class. If Elizabeth is alive when the
Insured dies, she receives the death
benefit. If Elizabeth is not alive but
Rachel and David are alive when the
Insured dies, Rachel and David receive
the death benefit.
Any Beneficiary may be named an Irrevocable
Beneficiary. An Irrevocable Beneficiary is one whose
consent is needed to change that Beneficiary. Also,
this Beneficiary must consent to the exercise of
certain other policy rights.
If no Beneficiary designated under this policy
survives the Insured, the Beneficiary will be the
Owner unless the policy states otherwise. The
interest of any Beneficiary will be subject to any
assignment of this policy that is binding on us and
to any payment option in effect at the time of the
Insured's death.
See the "Policy Ownership" section in Part 4, and see
"Part 6. - Payment Options."
Page 1
<PAGE>
Dates - Policy Date, The Policy Date is shown in the Policy
Policy Anniversary Specifications. It is the starting point for
Date, Policy Year, determining Policy Anniversary Dates, Policy Years,
Monthly Charge and Monthly Charge Dates. The first Policy
Date, Issue Date, Anniversary Date is one year after the Policy Date.
Valuation Date, The period from the Policy Date to the first Policy
Valuation Period, Anniversary Date, or from one Policy Anniversary Date
Valuation Time, to the next, is called a Policy Year.
Register Date
The Monthly Charge Dates are the dates on which we
deduct monthly charges for this policy. The first
Monthly Charge Date is the Policy Date. Subsequent
Monthly Charge Dates are the same day of each month
thereafter.
Example: The Policy Date is June 10, 19X7. The
first Policy Anniversary Date is one
year later, June 10, 19X8. The period
from June 10, 19X7, through June 9,
19X8, is a Policy Year. The first
Monthly Charge Date is June 10, 19X7.
The next Monthly Charge Date is one
month later, July 10, 19X7.
The Issue Date is also shown in the Policy
Specifications. The Issue Date starts the
contestability and suicide periods. We discuss
contestability and suicide later in this Part.
A Valuation Date is any date on which the New York
Stock Exchange (or its successor) is open for
trading. A Valuation Period is the period of time
from the end of one Valuation Date to the end of the
next Valuation Date. A Valuation Time is the time the
New York Stock Exchange (or its successor) closes on
a Valuation Date. All actions that are to be
performed on a Valuation Date will be performed as of
the Valuation Time.
The Register Date is the date on which we first
allocate net premium payments for this policy among
the Guaranteed Principal Account and the divisions of
the Separate Account. It is the Valuation Date that
is on, or next follows, the later of:
. The day after the Issue Date; and
. The day we receive the first premium for
this policy at our Administrative Office.
Policy A Legal This policy is a legal contract between the Owner and
Contract us. The entire contract consists of Contract the
policy, which includes the application and any
rider(s) and endorsement(s) the policy has. We have
issued this policy in return for the application and
the payment of the first premium. Any changes or
waiver of its terms must be in writing and signed by
our Secretary or an Assistant Secretary to be valid.
A copy of the initial application is attached to and
made a part of this policy. Any subsequent
applications requesting changes in the policy also
will become part of the contract; copies of any such
applications will be sent to the Owner for attachment
to the policy.
Policy Is Not This policy is "not participating," which means
Participating that no dividends are payable on this policy.
Page 2
<PAGE>
Representations We rely on all statements made by or for the Insured
And in the application(s). Legally, those statements are
Contestability considered to be representations and not warranties.
We can bring legal action to contest the validity of
this policy, or any policy change requiring evidence
of insurability, for any material misrepresentation
of a fact. To do so, however, the misrepresentation
must have been in the initial application or in a
subsequent application, and a copy of that
application must have been attached to (or sent to
the Owner for attachment to) and made a part of this
policy. The initial Policy Specifications are
attached to this policy when issued. If a policy
change is made, we will send to the Owner any revised
or additional Policy Specifications for attachment to
the policy.
Except for any policy change or reinstatement
requiring evidence of insurability, we cannot contest
the validity of this policy after it has been in
force during the lifetime of the Insured for 2 years
after its Issue Date.
For any policy change requiring evidence of
insurability, we cannot contest the validity of the
change after it has been in effect for 2 years during
the lifetime of the Insured.
If evidence of insurability is required to reinstate
this policy (see "Reinstating This Policy" in Part
4), our right to contest the validity of this policy
begins again on the date of reinstatement. We cannot
contest the reinstated policy after it has been in
force during the lifetime of the Insured for 2 years
after that reinstatement date.
Misstatement Of If the Insured's date of birth or gender as given in
Age Or Gender the application is not correct, the Face Amount
(discussed in this Part) will be adjusted. The
adjustment will reflect the amount provided by the
most recent monthly insurance charges using the
correct age and gender. If the adjustment is made
while the Insured is living, monthly charges after
the adjustment will be based on the correct age and
gender.
Death By Suicide If the Insured commits suicide, while sane or insane,
within 2 years after the Issue Date of this policy
and while the policy is in force, this policy will
terminate. In this case, we will refund the amount of
premiums paid for this policy, less any amounts
withdrawn and less any policy debt.
If the Insured commits suicide, while sane or insane,
within 2 years after this policy is reinstated and
while the policy is in force, this policy will
terminate. In this case, we will refund any amount
paid to reinstate this policy and any premiums paid
thereafter, less any amounts withdrawn and less any
policy debt.
If the Insured commits suicide, while sane or insane,
within 2 years after the effective date of any
increase in the Face Amount, the increase will
terminate. In this case, we will refund the monthly
charges made for that increase. However, if a refund
as described in either of the two preceding
paragraphs is payable, there will be no additional
refund for the increase.
Monthly charges are discussed in Part 3. Withdrawals,
policy debt, and reinstatement are discussed in Part
4.
Page 3
<PAGE>
Meaning Of "In force" means that the insurance provided by this
In Force policy is in effect and has not terminated. This
policy will be in force from its Issue Date or, if
later, the date the first premium is paid.
This policy will continue in force to the Insured's
death unless:
. The Insured commits suicide within 2 years
after the Issue Date or the date the policy is
reinstated;
. The policy terminates under the terms of the
Grace Period And Termination provision in Part 3;
. The policy terminates because the policy debt
limit is reached; or
. The policy is surrendered.
Policy debt and surrender are discussed in Part 4.
Face Amount The Face Amount is the amount of insurance coverage
this policy provides while the policy is in force.
The Initial Face Amount is the Face Amount on the
Policy Date.
Year Of Coverage For the Initial Face Amount, each Policy Year is a
year of coverage. If the Face Amount of this policy
has been increased (as discussed in Part 4), years of
coverage for each increase will be measured from the
effective date of the increase.
Ages - Issue Age, The Issue Age of the Insured (shown in the Policy
Attained Age Specifications) is the age of the Insured on the
birthday nearest the Policy Date.
Example: Elizabeth's 32nd birthday was May 12th.
The Policy Date is today, December 1.
Since December 1 is closer to her 33rd
birthday, her Issue Age will be 33.
The Attained Age of the Insured is the Insured's
Issue Age increased by the number of full Policy
Years elapsed.
Written Request A "written request" is a request in writing, in a
form satisfactory to us, received by us at our
Administrative Office.
Currency All payments made to us and by us will be in the
lawful currency of the United States of America. All
monetary amounts shown in this policy are in U.S.
dollars.
Administrative Our Administrative Office is in Springfield,
Office Massachusetts. The address is C.M. Life Insurance
Company, 1295 State Street, Springfield,
Massachusetts 01111-0001.
Part 2. Premium Payments
Premiums are the payments that may be paid to us to increase the account value
of this policy; they also may be needed to keep this policy in force. Premiums
for this policy are discussed in this Part.
The First Premium The first premium for this policy is shown in the
Policy Specifications. It is due on the Policy Date.
This policy will not be in force until the first
premium has been paid.
Page 4
<PAGE>
Planned Premiums The planned premium for this policy is shown in the
Policy Specifications. The frequency of planned
premiums for this policy is as elected in the
application. The frequency and amount of the planned
premium may be changed by written request; the
frequency may be quarterly, semiannually, or
annually.
We also provide a pre-authorized payment plan. This
plan, and any other alternate premium plans we
provide, are governed by the rules we set.
If continued payment of the planned premium during a
Policy Year would exceed the Limit On Premium
Payments for the Year shown in the Policy
Specifications, we may decrease the planned premium
to an amount that would not exceed that Limit.
If premium payments are discontinued, we will
continue to deduct monthly charges from the account
value and the policy will stay in force subject to
the Grace Period And Termination provision in Part 3.
Premium Flexibility After the first premium has been paid, there is no
And Premium Notices requirement that any amount of And Premium premium be
paid on any date. Subject to the Limit On Premium
Payments shown Notices in the Policy Specifications
and while this policy is in force, any amount of
premium may be paid at any time while the Insured is
living. However, each premium paid must be at least
$20 or, if greater, the amount needed to prevent
termination, as discussed in the Grace Period And
Termination provision.
We will send premium notices for the planned premium
based on the amount and frequency in effect. We will
stop sending notices for the planned premium upon
receipt of the Owner's written request to do so.
Where To Pay All premiums after the first premium are payable to
Premiums us at our Administrative Office or at the place shown
for payment on the premium notice. Upon request, a
receipt signed by our Secretary or an Assistant
Secretary will be given for any premium payment.
Right To Refund We have the right to refund any amount of premium
Premiums paid in a Policy Year that exceeds the Limit On
Premium Payments for the Year shown in the Policy
Specifications.
A Limit On Total Premium Payments also may be stated
in the Policy Specifications. If such a Limit is
stated, we will automatically refund the amount of
any premium paid that exceeds that Limit.
Net Premium A net premium is a premium payment we receive for
this policy less the premium expense charge we deduct
at that time. The Maximum Premium Expense Charge we
can deduct from each premium payment is shown in the
Policy Specifications.
We credit each net premium to the account value of
this policy on the date we receive the premium
payment. However, for any premium payment received
before the Policy Date, the net premium will be
credited to the account value as of the Policy Date.
Page 5
<PAGE>
If the Face Amount of this policy has been increased
(as discussed in Part 4), premium payments received
once an increase becomes effective will be allocated
to each segment of the Face Amount. (The Initial Face
Amount is one "segment"; each increase in the Face
Amount is a separate "segment.") This may affect the
premium expense charge deducted from premium
payments. The premium allocation will be made on a
pro rata basis using the Expense Premium for each
segment. The Expense Premium for each segment of the
Face Amount is shown with its Table Of Maximum
Monthly Insurance Charges in the Policy
Specifications.
Example: The Initial Face Amount of your policy
is $500,000; the Expense Premium for it
is $4,000. You later increase the Face
Amount by $700,000, to $1,200,000; the
Expense Premium for that increase is
$6,000. The sum of the Expense Premiums
is $10,000. Thereafter while the Face
Amount remains at $1,200,000, each
premium payment will be allocated 40%
(4,000 divided by 10,000) to the
Initial Face Amount and 60% (6,000
divided by 10,000) to the increase.
Allocation Of Net Each net premium we receive on or before the Issue
Premiums Date will be allocated to the Guaranteed Principal
Account. On the Register Date, any fixed value of
this policy will be allocated among the Guaranteed
Principal Account and the divisions of the Separate
Account, according to the net premium allocation in
effect on the Register Date. Fixed account value is
discussed in Part 3.
Each net premium we receive after the Issue Date will
be allocated according to the net premium allocation
in effect on the date of receipt.
The net premium allocation is specified at the time
of application for this policy. Changes in the net
premium allocation are subject to any limitations
stated in the Policy Specifications. Subject to those
limitations, the allocation may be changed by any
later election satisfactory to us and received at our
Administrative Office.
The amount of each net premium we receive for this
policy for allocation to a division of the Separate
Account will be applied to purchase accumulation
units for this policy in that division. See the
Purchase And Sale Of Accumulation Units provision in
Part 3.
Part 3. Accounts, Values, And Charges
This policy provides that certain values (referred to as the variable account
values) are based on the investment performance of the Separate Account and are
not guaranteed as to dollar amount. This policy also provides that other values
(referred to as the fixed account values) are based on the interest credited to
the Guaranteed Principal Account. The account value of this policy is the
variable account value plus the fixed account value. This Part gives information
about the Separate Account, the Guaranteed Principal Account, and the values and
monthly charges connected with them.
Page 6
<PAGE>
The Separate Account And The Guaranteed Principal
Account
The Separate The Separate Account shown in the Policy
Account Specifications is a designated segment of the
separate investment account we have established under
Connecticut law. It is also subject to the laws of
the state in which this policy was delivered.
The Separate Account has a number of divisions. Each
division invests in shares of an investment Fund. The
divisions are shown in the Policy Specifications.
The values of the assets in the divisions are
variable and are not guaranteed. They depend on the
investment results of the Separate Account shown in
the Policy Specifications.
We own the assets of the Separate Account. Those
assets will be used only to support variable life
insurance policies. That portion of the assets equal
to the reserves and other liabilities of the Separate
Account will not be charged with liabilities that
arise from any other business we may conduct.
However, we may transfer to our general account any
assets exceeding the reserves and other liabilities
of the Separate Account. The income and the realized
and unrealized capital gains and losses from each
division of the Separate Account are credited to or
charged against that division without regard to any
of our other income, capital gains, or capital
losses. The assets of the Separate Account are
protected from the claims of our creditors.
Changes In The We have the right to establish additional divisions
Separate Account of the Separate Account from time to time. Amounts
credited to any additional divisions established
would be invested in shares of other Funds. For any
division, we have the right to substitute new Funds.
We also have the right to close any division to new
investments.
Subject to applicable provisions of federal
securities laws, we have the right to change the
investment policy of any division of the Separate
Account.
We have the right to operate the Separate Account as
a unit investment trust under the Investment Company
Act of 1940 or in any other form permitted by law.
Accumulation Units Accumulation units are used to measure the variable
account value of this policy. The value of a unit is
determined as of the Valuation Time on each Valuation
Date for valuation of the Separate Account. The value
of any unit can vary from Valuation Date to Valuation
Date. That value reflects the investment performance
of the division of the Separate Account applicable to
that unit. The value of accumulation units is
discussed further in Part 7.
Purchase And Sale Amounts are credited to and taken from divisions of
Of Accumulation the Separate Account by purchasing and selling
Units accumulation units. Accumulation units will be
purchased and sold at the unit value as of the
Valuation Time on the Valuation Date of purchase or
sale. The number of units purchased or sold will be
the amount of money for purchase or sale divided by
that unit value.
Page 7
<PAGE>
Example: The amount applied is $550. The date of
purchase is June 10, 19X6. The
accumulation unit value on that date is
$10. The number of units purchased
would be 55 ($550 divided by $10 = 55).
If, instead, the unit value was $11,
then the amount applied would purchase
50 units ($550 divided by $11 = 50).
If we receive a premium or a written request that
causes us to purchase or sell accumulation units, and
we receive that premium or request before the
Valuation Time on a Valuation Date, accumulation
units will be purchased or sold as of that Valuation
Date. Otherwise, accumulation units will be purchased
or sold as of the next following Valuation Date.
At the Owner's request, we will purchase or sell
accumulation units as of a later Valuation Date.
In no case will accumulation units be purchased or
sold before the Register Date.
The Guaranteed The Guaranteed Principal Account is part of our
Principal Account general account. It has no connection with, and does
not depend on, the investment performance of the
Separate Account. We have a right to establish
additional guaranteed accounts from time to time.
Values Of This Policy
Account Value Of The account value of this policy on any date is the
Policy variable account value of this policy plus the fixed
account value of this policy, both determined as of
that date.
Variable Account The variable account value of this policy reflects:
Value Of Policy
. The net premiums for this policy allocated to the
Separate Account;
. Any amounts for this policy transferred into the
Separate Account from the Guaranteed Principal
Account;
. Any amounts transferred or withdrawn from the
Separate Account for this policy;
. Any surrender charges for this policy deducted
from the Separate Account due to any decreases in
the Face Amount;
. Any monthly charges for this policy deducted from
the Separate Account; and
. The net investment experience of the Separate
Account.
Net premiums, transfers, withdrawals, surrender
charges, and monthly charges are all reflected in the
variable account value through the purchase or sale
of accumulation units. The net investment experience
is reflected in the value of the accumulation units.
Net premiums are discussed in Part 2, and monthly
charges are discussed in this Part. Transfers,
withdrawals, and surrender charges are discussed in
Part 4.
The value of the accumulation units credited to this
policy in a division of the Separate Account is equal
to the accumulation unit value in that division on
the date the value is determined, multiplied by the
number of those units in that division.
Page 8
<PAGE>
The variable account value of this policy on any date
is the total of the values of the accumulation units
credited to this policy in each division of the
Separate Account.
Fixed Account Value The fixed account value of this policy is the
Of Policy accumulation at interest of:
. The net premiums for this policy allocated to the
Guaranteed Principal Account; plus
. Any amounts for this policy transferred into the
Guaranteed Principal Account from the Separate
Account; less
. Any amounts for this policy transferred or
withdrawn from the Guaranteed Principal Account;
less
. Any surrender charges for this policy deducted
from the Guaranteed Principal Account due to any
decreases in the Face Amount; and less
. Any monthly charges for this policy deducted from
the Guaranteed Principal Account.
Interest On Fixed The fixed account value of this policy earns interest
Account Value at an effective annual rate defined in this
provision. Interest is credited daily through the
date the fixed account value is computed.
For any fixed account value equal to the amount of
any policy loan, the interest rate we use will be the
daily equivalent of the greater of:
. The annual loan interest rate in effect during the
current Policy Year less the loan interest rate
expense charge; and
. The Minimum Annual Interest Rate For The
Guaranteed Principal Account.
The loan interest rate is discussed in the Interest
On Loans provision in Part 4. The Maximum Loan
Interest Rate Expense Charge and the Minimum Annual
Interest Rate For The Guaranteed Principal Account
are shown in the Policy Specifications.
For any fixed account value in excess of the amount
of any policy loan, the interest rate we use will be
the daily equivalent of the greater of:
. The Minimum Annual Interest Rate For The
Guaranteed Principal Account; and
. An alternate annual rate established by us. The
alternate annual rate of interest will reflect
our expectations for future investment results,
profits, and expenses. This rate will be declared
for each calendar month in advance; once declared
for a month, it cannot be changed.
Monthly Policy Charges
Monthly Charges Charges will be deducted monthly from the
account value of this policy. Monthly charges are due
on each Monthly Charge Date.
Page 9
<PAGE>
Monthly charges for this policy will be taken from
the divisions of the Separate Account and from the
Guaranteed Principal Account in proportion to the
values of this policy in each of those divisions and
in the Guaranteed Principal Account (excluding
outstanding policy loans). Deductions will be made,
and values will be determined, on the Valuation Date
that is on, or next follows, the latest of:
. The Register Date;
. The date the charges are due; and
. The date we receive the amount of premium needed
to prevent termination, as discussed in the Grace
Period And Termination provision in this Part.
We assess four types of monthly charges: an
administrative charge, a face amount charge, an
insurance charge, and a rider charge; each is
discussed in this section.
Administrative The amount of the monthly administrative charge will
Charge be determined by us. However, it will not exceed the
Maximum Monthly Administrative Charge shown in the
Policy Specifications.
Face Amount The amount of the monthly face amount charge will be
Charge determined by us. However, it will not exceed the
result of:
. The Face Amount divided by 1,000; then multiplied
by
. The Maximum Monthly Face Amount Charge for the
year of coverage. These maximum charges are shown
in the Policy Specifications.
If the Face Amount of the policy has been increased
(as discussed in Part 4), the face amount charge for
each month will be the sum of the charges determined
separately for each segment of the Face Amount.
Insurance Charge The maximum monthly insurance charge rates per
$1,000 of insurance risk are shown in the Table(s) Of
Maximum Monthly Insurance Charges of the Policy
Specifications. Maximum monthly insurance charge
rates for the Initial Face Amount and for each Face
Amount increase will be shown in a separate table.
The insurance risk is computed as of the date the
charge is due. All amounts are calculated as of that
date. The insurance risk is determined by the
following steps.
(a) We compute the account value of this policy after
all additions and deductions other than the
deduction of the insurance charge and the rider
charge for any disability benefit rider.
(b) We determine the amount of benefit under the
Death Benefit Option in effect (as discussed in
Part 5). The minimum death benefit (discussed in
Part 5) used here is based on the account value
computed in (a).
(c) We divide the amount of benefit determined in (b)
by 1 plus the monthly equivalent (expressed as a
decimal fraction) of the Minimum Annual Interest
Rate For The Guaranteed Principal Account shown
in the Policy Specifications.
(d) We subtract the account value, as computed in
(a), from the amount determined in (c). The
result is the insurance risk.
Page 10
<PAGE>
If there is more than one table of maximum monthly
insurance charges, the pro rata insurance risk
allocated to each table will be based on the
proportionate amount of Face Amount for the table to
the total Face Amount. If the insurance risk is
increased due to the minimum death benefit (discussed
in Part 5), the table that applies to the most recent
increase requiring evidence of insurability will be
used for such increase.
Example: The Initial Face Amount of your
policy is $500,000. You later
increase the Face Amount by
$250,000. The Death Benefit Option
is 1, and the benefit under Death
Benefit Option 1 is $750,000. The
pro rata portion of insurance risk
to be allocated to the table for the
Initial Face Amount is $500,000
divided by $750,000, or two-thirds.
The pro rata portion to be allocated
to the table for the increase is
$250,000 divided by $750,000, or
one-third.
The insurance risk is computed as
$600,000. The maximum monthly
insurance charge per $1,000 of
insurance risk will be based on the
charge for an amount equal to
two-thirds of $600,000, or $400,000,
from the Initial Face Amount and an
amount equal to one-third of
$600,000, or $200,000, from the
increase.
Suppose instead that the benefit
under Death Benefit Option 1 is
$810,000 due to the minimum death
benefit and that the insurance risk
is $660,000. Then the maximum
monthly insurance charge per $1,000
of insurance risk will be based on
the charge for an amount equal to
$400,000 from the Initial Face
Amount and an amount equal to
$260,000 from the increase ($200,000
plus the $60,000 due to the minimum
death benefit).
We may charge less than the maximum monthly insurance
charges shown in the table(s). In this case, the
monthly insurance charge rates will be based on our
expectations for future mortality, investment,
persistency and expense results, and future profits.
The expense component of these rates is used to
offset sales and issue expenses, which decrease over
time. Any change in these charges will apply to all
individuals in the same class.
Rider Charge The monthly rider charge is the sum of the
monthly charges for any riders in effect on the
Monthly Charge Date. The monthly charges for any
rider are shown in the Policy Specifications for the
rider.
Grace Period This policy may terminate without value if its
And Termination "policy value" on a Monthly Charge Date cannot cover
the monthly charges due and the safety test is not
met on that Date. However, we allow a grace period
for payment of the amount of premium (not less than
$20) needed to avoid termination. "Policy value" is
defined later in this provision; the safety test is
discussed in the next provision.
The grace period begins on the date the monthly
charges are due. It ends 61 days after that date or,
if later, 31 days after we mail a written notice to
the Owner and to any assignee shown in our records at
their last known addresses. This notice will state
the amount of premium needed to avoid termination.
Page 11
<PAGE>
During the grace period, the policy will stay in
force. If the Insured dies during the grace period,
any unpaid premium amount needed to avoid termination
will be deducted from the death benefit (see the
Amount Of Death Benefit provision in Part 5). The
policy will terminate without value if we do not
receive payment of the required amount by the end of
the grace period.
While there is a loan outstanding on this policy, our
right to terminate this policy under the terms of the
Policy Debt Limit provision (see Part 4) applies in
addition to our right under this provision.
As used in this provision, the "policy value" of this
policy on a Monthly Charge Date is equal to:
. On any Monthly Charge Date during the first 10
Policy Years, the account value on that Date
(just before the deduction of monthly charges)
less any outstanding policy debt; and
. On any Monthly Charge Date after the first 10
Policy Years, the net surrender value on that
Date (just before the deduction).
Policy debt and net surrender value are discussed in
Part 4.
If the "policy value" on a Monthly Charge Date (as
defined above in this provision) cannot cover the
monthly charges due, but the safety test is met on
that Date, then the monthly charges for that Date
will be reduced to an amount equal to the account
value on that Date (just before the deduction) less
any outstanding debt.
Safety Test The safety test can be met only during the First
and Second Guarantee Periods; each Guarantee Period
is associated with a Guarantee Premium. The First and
Second Guarantee Periods and the First and Second
Guarantee Premiums are shown in the Policy
Specifications.
For any day during the First Guarantee Period, the
safety test is met if the result of premiums paid
less any amounts withdrawn, accumulated with interest
to that day, equals or exceeds the result of payments
of the First Guarantee Premium from the Policy Date
to that day, accumulated with interest.
For any day after the First Guarantee Period but
during the Second Guarantee Period, the safety test
is met if premiums paid less any amounts withdrawn,
accumulated with interest to that day, equals or
exceeds the result of payments of the Second
Guarantee Premium from the Policy Date to that day,
accumulated with interest.
In the safety test, interest is accumulated at an
effective annual rate equal to the Minimum Annual
Interest Rate For The Guaranteed Principal Account,
which is shown in the Policy Specifications. In
accumulating premiums paid, we exclude any premium
amounts refunded under the Right To Refund Premiums
provision in Part 2. Also, we assume in this test
that Guarantee Premiums are paid on each Monthly
Charge Date.
Example: On the 6th Monthly Charge Date, the
monthly charges are $100, but the "policy
value" (during the first 3 Policy Years,
the account value before
Page 12
<PAGE>
the deduction for monthly charges, less any
outstanding policy debt) is only $95. There
is no policy debt. The policy is in the
First Guarantee Period, and the First
Guarantee Premium is $25. Premium payments
of $35 were made on each Monthly Charge
Date including the current one. There were
no withdrawals. In this case, the safety
test is met. So the monthly charges for
that 6th Monthly Charge Date are reduced to
$95, and the account value is reduced to
zero.
On the first Monthly Charge Date in the
21st Policy Year, the monthly charges
are $250, but the "policy value" (here,
the net surrender value before the
deduction for monthly charges) is only
$220. There are no surrender charges
and no policy debt. The policy is in
the Second Guarantee Period, and the
Second Guarantee Premium is $60.
Premium payments of $75 were made on
each Monthly Charge Date from the
Policy Date through the current Monthly
Charge Date. There were no withdrawals.
In this case, the safety test is met
also. So the monthly charges for that
Monthly Charge Date are reduced to
$220, and the account value is reduced
to zero.
Part 4. Life Benefits
This life insurance policy provides a death benefit if the Insured dies while
the policy is in force. Rights and benefits are also available while the Insured
is living. These "Life Benefits" are discussed in this Part.
Policy Ownership
Rights Of Owner While the Insured is living, the Owner may
exercise all rights given by this policy or allowed
by us. These rights include changing Beneficiaries,
changing ownership, assigning this policy, enjoying
all policy benefits, and exercising all policy
options.
The consent of any Irrevocable Beneficiary is needed
to exercise any policy right except the rights to:
. Change the frequency of planned premiums;
. Change the premium payment plan; and
. Reinstate this policy after termination.
Changing The While the Insured is living, the Owner or any
Owner Or Beneficiary may be changed by written request. We do
Beneficiary not limit the number of changes that may be made. The
change will take effect as of the date the request is
signed, even if the Insured dies before we receive
it. Each change will be subject to any payment we
made or other action we took before receiving the
written request.
Transfers Of Transfers of values are subject to the limitations
Values stated in the Policy Specifications. Subject to those
limitations, transfers of values may be made upon
direction, satisfactory to us, received at our
Administrative Office. These transfers are:
Page 13
<PAGE>
. Transfers of values between divisions of the
Separate Account. These transfers will be made by
selling all or part of the accumulation units in a
division and applying the value of the sold units
to purchase units in any other division.
. Transfers of values from one or more divisions of
the Separate Account to the Guaranteed Principal
Account. These transfers will be made by selling
all or part of the accumulation units in a
division and applying the value of the sold units
to the Guaranteed Principal Account .
. Transfers of values from the Guaranteed Principal
Account to one or more divisions of the Separate
Account. These transfers will be made by applying
all or part of the value in the Guaranteed
Principal Account (excluding any outstanding policy
loans) to purchase accumulation units in one or
more divisions of the Separate Account.
Transfers will be made as of the Valuation Date
specified in the Purchase And Sale Of Accumulation
Units provision in Part 3. All transfers made on the
Valuation Date will be considered one transfer.
Assigning This This policy may be assigned. However, for any
Policy assignment to be binding on us, we must receive a
signed copy of it at our Administrative Office. We
will not be responsible for the validity of any
assignment. Any assignment made after the Insured
dies will be valid only with our consent.
Once we receive a signed copy of an assignment, the
rights of the Owner and the interest of any
Beneficiary or any other person will be subject to
the assignment. An assignment is subject to any
policy debt. Policy debt is discussed in the Right To
Make Loans provisions in this Part.
Right To Change The Face Amount
While this policy is in force, the Face Amount may be
changed. Any change in the Face Amount will be
effective on a Monthly Charge Date. We may limit the
number and the size of the changes in a Policy year.
Increases In The While the Insured is living, the Face Amount of this
Face Amount policy may be increased upon written application.
Evidence of insurability, satisfactory to us, is
required for each increase. The amount of each
increase must be for at least the Minimum Face Amount
Increase shown in the Policy Specifications.
If the net surrender value is insufficient to
continue the changed policy in force for 3 months at
the new monthly charges and interest, we may require
a payment sufficient to increase the net surrender
value to such amount. Net surrender value is
discussed in the "Surrendering This Policy And Making
Withdrawals" section of this Part.
Any increase elected under any insurability
protection type of rider will be effective as
directed in that rider. Any other increase in the
Face Amount will be effective on the Monthly Charge
Date that is on, or precedes, the date we approve the
application.
Page 14
<PAGE>
Insurance charges for each increase elected are
determined and deducted from the account value of
this policy as described in the Monthly Charges
provision in Part 3. These charges will be deducted
from the account value beginning on the effective
date of the increase. Additional surrender charges
(discussed later in the Net Surrender Value provision
in this Part) will apply for each increase elected.
No increase in the Face Amount will be permitted
after the Policy Anniversary Date nearest the
Insured's 85th birthday.
Decreases In The After the first Policy Year, the Face Amount may be
Face Amount decreased by the Owner's written request while the
Insured is living. However, the decrease must not
reduce the Face Amount to an amount less than the
Minimum Face Amount shown in the Policy
Specifications. No decrease is permitted within one
year following the effective date of any increase.
Any decrease is effective on the Monthly Charge Date
that is on, or precedes, the date we receive the
written request. If a decrease follows one or more
increases, the decrease is taken from the most recent
increase(s).
Any surrender charge due upon a decrease in the Face
Amount is deducted from the account value on the
effective date of the decrease. The charge is
deducted from each division of the Separate Account
and from the Guaranteed Principal Account in
proportion to the values of this policy in each of
those divisions and in the Guaranteed Principal
Account (excluding any outstanding policy loans) on
that date. Surrender charges are discussed in the Net
Surrender Value provision in this Part.
Evidence Of If the Face Amount is changed, we will send the Owner
Changes any revised or additional Policy Specifications for
attachment to this policy. If the Face Amount is
increased, we will also send a copy of the
application for the increase. However, we have the
right to require that the policy be sent to us to
make the change.
Borrowing Against This Policy
Right To Make Once the account value exceeds any surrender charges
Loans that apply, the Owner may borrow against this policy
after the first Policy Year, while the Insured is
living. However, the policy must be properly assigned
to us before the loan is made. No other collateral is
needed. We refer to all outstanding loans plus
accrued interest as "policy debt."
Effect Of Loan A loan is attributed to each division of the Separate
Account and to the Guaranteed Principal Account in
proportion to the values of this policy in each of
those divisions and in the Guaranteed Principal
Account (excluding any outstanding policy loans) at
the time of the loan. The amount of the loan
attributed to each division of the Separate Account
will be transferred to the Guaranteed Principal
Account. Any such transfer is made by selling
accumulation units in the division and applying the
value of those units to the Guaranteed Principal
Account on the date the loan is made. Any interest
added to the loan will be treated as a new loan under
this provision.
Page 15
<PAGE>
The amount equal to any outstanding policy loans will
be held in the Guaranteed Principal Account and will
earn interest as described in the Interest On Fixed
Account Value provision in Part 3.
Maximum Loan The maximum amount that can be borrowed on any date
Available is determined as follows.
(1) We subtract from the account value any surrender
charges that would apply if the policy were
surrendered on that date.
(2) We calculate 90% of the amount determined in
(1) above.
(3) We subtract any policy debt from the amount
determined in (2) above. The result is the maximum
amount that can be borrowed.
Interest On Loans Interest on loans is not due in advance.
This interest accrues (builds up) each day and
becomes part of the policy debt as it accrues.
Interest is due on each Policy Anniversary Date. If
interest is not paid when due, it will be added to
the loan and will bear interest at the rate payable
on the loan.
Example: You have a loan of $1,000. The interest
due on the next Policy Anniversary Date
is $50. If it is not paid on that date,
we will add it to the existing loan.
From then on, the loan will be $1,050
and interest will be charged on this
new amount.
The type of interest rate on any policy loan is
elected at the time of application for this policy
and cannot be changed; the type elected for this
policy is shown in the Policy Specifications. The two
types of interest rates available are:
(1) A fixed loan rate of 5% per year; and
(2) A variable loan rate. Such loan rate is an
annual rate set by us. This rate may change from
year to year. Each year we will set the rate
that will apply for the next Policy Year. The
rate will apply to all policy debt under this
policy.
Each year there is a maximum limit on the
variable loan interest rate we can set. That limit is
based on a Published Monthly Average. That Average
will be:
. The Monthly Average Corporates yield shown in
Moody's Corporate Bond Yield Averages, as
published by Moody's Investors Service, Inc.,
or any successor to that service; or
. If that Monthly Average is no longer
published, a substantially similar average,
established by the insurance supervisory
official of the state where this policy was
delivered.
The maximum limit is the Published Monthly
Average for the calendar month ending 2 months
before the month in which the Policy Year begins
or, if higher, the Minimum Annual Interest Rate
For The Guaranteed Principal Account plus 1%.
Page 16
<PAGE>
Example: A Policy Year begins on June 10, 19X6.
The calendar month ending 2 months
before June is March. The loan interest
rate for the Policy Year beginning June
10, 19X6, will not be greater than the
Published Monthly Average for March,
19X6. However, if the Minimum Annual
Interest Rate For The Guaranteed
Principal Account (plus 1%) is higher
than the Average, then the Minimum
Annual Interest Rate For The Guaranteed
Principal Account (plus 1%) will be the
maximum loan interest rate for that
Policy Year.
If the maximum limit for a Policy Year is at
least 1/2% higher than the loan interest rate in
effect for the previous year, we may increase the
rate to a rate not higher than that limit.
If the maximum limit for a Policy Year is at
least 1/2% lower than the loan interest rate in
effect for the previous year, we must decrease the
rate to a rate not exceeding that limit.
Policy Debt Limit Policy debt (which includes accrued interest) may not
equal or exceed the account value less any surrender
charges that apply. If this limit is reached, we can
terminate this policy. To terminate for this reason,
we must mail written notice to the Owner and any
assignee shown in our records at their last known
addresses. This notice will state the amount needed
to bring the policy debt back within the limit. If we
do not receive payment within 31 days after the date
we mail the notice, the account value will be reduced
by any surrender charges that apply and this policy
will terminate without value at the end of those 31
days.
Our right to terminate this policy under the terms of
this provision applies in addition to our right under
the Grace Period And Termination provision in Part 3.
Repayment Of All or part of any policy debt may be repaid at any
Policy Debt time while the Insured is living. However, policy
debt can be repaid only while this policy is in
force. Loan repayments will be credited on the date
we receive them at our Administrative Office.
Any repayment of policy debt will be allocated first
to the Guaranteed Principal Account up to the amount
of the policy loan that was attributed to the
Guaranteed Principal Account. (For this purpose, no
amount of policy loan resulting from unpaid loan
interest will be considered to be attributed to the
Guaranteed Principal Account.) Any repayment in
excess of that amount will be allocated among the
Guaranteed Principal Account and the divisions of the
Separate Account according to the net premium
allocation then in effect.
Loan repayments must be clearly identified as such;
otherwise, they will be considered premium payments.
Other Borrowing We may delay the granting of any loan attributable to
Rules the Guaranteed Principal Account for up to six
months.
We may delay the granting of any loan attributable to
the Separate Account during any period that:
Page 17
<PAGE>
. The New York Stock Exchange (or its successor) is
closed, except for normal weekend or holiday
closing, or trading is restricted; or
. The Securities and Exchange Commission (or its
successor) determines that a state of emergency
exists; or
. The Securities and Exchange Commission (or its
successor) permits us to delay payment for the
protection of our policy owners.
Surrendering This Policy And Making Withdrawals
Right To Surrender This policy may be surrendered for its
net surrender value (see next provision) at any time
while the policy is in force and the Insured is
living. The surrender will be effective on the date
we receive this policy at our Administrative Office,
along with a written request to surrender. This
policy will terminate as of the date of surrender.
Net Surrender The net surrender value of this policy is equal to
Value the account value less any surrender charges that
apply and less any policy debt. The surrender charge
for this policy is the sum of the surrender charges
for the Initial Face Amount and all Face Amount
increases. These charges are shown in the Table(s) Of
Surrender Charges of the Policy Specifications. In no
event will the net surrender value be less than zero.
Making After the first Policy Year, withdrawals may be made
Withdrawals by written request at any time while the policy is in
force and the Insured is living. The request for a
withdrawal must state the Account (or Accounts) from
which the withdrawal will be made. For any withdrawal
from the Separate Account, the request must also
state the division (or divisions) from which the
withdrawal will be made. A withdrawal will be
effective on the date we receive the written request.
On the date of a withdrawal, the account value of
this policy is reduced by the amount of the
withdrawal. The withdrawal amount includes the
withdrawal fee. The Maximum Withdrawal Fee that can
be taken with each withdrawal is shown in the Policy
Specifications.
The withdrawal from the Guaranteed Principal Account
will be made by reducing the value in that Account to
provide the amount of the withdrawal. A withdrawal
from a division of the Separate Account will be made
by selling a sufficient number of accumulation units
to provide the amount of the withdrawal.
The Face Amount will be decreased by the amount of
the withdrawal if:
. Death Benefit Option 1 or Death Benefit Option
3 is in effect, as described in the Death Benefit
Options provision in Part 5; and
. We have not received evidence of insurability
satisfactory to us.
In this case, if a decrease follows one or more Face
Amount increases, the decrease is taken from the most
recent increase(s).
Page 18
<PAGE>
Withdrawals will be subject to the following limits:
. The minimum amount of a withdrawal (including the
withdrawal fee) is $100; . The maximum amount of a
withdrawal on any date is 75% of the net surrender
value of this policy on that date; and
. The Face Amount after a withdrawal must not be
less than the Minimum Face Amount shown in the
Policy Specifications.
Example: Death Benefit Option 1 is in effect and
you make a withdrawal without
furnishing us satisfactory evidence of
insurability. Prior to your withdrawal,
your policy has a Face Amount of
$600,000 and an account value of
$120,000. If you make a withdrawal of
$30,000, the account value will be
reduced to $90,000, the Face Amount
will be reduced to $570,000, and
$29,975 will be paid to you.
If the Face Amount is reduced due to a withdrawal, we
will send the Owner any revised or additional Policy
Specifications for attachment to this policy.
However, we have the right to require that the policy
be sent to us to make the changes.
How We Pay Any withdrawal made will be paid in one sum. If the
policy is surrendered, the net surrender value may be
paid in one sum or it may be applied under any
payment option elected. See Part 6.
We may delay paying any surrender or withdrawal from
the Guaranteed Principal Account for up to 6 months
from the date we receive the written request.
We may delay paying any surrender or withdrawal from
the Separate Account during any period that:
. The New York Stock Exchange (or its successor)
is closed, except for normal weekend or holiday
closing, or trading is restricted; or
. The Securities and Exchange Commission (or its
successor) determines that a state of emergency
exists; or
. The Securities and Exchange Commission (or its
successor) permits us to delay payment for the
protection of our policy owners.
If we delay paying any surrender or withdrawal,
interest will be added. The amount of interest will
be the same as would be paid for the same period of
time under Option 3 of the payment options or, if
greater, the amount using the minimum interest rate
for this purpose required by the laws of the state
where this policy was delivered. See Part 6 for a
description of Option 3.
Reinstating This Policy
When After this policy has terminated, it may be
Reinstatement reinstated -- that is, put back in force. However,
Can Be Made the policy cannot be reinstated if it has been
surrendered for its net surrender value.
Reinstatement must be made within 5 years after the
date of termination and during the Insured's
lifetime.
Page 19
<PAGE>
Requirements To A written application and evidence of insurability
Reinstate satisfactory to us is required to reinstate. Also, a
premium is required as a cost to reinstate. This
cost is the amount of premium needed to keep the
policy in force for 3 months after reinstatement.
This amount will be quoted on request.
Policy After The policy will be reinstated on the Monthly Charge
Reinstatement Date on, or preceding, the date we approve the
application. The Face Amount on the date of
reinstatement will be the Face Amount on the
termination date. The account value on the date of
reinstatement will be the reinstatement premium paid,
less any premium expense charge and less any monthly
charges due on that date.
Upon reinstatement of this policy, the Table(s) Of
Surrender Charges (shown in the Policy
Specifications) will apply as though the policy had
not terminated. However, if the surrender charge was
taken when this policy terminated, then the
applicable surrender charges will not be reinstated.
Our rights to contest the validity of, and terminate,
this policy begin again on the date of reinstatement.
See the Representations And Contestability and Death
By Suicide provisions in Part 1.
Reports To Owner
Annual Report Each year after the Policy Anniversary Date, we will
mail an annual report to the Owner. There will be no
charge for this report. This report will show the
account value at the beginning of the previous Policy
Year and all premiums paid since that time. It also
will show the additions to, and deductions from, the
account value during that Year, and the account
value, death benefit, net surrender value, and policy
debt as of the current Policy Anniversary Date.
This report also will include any additional
information required by applicable law or regulation.
Part 5. The Death Benefit
The death benefit is the amount of money we will pay when we receive due proof
at our Administrative Office that the Insured died while the policy was in
force. We discuss the death benefit in this Part.
Amount Of Death If the Insured dies while this policy is in force,
Benefit the death benefit will be the amount of benefit
provided by the Death Benefit Option in effect on
the date of death, reduced by any policy debt
outstanding on the date of death and any unpaid
premium amount needed to avoid termination under the
Grace Period And Termination provision in Part 3.
Page 20
<PAGE>
Death Benefit Three Death Benefit Options, described here, are
Options available under this policy. The Death Benefit
Option and the Face Amount in effect for this policy
are shown in the Policy Specifications. The minimum
death benefit is discussed in the next provision.
Death Benefit Option 1 - Under this Option, the
amount of benefit is the greater of:
. The Face Amount in effect on the date of
death;
. The minimum death benefit in effect on
the date of death.
Death Benefit Option 2 - Under this Option, the
amount of benefit is the greater of:
. The Face Amount in effect on the date of death
plus the account value on that date;
. The minimum death benefit in effect on the date
of death.
Death Benefit Option 3 - Under this Option, the
amount of benefit is the greater of:
. The Face Amount in effect on the date of death plus
the sum of all premiums paid (and not refunded
under the Right To Refund Premiums provision in
Part 2) to that date;
. The minimum death benefit in effect on the date of
death.
Minimum Death The minimum death benefit on any date is equal to
Benefit the account value on that date multiplied by the
Death Benefit Factor for the Insured's Attained Age
on that date. The Death Benefit Factor for each
Attained Age is shown in the Policy Specifications.
Changes In The After the first Policy Year, the Death Benefit
Death Benefit Option may be changed upon written request while
Option the Insured is living. However, the Insured's
Attained Age at the time of the change must be less
than 85.
A change in the Death Benefit Option will be
effective on the Monthly Charge Date that is on, or
precedes, the date we approve the change, unless a
later date is requested.
When the Death Benefit Option is changed, the Face
Amount of this policy also changes on the effective
date of the change as follows (all amounts are as of
the date of change):
. Option 1 to Option 2: Decreased by an amount
equal to the account value;
. Option 1 to Option 3: Decreased by an amount
equal to the sum of all premiums paid
(and not refunded);
. Option 2 to Option 1: Increased by an amount
equal to the account value;
. Option 2 to Option 3: Increased by an amount
equal to the sum of all premiums paid
(and not refunded), and then decreased by an
amount equal to the account value;
Page 21
<PAGE>
. Option 3 to Option 1: Increased by an amount
equal to the sum of all premiums paid
(and not refunded);
. Option 3 to Option 2: Decreased by an amount
equal to the sum of all premiums paid (and not
refunded), and then increased by an amount equal
to the account value.
A change in the Death Benefit Option may follow one
or more increases in the Face Amount of this policy.
In this case, the change will:
. If the Face Amount increases, increase the
most recent increase, and
. If the Face Amount decreases, decrease the most
recent increase(s).
No change in the Death Benefit Option will be allowed
if the Face Amount after the change would be less
than the minimum face amount shown in the Policy
Specifications.
We may require a written application and evidence of
insurability satisfactory to us for any Death Benefit
Option change. We also may limit the number of Death
Benefit Option changes in any Policy Year.
If the Death Benefit Option or the Face Amount is
changed, we will send the Owner any revised or
additional Policy Specifications for attachment to
this policy.
When We Pay The death benefit will be paid within 30 days
after the date we receive due proof of the Insured's
death, and any other requirements necessary for us to
make payment, at our Administrative Office.
Interest On If the death benefit is paid in one sum, we will add
Death Benefit interest from the date of death to the date of
payment. The amount of interest will be computed
using an effective annual rate not less than 3% or,
if greater, the annual rate required by law.
If the death benefit is applied under a payment
option (described in Part 6), interest will be paid
from the date of death to the effective date of that
option. It will be paid in one sum to the Beneficiary
living on that effective date. The amount of interest
will be computed using an effective annual rate not
less than 3% or, if greater, the annual rate required
by law.
Part 6. Payment Options
These are optional methods of settlement. These methods provide alternate ways
in which payment can be made by us.
Availability Of All or part of the death benefit or net surrender
Options value may be applied under any payment Death Benefit
option. If this policy is assigned, any amount
due to the assignee will be paid in one sum. The
balance, if any, may be applied under any payment
option.
Page 22
<PAGE>
Minimum Amounts If the amount to be applied under any option
for any one person is less than $5,000, we may pay
the amount in one sum instead. If the payments under
any option come to less than $50 each, we have the
right to make payments at less-frequent intervals.
Description Of Our regular payment options are Options 1 through 6.
Options They are described in terms of monthly payments.
Annual, semiannual, or quarterly payments may be
requested instead. The Payment Option Rates tables
are shown after Part 7.
Option 1 Installments For A Specified Period. Equal monthly
payments will be made for any period selected, up to
30 years. The amount of each payment depends on the
total amount applied, the period selected, and the
monthly income rates we are using when the first
payment is due. See the Option 1. Installments For A
Specified Period table for the minimum monthly income
rates.
Option 2 Life Income. Equal monthly payments will be based on
the life of a named person. Payments will continue
for the lifetime of that person. Income with or
without a minimum payment period may be elected. This
benefit may be increased by the Alternate Life Income
provision (in this Part). Proof of the named person's
age, satisfactory to us, will be required. See the
Option 2. Life Income tables for the minimum monthly
income rates.
Option 3 Interest. We will hold any amount applied under this
option. Interest on the amount will be paid at an
effective annual rate determined by us. This rate
will not be less than 3%.
Option 4 Installments Of Specified Amount. Each payment will
be made for an agreed fixed amount. The total amount
paid during the first year must be at least 6% of the
total amount applied. Interest will be credited each
month on the unpaid balance and added to it. This
interest will be at an effective annual rate
determined by us, but not less than 3%. Payments
continue until the balance we hold is reduced to an
amount less than the agreed fixed amount. The last
payment will be for the balance only.
Option 5 Life Income With Payments Guaranteed For Amount
Applied. Equal monthly payments will be based on the
life of a named person. Payments will be made until
the total amount paid equals the amount applied, and
as long thereafter as the named person lives. This
benefit may be increased by the Alternate Life Income
provision (in this Part). Proof of the named person's
age, satisfactory to us, will be required. See the
Option 5. Life Income With Payments Guaranteed For
Amount Applied tables for the minimum monthly income
rates.
Option 6 Joint Life Income With Reduced Payments To Survivor.
Monthly payments will be based on the lives of 2
named persons. Payments at the initial level will
continue while both are living or for 10 years if
longer. When one dies (but not before the 10 years
has elapsed), payments are reduced by one-third and
will continue at that level for the lifetime of the
other. After the 10 years has elapsed, payments stop
when both named persons have died. This benefit may
be increased by the Alternate Life Income provision
(in this Part). Proof of the named persons' ages,
satisfactory to us, will be required. See the Option
6. Joint Life Income With Reduced Payments To
Survivor tables for the minimum monthly income rates.
Page 23
<PAGE>
Alternate Life If Option 2, 5, or 6 is elected, the named person(s)
Income can elect to receive an alternate life income
instead of receiving income based on the rates shown
in the Payment Option Rates tables. The election must
be made at the time the income is to begin. The
monthly alternate life income will be at least equal
to the monthly income provided by a new single
premium immediate annuity (first payment immediate),
based on our published rates then in use when the
payment option is elected. The alternate life income
will not be available if we are not offering new
single premium immediate annuities at the time of
election.
Electing A To elect any payment option, we require a written
Payment Option request. The Owner may elect an option during the
Insured's lifetime. If the death benefit is
payable in one sum when the Insured dies, the
Beneficiary may elect an option with our consent.
Effective Date The effective date of a payment option is the date
And Payment the amount is applied under that option. For a
Dates death benefit, this is the date that due proof of
the Insured's death is received at our Administrative
Office. For the net surrender value, it is the
effective date of surrender.
The first payment is due on the effective date,
except the first payment under Option 3 is due one
month later. A later date for the first payment may
be requested in the payment option election. All
payment dates will fall on the same day of the month
as the first one. No payment will become due until a
payment date. No part payment will be made for any
period shorter than the time between payment dates.
Example: Monthly payments of $100 are being made to
your son on the 1st of each month. He dies
on the 10th. No part payment is due your
son or his estate for the period between
the 1st and the 10th.
Withdrawals And If provided in the payment option election, all or
Changes part of the unpaid balance under Option 3 or 4 may be
withdrawn or applied under any other option.
If the net surrender value is applied under Option 3
or 4, we may delay payment of any withdrawal for up
to 6 months. In this case, interest at the rate in
effect for Option 3 during this period will be paid
on the amount withdrawn.
Income Protection To the extent permitted by law, each option payment
and any withdrawal shall be free from legal process
and the claim of any creditor of the person entitled
to them. No option payment and no amount held under
an option can be taken or assigned in advance of its
payment date, unless the Owner's written consent is
given before the Insured dies. This consent must be
received at our Administrative Office.
Other Payment Options for any amount payable to an association,
Option Rules corporation, partnership, or fiduciary are
available only with our consent. However, a
corporation or partnership may apply any amount
payable to it under Option 2, 5, or 6 if the option
payments are based on the life or lives of the
Insured, the Insured's spouse, any child of the
Insured, or any other person agreed to by us.
If a minimum payment period is elected under Options
1, 2, 5, and 6, the effective annual interest rate
will not be less than 3%. This does not apply when an
alternate life income is elected.
Page 24
<PAGE>
If a minimum payment period is elected, after the
first payment is made we may increase the payments to
reflect any additional interest earnings determined
by us. This does not apply when an alternate life
income is elected.
If the income that would be payable under a given
payment option is the same for 2 or more periods of
time at a given age, we automatically will pay income
for the longest period.
Example: You choose Option 2. You are 50 years old.
The Payment Option Rate (for Option 2) is
$3.64 for 5 years. The Payment Option Rate
for 10 years is also $3.64. We will pay
income for at least 10 years, which is the
longest period.
Part 7. Notes On Our Computations
This Part covers some technical points about this policy.
Net Investment For each division of the Separate Account, the Net
Factor Investment Factor for any Valuation Period is the
gross investment rate for that period plus 1.00000000
and minus a Separate Account charge for mortality and
expense risk. This Separate Account charge will not
exceed .00002455 for each day of a Valuation Period.
The Net Investment Factor may be greater or less than
1.00000000.
For each division of the Separate Account, the gross
investment rate for any Valuation Period is equal to:
. The net earnings of that division during the
Valuation Period, divided by
. The value of the total assets of that division at
the beginning of the Valuation Period.
The net earnings of each division are equal to the
accrued investment income and capital gains and
losses (realized and unrealized) of that division
reduced by any investment management fees and any
other expenses, and by any amount charged against
that division for taxes paid or reserved by us.
The gross investment rate will be determined by us in
accordance with generally accepted accounting
principles and applicable laws, rules and
regulations. This determination shall be conclusive
upon the Owner, the Insured, any Beneficiary, any
assignee, and any other person under this policy.
Accumulation Unit The value of an accumulation unit in each division
Value was set at $1.000000 on the first Valuation Date
selected by us. The value on any date thereafter is
equal to the product of the Net Investment Factor for
that division for the Valuation Period that includes
that date and the accumulation unit value on the
preceding Valuation Date.
Page 25
<PAGE>
Adjustment Of Units We have the right to split or consolidate the number
And Values of accumulation units credited to the policy, with a
corresponding increase or decrease in the unit
values. We may exercise this right whenever we
consider an adjustment of units to be desirable.
However, strict equity will be preserved in making
any adjustment. No adjustment will have any material
effect on the benefits, provisions, or investment
return of this policy, or on the Owner, the Insured,
any Beneficiary, any assignee or other person, or on
us.
Basis Of The basis of computation consists of the mortality
Computation rates and interest rates we use to determine:
. The minimum net surrender values;
. The maximum monthly insurance charges;
. The minimum rate used to credit interest on
the fixed account value of the policy; and
. The minimum payments under payment Options 2, 5,
and 6.
The mortality rates for the minimum net surrender
values and for the maximum monthly insurance charges
are shown in each Table Of Maximum Monthly Insurance
Charges. The Minimum Annual Interest Rate For The
Guaranteed Principal Account used to credit interest
on the fixed account value of the policy is shown in
the Policy Specifications. The mortality tables
specified apply to amounts in a standard risk
classification. Appropriate modifications are made to
these tables for any amount that is not in a standard
risk classification.
In computing the minimum payments under payment
Options 2, 5, and 6, we use mortality rates from the
1983 Table "a" with Projection G for 32 years. The
interest rate used is an annual rate of 3%.
Method Of When required by the state where this policy was
Computing Values delivered, we filed a detailed statement of the
method we use to compute the policy benefits and
values. These benefits and values are not less than
those required by the laws of that state.
Page 26
<PAGE>
----------------------------------------------------
OPTION 1. INSTALLMENTS FOR
A SPECIFIED PERIOD -
PAYMENT OPTION RATES
----------------------------------------------------
MONTHLY INCOME PER
$1,000 OF AMOUNT APPLIED
----------------------------------------------------
Years Monthly Income
1 $ 84.47
2 42.86
3 28.99
4 22.06
5 17.91
6 15.14
7 13.16
8 11.68
9 10.53
10 9.61
11 8.86
12 8.24
13 7.71
14 7.26
15 6.87
16 6.53
17 6.23
18 5.96
19 5.73
20 5.51
21 5.32
22 5.15
23 4.99
24 4.84
25 4.71
26 4.59
27 4.47
28 4.37
29 4.27
30 4.18
----------------------------------------------------
The first income payment is payable
on the effective date of this Option.
----------------------------------------------------
Page 27
<PAGE>
- --------------------------------------------------------------------------------
OPTION 2. LIFE INCOME - PAYMENT OPTION RATES
OPTION 5. LIFE INCOME WITH PAYMENTS GUARANTEED FOR AMOUNT
APPLIED - PAYMENT OPTION RATES
- --------------------------------------------------------------------------------
MONTHLY LIFE INCOME PER $1,000 OF AMOUNT APPLIED
MALE
- --------------------------------------------------------------------------------
5 YEARS 10 YEARS 20 YEARS AMOUNT
AGE* LIFE ONLY MINIMUM MINIMUM MINIMUM APPLIED
- --------------------------------------------------------------------------------
50 $3.94 $3.93 $3.91 $3.84 $3.82
51 4.00 3.99 3.97 3.89 3.87
52 4.07 4.06 4.04 3.94 3.93
53 4.14 4.13 4.10 4.00 3.98
54 4.21 4.20 4.17 4.06 4.05
55 4.29 4.28 4.25 4.11 4.11
56 4.37 4.36 4.32 4.17 4.17
57 4.45 4.44 4.40 4.23 4.24
58 4.54 4.53 4.49 4.30 4.32
59 4.64 4.63 4.58 4.36 4.39
60 4.75 4.73 4.67 4.42 4.47
61 4.86 4.84 4.77 4.49 4.55
62 4.97 4.95 4.88 4.56 4.64
63 5.10 5.07 4.99 4.62 4.73
64 5.23 5.20 5.11 4.69 4.83
65 5.38 5.34 5.23 4.75 4.93
66 5.53 5.49 5.36 4.82 5.04
67 5.69 5.64 5.49 4.88 5.15
68 5.87 5.81 5.63 4.94 5.27
69 6.05 5.98 5.77 5.00 5.39
70 6.25 6.17 5.92 5.06 5.52
71 6.46 6.36 6.07 5.11 5.66
72 6.68 6.56 6.23 5.16 5.80
73 6.91 6.78 6.39 5.21 5.95
74 7.16 7.00 6.56 5.25 6.10
75 7.43 7.24 6.73 5.29 6.27
76 7.71 7.50 6.90 5.33 6.44
77 8.02 7.76 7.07 5.36 6.63
78 8.35 8.04 7.25 5.39 6.82
79 8.70 8.33 7.42 5.41 7.02
80 9.07 8.64 7.60 5.43 7.23
81 9.47 8.96 7.77 5.45 7.46
82 9.89 9.29 7.94 5.46 7.69
83 10.35 9.64 8.10 5.48 7.93
84 10.83 10.00 8.26 5.48 8.19
85 11.35 10.37 8.41 5.49 8.46
- --------------------------------------------------------------------------------
Rates for other ages are available upon request.
*Age on birthday nearest the due date of the first payment.
The first income payment is payable on the effective date of this Option.
- --------------------------------------------------------------------------------
Page 28
<PAGE>
- --------------------------------------------------------------------------------
OPTION 2. LIFE INCOME - PAYMENT OPTION RATES
OPTION 5. LIFE INCOME WITH PAYMENTS GUARANTEED FOR AMOUNT
APPLIED - PAYMENT OPTION RATES
- --------------------------------------------------------------------------------
MONTHLY LIFE INCOME PER $1,000 OF AMOUNT APPLIED
FEMALE
- --------------------------------------------------------------------------------
5 YEARS 10 YEARS 20 YEARS AMOUNT
AGE* LIFE ONLY MINIMUM MINIMUM MINIMUM APPLIED
- --------------------------------------------------------------------------------
50 $3.64 $3.64 $3.63 $3.60 $3.58
51 3.69 3.69 3.68 3.63 3.63
52 3.74 3.74 3.73 3.69 3.67
53 3.80 3.80 3.79 3.74 3.72
54 3.86 3.85 3.84 3.79 3.77
55 3.92 3.91 3.90 3.84 3.83
56 3.98 3.98 3.96 3.90 3.88
57 4.05 4.04 4.03 3.95 3.94
58 4.12 4.12 4.10 4.01 4.00
59 4.20 4.19 4.17 4.07 4.07
60 4.28 4.27 4.25 4.14 4.13
61 4.36 4.36 4.33 4.20 4.20
62 4.45 4.45 4.42 4.27 4.28
63 4.55 4.54 4.51 4.34 4.36
64 4.65 4.64 4.60 4.41 4.44
65 4.76 4.75 4.70 4.48 4.53
66 4.88 4.86 4.81 4.55 4.62
67 5.00 4.99 4.92 4.62 4.71
68 5.14 5.12 5.04 4.69 4.82
69 5.28 5.26 5.17 4.76 4.92
70 5.44 5.41 5.30 4.83 5.04
71 5.60 5.57 5.45 4.90 5.16
72 5.78 5.74 5.59 4.97 5.28
73 5.97 5.92 5.75 5.03 5.42
74 6.18 6.12 5.91 5.09 5.56
75 6.40 6.33 6.08 5.15 5.71
76 6.64 6.55 6.26 5.20 5.87
77 6.90 6.79 6.44 5.25 6.04
78 7.18 7.04 6.63 5.29 6.21
79 7.48 7.31 6.82 5.33 6.40
80 7.80 7.60 7.01 5.36 6.59
81 8.14 7.90 7.21 5.39 6.80
82 8.52 8.22 7.40 5.41 7.01
83 8.92 8.56 7.60 5.43 7.24
84 9.36 8.92 7.78 5.45 7.48
85 9.83 9.29 7.96 5.47 7.73
- --------------------------------------------------------------------------------
Rates for other ages are available upon request.
*Age on birthday nearest the due date of the first payment.
The first income payment is payable on the effective date of this Option.
- --------------------------------------------------------------------------------
Page 29
<PAGE>
<TABLE>
<CAPTION>
- -------------------------------------------------------------------------------------------
OPTION 6. JOINT LIFE INCOME WITH REDUCED PAYMENTS
TO SURVIVOR - PAYMENT OPTION RATES
- -------------------------------------------------------------------------------------------
MONTHLY LIFE INCOME PER $1,000 OF AMOUNT APPLIED
MALE & FEMALE
- -------------------------------------------------------------------------------------------
MALE FEMALE IS YOUNGER THAN MALE BY:
------------------------------------------------------------------------------------
AGE* 10 Yrs. 9 Yrs. 8 Yrs. 7 Yrs. 6 Yrs. 5 Yrs. 4 Yrs. 3 Yrs. 2 Yrs. 1 Yr.
- -------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
55 $3.63 $3.65 $3.68 $3.70 $3.73 $3.76 $3.79 $3.82 $3.85 $3.88
56 3.67 3.70 3.73 3.75 3.78 3.81 3.84 3.87 3.90 3.94
57 3.72 3.75 3.78 3.81 3.84 3.87 3.90 3.93 3.97 4.00
58 3.77 3.80 3.83 3.86 3.89 3.93 3.96 4.00 4.03 4.07
59 3.83 3.86 3.89 3.92 3.96 3.99 4.03 4.06 4.10 4.14
60 3.88 3.92 3.95 3.98 4.02 4.06 4.09 4.13 4.17 4.21
61 3.94 3.98 4.01 4.05 4.09 4.13 4.16 4.21 4.25 4.29
62 4.01 4.04 4.08 4.12 4.16 4.20 4.24 4.28 4.33 4.37
63 4.07 4.11 4.15 4.19 4.23 4.28 4.32 4.37 4.41 4.46
64 4.14 4.18 4.22 4.27 4.31 4.36 4.40 4.45 4.50 4.55
65 4.21 4.26 4.30 4.35 4.39 4.44 4.49 4.54 4.60 4.65
66 4.29 4.33 4.38 4.43 4.48 4.53 4.58 4.64 4.69 4.75
67 4.37 4.42 4.47 4.52 4.57 4.63 4.68 4.74 4.80 4.86
68 4.45 4.50 4.56 4.61 4.67 4.73 4.79 4.85 4.91 4.97
69 4.54 4.59 4.65 4.71 4.77 4.83 4.89 4.96 5.03 5.09
70 4.63 4.69 4.75 4.81 4.87 4.94 5.01 5.08 5.15 5.22
71 4.73 4.79 4.85 4.92 4.99 5.06 5.13 5.20 5.28 5.35
72 4.83 4.89 4.96 5.03 5.10 5.18 5.25 5.33 5.41 5.49
73 4.93 5.00 5.07 5.15 5.23 5.30 5.38 5.47 5.55 5.64
74 5.04 5.12 5.19 5.27 5.35 5.44 5.52 5.61 5.70 5.79
75 5.16 5.24 5.32 5.40 5.49 5.58 5.67 5.76 5.85 5.95
76 5.28 5.36 5.45 5.54 5.63 5.72 5.82 5.92 6.02 6.12
77 5.41 5.50 5.59 5.68 5.78 5.88 5.98 6.08 6.18 6.29
78 5.54 5.63 5.73 5.83 5.93 6.04 6.14 6.25 6.36 6.46
79 5.68 5.78 5.88 5.98 6.09 6.20 6.31 6.42 6.53 6.65
80 5.82 5.93 6.04 6.15 6.26 6.37 6.49 6.60 6.72 6.83
81 5.97 6.08 6.20 6.31 6.43 6.55 6.67 6.79 6.90 7.02
82 6.13 6.25 6.36 6.48 6.61 6.73 6.85 6.97 7.09 7.21
83 6.29 6.41 6.53 6.66 6.79 6.91 7.04 7.16 7.28 7.40
84 6.46 6.58 6.71 6.84 6.97 7.10 7.23 7.35 7.47 7.59
85 6.63 6.76 6.89 7.02 7.15 7.29 7.41 7.54 7.66 7.78
- -------------------------------------------------------------------------------------------
Rates for other ages are available upon request.
*Age on birthday nearest the due date of the first payment.
The first income payment is payable on the effective date of this Option.
- -------------------------------------------------------------------------------------------
</TABLE>
Page 30
<PAGE>
<TABLE>
<CAPTION>
- ----------------------------------------------------------------------------------------
OPTION 6. JOINT LIFE INCOME WITH REDUCED PAYMENTS
TO SURVIVOR - PAYMENT OPTION RATES
- ----------------------------------------------------------------------------------------
MONTHLY LIFE INCOME PER $1,000 OF AMOUNT APPLIED
MALE & FEMALE
- ----------------------------------------------------------------------------------------
MALE FEMALE IS OLDER THAN MALE BY:
-------------------------------------------------------------------------
AGE* SAME AGE 1 YEAR 2 YEARS 3 YEARS 4 YEARS 5 YEARS
- ----------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C>
55 $3.91 $3.94 $3.97 $4.01 $4.04 $4.08
56 3.97 4.00 4.04 4.07 4.11 4.15
57 4.04 4.07 4.11 4.15 4.18 4.22
58 4.10 4.14 4.18 4.22 4.26 4.30
59 4.18 4.22 4.26 4.30 4.34 4.39
60 4.25 4.30 4.34 4.38 4.43 4.47
61 4.33 4.38 4.42 4.47 4.52 4.57
62 4.42 4.47 4.52 4.57 4.62 4.67
63 4.51 4.56 4.61 4.66 4.72 4.77
64 4.60 4.66 4.71 4.77 4.83 4.88
65 4.71 4.76 4.82 4.88 4.94 5.00
66 4.81 4.87 4.93 4.99 5.06 5.12
67 4.92 4.99 5.05 5.12 5.18 5.25
68 5.04 5.11 5.18 5.25 5.32 5.39
69 5.16 5.24 5.31 5.38 5.46 5.53
70 5.29 5.37 5.45 5.52 5.60 5.68
71 5.43 5.51 5.59 5.67 5.76 5.84
72 5.58 5.66 5.74 5.83 5.91 6.00
73 5.73 5.81 5.90 5.99 6.08 6.17
74 5.88 5.97 6.07 6.16 6.25 6.34
75 6.05 6.14 6.24 6.33 6.43 6.52
76 6.21 6.31 6.41 6.51 6.61 6.70
77 6.39 6.49 6.59 6.69 6.79 6.89
78 6.57 6.68 6.78 6.88 6.98 7.07
79 6.76 6.86 6.97 7.07 7.17 7.26
80 6.94 7.05 7.16 7.26 7.36 7.45
81 7.13 7.25 7.35 7.45 7.55 7.63
82 7.33 7.44 7.54 7.64 7.73 7.82
83 7.52 7.62 7.73 7.82 7.91 7.99
84 7.70 7.81 7.91 8.00 8.08 8.16
85 7.88 7.99 8.08 8.17 8.25 8.32
- ----------------------------------------------------------------------------------------
Rates for other ages are available upon request.
*Age on birthday nearest the due date of the first payment.
The first income payment is payable on the effective date of this Option.
- ----------------------------------------------------------------------------------------
</TABLE>
Page 31
<PAGE>
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------
OPTION 6. JOINT LIFE INCOME WITH REDUCED PAYMENTS
TO SURVIVOR - PAYMENT OPTION RATES
- ------------------------------------------------------------------------------------------------------------------
MONTHLY LIFE INCOME PER $1,000 OF AMOUNT APPLIED
MALE1 & MALE2
- ------------------------------------------------------------------------------------------------------------------
MALE1 MALE2 IS YOUNGER THAN MALE1 BY:
--------------------------------------------------------------------------------------------------------
AGE* 10 Yrs. 9 Yrs. 8 Yrs. 7 Yrs. 6 Yrs. 5 Yrs. 4 Yrs. 3 Yrs. 2 Yrs. 1 Yr.
- -------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
60 $4.06 $4.09 $4.13 $4.17 $4.20 $4.24 $4.28 $4.33 $4.37 $4.41
61 4.12 4.16 4.20 4.24 4.28 4.32 4.36 4.41 4.45 4.50
62 4.20 4.24 4.28 4.32 4.36 4.41 4.45 4.50 4.54 4.59
63 4.27 4.31 4.36 4.40 4.45 4.49 4.54 4.59 4.64 4.69
64 4.35 4.39 4.44 4.49 4.53 4.58 4.63 4.69 4.74 4.79
65 4.43 4.48 4.53 4.58 4.63 4.68 4.73 4.79 4.84 4.90
66 4.52 4.57 4.62 4.67 4.73 4.78 4.84 4.90 4.95 5.01
67 4.61 4.66 4.72 4.77 4.83 4.89 4.95 5.01 5.07 5.13
68 4.71 4.76 4.82 4.88 4.94 5.00 5.06 5.13 5.19 5.26
69 4.81 4.87 4.93 4.99 5.05 5.12 5.19 5.25 5.32 5.39
70 4.91 4.98 5.04 5.11 5.17 5.24 5.31 5.38 5.46 5.53
71 5.02 5.09 5.16 5.23 5.30 5.37 5.45 5.52 5.59 5.67
72 5.14 5.21 5.28 5.36 5.43 5.51 5.58 5.66 5.74 5.82
73 5.26 5.33 5.41 5.49 5.57 5.65 5.73 5.81 5.89 5.97
74 5.39 5.47 5.55 5.63 5.71 5.79 5.88 5.96 6.04 6.13
75 5.52 5.60 5.69 5.77 5.86 5.95 6.03 6.12 6.21 6.29
==================================================================================================================
MALE1 MALE2 IS OLDER THAN MALE1 BY:
--------------------------------------------------------------------------------------------------------
AGE* SAME AGE 1 Yr. 2 Yrs. 3 Yrs. 4 Yrs. 5 Yrs.
- -------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C>
60 $4.45 $4.50 $4.54 $4.59 $4.63 $4.68
61 4.54 4.59 4.64 4.69 4.73 4.78
62 4.64 4.69 4.74 4.79 4.84 4.89
63 4.74 4.79 4.84 4.90 4.95 5.00
64 4.85 4.90 4.95 5.01 5.06 5.12
65 4.96 5.01 5.07 5.13 5.19 5.24
66 5.07 5.13 5.19 5.25 5.31 5.37
67 5.20 5.26 5.32 5.38 5.45 5.51
68 5.32 5.39 5.46 5.52 5.58 5.65
69 5.46 5.53 5.59 5.66 5.73 5.79
70 5.60 5.67 5.74 5.81 5.88 5.95
71 5.74 5.82 5.89 5.96 6.03 6.10
72 5.89 5.97 6.04 6.12 6.19 6.26
73 6.05 6.13 6.21 6.28 6.36 6.43
74 6.21 6.29 6.37 6.45 6.53 6.60
75 6.38 6.46 6.54 6.62 6.70 6.77
- ------------------------------------------------------------------------------------------------------------------
Rates for other ages are available upon request.
*Age on birthday nearest the due date of the first payment.
The first income payment is payable on the effective date of this Option.
- ------------------------------------------------------------------------------------------------------------------
</TABLE>
Page 32
<PAGE>
<TABLE>
<CAPTION>
- ----------------------------------------------------------------------------------------------------------------------
OPTION 6. JOINT LIFE INCOME WITH REDUCED PAYMENTS
TO SURVIVOR - PAYMENT OPTION RATES
- ----------------------------------------------------------------------------------------------------------------------
MONTHLY LIFE INCOME PER $1,000 OF AMOUNT APPLIED
FEMALE1 & FEMALE2
- ----------------------------------------------------------------------------------------------------------------------
FEMALE1 FEMALE2 IS YOUNGER THAN FEMALE1 BY:
--------------------------------------------------------------------------------------------------------
AGE* 10 Yrs. 9 Yrs. 8 Yrs. 7 Yrs. 6 Yrs. 5 Yrs. 4 Yrs. 3 Yrs. 2 Yrs. 1 Yr.
- ----------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
60 $3.76 $3.79 $3.82 $3.85 $3.88 $3.91 $3.95 $3.98 $4.01 $4.05
61 3.82 3.85 3.88 3.91 3.94 3.98 4.01 4.05 4.08 4.12
62 3.88 3.91 3.94 3.98 4.01 4.05 4.08 4.12 4.16 4.20
63 3.94 3.97 4.01 4.04 4.08 4.12 4.16 4.19 4.23 4.28
64 4.00 4.04 4.07 4.11 4.15 4.19 4.23 4.27 4.32 4.36
65 4.07 4.11 4.15 4.19 4.23 4.27 4.31 4.36 4.40 4.45
66 4.14 4.18 4.22 4.27 4.31 4.35 4.40 4.45 4.50 4.54
67 4.22 4.26 4.30 4.35 4.40 4.44 4.49 4.54 4.59 4.64
68 4.30 4.34 4.39 4.44 4.49 4.54 4.59 4.64 4.70 4.75
69 4.38 4.43 4.48 4.53 4.58 4.64 4.69 4.75 4.80 4.86
70 4.47 4.52 4.57 4.63 4.68 4.74 4.80 4.86 4.92 4.98
71 4.56 4.62 4.67 4.73 4.79 4.85 4.91 4.98 5.04 5.11
72 4.66 4.72 4.78 4.84 4.91 4.97 5.04 5.10 5.17 5.24
73 4.77 4.83 4.89 4.96 5.03 5.09 5.16 5.24 5.31 5.38
74 4.88 4.94 5.01 5.08 5.15 5.23 5.30 5.38 5.45 5.53
75 4.99 5.06 5.14 5.21 5.29 5.36 5.44 5.52 5.60 5.69
======================================================================================================================
FEMALE1 FEMALE2 IS OLDER THAN FEMALE1 BY:
--------------------------------------------------------------------------------------------------------
AGE* SAME AGE 1 Yr. 2 Yrs. 3 Yrs. 4 Yrs. 5 Yrs.
- ----------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C>
60 $4.08 $4.12 $4.16 $4.19 $4.23 $4.27
61 4.16 4.20 4.23 4.27 4.31 4.35
62 4.24 4.28 4.32 4.36 4.40 4.44
63 4.32 4.36 4.40 4.45 4.49 4.54
64 4.40 4.45 4.50 4.54 4.59 4.64
65 4.50 4.54 4.59 4.64 4.69 4.74
66 4.59 4.64 4.70 4.75 4.80 4.85
67 4.70 4.75 4.80 4.86 4.91 4.97
68 4.81 4.86 4.92 4.98 5.04 5.09
69 4.92 4.98 5.04 5.10 5.16 5.23
70 5.04 5.11 5.17 5.24 5.30 5.36
71 5.17 5.24 5.31 5.38 5.44 5.51
72 5.31 5.38 5.45 5.52 5.59 5.66
73 5.46 5.53 5.60 5.68 5.75 5.82
74 5.61 5.69 5.76 5.84 5.92 5.99
75 5.77 5.58 5.93 6.01 6.09 6.16
- ----------------------------------------------------------------------------------------------------------------------
Rates for other ages are available upon request.
*Age on birthday nearest the due date of the first payment.
The first income payment is payable on the effective date of this Option.
- ----------------------------------------------------------------------------------------------------------------------
</TABLE>
Page 33
<PAGE>
C.M. Life Insurance Company C.M. Life Insurance Company
A STOCK COMPANY Home Office: Hartford, Connecticut
Administrative Office: Springfield,
Massachusetts
Flexible Premium Adjustable Variable Life Insurance Policy
- --------------------------------------------------------------------------------
This Policy provides that:
A death benefit is payable when the Insured dies.
Within specified limits, flexible premiums may be paid during the Insured's
lifetime.
No dividends will be paid.
<PAGE>
Exhibit 99.A.10
[LOGO OF MASSMUTUAL APPEARS HERE]
Life
Application
Part 1 (A10GE) - General Version
This application package may be used to apply for the following individual
policies:
. All New Non-Qualified Life Insurance Policies for One Insured
- --------------------------------------------------------------------------------
Contents
This package includes:
. Part 1 of Application
. Investor Account Card for Variable Life
. Agent's Statement
. Temporary Life Insurance Receipt
. MIB and Fair Credit Reporting Act Notice
- --------------------------------------------------------------------------------
See additional information on reverse side
Massachusetts Mutual Life Insurance Company and affiliated insurance companies
Springfield MA 01111-0001
A10GE197
<PAGE>
Notes On Using This Application Package
- --------------------------------------------------------------------------------
Carefully review the Agent's Guide Booklet for specific instructions and details
---------------------
for completing the application forms.
. Any non-application pages that are not needed may be removed from
the package.
. Do not use this application for changes, additions or
reinstatements, or for increases on universal life (UL) or variable
life (VL) policies; instead, use the appropriate Change Application.
. VL monies must be remitted immediately; do not hold them while
completing requirements for other products being applied for
concurrently.
. Fully complete the Agent's Statement. Do not omit item 9 (Telephone
Numbers).
. If more space is needed in answering questions, use the "Remarks"
sections included throughout the application.
Checklist
- --------------------------------------------------------------------------------
For Enterprise Plus (Universal Life) and Enterprise 10 (10-Year Level Term):
[_] Check C.M. Life Insurance Company at top of application.
[_] For UL, do not use item 20(b), "Initial Additional Premium," for
------
Section 1035 Exchanges.
For Variable Life Select (VL):
[_] Check MML Bay State Life Insurance Company at top of application.
[_] Do not use item 20(b), "Initial Additional Premium," for Section
------
1035 Exchanges.
[_] Complete and forward the Investor Account Card (IAC).
[_] Give owner the current VL Select Prospectus.
Signature Instructions for Part 1 of Application (Agreement and Signatures):
[_] Proposed Insured must always sign (if under age 16, parent or legal
guardian signs in that space).
[_] Applicant, if different from the Proposed Insured, must also sign.
[_] Owner must always sign at the bottom of the page, even if already
------ ---------------
signed as Insured or as Applicant.
---------------------------------
For Conversion, Exchange, or Option Exercise:
[_] In all cases, the Owner and any Assignee of the original policy
sign on the right side of the signature area.
[_] The Proposed Insured, if not the Owner of the original policy, must
sign on the left side.
[_] For Option Exercise, the Proposed Insured and the Owner must always
sign, even if no additional amount of insurance is applied for.
--------------------------------------------------------
For Prepaid Cases:
[_] Complete the health questions on the Temporary Life Insurance
Receipt.
[_] If all health questions are answered "No":
---
[_] Finish completing the Receipt and give Premium Payer Part to the
client.
[_] Obtain a separate check for VL Premium.
[_] Obtain a separate check for Adjustable Life Insurance Purchase
Rider (ALIR) payment.
[_] If any health question is answered "Yes" or is left unanswered:
---------------------
[_] Do not take any monies.
------
[_] Do not give the receipt.
------
Give Client:
[_] MIB and Fair Credit Notice, and
[_] Buyer's Guide (if applicable).
A10GE197
<PAGE>
APPLICATION NO.
LIFE INSURANCE APPLICATION (PART 1)
To: [_] Massachusetts Mutual Life Insurance Co.
[_] MML Bay State Life Insurance Co.
[_] C.M. Life Insurance Co.
Springfield, Massachusetts 01111-0001 140 Garden St., Hartford, CT 06154
For: [_] New Life Insurance Policy
[_] New Policy as Exchange of Term Insurance
[_] Conversion of Term Insurance
[_] New Policy Under Guaranteed Insurability Option [_]
-------------------
- --------------------------------------------------------------------------------
Client Data
- --------------------------------------------------------------------------------
1. Name of Proposed Insured first name
(hereinafter referred to as Insured) [_][_][_][_][_][_][_][_][_][_][_]
middle name
[_][_][_][_][_][_][_][_][_]
last name
[_][_][_][_][_][_][_][_][_][_][_][_][_]
suffix (e.g., Jr.)
[_][_][_]
2. Current Address
----------------------------------------------------------
street & no. city state
[_][_][_][_][_]-[_][_][_][_]
zip
3. Prior Address
(if within 5 years ----------------------------------------------------------
street & no. city state
[_][_][_][_][_]-[_][_][_][_]
zip
4. Business/Employer
Name & Address ----------------------------------------------------------
name
----------------------------------------------------------
street & no. city state
[_][_][_][_][_]-[_][_][_][_]
zip
5. Social Security Number [_][_][_]-[_][_]-[_][_][_][_]
6. Date of Birth
---------------------------------------
mo. day yr.
7. [_] Male [_] Female 8. Birthplace
-------------------------------
9. Citizen of USA [_] Yes [_] No If "No," what country?
-------------------
Type of Visa [_] Perm. [_] Temp.
10. Applicant [_] Owner [_] Insured
[_] Other
---------------------------------------------
(Print full name and relationship to Insured)
11. Plan Account Name (Employer)
(complete if applicable) --------------------------------------
Plan Account No.
--------------------------------
- --------------------------------------------------------------------------------
12. Owner(Select only one of (a) through (k).) (*Print full name(s) and
relationship(s) to the Insured.)
(a) [_] Insured
* (b) [_] Upon attainment of age , the Insured shall become
---------------
the Owner. Until then, the Owner shall be the Insured's
-----------
, if living otherwise the Insured's
-------------------- -----------
, if living, otherwise the Insured.
--------------------
* (c) [_] Lifetime Ownership in the Insured's , if living,
-----------------
thereafter in the Insured's , if living, thereafter
----------------
in the Insured.
* (d) [_] Insured's , or his/her estate.
-------------------------------------
* (e) [_] Joint Ownership: , or the survivor(s) of them.
-----------------------
(f) [_] as Trustee(s), or the then-acting Trustee(s)
------------------------
under the Trust Agreement dated . (Copy of signed
------------------
Trust Agreement required.)
(g) [_] Corporation , its successors or assigns.
----------------------------
(h) [_] Business Associate/Business Partner , or his/her estate.
------------
(i) [_] Partnership .
-------------------------------------------------------
(j) [_] Incorporated Charitable Organization , its
--------------------------
successors or assigns.
* (k) [_] Other (e.g., Non-Incorporated Charity, Custodian, or Tenancy-In-
Common)
-------------------------------------------------------------
If the last Owner is other than the Insured and all Owners predecease the
Insured, then the Owner shall be the estate of the last Owner to die unless
otherwise requested.
13. Owner's (if other than the Insured) Soc. Sec. No. or
Taxpayer ID No.
------------------------------------------------------------
(If more than one Owner, give name and Soc. Sec. No. of all Owners in 15.)
14. Owner's (if other than the Insured) Address
----------------------------------------------------------------------------
street & no. city state
[_][_][_][_][_]-[_][_][_][_]
zip
15. Remarks
- --------------------------------------------------------------------------------
A10GE197
<PAGE>
APPLICATION NO. Page 2
- --------------------------------------------------------------------------------
16. Beneficiary (Select only one of (a) through (i).) (For all Beneficiaries,
print full name(s) and relationship(s) to the Insured.) Payment to all
Beneficiaries shall be made in one sum unless otherwise requested.
(a) [_] Primary
------------------------------------------------------------
------------------------------------------------------------
Secondary (optional)
-----------------------------------------------
---------------------------------------------------------------
[_] AND any lawful children of the Insured
Select [_] AND any children born of the marriage of the Insured and
said spouse
only one [_] AND any children born of the marriage of, or legally adopted
by, the Insured and said spouse
option [_] *Trustee(s) under the Will of the Insured
Tertiary (third to receive payment) (optional)
----------------------------
---------------------------------------------------------------------
[_] issue per stirpes of: [_] Primary Beneficiary(ies)
[_] Secondary Beneficiary(ies)
[_] Tertiary Beneficiary(ies)
(b) [_] Estate of the Insured (Select only if Estate is Primary Beneficiary.)
(c) [_] *Trustee(s) under the Will of the Insured (Select only if Trustee(s)
under the Will is Primary Beneficiary)
(d) [_] __________________________________________________ as Trustee(s), or the
then-acting Trustee(s), under the Trust Agreement dated _______________
(e) [_] Corporation named in 12(g)
(f) [_] Business Associate/Business Partner named in 12(h)
(g) [_] Partnership named in 12(i)
(h) [_] Incorporated Charitable Organization named in 12(j)
(i) [_] Other
-------------------------------------------------------------------
*"Trustee(s) under the Will of the Insured" means the then-acting Trustee(s) of
the Trust under the Insured's Will that is probated. If no Will of the Insured
is probated or no Trust is in effect under the Will that is probated, payment
will be made to the Owner or to the estate of the Owner.
Optional Provisions (for (a) and (f) only):
UTMA/UGMA Custodian- During minority of the
named child(ren),
-----------------------------------
(name of adult to act as Custodian)
shall be Custodian for said child(ren) under the Uniform
------------------
(state)
Transfers/Gifts to Minors Act.
(If the Custodian is named for more than one child, the Custodian will
act separately for each.)
Option D, Monthly Interest
Payments,for
[_] Primary Beneficiary
[_] Secondary Beneficiary
[_] Tertiary Beneficiary
(not available for any beneficiary
for whom UTMA/UGMA is selected)
Deferral Clause for [_] Primary [_] Secondary [_] Tertiary Beneficiary(ies).
Payment shall be made on the date [_] 30 days [_] days after the Insured's
---
death.
Any beneficiary whose death occurs before such date will be considered as having
predeceased the Insured.
If two or more persons are the beneficiaries in any class, payment shall be made
equally to them or equally to the surviving beneficiaries in that class unless
otherwise requested. If percentages or fractions are indicated and any
beneficiary dies before the Insured, any share due that beneficiary will be paid
proportionately to the surviving beneficiaries in that class. If payment is made
in one sum and there is no beneficiary entitled to payment when the Insured dies
and the Insured is the Owner at that time, payment shall be made to the estate
of the Insured; but if the Insured is not the Owner, payment shall be made to
the Owner.
- --------------------------------------------------------------------------------
Life Insurance Data
- --------------------------------------------------------------------------------
17. Product
[_] Whole Life [_] 10-Year Level Term
[_] Limited Pay WL [_] APT
--------
[_] Enhanced Whole Life [_] Variable Life
[_] Modified Whole Life [_] Universal Life
[_]
---------------------------------------------
18. Amount of Insurance (a or b)
(a) Face Amount $
-----------------------
(b) Face Amount purchased by a premium of $ at premium frequency
----------
applied for in 39.
[_] This premium includes all riders.
- --------------------------------------------------------------------------------
A10GE197
<PAGE>
<TABLE>
<CAPTION>
APPLICATION NO. Page 3
- ------------------------------------------------------------------------------------------------------------------------------------
Life Insurance Data (continued)
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C>
19. Variable Life Net Premium Allocation (must total 100%) 20. Variable Life and Universal Life
[_] MML Equity % (a) Planned Premium (at frequency) $
---------------- ---------------------------
[_] MML Money Market % (b) Initial Additional Premium $
---------------- ------------------------------
[_] MML Managed Bond % (c) Death Benefit Option (if applicable) [_] 1 [_] 2
----------------
[_] MML Blend % 21. Automatic Premium Loan [_] Yes [_] No
----------------
[_] GPA % (not available on Term or Variable Life)
----------------
[_] Opp. Capital Appreciation % 22. Loan Interest Rate (where elective)
----------------
[_] Opp. Growth %
----------------
[_] Adjustable [_] 8% [_] 6% (VL only) [_] %
[_] Opp. Global Securities % ------
----------------
[_] Opp. Strategic Bond % 23. Policy Date (optional)
---------------- ----------------------
[_] % 24. To Save Issue Age (optional)
---------------------- ---------------- ----------------
- ------------------------------------------------------------------------------------------------------------------------------------
For Variable Life Insurance, the Applicant acknowledges:
. Receipt of a prospectus for the policy applied for;
. That the variable value of the policy may increase or decrease in accordance with the experience of the Separate Account(s);
. That there are no minimum guarantees as to the variable value;
. That the fixed value of the policy earns interest at a rate not less than a minimum specified rate; and
. That the death benefit may be variable or fixed under specified conditions.
- ------------------------------------------------------------------------------------------------------------------------------------
25. If the policy applied for will be used in connection with an employer-sponsored plan involving both males and females, will the
policy be issued on a Unisex basis? [_] Yes [_] No
26. Waiver Of Premium and Disability Benefit Riders on: * [_] Applicant-Adult Insured (Disability Only)
[_] Insured (Disability Waiver) (not available on VL) * [_] Applicant-Adult Insured (Death or Disability)
[_] Insured (Disability Benefit) (UL and VL only) * [_] Applicant-Juvenile Insured (Death Only)
Specified Monthly Amount (VL only) $ * [_] Applicant-Juvenile Insured (Death or Disability)
---------------------- *Complete Supplement A3300
- ------------------------------------------------------------------------------------------------------------------------------------
27. Other Riders 28. Dividend Option (not available on Variable Life)
[_] Accid. Dth Ben $ [_] Guar. Insurability $ [_] Paid-up Additions(not available on Term)
--------- ----------
[_] Add'l Life Ins. Purch. (ALIR) $ [_] Dth. Ben. Guar. [_] Reduce Premiums [_] Cash
----------
[_] Ren. Term 1-Yr. $ [_] $ [_] Accumulate at Interest [_] Suppl. Insurance (EWL &
-------- ---------------- ---------- LISR)
[_] Life Insurance Supplement Rider (LISR) [_] Dividend applied as Yearly } (not available on
(a) Requested Supplemental Ins. Amt. $ Term Purchase with balance to: } Term, EWL, or LISR)
-------------------------
(b) LISR Annual Premium $ [_] Paid-up Additions [_] Reduce Premiums
-------------------------
(c) LISR Lump-Sum Payment $ [_]
------------------------- -------------------------------------------
[_] Cost Of Living Adj.: 29. ALIR Dividend Option
(a) Incr. Factor (xx.xx) (b) Expiry Age [_] Paid-up Additions [_] Same as Basic Policy
-------- --------
[_] Other Insured Term:
(a) Name (b) Amt. $
------------------------ -------------
(c) Qualified (spouse, child, adopted child, stepchild, self) [_] Y [_] N
- ------------------------------------------------------------------------------------------------------------------------------------
30. Life Insurance currently applied for, contemplated, or now in force on the
Insured in other companies. (Exclude amounts shown in 32(a).) If none, check
here [_]
Currently
Name of Other Company (No MassMutual or affiliates) Amount Year(s) Issued or Applied For
- ------------------------------------------------------------------------------------------------------------------------------------
$ [_]
- ------------------------------------------------------------------------------------------------------------------------------------
[_]
- ------------------------------------------------------------------------------------------------------------------------------------
[_]
- ------------------------------------------------------------------------------------------------------------------------------------
31. Total amount of new insurance to be placed currently in all companies $
------------------------------------
32. Replacement/Section 1035 Exchange (For each policy listed in (a), include completed replacement forms with this application.)
(Do not complete for Term Conversions and Term Exchanges)
(a) Will the insurance now being applied for replace or change, or is it
intended to replace or change, any insurance or annuity, in whole or in
part, issued by this or any other company? [_] Yes [_] No If "Yes," complete
the following.
Company Name Policy Number Product Face Amount
- ------------------------------------------------------------------------------------------------------------------------------------
$
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
(b) If the policy applied for is intended to qualify for a Section 1035
exchange, the approximate value of the policy to be exchanged is
$ and will be applied for on the new
--------------------------------
policy in the form of:
[_] ALIR [_] LISR [_] Additional Premium (UL, VL) [_] Initial Premium
(Other Life). (If exchanging another company's policy, the policy, a
completed absolute assignment form, and the other company's blank
surrender form should accompany this application.)
</TABLE>
A10GE197
<PAGE>
APPLICATION NO. Page 4
- --------------------------------------------------------------------------------
Juvenile Data (ages 0-15)
- --------------------------------------------------------------------------------
33. Total life insurance currently applied for, contemplated, or now in force
on Insured's father/mother/siblings in all companies. (Name, age,
relationship to Insured, and amount - explain if none)
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
34. Total life insurance now in force in all companies on Applicant if other
than parent of Insured $ ___________________________________________________
35. Does the Insured reside with the Applicant? [_] Yes [_] No
If "No," the Insured resides with
Name ___________________________ Relationship to Insured ___________________
36. Remarks
- --------------------------------------------------------------------------------
Conversion, Exchange, and Option Data
- --------------------------------------------------------------------------------
Term Insurance Conversion or Exchange
- --------------------------------------------------------------------------------
<TABLE>
<S> <C>
37.(a) [_] Conversion of term insurance under policy(ies) numbered: ______________ ______________ ______________
Date of New Policy (required) ____________ Type of Term: ______________ ______________ ______________
If not all of the term insurance is to be converted, complete the following.
<CAPTION>
Balance to be
Policy Number Name(s) of Term Rider(s) if applicable Amount to be converted Terminated Continued
----------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C>
[_] [_]
----------------------------------------------------------------------------------------------------------------------
[_] [_]
----------------------------------------------------------------------------------------------------------------------
</TABLE>
(b) [_] Exchange of term insurance under policy(ies) numbered _____________
[_] Term policy numbered ___________ is amended by adding the right
to exchange the term insurance provided by the policy for new
term insurance. It is to be exchanged for the new term insurance
applied for in this application. The policy will terminate when
this new policy takes effect. Any dividends to the credit of the
exchanged policy will be paid in cash.
[_] The _________ term rider under policy numbered is amended by
adding the right to exchange the term insurance provided by the
rider for the new term insurance. It is to be exchanged for the
new term policy applied for in this application. The rider will
terminate when this new policy takes effect. If the existing
policy has more than one term rider and not all of them are
being exchanged, identify the one(s) being
exchanged:_____________________
--------------------------------------------------------------------
The following applies to conversions only:
(c) If the term insurance provides that ADB, GIO/IPR, and/or Waiver Of
Premium are to be included in the new policy, the riders will
automatically included unless otherwise requested here: Do not include
[_] ADB [_] GIO/IPR [_] Waiver Of Premium
(d) [_] Policy(ies) listed above in (a) or (b) does not have rider(s)
applied for in 27 (requires evidence of insurability).
(e) [_] The Face Amount applied for in 18 is greater than the amount
available for the conversion; this additional amount is
$ __________________ (requires evidence of insurability).
- --------------------------------------------------------------------------------
Guaranteed Insurability Option
- --------------------------------------------------------------------------------
<TABLE>
<S> <C> <C>
38.(a) Option under Policy(ies) Numbered Type of Option Date Amount Being Exercised
[_] Regular [_] Substitute $
--------------------------------- -------------------------
[_] Regular [_] Substitute $
--------------------------------- -------------------------
[_] Regular [_] Substitute $
--------------------------------- -------------------------
(b) [_] For Substitute Option Date
Reason: [_] marriage [_] birth of child(ren) [_] adoption of child(ren) Date of applicable event: __________
(c) [_] Face Amount applied for in 18 exceeds total of amounts being exercised under option; this additional amount is
$ ____________________ (requires evidence of insurability).
(d) [_] Original policy(ies) does not have rider(s) applied for in 27 (requires evidence of insurability).
</TABLE>
A10GE197
<PAGE>
APPLICATION NO. Page 5
- --------------------------------------------------------------------------------
Payment Data
- --------------------------------------------------------------------------------
<TABLE>
<S> <C> <C>
39. Premium Payments
(a) Billing Type (b) Frequency
[_] Automatic Bank Account Withdrawal [_] Annual [_] Quarterly
[_] Regular [_] Semiannual [_] Monthly (not with Regular)
[_] Invoice/Franchise [_]
-----------------------------------------------------------
40. Premium Payer: [_] Insured [_] Owner [_] Other
--------------------------------------------------------
Mailing Address: [_] Insured's Home [_] Other
--------------------------------------------------------
[_] Insured's Business
--------------------------------------------------------
[_] Owner's Address
--------------------------------------------------------
41. Has the first premium on the insurance applied for been paid? [_] Yes [_] No If "Yes," amount paid is $
-----------
- ------------------------------------------------------------------------------------------------------------------------------------
Personal Data Regarding the Insured
- ------------------------------------------------------------------------------------------------------------------------------------
42. (a) Has the Insured smoked cigarettes during the past 12 months? [_] Yes [_] No
(b) If "No," has the Insured used tobacco or nicotine in any other form during the past 12 months? [_] Yes [_] No
(c) Has the Insured used tobacco or nicotine in any form during the past 3 years? (If "Yes," give details in 50.) [_] Yes [_] No
- ------------------------------------------------------------------------------------------------------------------------------------
Complete the following only if Evidence of Insurability is required. Explain "Yes" answers in 50.
- ------------------------------------------------------------------------------------------------------------------------------------
43. (a) Insured's Occupation(s) and Exact Duties
Occupation(s) Exact Duties
----------------------------------------------------------- ----------------------------------------------------------
----------------------------------------------------------- ----------------------------------------------------------
(b) Length of time with current employer ______________________________ (If less than 6 mos., give name(s) of previous
employer(s), occupation(s), duties, and dates of employment for last three years in 50.)
44. Insured's current driver's license no. State
-------------------------------------------- --------------------
45. Does the Insured now contemplate any foreign travel? [_] Yes [_] No
46. Within the last 3 years has the Insured been, or does the Insured now expect to
become, a pilot, student pilot, or crew member of any type of aircraft?
If "Yes," complete Aviation Supplement A3310 [_] Yes [_] No
47. Within the last 3 years has the Insured taken part in, or does the Insured now
expect to take part in, underwater diving, hang gliding, para sailing, para kiting,
parachuting, skydiving, mountain climbing, or organized racing by automobile,
motorcycle, motorboat, or snowmobile, or any other form(s) of hazardous activity?
If "Yes," complete Avocation Supplement A3320 [_] Yes [_] No
48. Within the last 5 years has the Insured been in a motor vehicle accident,
been convicted of operating a motor vehicle while under the influence of
alcohol or other drugs, been convicted of a moving violation, or received a
driver's license restriction or revocation? [_] Yes [_] No
49. Has the Insured ever been convicted of a felony? [_] Yes [_] No
50. Remarks
</TABLE>
A10GE197
<PAGE>
APPLICATION NO. Page 6
- --------------------------------------------------------------------------------
Agreement And Signatures
- --------------------------------------------------------------------------------
The person(s) signing below agree that:
The Application - This is Part 1 of an application for Life Insurance. The
application includes any Part 2 that may be required and any amendments and
supplements to either Part. To the best of the knowledge and belief of the
person(s) signing below, all statements in this Part 1 are complete and true and
were correctly recorded. Each person signing below adopts all of the statements
made in the application and agrees to be bound by them.
Company, as used in this Application, refers to Massachusetts Mutual Life
Insurance Company and/or MML Bay State Life Insurance Company and/or C.M. Life
Insurance Company.
Liability of Company - The insurance applied for will not take effect unless
each of the applicable conditions is met:
1. For all cases: The first premium has been paid during the lifetime of all
-------------
persons to be insured by the policy and the application has been approved
by the Company at its Home Office/Principal Administrative Office.
2. For insurance purchased under a guaranteed insurability rider or
----------------------------------------------------------------
agreement: The first premium must be paid within the time period specified
---------
in the rider or agreement. If all applicable conditions are met, the
insurance purchased under such rider or agreement becomes effective
according to its terms.
3. For conversion or exchange: The policy that provides the insurance being
--------------------------
converted or exchanged must be received by the Company at it Home
Office/Principal Administrative Office. The first premium may be reduced
by any conversion allowances permitted. If all applicable conditions are
met, the insurance purchased under an exchange or conversion becomes
effective, and coverage being converted or exchanged terminates, on the
Issue Date of the policy applied for.
4. For insurance not provided for in 2 or 3 above: The first premium may be
----------------------------------------------
paid to the agent in exchange for a Temporary Life Insurance Receipt
signed by that agent. If this is done, the Company shall be liable only as
set forth in that Receipt. If not, (i) the policy must be delivered to the
person named as Owner therein; and (ii) at the time of payment and
delivery, all statements that relate to the insurability of all persons to
be insured under the policy are complete and true as though they were made
at that time.
Authority of Agents - No agent can change the terms of this application or any
policy issued by the Company. No agent can waive any of the Company's rights or
requirements or extend the time for any payment.
Changes and Corrections - Any change or correction of the application will be
shown on an Amendment of Application attached to the policy. Acceptance of any
policy issued shall be acceptance of any change or correction of the application
made by the Company. However, any correction or change of amount,
classification, plan of insurance, or riders applied for in this application
must be agreed to in writing.
Authorization To Obtain And Disclose Information (For The Insured And/Or
Applicant) - I have received the Notice about the Medical Information Bureau,
Inc. (MIB). I have also received the Notice about the Fair Credit Reporting Act.
I understand and authorize an investigative report to be made. This report may
include information about my character, general reputation, personal
characteristics, and mode of living. I hereby authorize certain parties that
have any records or knowledge of me and my health (or my children and their
health if juvenile insurance), to make such information available to the Company
and its reinsurers. These parties include: any licensed physician, medical
practitioner, hospital, clinic, other medical or medically related facility,
insurance company, the MIB, or other organization. I agree that a photocopy or
facsimile of this authorization may be used to obtain information.
- --------------------------------------------------------------------------------
ANY POLICY ISSUED AS A RESULT OF A MATERIAL MISSTATEMENT OR OMISSION
OF FACTS MAY BE VOIDED, AND THE COMPANY'S ONLY OBLIGATION SHALL BE TO
RETURN PREMIUMS PAID.
- --------------------------------------------------------------------------------
<TABLE>
<S> <C>
For All Cases For Conversions, Exchanges, and Option Purchases
Proposed Insured (if age 16 or older) Owner of Original Policy
- ---------------------------------------------------- ------------------------------------------------------
Applicant, as given in 10 (if not Proposed Insured) Assignee of Original Policy
- ---------------------------------------------------- ------------------------------------------------------
- --------------------------------------------------------------------------------------------------------------
Signed at on
------------------------------------------------------------------------- -------------------------
city state date
- --------------------------------------------------------------------------------------------------------------
General Agent submitting application (Agcy. No.) Agent who actually solicited this application (print name here)
- ------------------------------------------------- --------------------------------------------- -----------------
- -----------------------------------------------------------------------------------------------------------------------------
A10GE197 Massachusetts Mutual Life Insurance Company and affiliated insurance companies Springfield MA 01111-0001
</TABLE>
Taxpayer Identification - The Owner of the policy applied for herein certifies,
under penalties of perjury, that: (i) the number referred to in 5 or 13 of this
application is his/her correct Taxpayer Identification Number (or he/she is
waiting for a number to be issued); and (ii) he/she is not subject to backup
withholding either because he/she has not been notified by the Internal Revenue
Service (IRS) that he/she is subject to backup withholding as a result of a
failure to report all interest or dividends, or the IRS has notified him/her
that he/she is no longer subject to backup withholding. If the IRS has notified
the Owner that he/she is subject to backup withholding and he/she has not
received notice from the IRS that backup withholding has terminated, he/she
should strike out the language here in (ii) that he/she is not subject to
backup withholding due to notified payee underreporting.
on
- --------------------------------------------------- -------------------------
Signature of Owner of New Policy Date
<PAGE>
APPLICATION NO. Massachusetts Mutual Life Insurance Company
and Affiliated Insurance Companies
Investor Account Card
This suitability form is required for all variable products unless otherwise
directed.
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C>
1. Owner's Name _____________________________________________ 2. Approximate net worth (exclusive of home, fur-
nishings, and automobiles)
------------------------------------------------
For non-individually owned contracts, leave 3 through 9 blank.
3. Number of Dependents _________________________________ 4. Age(s) of Dependents __________________________
5. Owner's Date of Birth ________________________________ 6. Estimated current annual household income
--------------------------------------------------------------
Earned Unearned
$ _________________________ $ __________________________
--------------------------------------------------------------
7. Name of Owner's Employer __________________________________ 8.Owner's Occupation _______________________________________
no. & street city state zip
9. Address of Employer ______________________________________________________________________|__|__|__|__|__|-|__|__|__|__|
10. Is Employer a member of the NASD? 11. Owner's estimated Federal Income Tax bracket
[_] Yes [_] No [_] 15% [_] 28% [_] 31% _______ %
12. Investment Objectives: (check all that apply)
[_] Growth of Assets [_] Conservation of Principal [_] Other (specify) _____________________________
[_] Retirement Income [_] Tax Sheltered Accumulations
13. I am comfortable assuming: (check all that apply)
[_] Low Risk [_] Moderate Risk [_] High Risk [_] Other (specify) _____________________________
14. Source of Funds:
[_] Current Income [_] Qualified Plan Distribution [_] IRA Rollover
[_] Personal Savings [_] Mutual Fund Redemption [_] Other (specify) _____________________________
[_] CD/Money Market Fund [_] Insurance Proceeds
If the owner of this contract is other than an individual, i.e. trust, guardian, conservator, etc., substantiating documents that
include authorized signatures must be submitted.
15. Comments:
16. To the best of my knowledge, the above answers are true and correctly recorded. I believe the contract or policy applied for
is suitable for my investment objectives.
_____________________________________________________________ ____________________________________________________________
Signature of Owner Date
- ------------------------------------------------------------------------------------------------------------------------------------
17. Attestation of Registered Representative
The Owner listed above has been informed of the risks involved in this investment, and I certify that I have reasonable grounds
for believing that this contract or policy is suitable for the Owner's objectives.
_____________________________________________________________ ____________________________________________________________
Signature of Registered Representative Date
- ------------------------------------------------------------------------------------------------------------------------------------
18. Home Office Use Only
_____________________________________________________________ ____________________________________________________________
Approval of Authorized Principal Date
Comments:
- ------------------------------------------------------------------------------------------------------------------------------------
LAC-9700
</TABLE>
<PAGE>
APPLICATION NO. AGENT'S STATEMENT
- -------------------------------------------------------------------------------
Complete for all cases
- -------------------------------------------------------------------------------
Additional Issue Information
1. Is best underwriting class anticipated? [_] Yes [_] No
2. If Insured's name is to appear on the policy other than as "First Name-
Middle Initial-Last Name," specify below
--------------------------------------------------------------------------
3. (a) Is application from a new premium-payer client to the company?
[_] Yes [_] No
(b) If the Insured is a previous client, give the Client Identification No.
---------------------------------
4. How long have you known the Insured? _____________________________________
5. How well do you know the Insured?
[_] Very well [_] Casually [_] Met on solicitation(Give details in 22.)
6. (a) Insured's Annual Earned Income Actual Agent Estimate
------ ------ --------------
$ _______________________________ [_] [_]
(b) Insured's Annual Unearned Income
--------
$ _______________________________ [_] [_]
(c) Spouse's Total Annual Income
$ _______________________________ [_] [_]
(d) Insured's Net Financial Worth
$ _______________________________ [_] [_]
7. Insured's Marital Status
[_] Single [_] Married [_] Widowed [_] Divorced
8. Do you have any knowledge of a present disability of the Insured?
[_] Yes [_] No
(If "Yes," explain in 22.)
9. (a) Soliciting Agent telephone (if different from agency)
------------------------------
(b) Insured's telephone (Best time of day to call _________________________)
Home _________-_________-_________ Business _________-_________-________
10. (a) To the best of your knowledge, during the last six months has any policy
on the life of the Insured been, or if the application is approved is it
contemplated that any policy will subsequently be, surrendered or otherwise
terminated, lapsed, or placed on other than a premium-paying basis,
rewritten to release cash values, reduced in amount or term of coverage,
assigned as collateral for a loan, or subjected to borrowing of loan values?
[_] Yes [_] No
(If "Yes," complete the following.)
Company Name Policy Number Product Face Amount
---------------------------------------------------------------------
$
---------------------------------------------------------------------
$
---------------------------------------------------------------------
$
---------------------------------------------------------------------
(b) Have you delivered the appropriate replacement form? [_] Yes [_] No
(c) Is a copy of the sales illustration used being forwarded with this
application? [_] Yes [_] No
11. If ALIR is requested, to the best of your understanding ALIR payments will
be [_] for one year [_] on a continuing basis
12. (a) Will dividends from any existing MassMutual Policy be used to pay
all or part of the initial premium on this policy? [_] Yes [_] No
(If "Yes," complete Form F5341.)
(b) Will initial premium be paid by a loan from any MassMutual policy?
[_] Yes [_] No
(If "Yes," complete Form F5341.)
Information About This Sale
13. Was this application taken by mail? [_] Yes [_] No
14. Supporting information for a business-related sale
(a) Business is a:
[_] Sole Proprietorship [_] Partnership [_] Corporation
Year established ___________ No. of employees ____________
(b) If policy is to be owned by a business or business associate, give
names of the other officers or partners and the amount of insurance
the business now carries on their lives. (If any officers or partners
are not insured, explain in 22.)
Name Title Amount
________________________ __________________ $_______________
________________________ __________________ $_______________
________________________ __________________ $_______________
15. (a) Is this part of a multi-life case? [_] Yes [_]No
(b) If yes, total number of applications _______
(c) Was census submitted to Home Office? [_] Yes [_]No
(d) Guaranteed Acceptance Prog. for Exec. (GAPE)? [_] Yes [_]No
(e) Is any policy to be part of a:
[_] Pension/Profit Sharing Plan [_] Split Dollar Plan
16. If Split Dollar, Method:
[_]Endorsement [_]Collateral Assignment
17. Primary purpose of insurance(check one only)
Personal Needs:
[_] Mortgage Cancellation [_] Retirement [_] Estate Taxes
[_] Income for Dependents [_] Education Fund [_] Gifts/Bequests
[_] Other Personal Needs(Explain in 22.)
Business Needs:
[_] Stock Redemption [_] Cross Purchase
[_] Key Employee [_] Deferred Compensation
[_] Sec.162 Bonus Plan [_] Other Business Needs(Explain in 22.)
Agent and Compensation Information
18. (a) Are you the Proposed Insured? [_] Yes [_]No
(b) Is Insured your spouse/child/parent/sibling? [_] Yes [_]No
19. If you are not a full-time MassMutual Agent, what is your primary
company affiliation? _________________________________________
20. List below the agent(s) who will receive commissions.
If more than one, enter percentage applicable to each.
Agent's Name Ident. Code First Yr. % Ren'l %
1. ________________ __________________ _____________ ___________
2. ________________ __________________ _____________ ___________
3. ________________ __________________ _____________ ___________
4. ________________ __________________ _____________ ___________
5. ________________ __________________ _____________ ___________
6. ________________ __________________ _____________ ___________
100% 100%
21. If the sale of this policy will be credited to more than one General
Agency, specify below:
Agency Name Agency No. % of Split
__________________ __________________ _________________
__________________ __________________ _________________
100%
22. Remarks
- --------------------------------------------------------------------------------
Date ______________________ Signature of Soliciting Agent ____________________
- --------------------------------------------------------------------------------
A1AGE197
<PAGE>
APPLICATION NO.
TEMPORARY LIFE INSURANCE RECEIPT
<TABLE>
<CAPTION>
<S> <C> <C>
To: [_] Massachusetts Mutual Life Insurance Co. [_] MML Bay State Life Insurance Co. [_] C.M. Life Insurance Co.
Springfield, Massachusetts 01111-0001 140 Garden St., Hartford, CT 0615
Person(s) Proposed _____________________________________________________________________________________________________
for Insurance Last Name First Name Initial Suffix (e.g., Jr., III)
(please print) _____________________________________________________________________________________________________
Last Name First Name Initial Suffix (e.g., Jr., III)
====================================================================================================================================
Health Questions
(If more than one person is proposed for insurance and a "Yes" answer applies to either one, the question must be answered
"Yes." No agent is authorized to accept premium if any of the questions are answered "Yes" or left unanswered.)
Has the Proposed Insured(s):
1. Ever been treated for, or been diagnosed by a member of the medical profession as having,
cancer, stroke, or disease of the heart? [_] Yes [_] No
2. In the last 10 years applied for life insurance and been declined, postponed, rated, or restricted? [_] Yes [_] No
3. In the last 90 days been admitted, or been advised by a member of the medical profession to be
admitted, to a hospital or other medical facility? [_] Yes [_] No
4. Ever been treated for, or been diagnosed by a member of the medical profession as having,
a deficiency of the immune system such as acquired immune deficiency syndrome (AIDS)? [_] Yes [_] No
R10GE197 (Company Part) (continued on reverse side)
- ------------------------------------------------------------------------------------------------------------------------------------
1296105901 TEMPORARY LIFE INSURANCE RECEIPT
APPLICATION NO.
Company:
[_] Massachusetts Mutual Life Insurance Co. [_] MML Bay State Life Insurance Co. [_] C.M. Life Insurance Co.
Springfield, Massachusetts 01111-0001 140 Garden St., Hartford, CT 06154
Payment in the amount of $ ______________________________ for life insurance on ____________________________________________________
____________________________________________________________________________________________________________________________________
Print Name of Proposed Insured(s)
was received by _________________________________________________________ on _____________________________________________________ .
Agent's Signature Date
IMPORTANT: THIS RECEIPT PROVIDES A LIMITED AMOUNT OF LIFE INSURANCE FOR A LIMITED PERIOD OF TIME. THE LIFE INSURANCE IS SUBJECT TO
THE PROVISIONS OF THIS RECEIPT. NO LIFE INSURANCE GOES INTO EFFECT UNDER THIS RECEIPT UNLESS (i) ALL HEALTH QUESTIONS WERE ANSWERED
"NO" AND (ii) PART 1 OF THE APPLICATION FOR LIFE INSURANCE HAS BEEN COMPLETED AS OF THE DATE OF THIS RECEIPT. NO LIFE INSURANCE GOES
INTO EFFECT UNDER THIS RECEIPT FOR AMOUNTS APPLIED FOR UNDER CONVERSION OR GUARANTEED-INSURABILITY OPTIONS.
- ------------------------------------------------------------------------------------------------------------------------------------
Temporary Life Insurance
Subject to the limitations stated in this receipt, the temporary life insurance provided by this receipt becomes effective as of the
date of this receipt.
The temporary life insurance provided by this receipt continues to, but not including, the earliest of:
1. The date 60 days after the date the temporary life insurance becomes effective;
2. The date the life insurance applied for is approved;
3. The date a policy, other than as applied for, is presented to the applicant for acceptance or rejection;
4. If the application is rejected, the date the Company mails the notice of rejection and refunds the payment made;
5. The date the premium payer requests from the Company a refund of the amount paid under this receipt.
If benefits are payable under the policy issued pursuant to the application for insurance, no benefits are payable under this
receipt.
(continued on reverse side)
R10GE197
</TABLE>
<PAGE>
COMPANY'S LIABILITY
Subject to the provisions of this receipt, the amount of temporary life
insurance is equal to the amount of life insurance applied for, including any
riders. However, the amount of temporary life insurance plus the life insurance
under any other receipt(s) the Company has outstanding on each person proposed
for insurance cannot exceed the following limits:
Age* Limit Age* Limit
under 56 $1,000,000 66-70 $250,000
56-60 750,000 71-75 100,000
61-65 500,000 over 75 0
*Age means the age, on the birthday nearest the date of this receipt, of
each person proposed for insurance.
These limits include amounts under any accidental death benefit agreement or
rider applied for. If the amount of insurance applied for exceeds these limits,
the Company's only liability for the excess will be to return the amount of
payment made for it.
If any Proposed Insured commits suicide, while sane or insane, the Company's
only liability under this receipt is to refund the payment made.
If the check or draft received in payment for the premium is not honored when
first presented for payment, coverage under this receipt is void.
CONTESTABILITY
We rely on all statements made by or for the Proposed Insured(s) in this receipt
and in the application. The Company can contest the validity of the temporary
life insurance for any material misrepresentation of fact either in the health
questions stated in this receipt or in the application numbered above.
AUTHORITY OF AGENT
No agent can change the terms of this receipt, or the application, or any policy
issued by the Company. No agent can waive any conditions or extend the time
requirements to meet them. No agent is authorized to accept premium before Part
1 of the application for life insurance has been completed. No agent is
authorized to accept premium if any of the health questions stated on the
Company Part of this receipt are answered "Yes" or left unanswered.
(Premium Payer Part)
................................................................................
Payment in the amount of $ was received on
---------------- --------------------
Date
AGREEMENT AND SIGNATURES
The person(s) signing below agree that:
They have received and read (or had read to them) the receipt detached from this
form for the amount indicated above. They understand and agree to its terms and
conditions. To the best of their knowledge and belief, the answers to all health
questions stated on the reverse side are complete and true and were correctly
recorded before they signed their name(s) below.
- ------------------------------------------------
Premium Payer
- ------------------------------------------------ ------------------------------
Person(s) Proposed for Insurance (if different)
Signed at on
---------------------------------------- --------------------------
City State Date
(Company Part)
R10GE197 (Company Part)
<PAGE>
Notice To Insured And/Or Applicant For Insurance
Thank you for applying for insurance with us. We will give your application
prompt consideration and will notify you of our action as soon as possible.
In addition to your answers on the application, we must also consider
information from other sources. These sources may include results of a physical
examination, an investigative consumer report, and reports from doctors who have
attended you or from hospitals where you have been treated.
MEDICAL INFORMATION BUREAU NOTICE - Information regarding your insurability will
be treated as confidential. We or our reinsurers may, however, make a brief
report thereon to the Medical Information Bureau, Inc., 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 that company with the information
it may have in its files.
Upon receipt of a request from you, the Bureau will arrange disclosure of any
information it may have in your file. Unless the Medical Director feels that it
is in your best interest to disclose this information to your physician, it will
be disclosed directly to you. 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. We or our
reinsurers may also release information in our 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.
The purpose of the Bureau is to protect its member companies and their
policyholders from the costs created by people who try to hide facts about their
insurability. Information furnished by the Bureau cannot be used as a basis for
evaluating risks. However it may be used to alert us to the possible need for
further investigation. THE BUREAU DOES NOT HAVE MEDICAL REPORTS FROM HOSPITALS
AND DOCTORS. THE INFORMATION IN ITS FILES DOES NOT SHOW WHETHER AN INSURANCE
APPLICATION WAS ACCEPTED, PLACED IN AN INCREASED PREMIUM CLASS OR DECLINED.
(This Notice is only valid where permitted by law).
FAIR CREDIT REPORTING ACT NOTICE - As previously noted, an investigative
consumer report may be made on you. It will cover information about your
insurability, including information regarding your character, general
reputation, personal characteristics and mode of living. The information may be
obtained through personal interviews with you, an adult family member, friends,
neighbors and associates. You may send us a written request for a complete and
accurate disclosure of the nature and scope of any report that is made.
If requested, we will be happy to let you know whether or not we asked for an
investigative consumer report to be made. If we did, we will also tell you the
name and address of the consumer reporting agency that furnished the report. By
contacting that agency, you may inspect and receive a copy of the report.
OUR PURPOSE - Part of our basic Company purpose is to provide insurance at the
lowest possible cost. The underwriting process is necessary both to assure this
low cost and to make sure that each policyholder contributes his or her fair
share of the cost. The procedures described above benefit you as a policyholder,
because they assist us in providing your insurance at the lowest possible cost.
N148-9000
<PAGE>
Adult
[LOGO OF MASSMUTUAL APPEARS HERE] Form
Application
Part 2 (A50GE) - General Version
This application may be completed for all products when the Proposed Insured's
insurance age is 16 years or older. (Use Juvenile Form Part 2, A55, for ages 0
through 15.)
- --------------------------------------------------------------------------------
Contents
Part 2 of Application:
. For use by an Authorized Agent with Non-Medical Privilege
. For use by an Authorized Examiner
- --------------------------------------------------------------------------------
See additional information on reverse side
Massachusetts Mutual Life Insurance Company and affiliated insurance companies
Springfield MA 01111-0001
A50GE197
<PAGE>
There is a direct relationship between providing complete and accurate medical
history and facilitating the underwriting and issue cycle so that clients
receive the best possible service.
Avoid The Common Reasons For Delays In Processing
================================================================================
1. If amount limits, underwriting requirements, etc. qualify the Proposed
Insured non-medically, do not have the client examined.
2. Answer all questions completely -
. Ensure that all required questions are answered. Don't skip any "yes/no"
questions.
. Fully describe all medical history and findings.
. A history should be described thoroughly but concisely so that the "who,
what, when and why" are clear to the reader.
. When the Proposed Insured is unclear as to the specifics, try to include
as much information as possible, particularly as to the relevant dates,
names and addresses of physicians, hospitals, etc.
. In "Explanatory Details and Remarks," reference to the precise "Question
-------
Number" is important. For example, if reference is to a question with more
than one part, do not enter the Question Number as "5"; use "5c" even
though it may seem obvious which part of the question is being referred
to.
3. Ensure that all necessary signatures have been obtained (Proposed Insured,
Witness, Examiner) and, where forms require dating, the dates have been
included.
General Instructions
================================================================================
Medical
-------
. When scheduling an exam, furnish the client with the name of the
soliciting agent, agency name and number and the total amount of
insurance applied for so this information may be included by the
examiner at the bottom of page 3.
. If an examiner has not previously been authorized by the Home Office,
authorization should be obtained from the Medical Examiner's Section
of New Business before the exam is performed. Form M1300, Explanation
------
of Using Unauthorized Examiner, should also be completed.
Non-medical
-----------
. If the Proposed Insured is a member of the agent's immediate family,
the "Witness" area of the Part 2 is to be signed by the agent and
---
either the General Agent or the authorized Manager.
A50GE197
<PAGE>
APPLICATION (PART 2)
APPLICATION NO.
<TABLE>
<S> <C> <C>
To: [_] Massachusetts Mutual Life Insurance Co. [_] MML Bay State Life Insurance Co. [_] C.M. Life Insurance Co.
Springfield, Massachusetts 01111-0001 140 Garden St., Hartford, CT 06154
</TABLE>
- --------------------------------------------------------------------------------
Personal Information
- --------------------------------------------------------------------------------
In all cases, the terms "you" and "your" refer to the Proposed Insured.
1. a. Full name of Proposed Insured
First Name
[_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_]
Middle Name
[_][_][_][_][_][_][_][_][_][_][_][_][_][_]
Last Name
[_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_][_]
Suffix
[_][_][_] (e.g. Jr., III)
mo. day yr.
b. Date of Birth _______________________________________________________________
c. Client ID (If known) ________________________________________________________
d. Social Security No. [_][_][_] [_][_] [_][_][_][_]
- --------------------------------------------------------------------------------
Do not complete 2 if being medically examined.
2. a. Height in shoes ______ ft. _____ in.
b. Weight (clothed) __________ lbs.
c. Loss in weight in the past year? [_] Yes [_] No
If "Yes," Amount ________ lbs. Reason __________________________________
- --------------------------------------------------------------------------------
Age if Age at
3. Family History Living Death Cause of Death
- --------------------------------------------------------------------------------
a. Father
- --------------------------------------------------------------------------------
b. Mother
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
General Health
- --------------------------------------------------------------------------------
If "Yes" to any question, please explain in 11 below. Yes No
- --------------------------------------------------------------------------------
4. Have any of your parents, brothers or sisters:
a. had cardiovascular disease prior to age 60?............. [_] [_]
b. ever had diabetes, kidney disease, or other familial
Disorder?............................................... [_] [_]
- --------------------------------------------------------------------------------
5. a. Have you smoked cigarettes in the past 12 months?....... [_] [_]
b. If "No," have you used tobacco or nicotine in any other
form during the past 12 months?......................... [_] [_]
c. Have you used tobacco or nicotine in any form during
the past 3 years?....................................... [_] [_]
- --------------------------------------------------------------------------------
6. Have you ever received any treatment in relation to
alcoholism or use of alcohol?.............................. [_] [_]
- --------------------------------------------------------------------------------
7. Have you ever used barbiturates, narcotics, cocaine or
other controlled substances not prescribed by a physician?. [_] [_]
- --------------------------------------------------------------------------------
8. Have you applied for life or health insurance and been
declined, postponed, rated or restricted in the last
ten years?................................................. [_] [_]
- --------------------------------------------------------------------------------
9. Have you ever requested or received a pension, benefits,
or payment because of an injury, sickness or disability?... [_] [_]
- --------------------------------------------------------------------------------
10. Have you been treated for, or been diagnosed by a member
of the medical profession as having, a deficiency of the
immune system such as acquired immune deficiency syndrome
(AIDS) or AIDS related complex (ARC)?...................... [_] [_]
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
11. COMPLETE 11 FOR EACH "YES" ANSWER IN 4 - 10 ABOVE
- --------------------------------------------------------------------------------
Question
Number Explanatory Details and Remarks
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
A50GE197
<PAGE>
Page 2
APPLICATION NO.
- --------------------------------------------------------------------------------
Medical History
- --------------------------------------------------------------------------------
Complete 29 Below For Each Medical History Checked in 12 - 27
For Questions 12 - 27, have you ever been advised of, treated for, or had any
known indication of:
- --------------------------------------------------------------------------------
12. ASTHMA OR BRONCHITIS
[_] Not Applicable
Type:
a - [_] Asthma
b - [_] Bronchitis
c - [_] Chronic Bronchitis
d - [_] Other ______________________
(specify)
Yes No
[_] [_] Wheezing between acute attacks?
[_] [_] Are the symptoms continuing?
- --------------------------------------------------------------------------------
13. ARTHRITIS
[_] Not Applicable
Type:
a - [_] Degenerative/Osteoarthritis
b - [_] Rheumatoid
c - [_] Gouty
d - [_] Other ______________________
(specify)
Bones or joints involved _________________
__________________________________________
- --------------------------------------------------------------------------------
14. ULCER
[_] Not Applicable
Type:
a - [_] Duodenal
b - [_] Gastric (stomach)
c - [_] Other ______________________
(specify)
Yes No
[_] [_] Have you had a bleeding ulcer?
[_] [_] Do you now have symptoms?
[_] [_] Was surgery required?
- --------------------------------------------------------------------------------
15. COLITIS OR ILEITIS
[_] Not Applicable
Type:
a - [_] Spastic or Mucous Colitis
b - [_] Ulcerative Colitis
c - [_] Crohn's Disease (Ileitis)
d - [_] Other ______________________
(specify)
Yes No
[_] [_] Was there associated bleeding?
[_] [_] Do you now have symptoms?
- --------------------------------------------------------------------------------
16. CYSTS
[_] Not Applicable
a - Type: ________________________________
(specify)
[_] Check here if removed
Pathology:
[_] Benign (non cancerous)
[_] Malignant (cancerous)
b - Type: ________________________________
(specify)
[_] Check here if removed
Pathology:
[_] Benign (non cancerous)
[_] Malignant (cancerous)
- --------------------------------------------------------------------------------
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------------------
17. Disorder of:
<S> <C> <C> <C> <C>
a-[_] Eyes b-[_] Ears c-[_] Nose d-[_] Throat e-[_] None of These
- ------------------------------------------------------------------------------------------------------------------------------------
18. a-[_] Spine c-[_] Back e-[_] Muscles g-[_] Joints
b-[_] Bones d-[_] Neck f-[_] Nerves (incl. Neuritis) h-[_] None of These
- ------------------------------------------------------------------------------------------------------------------------------------
19. a-[_] Fainting c-[_] Convulsions e-[_] Recurrent Headache g-[_] Nervous Disorder
b-[_] Dizziness d-[_] Paralysis f-[_] Stroke h-[_] Mental Disorder i-[_] None of These
- ------------------------------------------------------------------------------------------------------------------------------------
20. a-[_] Pneumonia d-[_] Pleurisy g-[_] Persistent Hoarseness
b-[_] Emphysema e-[_] Shortness of Breath h-[_] Chronic Respiratory i-[_] None of These
c-[_] Tuberculosis f-[_] Persistent Cough Disorder
- ------------------------------------------------------------------------------------------------------------------------------------
21. a-[_] High Blood Pressure c-[_] Heart Murmur e-[_] Heart Attack g-[_] Blood Vessel Disorder
b-[_] Rheumatic Fever d-[_] Palpitation f-[_] Chest Pain h-[_] Heart Disorder i-[_] None of These
- ------------------------------------------------------------------------------------------------------------------------------------
22. a-[_] Hemorrhoids d-[_] Anorexia Nervosa g-[_] Recurrent Indigestion j-[_] Intestinal Disorder
b-[_] Hepatitis e-[_] Bulimia h-[_] Stomach Disorder k-[_] Gallbladder Disorder
c-[_] Diverticulitis f-[_] Liver Disorder i-[_] Recurrent Diarrhea l-[_] Intestinal Bleeding m-[_] None of These
- ------------------------------------------------------------------------------------------------------------------------------------
23. a-[_] Kidney Stone d-[_] Sugar in Urine g-[_] Kidney Disorder i-[_] Pus in Urine
b-[_] Albumin in Urine e-[_] Prostate Disorder h-[_] Reproductive System j-[_] Sexually Transmitted
c-[_] Blood in Urine f-[_] Bladder Disorder Disorder Disease k-[_] None of These
- ------------------------------------------------------------------------------------------------------------------------------------
24. a-[_] Diabetes b-[_] Thyroid Disorder c-[_] Endocrine (glandular) Disorder d-[_] None of These
- ------------------------------------------------------------------------------------------------------------------------------------
25. a-[_] Allergies c-[_] Leukemia e-[_] Congenital Disorder g-[_] None of These
b-[_] Anemia d-[_] Blood Disorder f-[_] Recurrent Infections
- ------------------------------------------------------------------------------------------------------------------------------------
26. a-[_] Sciatica c-[_] Lameness e-[_] Amputation g-[_] None of These
b-[_] Gout d-[_] Deformity f-[_] Speech Defect
- ------------------------------------------------------------------------------------------------------------------------------------
27. a-[_] Skin Cancer c-[_] Cancer e-[_] Tumor
b-[_] Fibroids d-[_] Skin Disorder f-[_] Lymph Gland Disorder g-[_] None of These
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
- --------------------------------------------------------------------------------
Other Medical Information and Details
- --------------------------------------------------------------------------------
28. Other than previously stated in this application, within the last five years
------------------------------------------------
have you: Yes No
a. Had any mental or physical disorder?.......................... [_] [_]
b. Had a consultation, surgery, or injury requiring treatment
by a physician, hospital or other medical facility?........... [_] [_]
c. Had any electrocardiogram, x-ray or other diagnostic test?.... [_] [_]
d. Been advised to have medical treatment, diagnostic tests,
hospitalization or surgery which was not completed;
or are you now planning to seek such advice or treatment?..... [_] [_]
e. Been, or are you currently, under treatment or taking
any medication?............................................... [_] [_]
For each item checked "Yes," enter details in 29.
A50GE197
<PAGE>
<TABLE>
<S> <C>
APPLICATION NO.
- ------------------------------------------------------------------------------------------------------------------------------------
COMPLETE 29 FOR EACH APPROPRIATE ITEM CHECKED IN 12 - 28 ABOVE
- ------------------------------------------------------------------------------------------------------------------------------------
29. Explanatory Details and Remarks for Medical History (Use form A51 for additional histories).
- ------------------------------------------------------------------------------------------------------------------------------------
A. Ques. Medication/ Still Under # of Attacks/ Dates (mo/yr)
No. Diagnosis Treatment Treatment Occurrences Onset Recovery
---------------------------------------------------------------------------------------------------------------------------------
[_]Yes [_]No
------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
Physician / Medical Facility Name Address ZIP
----------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
B. Ques. Medication/ Still Under # of Attacks/ Dates (mo/yr)
No. Diagnosis Treatment Treatment Occurrences Onset Recovery
---------------------------------------------------------------------------------------------------------------------------------
[_]Yes [_]No
------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
Physician / Medical Facility Name Address ZIP
----------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
C. Ques. Medication/ Still Under # of Attacks/ Dates (mo/yr)
No. Diagnosis Treatment Treatment Occurrences Onset Recovery
---------------------------------------------------------------------------------------------------------------------------------
[_]Yes [_]No
------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
Physician / Medical Facility Name Address ZIP
----------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
D. Ques. Medication/ Still Under # of Attacks/ Dates (mo/yr)
No. Diagnosis Treatment Treatment Occurrences Onset Recovery
---------------------------------------------------------------------------------------------------------------------------------
[_]Yes [_]No
------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
Physician / Medical Facility Name Address ZIP
----------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
30. Personal Physician Information
a. [_] Name / Address given in: [_] 29A [_] 29B [_] 29C [_] 29D b. Reason you last consulted this physician
[_] Have no personal physician [_] As indicated in: [_] 29A [_] 29B [_] 29C [_] 29D
[_] Other - give Personal Physician Name / Address here: [_] Routine or General Exam - all findings normal
[_] Other - give details here:
Physician Name
Date Last Seen
- ---------------------------------------------------------------------- ----------------------------------------
Address Diagnosis or
Reason Last Seen
- ---------------------------------------------------------------------- --------------------------------------
City State ZIP Medication/
Treatment
- ---------------------------------------------------------------------- ---------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
Agreement and Signatures
I agree that: (1) this application consists of Parts 1 and 2 and any amendments and supplements which shall be attached to the
policy if issued and (2) no knowledge on the part of any agent, medical examiner or any other person as to any facts pertaining to
me shall be considered as having been made to or brought to the knowledge of the Company unless stated in either Part 1 or part 2
of this application or any amendments or supplements. To the best of my knowledge and belief, all information is complete and true
and was correctly recorded before I signed my name below.
Signed at on , 19
--------------------------------------------------------------- ------------------------- --------------
city state date
Witness Proposed Insured
----------------------------------------------- ------------------------------------------------------
Medical Examiner - or Agent if Non-Medical
- ------------------------------------------------------------------------------------------------------------------------------------
A50GE197
Amount Agency Agency Printed Name
Applied For $ Name No. of Agent
------------------------ ------------------------- ------------------- --------------------------------
</TABLE>
<PAGE>
APPLICATION NO.
MEDICAL EXAMINER'S REPORT
EXAMINATION TO BE MADE IN PRIVATE AND THIS BLANK TO BE COMPLETED BY THE MEDICAL
EXAMINER IN HIS OR HER HANDWRITING
- --------------------------------------------------------------------------------
1. A. Height in shoes ft. in.
----------- ----------
B. Weight (clothed) lbs.
-------------
C. Loss in weight the past year [_] Yes [_] No
If "Yes", Amount lbs. Reason
-------- -------------------------------
- --------------------------------------------------------------------------------
2. BLOOD PRESSURE (sitting):
If first reading over 140/90 or under 110/70, make two additional readings.
----------------------------------------------------
Systolic
----------------------------------------------------
Diastolic (fifth phase)
- --------------------------------------------------------------------------------
3. PULSE:
At Rest After Exercise 3 Minutes Later
Rate
----------------------------------------------------
Irregularities per min.
- --------------------------------------------------------------------------------
4. HEART: Is there any
Enlargement [_] Yes [_] No Dyspnea [_] Yes [_] No
Murmur(s) [_] Yes [_] No Edema [_] Yes [_] No
(Describe below - if more than one, describe separately)
-----------------
Location Murmur Murmur
1. 2. Indicate:
-----------------
Frequency:
- Constant [_] [_]
- Inconstant [_] [_] Apex by X.
Transmission: [GRAPHIC
- Transmitted [_] [_] OF RIBCAGE
- Localized [_] [_] Murmur area by O. APPEARS HERE]
Timing: Point of greatest
- Systolic [_] [_] intensity by M.
- Diastolic [_] [_]
- Presystolic [_] [_] Transmission by
Grade:
- Soft (Gr. 1 - 2) [_] [_] Based on the history and examination,
- Mod. (Gr. 3 - 4) [_] [_] what is your impression?
- Loud (Gr. 5 - 6) [_] [_]
After exercise characteristics:
- Increased [_] [_]
- Absent [_] [_]
- Unchanged [_] [_]
- Decreased [_] [_]
- --------------------------------------------------------------------------------
5. Is there on examination any abnormality of the following:
<TABLE>
<CAPTION>
(Circle applicable items and give details) Yes No
<S> <C> <C>
A. Head; eyes; ears; nose; mouth; pharynx? ......................................... [_] [_]
B. Skin (incl. scars); lymph nodes; varicose veins or peripheral arteries? ......... [_] [_]
C. Nervous system (include reoexes, gait, paralysis)? .............................. [_] [_]
D. Lungs? .......................................................................... [_] [_]
E. Abdomen (include scars)? ........................................................ [_] [_]
F. Genitourinary system? ........................................................... [_] [_]
G. Endocrine system (include thyroid and breasts)? ................................. [_] [_]
H. Musculoskeletal system (include spine, joints, amputations, deformities)? ....... [_] [_]
- ------------------------------------------------------------------------------------------------------
6. A. Are there any hernias? .......................................................... [_] [_]
B. Any hemorrhoids (by history or observation)? .................................... [_] [_]
- ------------------------------------------------------------------------------------------------------
7. Are you aware of or do you suspect any other medical, alcoholic or drug history? .... [_] [_]
(A confidential report may be sent to the Medical Director.)
- ------------------------------------------------------------------------------------------------------
A urinalysis must be performed unless a specimen is being sent.
8. URINALYSIS: Albumin Sugar
If albumin or sugar is found, or the blood pressure is over 140/90, or if there is a history
of genitourinary disease, diabetes or hypertension, a specimen should be mailed to the
designated lab facility. Is a specimen being sent to the designated lab facility? ... [_] [_]
- ------------------------------------------------------------------------------------------------------
9. Have you drawn blood or completed an EKG or X-ray on the Proposed Insured?
[_] Drawn Blood [_] EKG [_] X-ray
- ------------------------------------------------------------------------------------------------------
</TABLE>
10. Details of "yes" answers and supplementary remarks. Identify them by
question number.
- --------------------------------------------------------------------------------
Ques. No. Comments
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
Place lab ID slip } [BAR CODE APPEARS HERE]
bar code label here }
}
- --------------------------------------------------------------------------------
<TABLE>
<S> <C>
Do you know the Proposed Insured? [_] Yes [_] No Are you related? [_] Yes [_] No
I have reviewed the history and examined the Proposed Insured in private and witnessed his/her
signature at [_] My office [_] Proposed Insured's place of business
[_] Proposed Insured's residence [_]
-------------------------------------
on this day of , 19 at o'clock M.
-------------- ------------- -------- -------- -----
</TABLE>
- ----------------------------------------------------
Printed Name or Paramedical Facility (if used)
M.D.
- -----------------------------------------------
Signature of Medical Examiner
M.D.
- -----------------------------------------------
Printed Name of Medical Examiner
- --------------------------------------------------------------------------------
Confidential information should be forwarded on separate copy to:
Medical Director, Massachusetts Mutual Life Insurance Company,
Springfield, Massachusetts 01111
A59GE197
<PAGE>
EXHIBIT 99.B.
(MASSMUTUAL LETTERHEAD)
April 3, 1998
C.M. Life Insurance Company
140 Garden Street
Hartford, CT 06154
RE: Registration Statement
filed on Form S-6
Ladies and Gentlemen:
This opinion is furnished in connection with the filing of Registration
Statement under the Securities Act of 1933 for C.M. Life Insurance Company's
("C.M. Life") Flexible Premium Adjustable Variable Life Insurance Policies (the
"Policies"). C.M. Life Variable Life Separate Account I issues the Policies.
As 2nd Vice President & Associate General Counsel of Massachusetts Mutual Life
Insurance Company, I provide legal advice to C.M. Life in connection with the
operation of its variable products. In such role I am familiar with the filing
for the Policies. In so acting, I have made such examination of the law and
examined such records and documents as in my judgment are necessary or
appropriate to enable me to render the opinion expressed below. I am of the
following opinion:
1. C.M. Life is a valid and subsisting corporation, organized and operated under
the laws of the state of Connecticut and is subject to regulation by the
Connecticut Commissioner of Insurance.
2. C.M. Life Variable Life Separate Account I is a separate account validly
established and maintained by C.M. Life in accordance with Connecticut law.
3. All of the prescribed corporate procedures for the issuance of the Policies
have been followed, and all applicable state laws have been complied with.
I hereby consent to the use of this opinion as an exhibit to this filing.
Very truly yours,
/s/ Richard M. Howe
- ------------------------
Richard M. Howe
2nd Vice President & Associate General Counsel
Massachusetts Mutual Life Insurance Company
<PAGE>
EXHIBIT 99.F.
(MASSMUTUAL LETTERHEAD)
April 3, 1998
C.M. Life Insurance Company
140 Garden Street
Hartford, CT 06154
Ladies and Gentlemen:
This opinion is furnished in connection with Registration Statement for C.M.
Life Insurance Company's Flexible Premium Adjustable Variable Life Insurance
Policies (the "Policies") under the Securities Act of 1933. The prospectus
included in the filing describes the Policies. I am familiar with the forms of
the Policies and the prospectus.
In my opinion, the illustrations of benefits under the Policies included in the
section entitled "Illustrations" in Appendix A of the prospectus, based on the
assumptions stated in the illustrations, are consistent with the provisions of
the respective forms of the Policies. The age selected in the illustrations is
representative of the manner in which the Policies operate.
I hereby consent to the use of this opinion as an exhibit to Registration
Statement filing and to the reference of my name under the heading "Experts" in
the prospectus.
Sincerely,
/s/ Craig Waddington
- -------------------------
Craig Waddington, FSA, MAAA
Vice President and Actuary
