LifeScape Whole Life Basic Illustration NARRATIVE SUMMARY

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1 Prepared for: d Client Issue Age: 31 NARRATIVE SUMMARY Policy Description LifeScape Whole Life is a level-benefit, participating whole life insurance policy with level, guaranteed premiums through maturity at age 121. Any dividends declared on this policy due to its participating status will be paid according to the dividend option selected. Underwriting Class: Male, Select Non- Tobacco Initial Base : $36,621 First-Year Contract : $ Initial Dividend Option Selected: Paid-Up Additions The premium required for the insurance coverage will depend on the outcome of the underwriting process and may vary from what is shown on this illustration. If so, you will receive a revised illustration with your policy. The initial base death benefit is $36,621. This premium is based on monthly premiums of $ The first-year contract premium is $ Policy dividends are used to purchase additional paid-up insurance. The amount of additional insurance purchased is what the dividend, applied as net single premium, can buy at the insured's attained age. This dividend option is selected from age 31 to 121. NUMERIC SUMMARY AND POLICY VALUES DEFINITIONS Guaranteed Columns Illustrate the policy values that are guaranteed and established at issue. These policy values assume no dividends are paid. Available cash values and death benefits will never be less than the values shown here assuming timely payment of the contract premium. Non-Guaranteed Columns Illustrated Scale Columns Midpoint Scale Columns Illustrate the policy values that are not guaranteed because the assumptions on which they are based are subject to change. These underlying assumptions will change as Assurity's future experience with respect to mortality, interest, expenses, taxes and other factors unfolds. The outlays, values, and benefits shown in these columns are neither guarantees nor estimates of future Assurity performance. Actual outlays, values and benefits may be more or less favorable than those illustrated. The expense basis used in this illustration is the current NAIC-approved Generally Recognized Expense Table. Illustrate the policy values that are based on the current dividend scale. The values shown in these columns assume that dividends are payable according to the current scale for the life of the policy. This is very unlikely to occur. Actual results may be more or less favorable. Illustrate the policy values that are based on dividends payable at one-half of the current scale for the life of the policy. Contract Illustrated at beginning of the year and represents the yearly total of the monthly premium payments required to maintain the base policy and rider benefits shown in this illustration. THIS IS ONLY A LIFE INSURANCE ILLUSTRATION, NOT A CONTRACT. AMOUNTS, BENEFITS, TERMS AND CONDITIONS ARE GOVERNED ONLY BY THE ACTUAL CONTRACT, NOT BY THIS ILLUSTRATION. Version Page 1 of 9

2 Prepared for: d Client Issue Age: 31 NARRATIVE SUMMARY (continued) Guaranteed Guaranteed Illustrated at the end of the year and represents the cash value guaranteed to be available upon policy surrender, assuming timely payment of the guaranteed contract premiums by the owner/payor. Policy loans, withdrawals, and partial surrenders will reduce any death benefits and cash values. Illustrated at the end of the year and represents the death benefit guaranteed to be paid upon the death of the insured assuming timely payment of the guaranteed contract premiums by the owner/payor. Policy loans, withdrawals, and partial surrenders will reduce any death benefits and cash values. Shows the contract premium less any dividends paid in cash or used to reduce premium, any surrenders of paid-up additions, and/or any new policy loans or loan repayments in the year. These values are meant to represent the owner/payor's out-of-pocket cost for the given year. These premium outlay amounts are not guaranteed to maintain the policy and rider benefits illustrated since these outlays assume that portions or all of the contract premium will be paid from nonguaranteed elements. Annual Dividend Illustrated at the end of the year and includes dividends earned on the base policy and any paid-up additions. These values are not guaranteed. The dividends illustrated are based on 100% of Assurity's current scale and are neither guaranteed nor estimates for the future. Illustrated at the end of the year and includes the guaranteed cash value and any paid-up additions cash value. Policy loans, withdrawals, and partial surrenders will reduce any death benefits and cash values. These values are not guaranteed. Reduced Paid-up Insurance Illustrated at the end of the year and represents the amount of paid-up insurance provided by the total cash value, assuming the policy is lapsed at the end of the year and processed to a reduced paid-up nonforfeiture option where no further premiums are paid. These values are not guaranteed. Illustrated at the end of the year to include the death benefit provided by the base policy, any riders, and any paid-up insurance purchased by the annual dividends on the policy or riders. Policy loans, withdrawals and partial surrenders will reduce any death benefit and cash value. These values are not guaranteed. Accelerated s Rider (AB) Exchange Privilege Rider (EP) RIDER DESCRIPTIONS In some states, this policy may include coverage under the Accelerated s Rider at no additional cost. The Accelerated s Rider can advance funds from your life insurance policy in the event the insured becomes terminally ill or permanently confined to a nursing home. Provides the right for the policy owner to exchange this policy for a new policy on the life of another person subject to full underwriting at no additional cost. Version Page 2 of 9

3 Prepared for: d Client Issue Age: 31 NARRATIVE SUMMARY (continued) DISCLOSURE Suicide, incorrect age and incontestability provisions apply. Please review the policy or ask your representative for more information. Version Page 3 of 9

4 Prepared for: d Client Initial : $36,621 Issue Age: 31 Initial Monthly : $50.00 NUMERIC SUMMARY Guaranteed Non-Guaranteed Mid-Point Illustrated Scale Yr Age Contract , , ,014 37, ,757 36, ,957 37, ,168 38, ,867 10, ,349 12, ,890 13, ,665 10, ,399 13, ,621 17, ,780 10, ,090 20, ,071 38,071 I have received a copy of this illustration and understand that any non-guaranteed elements illustrated are subject to change and could be either higher or lower. The agent has told me they are not guaranteed. Policy Owner: Date: I certify that this illustration has been presented to the applicant and that I have explained that any non-guaranteed elements illustrated are subject to change. I have made no statements that are inconsistent with the illustration. Authorized Representative: Date: EDISON RISK, LLC EDISON RISK, LLC 134 NE 1ST AVE DELRAY BEACH, Florida Phone Number: Version Page 4 of 9

5 Prepared for: d Client Initial : $36,621 Issue Age: 31 Initial Monthly : $50.00 POLICY VALUES Yr Guaranteed Non-Guaranteed Annual Dividend Reduced Paid-Up Insurance Age Contract , , , , , ,305 36, , ,050 37, , ,014 4,734 37, ,226 36, ,413 6,366 37, ,590 36, ,827 7,944 37, ,967 36, ,258 9,474 37, ,355 36, ,705 10,954 38, ,757 36, ,168 12,387 38, ,856 10, ,310 12,493 12, ,957 10, ,457 12,602 12, ,061 10, ,610 12,715 12, ,167 10, ,771 12,835 12, ,276 10, ,938 12,960 12, ,387 10, ,113 13,089 13, ,502 10, ,295 13,222 13, ,620 10, ,485 13,357 13, ,742 10, ,684 13,494 13, ,867 10, ,890 13,633 13, ,995 10, ,106 13,776 13, ,127 10, ,330 13,923 13, ,261 10, ,563 14,075 14, ,398 10, ,806 14,231 14, ,537 10, ,056 14,390 14, ,678 10, ,315 14,553 14, ,821 10, ,584 14,722 14, ,967 10, ,863 14,895 14, ,116 10, ,152 15,072 15, ,266 10, ,452 15,255 15, ,418 10, ,763 15,444 15, ,571 10, ,083 15,643 15, ,724 10, ,415 15,848 15, ,878 10, ,757 16,061 16, ,032 10, ,109 16,278 16,278 Version Page 5 of 9

6 Prepared for: d Client Initial : $36,621 Issue Age: 31 Initial Monthly : $50.00 POLICY VALUES (continued) Guaranteed Non-Guaranteed Annual Dividend Reduced Paid-Up Insurance Yr Age Contract ,188 10, ,471 16,500 16, ,345 10, ,845 16,725 16, ,504 10, ,228 16,951 16, ,665 10, ,621 17,180 17, ,826 10, ,025 17,411 17, ,987 10, ,438 17,647 17, ,146 10, ,860 17,890 17, ,305 10, ,291 18,138 18, ,463 10, ,731 18,390 18, ,619 10, ,179 18,647 18, ,774 10, ,636 18,908 18, ,927 10, ,101 19,176 19, ,076 10, ,574 19,453 19, ,221 10, ,053 19,739 19, ,361 10, ,540 20,036 20, ,496 10, ,032 20,342 20, ,626 10, ,530 20,657 20, ,752 10, ,034 20,981 20, ,873 10, ,542 21,314 21, ,987 10, ,052 21,654 21, ,095 10, ,562 22,002 22, ,195 10, ,070 22,357 22, ,288 10, ,575 22,719 22, ,374 10, ,073 23,085 23, ,453 10, ,567 23,454 23, ,528 10, ,060 23,826 23, ,599 10, ,550 24,202 24, ,665 10, ,038 24,581 24, ,726 10, ,523 24,964 24, ,782 10, ,005 25,352 25, ,837 10, ,490 25,743 25, ,888 10, ,975 26,139 26, ,935 10, ,460 26,539 26, ,978 10, ,939 26,943 26, ,017 10, ,417 27,353 27,353 Version Page 6 of 9

7 Prepared for: d Client Initial : $36,621 Issue Age: 31 Initial Monthly : $50.00 POLICY VALUES (continued) Guaranteed Non-Guaranteed Annual Dividend Reduced Paid-Up Insurance Yr Age Contract ,055 10, ,900 27,767 27, ,092 10, ,388 28,187 28, ,128 10, ,881 28,612 28, ,163 10, ,379 29,042 29, ,197 10, ,883 29,477 29, ,230 10, ,391 29,917 29, ,262 10, ,905 30,363 30, ,294 10, ,424 30,815 30, ,324 10, ,958 31,282 31, ,353 10, ,519 31,777 31, ,382 10, ,109 32,303 32, ,409 10, ,725 32,857 32, ,435 10, ,368 33,437 33, ,460 10, ,034 34,044 34, ,485 10, ,724 34,674 34, ,508 10, ,434 35,326 35, ,530 10, ,164 35,997 35, ,552 10, ,903 36,680 36, ,571 10, ,652 37,376 37, ,780 10, ,071 38,071 38,071 Version Page 7 of 9

8 Prepared for: d Client Initial : $36,621 Issue Age: 31 Initial Monthly : $50.00 INDICES AND PREMIUM MODES Life Insurance Indices at 5.00% 10 Year 20 Year Surrender Cost Net Payment Cost Equivalent Level Annual Dividend Alternative Modes s Included Annual Semi-Annual Quarterly Monthly Base policy $ $ $ $50.00 $ $ $ $50.00 Version Page 8 of 9

9 Prepared for: d Client Initial : $36,621 Issue Age: 31 Initial Monthly : $50.00 HOME OFFICE INFORMATION New Business-ID Units I L0880 (R01-13) TAMRA Limit $1, Initial TAMRA $ Exchange $0.00 State: FL Version Page 9 of 9

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