The Lincoln National Life Insurance Company (the Company ) Home Office: Service Office: Fort Wayne, Indiana One Granite Place P.O. Box 515 Concord, NH 03302-0515 (800) 258-3648 A Stock Company State of Issue Department of Insurance: Alabama Consumer Services Phone Number: (334) 269-3550 This policy is a legal contract between You and Us. It is important that You read Your contract carefully. We will pay the Proceeds of this policy to the beneficiary upon receipt of due proof that the death of the Insured occurred while this policy was in force. This payment and all other rights, options and benefits will be subject to the terms of this policy. Right to Cancel Policy Within 20 days after You receive this policy, You may have it cancelled by returning it to Us, to the agent from whom You bought it, or to any of Our agents. The return of this policy will void it from the beginning and We will refund any premiums paid. If this policy is issued as a replacement of another policy, within 30 days after You receive this policy, or any longer period as may be required by the applicable law in the state where this policy is delivered or issued for delivery, You may have it cancelled by returning it to Us, to the agent from whom You bought it, or to any of Our agents. President Secretary Insured: Policy Number: PAT Q TESTOWNER JR LRIUL00AL FLEXIBLE PREMIUM ADJUSTABLE LIFE INSURANCE POLICY WITH OPTIONAL INDEXED FEATURES Proceeds payable at death. Adjustable Death Benefit. Flexible premiums payable to the earlier of the death of the Insured or the Insured s Attained Age 121. Benefits, values, periods of coverage, and premiums are on an indeterminate basis and may vary according to the policy terms. Policy Values may increase or decrease due to changes in interest credited to the Dollar Cost Averaging Account, Holding Account, and Fixed Account, Index Credits earned on the Indexed Account(s), expense charges and cost of insurance rates. Any Index Credits are credited on a Segment Maturity Date and are based on growth rates of an external Index (or Indexes). This policy does not participate in any stock, bond or equity investments. 10 Year No-Lapse Minimum Premium provision. Nonparticipating No Dividends. ICC15UL 6046 Page 1 Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.
Provision Table of Contents Summary of Policy Features... 2 Schedule of Benefits and Premiums - Policy Specifications...3 Definitions... 5 Owner and Beneficiary... 6 General Provisions... 6 10 Year No-Lapse Minimum Premium Provisions... 8 Premium Provisions... 8 Indexed Account Provisions... 10 Holding Account Provisions... 10 Dollar Cost Averaging Account Provisions... 11 Insurance Coverage Provisions... 11 Nonforfeiture Provisions... 13 Loans... 17 Effect of Policy on Riders... 18 Settlement Options... 19 Settlement Option Tables... 21 Amendments, Endorsements, or Riders, if any, and a copy of the application follow Page 22. Page ICC15UL 6046 Page 1A
Summary of Policy Features This summary is an overview of the important features and operations of Your policy. It is meant to give You a basic understanding of Your policy. Specific details regarding these features are only provided in the policy provisions and cannot be fully described in a summary. This summary is not a substitute for reading the entire policy carefully. Flexible Premium Adjustable Life Insurance This title is Our generic name for universal life insurance. Flexible premium means that You may pay premiums by any method agreeable with Us, at any time prior to the Insured s Attained Age 121 and in any amount subject to certain limitations. It is important to maintain the payment(s) of Your Planned Premium, as shown on the policy specifications pages, in order to keep Your policy in force. Adjustable life insurance means that You, with Our agreement, can change the death benefit to meet Your changing needs, after the first policy year. This policy provides for a Fixed Account and for one or more Indexed Accounts as described in the Indexed Account Provisions and policy specifications pages. These optional Indexed Account(s) use the gains and losses of an outside financial index to calculate the annual crediting rate, subject to a minimum guarantee. Index Credits, if any, are not applied to an Indexed Account until the Segment Maturity Date. This policy provides for an optional Dollar Cost Averaging Account and a Holding Account. Coverage Duration The duration of coverage will vary based upon changes in the amount, timing and frequency of Your premium payments, changes to the coverage under Your policy and Riders attached to Your policy and the other factors described in the following sections. Policy Value The Policy Value is a key component of Your policy. The Policy Value is where Your premiums go and where We assess Our charges for providing coverage. The Policy Value is the total of the Dollar Cost Averaging Account, Holding Account, Fixed Account, Indexed Account(s), and Collateral Account. We apply a charge to each premium You pay and then add the balance to the Dollar Cost Averaging Account or Holding Account in accordance with Your Premium Allocation instructions. Then on each Monthly Allocation Date, We transfer amounts to the Fixed Account and/or Indexed Account(s) in accordance with Your Account Allocation instructions. We deduct the cost of providing the coverage (the cost of insurance), the cost of any surrender charges due to any partial surrender or decrease in Specified Amount, and the cost of any additional benefits and/or Riders and administrative charges. This charge is known as the monthly deduction and is taken from the Fixed Account unless the value in the Fixed Account cannot cover the cost of the entire charge. In that case, We will apply the charge in successive order to the Holding Account, Dollar Cost Averaging Account and in successive order to the most recently opened Indexed Account Segment(s), and Collateral Account until the entire charge has been paid. We then credit interest to the difference remaining in the Holding Account, Dollar Cost Averaging Account, Fixed Account, and Collateral Account. The charges assessed from the Policy Value include the cost of providing the coverage (the cost of insurance), the cost of any additional benefits and/or Riders and administrative charges (all of these charges together are the monthly deduction ) and the cost of any surrender charges due to any partial surrender or decrease in Specified Amount. The individual charges that make up the monthly deduction will be detailed in Your annual Statement of Account. We can change these charges based on certain contractually identified factors subject to the maximum guaranteed factors shown in Your policy. We can also change interest rates credited to this policy at any time based on certain contractually identified factors subject to a minimum rate. Simply put, premium and interest additions increase the Policy Value; Our charges decrease the Policy Value. If additions exceed deductions, Your Policy Value increases; if deductions exceed additions, Your Policy Value decreases. If the Cash Surrender Value (Policy Value, less surrender charge, less Debt) becomes so small that We cannot take an entire monthly deduction, Your policy may terminate; see, however, the Grace Period provision and the 10 Year No-Lapse Minimum Premium provision. ICC15UL 6046 Page 2 ICC15F6047 Policy Number LRIUL00AL
Summary of Policy Features (Continued) The length of time Your policy remains in force will vary based on the following factors: A change in the frequency, timing or amount of any premium payment(s). Policy changes such as loans, partial surrenders, increases or decreases in Specified Amount and the addition or removal of Riders. If the 10 Year No-Lapse Minimum Premium provision is in force. Credited Interest to the Dollar Cost Averaging Account, Holding Account, and Fixed Account and Index Credits to the Indexed Account(s) Interest is a volatile component of Your policy. Do not assume that interest rates will remain constant for any extended period of time. We may change Interest rates at any time on the Dollar Cost Averaging Account, Holding Account, and Fixed Account based on certain contractually identified factors subject to a minimum rate. Index Credits on the Indexed Account(s) are linked to an outside financial index and are only applied on a Segment Maturity Date to funds having remained in that Segment for the full Segment Duration. Monthly Cost of Insurance Charges These charges are assessed against Your Policy Value to cover the Company s cost of insurance and other expenses. These charges will be detailed in Your Annual Report. We can change these charges based on certain contractually identified factors subject to the maximum guaranteed factors shown in Your policy. 10 Year No-Lapse Minimum Premium Your policy provides for a 10 Year No-Lapse Minimum Premium provision at no extra charge, which can ensure that Your coverage will continue during the first 10 policy years even if Your Cash Surrender Value is insufficient to cover the cost of a monthly deduction. How does this provision work? Under the 10 Year No-Lapse Minimum Premium provision, this policy will not enter the grace period during the first 10 policy years if the 10 Year No-Lapse Minimum Monthly Premium Test is met as described on the policy specifications pages. Note conditions that can impact whether the 10 Year No-Lapse Minimum Premium provision will remain in force include: Partial surrenders taken; Debt and any new loans; and Continued payment of premiums required to satisfy the 10 No-Lapse Year Minimum Monthly Premium Test. Monitoring Your Policy s Performance We will send You an Annual Report (Statement of Account) of Your policy to help You monitor Your Policy Values and compare it to Your objectives when You purchased Your policy. Ask Your life insurance agent to explain anything You do not understand. You may need to adjust Your premiums to achieve Your insurance objectives. You may Request from Us, at any time while Your policy is in force, an in force illustration of future death benefits and Policy Values. We encourage You to request an in force illustration at least once each policy year, subject to the terms of the Annual Report provision of this policy. We are also available to answer Your questions and assist You in making changes to Your policy. ICC15UL 6046 Page 2A ICC15F6047
SCHEDULE OF BENEFITS AND PREMIUMS POLICY NUMBER JJ1006046 FORM NUMBER BENEFIT ISSUE DATE MONTHLY DEDUCTION RATE CLASS YEARS PAYABLE ICC15UL 6046 INITIAL SPECIFIED AMOUNT 100,000 MAY 1, 2015 SEE PAGE 15 STD NON-TOBACCO 86 ICC15END- 7028 OVERLOAN PROTECTION ENDORSEMENT MAY 1, 2015 SEE PAGE 4 (CONTINUED) BJ-4889 ACCIDENTAL DEATH BENEFIT 75,000 MAY 1, 2015 SEE PAGE 4 STD NON-TOBACCO 35 BJ-4966 GUARANTEED INSURABILITY 50,000 MAY 1, 2015 7.50 5 J-371 DISABILITY WAIVER OF MONTHLY DEDUCTION MAY 1, 2015 SEE PAGE 4 STD NON-TOBACCO 30 CTR-5613 CHILDREN S RIDER 5.000 UNITS MAY 1, 2015 2.50 30 J-387 ACCELERATED BENEFITS RIDER J-5752 SUPPLEMENTAL TERM INSURANCE RIDER, PRIMARY INSURED J-5753 SUPPLEMENTAL TERM INSURANCE RIDER, OTHER INSURED POLICY SPECIFICATIONS MAY 1, 2015 0.00 100,000 MAY 1, 2015 SEE PAGE 4 STD NON-TOBACCO 100,000 MAY 1, 2015 SEE PAGE 4 STD NON-TOBACCO 10 10 NOTE: OWNER: THIS POLICY PROVIDES LIFE INSURANCE COVERAGE TO THE DEATH OF THE INSURED IF SUFFICIENT PREMIUMS ARE PAID. THE DURATION OF COVERAGE WILL DEPEND ON THE AMOUNT, TIMING AND FREQUENCY OF PREMIUM PAYMENTS, INTEREST CREDITED, INDEX CREDITS, IF ANY, COST OF INSURANCE, ADMINISTRATIVE CHARGES, ANY LOANS OR PARTIAL SURRENDERS, AND THE COST OF ADDITIONAL BENEFITS. THE PLANNED PREMIUM MAY NEED TO BE INCREASED TO KEEP THIS POLICY AND THE COVERAGE IN FORCE. JOHN DOE, THE INSURED BENEFICIARY: INSURED: AS STATED IN THE APPLICATION UNLESS LATER CHANGED. JOHN DOE POLICY NUMBER: JJ1006046 POLICY DATE: MAY 1, 2015 AGE AND SEX: 35 MALE SPECIFIED AMOUNT: $100,000 DEATH BENEFIT OPTION: I PLAN OF INSURANCE FLEXIBLE PREMIUM ADJUSTABLE LIFE ICC15F6048-A PAGE 3
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 PLANNED PREMIUM: $531.90 ANNUALLY MINIMUM SPECIFIED AMOUNT: $100,000 NO PREMIUM PAYMENT MAY BE LESS THAN $200.00 ANNUALLY OR $15.00 IF PAID BY ELECTRONIC FUNDS TRANSFER. FACTORS USED IN THE CALCULATION OF POLICY VALUES: GUARANTEED MAXIMUM MONTHLY ADMINISTRATIVE CHARGES: 1. $6.00 IN ALL POLICY MONTHS UNTIL THE INSURED S ATTAINED AGE 121. 2. $0.203 PER $1,000 OF INITIAL SPECIFIED AMOUNT FOR THE FIRST 120 POLICY MONTHS AND A CHARGE PER $1,000 OF ANY INCREASE IN SPECIFIED AMOUNT FOR 120 POLICY MONTHS FOLLOWING THE EFFECTIVE DATE OF THE INCREASE. WE WILL PROVIDE YOU WITH ADDITIONAL INFORMATION REGARDING THE CHARGE FOR AN INCREASE IN SPECIFIED AMOUNT AT THE TIME OF THE INCREASE. A DECREASE IN SPECIFIED AMOUNT WILL HAVE NO EFFECT ON THIS MONTHLY ADMINISTRATIVE CHARGE. GUARANTEED NET PREMIUM FACTOR: 93.00% OF PREMIUM PAID IN THE FIRST 10 POLICY YEAR(S); 95.00% OF PREMIUM PAID IN POLICY YEAR(S) 11 20; 95.00% OF PREMIUM PAID IN POLICY YEAR(S) 21 AND THEREAFTER UNTIL THE INSURED S ATTAINED AGE 121. AFTER THE INSURED S ATTAINED AGE 121, NO FURTHER PREMIUM PAYMENTS MAY BE MADE. INTEREST RATE USED TO CALCULATE MINIMUM CASH SURRENDER VALUES IN THE FIXED ACCOUNT: 1.00% PER YEAR FROM DATE OF ISSUE TO THE INSURED S ATTAINED AGE 121. 3.00% PER YEAR AFTER THE INSURED S ATTAINED AGE 121. PERSISTENCY BONUS RATE: 0.55% PER YEAR (0.0457% MONTHLY) IN POLICY YEAR(S) 16-20; 0.55% PER YEAR (0.0457% MONTHLY) IN POLICY YEAR(S) 21 AND THEREAFTER UNTIL THE INSURED S ATTAINED AGE 121. DEATH BENEFIT OPTION II FACTOR (APPLICABLE IF DEATH BENEFIT OPTION II IS ELECTED): 115.00% MORTALITY TABLE USED TO CALCULATE MINIMUM CASH SURRENDER VALUES: 2001 CSO MALE OR FEMALE, UNISMOKE, ULTIMATE ONLY, AGE NEAREST BIRTHDAY PLAN OF INSURANCE FLEXIBLE PREMIUM ADJUSTABLE LIFE ICC15F6048-A PAGE 4
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 TABLE OF SURRENDER CHARGES POLICY YEAR SURRENDER CHARGE 1 $3,096.00 2 $3,040.00 3 $2,984.00 4 $2,927.00 5 $2,870.00 6 $2,272.00 7 $1,669.00 8 $1,089.00 9 $532.00 10 AND LATER $0.00 THE SURRENDER CHARGES ABOVE ARE BASED ON THE INITIAL SPECIFIED AMOUNT. ADDITIONAL SURRENDER CHARGES RELATED TO ANY INCREASE IN SPECIFIED AMOUNT WILL BEGIN FROM THE EFFECTIVE DATE OF THE INCREASE IN COVERAGE. WE WILL PROVIDE YOU WITH ADDITIONAL INFORMATION AT THE TIME OF THE CHANGE. IN NO EVENT WILL THE CHARGE ASSESSED UPON A FULL SURRENDER EXCEED THE THEN CURRENT POLICY VALUE LESS ANY DEBT. PARTIAL SURRENDER MINIMUM AMOUNT: $500.00 PARTIAL SURRENDER MAXIMUM AMOUNT: NOT TO EXCEED THE CASH SURRENDER VALUE LESS $500.00. PARTIAL SURRENDER FEE NOT TO EXCEED: $25.00 INCREASES AND DECREASES IN SPECIFIED AMOUNT MAXIMUM ATTAINED AGE FOR AN INCREASE: 85 MINIMUM AMOUNT FOR AN INCREASE IN SPECIFIED AMOUNT: $1,000.00 MINIMUM AMOUNT FOR A DECREASE IN SPECIFIED AMOUNT: $1,000.00 PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4A
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 LOAN INFORMATION PARTICIPATING LOAN INTEREST RATE CHARGED IN ARREARS: 6.00% PER YEAR IN THE FIRST 10 POLICY YEAR(S); 5.00% PER YEAR IN POLICY YEAR(S) 11 AND THEREAFTER TO THE INSURED S ATTAINED AGE 121; AND 3.00% PER YEAR AFTER THE INSURED S ATTAINED AGE 121. FIXED LOAN INTEREST RATE CHARGED IN ARREARS: 4.00% PER YEAR IN THE FIRST 10 POLICY YEAR(S); AND 3.00% PER YEAR IN POLICY YEAR(S) 11 AND THEREAFTER. COLLATERAL ACCOUNT INTEREST RATE CREDITED: 3.00% PER YEAR IN ALL POLICY YEARS. LOAN MINIMUM AMOUNT: $10.00 MINIMUM LOAN REPAYMENT AMOUNT: $25.00 PLAN OF INSURANCE FLEXIBLE PREMIUM ADJUSTABLE LIFE ICC15F6048-A PAGE 4B
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 DEATH BENEFIT QUALIFICATION TEST GUIDELINE PREMIUM TEST TABLE OF CORRIDOR FACTORS ATTAINED AGE CORRIDOR FACTOR ATTAINED AGE CORRIDOR FACTOR 35 2.50 70 1.15 36 2.50 71 1.13 37 2.50 72 1.11 38 2.50 73 1.09 39 2.50 74 1.07 40 2.50 75 1.05 41 2.43 76 1.05 42 2.36 77 1.05 43 2.29 78 1.05 44 2.22 79 1.05 45 2.15 80 1.05 46 2.09 81 1.05 47 2.03 82 1.05 48 1.97 83 1.05 49 1.91 84 1.05 50 1.85 85 1.05 51 1.78 86 1.05 52 1.71 87 1.05 53 1.64 88 1.05 54 1.57 89 1.05 55 1.50 90 1.05 56 1.46 91 1.04 57 1.42 92 1.03 58 1.38 93 1.02 59 1.34 94 1.01 60 1.30 95 AND 1.00 61 1.28 LATER 62 1.26 63 1.24 64 1.22 65 1.20 66 1.19 67 1.18 68 1.17 69 1.16 PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4C
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 TABLE OF GUARANTEED MAXIMUM COST OF INSURANCE RATES POLICY YEAR MONTHLY RATE PER $1,000 OF NET AMOUNT AT RISK POLICY YEAR MONTHLY RATE PER $1,000 OF NET AMOUNT AT RISK POLICY YEAR MONTHLY RATE PER $1,000 OF NET AMOUNT AT RISK 1 0.10090 31 1.41713 61 26.47561 2 0.10674 32 1.55477 62 28.42724 3 0.11175 33 1.69264 63 30.56000 4 0.12009 34 1.84272 64 32.89883 5 0.12844 35 1.99565 65 35.47494 6 0.13762 36 2.17802 66 38.32309 7 0.14931 37 2.38232 67 40.65162 8 0.16351 38 2.65527 68 43.20718 9 0.17938 39 2.94044 69 46.02012 10 0.19942 40 3.24057 70 49.12439 11 0.22115 41 3.57417 71 52.56182 12 0.24205 42 3.93903 72 56.38257 13 0.26462 43 4.36468 73 60.65304 14 0.27800 44 4.86367 74 65.44960 15 0.29389 45 5.44276 75 70.87255 16 0.31397 46 6.07850 76 77.05095 17 0.33908 47 6.80775 77 83.33333 18 0.37340 48 7.57149 78 83.33333 19 0.41193 49 8.40042 79 83.33333 20 0.45970 50 9.32758 80 83.33333 21 0.51589 51 10.38213 81 83.33333 22 0.57548 52 11.56722 82 83.33333 23 0.63932 53 12.87883 83 83.33333 24 0.69227 54 14.30705 84 83.33333 25 0.75284 55 15.84059 85 83.33333 26 0.82609 56 17.47055 86 83.33333 27 0.91711 57 19.02863 87 AND 0.00000 28 1.02767 58 20.68462 LATER 29 1.15107 59 22.46745 30 1.28060 60 24.39303 PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4D
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 10 YEAR NO-LAPSE MINIMUM PREMIUM FACTORS: 10 YEAR NO-LAPSE MINIMUM MONTHLY PREMIUM: $63.82 10 YEAR NO-LAPSE MINIMUM MONTHLY PREMIUM TEST THE 10 YEAR NO-LAPSE MINIMUM MONTHLY PREMIUM TEST IS MET IF (1) MINUS (2) MINUS (3) IS GREATER THAN OR EQUAL TO (4), WHERE: (1) IS THE TOTAL PREMIUMS PAID; (2) IS ALL PARTIAL SURRENDERS TAKEN; (3) IS ANY DEBT; AND (4) IS THE CUMULATIVE 10 YEAR NO-LAPSE MINIMUM MONTHLY PREMIUMS DUE. HOLDING ACCOUNT SPECIFICATIONS MINIMUM GUARANTEED HOLDING ACCOUNT INTEREST RATE: 1.00% PER YEAR DOLLAR COST AVERAGING ACCOUNT SPECIFICATIONS AVAILABLE DOLLAR COST AVERAGING MODAL PREMIUMS FREQUENCY: ANNUALLY OR SEMI- ANNUALLY MINIMUM GUARANTEED DOLLAR COST AVERAGING ACCOUNT INTEREST RATE: 1.00% PER YEAR MINIMUM DOLLAR COST AVERAGING PREMIUM: $1,000.00 INDEXED ACCOUNT SPECIFICATIONS INITIAL ALLOCATION DATE: THE 15TH DAY OF THE CALENDAR MONTH FOLLOWING THE DATE WE PROCESS PAYMENT OF THE INTIAL PREMIUM. MONTHLY ALLOCATION DATE: 15TH DAY OF EACH CALENDAR MONTH AS MEASURED FROM THE INITIAL ALLOCATION DATE. INDEX BONUS WE MAY CREDIT AN INDEX BONUS AS A RESULT OF A MONTHLY DEDUCTION. THE CREDITING OF AN INDEX BONUS WILL ONLY APPLY IF THE VALUE OF ANY INDEX SEGMENT IS REDUCED TO AN AMOUNT GREATER THAN ZERO DUE TO A MONTHLY DEDUCTION. IF AN INDEX BONUS IS CREDITED, THE AMOUNT WILL BE EQUAL TO (A) TIMES (B) WHERE: (A) IS THE REDUCTION IN THE VALUE OF ANY INDEX SEGMENT; AND (B) IS A RATE NOT LESS THAN THE MINIMUM GUARANTEED INDEX BONUS RATE OF 0.457%. THE INDEX BONUS WILL BE CREDITED ON THE MONTHLY ANNIVERSARY DAY, AFTER THE PROCESSING OF THE MONTHLY DEDUCTION, TO THE MOST RECENTLY OPENED INDEX SEGMENT WITH A VALUE GREATER THAN ZERO. IF MULTIPLE INDEX SEGMENTS WERE OPENED ON THE SAME ALLOCATION DATE, A PRORATED PORTION OF THE INDEX BONUS WILL BE CREDITED TO EACH OF THE INDEX SEGMENTS. PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4E
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 INDEXED ACCOUNT SPECIFICATIONS (CONTINUED) NAME OF ACCOUNT: 1-YEAR POINT-TO-POINT - CAPPED INDEX: S & P 500 SEGMENT DURATION: 1 YEAR MINIMUM GUARANTEED INDEX PARTICIPATION RATE: 100.00% MINIMUM GUARANTEED INDEX GROWTH CAP: 1.00% INDEX GROWTH CAP TRIGGER FOR WAIVER OF SURRENDER CHARGES: 6.00% OR LOWER MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT: 1.00% INDEX CREDITS INDEX CREDITS ARE CALCULATED SEPARATELY FOR EACH SEGMENT ON THE SEGMENT MATURITY DATE. INDEX CREDITS ARE NOT CALCULATED OR CREDITED TO A SEGMENT BETWEEN SEGMENT MATURITY DATES. ANY AMOUNT DEDUCTED FROM A SEGMENT PRIOR TO THE SEGMENT MATURITY DATE WILL NOT RECEIVE ANY INDEX CREDIT. THE PAYMENT OF A FULL SURRENDER PRIOR TO THE SEGMENT MATURITY DATE WILL RESULT IN THE MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT BEING APPLIED ON A PRORATED BASIS. THE INDEX CREDIT ON THE SEGMENT MATURITY DATE IS EQUAL TO (A) TIMES (B) WHERE: (A) IS THE INDEX GROWTH RATE; AND (B) IS THE VALUE OF THE SEGMENT AS OF ITS SEGMENT MATURITY DATE PRIOR TO ANY INDEX CREDIT BEING APPLIED. IF THE INDEX CREDIT FOR A MATURING SEGMENT RESULTS IN AN EFFECTIVE ANNUAL RATE LESS THAN THE MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT AS SHOWN ABOVE, THEN ADDITIONAL INTEREST WILL BE CREDITED AS REQUIRED TO EQUAL THE MINIMUM RATE. SEGMENT MATURITY DATE: THE SEGMENT MATURITY DATE IS THE DATE EACH SEGMENT MATURES, WHICH IS AT THE END OF A SEGMENT DURATION. CALCULATION OF THE INDEX GROWTH RATE USED IN DETERMINING INDEX CREDITS - WE WILL DETERMINE THE INDEXED INTEREST GROWTH RATE IN EFFECT ON A SEGMENT MATURITY DATE SUBJECT TO ANY GUARANTEED FACTORS FOR THE INDEXED ACCOUNT AS SHOWN ABOVE. INDEX GROWTH RATE: THE INDEX GROWTH RATE IS EQUAL TO [(A/B) 1] X C; NOT TO EXCEED D WHERE: A = THE CLOSING VALUE OF THE INDEX AS OF THE SEGMENT MATURITY DATE; B = THE CLOSING VALUE OF THE INDEX AS OF THE SEGMENT DATE; C = THE PARTICIPATION RATE; AND D = THE INDEX GROWTH CAP IN EFFECT ON THE SEGMENT DATE. INDEX-LINKED RETURNS DO NOT INCLUDE THE PORTION OF RETURNS GENERATED BY THE UNDERLYING INDEX THAT COME FROM DIVIDENDS; AND THE ELEMENTS USED IN DETERMINING THE CREDITED RATE FROM THE INDEX ARE NOT GUARANTEED AND CAN BE CHANGED BY US, SUBJECT TO THE GUARANTEES IN THE POLICY AND THAT ANY SUCH CHANGES CAN AFFECT THE RETURN. PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4F
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 INDEXED ACCOUNT SPECIFICATIONS (CONTINUED) NAME OF ACCOUNT: 1-YEAR POINT-TO-POINT - CAPPED (CONTINUED) THE S&P 500 INDEX IS A PRODUCT OF S&P DOW JONES INDICES LLC ( SPDJI ), AND HAS BEEN LICENSED FOR USE BY THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. STANDARD & POOR S, S&P AND S&P 500 ARE REGISTERED TRADEMARKS OF STANDARD & POOR S FINANCIAL SERVICES LLC ( S&P ); DOW JONES IS A REGISTERED TRADEMARK OF DOW JONES TRADEMARK HOLDINGS LLC ( DOW JONES ); AND THESE TRADEMARKS HAVE BEEN LICENSED FOR USE BY SPDJI AND SUBLICENSED FOR CERTAIN PURPOSES BY THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. THE LINCOLN NATIONAL LIFE INSURANCE COMPANY S PRODUCT IS NOT SPONSORED, ENDORSED, SOLD OR PROMOTED BY SPDJI, DOW JONES, S&P, THEIR RESPECTIVE AFFILIATES, AND NONE OF SUCH PARTIES MAKE ANY REPRESENTATION REGARDING THE ADVISABILITY OF INVESTING IN SUCH PRODUCT NOR DO THEY HAVE ANY LIABILITY FOR ANY ERRORS, OMISSIONS, OR INTERRUPTIONS OF THE S&P 500 INDEX. PARTICIPATION RATE A FACTOR USED IN CALCULATING THE INDEX GROWTH RATE AND THE INDEX CREDIT APPLICABLE TO A SEGMENT. WE WILL DECLARE THE PARTICIPATION RATE APPLICABLE TO A SEGMENT AT THE BEGINNING OF THE SEGMENT YEAR. WE GUARANTEE THAT THE PARTICIPATION RATE WILL NEVER BE LESS THAN THE MINIMUM GUARANTEED INDEX PARTICIPATION RATE SHOWN ABOVE. INDEX GROWTH CAP A FACTOR USED IN CALCULATING THE INDEX GROWTH RATE AND THE INDEX CREDIT APPLICABLE TO A SEGMENT. WE WILL DECLARE THE INDEX GROWTH CAP APPLICABLE TO A SEGMENT AT THE BEGINNING OF THE SEGMENT YEAR. WE GUARANTEE THAT THE INDEX GROWTH CAP WILL NEVER BE LESS THAN THE MINIMUM GUARANTEED INDEX GROWTH CAP AS SHOWN ABOVE. PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4G
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 INDEXED ACCOUNT SPECIFICATIONS (CONTINUED) NAME OF ACCOUNT: 1-YEAR POINT-TO-POINT - UNCAPPED INDEX: S & P 500 SEGMENT DURATION: 1 YEAR MINIMUM GUARANTEED INDEX PARTICIPATION RATE: 15.00% MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT: 1.00% INDEX CREDITS INDEX CREDITS ARE CALCULATED SEPARATELY FOR EACH SEGMENT ON THE SEGMENT MATURITY DATE. INDEX CREDITS ARE NOT CALCULATED OR CREDITED TO A SEGMENT BETWEEN SEGMENT MATURITY DATES. ANY AMOUNT DEDUCTED FROM A SEGMENT PRIOR TO THE SEGMENT MATURITY DATE WILL NOT RECEIVE ANY INDEX CREDIT. THE PAYMENT OF A FULL SURRENDER PRIOR TO THE SEGMENT MATURITY DATE WILL RESULT IN THE MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT BEING APPLIED ON A PRORATED BASIS. THE INDEX CREDIT ON THE SEGMENT MATURITY DATE IS EQUAL TO (A) TIMES (B) WHERE: (A) IS THE INDEX GROWTH RATE; AND (B) IS THE VALUE OF THE SEGMENT AS OF ITS SEGMENT MATURITY DATE PRIOR TO ANY INDEX CREDIT BEING APPLIED. IF THE INDEX CREDIT FOR A MATURING SEGMENT RESULTS IN AN EFFECTIVE ANNUAL RATE LESS THAN THE MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT AS SHOWN ABOVE, THEN ADDITIONAL INTEREST WILL BE CREDITED AS REQUIRED TO EQUAL THE MINIMUM RATE. SEGMENT MATURITY DATE: THE SEGMENT MATURITY DATE IS THE DATE EACH SEGMENT MATURES, WHICH IS AT THE END OF A SEGMENT DURATION. CALCULATION OF THE INDEX GROWTH RATE USED IN DETERMINING INDEX CREDITS - WE WILL DETERMINE THE INDEXED INTEREST GROWTH RATE IN EFFECT ON A SEGMENT MATURITY DATE SUBJECT TO ANY GUARANTEED FACTORS FOR THE INDEXED ACCOUNT AS SHOWN ABOVE. INDEX GROWTH RATE: THE INDEX GROWTH RATE IS EQUAL TO [(A/B) 1] X C WHERE: A = THE CLOSING VALUE OF THE INDEX AS OF THE SEGMENT MATURITY DATE; B = THE CLOSING VALUE OF THE INDEX AS OF THE SEGMENT DATE; AND C = THE PARTICIPATION RATE. INDEX-LINKED RETURNS DO NOT INCLUDE THE PORTION OF RETURNS GENERATED BY THE UNDERLYING INDEX THAT COME FROM DIVIDENDS; AND THE ELEMENTS USED IN DETERMINING THE CREDITED RATE FROM THE INDEX ARE NOT GUARANTEED AND CAN BE CHANGED BY US, SUBJECT TO THE GUARANTEES IN THE POLICY AND THAT ANY SUCH CHANGES CAN AFFECT THE RETURN. PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4H
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 ICC15UL 6046 ICC15UL 6046 INDEXED ACCOUNT SPECIFICATIONS (CONTINUED) NAME OF ACCOUNT: 1-YEAR POINT-TO-POINT - UNCAPPED (CONTINUED) THE S&P 500 INDEX IS A PRODUCT OF S&P DOW JONES INDICES LLC ( SPDJI ), AND HAS BEEN LICENSED FOR USE BY THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. STANDARD & POOR S, S&P AND S&P 500 ARE REGISTERED TRADEMARKS OF STANDARD & POOR S FINANCIAL SERVICES LLC ( S&P ); DOW JONES IS A REGISTERED TRADEMARK OF DOW JONES TRADEMARK HOLDINGS LLC ( DOW JONES ); AND THESE TRADEMARKS HAVE BEEN LICENSED FOR USE BY SPDJI AND SUBLICENSED FOR CERTAIN PURPOSES BY THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. THE LINCOLN NATIONAL LIFE INSURANCE COMPANY S PRODUCT IS NOT SPONSORED, ENDORSED, SOLD OR PROMOTED BY SPDJI, DOW JONES, S&P, THEIR RESPECTIVE AFFILIATES, AND NONE OF SUCH PARTIES MAKE ANY REPRESENTATION REGARDING THE ADVISABILITY OF INVESTING IN SUCH PRODUCT NOR DO THEY HAVE ANY LIABILITY FOR ANY ERRORS, OMISSIONS, OR INTERRUPTIONS OF THE S&P 500 INDEX. PARTICIPATION RATE A FACTOR USED IN CALCULATING THE INDEX GROWTH RATE AND THE INDEX CREDIT APPLICABLE TO A SEGMENT. WE WILL DECLARE THE PARTICIPATION RATE APPLICABLE TO A SEGMENT AT THE BEGINNING OF THE SEGMENT YEAR. WE GUARANTEE THAT THE PARTICIPATION RATE WILL NEVER BE LESS THAN THE MINIMUM GUARANTEED INDEX PARTICIPATION RATE SHOWN ABOVE. PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4I
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 INDEXED ACCOUNT SPECIFICATIONS (CONTINUED) NAME OF ACCOUNT: 1-YEAR POINT-TO-POINT HIGH PARTICIPATION INDEX: S & P 500 SEGMENT DURATION: 1 YEAR MINIMUM GUARANTEED INDEX PARTICIPATION RATE: 140.00% MINIMUM GUARANTEED INDEX GROWTH CAP: 1.00% MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT: 1.00% INDEX CREDITS INDEX CREDITS ARE CALCULATED SEPARATELY FOR EACH SEGMENT ON THE SEGMENT MATURITY DATE. INDEX CREDITS ARE NOT CALCULATED OR CREDITED TO A SEGMENT BETWEEN SEGMENT MATURITY DATES. ANY AMOUNT DEDUCTED FROM A SEGMENT PRIOR TO THE SEGMENT MATURITY DATE WILL NOT RECEIVE ANY INDEX CREDIT. THE PAYMENT OF A FULL SURRENDER PRIOR TO THE SEGMENT MATURITY DATE WILL RESULT IN THE MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT BEING APPLIED ON A PRORATED BASIS. THE INDEX CREDIT ON THE SEGMENT MATURITY DATE IS EQUAL TO (A) TIMES (B) WHERE: (A) IS THE INDEX GROWTH RATE; AND (B) IS THE VALUE OF THE SEGMENT AS OF ITS SEGMENT MATURITY DATE PRIOR TO ANY INDEX CREDIT BEING APPLIED. IF THE INDEX CREDIT FOR A MATURING SEGMENT RESULTS IN AN EFFECTIVE ANNUAL RATE LESS THAN THE MINIMUM GUARANTEED ANNUAL INTEREST RATE CREDITED TO A MATURING SEGMENT AS SHOWN ABOVE, THEN ADDITIONAL INTEREST WILL BE CREDITED AS REQUIRED TO EQUAL THE MINIMUM RATE. SEGMENT MATURITY DATE: THE SEGMENT MATURITY DATE IS THE DATE EACH SEGMENT MATURES, WHICH IS AT THE END OF A SEGMENT DURATION. CALCULATION OF THE INDEX GROWTH RATE USED IN DETERMINING INDEX CREDITS - WE WILL DETERMINE THE INDEXED INTEREST GROWTH RATE IN EFFECT ON A SEGMENT MATURITY DATE SUBJECT TO ANY GUARANTEED FACTORS FOR THE INDEXED ACCOUNT AS SHOWN ABOVE. INDEX GROWTH RATE: THE INDEX GROWTH RATE IS EQUAL TO [(A/B) 1] X C, NOT TO EXCEED D WHERE: A = THE CLOSING VALUE OF THE INDEX AS OF THE SEGMENT MATURITY DATE; B = THE CLOSING VALUE OF THE INDEX AS OF THE SEGMENT DATE; C = THE PARTICIPATION RATE; AND D = THE INDEX GROWTH CAP IN EFFECT ON THE SEGMENT DATE. INDEX-LINKED RETURNS DO NOT INCLUDE THE PORTION OF RETURNS GENERATED BY THE UNDERLYING INDEX THAT COME FROM DIVIDENDS; AND THE ELEMENTS USED IN DETERMINING THE CREDITED RATE FROM THE INDEX ARE NOT GUARANTEED AND CAN BE CHANGED BY US, SUBJECT TO THE GUARANTEES IN THE POLICY AND THAT ANY SUCH CHANGES CAN AFFECT THE RETURN. PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4J
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: ICC15UL 6046 INDEXED ACCOUNT SPECIFICATIONS (CONTINUED) NAME OF ACCOUNT: 1-YEAR POINT-TO-POINT HIGH PARTICIPATION (CONTINUED) THE S&P 500 INDEX IS A PRODUCT OF S&P DOW JONES INDICES LLC ( SPDJI ), AND HAS BEEN LICENSED FOR USE BY THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. STANDARD & POOR S, S&P AND S&P 500 ARE REGISTERED TRADEMARKS OF STANDARD & POOR S FINANCIAL SERVICES LLC ( S&P ); DOW JONES IS A REGISTERED TRADEMARK OF DOW JONES TRADEMARK HOLDINGS LLC ( DOW JONES ); AND THESE TRADEMARKS HAVE BEEN LICENSED FOR USE BY SPDJI AND SUBLICENSED FOR CERTAIN PURPOSES BY THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. THE LINCOLN NATIONAL LIFE INSURANCE COMPANY S PRODUCT IS NOT SPONSORED, ENDORSED, SOLD OR PROMOTED BY SPDJI, DOW JONES, S&P, THEIR RESPECTIVE AFFILIATES, AND NONE OF SUCH PARTIES MAKE ANY REPRESENTATION REGARDING THE ADVISABILITY OF INVESTING IN SUCH PRODUCT NOR DO THEY HAVE ANY LIABILITY FOR ANY ERRORS, OMISSIONS, OR INTERRUPTIONS OF THE S&P 500 INDEX. PARTICIPATION RATE A FACTOR USED IN CALCULATING THE INDEX GROWTH RATE AND THE INDEX CREDIT APPLICABLE TO A SEGMENT. WE WILL DECLARE THE PARTICIPATION RATE APPLICABLE TO A SEGMENT AT THE BEGINNING OF THE SEGMENT YEAR. WE GUARANTEE THAT THE PARTICIPATION RATE WILL NEVER BE LESS THAN THE MINIMUM GUARANTEED INDEX PARTICIPATION RATE SHOWN ABOVE. INDEX GROWTH CAP A FACTOR USED IN CALCULATING THE INDEX GROWTH RATE AND THE INDEX CREDIT APPLICABLE TO A SEGMENT. WE WILL DECLARE THE INDEX GROWTH CAP APPLICABLE TO A SEGMENT AT THE BEGINNING OF THE SEGMENT YEAR. WE GUARANTEE THAT THE INDEX GROWTH CAP WILL NEVER BE LESS THAN THE MINIMUM GUARANTEED INDEX GROWTH CAP AS SHOWN ABOVE. PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4K
INSURED: POLICY NUMBER: FORM NUMBER: JOHN DOE JJ1006046 ICC15END-7028 OVERLOAN PROTECTION ENDORSEMENT THE ELECTION CHARGE FOR THE OVERLOAN PROTECTION ENDORSEMENT IS GUARANTEED NOT TO EXCEED 3.00% OF THE POLICY VALUE ON THE DATE THE ELECTION IS SELECTED. PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4 (CONTINUED)
INSURED: POLICY NUMBER: FORM NUMBER: JOHN DOE JJ1006046 BJ-4889 SCHEDULE OF MONTHLY DEDUCTIONS FOR $75,000 ACCIDENTAL DEATH RIDER YEAR ATTAINED AGE MONTHLY DEDUCTION RIDER YEAR ATTAINED AGE MONTHLY DEDUCTION 1 35 5.25 19 53 6.00 2 36 5.25 20 54 6.75 3 37 5.25 21 55 6.75 4 38 5.25 22 56 6.75 5 39 5.25 23 57 6.75 6 40 5.25 24 58 7.50 7 41 5.25 25 59 7.50 8 42 6.00 26 60 7.50 9 43 6.00 27 61 8.25 10 44 6.00 28 62 9.00 11 45 6.00 29 63 9.00 12 46 6.00 30 64 9.75 13 47 6.00 31 65 10.50 14 48 6.00 32 66 10.50 15 49 6.00 33 67 11.25 16 50 6.00 34 68 12.00 17 51 6.00 35 69 12.00 18 52 6.00 PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4 (CONTINUED)
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: J-371 SCHEDULE OF MONTHLY DEDUCTION FACTORS FOR DISABILITY WAIVER THE DEDUCTION FOR THE DISABILITY WAIVER RIDER IS THE PRODUCT OF THE FACTOR SHOWN FOR THE ATTAINED AGE OF THE INSURED TIMES THE COST OF INSURANCE PLUS ANY ADMINISTRATIVE CHARGES PLUS THE COST OF ANY ADDITIONAL BENEFITS FOR THAT MONTH. RIDER YEAR ATTAINED AGE MONTHLY FACTOR RIDER YEAR ATTAINED AGE MONTHLY FACTOR 1 35 0.0630 16 50 0.1110 2 36 0.0650 17 51 0.1240 3 37 0.0680 18 52 0.1380 4 38 0.0710 19 53 0.1550 5 39 0.0730 20 54 0.1750 6 40 0.0750 21 55 0.1980 7 41 0.0750 22 56 0.2000 8 42 0.0750 23 57 0.2040 9 43 0.0750 24 58 0.2080 10 44 0.0750 25 59 0.2120 11 45 0.0770 26 60 0.2160 12 46 0.0810 27 61 0.2210 13 47 0.0860 28 62 0.2260 14 48 0.0920 29 63 0.2320 15 49 0.1000 30 64 0.2370 PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4 (CONTINUED)
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: J-5752 SUPPLEMENTAL TERM ON INSURED: JOHN A. DOE MONTHLY COST OF INSURANCE PER $1,000 OF RIDER AMOUNT: $0.05475 EXCHANGE DATE: MAY 1, 2024 EXPIRY DATE: MAY 1, 2024 PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4 (CONTINUED)
INSURED: POLICY NUMBER: JOHN DOE JJ1006046 FORM NUMBER: J-5753 SUPPLEMENTAL TERM ON OTHER INSURED: JANE A. DOE AGE AND SEX: 35 FEMALE MONTHLY COST OF INSURANCE PER $1,000 OF RIDER AMOUNT: $0.0495 EXCHANGE DATE: MAY 1, 2024 EXPIRY DATE: MAY 1, 2024 PLAN OF INSURANCE ICC15F6048-A FLEXIBLE PREMIUM ADJUSTABLE LIFE PAGE 4 (CONTINUED)
Definitions Where the terms below appear in this policy, We define them as follows: Age The Insured's Age, nearest birthday, on the Policy Date. Amendment, Endorsement, or Rider Any form issued by Us and attached to this policy which adds, modifies, changes, or deletes any policy provisions or benefits. Attained Age The Insured's Age as measured from the Policy Date plus the number of completed policy years. Cash Surrender Value The Policy Value as of the date of surrender less the charge, if any, for full surrender, and less any Debt. To the extent that the amount of the surrender charge exceeds the available Policy Value, less Debt, the Policy Value will not be less than zero. Cash Value Policy Value less any surrender charge. Closing Value of an Index is defined as the value of an Index as of the close of the New York Stock Exchange, which is usually 4:00 p.m. eastern time. If no closing value is published, We will use the closing value for the next day for which a closing value is published. Collateral Account The portion of the Policy Value that secures the principal of any Fixed Loan taken from Your policy. Debt The principal of the Participating Loan or the Fixed Loan with interest due. On any day, Debt is equal to the principal of the loan plus accrued interest on the loan. Dollar Cost Averaging Account An optional account that may be used by You to direct Net Premiums according to Your Premium Allocation instructions, from which a portion is then systematically transferred according to Your Account Allocation instructions. On each Monthly Allocation Date, an amount equal to one twelfth (1/12) of the premiums that have been allocated to the Dollar Cost Averaging Account within the last 12 month period plus any interest credited to the Dollar Cost Averaging Account since the last Monthly Allocation Date is systematically transferred to the Holding Account. The Dollar Cost Averaging Account is part of the Policy Value and is credited with interest daily as explained in the Dollar Cost Averaging Account Provisions. Fixed Account In accordance with Your Account Allocation instructions, an account into which value is deposited from the Holding Account on each Monthly Allocation Date. This account is part of the Policy Value and is credited with interest daily as explained in the Interest Rate on Fixed Account provision. The Interest Rate Used to Calculate Minimum Cash Surrender Values In The Fixed Account is shown on the policy specifications pages. Please refer to the Policy Value provision. Guideline Premium Is the premium limit used for the policy to continue to qualify as Life Insurance under the Internal Revenue Code Section 7702. Holding Account An account from which value is systematically transferred to the Fixed Account and/or Indexed Account(s) according to Your Account Allocation instructions on each Monthly Allocation Date. This account is part of the Policy Value and is credited with interest daily as explained in the Holding Account Provisions. Index An external index used as a basis to determine the value of the Indexed Account(s). The Index(es) is(are) as shown on the policy specifications pages. If an Index is discontinued, or if an Index calculation changes substantially, We will select an alternative Index and will notify You. Any substitution of an Index is subject to approval by the Interstate Insurance Product Regulation Commission (IIPRC). Indexed Account Is the portion of the Policy Value that represents the total value of all open Segments. The Minimum Guaranteed Annual Interest Rate Credited To A Maturing Segment on a Segment Maturity Date is shown on the policy specifications pages. Please refer to the Policy Value provision. Insured The person whose life is insured under this policy. Irrevocable Beneficiary A beneficiary named by You as irrevocable. Any beneficiary that You designate as irrevocable must provide written consent for You to exercise certain of Your ownership rights as specified in this policy. Issue Date The date this policy is issued at Our Service Office as stated on the policy specifications pages. Monthly Anniversary Day Net Premium Nonparticipating The same day in each month as the Policy Date. Equals premiums paid, multiplied by the Guaranteed Net Premium Factor. No dividends will be paid on this policy. ICC15UL 6046 Page 5 ICC15F6049 Policy Number LRIUL00AL
Definitions (Continued) Notice, Election, Request A written form in a manner We accept, that is satisfactory to Us and filed at Our Service Office. We retain the right to agree in advance to accept communication regarding a specific matter by telephone or by some other form of electronic transmission, in a manner We prescribe. We will not be held responsible for any payment or other action We have taken before Your communication is recorded at Our Service Office. Policy Date The date We use to determine policy anniversaries and monetary values. If a requested Policy Date should fall on the 29th, 30th or 31st of a month, the Policy Date will be the 28th of such month. Policy Value Equals the total of the Fixed Account Value, Holding Account Value, Dollar Cost Averaging Account Value, Indexed Account Value, and the Collateral Account Value as defined in the Nonforfeiture Provisions. Proceeds The money We will pay as a death benefit following receipt of due proof that the death of the Insured occurred while this policy was in force or the money We will pay if this policy is surrendered for its Cash Surrender Value. 1. As a Death Claim The Proceeds will be the amount of insurance as described in the Death Benefit provision. 2. Upon Surrender The Proceeds will be the Cash Surrender Value. Service Office Our principal place of business as shown on Page 1. We, Our, Us You, Your The Company. The Owner of this policy. Owner and Beneficiary Owner The Owner, at issue, is shown on the policy specifications pages or in an Amendment, Endorsement, or Rider. While the Insured is alive, the Owner may exercise every right and option and receive every benefit provided by this policy. These rights, however, may be subject to the written consent of any Irrevocable Beneficiary. Any rights and privileges that may be exercised by the Owner may be exercised only with the consent of all joint Owners. Beneficiary The beneficiary is as stated in the application unless later changed. Change of Owner or Beneficiary While the Insured is alive, the Owner or beneficiary may be changed. Unless otherwise specified by You, any change will take effect as of the date the Request is signed, subject to the applicable law in the state where this policy is delivered or issued for delivery, and subject to any payments We make or other actions We take before We receive it. The Insured need not be living when the requested change is recorded at Our Service Office, however the requested change must be delivered to Us prior to the death of the Insured. Death of the Owner or Beneficiary If an Owner other than the Insured dies while the Insured is living, all rights and options of the Owner will belong to the Owner's executors or administrators or to the Owner s successor in interest (if the Owner is a non-natural person) unless otherwise provided. The interest of any beneficiary, including any Irrevocable Beneficiary, who dies before the Insured, will belong to the Owner unless otherwise provided. General Provisions The Contract This policy is issued in consideration of the application and payment of the initial premium. This policy, the attached copy of the application, any attached supplemental applications, and any Amendment, Endorsement, or Rider form the entire contract. All statements made by or by the authority of the Insured are, in the absence of fraud, considered to be representations and not warranties. We will not use any statement by or for the Insured to void this policy or to deny a claim unless it is contained in an application. Policy Changes Only an authorized officer of the Company can change the terms of this policy or is authorized to waive provisions of this policy. A change must be in writing. Incontestability Except when this policy may be contested for fraud in the state where this policy is delivered or issued for delivery, We will not contest this policy after it has been in force during the Insured's lifetime for 2 years from the Issue Date. An increase in the Specified Amount will not be contested after it has been in force during the Insured's lifetime for 2 years from its effective date. We will only contest those statements determined to be material misrepresentations. ICC15UL 6046 Page 6 ICC15F6049
General Provisions (Continued) Suicide If the Insured, while sane or insane, commits suicide within 2 years from the Issue Date, the amount payable will be no more than the sum of the premiums paid less any Debt and any partial surrenders. If the Insured, while sane or insane, commits suicide within 2 years from the effective date of an increase in the Specified Amount, the amount payable under such increase will be the sum of the monthly deductions for such increase. The amount payable under this provision will be paid to the beneficiary. Any amount payable will first be used to pay the interest of anyone to whom this policy has been assigned. Assignment Only You have the right to assign this policy. We are not bound by an assignment unless it has been recorded at Our Service Office. Unless otherwise specified by You, the assignment will go into effect when it is signed, subject to the applicable law in the state where this policy is delivered or issued for delivery, and subject to any payments We make or other actions We take before We receive it. We are not responsible for the validity or effect of any assignment. Misstatement of Age or Sex If the Age or sex of the Insured has been misstated, the amount of death benefit will be adjusted to the amount which would have been provided by the most recent cost of insurance deduction at the true Age and sex. The Policy Value will not be affected. Compliance with the Internal Revenue Code This policy is intended to qualify as life insurance under the Internal Revenue Code. The death benefit provided by this policy is intended to qualify for the Federal Income Tax exclusion. If at any time the premium paid under this policy exceeds the amount allowable for such qualification, We will refund the premium to You with interest within sixty days after the end of the policy year in which the premium was received. If, for any reason, We do not refund the excess premium within sixty days after the end of such policy year, the excess premium will be held in a separate deposit fund and credited with interest until refunded to You. The interest rate used on any refund or credited to the separate deposit fund created by this provision will be the current rate of interest We are paying on this policy until the date We notify You that the excess premium and the earnings on such premium have been removed from the policy. After the date of such notice, the interest rate paid on the separate deposit fund will be the rate as We may declare from time to time on advance premium deposit funds. We also reserve the right to refuse to make any change in the Specified Amount or any other change if such change would cause this policy to fail to qualify as life insurance under the Internal Revenue Code. Modified Endowment Only with Your written consent, provided at the time of application or a later date, will this policy will be allowed to become a modified endowment contract under the Internal Revenue Code. Otherwise, if at any time the premiums paid under the policy exceed the limit for avoiding modified endowment contract status, the excess premium will be held in a separate deposit fund and credited with interest and will be used to pay future premium payments. If You instead elect to have the excess premium refunded to You, We will refund the excess premium to You with interest within sixty days after the end of the policy year in which the premium was received. The interest rate used on any refund or credited to the separate deposit fund created by this provision will be a rate of interest that We may declare from time to time. Annual Report We will provide an Annual Report (Statement of Account) to You. This report will show the activity of this policy for the past policy year. It will list premiums paid, administrative charges, interest credited, Index Credits, Persistency Bonus, Indexed Account Values, cost of insurance, and partial surrenders. It will show the then current death benefit, Policy Values, Debt, and projected policy expiration dates. This report will also include any other information required under federal law or the laws and regulations of the state in which this policy was issued. By comparing the actual Policy Value to the illustration received when this policy was purchased, You can determine whether this policy is performing as planned. Upon Request, We will provide an illustration of future death benefits and Policy Values. The first illustration in any policy year will be furnished free of charge. If You request more than one illustration in a policy year We reserve the right to apply a charge of $10.00 for each illustration thereafter. Settlement Payment or settlement under this policy will be made at Our Service Office in a lump sum payment unless You elect to receive Proceeds under a settlement option as stated in the Settlement Options provision. At the time of settlement, any Debt will be deducted. At the time of settlement, We reserve the right to require surrender of this policy. Deferment We may defer making a partial surrender, full surrender or loan up to 6 months after We receive Your Request, however a partial surrender or loan for payment of premiums to Us will not be deferred. ICC15UL 6046 Page 7 ICC15F6050 Policy Number LRIUL00AL
General Provisions (Continued) Conformity with Interstate Insurance Product Regulation Commission Standards This policy was approved under the authority of the Interstate Insurance Product Regulation Commission (the Commission) and issued under the Commission Standards. On this provision's effective date, any provision of this policy that is in conflict with the Commission Standards for this product type is hereby amended to the Commission Standards for this product type as of the provision's effective date. 10 Year No-Lapse Minimum Premium Provisions 10 Year No-Lapse Minimum Premium The 10 Year No-Lapse Minimum Monthly Premium applicable during the first 10 policy years and the 10 Year No-Lapse Minimum Monthly Premium Test are shown on the policy specifications pages. The 10 Year No-Lapse Minimum Monthly Premium is due on each Monthly Anniversary Day during the first 10 policy years. This policy will not terminate according to the Grace Period provision during the first 10 policy years if the 10 Year No-Lapse Minimum Premium provision is in effect and the 10 Year No-Lapse Minimum Monthly Premium Test is met. The 10 Year No-Lapse Minimum Premium provision will cease to be in effect on the earliest of the following: 1. The end of the 10th policy year; 2. The date this policy terminates, even if later reinstated; or 3. The date that continued payment of the 10 Year No-Lapse Minimum Monthly Premium would result in this policy failing to qualify as life insurance under the Internal Revenue Code. This could occur if a decrease in Specified Amount or removal of a Rider results in a decrease in the Guideline Premium. Increases in Specified Amount for the policy or any attached Rider or the addition of Riders may increase the amount of the 10 Year No-Lapse Minimum Monthly Premium; however, any such increase in Specified Amount will not extend the period during which the 10 Year No-Lapse Minimum Premium provision will be in effect. Decreases in Specified Amount, the removal of Riders, or a Death Benefit Option change will have no effect on the amount of the 10 Year No- Lapse Minimum Monthly Premium unless such change results in a decrease in the Guideline Premium as specified in 3. above. Catch Up Provision If the 10 Year No-Lapse Minimum Premium provision is no longer in effect because You have not satisfied the 10 Year No-Lapse Minimum Monthly Premium Test, You may bring the 10 Year No-Lapse Minimum Premium provision back into effect by satisfying the test requirements as specified on the policy specifications pages provided that the 10 Year No-Lapse Minimum Premium provision has not been permanently lost. Premium Provisions Premium Payment The initial premium is due on the Policy Date and is payable on or before delivery of this policy. Thereafter, premiums may be paid at any time prior to the Insured s Attained Age 121 and in any amount, subject to the following conditions, unless otherwise agreed to in writing by Us, however sufficient premium must be paid to keep this policy in force. We reserve the right to limit the amount of premiums paid in accordance with the Compliance with the Internal Revenue Code and Modified Endowment Contract provisions. We also reserve the right to require evidence of insurability satisfactory to Us for any premium payment that would result in an immediate increase in the difference between the death benefit and the Policy Value. If satisfactory evidence of insurability is not received, the premium, or any portion of the premium, may be returned. Your premiums are payable in United States currency. We will provide a premium receipt signed by an officer of the Company upon Request as required by the laws of the state in which this policy is delivered. Premium payments, after the first, can be made as follows: 1. Through prearranged withdrawals by contacting the Service Office; or 2. Sent to any premium address designated by Us. Sufficient premium payments must be paid in order to keep this policy in force. A change in the frequency, timing and amount of any premium payment(s) may decrease or increase the length of time this policy will remain in force and additional premium payments may be required. ICC15UL 6046 Page 8 ICC15F6050