1
General POLICY NUMBER:
American
LIFE INSURANCE COMPANY 16,000,001
13045 TESSON FERRY RD.
ST. LOUIS, MISSOURI 63128 INSURED:
John Doe
FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE
PARTICIPATING
Flexible Premiums are payable during the lifetime of the Insured to Attained
Age 100. If the Insured dies while this policy is in force, we will pay the
policy proceeds to the beneficiary. We must receive proof of the Insured's
death. The policy must also be surrendered to us after death occurs. Any
payment will be subject to all of the provisions and conditions on this and
the following pages of this policy.
THE AMOUNT OF THE DEATH BENEFIT OR THE DURATION OF THE DEATH BENEFIT MAY
INCREASE OR DECREASE UNDER THE CONDITIONS DESCRIBED ON PAGES 4.01 AND 4.02.
THE POLICY'S CASH VALUE IN EACH INVESTMENT DIVISION OF THE SEPARATE ACCOUNT
IS BASED ON THE INVESTMENT EXPERIENCE OF THAT INVESTMENT DIVISION AND MAY
INCREASE OR DECREASE DAILY. IT IS NOT GUARANTEED AS TO DOLLAR AMOUNT. SEE THE
SEPARATE ACCOUNT PROVISION.
THE POLICY'S CASH VALUE IN THE GENERAL ACCOUNT WILL BE CREDITED WITH INTEREST
AT A MINIMUM GUARANTEED RATE AS SHOWN ON THE POLICY SPECIFICATIONS PAGE. WE
MAY CREDIT ADDITIONAL INTEREST IN EXCESS OF THE GUARANTEED RATE. SEE THE
GENERAL ACCOUNT CASH VALUE PROVISION.
RIGHT TO EXAMINE POLICY
Please read this policy. You may return this policy to us or to the agent
through whom it was purchased within 20 days from the date you receive it or
within 45 days after the application is signed, whichever period ends later.
If you return it within this period, the policy will be void from the
beginning. We will refund any premium paid.
This policy is a legal contract between the policyowner and General American.
PLEASE READ YOUR CONTRACT CAREFULLY. This cover sheet provides only a brief
outline of some of the important features of your policy. This cover sheet is
not the complete insurance contract and only the actual policy provisions
will control. The policy itself sets forth, in detail, the rights and
obligations of both you and your insurance company. IT IS, THEREFORE,
IMPORTANT THAT YOU READ YOUR POLICY.
Signed for the company at its Home Office, St. Louis, Missouri 63128.
(1-800-638-9294)
/s/ Robert J. Banstetter /s/ Richard A. Liddy
V.P., GENERAL COUNSEL CHAIRMAN, PRESIDENT
AND SECRETARY AND CEO
100016 0.01
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2
ALPHABETIC GUIDE TO YOUR CONTRACT
Page
3.07 Addition, Deletion or Substitution
of Investments
4.04 Allocation of Net Premiums
3.04 Assignments
6.09 Basis of Computation
3.02 Beneficiary
6.06 Cash Surrender Value
6.02 Cash Values
4.02 Change in Contract Type
4.02 Change in Face Amount
3.05 Change of Insured
3.04 Change of Owner or Beneficiary
3.04 Claims of Creditors
3.04 Conformity with Statutes
4.01 Death Benefit
3.01 Definitions
6.01 Dividends
6.01 Dividend Options
6.02 General Account Cash Value
6.03 General Account Interest Rate
4.04 Grace Period
3.05 Incontestability
7.01 Interest on Proceeds
3.01 Issue Date
6.05 Loan Account Cash Value
Page
6.01 Loans
3.05 Misstatement of Age or Sex and
Corrections
6.05 Monthly Cost of Insurance
6.06 Monthly Deduction
6.06 Monthly Policy Charge
6.04 Net Investment Factor
4.03 Net Premium
3.02 Owner
6.07 Partial Withdrawals
7.01 Payment of Policy Benefits
4.03 Payment of Premiums
4.02 Policy Changes
4.01 Policy Proceeds
6.09 Postponement of Payments
or Transfers
4.05 Reinstatement
3.04 Requests for Changes and/or
Information
6.03 Separate Account Cash Value
3.06 Separate Account Provisions
3.04 Statements in Application
3.05 Suicide Exclusion
6.07 Surrender
3.07 Transfers
Additional Benefit Riders, Modifications and Amendments, if any, and a Copy
of the Application are found following the final section.
NOTICE OF ANNUAL MEETING
The annual meeting for the election of directors and the transaction of other
business for General American Mutual Holding Company is held each year at its
Home Office in St. Louis, Missouri. This meeting is at 11:00 a.m. on the
fourth Thursday in April. General American Mutual Holding Company is a mutual
company owned by its members. Each member is entitled to vote at such
elections and to participate in such meetings.
100016 0.02
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3
1. POLICY SPECIFICATIONS
GENERAL POLICY SPECIFICATIONS
INSURED [JOHN DOE]
POLICY NUMBER [16,000,001]
ISSUE DATE [JANUARY 1, 1998]
FACE AMOUNT [$50,000]
CONTRACT TYPE [OPTION A]
INSURED AGE [35]
SEX [MALE]
RISK CLASSIFICATION [STANDARD
SMOKER]
INITIAL PREMIUM PAID [$732.50]
PLANNED ANNUAL PREMIUM [$732.50]
MINIMUM INITIAL ANNUAL PREMIUM AMOUNT [$732.50]
QUALIFIED ROLLOVER PREMIUM [$0.00]
TARGET PREMIUM [$425.00]
TARGET PREMIUM (BASE ONLY) [$425.00]
NO LAPSE ANNUAL PREMIUM [$732.50]
NO LAPSE PREMIUM DATE [JANUARY 1, 2003]
PREMIUM TAX CHARGE [2%]
FEDERAL TAX CHARGE [1.3%]
MAXIMUM PERCENT OF PREMIUM CHARGE -
1st YEAR: UP TO TARGET PREMIUM [15%]
ABOVE TARGET PREMIUM [5%]
QUALIFIED ROLLOVER PREMIUM [0%]
YEARS 2-10 [5%]
YEARS 11+ [2%]
FORM BENEFITS - AS SPECIFIED IN POLICY
NUMBERS AND IN ANY RIDER
POLICY PLAN: FLEXIBLE PREMIUM VARIABLE
LIFE INSURANCE
100016
11202
11203
11204
11205
103014
104008
106006
00780
11202 1.01
4
2. POLICY SPECIFICATIONS
GENERAL ACCOUNT CASH VALUE
GUARANTEED INTEREST RATE [4%]
GENERAL ACCOUNT MAXIMUM
ALLOCATION PERCENT [100%]
GENERAL ACCOUNT MAXIMUM
WITHDRAWAL PERCENT LIMIT [25%]
MAXIMUM MONTHLY COST OF
INSURANCE FACTOR [1.0032737]
MAXIMUM DAILY MORTALITY AND
EXPENSE RISK PERCENTAGE:
YEARS 1-10 [0.0015027%]
YEARS 11-20 [0.0012301%]
YEARS 21+ [0.0009572%]
MAXIMUM ANNUAL MORTALITY AND EXPENSE
RISK PERCENTAGE:
YEARS 1-10 [0.55%]
YEARS 11-20 [0.45%]
YEARS 21+ [0.35%]
MAXIMUM MONTHLY POLICY CHARGE:
1ST YEAR [$25.00]
YEARS 2+ [$6.00]
MAXIMUM SELECTION AND ISSUE
EXPENSE CHARGE RATE:
YEARS 1-10 [$1.05]
YEARS 11+ [$0]
MINIMUM FACE AMOUNT [$50,000]
MINIMUM FACE AMOUNT INCREASE [$5,000]
MINIMUM FACE AMOUNT DECREASE [$5,000]
MAXIMUM FEE FOR PROJECTION OF [$25.00]
BENEFITS AND VALUES
MAXIMUM TRANSFER CHARGE [$25.00]
GUARANTEED INTEREST RATE ON [4.0%]
PROCEEDS
7702 TABLE [1980 CSO MORTALITY TABLE
FOR A MALE SMOKER,
AGE NEAREST BIRTHDAY]
BASIS OF COMPUTATION OF MINIMUM [1980 CSO MORTALITY TABLE
CASH VALUES FOR A MALE SMOKER,
AGE NEAREST BIRTHDAY]
IF THE INITIAL PREMIUM PAID AND SUBSEQUENT PREMIUMS PROVE TO BE TOO LOW,
COVERAGE PROVIDED BY THIS POLICY MAY CEASE.
11202 1.02
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SURRENDER CHARGE SCHEDULE
INSURED JOHN DOE POLICY NUMBER 16,000,001
FACE AMOUNT $50,000 COVERAGE FPVL
TARGET PREMIUM (Base Only) $425.00 EFFECTIVE DATE JANUARY 1, 1998
MAXIMUM MAXIMUM
POLICY SURRENDER POLICY SURRENDER
MONTH CHARGE MONTH CHARGE
1-60 45.00% 91 24.17%
61 44.58% 92 23.33%
62 44.17% 93 22.50%
63 43.75% 94 21.67%
64 43.33% 95 20.83%
65 42.92% 96 20.00%
66 42.50% 97 19.17%
67 42.08% 98 18.33%
68 41.67% 99 17.50%
69 41.25% 100 16.67%
70 40.83% 101 15.83%
71 40.42% 102 15.00%
72 40.00% 103 14.17%
73 39.17% 104 13.33%
74 38.33% 105 12.50%
75 37.50% 106 11.67%
76 36.67% 107 10.83%
77 35.83% 108 10.00%
78 35.00% 109 9.17%
79 34.17% 110 8.33%
80 33.33% 111 7.50%
81 32.50% 112 6.67%
82 31.67% 113 5.83%
83 30.83% 114 5.00%
84 30.00% 115 4.17%
85 29.17% 116 3.33%
86 28.33% 117 2.50%
87 27.50% 118 1.67%
88 26.67% 119 0.83%
89 25.83% 120 0.00%
90 25.00%
11203
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TABLE OF GUARANTEED MONTHLY COST OF INSURANCE RATES
RATES ARE PER $1,000
COVERAGE: FPVL INSURED: JOHN DOE
POLICY NUMBER: 16,000,001 ISSUE DATE: JANUARY 1, 1998
ATTAINED AGE RATE ATTAINED AGE RATE ATTAINED AGE RATE
35 0.22 57 1.51 79 9.46
36 0.23 58 1.64 80 10.13
37 0.25 59 1.78 81 10.87
38 0.28 60 1.93 82 11.68
39 0.30 61 2.11 83 12.59
40 0.33 62 2.30 84 13.54
41 0.36 63 2.52 85 14.52
42 0.40 64 2.76 86 15.48
43 0.44 65 3.02 87 16.42
44 0.48 66 3.30 88 17.45
45 0.52 67 3.58 89 18.46
46 0.57 68 3.88 90 19.47
47 0.62 69 4.19 91 20.51
48 0.67 70 4.54 92 21.61
49 0.73 71 4.92 93 23.03
50 0.80 72 5.36 94 24.85
51 0.87 73 5.85 95 27.50
52 0.95 74 6.39 96 32.05
53 1.05 75 6.98 97 40.02
54 1.15 76 7.59 98 54.83
55 1.26 77 8.21 99 83.33
56 1.38 78 8.83 100+ 0.00
THESE RATES ARE FOR THE BASE POLICY AT ISSUE. THEY ARE BASED ON THE 1980
COMMISSIONERS STANDARD ORDINARY MORTALITY TABLE FOR A MALE SMOKER.
11204
7
DEATH BENEFIT OPTION C ATTAINED AGE FACTORS
COVERAGE: FPVL INSURED: JOHN DOE
POLICY NUMBER: 16,000,001 ISSUE DATE: JANUARY 1, 1998
ATTAINED ATTAINED ATTAINED
AGE RATE AGE RATE AGE RATE
35 5.64184 57 2.45952 79 1.33835
36 5.42508 58 2.37604 80 1.31492
37 5.21686 59 2.29637 81 1.29295
38 5.01683 60 2.22033 82 1.27239
39 4.82481 61 2.14774 83 1.25326
40 4.64044 62 2.07858 84 1.23556
41 4.46354 63 2.01279 85 1.21935
42 4.29389 64 1.95040 86 1.20433
43 4.13112 65 1.89131 87 1.19047
44 3.97514 66 1.83546 88 1.17738
45 3.82557 67 1.78261 89 1.16503
46 3.68227 68 1.73259 90 1.15300
47 3.54498 69 1.68510 91 1.14119
48 3.41344 70 1.64002 92 1.12932
49 3.28747 71 1.59723 93 1.11709
50 3.16694 72 1.55674 94 1.10423
51 3.05154 73 1.51862 95 1.09045
52 2.94120 74 1.48292 96 1.07580
53 2.83570 75 1.44965 97 1.06037
54 2.73495 76 1.41875 98 1.04422
55 2.63880 77 1.39005 99 1.02648
56 2.54704 78 1.36333 100+ 1.01000
11205
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1. DEFINITIONS IN THIS POLICY
WE, US AND OUR GENERAL AMERICAN LIFE INSURANCE COMPANY.
YOU AND YOUR THE OWNER OF THIS POLICY. THE OWNER MAY BE SOMEONE OTHER THAN THE INSURED.
IN THE APPLICATION THE WORDS "YOU" AND "YOUR" REFER TO THE PROPOSED INSURED
PERSON(S).
INSURED THE PERSON WHOSE LIFE IS INSURED UNDER THIS POLICY. SEE THE POLICY
SPECIFICATIONS PAGE.
ISSUE AGE THE AGE OF EACH INSURED AS OF HIS OR HER NEAREST BIRTHDAY TO THE ISSUE DATE.
ATTAINED AGE THE ISSUE AGE PLUS THE NUMBER OF COMPLETED POLICY YEARS. THIS INCLUDES ANY PERIOD DURING
WHICH THIS POLICY WAS LAPSED.
ISSUE DATE THE EFFECTIVE DATE OF THE COVERAGE UNDER THIS POLICY WHICH IS THE ISSUE DATE SHOWN
ON THE POLICY SPECIFICATIONS PAGE. IT IS ALSO THE DATE FROM WHICH POLICY
ANNIVERSARIES, POLICY YEARS, AND POLICY MONTHS ARE MEASURED.
INVESTMENT THE DATE THE FIRST PREMIUM IS APPLIED TO THE GENERAL ACCOUNT AND/OR THE DIVISIONS
START DATE OF SEPARATE ACCOUNT ELEVEN. THIS DATE WILL BE THE LATER OF:
- THE ISSUE DATE OF THE POLICY; OR
- THE DATE WE RECEIVE THE FIRST PREMIUM AT OUR HOME OFFICE.
MONTHLY THE SAME DATE IN EACH SUCCEEDING MONTH AS THE ISSUE DATE EXCEPT THAT WHENEVER THE
ANNIVERSARY MONTHLY ANNIVERSARY FALLS ON A DATE OTHER THAN A VALUATION DATE, THE MONTHLY
ANNIVERSARY WILL BE DEEMED THE NEXT VALUATION DATE. IF ANY MONTHLY ANNIVERSARY
WOULD BE THE 29TH, 30TH, OR 31ST DAY OF A MONTH THAT DOES NOT HAVE THAT NUMBER OF
DAYS, THEN THE MONTHLY ANNIVERSARY WILL BE THE LAST DAY OF THAT MONTH.
GENERAL ACCOUNT THE ASSETS HELD BY US, EXCLUDING ANY LOANS, OTHER THAN THOSE ALLOCATED TO THE
DIVISIONS OF SEPARATE ACCOUNT ELEVEN OR ANY OTHER SEPARATE ACCOUNT.
SEPARATE ACCOUNT SEPARATE ACCOUNT ELEVEN, A SEPARATE INVESTMENT ACCOUNT CREATED BY US TO RECEIVE AND
INVEST NET PREMIUMS RECEIVED FOR THIS POLICY OR OTHER POLICIES.
LOAN ACCOUNT THE ACCOUNT TO WHICH WE WILL TRANSFER FROM THE GENERAL ACCOUNT AND THE DIVISIONS OF
SEPARATE ACCOUNT ELEVEN THE AMOUNT OF ANY POLICY LOAN.
LOAN SUBACCOUNT A LOAN SUBACCOUNT EXISTS FOR THE GENERAL ACCOUNT AND EACH DIVISION OF SEPARATE
ACCOUNT ELEVEN. ANY CASH VALUE TRANSFERRED TO THE LOAN ACCOUNT WILL BE ALLOCATED TO
THE APPROPRIATE LOAN SUBACCOUNT TO REFLECT THE ORIGIN OF THE CASH VALUE. AT ANY
POINT IN TIME, THE LOAN ACCOUNT WILL EQUAL THE SUM OF ALL THE LOAN SUBACCOUNTS.
VALUATION DATE EACH DAY THAT THE NEW YORK STOCK EXCHANGE IS OPEN FOR TRADING, WE ARE OPEN FOR
BUSINESS AND THE SEC HAS NOT RESTRICTED TRADING OR DECLARED AN EMERGENCY.
SEC THE UNITED STATES SECURITIES AND EXCHANGE COMMISSION.
103014 3.01
(6/98)
9
2. PERSONS WITH AN INTEREST IN THE POLICY
OWNER THE OWNER OF THIS POLICY IS AS SHOWN IN THE APPLICATION OR IN ANY SUPPLEMENTAL
AGREEMENT ATTACHED TO THIS POLICY, UNLESS LATER CHANGED AS PROVIDED IN THIS POLICY.
IF THERE IS MORE THAN ONE OWNER AT A GIVEN TIME, ALL MUST EXERCISE THE RIGHTS OF
OWNERSHIP BY JOINT ACTION. OWNERSHIP MAY BE CHANGED IN ACCORDANCE WITH THE CHANGE
OF OWNER OR BENEFICIARY PROVISION.
YOU, AS OWNER, ARE ENTITLED TO EXERCISE ALL OWNERSHIP RIGHTS PROVIDED BY THIS
POLICY, WHILE IT IS IN FORCE. ANY PERSON WHOSE RIGHTS OF OWNERSHIP DEPEND UPON SOME
FUTURE EVENT WILL NOT POSSESS ANY PRESENT RIGHTS OF OWNERSHIP. IF THE OWNER IS A
TRUSTEE(S), WE MAY ACT IN RELIANCE UPON THE WRITTEN REQUEST OF ANY TRUSTEE AND WE
ARE NOT RESPONSIBLE FOR PROPER ADMINISTRATION OF THE TRUST. UNLESS OTHERWISE
PROVIDED, THE FINAL OWNER WILL BE THE ESTATE OF THE LAST OWNER TO DIE.
BENEFICIARY THE BENEFICIARY TO RECEIVE THE PROCEEDS IN THE EVENT OF THE INSURED'S DEATH IS
AS SHOWN IN THE APPLICATION OR IN ANY SUPPLEMENTAL AGREEMENT ATTACHED TO THIS
POLICY, UNLESS LATER CHANGED AS PROVIDED IN THE POLICY. YOU MAY CHANGE THE
BENEFICIARY IN ACCORDANCE WITH THE CHANGE OF OWNER OR BENEFICIARY PROVISION. UNLESS
OTHERWISE STATED, THE BENEFICIARY HAS NO RIGHTS IN THIS POLICY BEFORE THE DEATH OF
THE INSURED. IF THERE IS MORE THAN ONE BENEFICIARY AT THE DEATH OF THE INSURED, EACH
WILL RECEIVE EQUAL PAYMENTS UNLESS OTHERWISE PROVIDED. UNLESS YOU PROVIDE OTHERWISE,
IF A BENEFICIARY DIES PRIOR TO THE INSURED'S DEATH, THAT BENEFICIARY'S SHARE WILL BE
PAID TO THE LIVING BENEFICIARIES OF THAT CLASS. THE DECEASED BENEFICIARY'S SHARE
WILL BE PAID IN THE SAME PROPORTION AS THE LIVING BENEFICIARIES' SHARES. IF THERE
ARE NO BENEFICIARIES LIVING WHEN THE INSURED DIES, OR AT THE END OF ANY COMMON
DISASTER PERIOD, THE PROCEEDS (COMMUTED IF REQUIRED) WILL BE PAYABLE TO YOU, IF YOU
ARE LIVING, OR TO YOUR ESTATE.
ANY PAYMENT WE MAKE WILL TERMINATE OUR LIABILITY WITH RESPECT TO SUCH PAYMENT. IF
THE INSURED DESIGNATES SPECIFIC AMOUNTS TO BE PAID TO SPECIFIC BENEFICIARIES AND
THE TOTAL OF THOSE AMOUNTS IS OTHER THAN THE AMOUNT OF PROCEEDS PAYABLE, THE
PROCEEDS PAYABLE WILL BE ADJUSTED AND PAID IN THE SAME PROPORTION AS THE SPECIFIC
AMOUNTS WERE TO BE PAID.
ANY TERM USED IN THE MASCULINE, FEMININE, SINGULAR OR PLURAL, WILL INCLUDE OR BE
THE OPPOSITE GENDER OR NUMBER WHERE NECESSARY.
IF ANY BENEFICIARY DESIGNATION IN THE APPLICATION INCLUDES ANY OF THE FOLLOWING
PROVISIONS, THE TERMS OF THAT PROVISION SHOWN BELOW WILL APPLY:
1. PER STIRPES. THE SHARE OF A DECEASED BENEFICIARY WILL BE PAID TO THAT
BENEFICIARY'S SURVIVING CHILDREN, EQUALLY.
2. COMMON DISASTER. WE WILL NOT MAKE PAYMENT UNTIL THE STATED NUMBER OF DAYS
AFTER THE INSURED'S DEATH. IF ANY BENEFICIARY DIES DURING THIS PERIOD,
OR IF THE ORDER OF DEATH OF ANY BENEFICIARY AND THE INSURED CANNOT BE
DETERMINED, WE WILL PAY AS THOUGH SUCH BENEFICIARY DIED FIRST.
3. TRUST FOR MINOR BENEFICIARY. THE ORIGINAL OR SUCCESSOR TRUSTEE FOR A MINOR
BENEFICIARY WILL SERVE WITHOUT BOND AND EXERCISE ALL RIGHTS AND RECEIVE
ALL PROCEEDS FOR THE MINOR BENEFICIARY. SUCH PROCEEDS WILL BE HELD IN A
SEPARATE TRUST AND USED AT THE TRUSTEE'S DISCRETION FOR SUCH MINOR'S
EDUCATION, SUPPORT, CARE AND GENERAL WELFARE. THE TRUST WILL TERMINATE
AT THE LEGAL AGE OF MAJORITY OR PRIOR DEATH OF THE MINOR BENEFICIARY.
ANY FUNDS THEN HELD BY THE TRUSTEE WILL BE PAID IN ONE SUM TO SUCH
BENEFICIARY OR THE BENEFICIARY'S ESTATE. THE TRUST CAN BE REVOKED BY A
CHANGE OF BENEFICIARY UNDER THE POLICY. PAYMENT TO ANY TRUSTEE WILL
DISCHARGE US TO THE EXTENT OF SUCH PAYMENT.
103014 3.02
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4. TRUST UNDER WILL. WHEN WE RECEIVE AT OUR HOME OFFICE:
A) CERTIFIED COPIES OF THE LAST WILL AND TESTAMENT OF THE NAMED TESTATOR;
AND
B) THE ORDER ADMITTING THE WILL TO PROBATE; AND IF SUCH WILL CREATED A
TRUST CAPABLE OF RECEIVING PROCEEDS;
THEN WE WILL PAY THE PROCEEDS TO THE TRUSTEE.
IF, BEFORE WE RECEIVE THESE DOCUMENTS, SATISFACTORY PROOF IS FURNISHED
THAT:
A) THE TESTATOR DIED INTESTATE; OR
B) THE WILL CREATED NO TRUST CAPABLE OF RECEIVING PROCEEDS; OR
C) THE TESTATOR WAS NOT THE INSURED, BUT SURVIVED THE INSURED;
THEN WE WILL PAY THE PROCEEDS TO YOU, UNLESS OTHERWISE PROVIDED.
IF WE PAY UNDER ANY OF THESE CONDITIONS, WE WILL BE DISCHARGED TO THE
EXTENT OF SUCH PAYMENT. WE ARE NOT REQUIRED TO CHECK INTO THE VALIDITY,
GENERAL TERMS OR PROPER ADMINISTRATION OF THE TRUST. SUCH TRUSTEE
DESIGNATION WILL NOT AFFECT YOUR RIGHTS UNDER THE POLICY, INCLUDING THE
RIGHT TO CHANGE THE BENEFICIARY.
5. TRUST UNDER SEPARATE WRITTEN AGREEMENT. WHEN WE RECEIVE AT OUR HOME OFFICE
A WRITTEN STATEMENT FROM THE TRUSTEE NAMED IN THE BENEFICIARY DESIGNATION
THAT:
A) THE TRUST AGREEMENT IS IN FORCE; AND
B) THE AGREEMENT PERMITS THE TRUSTEE TO RECEIVE THE PROCEEDS;
THEN WE WILL PAY THE PROCEEDS TO THE TRUSTEE.
IF, BEFORE WE RECEIVE THE TRUSTEE'S STATEMENT, SATISFACTORY PROOF IS
FURNISHED THAT:
A) THE TRUST AGREEMENT IS NOT IN EFFECT; OR
B) THE AGREEMENT DOES NOT PERMIT THE TRUSTEE TO RECEIVE THE PROCEEDS;
THEN WE WILL PAY THE PROCEEDS TO YOU, UNLESS OTHERWISE PROVIDED.
IF WE PAY UNDER ANY OF THESE CONDITIONS, WE WILL BE DISCHARGED TO THE
EXTENT OF SUCH PAYMENT. WE ARE ENTITLED TO RELY ON ANY STATEMENTS OR
DOCUMENTS FURNISHED TO US BY THE TRUSTEE AND ARE NOT REQUIRED TO CHECK
INTO THE VALIDITY, GENERAL TERMS OR PROPER ADMINISTRATION OF THE TRUST
AGREEMENT. SUCH TRUSTEE DESIGNATION WILL NOT AFFECT YOUR RIGHTS UNDER
THE POLICY, INCLUDING THE RIGHT TO CHANGE THE BENEFICIARY.
6. IRREVOCABLE BENEFICIARY. YOU CANNOT CHANGE AN IRREVOCABLE BENEFICIARY
WITHOUT THE WRITTEN CONSENT OF SUCH BENEFICIARY. ALSO, YOU CANNOT
EXERCISE ANY OTHER OWNERSHIP RIGHTS WITHOUT THE CONSENT OF SUCH
BENEFICIARY, IF THE EXERCISE OF SUCH RIGHTS WILL HAVE THE EFFECT OF
DIMINISHING THE RIGHTS AND INTEREST OF THE IRREVOCABLE BENEFICIARY.
7. CREDITOR BENEFICIARY. PROCEEDS PAYABLE TO ANY CREDITOR BENEFICIARY ARE
LIMITED TO ITS PROVABLE INTEREST. THE BALANCE OF ANY PROCEEDS WILL BE
PAID TO ANY OTHER NAMED BENEFICIARY. IF THERE IS NO OTHER BENEFICIARY
LIVING, WE WILL PAY THE PROCEEDS TO YOU, UNLESS OTHERWISE PROVIDED. YOU
CANNOT CHANGE A CREDITOR BENEFICIARY WITHOUT THE WRITTEN CONSENT OF THE
CREDITOR OR RELEASE OF ITS INTEREST. ALSO, YOU CANNOT EXERCISE ANY OTHER
OWNERSHIP RIGHTS WITHOUT THE CONSENT OF SUCH BENEFICIARY, IF THE
EXERCISE OF SUCH RIGHTS WILL HAVE THE EFFECT OF DIMINISHING THE RIGHTS
AND INTEREST OF THE CREDITOR BENEFICIARY.
103014 3.03
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11
CHANGE OF DURING THE INSURED'S LIFETIME YOU MAY CHANGE THE OWNERSHIP AND BENEFICIARY
OWNER OR DESIGNATIONS, SUBJECT TO ANY RESTRICTIONS AS STATED IN THE OWNER OR BENEFICIARY
BENEFICIARY PROVISIONS. YOU MUST MAKE THE CHANGE IN WRITTEN FORM SATISFACTORY TO US. IF
ACCEPTABLE TO US THE CHANGE WILL TAKE EFFECT AS OF THE TIME YOU SIGNED THE REQUEST,
WHETHER OR NOT THE INSURED IS LIVING WHEN WE RECEIVE YOUR REQUEST AT OUR HOME
OFFICE. THE CHANGE WILL BE SUBJECT TO ANY ASSIGNMENT OF THIS POLICY OR OTHER LEGAL
RESTRICTIONS. IT WILL ALSO BE SUBJECT TO ANY PAYMENT WE MADE OR ACTION WE TOOK
BEFORE WE RECEIVED YOUR WRITTEN NOTICE OF THE CHANGE. WE HAVE THE RIGHT TO REQUIRE THE
POLICY FOR ENDORSEMENT BEFORE WE ACCEPT THE CHANGE.
IF YOU ARE ALSO THE BENEFICIARY OF THE POLICY AT THE TIME OF THE INSURED'S DEATH, YOU
MAY DESIGNATE SOME OTHER PERSON TO RECEIVE THE PROCEEDS OF THE POLICY WITHIN 60 DAYS
AFTER THE INSURED'S DEATH.
ASSIGNMENTS WE WILL NOT BE BOUND BY AN ASSIGNMENT OF THE POLICY OR OF ANY INTEREST IN IT
UNLESS:
1. THE ASSIGNMENT IS MADE AS A WRITTEN INSTRUMENT,
2. YOU FILE THE ORIGINAL INSTRUMENT OR A CERTIFIED COPY WITH US AT OUR HOME
OFFICE, AND
3. WE SEND YOU AN ACKNOWLEDGED COPY.
WE ARE NOT RESPONSIBLE FOR DETERMINING THE VALIDITY OF ANY ASSIGNMENT.
IF A CLAIM IS BASED ON AN ASSIGNMENT, WE MAY REQUIRE PROOF OF INTEREST OF THE
CLAIMANT. A VALID ASSIGNMENT WILL TAKE PRECEDENCE OVER ANY CLAIM OF A BENEFICIARY.
REQUESTS FOR SUBMIT ALL REQUESTS FOR CHANGE AND/OR INFORMATION IN WRITING TO OUR HOME OFFICE -
CHANGES AND/OR GENERAL AMERICAN LIFE INSURANCE COMPANY, P.O. BOX 14490, ST. LOUIS, MO 63178.
INFORMATION
3. GENERAL PROVISIONS
THE CONTRACT WE HAVE ISSUED THIS POLICY IN CONSIDERATION OF THE APPLICATION AND PAYMENT OF
PREMIUMS. THE POLICY, THE APPLICATION FOR IT, ANY RIDERS AND ANY APPLICATION FOR
AN INCREASE IN FACE AMOUNT CONSTITUTE THE ENTIRE CONTRACT AND ARE ATTACHED TO AND
MADE A PART OF THE POLICY WHEN THE INSURANCE APPLIED FOR IS ACCEPTED. A COPY OF ANY
APPLICATION FOR REINSTATEMENT WILL BE SENT TO YOU FOR ATTACHMENT TO THIS POLICY AND
WILL BECOME PART OF THE CONTRACT OF REINSTATEMENT AND OF THIS POLICY. THE POLICY MAY
BE CHANGED BY MUTUAL AGREEMENT. ANY CHANGE MUST BE IN WRITING AND APPROVED BY OUR
PRESIDENT, VICE-PRESIDENT OR SECRETARY. OUR AGENTS HAVE NO AUTHORITY TO ALTER OR
MODIFY ANY TERMS, CONDITIONS, OR AGREEMENTS OF THIS POLICY, OR TO WAIVE ANY OF ITS
PROVISIONS.
CONFORMITY WITH IF ANY PROVISION IN THIS POLICY IS IN CONFLICT WITH THE LAWS OF THE STATE WHICH
STATUTES GOVERN THIS POLICY, THE PROVISION WILL BE DEEMED TO BE AMENDED TO CONFORM WITH SUCH
LAWS. IN ADDITION, WE RESERVE THE RIGHT TO CHANGE THIS POLICY IF WE DETERMINE THAT
A CHANGE IS NECESSARY TO CAUSE THIS POLICY TO COMPLY WITH, OR GIVE YOU THE BENEFIT
OF, ANY FEDERAL OR STATE STATUTE, RULE, OR REGULATION, INCLUDING, BUT NOT LIMITED
TO, REQUIREMENTS FOR LIFE INSURANCE CONTRACTS UNDER THE INTERNAL REVENUE CODE, OR
ITS REGULATIONS OR PUBLISHED RULINGS.
STATEMENTS IN ALL STATEMENTS MADE BY THE INSURED OR ON HIS OR HER BEHALF, OR BY THE APPLICANT, WILL
APPLICATION BE DEEMED REPRESENTATIONS AND NOT WARRANTIES, EXCEPT IN THE CASE OF FRAUD. MATERIAL
MISSTATEMENTS WILL NOT BE USED TO VOID THE POLICY, ANY RIDER OR ANY INCREASE IN
FACE AMOUNT OR DENY A CLAIM UNLESS MADE IN THE APPLICATION FOR A POLICY, A RIDER OR
AN INCREASE IN FACE AMOUNT.
CLAIMS OF TO THE EXTENT PERMITTED BY LAW, NEITHER THE POLICY NOR ANY PAYMENT UNDER IT WILL BE
CREDITORS SUBJECT TO THE CLAIMS OF CREDITORS OR TO ANY LEGAL PROCESS.
103014 3.04
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RIGHT TO EXAMINE YOU HAVE THE RIGHT TO REQUEST US TO CANCEL AN INCREASE IN FACE AMOUNT AND RECEIVE A
INCREASE IN PREMIUM REFUND. THE REQUEST MUST BE IN WRITING AND MUST BE MADE NO LATER THAN:
FACE AMOUNT
- 20 DAYS FROM THE DATE YOU RECEIVED THE NEW POLICY SPECIFICATIONS PAGE FOR THE
INCREASE; OR
- 45 DAYS AFTER THE DATE YOU SIGNED THE APPLICATION FOR THE INCREASE.
IF YOU DO REQUEST US TO CANCEL THE INCREASE, THE MONTHLY DEDUCTIONS ASSOCIATED WITH
THAT INCREASE WILL BE RESTORED TO THE POLICY'S CASH VALUE. THIS AMOUNT WILL BE
ALLOCATED TO THE GENERAL ACCOUNT AND THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN IN
THE SAME MANNER AS IT WAS DEDUCTED.
CONVERSION RIGHTS WHILE YOUR POLICY IS IN FORCE, YOU HAVE A ONE TIME RIGHT DURING THE FIRST TWO
POLICY YEARS TO TRANSFER ALL OF YOUR CASH VALUE FROM THE DIVISIONS OF SEPARATE
ACCOUNT ELEVEN TO THE GENERAL ACCOUNT.
IF, AT ANY TIME DURING THE FIRST TWO POLICY YEARS, YOU REQUEST IN WRITING THE
TRANSFER OF THE CASH VALUE HELD IN THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN TO THE
GENERAL ACCOUNT AND YOU INDICATE THAT YOU ARE MAKING THIS TRANSFER IN EXERCISE OF
YOUR CONVERSION RIGHTS, THE TRANSFER WILL NOT BE SUBJECT TO A TRANSFER CHARGE OR
TRANSFER LIMITS, IF ANY. AT THE TIME OF SUCH TRANSFER, THERE WILL NOT BE ANY EFFECT
ON THE POLICY'S DEATH BENEFIT, FACE AMOUNT, NET AMOUNT AT RISK, RATE CLASS OR ISSUE
AGE.
IF YOU EXERCISE YOUR ONE TIME CONVERSION RIGHT, WE WILL AUTOMATICALLY ALLOCATE ALL
FUTURE NET PREMIUMS TO THE GENERAL ACCOUNT.
MISSTATEMENT OF IF THERE IS A MISSTATEMENT OF AGE OR SEX IN THE APPLICATION, THE AMOUNT OF THE
AGE OR SEX AND DEATH BENEFIT WILL BE THAT WHICH WOULD BE PURCHASED BY THE MOST RECENT MONTHLY
CORRECTIONS COST OF INSURANCE CHARGE AT THE CORRECT AGE OR SEX.
IF WE MAKE ANY PAYMENT OR POLICY CHANGES IN GOOD FAITH, RELYING ON OUR RECORDS, OR
EVIDENCE SUPPLIED TO US, OUR DUTY WILL BE FULLY DISCHARGED. WE RESERVE THE RIGHT TO
CORRECT ANY ERRORS IN THE POLICY.
INCONTESTABILITY WE CANNOT CONTEST THIS POLICY AFTER IT HAS BEEN IN FORCE DURING THE LIFETIME OF
THE INSURED FOR TWO YEARS FROM ITS ISSUE DATE. WE CANNOT CONTEST AN INCREASE IN
FACE AMOUNT WITH REGARD TO MATERIAL MISSTATEMENTS MADE CONCERNING SUCH INCREASE
AFTER IT HAS BEEN IN FORCE DURING THE LIFETIME OF THE INSURED FOR TWO YEARS FROM
ITS EFFECTIVE DATE. WE CANNOT CONTEST ANY REINSTATEMENT OF THIS POLICY, WITH REGARD
TO MATERIAL MISSTATEMENTS MADE CONCERNING SUCH REINSTATEMENT, AFTER IT HAS BEEN IN
FORCE DURING THE LIFETIME OF THE INSURED FOR A PERIOD OF TWO YEARS FROM THE DATE WE
APPROVE THE REINSTATEMENT. THIS PROVISION WILL NOT APPLY TO ANY RIDER WHICH CONTAINS
ITS OWN INCONTESTABILITY CLAUSE.
SUICIDE EXCLUSION IF THE INSURED DIES BY SUICIDE, WHILE SANE OR INSANE, WITHIN TWO YEARS FROM THE
ISSUE DATE (OR WITHIN THE MAXIMUM PERIOD PERMITTED BY LAW OF THE STATE IN WHICH
THIS POLICY WAS DELIVERED, IF LESS THAN TWO YEARS), THE AMOUNT PAYABLE WILL BE
LIMITED TO THE AMOUNT OF PREMIUMS PAID, LESS ANY OUTSTANDING POLICY LOANS WITH
INTEREST TO THE DATE OF DEATH, AND LESS ANY PARTIAL WITHDRAWALS.
IF THE INSURED, WHILE SANE OR INSANE, COMMITS SUICIDE WITHIN TWO YEARS AFTER THE
EFFECTIVE DATE OF ANY INCREASE IN FACE AMOUNT, THE DEATH BENEFIT FOR THAT INCREASE
WILL BE LIMITED TO THE MONTHLY DEDUCTIONS FOR THE INCREASE.
CHANGE OF WHILE THIS POLICY IS IN FORCE, YOU MAY CHANGE THE INSURED. TO DO THIS, YOU MUST
INSURED MEET THE REQUIREMENTS ESTABLISHED BY US. ANY RIDER ATTACHED TO THIS POLICY MAY BE
CONTINUED ONLY WITH OUR CONSENT. WE RESERVE THE RIGHT TO CHARGE A NOMINAL FEE FOR
PROCESSING A CHANGE OF INSURED.
103014 3.05
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ANNUAL REPORT EACH YEAR A REPORT WILL BE SENT TO YOU WHICH SHOWS THE CURRENT POLICY VALUES,
PREMIUMS PAID AND DEDUCTIONS MADE SINCE THE LAST REPORT, AND ANY OUTSTANDING POLICY
LOANS.
PROJECTION OF YOU MAY MAKE A WRITTEN REQUEST TO US FOR A PROJECTION OF ILLUSTRATIVE FUTURE CASH
BENEFITS AND VALUES AND DEATH BENEFITS. IF REQUESTED MORE THAN ONCE PER POLICY YEAR, THIS
VALUES PROJECTION WILL BE FURNISHED TO YOU FOR A NOMINAL FEE. THIS FEE WILL NOT EXCEED THE
MAXIMUM FEE FOR PROJECTION OF BENEFITS AND VALUES SHOWN ON THE POLICY
SPECIFICATIONS PAGE.
4. SEPARATE ACCOUNT PROVISIONS
SEPARATE ACCOUNT THE VARIABLE BENEFITS UNDER THIS POLICY ARE PROVIDED THROUGH INVESTMENTS IN
SEPARATE ACCOUNT ELEVEN. THIS ACCOUNT IS USED FOR FLEXIBLE PREMIUM VARIABLE LIFE
INSURANCE POLICIES AND, IF PERMITTED BY LAW, MAY BE USED FOR OTHER POLICIES OR
CONTRACTS AS WELL.
WE HOLD THE ASSETS OF SEPARATE ACCOUNT ELEVEN. THESE ASSETS ARE HELD SEPARATELY
FROM THE ASSETS HELD IN THE GENERAL ACCOUNT. INCOME, GAINS AND LOSSES---WHETHER OR
NOT REALIZED---FROM ASSETS ALLOCATED TO SEPARATE ACCOUNT ELEVEN WILL BE CREDITED TO
OR CHARGED AGAINST THE ACCOUNT WITHOUT REGARD TO OUR OTHER INCOME, GAINS OR LOSSES.
THE PORTION OF THE ASSETS HELD BY SEPARATE ACCOUNT ELEVEN EQUAL TO THE RESERVES AND
OTHER POLICY LIABILITIES WITH RESPECT TO SEPARATE ACCOUNT ELEVEN WILL NOT BE
CHARGED WITH LIABILITIES THAT ARISE FROM ANY OTHER BUSINESS WE MAY CONDUCT. WE HAVE
THE RIGHT TO TRANSFER TO OUR GENERAL ACCOUNT ANY ASSETS OF SEPARATE ACCOUNT ELEVEN
WHICH ARE IN EXCESS OF THE RESERVES AND OTHER POLICY LIABILITIES OF SEPARATE
ACCOUNT ELEVEN.
SEPARATE ACCOUNT ELEVEN IS REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION
AS A UNIT INVESTMENT TRUST UNDER THE INVESTMENT COMPANY ACT OF 1940. SEPARATE
ACCOUNT ELEVEN IS ALSO SUBJECT TO THE LAWS OF THE STATE OF MISSOURI, WHICH REGULATE
THE OPERATIONS OF INSURANCE COMPANIES INCORPORATED IN MISSOURI. THE INVESTMENT
POLICY OF SEPARATE ACCOUNT ELEVEN WILL NOT BE CHANGED WITHOUT THE APPROVAL OF THE
INSURANCE COMMISSIONER OF THE STATE OF MISSOURI. THE APPROVAL PROCESS IS ON FILE
WITH THE INSURANCE COMMISSIONER OF THE STATE IN WHICH THIS POLICY WAS DELIVERED.
DIVISIONS SEPARATE ACCOUNT ELEVEN HAS SEVERAL DIVISIONS. EACH DIVISION INVESTS IN A
CORRESPONDING INVESTMENT PORTFOLIO FROM ONE OR MORE REGISTERED INVESTMENT
COMPANIES.
INCOME, GAINS AND LOSSES---WHETHER OR NOT REALIZED---FROM THE ASSETS OF EACH
DIVISION OF SEPARATE ACCOUNT ELEVEN ARE CREDITED TO OR CHARGED AGAINST THAT
DIVISION WITHOUT REGARD TO INCOME, GAINS OR LOSSES IN OTHER DIVISIONS OF SEPARATE
ACCOUNT ELEVEN OR IN THE GENERAL ACCOUNT.
WE WILL VALUE THE ASSETS OF EACH DIVISION OF SEPARATE ACCOUNT ELEVEN AT THE END OF
EACH VALUATION PERIOD. A VALUATION PERIOD IS THE PERIOD BETWEEN TWO SUCCESSIVE
VALUATION DATES. A VALUATION DATE IS ANY DAY THAT BENEFITS VARY AND ON WHICH THE
NEW YORK STOCK EXCHANGE AND OUR HOME OFFICE ARE OPEN FOR BUSINESS OR ANY OTHER DAY
THAT MAY BE REQUIRED BY ANY APPLICABLE SECURITIES AND EXCHANGE COMMISSION RULES AND
REGULATIONS.
103014 3.06
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TRANSFERS YOU MAY TRANSFER AMOUNTS AS FOLLOWS:
- BETWEEN THE GENERAL ACCOUNT AND THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN;
OR
- AMONG THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN.
- THE FIRST 12 REQUESTED TRANSFERS AND/OR PARTIAL WITHDRAWALS PER POLICY
YEAR WILL BE ALLOWED FREE OF CHARGE; THEREAFTER WE MAY IMPOSE A TRANSFER
CHARGE NOT TO EXCEED THE MAXIMUM TRANSFER CHARGE SHOWN ON THE POLICY
SPECIFICATIONS PAGE.
THESE TRANSFERS WILL BE SUBJECT TO THE FOLLOWING CONDITIONS:
- WE MUST RECEIVE A REQUEST FOR TRANSFER IN A FORM ACCEPTABLE TO US.
- TRANSFERS FROM OR AMONG THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN MUST BE
AT LEAST $500.00 OR THE ENTIRE AMOUNT YOU HAVE IN A DIVISION, IF SMALLER.
- TRANSFERS AND/OR PARTIAL WITHDRAWALS FROM THE GENERAL ACCOUNT TO THE
DIVISIONS OF SEPARATE ACCOUNT ELEVEN MUST BE AT LEAST $500.00. THE
MAXIMUM AMOUNT OF ALL TRANSFERS AND PARTIAL WITHDRAWALS FROM THE GENERAL
ACCOUNT IN ANY POLICY YEAR WILL BE THE GREATER OF (1) OR (2):
1. THE CASH SURRENDER VALUE OF THE GENERAL ACCOUNT AT THE BEGINNING OF
THAT POLICY YEAR MULTIPLIED BY THE GENERAL ACCOUNT MAXIMUM
WITHDRAWAL PERCENT LIMIT, AS SHOWN ON THE POLICY SPECIFICATIONS
PAGE.
2. THE PREVIOUS YEAR'S GENERAL ACCOUNT MAXIMUM WITHDRAWAL AMOUNT.
- THE GENERAL ACCOUNT CASH VALUE IMMEDIATELY AFTER ANY TRANSFER IN TO THE
GENERAL ACCOUNT CANNOT EXCEED 1., BELOW, MULTIPLIED BY 2., BELOW:
1. THE GENERAL ACCOUNT CASH VALUE PLUS THE SEPARATE ACCOUNT CASH VALUE.
2. THE GENERAL ACCOUNT MAXIMUM ALLOCATION PERCENT AS SHOWN ON THE POLICY
SPECIFICATIONS PAGE.
WE MAY REVOKE OR MODIFY THE TRANSFER PRIVILEGE AT ANY TIME, INCLUDING THE MINIMUM
AMOUNT TRANSFERABLE, THE GENERAL ACCOUNT MAXIMUM ALLOCATION PERCENT, AND THE
TRANSFER CHARGE, IF ANY.
ADDITION, DELETION WE RESERVE THE RIGHT, SUBJECT TO COMPLIANCE WITH APPLICABLE LAW, TO MAKE ADDITIONS
OR SUBSTITUTION TO, DELETIONS FROM, OR SUBSTITUTIONS FOR THE SHARES OF A FUND THAT ARE HELD BY
OF INVESTMENTS SEPARATE ACCOUNT ELEVEN OR THAT SEPARATE ACCOUNT ELEVEN MAY PURCHASE. WE RESERVE
THE RIGHT TO ELIMINATE THE SHARES OF ANY OF THE FUNDS OF THIS POLICY AND TO
SUBSTITUTE SHARES OF ANOTHER FUND OF A REGISTERED INVESTMENT COMPANY, IF THE SHARES
OR FUNDS ARE NO LONGER AVAILABLE FOR INVESTMENT OR IF IN OUR JUDGEMENT, FURTHER
INVESTMENT IN ANY FUND SHOULD BECOME INAPPROPRIATE IN VIEW OF THE PURPOSE OF THE
POLICY. WE WILL NOT SUBSTITUTE ANY SHARES ATTRIBUTABLE TO THE OWNER'S INTEREST IN A
DIVISION OF SEPARATE ACCOUNT ELEVEN WITHOUT NOTICE TO THE OWNER AND COMPLIANCE WITH
THE INVESTMENT COMPANY ACT OF 1940. THIS WILL NOT PREVENT SEPARATE ACCOUNT ELEVEN
FROM PURCHASING OTHER SECURITIES FOR OTHER SERIES OR CLASSES OF POLICIES, OR FROM
PERMITTING CONVERSION BETWEEN SERIES OR CLASSES OF POLICIES OR CONTRACTS ON THE
BASIS OF REQUESTS MADE BY OWNERS.
WE RESERVE THE RIGHT TO ESTABLISH ADDITIONAL DIVISIONS OF SEPARATE ACCOUNT ELEVEN
WHICH WOULD INVEST IN SHARES OF REGISTERED INVESTMENT COMPANIES AND TO MAKE SUCH
DIVISIONS AVAILABLE TO SUCH CLASS OR SERIES OF POLICIES AS WE DEEM APPROPRIATE. WE
ALSO RESERVE THE RIGHT TO ELIMINATE OR COMBINE EXISTING DIVISIONS OF SEPARATE
ACCOUNT ELEVEN OR TO TRANSFER ASSETS BETWEEN DIVISIONS.
IF WE CONSIDER IT TO BE IN THE BEST INTEREST OF PERSONS HAVING VOTING RIGHTS UNDER
THE POLICIES, SEPARATE ACCOUNT ELEVEN MAY BE OPERATED AS A MANAGEMENT COMPANY UNDER
THE INVESTMENT COMPANY ACT OF 1940; IT MAY BE DEREGISTERED UNDER THAT ACT IN THE
EVENT REGISTRATION IS NO LONGER REQUIRED; IT MAY BE COMBINED WITH OTHER SEPARATE
ACCOUNTS; OR ITS ASSETS MAY BE TRANSFERRED TO OTHER SEPARATE ACCOUNTS.
103014 3.07
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5. POLICY BENEFITS
POLICY PROCEEDS THE POLICY PROCEEDS ARE:
1. THE DEATH BENEFIT UNDER THE CONTRACT TYPE THEN IN EFFECT; PLUS
2. ANY DIVIDEND DUE; PLUS
3. THE MONTHLY COST OF INSURANCE FOR THE PORTION OF THE POLICY MONTH FROM THE
DATE OF DEATH TO THE END OF THE POLICY MONTH OF DEATH; MINUS
4. ANY PAYMENT DUE UNDER THE GRACE PERIOD PROVISION AS OF THE DATE OF
DEATH; MINUS
5. ANY LOAN AND LOAN INTEREST DUE.
DEATH BENEFIT PRIOR TO THE INSURED'S ATTAINED AGE 100, THE DEATH BENEFIT DEPENDS UPON THE
CONTRACT TYPE IN EFFECT ON THE DATE OF THE INSURED'S DEATH. THE CONTRACT TYPE
IN EFFECT IS SHOWN ON THE POLICY SPECIFICATIONS PAGE.
OPTION A CONTRACT TYPE:
THE DEATH BENEFIT IS THE GREATER OF:
1. THE FACE AMOUNT; OR
2. THE APPLICABLE PERCENTAGE OF THE CASH VALUE ON THE DATE OF DEATH AS DESCRIBED
IN SECTION 7702(D) OF THE INTERNAL REVENUE CODE OF 1986 OR ANY APPLICABLE
SUCCESSOR PROVISION AND MODIFIED FOR AGES 95 AND ABOVE.
OPTION B CONTRACT TYPE:
THE DEATH BENEFIT IS THE GREATER OF:
1. THE FACE AMOUNT PLUS THE CASH VALUE ON THE DATE OF DEATH; OR
2. THE APPLICABLE PERCENTAGE OF THE CASH VALUE ON THE DATE OF DEATH AS
DESCRIBED IN SECTION 7702(D) OF THE INTERNAL REVENUE CODE OF 1986 OR
ANY APPLICABLE SUCCESSOR PROVISION AND MODIFIED FOR AGES 95 AND ABOVE.
OPTION C CONTRACT TYPE:
THE DEATH BENEFIT IS THE GREATER OF:
1. THE FACE AMOUNT; OR
2. THE CASH VALUE ON THE DATE OF DEATH MULTIPLIED BY THE APPLICABLE ATTAINED
AGE FACTOR AS SHOWN ON THE POLICY'S DEATH BENEFIT OPTION C ATTAINED AGE
FACTORS PAGE.
NOTWITHSTANDING ANYTHING IN THIS POLICY, THE DEATH BENEFIT WILL IN NO CASE BE LESS
THAN THE AMOUNT NECESSARY TO CAUSE THE POLICY TO MEET THE REQUIREMENTS FOR THE
DEFINITION OF LIFE INSURANCE UNDER THE INTERNAL REVENUE CODE OF 1986 OR ANY
APPLICABLE SUCCESSOR PROVISION.
APPLICABLE THE PERCENTAGES AS CURRENTLY DESCRIBED IN SECTION 7702(D) OF THE INTERNAL REVENUE
PERCENTAGE: CODE OF 1986 AND MODIFIED FOR AGES 95 AND ABOVE ARE AS FOLLOWS:
IN THE CASE OF AN INSURED WITH AN THE APPLICABLE PERCENTAGE WILL
ATTAINED AGE AS OF THE BEGINNING DECREASE BY A RATABLE PORTION
OF THE CONTRACT YEAR OF: FOR EACH FULL YEAR:
MORE THAN: BUT NOT MORE THAN: FROM: TO:
0 40 250 250
40 45 250 215
45 50 215 185
50 55 185 150
55 60 150 130
60 65 130 120
65 70 120 115
70 75 115 105
75 90 105 105
90 95 105 101
95 OR 101
HIGHER
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CONTINUATION IF THIS POLICY IS IN FORCE BEYOND THE INSURED'S ATTAINED AGE 100, THE DEATH BENEFIT
OF THE POLICY WILL BE 101% OF THE POLICY'S CASH VALUE.
BEYOND ATTAINED
AGE 100 PLEASE NOTE: THIS POLICY MAY NOT QUALIFY AS LIFE INSURANCE AFTER THE INSURED'S
ATTAINED AGE 100 AND MAY BE SUBJECT TO TAX CONSEQUENCES. PLEASE CONSULT A TAX
ADVISER PRIOR TO CONTINUING THE POLICY BEYOND THE INSURED'S ATTAINED AGE 100.
IT IS POSSIBLE THAT INSURANCE COVERAGE MAY NOT CONTINUE EVEN IF PLANNED PREMIUMS
ARE PAID IN A TIMELY MANNER.
POLICY CHANGES YOU MAY REQUEST POLICY CHANGES AT ANY TIME UNLESS WE SPECIFICALLY INDICATE
OTHERWISE. WE LIMIT THE NUMBER OF CHANGES TO ONE PER POLICY YEAR, AND WE DO NOT
PERMIT CHANGES IN THE FIRST POLICY YEAR. THE TYPES OF CHANGES ALLOWED ARE EXPLAINED
BELOW.
NO CHANGE WILL BE PERMITTED THAT WOULD RESULT IN THIS POLICY NOT SATISFYING THE
DEFINITION OF LIFE INSURANCE UNDER THE INTERNAL REVENUE CODE OF 1986 OR ANY
APPLICABLE SUCCESSOR PROVISION.
CHANGE IN THE FACE AMOUNT MAY BE CHANGED BY SENDING US A WRITTEN REQUEST.
FACE AMOUNT
ANY DECREASE IN FACE AMOUNT WILL BE SUBJECT TO THE FOLLOWING CONDITIONS:
1. THE DECREASE WILL BECOME EFFECTIVE ON THE MONTHLY ANNIVERSARY ON OR
FOLLOWING OUR RECEIPT OF THE REQUEST.
2. THE DECREASE WILL REDUCE THE FACE AMOUNT IN THE FOLLOWING ORDER;
A. THE FACE AMOUNT PROVIDED BY THE MOST RECENT INCREASE;
B. FACE AMOUNTS PROVIDED BY THE NEXT MOST RECENT INCREASES,
SUCCESSIVELY; AND
C. THE FACE AMOUNT WHEN THE POLICY WAS ISSUED.
3. THE FACE AMOUNT REMAINING IN FORCE AFTER ANY REQUESTED DECREASE MAY NOT BE
LESS THAN THE MINIMUM FACE AMOUNT SHOWN ON THE POLICY SPECIFICATIONS PAGE.
4. ANY DECREASE MUST BE AT LEAST THE MINIMUM FACE AMOUNT DECREASE AS SHOWN ON
THE POLICY SPECIFICATIONS PAGE.
A SURRENDER CHARGE WILL APPLY TO ANY DECREASE IN FACE AMOUNT AS EXPLAINED IN THE
SURRENDER CHARGE PROVISION.
AFTER THE FIRST POLICY ANNIVERSARY, YOU CAN INCREASE THE FACE AMOUNT SUBJECT TO THE
FOLLOWING CONDITIONS:
1. PROOF THAT THE INSURED IS INSURABLE BY OUR STANDARDS ON THE DATE OF THE
REQUESTED INCREASE MUST BE SUBMITTED.
2. THE INCRREASE, IF APPROVED BY US, WILL BECOME EFFECTIVE ON THE MONTHLY
ANNIVERSARY ON OR FOLLOWING OUR RECEIPT OF THE REQUEST.
3. ANY INCREASE MUST BE AT LEAST THE MINIMUM FACE AMOUNT INCREASE AS SHOWN
ON THE POLICY SPECIFICATIONS PAGE.
4. THE INSURED MUST HAVE AN ATTAINED AGE NOT GREATER THAN AGE 80 ON THE POLICY
ANNIVERSARY THAT THE INCREASE WILL BECOME EFFECTIVE.
WE WILL AMEND YOUR POLICY TO SHOW THE EFFECTIVE DATE OF THE DECREASE OR INCREASE.
CHANGE IN IF THE CONTRACT TYPE IN EFFECT IS OPTION A OR OPTION B, YOU MAY CHANGE THE CONTRACT
CONTRACT TYPE TYPE BY SENDING US A WRITTEN REQUEST. THE EFFECTIVE DATE OF THE CHANGE WILL BE THE
MONTHLY ANNIVERSARY ON OR FOLLOWING THE DATE WE RECEIVE YOUR REQUEST. ON THE
EFFECTIVE DATE OF THIS CHANGE THE DEATH BENEFIT PAYABLE DOES NOT CHANGE, BUT THE
FACE AMOUNT MAY CHANGE.
IF THE CONTRACT TYPE IN EFFECT IS OPTION B, YOU MAY CHANGE IT TO OPTION A. THE FACE
AMOUNT WILL BE INCREASED TO EQUAL THE DEATH BENEFIT ON THE EFFECTIVE DATE OF
CHANGE. THE CONTRACT TYPE CANNOT BE CHANGED FROM OPTION B TO OPTION C.
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IF THE CONTRACT TYPE IN EFFECT IS OPTION A, YOU MAY CHANGE IT TO OPTION B. PROOF
THAT THE INSURED IS INSURABLE BY OUR STANDARDS ON THE DATE OF THE CHANGE MUST BE
SUBMITTED. THE FACE AMOUNT WILL BE DECREASED TO EQUAL THE DEATH BENEFIT LESS THE
CASH VALUE ON THE EFFECTIVE DATE OF CHANGE. THIS CHANGE MAY NOT BE MADE IF IT WOULD
RESULT IN A FACE AMOUNT WHICH IS LESS THAN THE MINIMUM FACE AMOUNT SHOWN ON THE
POLICY SPECIFICATIONS PAGE. A SURRENDER CHARGE WILL APPLY TO ANY DECREASE IN FACE
AMOUNT AS EXPLAINED IN THE SURRENDER CHARGE PROVISION. THE CONTRACT TYPE CANNOT BE
CHANGED FROM OPTION A TO OPTION C.
IF THE CONTRACT TYPE IN EFFECT IS OPTION C, THE CONTRACT TYPE CANNOT BE CHANGED.
6. PREMIUMS AND GRACE PERIOD
PAYMENT OF PREMIUMS YOUR FIRST PREMIUM IS DUE AS OF THE ISSUE DATE. WHILE INSURED IS LIVING, PREMIUMS
AFTER THE FIRST MUST BE PAID AT OUR HOME OFFICE. A PREMIUM RECEIPT WILL BE FURNISHED
UPON REQUEST. IF THIS POLICY IS IN YOUR POSSESSION AND YOU HAVE NOT PAID THE FIRST
PREMIUM, IT IS NOT IN FORCE. IT WILL BE CONSIDERED THAT YOU HAVE THE POLICY FOR
INSPECTION ONLY.
PREMIUMS MAY BE PAID IN ANY AMOUNT AND AT ANY INTERVAL SUBJECT TO THE FOLLOWING
CONDITIONS:
1. AT THE END OF THE FIRST POLICY YEAR, YOUR TOTAL PREMIUM PAYMENTS FOR THIS
POLICY MUST BE GREATER THAN OR EQUAL TO THE MINIMUM INITIAL ANNUAL PREMIUM
AMOUNT AS SHOWN ON THE POLICY SPECIFICATIONS PAGE.
2. ANY SUBSEQUENT PREMIUM PAYMENT MUST BE AT LEAST $10.00.
3. TOTAL PREMIUMS PAID IN ANY POLICY YEAR FOR POLICIES ISSUED WITH THE OPTION
A OR B CONTRACT TYPE MAY NOT EXCEED AN AMOUNT THAT WOULD CAUSE THE
POLICY TO FAIL THE DEFINITION OF LIFE INSURANCE AS DEFINED BY SECTION
7702 OF THE INTERNAL REVENUE CODE OF 1986, OR ANY APPLICABLE SUCCESSOR
PROVISION THERETO. THE MAXIMUM PREMIUM LIMIT FOR THE FOLLOWING POLICY
YEAR WILL BE SHOWN ON YOUR ANNUAL REPORT.
ON ANY DATE THAT WE RECEIVE A PREMIUM WHICH CAUSES THE DEATH BENEFIT UNDER ANY OF
THE CONTRACT TYPES TO INCREASE BY AN AMOUNT THAT EXCEEDS THAT PREMIUM RECEIVED, WE
RESERVE THE RIGHT TO REFUSE THAT PREMIUM PAYMENT. WE MAY REQUIRE ADDITIONAL
EVIDENCE OF INSURABILITY BEFORE WE ACCEPT THE PREMIUM.
NET PREMIUM THE NET PREMIUM IS:
1. THE PREMIUM PAID; MINUS
2. THE PREMIUM PAID MULTIPLIED BY THE PREMIUM TAX CHARGE AS SHOWN ON THE
POLICY SPECIFICATIONS PAGE; MINUS
3. THE PREMIUM PAID MULTIPLIED BY THE FEDERAL TAX CHARGE AS SHOWN ON THE
POLICY SPECIFICATIONS PAGE; MINUS
4. THE PREMIUM PAID MULTIPLIED BY THE APPLICABLE PERCENT OF PREMIUM CHARGE.
PREMIUM TAX A CHARGE WILL BE DEDUCTED FOR PREMIUM TAXES FROM EACH PREMIUM SUBMITTED. THE
CHARGE CURRENT CHARGE, AS A PERCENT OF THE PREMIUM, IS SHOWN ON THE POLICY SPECIFICATIONS
PAGE. WE RESERVE THE RIGHT TO CHANGE THE PREMIUM TAX CHARGE DUE TO RATE CHANGES OF
THE GOVERNING JURISDICTION. WE WILL AMEND YOUR POLICY TO SHOW THE CURRENT PREMIUM
TAX RATE, IF CHANGED.
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FEDERAL TAX A CHARGE WILL BE DEDUCTED FOR FEDERAL TAXES FROM EACH PREMIUM SUBMITTED. THE
CHARGE CURRENT CHARGE, AS A PERCENT OF THE PREMIUM, IS SHOWN ON THE POLICY SPECIFICATIONS
PAGE. WE RESERVE THE RIGHT TO CHANGE THE FEDERAL TAX CHARGE TO REFLECT A CHANGE IN
THE FEDERAL TAX LAW. WE WILL AMEND YOUR POLICY TO SHOW THE CURRENT FEDERAL TAX
CHARGE, IF CHANGED.
PERCENT OF A CHARGE WILL BE DEDUCTED FROM EACH PREMIUM SUBMITTED. THE MAXIMUM PERCENT OF
PREMIUM CHARGE PREMIUM CHARGES ARE SHOWN ON THE POLICY SPECIFICATIONS PAGE.
THE PERCENT OF PREMIUM CHARGE WILL VARY, ON A NON-DISCRIMINATORY BASIS, BASED ON
THE AMOUNT OF PREMIUM PAID, BUT WILL NEVER EXCEED THE MAXIMUM PERCENT OF PREMIUM
CHARGES SHOWN ON THE POLICY SPECIFICATIONS PAGE.
ALLOCATION OF YOU DETERMINE THE ALLOCATION OF NET PREMIUMS AMONG THE GENERAL ACCOUNT AND THE
NET PREMIUMS DIVISIONS OF SEPARATE ACCOUNT ELEVEN. FOR ANY CHOSEN ALLOCATION THE MINIMUM
PERCENTAGE THAT MAY BE ALLOCATED IS 5% OF THE NET PREMIUM. PERCENTAGES MUST BE IN
WHOLE NUMBERS. THE GENERAL ACCOUNT CASH VALUE IMMEDIATELY AFTER PAYMENT OF THE
PREMIUM CANNOT EXCEED 1., BELOW, MULTIPLIED BY 2., BELOW:
1. THE GENERAL ACCOUNT CASH VALUE PLUS THE SEPARATE ACCOUNT CASH VALUE.
2. THE GENERAL ACCOUNT MAXIMUM ALLOCATION PERCENT AS SHOWN ON THE POLICY
SPECIFICATIONS PAGE.
THE INITIAL ALLOCATION IS SHOWN ON THE APPLICATION, A COPY OF WHICH IS ATTACHED. WE
MAY MODIFY THE GENERAL ACCOUNT MAXIMUM ALLOCATION PERCENT AT ANY TIME.
FOR ANY PREMIUM RECEIVED DURING THE "RIGHT TO EXAMINE POLICY" PERIOD, WE WILL
INITIALLY ALLOCATE THE NET PREMIUM TO THE DIVISION THAT INVESTS EXCLUSIVELY IN
SHARES OF OUR MONEY MARKET FUND UNLESS PROHIBITED BY STATE LAW. WHEN THIS PERIOD
EXPIRES, CASH VALUE IN THAT DIVISION WILL BE TRANSFERRED TO THE GENERAL ACCOUNT AND
THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN ACCORDING TO THE ALLOCATION PERCENTAGES
SHOWN ON THE APPLICATION, A COPY OF WHICH IS ATTACHED. FOR ANY PREMIUM RECEIVED
AFTER THE "RIGHT TO EXAMINE POLICY" PERIOD, THE NET PREMIUM WILL BE ALLOCATED
ACCORDING TO THE ALLOCATION PERCENTAGES SHOWN ON THE POLICY SPECIFICATIONS PAGE OR
YOUR MOST RECENT ALLOCATION INSTRUCTIONS RECEIVED BY US.
YOUR RIGHT YOU MAY CHANGE THE ALLOCATION OF FUTURE NET PREMIUMS AMONG THE GENERAL ACCOUNT
TO CHANGE AND/OR THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN SUBJECT TO THE CONDITIONS OUTLINED
ALLOCATION IN THE ALLOCATION OF THE NET PREMIUMS PROVISION. THE CHANGE IN ALLOCATION
PERCENTAGES WILL TAKE EFFECT IMMEDIATELY UPON OUR RECEIPT OF YOUR WRITTEN REQUEST.
NO-LAPSE PERIOD IF, ON A MONTHLY ANNIVERSARY DAY PRIOR TO THE NO LAPSE PREMIUM DATE, THE SUM OF ALL
PREMIUMS PAID ON THIS POLICY, REDUCED BY ANY PARTIAL WITHDRAWALS AND ANY
OUTSTANDING LOAN BALANCE, IS GREATER THAN OR EQUAL TO THE SUM OF THE NO LAPSE
MONTHLY PREMIUMS FOR THE ELAPSED MONTHS SINCE THE ISSUE DATE, THIS POLICY WILL NOT
LAPSE AS A RESULT OF A CASH VALUE LESS ANY LOANS, LOAN INTEREST DUE, AND ANY
SURRENDER CHARGE BEING INSUFFICIENT TO PAY THE MONTHLY DEDUCTION. THE NO LAPSE
PREMIUM DATE AND THE NO LAPSE ANNUAL PREMIUM ARE SHOWN ON THE POLICY SPECIFICATIONS
PAGE. THE NO LAPSE MONTHLY PREMIUM IS ONE TWELFTH OF THE NO LAPSE ANNUAL PREMIUM.
GRACE PERIOD IF, ON A MONTHLY ANNIVERSARY DAY PRIOR TO THE NO LAPSE PREMIUM DATE:
1. THE CASH VALUE LESS ANY LOANS, LOAN INTEREST DUE, AND ANY SURRENDER CHARGE
IS INSUFFICIENT TO COVER THE MONTHLY DEDUCTION; AND
2. THE SUM OF ALL PREMIUMS PAID ON THIS POLICY, REDUCED BY ANY PARTIAL
WITHDRAWALS AND ANY OUTSTANDING LOAN BALANCE, IS LESS THAN THE SUM OF
THE NO LAPSE MONTHLY PREMIUMS FOR THE ELAPSED MONTHS SINCE THE ISSUE
DATE;
THEN THE GRACE PERIOD OF 62 DAYS WILL BE ALLOWED FOR THE PAYMENT OF A PREMIUM
SUFFICIENT TO KEEP YOUR POLICY IN FORCE. THE NO LAPSE PREMIUM DATE AND THE NO LAPSE
ANNUAL PREMIUM ARE SHOWN ON THE POLICY SPECIFICATIONS PAGE.
A CHANGE IN YOUR POLICY'S FACE AMOUNT, THE ADDITION OR DELETION OF A SUPPLEMENTAL
RIDER TO THIS POLICY, OR A CHANGE IN THE PREMIUM CLASS OF THE INSURED BEFORE THE
NO LAPSE PREMIUM DATE SHOWN ON THE POLICY SPECIFICATIONS PAGE MAY RESULT IN A
CHANGE IN THE NO LAPSE MONTHLY PREMIUM. THE NO LAPSE PREMIUM DATE WILL NOT BE
---
CHANGED.
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IF, ON A MONTHLY ANNIVERSARY DAY ON OR AFTER THE NO LAPSE PREMIUM DATE, THE CASH
VALUE LESS ANY LOANS, LOAN INTEREST DUE, AND ANY SURRENDER CHARGE IS INSUFFICIENT
TO COVER THE NEXT MONTHLY DEDUCTION, A GRACE PERIOD OF 62 DAYS WILL BE ALLOWED FOR
THE PAYMENT OF A PREMIUM SUFFICIENT TO PAY THE MONTHLY DEDUCTION. (MONTHLY
DEDUCTION IS DEFINED IN THE CASH VALUES SECTION.)
NOTICE OF THE AMOUNT OF PREMIUM REQUIRED TO BE PAID TO KEEP THIS POLICY IN FORCE
WILL BE SENT AT THE BEGINNING OF THE GRACE PERIOD TO YOUR LAST KNOWN ADDRESS AND TO
ANY ASSIGNEE ON RECORD. IF WE DO NOT RECEIVE A PREMIUM LARGE ENOUGH SO THAT THE NET
PREMIUM COVERS THE MONTHLY DEDUCTION BY THE END OF THE GRACE PERIOD, YOUR POLICY
WILL LAPSE AT THE END OF THAT 62 DAY PERIOD AND IT WILL THEN TERMINATE WITHOUT CASH
SURRENDER VALUE. IF THE INSURED DIES DURING THE GRACE PERIOD, ANY PAST DUE MONTHLY
DEDUCTIONS WILL BE DEDUCTED FROM THE DEATH BENEFIT.
REINSTATEMENT YOU MAY REINSTATE YOUR LAPSED POLICY WITHIN 5 YEARS AFTER THE DATE OF LAPSE. THIS
MUST BE DONE PRIOR TO THE INSURED'S ATTAINED AGE 100. THE POLICY CAN NOT BE REINSTATED
IF IT HAS BEEN SURRENDERED. TO REINSTATE, YOU MUST SUBMIT THE FOLLOWING ITEMS:
1. A WRITTEN REQUEST FOR REINSTATEMENT.
2. PROOF SATISFACTORY TO US THAT THE INSURED IS INSURABLE BY OUR
STANDARDS.
3. A NET PREMIUM PAYMENT LARGE ENOUGH TO COVER:
A. THE MONTHLY DEDUCTIONS DUE AT THE TIME OF LAPSE; AND
B. TWO TIMES THE MONTHLY DEDUCTION DUE AT THE TIME OF REINSTATEMENT.
4. A PAYMENT TO COVER ANY LOAN INTEREST DUE AND UNPAID AT THE TIME OF LAPSE.
UPON RECEIPT OF THE ABOVE PAYMENTS, WE WILL DEDUCT ANY MONTHLY DEDUCTIONS AND LOAN
INTEREST DUE AND UNPAID AT THE TIME OF LAPSE. THE INSURED MUST BE ALIVE ON THE DATE
WE APPROVE THE REQUEST FOR REINSTATEMENT. IF THE INSURED IS NOT ALIVE, SUCH APPROVAL
IS VOID AND OF NO EFFECT.
THE REINSTATED POLICY WILL BE IN FORCE FROM THE DATE WE APPROVE THE REINSTATEMENT
APPLICATION. THERE WILL BE A FULL MONTHLY DEDUCTION FOR THE POLICY MONTH WHICH
INCLUDES THIS DATE. ANY APPLICATION FOR REINSTATEMENT BECOMES PART OF THE CONTRACT
OF REINSTATEMENT AND OF THIS POLICY.
ANY LOAN MAY BE PAID OR REINSTATED. ANY LOAN REINSTATED WILL CAUSE A CASH VALUE OF
AN EQUAL AMOUNT TO BE REINSTATED.
ANY LOAN REPAID AT THE TIME OF REINSTATEMENT WILL CAUSE AN INCREASE IN CASH VALUE
EQUAL TO THE AMOUNT OF THE REPAID LOAN.
THE SURRENDER CHARGE AT THE TIME OF REINSTATEMENT WILL BE THE SURRENDER CHARGE IN
EFFECT AT THE TIME OF LAPSE. IF ONLY A PORTION OF THE COVERAGE IS REINSTATED THEN
ONLY THE APPLICABLE PORTION OF THE SURRENDER CHARGE WILL BE REINSTATED. IF ONLY A
PORTION OF THE COVERAGE IS REINSTATED, THE CASH VALUE FOLLOWING REINSTATEMENT WILL
BE INCREASED BY THE APPLICABLE PORTION OF THE SURRENDER CHARGE IMPOSED AT THE TIME
OF LAPSE.
FOLLOWING REINSTATEMENT, THE NO-LAPSE PERIOD PROVISION WILL AGAIN BE APPLICABLE
UNTIL THE NO-LAPSE PREMIUM DATE, SHOWN ON THE POLICY SPECIFICATIONS PAGE, IF
SUFFICIENT PREMIUM IS PAID SO THAT, AS OF THE EFFECTIVE DATE OF REINSTATEMENT, THE
SUM OF ALL PREMIUMS PAID, REDUCED BY ANY PARTIAL WITHDRAWALS AND ANY LOANS, IS
GREATER THAN THE NO-LAPSE MONTHLY PREMIUMS MULTIPLIED BY THE NUMBER OF ELAPSED
MONTHS SINCE THE ISSUE DATE.
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7. DIVIDENDS
ANNUAL DIVIDENDS WHILE YOUR POLICY IS IN FORCE IT MAY SHARE IN OUR DIVISIBLE SURPLUS. EACH YEAR WE
WILL DETERMINE THE SHARE OF DIVISIBLE SURPLUS, IF ANY, ACCRUING TO YOUR POLICY. WE
WILL DISTRIBUTE THIS SURPLUS AS A DIVIDEND. WE DO NOT EXPECT TO PAY ANY DIVIDENDS
ON THIS POLICY AT THIS TIME.
DIVIDEND OPTIONS YOU MAY CHOOSE ONE OF THE FOLLOWING OPTIONS. IF YOU DO NOT, WE WILL CREDIT ANY
DIVIDEND UNDER OPTION 2 UNTIL SUCH TIME AS YOU REQUEST IN WRITING A DIFFERENT
OPTION. THE OPTION YOU CHOOSE WILL REMAIN IN EFFECT UNTIL YOU CHANGE IT.
OPTION 1. CASH. PAID IN CASH.
OPTION 2. INCREASE CASH VALUE. PAID TO THE POLICY'S CASH VALUE ON THE DATE OF
ANY DIVIDEND PAYMENT. THE CASH VALUE WILL INCREASE BY EXACTLY THE
AMOUNT OF THE DIVIDEND.
THE DIVIDEND WILL BE ALLOCATED TO THE GENERAL ACCOUNT AND THE DIVISIONS
OF SEPARATE ACCOUNT ELEVEN ACCORDING TO THE CURRENT ALLOCATION OF THE
NET PREMIUM.
8. LOANS
UPON WRITTEN REQUEST TO US, YOU MAY BORROW AN AMOUNT NOT IN EXCESS OF THE LOAN
VALUE OF YOUR POLICY WHILE IT IS IN FORCE. THE MINIMUM AMOUNT OF YOUR NET LOAN
REQUEST AT ANY ONE TIME MUST BE AT LEAST $500. YOUR POLICY WILL BE THE SOLE
SECURITY FOR SUCH LOAN. WE HAVE THE RIGHT TO REQUIRE YOUR POLICY FOR ENDORSEMENT.
THE LOAN VALUE IS THE CASH VALUE OF YOUR POLICY AT THE DATE OF THE LOAN REQUEST
PLUS INTEREST TO THE NEXT POLICY ANNIVERSARY AT THE GENERAL ACCOUNT CASH VALUE
GUARANTEED INTEREST RATE, SHOWN ON THE POLICY SPECIFICATIONS PAGE, REDUCED BY:
1. ANY EXISTING LOANS; AND
2. LOAN INTEREST TO THE NEXT LOAN INTEREST DUE DATE; AND
3. EVERY MONTHLY DEDUCTION DUE TO THE NEXT LOAN INTEREST DUE DATE; AND
4. ANY SURRENDER CHARGES.
YOU MAY ALLOCATE THE POLICY LOAN AMONG THE GENERAL ACCOUNT AND THE DIVISIONS OF
SEPARATE ACCOUNT ELEVEN. IF YOU DO NOT SPECIFY THE ALLOCATION, THEN THE POLICY LOAN
WILL BE ALLOCATED AMONG THE GENERAL ACCOUNT AND THE DIVISIONS OF SEPARATE ACCOUNT
ELEVEN IN THE SAME PROPORTION THAT THE CASH VALUE IN THE GENERAL ACCOUNT, AND THE
CASH VALUE IN EACH DIVISION BEARS TO THE TOTAL CASH VALUE OF THE POLICY, MINUS THE
CASH VALUE IN THE LOAN ACCOUNT, ON THE DATE OF THE POLICY LOAN.
CASH VALUE EQUAL TO THE POLICY LOAN ALLOCATED TO THE GENERAL ACCOUNT AND EACH
DIVISION OF SEPARATE ACCOUNT ELEVEN WILL BE TRANSFERRED TO THE LOAN ACCOUNT,
REDUCING THE CASH VALUE ACCORDINGLY. ANY CASH VALUE TRANSFERRED TO THE LOAN ACCOUNT
WILL BE ALLOCATED TO THE APPROPRIATE LOAN SUBACCOUNT.
LOAN INTEREST THE ACCRUED LOAN INTEREST WILL BE DUE THE EARLIEST OF:
DUE DATE
1. THE NEXT POLICY ANNIVERSARY DATE.
2. THE DATE OF TERMINATION OF THE POLICY.
3. THE DATE THE LOAN IS REPAID IN FULL.
4. THE DATE THE LOAN PLUS LOAN INTEREST ACCRUED EXCEEDS THE CASH VALUE LESS
ANY SURRENDER CHARGES.
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INTEREST WILL BE PAYABLE ANNUALLY ON EACH POLICY ANNIVERSARY. IF YOU DO NOT PAY THE
INTEREST WHEN IT IS DUE ON A POLICY ANNIVERSARY, AN AMOUNT OF CASH VALUE EQUAL TO
THE LOAN INTEREST WILL ALSO BE TRANSFERRED TO THE LOAN ACCOUNT. WE WILL CHARGE THE
SAME RATE OF INTEREST ON THIS AMOUNT AS ON THE POLICY LOAN. THE AMOUNT TRANSFERRED
WILL BE DEDUCTED FROM THE GENERAL ACCOUNT AND THE DIVISIONS OF SEPARATE ACCOUNT
ELEVEN IN THE SAME PROPORTION THAT THE CASH VALUE IN THE GENERAL ACCOUNT AND THE
CASH VALUE IN EACH DIVISION BEARS TO THE TOTAL CASH VALUE OF THE POLICY, MINUS THE
CASH VALUE IN THE LOAN ACCOUNT.
FIXED LOAN THE FIXED LOAN INTEREST RATE IS 4.5% FOR POLICY YEARS 1 THROUGH 10, 4.25% FOR
INTEREST RATES POLICY YEARS 11 THROUGH 20 AND 4.15% FOR POLICY YEARS 21 AND LATER. LOAN INTEREST
IS PAYABLE IN ARREARS.
LOAN ALL FUNDS RECEIVED WILL BE CREDITED TO YOUR POLICY AS A PREMIUM UNLESS CLEARLY
REPAYMENTS MARKED FOR LOAN REPAYMENT.
YOU MAY REPAY YOUR LOAN IN WHOLE OR IN PART AT ANY TIME BEFORE THE DEATH OF THE
INSURED WHILE THE POLICY IS IN FORCE. WHEN A LOAN REPAYMENT IS MADE, CASH VALUE
SECURING THE DEBT IN THE LOAN ACCOUNT EQUAL TO THE LOAN REPAYMENT WILL BE REPAID
TO THE GENERAL ACCOUNT AND THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN IN THE SAME
PROPORTION THAT THE CASH VALUE IN THE LOAN ACCOUNT BEARS TO THE CASH VALUE IN
EACH LOAN SUBACCOUNT. UNPAID LOANS AND LOAN INTEREST WILL BE DEDUCTED FROM ANY
SETTLEMENT OF YOUR POLICY.
IF YOU FAIL TO MAKE REPAYMENTS WHEN THE TOTAL LOAN AND LOAN INTEREST DUE WOULD
EXCEED THE CASH VALUE, LESS ANY SURRENDER CHARGES, YOUR POLICY WILL TERMINATE. WE
WILL ALLOW YOU A GRACE PERIOD FOR SUCH PAYMENT OF LOANS AND LOAN INTEREST DUE. IN
SUCH EVENT THE POLICY BECOMES VOID AT THE END OF THE GRACE PERIOD. WE WILL MAIL
NOTICE TO YOUR LAST KNOWN ADDRESS, AND THAT OF ANY ASSIGNEE OF RECORD. THIS GRACE
PERIOD WILL EXPIRE 62 DAYS FROM THE MONTHLY ANNIVERSARY IMMEDIATELY BEFORE THE DATE
THE TOTAL LOAN AND LOAN INTEREST EXCEEDS THE CASH VALUE LESS ANY SURRENDER CHARGES;
OR 31 DAYS AFTER SUCH NOTICE HAS BEEN MAILED, IF LATER.
9. CASH VALUES
CASH VALUE THE CASH VALUE OF YOUR POLICY IS EQUAL TO THE TOTAL OF:
- THE CASH VALUE IN THE GENERAL ACCOUNT; PLUS
- THE CASH VALUE IN THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN; PLUS
- THE CASH VALUE IN THE LOAN ACCOUNT.
CASH VALUE IF THIS POLICY IS IN FORCE BEYOND THE INSURED'S ATTAINED AGE 100, THE CASH VALUE
AFTER ATTAINED OF YOUR POLICY WILL BE DETERMINED IN THE SAME MANNER AS DESCRIBED BELOW; EXCEPT
AGE 100 NO DEDUCTIONS WILL BE MADE FOR MONTHLY COST OF INSURANCE CHARGES. PREMIUMS CAN NOT
BE PAID AFTER THE INSURED ATTAINS AGE 100.
GENERAL ACCOUNT THE CASH VALUE IN THE GENERAL ACCOUNT AS OF THE INVESTMENT START DATE IS EQUAL TO:
CASH VALUE
- THE PORTION OF THE INITIAL NET PREMIUM RECEIVED AND ALLOCATED TO THE
GENERAL ACCOUNT; MINUS
- THE PORTION OF THE MONTHLY DEDUCTIONS DUE FROM THE ISSUE DATE THROUGH THE
INVESTMENT START DATE CHARGED TO THE GENERAL ACCOUNT.
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THE CASH VALUE IN THE GENERAL ACCOUNT ON ANY DAY AFTER THE INVESTMENT START DATE IS
EQUAL TO:
- THE CASH VALUE ON THE PRECEDING VALUATION DATE, WITH INTEREST ON SUCH
VALUE AT THE CURRENT RATE; PLUS
- ANY PORTION OF NET PREMIUM RECEIVED AND ALLOCATED TO THE GENERAL ACCOUNT
ON THAT DAY; PLUS
- ANY AMOUNTS TRANSFERRED TO THE GENERAL ACCOUNT ON THAT DAY; PLUS
- ANY LOAN REPAYMENTS ALLOCATED TO THE GENERAL ACCOUNT ON THAT DAY; PLUS
- THAT PORTION OF ANY INTEREST CREDITED ON OUTSTANDING LOANS WHICH IS
ALLOCATED TO THE GENERAL ACCOUNT ON THAT DAY; MINUS
- ANY AMOUNT TRANSFERRED PLUS ANY TRANSFER CHARGE FROM THE GENERAL ACCOUNT
TO THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN ON THAT DAY; MINUS
- ANY PARTIAL WITHDRAWAL PLUS ANY WITHDRAWAL TRANSACTION CHARGE MADE FROM
THE GENERAL ACCOUNT ON THAT DAY; MINUS
- ANY PORTION OF THE SURRENDER CHARGE INCURRED ON THAT DAY ATTRIBUTED TO THE
GENERAL ACCOUNT; MINUS
- ANY AMOUNT TRANSFERRED FROM THE GENERAL ACCOUNT TO THE LOAN ACCOUNT ON
THAT DAY; MINUS
- IF THAT DAY IS A MONTHLY ANNIVERSARY, ANY WITHDRAWAL DUE TO A PRO RATA
SURRENDER PLUS ANY WITHDRAWAL TRANSACTION CHARGE MADE FROM THE GENERAL
ACCOUNT ON THAT DAY; MINUS
- IF THAT DAY IS A MONTHLY ANNIVERSARY, THE PORTION OF THE MONTHLY DEDUCTION
CHARGED TO THE GENERAL ACCOUNT, TO COVER THE POLICY MONTH WHICH STARTS ON
THAT DAY; PLUS
- IF THAT DAY IS A POLICY ANNIVERSARY, THE PORTION OF THE DIVIDEND PAID ON
THAT DAY, IF ANY, ALLOCATED TO THE GENERAL ACCOUNT.
GENERAL ACCOUNT THE INTEREST CREDITED TO THE GENERAL ACCOUNT CASH VALUE FOR A SPECIFIC DAY WILL BE
INTEREST RATE AT AN EFFECTIVE ANNUAL RATE NOT LESS THAN THE GENERAL ACCOUNT CASH VALUE GUARANTEED
INTEREST RATE SHOWN ON THE POLICY SPECIFICATIONS PAGE.
SEPARATE ACCOUNT THE CASH VALUE IN EACH DIVISION OF SEPARATE ACCOUNT ELEVEN ON THE INVESTMENT START
CASH VALUE DATE IS EQUAL TO:
- THE PORTION OF THE INITIAL NET PREMIUM RECEIVED AND ALLOCATED TO THE
DIVISION; MINUS
- THE PORTION OF THE MONTHLY DEDUCTIONS DUE FROM THE ISSUE DATE THROUGH THE
INVESTMENT START DATE CHARGED TO THE DIVISION.
THE CASH VALUE IN EACH DIVISION OF SEPARATE ACCOUNT ELEVEN ON SUBSEQUENT VALUATION
DATES IS EQUAL TO:
- THE CASH VALUE IN THE DIVISION ON THE PRECEDING VALUATION DATE MULTIPLIED
BY THAT DIVISION'S NET INVESTMENT FACTOR FOR THE CURRENT VALUATION PERIOD;
PLUS
- ANY PORTION OF NET PREMIUM RECEIVED AND ALLOCATED TO THE DIVISION DURING
THE CURRENT VALUATION PERIOD; PLUS
- ANY AMOUNTS TRANSFERRED TO THE DIVISION FROM THE GENERAL ACCOUNT OR FROM
ANOTHER DIVISION DURING THE CURRENT VALUATION PERIOD; PLUS
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- ANY LOAN REPAYMENTS ALLOCATED TO THE DIVISION DURING THE CURRENT VALUATION
PERIOD; PLUS
- THAT PORTION OF ANY INTEREST CREDITED ON OUTSTANDING LOANS WHICH IS
ALLOCATED TO THE DIVISION DURING THE CURRENT VALUATION PERIOD; MINUS
- ANY AMOUNTS TRANSFERRED PLUS ANY TRANSFER CHARGE FROM THE DIVISION DURING
THE CURRENT VALUATION PERIOD; MINUS
- ANY PARTIAL WITHDRAWAL PLUS ANY WITHDRAWAL TRANSACTION CHARGE FROM THE
DIVISION DURING THE CURRENT VALUATION PERIOD; MINUS
- ANY PORTION OF THE SURRENDER CHARGE INCURRED DURING THE CURRENT VALUATION
PERIOD ATTRIBUTED TO THE DIVISION; MINUS
- ANY AMOUNT TRANSFERRED FROM THE DIVISION TO THE LOAN ACCOUNT DURING THAT
VALUATION PERIOD; MINUS
- IF A MONTHLY ANNIVERSARY OCCURS DURING THE CURRENT VALUATION PERIOD, ANY
WITHDRAWAL DUE TO A PRO RATA SURRENDER PLUS ANY WITHDRAWAL TRANSACTION
CHARGE FROM THE DIVISION DURING THE CURRENT VALUATION PERIOD; MINUS
- IF A MONTHLY ANNIVERSARY OCCURS DURING THE CURRENT VALUATION PERIOD, THE
PORTION OF THE MONTHLY DEDUCTION CHARGED TO THE DIVISION DURING THE
CURRENT VALUATION PERIOD TO COVER THE POLICY MONTH WHICH STARTS DURING
THAT VALUATION PERIOD; PLUS
- IF A POLICY ANNIVERSARY OCCURS DURING THE CURRENT VALUATION PERIOD, THE
PORTION OF THE DIVIDEND PAID, IF ANY, ALLOCATED TO THE DIVISION.
NET INVESTMENT THE NET INVESTMENT FACTOR MEASURES THE INVESTMENT PERFORMANCE OF A DIVISION DURING
FACTOR A VALUATION PERIOD. THE NET INVESTMENT FACTOR FOR EACH DIVISION FOR A VALUATION
PERIOD IS CALCULATED AS FOLLOWS:
- THE VALUE OF THE ASSETS AT THE END OF THE PRECEDING VALUATION PERIOD; PLUS
- THE INVESTMENT INCOME AND CAPITAL GAINS---REALIZED OR
UNREALIZED---CREDITED TO THE ASSETS IN THE VALUATION PERIOD FOR WHICH
THE NET INVESTMENT FACTOR IS BEING DETERMINED; MINUS
- THE CAPITAL LOSSES---REALIZED OR UNREALIZED---CHARGED AGAINST THOSE
ASSETS DURING THE VALUATION PERIOD; MINUS
- ANY AMOUNT CHARGED AGAINST EACH DIVISION FOR TAXES, INCLUDING ANY TAX OR
OTHER ECONOMIC BURDEN RESULTING FROM THE APPLICATION OF TAX LAWS THAT WE
DETERMINE TO BE PROPERLY ATTRIBUTABLE TO THE DIVISIONS OF THE SEPARATE
ACCOUNT, OR ANY AMOUNT WE SET ASIDE DURING THE VALUATION PERIOD AS A
RESERVE FOR TAXES ATTRIBUTABLE TO THE OPERATION OR MAINTENANCE OF EACH
DIVISION; MINUS
- A CHARGE NOT TO EXCEED THE DAILY INVESTMENT PERCENTAGE SHOWN ON THE POLICY
SPECIFICATIONS PAGE FOR EACH DAY IN THE VALUATION PERIOD. THIS
CORRESPONDS TO AN ANNUAL INVESTMENT PERCENTAGE OF THE MORTALITY AND
EXPENSE RISK PERCENTAGE SHOWN ON THE POLICY SPECIFICATIONS PAGE;
DIVIDED BY
- THE VALUE OF THE ASSETS AT THE END OF THE PRECEDING VALUATION PERIOD.
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LOAN ACCOUNT THE CASH VALUE IN THE LOAN ACCOUNT AS OF THE INVESTMENT START DATE IS ZERO.
CASH VALUE
THE CASH VALUE IN THE LOAN ACCOUNT ON ANY DAY AFTER THE INVESTMENT START DATE IS
EQUAL TO:
- THE CASH VALUE IN THE LOAN ACCOUNT ON THE PRECEDING VALUATION DATE, WITH
INTEREST; PLUS
- ANY AMOUNT TRANSFERRED TO THE LOAN ACCOUNT FROM THE GENERAL ACCOUNT ON
THAT DAY; PLUS
- ANY AMOUNT TRANSFERRED TO THE LOAN ACCOUNT FROM THE DIVISIONS OF SEPARATE
ACCOUNT ELEVEN ON THAT DAY; MINUS
- ANY LOAN REPAYMENTS ON THAT DAY; PLUS
- IF THAT DAY IS A POLICY ANNIVERSARY, AN AMOUNT DUE TO COVER THE LOAN
INTEREST, IF NOT PAID BY YOU.
CASH VALUE HELD IN THE LOAN ACCOUNT FOR LOAN COLLATERAL WILL EARN INTEREST DAILY AT
AN ANNUAL RATE OF NOT LESS THAN THE GENERAL ACCOUNT CASH VALUE GUARANTEED INTEREST
RATE SHOWN ON THE POLICY SPECIFICATIONS PAGE. INTEREST CREDITED ON THE CASH VALUE
HELD IN THE LOAN ACCOUNT WILL BE ALLOCATED AT LEAST ONCE A YEAR TO THE GENERAL
ACCOUNT AND THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN IN THE SAME PROPORTION THAT
THE CASH VALUE IN EACH LOAN SUBACCOUNT BEARS TO THE CASH VALUE IN THE LOAN ACCOUNT.
MONTHLY COST THE MONTHLY COST OF INSURANCE FOR THE FOLLOWING MONTH IS DEDUCTED ON THE MONTHLY
OF INSURANCE ANNIVERSARY DATE. THE MONTHLY COST OF INSURANCE IS 1, BELOW, MULTIPLIED BY THE
DIFFERENCE BETWEEN 2 AND 3 BELOW:
1. THE MONTHLY COST OF INSURANCE RATE DIVIDED BY 1,000.
2. AN AMOUNT AS FOLLOWS:
OPTION A CONTRACT TYPE: THE GREATER OF:
A. THE FACE AMOUNT DIVIDED BY THE MONTHLY COST OF INSURANCE FACTOR SHOWN
ON THE POLICY SPECIFICATIONS PAGE; OR
B. THE CASH VALUE AT THE BEGINNING OF THE POLICY MONTH MULTIPLIED BY THE
APPLICABLE PERCENTAGE OF THE CASH VALUE AS DESCRIBED IN SECTION
7702(D) OF THE INTERNAL REVENUE CODE OF 1986 AND MODIFIED FOR AGES
95 AND ABOVE.
OPTION B CONTRACT TYPE: THE GREATER OF:
A. THE FACE AMOUNT DIVIDED BY THE MONTHLY COST OF INSURANCE FACTOR SHOWN
ON THE POLICY SPECIFICATIONS PAGE PLUS THE CASH VALUE AT THE BEGINNING
OF THE POLICY MONTH; OR
B. THE CASH VALUE AT THE BEGINNING OF THE POLICY MONTH MULTIPLIED BY THE
APPLICABLE PERCENTAGE OF THE CASH VALUE AS DESCRIBED IN SECTION
7702(D) OF THE INTERNAL REVENUE CODE OF 1986 AND MODIFIED FOR AGES
95 AND ABOVE.
OPTION C CONTRACT TYPE: THE GREATER OF:
A. THE FACE AMOUNT DIVIDED BY THE MONTHLY COST OF INSURANCE FACTOR SHOWN
ON THE POLICY SPECIFICATIONS PAGE; OR
B. THE CASH VALUE AT THE BEGINNING OF THE POLICY MONTH MULTIPLIED BY THE
INSURED'S ATTAINED AGE FACTOR AS SHOWN ON THE POLICY'S DEATH BENEFIT
OPTION C ATTAINED AGE FACTORS PAGE.
3. THE CASH VALUE AT THE BEGINNING OF THE POLICY MONTH, BEFORE THE DEDUCTION
OF THE MONTHLY COST OF INSURANCE.
IF THE CONTRACT TYPE IS OPTION A OR OPTION C AND IF THERE HAS BEEN AN INCREASE IN THE
FACE AMOUNT, THEN THE CASH VALUE WILL FIRST BE CONSIDERED A PART OF THE FACE AMOUNT
WHEN THE POLICY WAS ISSUED. IF THE CASH VALUE IS GREATER THAN THE INITIAL FACE AMOUNT,
THE EXCESS CASH VALUE WILL THEN BE CONSIDERED A PART OF EACH INCREASE IN ORDER,
STARTING WITH THE FIRST INCREASE.
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MONTHLY COST AT THE BEGINNING OF EACH POLICY YEAR, THE MONTHLY COST OF INSURANCE RATE IS
OF INSURANCE DETERMINED FOR THE INITIAL FACE AMOUNT AND EACH INCREASE IN FACE AMOUNT. THE
RATES MONTHLY COST OF INSURANCE RATE IS BASED ON THE ATTAINED AGE, RISK CLASSIFICATION,
SEX AND COMPLETED POLICY YEARS FROM THE EFFECTIVE DATE OF THE INITIAL FACE AMOUNT
AND EACH INCREASE IN FACE AMOUNT. FOR THE INITIAL FACE AMOUNT, WE WILL USE THE
RISK CLASSIFICATION AS OF THE ISSUE DATE. FOR EACH INCREASE, WE WILL USE THE RISK
CLASSIFICATION APPLICABLE TO THE INCREASE. IF THE DEATH BENEFIT EQUALS A PERCENTAGE
OF THE CASH VALUE, ANY INCREASE IN CASH VALUE WILL CAUSE AN AUTOMATIC INCREASE IN
THE DEATH BENEFIT. THE RISK CLASSIFICATION FOR SUCH INCREASE WILL BE THE SAME AS
THAT USED FOR THE MOST RECENT INCREASE, EXCLUDING ANY RIDERS, THAT REQUIRED PROOF
THAT THE INSURED WAS INSURABLE BY OUR STANDARDS.
THE MONTHLY COST OF INSURANCE RATES WILL NEVER EXCEED THE RATES SHOWN ON THE TABLE
OF GUARANTEED MONTHLY COST OF INSURANCE RATES PAGE. ANY CHANGE IN THE COST OF
INSURANCE RATES WILL APPLY TO ALL PERSONS OF THE SAME AGE, SEX, AND CLASSIFICATION
WHOSE INITIAL FACE AMOUNTS OR INCREASE IN FACE AMOUNT HAVE BEEN IN FORCE FOR THE
SAME LENGTH OF TIME.
SELECTION AND THE SELECTION AND ISSUE EXPENSE CHARGE FOR THE INITIAL FACE AMOUNT OR FOR ANY INCREASE
ISSUE EXPENSE IN FACE AMOUNT IS A MONTHLY CHARGE FOR THE FIRST 10 POLICY YEARS OR FOR THE FIRST 10
CHARGE POLICY YEARS FOLLOWING ANY INCREASE IN FACE AMOUNT. THIS CHARGE EQUALS THE APPLICABLE
FACE AMOUNT TIMES A SELECTION AND ISSUE EXPENSE CHARGE RATE, DIVIDED BY 1,000. THE
SELECTION AND ISSUE EXPENSE CHARGE IS BASED ON THE INSURED'S ISSUE AGE, SEX AND RISK
CLASSIFICATION ON THE EFFECTIVE DATE OF THE INITIAL FACE AMOUNT OR ANY INCREASE IN
FACE AMOUNT. THE SELECTION AND ISSUE EXPENSE CHARGE RATE FOR THE INITIAL FACE AMOUNT
OF THE POLICY WILL NEVER EXCEED THE MAXIMUM SELECTION AND ISSUE EXPENSE CHARGE RATE
SHOWN ON THE POLICY SPECIFICATIONS PAGE FOR THE INITIAL FACE AMOUNT. A SELECTION
AND ISSUE EXPENSE CHARGE WILL ALSO BE APPLIED TO ANY INCREASE IN FACE AMOUNT. THIS
CHARGE WILL NEVER EXCEED THE MAXIMUM SELECTION AND ISSUE EXPENSE CHARGE RATE SHOWN
ON THE POLICY SPECIFICATIONS PAGE FOR THAT INCREASE.
MONTHLY POLICY A POLICY CHARGE WILL BE DEDUCTED EACH POLICY MONTH FROM THE CASH VALUE. THE AMOUNT
CHARGE OF THE MONTHLY POLICY CHARGE WILL NEVER EXCEED THE AMOUNT SHOWN ON THE POLICY
SPECIFICATIONS PAGE.
MONTHLY THE MONTHLY DEDUCTION IS:
DEDUCTION
1. THE MONTHLY COST OF INSURANCE; PLUS
2. THE SELECTION AND ISSUE EXPENSE CHARGE MULTIPLIED BY THE FACE AMOUNT
DIVIDED BY 1,000; PLUS
3. THE MONTHLY POLICY CHARGE; PLUS
4. THE MONTHLY COST, IF ANY, FOR ANY RIDER INCLUDED WITH THIS POLICY.
THE MONTHLY DEDUCTION FOR A POLICY MONTH WILL BE ALLOCATED AMONG THE GENERAL
ACCOUNT AND THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN IN THE SAME PROPORTION THAT
THE CASH VALUE IN THE GENERAL ACCOUNT AND THE CASH VALUE IN EACH DIVISION BEARS TO
THE TOTAL CASH VALUE OF THE POLICY, MINUS THE CASH VALUE IN LOAN ACCOUNT ON THE
MONTHLY ANNIVERSARY.
CASH SURRENDER THE CASH SURRENDER VALUE OF THIS POLICY IS:
VALUE
1. THE CASH VALUE AT THE TIME OF SURRENDER; MINUS
2. ANY LOAN AND LOAN INTEREST ACCRUED; MINUS
3. ANY UNPAID SELECTION AND ISSUE EXPENSE CHARGE DUE FOR THE REMAINDER OF THE
FIRST POLICY YEAR FOR THE INITIAL FACE AMOUNT AND ANY INCREASE IN FACE
AMOUNT; MINUS
4. ANY UNPAID MONTHLY POLICY CHARGE DUE FOR THE REMAINDER OF THE FIRST POLICY
YEAR; MINUS
5. ANY SURRENDER CHARGE.
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SURRENDER YOU MAY SURRENDER YOUR POLICY FOR ITS CASH SURRENDER VALUE AT ANY TIME DURING THE
LIFETIME OF THE INSURED. WE WILL DETERMINE THE CASH SURRENDER VALUE AS OF THE
DATE WE RECEIVE YOUR WRITTEN REQUEST AT OUR HOME OFFICE. THE CASH SURRENDER VALUE
WILL NOT BE REDUCED BY ANY MONTHLY DEDUCTION DUE ON THAT DATE FOR A SUBSEQUENT
POLICY MONTH.
PARTIAL AFTER THE FIRST POLICY YEAR, UPON WRITTEN REQUEST TO US, YOU CAN MAKE A PARTIAL
WITHDRAWALS WITHDRAWAL OF CASH SUBJECT TO THE CONDITIONS LISTED BELOW. THE FIRST 12 REQUESTED
PARTIAL WITHDRAWALS OR TRANSFERS PER POLICY YEAR WILL BE ALLOWED FREE OF CHARGE;
THEREAFTER WE MAY IMPOSE A TRANSFER CHARGE NOT TO EXCEED THE MAXIMUM TRANSFER
CHARGE SHOWN ON THE POLICY SPECIFICATIONS PAGE.
NO PARTIAL WITHDRAWAL WILL BE PROCESSED WHICH WILL RESULT IN THE FACE AMOUNT,
EXCLUDING RIDERS, BEING DECREASED BELOW THE MINIMUM FACE AMOUNT SHOWN ON THE POLICY
SPECIFICATIONS PAGE.
WE RESERVE THE RIGHT TO CHANGE THE MINIMUM AMOUNT OR THE NUMBER OF TIMES YOU MAY
MAKE A PARTIAL WITHDRAWAL. WE ALSO MAY ASSESS A TRANSACTION CHARGE FOR A
WITHDRAWAL.
IF THE CONTRACT TYPE IS OPTION A OR OPTION C AND THE DEATH BENEFIT EQUALS THE FACE
AMOUNT, THEN A PARTIAL WITHDRAWAL WILL DECREASE THE FACE AMOUNT BY AN AMOUNT EQUAL
TO THE PARTIAL WITHDRAWAL PLUS THE APPLICABLE SURRENDER CHARGE. THIS SURRENDER
CHARGE WILL BE ALLOCATED AMONG THE GENERAL ACCOUNT AND THE DIVISIONS OF SEPARATE
ACCOUNT ELEVEN IN THE SAME PROPORTION THAT THE PARTIAL WITHDRAWAL WAS ALLOCATED
AMONG THE GENERAL ACCOUNT AND THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN. IF THE
DEATH BENEFIT EQUALS A PERCENTAGE OF THE CASH VALUE THEN A PARTIAL WITHDRAWAL WILL
DECREASE THE FACE AMOUNT BY ANY AMOUNT BY WHICH THE PARTIAL WITHDRAWAL PLUS THE
APPLICABLE SURRENDER CHARGE EXCEEDS THE DIFFERENCE BETWEEN THE DEATH BENEFIT AND
THE FACE AMOUNT. THE FACE AMOUNT WILL BE DECREASED IN THE FOLLOWING ORDER:
1. THE FACE AMOUNT AT ISSUE, EXCLUDING RIDERS; AND
2. ANY INCREASES IN THE SAME ORDER IN WHICH THEY WERE ISSUED.
GENERAL ACCOUNT THE MINIMUM AMOUNT OF YOUR PARTIAL WITHDRAWAL REQUEST AT ANY ONE TIME MUST BE AT
PARTIAL LEAST $500 OF YOUR ACCOUNT.
WITHDRAWALS
- THE MAXIMUM AMOUNT OF ALL PARTIAL WITHDRAWALS AND TRANSFERS FROM THE
GENERAL ACCOUNT IN A POLICY YEAR WILL BE THE GREATER OF (1) OR (2):
1. THE CASH SURRENDER VALUE OF THE GENERAL ACCOUNT AT THE BEGINNING OF
THAT POLICY YEAR MULTIPLIED BY THE WITHDRAWAL PERCENTAGE LIMIT, AS
SHOWN ON THE POLICY SPECIFICATIONS PAGE.
2. THE PREVIOUS YEAR'S GENERAL ACCOUNT MAXIMUM WITHDRAWAL AMOUNT.
SEPARATE ACCOUNT - THE MINIMUM AMOUNT OF YOUR PARTIAL WITHDRAWAL REQUEST AT ANY ONE TIME MUST
PARTIAL BE THE LESSER OF $500 OF A DIVISION OR YOUR ENTIRE BALANCE IN THAT
WITHDRAWALS DIVISION.
- THE MAXIMUM AMOUNT OF YOUR PARTIAL WITHDRAWAL FROM ANY ONE OF THE
DIVISIONS OF SEPARATE ACCOUNT ELEVEN IN A POLICY YEAR WILL BE THE CASH
SURRENDER VALUE OF THAT DIVISION.
ALLOCATION YOU MAY ALLOCATE THE PARTIAL WITHDRAWAL PLUS ANY APPLICABLE SURRENDER CHARGE,
OF PARTIAL SUBJECT TO THE ABOVE CONDITIONS, AMONG THE GENERAL ACCOUNT AND THE DIVISIONS OF
WITHDRAWALS SEPARATE ACCOUNT ELEVEN. IF YOU DO NOT SPECIFY THE ALLOCATION, THEN THE PARTIAL
WITHDRAWAL WILL BE ALLOCATED AMONG THE GENERAL ACCOUNT AND THE DIVISIONS OF
SEPARATE ACCOUNT ELEVEN IN THE SAME PROPORTION THAT THE CASH VALUE IN THE GENERAL
ACCOUNT AND THE CASH VALUE IN EACH DIVISION BEARS TO THE TOTAL CASH VALUE OF THE
POLICY, MINUS THE CASH VALUE IN THE LOAN ACCOUNT ON THE DATE OF THE PARTIAL
WITHDRAWAL. IF THE GENERAL ACCOUNT CONDITIONS WILL NOT ALLOW THIS PROPORTIONATE
ALLOCATION, WE WILL REQUEST THAT YOU SPECIFY AN ACCEPTABLE ALLOCATION.
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27
PRO RATA AFTER THE FIRST POLICY YEAR, UPON WRITTEN REQUEST TO US, YOU CAN MAKE A PRO RATA
SURRENDER SURRENDER OF YOUR POLICY. THE PRO RATA SURRENDER CAN BE ANY WHOLE NUMBER PERCENTAGE
OF YOUR POLICY. THE PRO RATA SURRENDER WILL REDUCE THE FACE AMOUNT AND THE CASH
VALUE BY THE PERCENTAGE CHOSEN. THE FACE AMOUNT DECREASE WILL BE SUBJECT TO THE
FOLLOWING CONDITIONS:
1. THE DECREASE WILL BECOME EFFECTIVE ON THE MONTHLY ANNIVERSARY ON OR
FOLLOWING OUR RECEIPT OF THE REQUEST.
2. THE DECREASE WILL REDUCE THE FACE AMOUNT IN THE FOLLOWING ORDER:
A. THE FACE AMOUNT PROVIDED BY THE MOST RECENT INCREASE;
B. FACE AMOUNTS PROVIDED BY THE NEXT MOST RECENT INCREASES,
SUCCESSIVELY; AND
C. THE FACE AMOUNT WHEN THE POLICY WAS ISSUED.
3. YOU MAY ALLOCATE THE DECREASE IN CASH VALUE DUE TO THE PRO RATA SURRENDER
PLUS ANY APPLICABLE SURRENDER CHARGE AMONG THE GENERAL ACCOUNT AND THE
DIVISIONS OF SEPARATE ACCOUNT ELEVEN. IF YOU DO NOT SPECIFY THE
ALLOCATION, THEN THE DECREASE IN CASH VALUE PLUS ANY APPLICABLE
SURRENDER CHARGE WILL BE ALLOCATED AMONG THE GENERAL ACCOUNT AND THE
DIVISIONS OF SEPARATE ACCOUNT ELEVEN IN THE SAME PROPORTION THAT THE
CASH VALUE IN THE GENERAL ACCOUNT AND THE CASH VALUE IN EACH DIVISION
BEARS TO THE TOTAL CASH VALUE OF THE POLICY, MINUS THE CASH VALUE IN THE
LOAN ACCOUNT ON THE DATE OF THE PRO RATA SURRENDER.
A PRO RATA SURRENDER CAN NOT BE PROCESSED IF IT WILL REDUCE THE FACE AMOUNT BELOW
THE MINIMUM FACE AMOUNT SHOWN ON THE POLICY SPECIFICATIONS PAGE. NO PRO RATA
SURRENDER WILL BE PROCESSED FOR MORE CASH SURRENDER VALUE THAN IS AVAILABLE ON THE
DATE OF THE PRO RATA SURRENDER. A CASH PAYMENT WILL BE MADE TO YOU FOR THE AMOUNT
OF CASH VALUE REDUCTION LESS ANY APPLICABLE SURRENDER CHARGES.
SURRENDER CHARGE A SURRENDER CHARGE WILL APPLY UPON SURRENDER, UPON LAPSE, UPON A PARTIAL WITHDRAWAL
THAT REDUCES THE FACE AMOUNT, OR UPON A DECREASE IN FACE AMOUNT FOR UP TO 10 YEARS
FROM THE POLICY'S ISSUE DATE OR FOR UP TO 10 YEARS FOLLOWING THE EFFECTIVE DATE OF
ANY INCREASE IN FACE AMOUNT.
THE SURRENDER CHARGE FOR THE INITIAL FACE AMOUNT IS THE TARGET ANNUAL PREMIUM (BASE
ONLY), SHOWN ON THE POLICY SPECIFICATIONS PAGE, MULTIPLIED BY THE APPLICABLE SURRENDER
CHARGE PERCENTAGE, PLUS THE SURRENDER CHARGE FOR ANY INCREASE IN FACE AMOUNT. THE
SURRENDER CHARGE FOR ANY INCREASE IN FACE AMOUNT IS THE TARGET ANNUAL PREMIUM (BASE
ONLY) FOR THAT INCREASE, SHOWN ON THE POLICY SPECIFICATIONS PAGE FOR THAT INCREASE,
MULTIPLIED BY THE APPLICABLE SURRENDER CHARGE PERCENTAGE. THE SURRENDER CHARGE
PERCENTAGE WILL NEVER EXCEED THE MAXIMUM SURRENDER CHARGE PERCENTAGE SHOWN ON
THE SURRENDER CHARGE SCHEDULE PAGE, FOR THE INITIAL FACE AMOUNT AND FOR ANY INCREASE.
THE SURRENDER CHARGES FOR THIS POLICY WILL VARY ON A NON-DISCRIMINATORY BASIS, BASED
ON THE AMOUNT OF PREMIUM PAID, BUT WILL NEVER EXCEED THE MAXIMUM SURRENDER CHARGE
PERCENTAGE SHOWN ON THE SURRENDER CHARGE SCHEDULE PAGE.
A SURRENDER CHARGE WILL APPLY TO ANY DECREASE IN FACE AMOUNT. A DECREASE IN FACE
AMOUNT MAY DECREASE SOME OR ALL OF THE INITIAL FACE AMOUNT AND INCREASES IN FACE
AMOUNT AS PROVIDED IN SECTION 5. A PARTIAL WITHDRAWAL MAY CAUSE A DECREASE IN FACE
AMOUNT AS PROVIDED ABOVE AND, THEREFORE, A SURRENDER CHARGE MAY BE TAKEN. IF THE
FACE AMOUNT IS DECREASED BY SOME FRACTION OF ANY PREVIOUS INCREASES IN FACE AMOUNT
AND/OR THE FACE AMOUNT AT ISSUE, THE SURRENDER CHARGE DEDUCTED WILL BE THE PREVIOUSLY
DEFINED SURRENDER CHARGE MULTIPLIED BY THE FRACTION.
THE SURRENDER CHARGE WILL BE ALLOCATED AMONG THE GENERAL ACCOUNT AND THE DIVISIONS
OF SEPARATE ACCOUNT ELEVEN IN THE SAME PROPORTION THAT THE CASH VALUE IN THE
GENERAL ACCOUNT AND THE CASH VALUE IN EACH DIVISION BEARS TO THE TOTAL CASH VALUE
OF THE POLICY MINUS THE CASH VALUE IN THE LOAN ACCOUNT.
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28
POSTPONEMENT WE WILL USUALLY PAY ANY AMOUNTS PAYABLE ON SURRENDER, PARTIAL WITHDRAWAL, OR POLICY
OF PAYMENTS LOAN ALLOCATED TO THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN WITHIN SEVEN DAYS AFTER
OR TRANSFERS WRITTEN NOTICE IS RECEIVED. WE WILL USUALLY PAY ANY DEATH BENEFIT PROCEEDS WITHIN
SEVEN DAYS AFTER WE RECEIVE DUE PROOF OF CLAIM. PAYMENT OF ANY AMOUNT PAYABLE, FROM
THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN, ON SURRENDER, PARTIAL WITHDRAWAL, POLICY
LOAN OR DEATH MAY BE POSTPONED WHENEVER:
1. THE NEW YORK STOCK EXCHANGE IS CLOSED (OTHER THAN CUSTOMARY WEEKEND AND
HOLIDAY CLOSING) OR TRADING ON THE NEW YORK STOCK EXCHANGE IS RESTRICTED
AS DETERMINED BY THE SEC;
2. THE SEC, BY ORDER, PERMITS POSTPONEMENT FOR THE PROTECTION OF POLICY
OWNERS; OR
3. AN EMERGENCY EXISTS AS DETERMINED BY THE SEC, AS A RESULT OF WHICH
DISPOSAL OF SECURITIES IS NOT REASONABLY PRACTICABLE OR IT IS NOT
REASONABLY PRACTICABLE TO DETERMINE THE VALUE OF THE NET ASSETS OF
SEPARATE ACCOUNT ELEVEN.
WE MAY DEFER PAYMENT OF THE PORTION OF ANY AMOUNT PAYABLE FROM THE GENERAL ACCOUNT
ON SURRENDER, OR PARTIAL WITHDRAWAL FOR NOT MORE THAN SIX MONTHS. IF WE DEFER
PAYMENT FOR 30 DAYS OR MORE, WE WILL PAY INTEREST AT THE RATE OF 2 1/2% PER YEAR
FOR THE PERIOD OF DEFERMENT.
TRANSFERS MAY ALSO BE POSTPONED UNDER THE CIRCUMSTANCES LISTED ABOVE.
WE MAY DEFER PAYMENT OF THE PORTION OF ANY POLICY LOAN FROM THE GENERAL ACCOUNT FOR
NOT MORE THAN SIX MONTHS. NO PAYMENT FROM THE GENERAL ACCOUNT TO PAY PREMIUMS ON
THIS POLICY WILL BE DEFERRED.
CONTINUATION IF ALL PREMIUM PAYMENTS CEASE, THE INSURANCE PROVIDED UNDER THIS POLICY, INCLUDING
OF INSURANCE BENEFITS PROVIDED BY ANY RIDER ATTACHED TO THIS POLICY, WILL CONTINUE IN ACCORDANCE
WITH THE PROVISIONS OF THIS POLICY FOR AS LONG AS THE CASH VALUE LESS ANY LOANS,
LOAN INTEREST ACCRUED AND ANY SURRENDER CHARGE IS SUFFICIENT TO COVER THE MONTHLY
DEDUCTIONS.
BASIS OF THE MINIMUM CASH VALUES ARE BASED ON 1) THE MINIMUM CASH VALUE MORTALITY TABLE
COMPUTATION SHOWN ON THE POLICY SPECIFICATIONS PAGE; AND 2) FOR AMOUNTS ALLOCATED TO THE
GENERAL ACCOUNT, COMPOUND INTEREST AT AN ANNUAL RATE OF NOT LESS THAN THE GENERAL
ACCOUNT CASH VALUE GUARANTEED INTEREST RATE SHOWN ON THE POLICY SPECIFICATIONS
PAGE. THERE IS NO MINIMUM CASH VALUE GUARANTEED INTEREST RATE FOR AMOUNTS ALLOCATED
TO THE DIVISIONS OF SEPARATE ACCOUNT ELEVEN.
NET SINGLE PREMIUMS ARE BASED ON 1) THE 7702 TABLE AS SHOWN ON THE POLICY
SPECIFICATIONS PAGE; AND 2) THE GENERAL ACCOUNT CASH VALUE GUARANTEED INTEREST RATE
AS SHOWN ON THE POLICY SPECIFICATIONS PAGE.
ALL VALUES ARE AT LEAST EQUAL TO THOSE REQUIRED BY ANY APPLICABLE LAW OF THE STATE
THAT GOVERNS YOUR POLICY. WE HAVE FILED A DETAILED STATEMENT OF THE METHOD OF
CALCULATING CASH VALUES AND RESERVES WITH THE INSURANCE SUPERVISORY OFFICIAL OF
THAT STATE.
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29
10. PAYMENT OF POLICY BENEFITS
PAYMENT A LUMP SUM PAYMENT WILL BE MADE AS PROVIDED ON THE FACE PAGE.
INTEREST ON WE WILL PAY INTEREST ON PROCEEDS FROM THE DATE OF THE INSURED'S DEATH TO THE DATE
PROCEEDS OF PAYMENT. INTEREST WILL BE AT AN ANNUAL RATE DETERMINED BY US, BUT NEVER LESS
THAN THE GUARANTEED INTEREST RATE, SHOWN ON THE POLICY SPECIFICATIONS PAGE.
EXTENDED PROVISIONS FOR SETTLEMENT OF PROCEEDS DIFFERENT FROM A LUMP SUM PAYMENT MAY ONLY BE
PROVISIONS MADE UPON WRITTEN AGREEMENT WITH US.
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30
FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE
PARTICIPATING
General
American
LIFE INSURANCE COMPANY
13045 TESSON FERRY RD.
ST. LOUIS, MISSOURI 63128
100016
(6/98)