Exhibit 1.A.5(d)
2E-5ACC-02
ACCELERATION OF DEATH BENEFIT RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
THE WAITING PERIODS FOR SUICIDE AND INCONTESTABILITY ARE DIFFERENT FROM THOSE IN
THE POLICY AND BEGIN ON THE ISSUE DATE OF THE RIDER.
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page or on the Policy Specifications page for Policy
Change. A copy of the application for this Rider is attached to and made a part
of the Rider.
IMPORTANT: THE BENEFIT PAYMENTS UNDER THIS RIDER MAY BE TAXABLE OR MAY AFFECT
ELIGIBILITY FOR BENEFITS UNDER STATE OR FEDERAL LAW. YOU SHOULD CONSULT YOUR TAX
ADVISER TO DETERMINE THE EFFECT ON YOU.
DEFINITIONS "Eligible Proceeds" are the Policy Proceeds as defined
in your Policy: less any Face Amount provided by a
Supplemental Coverage Term Rider; and plus any amount
of benefit provided by a rider that we consent to
apply to an Accelerated Death Benefit.
"Accelerated Death Benefit" is the amount we will pay
under this Rider if we receive proof that the Insured
is terminally ill.
We will compute the Accelerated Death Benefit based on
the following:
1. The amount of Eligible Proceeds you choose to
accelerate. (See Amount of Accelerated Death
Benefit);
2. Reduced life expectancy;
3. A processing charge not to exceed $150; and
4. An Interest Rate no greater than the greater of:
a. The current yield on 90 day treasury bills;
and
b. The current maximum statutory adjustable
policy loan interest rate.
This method of computation has been filed with the
insurance supervisory official of the state that
governs your Policy. We may change the assumptions we
use from time to time.
"Terminally ill" means having a life expectancy of 12
months or less.
AMOUNT OF ACCELERATED You may choose to apply all or part of the Eligible
DEATH BENEFIT Proceeds to your Accelerated Death Benefit subject to
the following conditions:
1. You must apply at least $20,000.
2. You cannot apply more than the greater of:
a. $250,000; and
b. 10% of the Eligible Proceeds under this and
all other similar riders issued by us and our
affiliates.
3. The Face Amount of your Policy after payment of a
partial Accelerated Death Benefit must be at least
$50,000.
CONDITIONS Your right to the Accelerated Death Benefit under this
Rider is subject to the following:
1. You must provide proof satisfactory to us,
including a statement signed by a physician, that
the Insured is terminally ill. The physician may
not be you, the Insured, or a member of the
Insured's family. We have the right to have the
Insured examined at our expense by a physician we
choose.
2. You must make a written request for payment in a
form acceptable to us.
3. Any irrevocable beneficiary must give written
consent for payment in a form acceptable to us.
4. Any assignee must give written consent for payment
in a form acceptable to us.
5. We may require the Policy for endorsement.
6. You may request only one Accelerated Death Benefit
under this Rider.
7. Insurance subject to incontestability and suicide
provisions will not be included in the Eligible
Proceeds.
8. Your Policy is not eligible for this benefit if:
a. You are required by law to use this Rider to
meet the claims of creditors, whether in
bankruptcy or otherwise; or
b. You are required by a government agency to use
this Rider to apply for, obtain, or keep a
government benefit or entitlement.
PAYMENT OF Unless otherwise requested, we may pay the Accelerated
ACCELERATED DEATH Death Benefit in one sum or by placing the amount in
BENEFIT an account that earns interest. You will have
immediate access to all or any part of the account.
EFFECT OF BENEFIT All policy values and the Death Benefit on the
ACCELERATION ON remaining Policy, if any, will be reduced in the same
POLICY AND RIDERS proportion as the amount of Eligible Proceeds was
applied to the Accelerated Death Benefit. Upon
acceleration, future premiums and policy charges will
be based on the reduced Death Benefit of the Policy.
If you apply all of the Eligible Proceeds to your
Accelerated Death Benefit, all policy benefits based
on the Insured's life, except for any benefit for
accidental death, will end. Any accidental death
benefit rider on the life of the Insured will continue
in force for 12 months from the date of any payment
under this Rider. Any riders that provide a benefit on
the life of someone other than the Insured will stay
in effect pursuant to their terms as if the Insured
had died. No further cost for those riders will be
payable.
INCONTESTABILITY This Rider will not be contestable after it has been
in force during the life of the Insured for two years
from the Issue Date of the Rider.
SUICIDE EXCLUSION This Rider does not apply if the Insured's terminal
illness is the result of an attempt to commit suicide,
while sane or insane, within two years from the Issue
Date of the Rider.
TERMINATION This Rider will terminate at the earliest of:
1. When an Accelerated Death Benefit is paid;
2. The date on which the Policy would be disqualified
as a life insurance contract because this Rider is
attached, under the Internal Revenue Code as
interpreted by the Internal Revenue Service;
3. When the Policy to which this Rider is attached
terminates; and
4. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of your written request to
terminate this Rider. We may require the Policy
for endorsement.
The Issue Date and effective date of this Rider and the Policy are the same
unless another Issue Date is shown below.
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Issue Date
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
2E-5ABT-02
ADJUSTABLE BENEFIT TERM RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page. A copy of the application for this Rider is
attached to and made part of the Rider.
FACE AMOUNT The Face Amount of this Rider is shown on the Policy
Specifications page.
LIFE INSURANCE BENEFIT This Rider provides non-convertible term life
insurance on the Insured shown on the Policy
Specifications page. We will pay the Death Benefit of
this Rider to the Beneficiary if the Insured dies
while this Rider is in force.
The Death Benefit and Net Amount at Risk provisions in
the Policy are modified so that where it states "Face
Amount" it includes this Rider's Face Amount.
ADJUSTABLE BENEFIT TERM While this Rider is in force an adjustment in the Face
DATES Amount of this Rider may be requested. Except with our
consent, such request may be made once each Policy
year. The adjustment will be effective on the monthly
anniversary on or after our receipt of the request.
ADJUSTABLE BENEFIT TERM The Face Amount of this Rider may be increased subject
AMOUNT to the following conditions:
1. Written request, subject to our approval, to
increase the Face Amount of this Rider;
2. Proof that the Insured is insurable based on our
underwriting rules for this Rider; and
3. An increase of at least $1,000, except with our
consent.
The Face Amount of this Rider may be decreased,
subject to our approval, upon our receipt of a written
request.
If you request a change in Death Benefit Option, this
Rider's Face Amount may be decreased. (See the Change
in Death Benefit Option provision in your Policy.)
If you request a partial withdrawal, this Rider's Face
Amount may be decreased. (See the Partial Withdrawal
provision in your Policy.)
MONTHLY COST OF The Monthly Cost of Insurance for this Rider for the
INSURANCE following month is charged as part of the Monthly
Deduction and is included in the Total Monthly Cost of
Insurance. The Monthly Cost of Insurance is calculated
as described in the Policy. (See the Monthly Deduction
and the Monthly Cost of Insurance provisions in the
Policy.).
MONTHLY COST OF The Monthly Cost of Insurance Rate for this benefit is
INSURANCE RATES based on the Insured's Attained Age, Risk
Classification and sex. Monthly Cost of Insurance
Rates will be determined by us based on expectations
as to future mortality, tax, interest earnings,
expense and persistency experience. We will not adjust
such rates as a means of recovering prior losses nor
as a means of distributing prior profits. These rates
will not exceed those shown in the Table of Maximum
Monthly Cost of Insurance Rates for the Adjustable
Benefit Term Rider.
TERMINATION This Rider will terminate on the first of the
following events to occur:
1. The lapse of the Policy;
2. The surrender of the Policy;
3. The Insured's date of death; and
4. Attained Age 100 of the Insured.
The Issue Date and effective date of this Rider and the Policy are the same.
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
TABLE OF MAXIMUM MONTHLY COST OF INSURANCE RATES
PER $1,000
INSURED: [JOHN DOE]
COVERAGE: [ADJUSTABLE BENEFIT TERM RIDER]
POLICY NUMBER: [16,000,001]
ATTAINED ATTAINED ATTAINED RATE
AGE RATE AGE RATE AGE
35 0.2192 71 4.9242
36 0.2342 72 5.3608
37 0.2533 73 5.8525
38 0.2750 74 6.3883
39 0.3000 75 6.9808
40 0.3283 76 7.5917
41 0.3617 77 8.2100
42 0.3958 78 8.8258
43 0.4350 79 9.4575
44 0.4758 80 10.1325
45 0.5225 81 10.8675
46 0.5692 82 11.6833
47 0.6200 83 12.5858
48 0.6733 84 13.5408
49 0.7333 85 14.5167
50 0.7967 86 15.4817
51 0.8700 87 16.4217
52 0.9517 88 17.4475
53 1.0450 89 18.4600
54 1.1500 90 19.4742
55 1.2617 91 20.5100
56 1.3825 92 21.6108
57 1.5075 93 23.0250
58 1.6408 94 24.8458
59 1.7792 95 27.4967
60 1.9325 96 32.0458
61 2.1050 97 40.0167
62 2.2992 98 54.8317
63 2.5192 99 83.3333
64 2.7617
65 3.0242
66 3.2975
67 3.5842
68 3.8792
69 4.1933
70 4.5400
THESE RATES ARE FOR THE ADJUSTABLE BENEFIT TERM RIDER AS OF THE ISSUE DATE. THEY
ARE BASED ON THE 1980 COMMISSIONERS STANDARD ORDINARY MORTALITY TABLE FOR A
[MALE, SMOKER].
2E-5CT-02
CHILDREN'S LIFE INSURANCE RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
THE WAITING PERIODS FOR SUICIDE AND INCONTESTABILITY ARE DIFFERENT FROM THOSE IN
THE POLICY AND BEGIN ON THE ISSUE DATE OF THE RIDER.
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page or on the Policy Specifications page for Policy
Change. A copy of the application for this Rider is attached to and made part of
the Rider.
FACE AMOUNT The Face Amount for this Rider on each Insured Child
at and after age 6 months is the Face Amount shown for
the Rider on the Policy Specifications page, or half
of that amount before age 6 months. If the Rider is
added after issue, the Policy Specifications page for
Policy Change shows the Face Amount for the Rider.
LIFE INSURANCE BENEFIT We will pay the Face Amount to the Beneficiary under
this Rider upon the death of the Insured Child while
this Rider is in force. We must receive proof that the
death occurred before the Expiry Date of insurance on
such Insured Child.
DEFINITION OF INSURED The Insured, as shown on the Policy Specifications
page, is the person whose life is covered under the
Policy to which this Rider is attached.
DEFINITION OF INSURED Any child, stepchild or legally adopted child of the
CHILD Insured is an Insured Child if named in the
application for this Rider. Any child of the Insured
born after the date of the application for this Rider
will become an Insured Child at age 15 days. Any child
who is legally adopted by the Insured after the date
of the application for this Rider but before the
child's 18th birthday will become an Insured Child at
age 15 days or on the date of adoption, if later. Each
Insured Child will cease to be an Insured Child on the
first to occur of:
1. His or her 25th birthday;
2. The Expiry Date of this Rider;
3. A conversion of the insurance provided by the
Rider on that Insured Child; and
4. The death of the Insured Child.
OWNER Unless otherwise provided, during the lifetime of the
Insured, the Owner of the Policy will be the Owner of
this Rider. Upon the death of the Insured, all such
rights with respect to insurance then in force under
this Rider on the life of an Insured Child, will,
unless otherwise provided, vest in such Insured Child.
THE BENEFICIARY The Beneficiary of any benefit payable as a result of
the death of any Insured Child will be: the Insured,
if living; if not then the estate of the person upon
whose death payment is to be made; unless: otherwise
provided in the application; or changed by you.
You may change the beneficiary designation of the
insurance on the life of
any person insured under this Rider. This change must
be done during the lifetime of such person. To make
such a change you must file a proper written request
with us. This request must be accepted by us at our
Home Office or any other office designated by us. If
we accept your request, the change will take effect as
of the date of the request. This change will be
subject to any payment or action we took before we
received your written request for the change. The
beneficiary designation and any changes made will be
subject to any assignment of the Policy.
MONTHLY COST OF RIDER The Monthly Cost of Rider for the following month is
charged as part of the Monthly Deduction. The Monthly
Cost of Rider for the Children's Life Insurance Rider
is:
1. The Face Amount shown for the Rider on the Policy
Specifications page or Policy Specifications page
for Policy Change divided by $1,000; times
2. The Monthly Cost of Rider Rate -Children's Life
Insurance Rider shown on the Policy Specifications
page or on the Policy Specifications page for
Policy Change
EXTRA AMOUNT OF We will provide an extra amount of insurance on an
INSURANCE Insured Child for 90 days at no extra charge when:
1. That Insured Child marries;
2. A child is born to that Insured Child; and
3. A child is legally adopted by that Insured Child.
The extra amount of insurance will be four times the
Face Amount under this Rider. On receipt of proof that
that Insured Child died within 90 days after the
marriage, birth or adoption, we will pay the extra
amount to the estate of that Insured Child. The extra
insurance will expire at the end of 90 days after the
marriage, birth or adoption. In no event will the
amount of extra insurance on an Insured Child be more
than four times the Face Amount if any 90-day periods
overlap. Any extra amount of insurance provided under
this provision is not convertible under the Conversion
Rights provision.
PAID-UP TERM BENEFIT Except as provided under the Suicide Exclusion
provision of this Rider, if the Insured's death occurs
while this Rider is in force, this Rider will be
continued as if the Insured had not died at no extra
cost. This fully paid-up benefit will be subject to
the terms of this Rider. We must receive proof of
death of the Insured.
Any child who would have become an Insured Child if
the Insured's death had not occurred will become an
insured child in accordance with the provisions of
this Rider.
CONVERSION RIGHTS The Owner may convert the term insurance in force
under this Rider on each Insured Child for a new
policy on that Insured Child's Date of Conversion. The
Date of Conversion is the 25th birthday of that
Insured Child or, if earlier, the Expiry Date of this
Rider. An Insured Child's Date of Conversion can be
advanced to the date any extra amount of insurance on
that Insured Child expires under this Rider. The new
policy will be issued:
1. On the life of the Insured Child;
2. Without proof of insurability;
3. With a Face Amount not more than 5 times the Face
Amount of this Rider on the Insured Child;
4. Based on a standard nonsmoker risk classification
or the risk classification the issuing company
determines is closest to it if that classification
is not available on the new policy;
5. With a current Policy Date;
6. By us or by an affiliate designated by us;
7. On a plan agreed to by the issuing company;
8. At the then current age of the Insured Child as
calculated by the issuing company for that plan of
insurance;
9. Subject to payment of the first premium for the
new policy;
10. On a policy form and at rates in use by the
issuing company on the Policy Date of the new
policy; and
11. Subject to any assignments and limitations to
which this Rider is subject.
The conversion may be made only with our consent if
the amount of insurance to be converted is less than
the issuing company's published minimum limits of
issue.
REINSTATEMENT If this Rider lapses, you may reinstate it within
three years after the date of lapse. The Rider cannot
be reinstated, except with our consent, if more than
three years have passed since the date of lapse. To
reinstate, you must submit the following items:
1. A written application for reinstatement;
2. Proof satisfactory to us that each Insured Child
is insurable by our standards; and
3. Payment, while each Insured Child is living, of a
premium large enough to keep the Rider in force
for at least three months.
Upon Reinstatement, we will deduct any Monthly Cost of
Rider 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 rider will be in force from the date we
approve the Reinstatement application.
LIMITATIONS ON This Rider can be reinstated only if the Policy is
REINSTATEMENT also reinstated or is in force. If only a portion of
the Policy coverage is reinstated then only a portion
of the Rider coverage may also be reinstated.
INCONTESTABILITY This Rider will not be contestable after it has been
in force during the life of the Insured for two years
from the Issue Date of the Rider.
SUICIDE EXCLUSION If the Insured dies by suicide, while sane or insane,
within two years from the Issue Date of this Rider:
1. The Rider will not become paid-up under the
Paid-up Benefit provision;
2. The Rider will terminate; and
3. The Cost of Rider paid for the Rider will be
included in the Policy Proceeds.
INCORRECT AGE The date that coverage under this Rider ceases,
expires or terminates will
be based on the correct age of each person insured.
EXPIRATION OF INSURANCE The Expiry Date of this Rider is the policy
anniversary nearest the 65th birthday of the Insured.
If this Rider has not already expired or been
cancelled, then insurance on each Insured Child will
cease on the 25th birthday of such child.
TERMINATION This Rider will terminate upon the earliest of:
1. The lapse of the Policy;
2. The surrender of the Policy;
3. The Expiry Date for the Rider; and
4. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of the Owner's written request to
terminate this Rider. We may require the Policy
for endorsement.
The Issue Date and effective date of this Rider and Policy are the same unless
another Issue Date is shown below. The insurance provided by this Rider will be
in force from the Issue Date of the Rider.
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Issue Date
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
2E-5CTC-02
CONVERTIBLE SUPPLEMENTAL COVERAGE TERM RIDER
ISSUED BY NEW ENGLAND INSURANCE COMPANY
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page. A copy of the application for this Rider is
attached to and made a part of the Rider.
FACE AMOUNT The Face Amount of this Rider is shown on the Policy
Specifications page.
LIFE INSURANCE BENEFIT This Rider provides convertible term life insurance on
the life of the Insured shown on the Policy
Specifications page. We will pay the Face Amount of
this Rider to the Beneficiary as part of the Policy
Proceeds if the Insured dies while this Rider is in
force.
MONTHLY COST OF RIDER The Monthly Cost of Rider for the following month is
charged as part of the Monthly Deduction. The Monthly
Cost of Rider is the Monthly Cost of Rider Rate for
this Rider times the Face Amount of this Rider divided
by 1,000.
MONTHLY COST OF RIDER The Monthly Cost of Rider Rate for this benefit is
RATES based on the Insured's Attained Age, Risk
Classification and sex. Monthly Cost of Rider Rates
will be determined by us based on our expectations as
to future mortality, tax, interest earnings, expense
and persistency experience. We will not adjust such
rates as a means of recovering prior losses nor as a
means of distributing prior profits. These rates will
not exceed those shown in the Table of Maximum Monthly
Cost of Rider Rates for the Convertible Supplemental
Coverage Term Rider.
DECREASES IN RIDER After the first policy year, the Face Amount of this
FACE AMOUNT Rider may be decreased by sending us a written
request.
Any requested decrease in the Rider's 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 at our Home Office or any other office
designated by us;
2. The Face Amount after the decrease may not be less
than $10,000; and
3. Any decrease must be at least the Minimum Face
Amount Decrease as shown on the Policy
Specifications page.
CONVERSION RIGHTS After the first policy year, the Owner can, before the
policy anniversary on which the Insured is Attained
Age 80, convert any portion of the insurance then in
force under this Rider to: a new policy; or an
increase in Face Amount for the Policy:
1. If the Attained Age of the Insured meets the
issuing company's issue age requirements on the
date of the conversion; and
2. If the issuing company's underwriting class
requirements on the date of the conversion can be
met.
CONVERSION TO A NEW If the conversion is to a new policy, the new policy
POLICY will be issued:
1. With the same Insured as this Rider;
2. Without proof of insurability;
3. With a Face Amount equal to the amount of term
insurance being converted;
4. With the same underwriting class as this Rider, or
the class we determine is closest to it if the
class of this Rider is not offered on the new
policy;
5. With a current Policy Date;
6. By us or by an affiliate designated by us;
7. On a plan agreed to by the issuing company;
8. At the then current age of the Insured as
calculated by the issuing company for that plan of
insurance;
9. Subject to payment of the first premium for the
new policy less any conversion credit;
10. Subject to any assignments and limitations to
which this Rider is subject; and
11. On a policy form and at rates in use by the
issuing company on the Policy Date of the new
policy.
The conversion may be made only with our consent if:
1. The amount of term insurance you want to convert
is less than the issuing company's published
minimum limits of issue; or
2. Any rider is to be attached to the new policy.
The Contestable and Suicide periods of the new policy
will be measured from the Issue Date of this Rider.
CONVERSION TO AN If the conversion is to an increase in Face Amount,
INCREASE IN FACE AMOUNT any increase in Face Amount is subject to:
1. New insurance for the amount of the increase on
the same plan at the Attained Age of the Insured
on the date of the conversion being allowed under
the underwriting rules of the issuing company;
2. The amount of the increase being at least the
Minimum Face Amount Increase shown on the Policy
Specifications page, except with our consent; and
3. A Monthly Deduction for that increase.
An increase will be effective on the date shown in the
Policy Specifications page for Policy Change.
The Contestable and Suicide periods of the increase in
Face Amount will be measured from the Issue Date of
this Rider.
TERMINATION This Rider will terminate upon the earliest of:
1. The lapse of the Policy;
2. The surrender of the Policy;
3. The Insured's date of death;
4. A conversion of the entire Face Amount of the
Rider to new insurance;
5. Attained Age 100 of the Insured; and
6. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of your written request to
terminate this Rider. We may require the Policy
for endorsement.
The Issue Date and effective date of this Rider and the Policy are the same.
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
TABLE OF MAXIMUM MONTHLY COST OF INSURANCE RATES
PER $1,000
INSURED: [JOHN DOE]
COVERAGE: [CONVERTIBLE SUPPLEMENTAL COVERAGE TERM RIDER]
POLICY NUMBER: [16,000,001]
ATTAINED ATTAINED ATTAINED RATE
AGE RATE AGE RATE AGE
35 0.2192 71 4.9242
36 0.2342 72 5.3608
37 0.2533 73 5.8525
38 0.2750 74 6.3883
39 0.3000 75 6.9808
40 0.3283 76 7.5917
41 0.3617 77 8.2100
42 0.3958 78 8.8258
43 0.4350 79 9.4575
44 0.4758 80 10.1325
45 0.5225 81 10.8675
46 0.5692 82 11.6833
47 0.6200 83 12.5858
48 0.6733 84 13.5408
49 0.7333 85 14.5167
50 0.7967 86 15.4817
51 0.8700 87 16.4217
52 0.9517 88 17.4475
53 1.0450 89 18.4600
54 1.1500 90 19.4742
55 1.2617 91 20.5100
56 1.3825 92 21.6108
57 1.5075 93 23.0250
58 1.6408 94 24.8458
59 1.7792 95 27.4967
60 1.9325 96 32.0458
61 2.1050 97 40.0167
62 2.2992 98 54.8317
63 2.5192 99 83.3333
64 2.7617
65 3.0242
66 3.2975
67 3.5842
68 3.8792
69 4.1933
70 4.5400
THESE RATES ARE FOR THE CONVERTIBLE SUPPLEMENTAL COVERAGE TERM RIDER AS OF THE
ISSUE DATE. THEY ARE BASED ON THE 1980 COMMISSIONERS STANDARD ORDINARY MORTALITY
TABLE FOR A [MALE, SMOKER].
2E-E2-02
EXCHANGE TO TERM INSURANCE ENDORSEMENT
As of the Issue Date, this Endorsement is a part of the Policy and is subject to
all applicable terms and provisions except as modified herein.
EXCHANGE OF POLICY You can exchange this Policy for a policy which
FOR TERM INSURANCE provides fixed benefit term insurance:
1. If the Policy has not lapsed;
2. If the Policy is in force under a corporate plan
of deferred compensation;
3. If the purchase of insurance under the plan was
not at the option of the Insured; and
4. If the exchange is made within three years of the
Policy Date of the Policy.
The new policy:
1. Will be issued by us or by an affiliate designated
by us;
2. Will have the same Insured as this Policy;
3. Will have a Face Amount equal to the amount of
coverage being exchanged; and
4. Will be on a plan agreed to by the issuing
company.
The new policy will have the same Issue Age and Policy
Date as this Policy.
This Policy will terminate after an exchange. The
exchange will be subject to: an application to
exchange the Policy; and proof that the Insured is
then insurable. An exchange credit will be paid to
you. The credit will be quoted by us on request.
A detailed statement of the method of computing the
exchange credit has been filed, where required, with
the Insurance Department of the state in which the
Policy is delivered.
If you surrender this Policy for its Cash Surrender
Value at a time when this Exchange of Policy for Term
Insurance would have been available, we will
automatically pay an amount equal to the exchange
credit in lieu of the Cash Surrender Value if we
determine that the exchange credit would be greater.
ABCD ABCD
President Secretary
2E-5GI-02
OPTIONS TO PURCHASE ADDITIONAL LIFE INSURANCE RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page. A copy of the application for this Rider is
attached to and made a part of the Rider.
PURCHASE OF Additional life insurance can be purchased on each
ADDITIONAL LIFE Purchase Option Date shown on the Options to Purchase
INSURANCE Additional Life Insurance Rider Schedule. The
additional insurance can be: an increase in Face
Amount for the Policy; or a new policy. (See the
Increase in Face Amount and The New Policy provisions
below.) Application for the additional insurance must
be in writing, signed by the Owner and by the Insured
and received at our Home Office or any other office
designated by us within 60 days of the Purchase Option
Date.
MAXIMUM OPTION AMOUNT The Maximum Option Amount is the maximum amount of
additional life insurance that can be purchased on
each Purchase Option Date subject to the Maximum Total
Option Amount below. The Maximum Option Amount is
shown on the Options to Purchase Additional Life
Insurance Rider Schedule. You may purchase less than
the Maximum Option Amount on any Purchase Option Date.
Any portion of the Maximum Option Amount not purchased
within 60 days of a Purchase Option Date will be
forfeited.
MAXIMUM TOTAL OPTION The Maximum Total Option Amount is the lesser of:
AMOUNT
1. The number of Purchase Option Dates shown on the
Options to Purchase Additional Life Insurance
Rider Schedule times the Maximum Option Amount
shown on the Options to Purchase Additional Life
Insurance Rider Schedule; and
2. $1,000,000.
PURCHASE OPTION DATES The Purchase Option Dates are shown on the Options to
Purchase Additional Life Insurance Rider Schedule.
ADVANCEMENT OF After the second rider year, at your election, the
PURCHASE OPTION DATES next available Purchase Option Date can be advanced to
the date on which any of the following events occurs:
1. A child is born to the Insured;
2. A child under 21 is legally adopted by the
Insured;
3. A home or other real estate is purchased by the
Insured;
4. The Insured marries;
5. The Insured divorces; and
6. The Insured's Spouse dies.
Proof, satisfactory to us, of the event may be
required prior to advancement.
INCREASE IN FACE The increase will take effect on the Purchase Option
AMOUNT Date subject to the Change in Face Amount provision in
your Policy, except that proof of
insurability will not be required and the increase
will not be subject to the Maximum Face Amount
Increase Administration Charge. The underwriting class
for the increase in Face Amount will be based on the
Underwriting Class Basis for Purchase Options shown in
the Options to Purchase Additional Life Insurance
Rider Schedule.
The Contestable and Suicide periods of each increase
issued under this Rider will be measured from the
Issue Date of this Rider.
THE NEW POLICY The new policy will be issued:
1. With the same Insured as this Rider;
2. With the same underwriting class as the
Underwriting Class Basis for Purchase Options
shown in the Options to Purchase Additional Life
Insurance Rider Schedule for this Rider or the
class we determine is the closest to it if that
class is not offered on the new policy;
3. Subject to any assignments and limitations to
which this Rider is subject;
4. By us or by an affiliate designated by us;
5. On a plan agreed to by the issuing company;
6. At the then current age of the Insured as
calculated for that plan of insurance by the
issuing company;
7. On a policy form and at premium rates in use by
the issuing company on the Policy Date of the new
policy; and
8. With a Policy Date and Issue Date the same as the
Purchase Option Date.
The new policy will take effect on the Purchase Option
Date:
1. During the life of the Insured; and
2. Not later than 60 days after the Purchase Option
Date.
The Contestable and Suicide periods of each new policy
issued under this Rider will be measured from the
Issue Date of this Rider. Riders can be attached to a
new policy only with our consent.
MONTHLY COST OF RIDER The Monthly Cost of Rider for the following month is
charged as part of the Monthly Deduction. The Monthly
Cost of Rider is the Guaranteed Monthly Cost of Rider
Charge shown on the Options to Purchase Additional
Life Insurance Rider Schedule.
TERMINATION This Rider will terminate upon the earliest of:
1. The lapse of the Policy;
2. The surrender of the Policy;
3. The Insured's date of death;
4. When the total amount of coverage issued under
this Rider equals the Maximum Total Option Amount;
5. 60 days after the final Purchase Option Date; and
6. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of your written request to
terminate this Rider. We may require the Policy
for endorsement.
The Issue Date and effective date of this Rider and Policy are the same.
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
E-3GPO-00
Rider: Option to Purchase Long-Term Care Insurance
THE COMPANY agrees that the Owner of the Policy can purchase long-term care
insurance on the life of the Insured named in the attached Rider Schedule,
without proof of insurability.
PURCHASE OF LONG-TERM CARE INSURANCE
A long-term care policy can be applied for within 60 days of a Purchase Option
Date. Application for the long-term care policy must be in writing signed by the
Owner and by the Insured and received by the company within 60 days of a
Purchase Option Date.
PURCHASE OPTION DATES
The Purchase Option Dates are shown in the Rider Schedule.
THE LONG-TERM CARE POLICY
The long-term care policy will be issued:
- - With the same Insured as this Rider;
- - With the same underwriting class as this Rider or the class we determine
is the closest to it if the class of this Rider is not offered on the
long-term care policy;
- - On any individual plan of long-term care insurance issued by the Company
or by an affiliate designated by the Company on the date of purchase of
the long-term care policy;
- - On a policy form and at premium rates in use by the company on the date of
purchase of the long-term care policy;
- - Subject to any assignments and limitations to which this Rider is subject;
- - At the insurance age of the Insured on the date of purchase of the
long-term care policy;
- - With a Daily Benefit Amount, available at the time you exercise this
Option, up to the Amount shown in the Rider Schedule and with a Lifetime
Benefit Amount up to the Amount shown in the Rider Schedule;
- - With a minimum daily benefit amount based on the company's published
minimum on the date of purchase; or the Maximum Daily Benefit Amount shown
in the Rider Schedule for the Purchase Option Date, if less, except as
otherwise required by law; and
- - Subject to the New Policy Features as shown in the Rider Schedule .
The long-term care policy will take effect on the effective date stated in the
long-term care policy, but only if its initial premium is received by the
company.
The Company reserves the right to offer an option exercise credit. If an option
exercise credit is paid, it will be deducted from the initial premium for the
long-term care policy.
If the long-term care policy is issued on a basis other than daily benefits, the
Amounts shown in the long-term care policy will reflect the chosen benefit
period.
The contestable period of the long-term care policy issued under this Rider will
be measured from the Date of Issue of this Rider. Optional features or riders
can be attached to the long-term care policy only with the consent of the
company.
COST OF RIDER
The monthly cost of insurance charge for this Rider is guaranteed and shown in
the Rider Schedule.
DATE OF ISSUE
The Date of Issue of this Rider is the shown in the Rider Schedule.
NOT CONTESTABLE AFTER TWO YEARS
This Rider will not be contestable after it has been in force during the life of
the Insured for two years from its Date of Issue.
CONTRACT
A copy of the application for this Rider is attached to and made a part of the
Rider. This Rider is made a part of the Policy to which it is attached, if the
Rider is listed on the specifications page. This Rider has no cash value.
TERMINATION
This Rider will terminate upon the earliest of: (a) death of the Insured; (b)
surrender of the policy to which this Rider is attached; (c) 60 days after the
final Purchase Option Date; (d) the effective date of the long-term care policy;
and (e) the Company's recording of a written request signed by the Owner to end
the Rider.
NEW ENGLAND LIFE INSURANCE COMPANY
501 Boylston Street, Boston, Massachusetts
/s/ ABCD /s/ ABCD
President Secretary
Rider Schedule
INSURED NAME: John Doe POLICY NUMBER: Specimen
DATE OF ISSUE: March 1, 2001 RIDER CLASS: Standard
AGE: 35 GUARANTEED MONTHLY COST OF INSURANCE $4.17
CHARGE
INITIAL DAILY BENEFIT AMOUNT $110.00
NEW POLICY FEATURES:
WAITING PERIOD: 100 Days or if less, the minimum number of days required by law.
- ---------------------- ------------------------------ -----------------------
PURCHASE MAXIMUM DAILY MAXIMUM LIFETIME
OPTION DATE BENEFIT AMOUNT BENEFIT AMOUNT
- ---------------------- ------------------------------ -----------------------
- ---------------------- ------------------------------ -----------------------
3/1/2006 120.00 $131,400
- ---------------------- ------------------------------ -----------------------
3/1/2011 140.00 153,300
- ---------------------- ------------------------------ -----------------------
3/1/2016 170.00 186,150
- ---------------------- ------------------------------ -----------------------
3/1/2021 190.00 208,050
- ---------------------- ------------------------------ -----------------------
3/1/2026 220.00 240,900
- ---------------------- ------------------------------ -----------------------
- ---------------------- ------------------------------ -----------------------
- ---------------------- ------------------------------ -----------------------
- ---------------------- ------------------------------ -----------------------
2E-5SG-02
SECONDARY GUARANTEE RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page. A copy of the application for this Rider is
attached to and made part of the Rider.
SECONDARY GUARANTEE If, on a monthly anniversary day prior to the
BENEFIT Secondary Guarantee Date, shown on the Policy
Specifications page:
1. The sum of all premiums paid on this Policy; less
2. Any partial withdrawals; less
3. Any Cash Value paid to you to allow the Policy to
continue to qualify as a life insurance contract;
less
4. Any outstanding Loan and Loan Interest.
is greater than or equal to the sum of the Secondary
Guarantee Premium for each monthly anniversary since
the Policy Date, this Policy will not lapse even if
your Cash Surrender Value is not sufficient to cover
the Monthly Deduction on a monthly anniversary day.
DEATH BENEFIT The Death Benefit is the greater of:
1. The Face Amount of the Policy including any
increases; and
2. The Death Benefit otherwise provided by the Policy
including any increases.
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 a life insurance contract under
the Internal Revenue Code of 1986 or any applicable
successor.
MONTHLY COST OF RIDER The Monthly Cost of Rider for the following month is
charged as part of the Monthly Deduction. The Monthly
Cost of Rider is the Monthly Cost of Rider Rate shown
on the Policy Specifications page, divided by 1000,
multiplied by:
1. The Face Amount of any Convertible Supplemental
Coverage Term Rider; plus
2. The Net Amount at Risk. (See the Net Amount at
Risk and the Allocation of the Net Amount at Risk
to Coverages provisions in the Policy.)
POLICY CHANGES The Secondary Guarantee Premium may change if any of
the following events occur prior to the Secondary
Guarantee Date shown on the Policy Specifications
page:
1. A change in the Policy's Face Amount;
2. The addition or deletion of or a change to a rider
attached to this Policy;
3. A change in Risk Classification of the Insured; or
4. A change in Death Benefit Option.
The Secondary Guarantee Date will not change.
GUARANTEE GRACE PERIOD If on a monthly anniversary day prior to the Secondary
Guarantee Date, the sum of all premiums paid on this
Policy, reduced by any partial withdrawals, any Cash
Value paid to you to allow the Policy to continue to
qualify as a life insurance contract and any
outstanding Loan and loan interest, is less than the
sum of the Secondary Guarantee Premiums for each
monthly anniversary since the Policy Date, then the
Guarantee Grace Period of 62 days will be allowed for
the payment of a premium sufficient to keep this Rider
in force. The Secondary Guarantee Date and the
Secondary Guarantee Premium are shown on the Policy
Specifications page.
Notice of the amount of premium required to be paid to
keep this Rider in force will be sent at the beginning
of the Guarantee Grace Period to the last known
address of the Owner and of any assignee of record. If
we do not receive the premium required by the end of
the Guarantee Grace Period, this Rider will terminate
and the guarantee provided by this Rider will no
longer be in effect. If the premium requirement is not
met and death occurs during the Guarantee Grace
Period, there is no deduction of the Rider premium
required from the Death Benefit.
MISSTATEMENT OF AGE OR If there is a misstatement of age or sex in the
SEX application and such determination is made prior to
the death of the Insured and while this Rider is in
effect, then the Secondary Guarantee Premium will be
that amount which corresponds to the Face Amount, as
adjusted under the Policy, using the correct age
and/or sex. The Secondary Guarantee Date will change
based on the correct age.
SECONDARY GUARANTEE DATE The date the Secondary Guarantee Rider expires. This
date is shown on the Policy Specifications page.
SECONDARY GUARANTEE The premium required to keep the Secondary Guarantee
PREMIUM Rider in force. This premium is shown on the Policy
Specifications page.
PREMIUM LIMITATIONS We will restrict any premium payment 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. This limitation
will not cause this Rider to terminate. We will not
restrict payment of any premium, which is required to
maintain this Rider in force because such payment will
cause the Death Benefit to increase by an amount that
exceeds the premium received.
REINSTATEMENT If this Rider terminates it may not be reinstated.
TERMINATION This Rider will terminate on the first of the
following events to occur:
1. The death of the Insured;
2. The date of termination of the Policy to which
this Rider is attached;
3. The end of the Guarantee Grace Period following
our notice to you that the premium requirement was
not met;
4. The Secondary Guarantee Date shown on the Policy
Specifications page;
5. The date a Change of Insured, on the Policy to
which this Rider is attached, is executed;
6. The date the Term Insurance on Covered Insured
Rider is added if the definition of life insurance
test chosen for the Policy is the Guideline
Premium Test; and
7. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of your written request to
terminate this Rider. We may require the Policy
for endorsement.
CONTINUATION OF Once this Rider has terminated, the base Policy may
INSURANCE continue in accordance with the provisions of the base
Policy but without the benefit provided by this Rider.
The Issue Date and the effective date of this Rider and the Policy are the same.
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
2E-5TC-02
SUPPLEMENTAL COVERAGE TERM RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page. A copy of the application for this Rider is
attached to and made a part of the Rider.
FACE AMOUNT The Face Amount of this Rider is shown on the Policy
Specifications page.
LIFE INSURANCE BENEFIT This Rider provides non-convertible term life
insurance on the life of the Insured shown on the
Policy Specifications page. We will pay the Death
Benefit of this Rider to the Beneficiary if the
Insured dies while this Rider is in force.
The Death Benefit and Net Amount at Risk provisions in
the Policy are modified so that where it states "Face
Amount" it includes this Rider's Face Amount.
MONTHLY COST OF The Monthly Cost of Insurance for the following month
INSURANCE is charged as part of the Monthly Deduction and is
included in the Total Monthly Cost of Insurance. The
Monthly Cost of Insurance is calculated as described
in the Policy. (See the Monthly Deduction and the
Monthly Cost of Insurance provisions in the Policy.)
MONTHLY COST OF The Monthly Cost of Insurance Rate for this benefit is
INSURANCE RATES based on the Insured's Attained Age, Risk
Classification and sex. Monthly Cost of Insurance
Rates will be determined by us based on our
expectations as to future mortality, tax, interest
earnings, expense and persistency experience. We will
not adjust such rates as a means of recovering prior
losses nor as a means of distributing prior profits.
These rates will not exceed those shown in the Table
of Maximum Monthly Cost of Insurance Rates for the
Supplemental Coverage Term Rider.
MONTHLY ADMINISTRATION An Administration and Issue Expense Charge for this
AND ISSUE EXPENSE Rider will be charged as part of the Monthly
CHARGE Deduction. The Monthly Administrative and Issue
Expense Charge is calculated as described in the
Monthly Administrative and Issue Expense Charge
provision in the Policy; except that the provision is
modified so that where it states "initial Face Amount"
it includes this Rider's Face Amount.
DECREASES IN RIDER You can request a decrease in this Rider's Face Amount
FACE AMOUNT on any policy anniversary date. We must receive the
request in writing at our Home Office or any other
office designated by us no more than 25 days prior to
the policy anniversary on which the decrease is to be
effective. We may consent to a requested decrease in
this Rider's Face Amount that is received more than 25
days prior to a policy anniversary. If we consent to
such a decrease, the decrease will be effective on the
monthly anniversary on or following our receipt of the
written request.
Any requested decrease in the Rider's Face Amount must
be at least the Minimum Face Amount Decrease as shown
on the Policy Specifications page.
If you request a change in Death Benefit Option, this
Rider's Face Amount may be decreased. (See the Change
in Death Benefit Option provision in your Policy.)
If you request a partial withdrawal, this Rider's Face
Amount may be decreased. (See the Partial Withdrawal
provision in your Policy.)
TERMINATION This Rider will terminate upon the earliest of:
1. The lapse of the Policy;
2. The surrender of the Policy;
3. The Insured's date of death;
4. A decrease in Face Amount that causes this Rider's
Face Amount to go to zero;
5. Attained Age 100 of the Insured; and
6. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of your written request to
terminate this Rider. We may require the Policy
for endorsement.
The Issue Date and effective date of this Rider and the Policy are the same.
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
TABLE OF MAXIMUM MONTHLY COST OF INSURANCE RATES
PER $1,000
INSURED: [JOHN DOE]
COVERAGE: [SUPPLEMENTAL COVERAGE TERM RIDER]
POLICY NUMBER: [16,000,001]
ATTAINED ATTAINED ATTAINED RATE
AGE RATE AGE RATE AGE
35 0.2408 71 5.4167
36 0.2575 72 5.8967
37 0.2783 73 6.4375
38 0.3025 74 7.0275
39 0.3300 75 7.6792
40 0.3608 76 8.3508
41 0.3975 77 9.0308
42 0.4358 78 9.7083
43 0.4783 79 10.4033
44 0.5233 80 11.1458
45 0.5750 81 11.9542
46 0.6258 82 12.8517
47 0.6817 83 13.8442
48 0.7408 84 14.8950
49 0.8067 85 15.9683
50 0.8767 86 17.0300
51 0.9567 87 18.0642
52 1.0467 88 19.1925
53 1.1492 89 20.3058
54 1.2650 90 21.4217
55 1.3875 91 22.5608
56 1.5208 92 23.7717
57 1.6583 93 25.3275
58 1.8050 94 27.3308
59 1.9575 95 30.2467
60 2.1258 96 35.2508
61 2.3158 97 44.0183
62 2.5292 98 60.3150
63 2.7708 99 83.3333
64 3.0375
65 3.3267
66 3.6275
67 3.9425
68 4.2675
69 4.6125
70 4.9942
THESE RATES ARE FOR THE SUPPLEMENTAL COVERAGE TERM RIDER AS OF THE ISSUE DATE.
THEY ARE BASED ON THE 1980 COMMISSIONERS STANDARD ORDINARY MORTALITY TABLE FOR A
[MALE, SMOKER].
E2-5TT-02
TEMPORARY TERM INSURANCE RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
TERM INSURANCE BENEFIT We agree that the Policy and its riders will be in
force as temporary term insurance from the Issue Date
to the Policy Date. During that period the amounts of
insurance under the Policy and its riders will be the
same as the amounts on the Policy Date.
During the temporary term insurance period the Policy
will have no cash or loan value.
This Rider is made a part of the Policy to which it is
attached if the Rider is listed on the Policy
Specifications page.
The premium for this Rider is due on the Issue Date in
the amount shown on the Policy Specifications page.
ABCD ABCD
President Secretary
2E-5CIT-02
TERM INSURANCE ON COVERED INSURED RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
THE WAITING PERIODS FOR SUICIDE AND INCONTESTABILITY ARE DIFFERENT FROM THOSE IN
THE POLICY AND BEGIN ON THE ISSUE DATE OF THE RIDER.
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page or on the Policy Specifications page for Policy
Change. A copy of the application for this Rider is attached to and made part of
the Rider.
FACE AMOUNT The Face Amount for this Rider is the amount shown on
the Table of Maximum Monthly Cost of Rider Rates per
$1,000.
LIFE INSURANCE BENEFIT If the Covered Insured dies while this Rider is in
force, the Face Amount of the Rider will be paid in
one sum to the Beneficiary of the Rider.
COVERED INSURED The Covered Insured is named in the application for
this Rider.
OWNER OF THIS RIDER The Owner of this Rider is the Owner of the Policy and
cannot be changed.
MONTHLY COST OF RIDER The Monthly Cost of Rider for the following month is
charged as part of the Monthly Deduction. The Monthly
Cost of Rider is the Monthly Rate shown on the Table
of Maximum Monthly Cost of Rider Rates per $1,000
times the Face Amount of this Rider divided by 1,000.
MONTHLY COST OF RIDER The Monthly Cost of Rider Rate for this benefit is
RATES based on the Insured's Attained Age, Risk
Classification and sex. The rates for the Rider are
set by us each year on the rider anniversary, based on
our expectations as to future mortality, tax, interest
earnings, expense and persistency experience. We will
not adjust such rates as a means of recovering prior
losses nor as a means of distributing prior profits.
The rates for the Rider will never be more than the
rates shown in the Table of Maximum Monthly Cost of
Rider Rates per $1,000 for the Term Insurance on
Covered Insured Rider.
DECREASE IN RIDER After the first policy year, the Face Amount of this
FACE AMOUNT Rider can be decreased by sending us a written
request; but only if the Face Amount of the Rider
after the decrease is at least $50,000, except with
our consent. The decrease will become effective on the
monthly anniversary on or following receipt of the
request by us at our Home Office or any other office
designated by us. Upon a decrease, the new Face Amount
will be shown on the Policy Specifications page for
Policy Change.
REINSTATEMENT If this Rider lapses, you may reinstate it within
three years after the date of lapse. The Rider cannot
be reinstated, except with our consent, if more than
three years have passed since the date of lapse. To
reinstate, you must submit the following items:
1. A written application for Reinstatement;
2. Proof satisfactory to us that the Covered Insured
is insurable by our standards; and
3. Payment, while the Covered Insured is living, of a
premium large enough to keep the Rider in force
for at least three months.
Upon Reinstatement, we will deduct any Monthly Cost of
Rider 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 rider will be in force from the date we
approve the Reinstatement application.
LIMITATIONS ON This Rider can be reinstated only if the Policy is
REINSTATEMENT also reinstated or is in force. If only a portion of
the Policy coverage is reinstated then only a portion
of the Rider coverage may also be reinstated.
CONVERSION RIGHTS The Owner may, before the rider anniversary on which
the Covered Insured is Attained Age 65, or if later,
prior to the end of the fifth rider year, convert any
portion of the insurance then in force under this
Rider for a new policy:
1. If the Attained Age of the Covered Insured meets
the issuing company's issue age requirements on
the date of the conversion; and
2. If the issuing company's underwriting class
requirements on the date of the conversion can be
met.
Except with our consent, any Face Amount of the Rider
that will remain after a conversion must be at least
$50,000.
The new policy will be issued:
1. On the life of the Covered Insured;
2. Without proof of insurability;
3. With a Face Amount equal to the amount of term
insurance being converted;
4. With the same underwriting class as this Rider, or
the class we determine is closest to it if the
class of this Rider is not offered on the new
policy;
5. With a current Policy Date;
6. By us or by an affiliate designated by us;
7. On a plan agreed to by the issuing company;
8. At the then current age of the Covered Insured as
calculated by the issuing company for that plan of
insurance;
9. Subject to payment of the first premium for the
new policy;
10. On a policy form and at premium rates in use by
the issuing company on the Policy Date of the new
policy; and
11. Subject to any assignments and limitations to
which this Rider is subject.
The conversion may be made only with our consent if:
1. The amount of term insurance you want to convert
is less than the issuing company's published
minimum limits of issue; or
2. Any rider is to be attached to the new policy.
INCONTESTABILITY The insurance issued under this Rider will not be
contestable after it has been in force during the life
of the Covered Insured for two years from the Issue
Date of the Rider.
SUICIDE EXCLUSION If the Covered Insured dies by suicide, while sane or
insane, within two years from the Issue Date of this
Rider:
1. The Face Amount will not be paid;
2. The Rider will terminate; and
3. The Monthly Deductions paid for the Rider will be
paid in one sum to the Beneficiary of the Rider.
MISSTATEMENT OF AGE OR If the age or sex of the Covered Insured has not been
SEX OF COVERED correctly stated in the application, the Death
INSURED Benefit for this Rider will be corrected. The Death
Benefit will be that which the most recent Monthly
Deduction for the Rider would have purchased for the
correct age or sex.
TERMINATION This Rider will terminate upon the earliest of:
1. The conversion of the entire Face Amount of the
Rider to a new policy;
2. The lapse of the Policy;
3. The surrender of the Policy;
4. The Insured's date of death;
5. The Expiry Date shown for the Rider in the Table
of Maximum Monthly Cost of Rider Rates per $1,000
for the Term Insurance on Covered Insured Rider;
and
6. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of your written request to
terminate this Rider. We may require the Policy
for endorsement.
The Issue Date and effective date of this Rider and the Policy are the same
unless another Issue Date is shown below. The insurance provided by this Rider
will be in force from the Issue Date of the Rider.
- ---------------------
Issue Date
ABCD ABCD
President Secretary
TABLE OF MAXIMUM MONTHLY COST OF RIDER RATES
PER $1,000
COVERED INSURED: JOHN DOE
COVERAGE: TERM INSURANCE ON COVERED INSURED RIDER
ISSUE AGE: [35] RIDER FACE AMOUNT: [$50,000]
RISK CLASSIFICATION: [STANDARD SMOKER] RIDER EXPIRY DATE: [JANUARY 1, 2067]
POLICY NUMBER: [16,000,001] SEX: [MALE]
ATTAINED ATTAINED ATTAINED RATE
AGE RATE AGE RATE AGE
35 0.2192 71 4.9242
36 0.2342 72 5.3608
37 0.2533 73 5.8525
38 0.2750 74 6.3883
39 0.3000 75 6.9808
40 0.3283 76 7.5917
41 0.3617 77 8.2100
42 0.3958 78 8.8258
43 0.4350 79 9.4575
44 0.4758 80 10.1325
45 0.5225 81 10.8675
46 0.5692 82 11.6833
47 0.6200 83 12.5858
48 0.6733 84 13.5408
49 0.7333 85 14.5167
50 0.7967 86 15.4817
51 0.8700 87 16.4217
52 0.9517 88 17.4475
53 1.0450 89 18.4600
54 1.1500 90 19.4742
55 1.2617 91 20.5100
56 1.3825 92 21.6108
57 1.5075 93 23.0250
58 1.6408 94 24.8458
59 1.7792 95 27.4967
60 1.9325 96 32.0458
61 2.1050 97 40.0167
62 2.2992 98 54.8317
63 2.5192 99 83.3333
64 2.7617
65 3.0242
66 3.2975
67 3.5842
68 3.8792
69 4.1933
70 4.5400
THESE RATES ARE FOR THE TERM INSURANCE ON COVERED INSURED RIDER AS OF THE ISSUE
DATE. THEY ARE BASED ON THE 1980 COMMISSIONERS STANDARD ORDINARY MORTALITY TABLE
FOR A [MALE, SMOKER].
2E-5WMD-02
WAIVER OF MONTHLY DEDUCTION RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
THE WAITING PERIOD FOR INCONTESTABILITY IS DIFFERENT FROM THAT IN THE POLICY AND
BEGINS ON THE ISSUE DATE OF THIS RIDER.
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page or on the Policy Specifications page for Policy
Change. A copy of the application for this Rider is attached to and made part of
the Rider.
WAIVER OF MONTHLY We will waive the Monthly Deductions for this Policy
DEDUCTION BENEFIT if:
1. You furnish us with written proof that the Insured
is totally disabled, as defined in this Rider;
2. The Insured becomes disabled after age 5 and
before age 65;
3. Disability has continued without interruption for
at least six months; and
4. This Rider is in force.
Monthly Deductions for this Policy will be waived as
follows:
Disability Beginning Before Age 60. If the Insured's
disability begins before age 60, we will waive Monthly
Deductions which were due during the six months of
uninterrupted disability. After that, we will continue
to waive Monthly Deductions. However, the Insured must
continue to be totally disabled.
Disability Beginning Between Ages 60 and 65. If the
Insured's disability begins on or after age 60 but
before age 65, we will waive Monthly Deductions which
were due during the six months of uninterrupted
disability. We will continue to waive Monthly
Deductions after that, but no later than age 65.
However, the Insured must continue to be totally
disabled.
DEFINITION OF AGE 5, "Age 5," "Age 60," and "Age 65" begin on the policy
AGE 60, AND AGE 65 anniversary nearest the Insured's 5th, 60th,and 65th
birthdays, respectively.
INCREASE IN WAIVER Coverage under this Rider can be increased, subject to
COVERAGE our underwriting rules, if the Face Amount of the
Policy is increased and if the Insured is not totally
disabled. The increase in waiver coverage is subject
to:
1. The terms for a requested increase in Face Amount
as stated in the Change in Face Amount provision
of the Policy;
2. Our limits for Waiver of Monthly Deduction
benefits; and
3. An increase in the Cost of Rider.
Application to increase the Face Amount of the Policy
will also be deemed to be application to increase
waiver coverage under this Rider, unless otherwise
stated.
MONTHLY COST OF RIDER The Monthly Cost of Rider for the following month is
charged as part of the Monthly Deduction. The Monthly
Cost of Rider is the Monthly Cost of Rider Rate
divided by 100 times the Policy's Monthly Deduction
not including the cost of this Rider. The Monthly Cost
of Rider Rate for this benefit is based on the
Insured's Attained Age.
TOTAL DISABILITY "Total Disability" means the inability of the Insured
to perform the substantial and material duties of his
or her regular occupation. Such disability must be the
result of an accidental bodily injury or a sickness.
The injury or sickness must first manifest itself
after the Issue Date of this Rider.
However, after this period of disability has continued
for 60 months, the Insured will be considered to be
totally disabled only if he or she is unable to
perform the substantial and material duties of any
occupation for which he or she is reasonably fitted by
education, training or experience.
If after this Rider becomes effective, the Insured
suffers the total and irrecoverable loss of:
1. The sight in both eyes;
2. The use of both hands or both feet; or
3. The use of one hand and one foot.
this will be considered total disability as defined in
this Rider. Upon such a loss the Insured will still be
considered disabled even though working at an
occupation
RECURRENT TOTAL If, while the Policy and Rider are in force, the
DISABILITY Insured becomes disabled again after having been
totally disabled before, the new disability will be
considered a continuation of the previous period
unless:
1. It is due to an entirely different cause; or
2. The Insured has performed all of the material and
substantial duties of a gainful occupation for a
continuous period of six months or more between
such periods of total disability.
RISKS NOT ASSUMED We will not waive Monthly Deductions under this Rider
if disability results from war or any act of war while
the Insured is in the military, naval or air forces of
any country at war. We will also not waive Monthly
Deductions if the Insured becomes disabled while in a
civilian non-combatant unit serving with such forces.
"War" includes undeclared war and "any country"
includes any international organization or combination
of countries.
NOTICE OF CLAIM AND Before we waive any Monthly Deductions, we must
PROOF OF DISABILITY receive the following at our Home Office or any other
office designated by us:
1. Written notice of claim for this benefit during
the lifetime of the Insured. This notice must be
submitted during the continuance of total
disability. This notice must be submitted no later
than six months after this Rider terminates; and
2. Written proof of total disability within six
months after we receive written notice of claim.
In no event should this proof be submitted later
than the date when any of the following events
first occurs:
a. One year after age 65 of the Insured;
b. Surrender of the Policy; and
c. One year from the due date of the first unpaid
Monthly Deduction.
Failure to give such notice and proof within the time
allowed will not void the claim. We will consider the
claim if you show us that it was not reasonably
possible to file notice and proof on time. However,
you must file notice and proof as soon as reasonably
possible. In no event will any Monthly Deduction be
waived or refunded if its due date was more than one
year before we received notice of the claim.
We will require no further proof of disability and we
will automatically waive all further Monthly
Deductions if:
1. The Insured is totally disabled at age 65; and
2. All Monthly Deductions for at least the five years
preceding age 65 have been waived.
EXAMINATION OF THE We have the right to have the Insured examined by our
INSURED AND PROOF OF appointed examiner. Such exam will be at our expense.
CONTINUED DISABILITY
We also have the right to require written proof of
continuance of disability from the Insured at the
following times:
1. After receipt of notice of claim;
2. At reasonable intervals within two years after we
receive proof of total disability; and
3. Not more than once each year after the first two
years.
We will not waive any further Monthly Deductions if
the Insured refuses to be medically examined. Nor will
we waive further Monthly Deductions if proof of
continuance of disability is not furnished when we
request it.
INCONTESTABILITY We cannot contest this Rider after it has been in
force during the lifetime of the Insured, excluding
any period the Insured is totally disabled:
1. With respect to the original waiver coverage under
this rider, for two years from the Issue Date of
this Rider; and
2. With respect to each increase in waiver coverage
under this Rider, for two years from the effective
date of each increase in face amount under the
Policy.
GENERAL PROVISIONS If the Insured becomes totally disabled during the
Grace Period and becomes eligible for the Waiver of
Monthly Deduction Benefit, we will waive the Monthly
Deductions that were due during the Grace Period.
TERMINATION This Rider will terminate on the first of the
following events to occur:
1. Attained Age 65 of the Insured. This will be
without prejudice to any benefits granted for
total disability occurring before age 65;
2. The date the Policy lapses;
3. The date the Policy is surrendered;
4. The date of death of the Insured;
5. The date of an increase in Face Amount of the
Policy which does not qualify for an increase in
coverage under this Rider;
6. The date a Waiver of Specified Premium Rider is
added to the Policy to which this Rider is
attached; and
7. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of your written request to
terminate this Rider. We may require the Policy
for endorsement.
The Issue Date and effective date of this Rider and the Policy are the same
unless another Issue Date is shown below.
- ------------------------
Issue Date
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
TABLE OF MAXIMUM MONTHLY COST OF RIDER RATES
PER $100
INSURED: [JOHN DOE]
COVERAGE: [WAIVER OF MONTHLY DEDUCTION RIDER]
POLICY NUMBER: [16,000,001]
ATTAINED ATTAINED ATTAINED
AGE RATE AGE RATE AGE RATE
35 6.300000
36 6.800000
37 7.100000
38 7.600000
39 8.090000
40 8.510000
41 8.930000
42 9.770000
43 10.230000
44 10.930000
45 11.500000
46 12.000000
47 12.500000
48 13.000000
49 14.000000
50 14.500000
51 15.000000
52 16.280000
53 17.500000
54 18.000000
55 18.500000
56 19.430000
57 19.950000
58 20.330000
59 20.480000
60 6.200000
61 5.500000
62 4.750000
63 4.000000
64 3.000000
2E-5WSP-02
WAIVER OF SPECIFIED PREMIUM RIDER
ISSUED BY NEW ENGLAND LIFE INSURANCE COMPANY
THE WAITING PERIOD FOR INCONTESTABILITY IS DIFFERENT FROM THAT IN THE POLICY AND
BEGINS ON THE ISSUE DATE OF THIS RIDER.
This Rider is subject to all applicable terms and provisions of the Policy,
except as modified herein. This Rider is a part of the Policy if it is listed on
the Policy Specifications page or on the Policy Specifications page for Policy
Change. A copy of the application for this Rider is attached to and made part of
the Rider.
WAIVER OF SPECIFIED We will credit to the Policy, as a premium payment,
PREMIUM BENEFIT the amount shown as the monthly premium waived on the
Policy Specifications page if:
1. You furnish us with written proof that the Insured
is totally disabled, as defined in this Rider;
2. The Insured becomes disabled after age 5 and
before age 65;
3. Disability has continued without interruption for
at least six months; and
4. This Rider is in force.
The monthly premium waived will be credited as premium
to the Policy as long as the Policy remains in force
as follows:
Disability Beginning Before Age 60. If the Insured's
disability begins before age 60, we will credit the
monthly premiums waived which were due during the six
months of uninterrupted disability. After that, we
will continue to credit the monthly premiums waived.
However, the Insured must continue to be totally
disabled.
Disability Beginning Between Ages 60 and 65. If the
Insured's disability begins on or after age 60 but
before age 65, we will credit the monthly premiums
waived which were due during the six months of
uninterrupted disability. We will continue to credit
the monthly premiums waived after that, but no later
than age 65. However, the Insured must continue to be
totally disabled.
The Policy to which this Rider is attached is intended
to qualify as a life insurance contract under the
Internal Revenue Code or any applicable successor
provision or any interpretive regulation or rulings by
the Internal Revenue Service. To that end, if you have
selected the Guideline Premium Test for the Policy
(See the Definition of Life Insurance provision of the
Policy), premiums on the Policy are limited to an
amount no greater than that allowing the Policy to
continue to qualify. Therefore, the portion of any
monthly premium waived that would disqualify the
Policy will be paid to you in cash.
DEFINITION OF AGE 5, "Age 5," "Age 60," and "Age 65" begin on the policy
AGE 60 AND AGE 65 anniversary nearest the Insured's 5th, 60th and 65th
birthdays, respectively.
INCREASE IN WAIVER Coverage under this Rider can be increased, subject to
COVERAGE our underwriting
rules, if the Face Amount of the Policy is increased
and if the Insured is not totally disabled. The
increase in waiver coverage is subject to:
1. The terms for a requested increase in Face Amount
as stated in the Change in Face Amount provision
of the Policy;
2. Our limits for Waiver of Specified Premium
benefits; and
3. An increase in the Cost of Rider.
POLICY LAPSE Crediting of the monthly premium waived to the Policy
does not guarantee that the Policy will remain in
force.
MONTHLY COST OF RIDER The Monthly Cost of Rider for the following month is
charged as part of the Monthly Deduction. The Monthly
Cost of Rider is calculated as (1) multiplied by (2)
where:
1. Is the Monthly Cost of Rider Rate for this Rider
divided by 100; and
2. Is the monthly premium waived.
The Monthly Cost of Rider Rate for this benefit is
based on the Insured's Attained Age.
TOTAL DISABILITY "Total Disability" means the inability of the Insured
to perform the substantial and material duties of his
or her regular occupation. Such disability must be the
result of an accidental bodily injury or a sickness.
The injury or sickness must first manifest itself
after the Issue Date of this Rider.
However, after this period of disability has continued
for 60 months, the Insured will be considered to be
totally disabled only if he or she is unable to
perform the substantial and material duties of any
occupation for which he or she is reasonably fitted by
education, training or experience.
If, after this Rider becomes effective, the Insured
suffers the total and irrecoverable loss of:
1. The sight in both eyes;
2. The use of both hands or both feet; or
3. The use of one hand and one foot.
this will be considered total disability as defined in
this Rider. Upon such a loss the Insured will still be
considered disabled even though working at an
occupation.
RECURRENT TOTAL If, while the Policy and this Rider are in force, the
DISABILITY Insured becomes disabled again after having been
totally disabled before, the new disability will be
considered a continuation of the previous period
unless:
1. It is due to an entirely different cause; or
2. The Insured has performed all of the material and
substantial duties of a gainful occupation for a
continuous period of six months or more between
such periods of total disability.
RISKS NOT ASSUMED We will not credit the monthly premium waived under
this Rider to the Policy if disability results from
war or any act of war while the Insured is in the
military, naval or air forces of any country at war.
We will also not credit the monthly premium waived if
the Insured becomes disabled while in a civilian
non-combatant unit serving with such forces. "War"
includes undeclared war and "any country" includes any
international organization or combination of
countries.
NOTICE OF CLAIM AND Before we credit any monthly premium waived to the
PROOF OF DISABILITY Policy, we must receive the following at our Home
Office or any other office designated by us:
1. Written notice of claim for this benefit during
the lifetime of the Insured. This notice must be
submitted during the continuance of total
disability. This notice must be submitted no later
than six months after this Rider terminates; and
2. Written proof of total disability within six
months after we receive written notice of claim.
In no event should this proof be submitted later
than the date when any of the following events
first occurs:
a. One year after age 65 of the Insured;
b. Surrender of the Policy; and
c. One year from the due date of the first unpaid
Monthly Deduction.
Failure to give such notice and proof within the time
allowed will not void the claim. We will consider the
claim if you show us that it was not reasonably
possible to file notice and proof on time. However,
you must file notice and proof as soon as reasonably
possible. In no event will we credit any monthly
premium waived if its due date was more than one year
before we received notice of the claim.
We will require no further proof of disability and we
will automatically credit further monthly premiums
waived if:
1. The Insured is totally disabled at age 65; and
2. All monthly premiums waived for at least the
five years preceding age 65 have been
credited.
EXAMINATION OF THE We have the right to have the Insured examined by our
INSURED AND PROOF OF appointed examiner. Such exam will be at our expense.
CONTINUED DISABILITY We also have the right to require written proof of
continuance of disability from theInsured at the
following times:
1. After receipt of notice of claim;
2. At reasonable intervals within two years after we
receive proof of total disability; and
3. Not more than once each year after the first two
years.
We will not credit to the Policy any further monthly
premiums waived if the Insured refuses to be medically
examined. Nor will we credit to the Policy further
monthly premiums waived if proof of continuance of
disability is not furnished when we request it.
INCONTESTABILITY We cannot contest this Rider after it has been in
force during the lifetime of the Insured, excluding
any period the Insured is totally disabled:
1. With respect to the original waiver coverage under
this Rider, for two years from the Issue Date of
this Rider; and
2. With respect to each increase in waiver coverage
under this Rider, for two years from the effective
date of each increase in Face Amount under the
Policy.
GENERAL PROVISIONS If the Insured becomes totally disabled during the
Grace Period and becomes eligible for the Waiver of
Specified Premium Benefit, we will credit to the
Policy any monthly premiums waived during the Grace
Period.
TERMINATION This Rider will terminate on the first of the
following events to occur:
1. Attained Age 65 of the Insured. This will be
without prejudice to any benefits granted for
total disability occurring before age 65;
2. The date the Policy lapses;
3. The date the Policy is surrendered;
4. The date of death of the Insured;
5. The date of an increase in Face Amount of the
Policy which does not qualify for an increase in
coverage under this Rider;
6. The date a Waiver of Monthly Deduction Rider is
added to the Policy to which this Rider is
attached; and
7. The monthly anniversary on or following receipt by
us at our Home Office or any other office
designated by us of your written request to
terminate this Rider. We may require the Policy
for endorsement.
The Issue Date and effective date of this Rider and the Policy are the same
unless another Issue Date is shown below.
- ------------------------
Issue Date
/s/ [ILLEGIBLE] /s/ [ILLEGIBLE]
President Secretary
TABLE OF MAXIMUM MONTHLY COST OF RIDER RATES
PER $100
INSURED: [JOHN DOE]
COVERAGE: [WAIVER OF SPECIFIED PREMIUM RIDER]
POLICY NUMBER: [16,000,001]
ATTAINED ATTAINED ATTAINED
AGE RATE AGE RATE AGE RATE
35 3.000000
36 3.250000
37 3.250000
38 3.250000
39 3.250000
40 3.250000
41 3.250000
42 3.250000
43 3.400000
44 3.600000
45 3.800000
46 4.000000
47 4.250000
48 4.500000
49 5.000000
50 5.250000
51 5.500000
52 6.000000
53 6.500000
54 6.750000
55 7.000000
56 7.000000
57 7.250000
58 7.000000
59 6.250000
60 5.250000
61 4.750000
62 4.000000
63 3.250000
64 2.000000