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Individual Flexible Premium Universal Life Insurance Policy

Metropolitan Life Insurance Company

MetLife Brief Description of Your Policy This is an individual flexible premium universal life insurance policy where premiums can be paid until Attained Age 121. It does not pay dividends. You may continue the coverage provided by the Policy beyond Attained Age 121. If the Insured dies while the Policy is in force, we will pay the Policy Proceeds to the Beneficiary. The Policy Proceeds are described in the Payment to Your Beneficiary provision. We must receive due proof of the Insured’s death. Any payment will be subject to all of the provisions of the Policy. Right to Examine Your Policy Please read the Policy to be sure it meets your needs. You may return the Policy to our Designated Office or to our representative within [10] days from the date you receive it. If you return it within this period, we will refund any payments made and void the Policy from the start. The Policy is a legal contract between the Owner and Metropolitan Life Insurance Company. PLEASE READ YOUR CONTRACT CAREFULLY. Metropolitan Life Insurance Company Home Office, [200 Park Avenue, New York, NY 10166]

President

Secretary

Your MetLife Policy Insured [John Middle Doe] Policy Number [Specimen] Issue Age of Insured [35] Sex of Insured [Male] Policy Start Date [DATE] Policy Issue Date [DATE]

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Table of Contents Page

Policy Specifications…………………………………………………………………………………. 3 Schedule of Benefits………………………………………………………………………... 3 Planned Premium Payments………………………………………………………………. 3 Schedule of Charges……………………………………………………………………… 4 Table of Guaranteed Maximum Monthly Cost of Insurance Rates…………………….. 6 Minimum Death Benefit Factors…………………………………………………………… 7 Definitions……………………………………………………………………………………………… 9 Premium Payments for Your Policy………………………………………………………………… 10 Premiums, Grace Period and Reinstatement……………………………………………. 10 Your Policy’s Value…………………………………………………………………………………… 12 Cash Value…………………………………………………………………………………… 12 Accessing Your Policy Value………………………………………………………………………… 13 Cash Surrender Value of Your Policy…………………………………………………….. 13 Loans…………………………………………………………………………………………. 14 Withdrawals………………………………………………………………………………..… 14 Surrenders………………………………………………………………………………….... 15 Changing Your Policy………………………………………………………………………………… 16 Policy Changes……………………………………………………………………………… 16 Benefits Provided by Your Policy…………………………………………………………………… 17 Death Benefit………………………………………………………………………………… 17 Benefits on or after Attained Age 121…………………………………………………….. 18 Payment of the Policy Benefits……………………………………………………………. 19 Available Payment Options………………………………………………………………………….. 19 Payment Options……………………………………………………………………………. 19 Life Income Tables…………………………………………………………………………. 20 Charges Applied to Your Policy…………………………………………………………………….. 21 Charges Included in the Monthly Deduction……………………………………………… 21 Other Charges……………………………………………………………………………….. 22 General Provisions of Your Policy…………………………………………………………………... 23 General Provisions………………………………………………………………………….. 23 Owner and Beneficiary……………………………………………………………………… 25

Riders, Endorsements and Amendments, if any, and a copy of the Application are a part of the Policy and follow the Owner and Beneficiary Section.

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Policy Specifications Schedule of Benefits

Policy Plan/Benefit Face Amount/Benefit Amount Risk Class

Individual Flexible Premium Universal Life Insurance

[$50,000] [Standard Non Smoker]

[WAIVER OF SPECIFIED PREMIUM RIDER] [ACCELERATION OF DEATH BENEFIT RIDER] [OVERLOAN PROTECTION RIDER]

[MONTHLY PREMIUM WAIVED: $50.00]

[CLASS: 1]

[AVIATION LIMITATION RIDER]

[MILITARY AND NAVAL AVIATION LIMITATION RIDER]

[SPECIAL HAZARD EXCLUSION PROVISIONS RIDER]

[WAIVER EXCLUSION RIDER]

[TRAVEL EXCLUSION RIDER]

[NEW YORK JUVENILE INSURED LIMITATION]

Planned Premium Payments* Planned First Year Lump Sum [$0]

Planned [Annual] Premium Payments Payments for Year 1 [$1,200.00]

Payments for Years 2 - 20 [$581.84]

Payments for Years 21 & Later [$550.00]

Your MetLife Policy Insured [John Middle Doe] Policy Number [Specimen] Initial Face Amount [$50,000] Issue Age of Insured [35] Sex of Insured [Male] Date of Coverage [DATE] Death Benefit Option [A] Minimum Cash Value Guaranteed Interest Rate [2.00%] Minimum Loan Interest Rate Credited [2.00%]

Withdrawing Money from Your Policy Maximum Number of Withdrawals Yearly [12] Minimum Withdrawal Amount [$100.00] Percentage Used to Calculate Maximum Withdrawal Amount

[90.0%]

Other Minimums That Apply to Your Policy Minimum Face Amount [$50,000]

Minimum Face Amount Decrease [$5,000.00]

Minimum Face Amount Increase [$5,000.00]

Minimum Premium Payment Amount [$50.00] * It is possible that insurance coverage may not continue to Attained Age 121 even if your Planned Premium Payments are paid in a timely manner. You may change your Planned Premium Payments; however, new Policy Specifications pages will not be sent to you for such a change.

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Policy Specifications

Schedule of Charges Maximum Percent of Premium Charge # For Premium Payments

up to and including [581.84]## each policy year

For Premium Payments in excess of [$581.84]## each policy year

Year 1 43.00% 13.00% Years 2 & Later 18.00% 13.00% Maximum Monthly Policy Charge Years 1 – 20 $10.00 Years 21 & Later $10.00 Maximum Monthly Coverage Expense Charge # Year 1 0.2667 per $1,000 Years 2 – 20 0.2667 per $1,000 Years 21 & Later 0.1905 per $1,000 Maximum Fixed Loan Interest Rate Years 1- 20 5.00% Years 21 & Later 4.00%

Your MetLife Policy Insured [John Middle Doe] Policy Number [Specimen] Initial Face Amount [$50,000] Issue Age of Insured [35] Sex of Insured [Male] Date of Coverage [DATE] Death Benefit Option [A]

# If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the charges.

## This premium (called “Target Premium”) will be recalculated if: any Requested Increase or face decrease is made; any riders are changed, added or removed; there is a change in the Insured’s risk class; a Withdrawal that decreases the Face Amount is made; or there was a misstatement of the Insured’s age or sex. We will send you a new Policy Specifications page reflecting the new premiums upon any of these changes. Coverage may not be in force until Attained Age 121 since: you can change the amount, timing, and frequency of premium payments; the current charges (including the Cost of Insurance Rates) and current interest credited are not guaranteed; you can take Loans and Withdrawals; you can change the Death Benefit Option; the Face Amount may be changed; and the cost of additional benefits may change due to the addition or deletion of riders. Coverage may cease prior to the Attained Age 121 unless additional premium is received. The Planned Premium Payment may need to be increased to keep the Policy in force. The Policy will stay in effect after Attained Age 121 as long as the Cash Surrender Value remains greater than or equal to zero. No charges will be taken on or after Attained Age 121. However, Loan Interest will be charged on any Policy Loan.

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We have the right to change the rates of interest credited to the Cash Value of your Policy, but the rates will not be less than the Minimum Cash Value Guaranteed Interest Rate and the Minimum Loan Interest Rate Credited, as applicable. We have the right to change the Cost of Insurance Rates, but the rates will not be greater than those shown in the Table Of Guaranteed Maximum Monthly Cost Of Insurance Rates. We also have the right to change the cost of the other expense charges, but the charges will not be more than the maximum charges shown on the Policy Specifications pages. Any changes to the Cost of Insurance Rates and charges shown above will not exceed the maximums shown. Credited interest rates may be changed at any time. Factors may only be changed based on changes in our future expectations as to: mortality; investment earnings; taxes; expenses; capital and reserve requirements; and persistency. Changes will only be made according to procedures and standards filed, if required, with the insurance supervisory official of the state which governs the Policy. Changes will be made on a future basis only (and will not recoup past losses or distribute past gains) and will not be unfairly discriminatory. Actual Cash Value may be less than that illustrated. Actual premiums required to keep the Policy in force may be greater than those illustrated.

All charges are fully described in your Policy in the Charges Applied to Your Policy Section.

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Policy Specifications

Schedule of Charges (continued) Surrender Charge Schedule

Beginning of Year* Surrender Charge

[1 $10.27 2 10.24 3 9.84 4 9.42 5 8.99 6 8.50 7 7.65 8 6.79 9 5.93 10 5.07 11 4.21 12 3.36 13 2.50 14 1.64 15 0.79

16 & Later 0.00]

Your MetLife Policy Insured [John Middle Doe] Policy Number [Specimen] Initial Face Amount [$50,000] Issue Age of Insured [35] Sex of Insured [Male] Policy Start Date [DATE] Date of Coverage [DATE] Death Benefit Option [A]

* Measured from the Date of Coverage. If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the charges.

When We Deduct a Surrender Charge A Surrender Charge may be deducted during the first 15 years: after the Policy Start Date; and after the Date of Coverage of each Requested Increase. During the surrender charge period, a Surrender Charge will apply: upon surrender; upon lapse; upon a Withdrawal that decreases the Face Amount; upon a change in Death Benefit Option that decreases the Face Amount; and upon a requested decrease in Face Amount. The Surrender Charges for the first coverage month in each coverage year for the portion of the Face Amount issued on the Date of Coverage are shown above. In the first coverage year, the Surrender Charge is level in all months. In coverage years 2 through 15, the Surrender Charge decreases linearly each coverage month, rounded to two decimal places. The Surrender Charges for each Requested Increase will be shown in a new Surrender Charge Schedule page. A proportionate Surrender Charge will be deducted for: Withdrawals that decrease the Face Amount; changes in Death Benefit Option that decrease the Face Amount; and for requested decreases in the Face Amount. Thereafter, any Surrender Charges will be proportional to the remaining Face Amount.

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Policy Specifications Table of Guaranteed Maximum Monthly Cost of Insurance Rates (per $1,000 of Net Amount at Risk)

Attained

Age Rate Attained

Age Rate Attained

Age Rate

[35 0.0909 65 1.2984 95 25.5731 36 0.0959 66 1.4287 96 27.4319 37 0.1001 67 1.5609 97 29.4579 38 0.1076 68 1.7034 98 31.6727 39 0.1143 69 1.8513 99 34.0996 40 0.1218 70 2.0309 100 36.7714 41 0.1318 71 2.2323 101 38.9514 42 0.1443 72 2.4974 102 41.3354 43 0.1585 73 2.7779 103 43.9463 44 0.1752 74 3.0740 104 46.8129 45 0.1944 75 3.3987 105 49.9254 46 0.2128 76 3.7541 106 53.3626 47 0.2328 77 4.1685 107 57.1735 48 0.2445 78 4.6549 108 61.4191 49 0.2579 79 5.2198 109 66.1733 50 0.2771 80 5.8398 110 71.5294 51 0.2997 81 6.5510 111 77.6168 52 0.3307 82 7.2976 112 83.3334 53 0.3641 83 8.1097 113 83.3334 54 0.4068 84 9.0174 114 83.3334 55 0.4595 85 10.0424 115 83.3334 56 0.5132 86 11.1923 116 83.3334 57 0.5710 87 12.4651 117 83.3334 58 0.6205 88 13.8494 118 83.3334 59 0.6776 89 15.3335 119 83.3334 60 0.7464 90 16.9089 120 83.3334 61 0.8305 91 18.4164 121+ 83.3334] 62 0.9332 92 20.0153 63 1.0486 93 21.7337 64 1.1700 94 23.5855

Your MetLife Policy Insured [John Middle Doe] Policy Number [Specimen] Initial Face Amount [$50,000] Issue Age of Insured [35] Sex of Insured [Male] Date of Coverage [DATE] Basis of Computation of Minimum Cash Value 2001 CSO Mortality Table [for a Male Smoker], Age Nearest Birthday Monthly Cost of Insurance Factor 1.00165158

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Policy Specifications Minimum Death Benefit Factors Attained

Age Factor

Attained

Age Factor

Attained

Age Factor

[35 4.02046 65 1.68478 95 1.10506 36 3.88877 66 1.64935 96 1.09960 37 3.76159 67 1.61541 97 1.09440 38 3.63879 68 1.58265 98 1.08948 39 3.52059 69 1.55099 99 1.08488 40 3.40672 70 1.52020 100 1.08072 41 3.29713 71 1.49045 101 1.07715 42 3.19198 72 1.46172 102 1.07361 43 3.09122 73 1.43450 103 1.07006 44 2.99486 74 1.40852 104 1.06644 45 2.90292 75 1.38355 105 1.06261 46 2.81514 76 1.35968 106 1.05888 47 2.73097 77 1.33682 107 1.05527 48 2.65034 78 1.31506 108 1.05177 49 2.57206 79 1.29451 109 1.04843 50 2.49614 80 1.27524 110 1.04530 51 2.42290 81 1.25716 111 1.04259 52 2.35238 82 1.24032 112 1.04087 53 2.28495 83 1.22447 113 1.04086 54 2.22053 84 1.20946 114 1.04084 55 2.15934 85 1.19526 115 1.04077 56 2.10133 86 1.18209 116 1.04059 57 2.04618 87 1.17000 117 1.04010 58 1.99370 88 1.15899 118 1.03876 59 1.94308 89 1.14904 119 1.03515 60 1.89437 90 1.14009 120 1.02545 61 1.84772 91 1.13209 121+ 1.02545] 62 1.80336 92 1.12464 63 1.76149 93 1.11767 64 1.72205 94 1.11115

Your MetLife Policy Insured [John Middle Doe] Policy Number [Specimen] Date of Coverage [DATE] Death Benefit Calculation Test* [Guideline Premium Test]

* This test is used to determine whether this Policy qualifies as life insurance under applicable tax law. You may not change the test, which was chosen on the Application, after the Policy has been issued.

See next page.

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Definitions Definitions Application Application means the application, including any amendments, for: your Policy; any Reinstatement of your Policy; any application concerning the Insured’s smoking habits; any riders that are made a part of your Policy; and any policy changes. A copy of your Application is attached to and is part of the Policy.

Attained Age The Attained Age is equal to the Issue Age plus the number of completed policy years. This includes any period during which the Policy was lapsed.

Date of Coverage The Date of Coverage is the effective date of each piece of the Policy’s Face Amount. The Date of Coverage for the Initial Face Amount is the same as the Policy Start Date. The Date of Coverage for each increase in Face Amount will be shown on the Policy Specifications page for that piece of coverage. The contestable and suicide periods for each increase in Face Amount are measured from that coverage’s Date of Coverage.

Designated Office The Designated Office is our Home Office or any other office we designate.

Excess Loan An Excess Loan occurs when the Policy Loan Balance exceeds the Cash Value of the Policy less any Surrender Charge.

Initial Face Amount The Initial Face Amount is the Face Amount of the Policy on the Policy Start Date. The Initial Face Amount can be decreased as described in the Decreasing Your Policy’s Face Amount provision.

In Writing In Writing means in a written or other form satisfactory to us and received at our Designated Office.

Insured The Insured is the person whose life is covered by the Policy.

Interest Crediting Start Date The Interest Crediting Start Date is the date we start crediting interest to your Policy. The first Net Premium is applied to the Policy on this date. This date will be the later of: 1. The Policy Issue Date; and 2. The date we receive the first premium at our

Designated Office.

Issue Age The Issue Age is the age of the Insured. It is determined by using his or her birthday nearest to the Policy Start Date.

Face Amount The Face Amount of the Policy is the dollar amount we use to calculate the Death Benefit. The Face Amount may be increased or decreased as described in the Changing Your Policy’s Face Amount provision.

Net Amount at Risk We use the Net Amount at Risk to determine the Monthly Cost of Insurance for your Policy. For Death Benefit Option A, the Net Amount at Risk is equal to: the greatest of the Face Amount divided by the Monthly Cost of Insurance Factor, the Cash Value times the applicable Minimum Death Benefit Factor, and the minimum death benefit required by applicable tax law; less the Cash Value. For Death Benefit Option B, the Net Amount at Risk is equal to: the greatest of the Face Amount divided by the Monthly Cost of Insurance Factor plus the Cash Value, the Cash Value times the applicable Minimum Death Benefit Factor, and the minimum death benefit required by applicable tax law; less the Cash Value. The Cash Value used in the Net Amount at Risk calculation is the Cash Value at the start of the policy month before the deduction of the Total Monthly Cost of Insurance. The Monthly Cost of Insurance Factor is shown on the Policy Specifications page. The applicable Minimum Death Benefit Factor is based on the Insured’s Attained Age. It is shown on the Minimum Death Benefit Factors page. If the Face Amount or Death Benefit of a rider is to be included for the purposes of calculating the Net Amount at Risk under the Death Benefit Options, it will be indicated in the rider.

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Definitions (continued) The Net Amount at Risk will be allocated to the pieces of coverage in the following order: 1. Each increase in Face Amount in succession,

starting with the most recent increase; and then 2. To the coverage provided by the remaining

Initial Face Amount (which includes any increase in Face Amount resulting from a Death Benefit Option change).

Net Premium The Net Premium is the portion of the premium that will be applied to your Policy’s Cash Value. It is equal to: the premium paid; less the premium paid times the applicable Percent of Premium Charge for the current policy year.

Payee A Payee is a person, corporation, partnership, trust or charity entitled to receive the Policy Proceeds, surrender proceeds or Withdrawal amount in one sum or under a Payment Option. If the Payee is not a natural person, the choice of a Payment Option will be subject to our consent.

Planned First Year Lump Sum The Planned First Year Lump Sum is the amount of premium stated in the Application that is intended to be paid as a lump sum by the first policy anniversary. This amount is shown on the Policy Specifications page.

Planned Premium Payment The Planned Premium Payment is the amount stated in the Application that is intended to be paid as a premium on the Planned Premium Payment Due Dates. This amount is shown on the Policy Specifications page 4. You may change this amount by making a request In Writing.

Planned Premium Payment Due Date The Planned Premium Payment Due Date is based on the Policy Start Date and the mode in which you choose to pay premiums. If premiums are paid on an annual mode, it is the policy anniversary each year. If premiums are paid on other than an annual mode, it is the policy anniversary and each semi-annual, quarterly or monthly anniversary, as applicable.

Policy Issue Date The Policy Issue Date is used to measure the contestable and suicide periods for the initial coverage.

Policy Loan Balance The Policy Loan Balance at any time is equal to the outstanding Loan plus Loan Interest accrued to date.

Policy Proceeds The Policy Proceeds is the amount paid to the Beneficiary upon receipt of due proof of the Insured’s death.

Policy Start Date The Policy Start Date is used to measure policy years, months and anniversaries. It may be referred to as Policy Date on the Application.

Requested Increase A Requested Increase is an increase in Face Amount that you applied for after the Policy Issue Date.

We, Us and Our We, us and our refer to Metropolitan Life Insurance Company.

You and Your You and your refer to the Owner of the Policy.

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Premium Payments for Your Policy Premiums, Grace Period and Reinstatement Paying Premiums for Your Policy The first premium is due as of the Policy Start Date. The Policy will not be in force until the first premium is paid. If you have the Policy and the first premium has not been paid, we will consider that you have the Policy for inspection only. Premiums after the first premium must be paid at our Designated Office. Premiums may be paid in any amount and at any interval subject to the following conditions: 1. There is a minimum amount for premium

payments. Except with our consent, any premium payment must be at least the Minimum Payment Amount shown on the Policy Specifications page.

2. Total premiums paid in any policy year may not be equal to or exceed an amount that would cause the Policy to fail to qualify as life insurance under applicable tax law. We will refund any amount paid that exceeds this limit.

3. Premium payments cannot be made after Attained Age 121, unless they are required under a Grace Period.

4. If we receive a premium that causes the Death Benefit to increase by an amount that exceeds that Net Premium, we have the right to refuse that premium payment. We may require additional evidence of insurability before we accept that premium payment.

You may request a change to your Planned Premium Payments. However, we will not process an increase to the Planned Premium Payment if payment of the increased planned premium would cause the Policy to fail to qualify as life insurance under applicable tax law. If we receive a payment, we will treat it as a premium payment, unless you request otherwise In Writing.

Continuation of Insurance after Premium Payments Stop If you stop making premium payments, the insurance provided under the Policy, including benefits provided by any rider made a part of the Policy, will continue in accordance with the provisions of the Policy for as long as the Cash Surrender Value is large enough to cover the Monthly Deductions. See the Grace Period for Submitting any Amount Due provision.

Paid-Up Insurance Option You can exchange your Policy while it is in force, on any policy anniversary before Attained Age 121, for a new policy that provides Paid-Up Insurance. Your request for the exchange must be In Writing on or before the policy anniversary on which the exchange is to be effective. This Policy will be void as of the date of the exchange. Paid-Up Insurance will be provided by using: the Cash Surrender Value of the Policy as a net single premium at the then current age of the Insured as calculated by the issuing company for that plan of insurance; the 2001 CSO Mortality Table; and an interest rate of 4%. The cash value of the paid-up insurance will be based on an interest rate of 4% a year. Paid-Up Insurance is permanent life insurance with no further premiums due. The Paid-Up Insurance will be issued: on a plan of insurance offered by us or one of our affiliates; and with a start date as of the date this Policy ends.

Grace Period for Submitting Any Amount Due If, on a monthly anniversary date, the Cash Surrender Value is less than the next Monthly Deduction, we will give you a 62-day period called the “Grace Period” to allow you to pay premium sufficient to keep your Policy from lapsing. The required premium is called the “Amount Due”. At the start of the Grace Period, we will send a notice of the Amount Due. We will send this notice to your last known address and to that of any assignee on record. If we do not receive the Amount Due by the end of the Grace Period: the Policy will lapse; and it will terminate without Cash Surrender Value If the Insured dies during the Grace Period, any Amount Due will be deducted from the Policy Proceeds.

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Premium Payments for Your Your Policy’s Value Policy (continued)

Reinstating Your Policy after Lapse If the Policy has lapsed, you may reinstate your Policy (excluding riders) prior to Attained Age 121 and within three years after the date of lapse. This is called a “Reinstatement”. Riders can be reinstated if stated in the rider or with our consent. To reinstate your Policy, you must submit a request In Writing and the following: 1. Proof that the Insured is insurable by our

standards. 2. Payment of the Monthly Deductions that were

due and not paid at the time of lapse. 3. Payment of an amount large enough to keep

the Policy in force for at least three months. Any Loan in effect at the time of lapse may be paid or reinstated. If the Loan is reinstated, the reinstated Cash Value will be: reduced by any Loan Interest due at the time of lapse; and increased by any Surrender charge deducted at the time of lapse. If the Loan is not reinstated, the reinstated Cash Value will be: reduced by any Policy Loan Balance at the time of lapse; and increased by any Surrender Charge deducted at the time of lapse. If the Insured is alive on the date we approve the request for Reinstatement, the Policy will be in force from the date we approve the Reinstatement application. We will deduct a full Monthly Deduction for the policy month in which we approve the Reinstatement application. If the Insured is not alive on the date we approve the request for Reinstatement, such approval is void. The Surrender Charge, Maximum Monthly Coverage Expense Charge and Maximum Percent of Premium Charge at the time of Reinstatement will be those in effect at the time of lapse. See the Charges Applied to Your Policy Section.

Cash Value Cash Value of Your Policy Your Policy will accumulate cash value. See the Cash Surrender Value of Your Policy provision for information on the value available to you. The Cash Value on the Interest Crediting Start Date is equal to: 1. The initial Net Premium; less 2. The Monthly Deductions due from the Policy

Start Date through the Interest Crediting Start Date.

The Cash Value on any day after the Interest Crediting Start Date is equal to: 1. The Cash Value on the previous day, with

interest on such value at the current rate(s); less

2. Any Withdrawal made on that day (including any Surrender Charge taken on that day as a result of the Withdrawal); less

3. Any Cash Value paid to you on that day to allow the Policy to continue to qualify as a life insurance contract; less

4. Any Surrender Charge taken on that day due to a requested decrease in Face Amount or Death Benefit Option change; plus

5. Any Net Premium received on that day; less 6. The Monthly Deduction to cover the cost of the

policy month which starts on that day, if that day is a monthly anniversary.

Cash Value of Your Policy on and after Attained Age 121 If the Policy is continued beyond Attained Age 121, the Cash Value on and after Attained Age 121 will be determined in the same way described above, except: 1. There will be no Monthly Deductions taken; and 2. Premium Payments cannot be made on or after

Attained Age 121, except for payments required under a Grace Period.

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Your Policy’s Value Accessing Your Policy Value (continued)

The Interest We Credit to Your Policy’s Cash Value Interest is credited to the Cash Value of your Policy. The rate of interest we credit could be different for the un-loaned Cash Value and the amount of Cash Value securing a Loan. The effective annual interest rate applied to the un-loaned Cash Value will never be less than the Minimum Cash Value Guaranteed Interest Rate shown on the Policy Specifications page. The effective annual interest rate applied to the Cash Value securing any Loan will never be less than the Minimum Loan Interest Rate Credited shown on the Policy Specifications page.

Basis of Computation The minimum cash values and guaranteed cost of insurance rates are based on the mortality table and the Minimum Cash Value Guaranteed Interest Rate as shown on the Policy Specifications page. All values and benefits are at least equal to those required by the law of the state in which the Policy is delivered. We have filed a detailed statement showing the method of calculating cash values and reserves with the insurance supervisory official of that state. Cash Values are computed according to the Standard Nonforfeiture Law of life insurance.

Cash Surrender Value of Your Policy Cash Surrender Value The Cash Surrender Value of the Policy is the amount we use to determine what is available to you for Loans, Withdrawals and Surrenders. It is equal to the Cash Value at the time of surrender, less: 1. Any Policy Loan Balance; less 2. Any Surrender Charge.

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Accessing Your Policy Value (continued) Loans Borrowing Money from Your Policy If your Policy has Loan Value, you can borrow money from your Policy by making a request In Writing. The maximum amount you may borrow is defined below as the Loan Value. The Loan Value on the date the loan is made is equal to: 1. The Cash Value; plus 2. Interest at the Minimum Cash Value

Guaranteed Interest Rate credited to the next policy anniversary; less

3. Any Policy Loan Balance; less 4. Loan Interest at the Maximum Fixed Loan

Interest Rate to the next policy anniversary; less

5. The most recent Monthly Deduction charged, times the number of policy months to the next policy anniversary; and less

6. Any Surrender Charge. The Policy will be the sole security for such Loan. We have the right to defer your Loan for up to six months from the date we receive your request, unless the loan is being used to pay premiums to us.

Repaying Your Loan and Loan Interest Your Policy Loan Balance can be repaid in whole or in part at any time before the death of the Insured while the Policy is in force. Any payment we receive will be applied as a premium payment unless it is clearly marked as a Loan or Loan Interest repayment. The Policy Proceeds and Cash Surrender Value reflect the deduction of any outstanding Policy Loan Balance. If your Policy has an Excess Loan, we will send a notice to your last known address and that of any assignee of record. We will allow you a Grace Period for payment of the excess due. If the excess due remains unpaid at the end of the Grace Period, the Policy will lapse without value. The Grace Period will end 62 days from the date the notice is sent.

Withdrawals Withdrawing Money from Your Policy After the first policy year, you may make a request In Writing for a Withdrawal from the Cash Surrender Value. A Withdrawal is subject to the conditions below. 1. The maximum amount that can be withdrawn

from your Policy is determined on each policy anniversary for that policy year. The maximum withdrawal amount is the greater of: a. The Cash Surrender Value at the start of

that policy year times the Percentage Used to Calculate Maximum Withdrawal Amount, as shown on the Policy Specifications page; and

b. The previous year’s maximum withdrawal amount.

2. The maximum amount is limited by the following conditions. No Withdrawal will be processed unless: a. The Cash Surrender Value after the

Withdrawal is large enough to cover two Monthly Deductions;

b. The Face Amount after the Withdrawal, excluding riders, is at least the Minimum Face Amount shown on the Policy Specifications page; and

c. The Policy continues to qualify as life insurance under applicable tax law after the Withdrawal.

3. There is a minimum amount you can withdraw from your Policy at any one time. The minimum amount is shown on the Policy Specifications page as the Minimum Withdrawal Amount.

4. There is a limit on how many Withdrawals from your Policy you can make in any policy year. This limit is shown on the Policy Specifications page as the Maximum Number of Withdrawals Yearly. We may charge a fee for a Withdrawal. If we do, it will not be more than [$25.00].

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Accessing Your Policy Value (continued)

The Face Amount of the Policy will be decreased if necessary after the Withdrawal so that the Net Amount at Risk is not greater than it was prior to the Withdrawal. The Face Amount will be decreased in the following order, unless any rider made a part of the Policy states otherwise: 1. Each Requested Increase in succession,

starting with the most recent increase; and then 2. The remaining Initial Face Amount; and then 3. Any increase in Face Amount resulting from a

change in Death Benefit Option. A decrease in Face Amount may require a decrease in the amounts provided by any riders made a part of the Policy. If the piece of the Face Amount being decreased is still in its surrender charge period, a Surrender Charge will be deducted from the Cash Value. The Death Benefit of the Policy after the Withdrawal will be based on the new Face Amount and the reduced Cash Value. Unless otherwise requested, the proceeds will be paid to you in a single lump sum check. We may make other options available in addition to the single check option. You may choose In Writing to apply all or part of the amount to a Payment Option. See the Payment Options Section. We may defer payment of the Withdrawal for up to six months.

Surrenders Surrendering Your Policy You may surrender the Policy for its Cash Surrender Value during the lifetime of the Insured. We will determine the Cash Surrender Value as of the date we receive your request In Writing. If you surrender the Policy within 31 days after the policy anniversary date, the Cash Surrender Value you receive will not be less than the Cash Surrender Value on that anniversary date, reduced by: any Loans taken; any Loan Interest accrued to date; and any Withdrawals made during the 31-day period. If the surrender occurs on a monthly anniversary, the Policy will terminate on that date. Further, the Cash Surrender Value will not be reduced by the Monthly Deduction due on that date for a subsequent policy month. If the surrender occurs on any date other than a monthly anniversary, the Policy will terminate on the next monthly anniversary date. If the Insured dies on or after the date of surrender and before the Policy terminates: the surrender will be reversed; the Cash Surrender Value paid to you will be converted to a Loan; and the Policy Proceeds will be paid. This means the Cash Surrender Value paid to you will be deducted from the Policy Proceeds. See the Payment to Your Beneficiary provision. Unless otherwise requested, the proceeds will be paid to you in a single lump sum check. We may make other options available in addition to the single check option. You may choose In Writing to apply all or part of the proceeds to a Payment Option. See the Payment Options Section. We may defer payment of the full Cash Surrender Value for up to six months.

1E-37-14-NY Page 16

Changing Your Policy Policy Changes Policy Changes After the first policy anniversary and prior to Attained Age 121, you can request policy changes at any time unless we have stated otherwise in the Policy. We may allow only one change per policy year. No change will be made that would result in the Policy failing to qualify as life insurance under applicable tax law. Following are the types of changes that are allowed. Changing Your Policy’s Face Amount You can ask us to decrease or increase the Face Amount of your Policy. The request must be In Writing.

Decreasing Your Policy’s Face Amount Each requested decrease in Face Amount will be subject to the following: 1. The decrease will reduce the Face Amount in

the following order, unless any rider made a part of the Policy states otherwise: a. Each Requested Increase in succession,

starting with the most recent Requested Increase; and then

b. The remaining Initial Face Amount; and then

c. Any increase in Face Amount resulting from a change in Death Benefit Option.

2. The Face Amount after the requested decrease may not be less than the Minimum Face Amount shown on the Policy Specifications page.

3. The decrease must be at least equal to the Minimum Face Amount Decrease shown on the Policy Specifications page.

4. If the Face Amount being decreased is still in its surrender charge period, a Surrender Charge will apply to the decrease in Face Amount as explained in the Surrender Charge Schedule.

5. The decrease may require us to distribute a portion of the Cash Value to you.

6. The Policy must continue to qualify as life insurance under applicable tax law after the decrease.

We will send new Policy Specifications pages to show the decreased Face Amount. The decrease will take effect on the date we receive your request. See the riders attached to your Policy, if any, for information about how a decrease in Face Amount may cause a decrease in the amount provided by such riders.

Increasing Your Face Amount Each Requested Increase will be subject to the following: 1. We must receive proof satisfactory to us that

the Insured is insurable by our standards on the date of the Requested Increase.

2. The charges for the increase will be based on the risk class the Insured qualifies for on the Date of Coverage for the Requested Increase.

3. New insurance must be available under our underwriting rules on the same plan at the Attained Age of the Insured on the date of the Requested Increase.

4. The increase must be at least equal to the Minimum Face Amount Increase shown on the Policy Specifications page.

5. The total Face Amount after the increase cannot be greater than our published maximums. The total Face Amount is equal to the Face Amount before the Requested Increase plus the Requested Increase.

We will send new Policy Specifications pages to show the Date of Coverage for and charges applicable to the increase in Face Amount. The increase will take effect on the date we approve the Requested Increase.

Addition of Riders You can ask us to add a rider to the Policy. The request must be In Writing. Proof of insurability may be required. If we approve your request, the addition of the rider will take effect on the Issue Date of the Rider.

Change in Risk Class You can apply for a better risk class. The request must be In Writing. Proof of insurability will be required. If we approve your request, the change will take effect on the date we approve your request.

Change From a Smoker to Nonsmoker Risk Class If any coverage under your Policy was issued at a smoker risk class, you may be able to apply for a change to a nonsmoker risk class. Application can be made if the Insured has not used tobacco/nicotine products in the last 12 months and the Policy has been in force for at least one year.

1E-37-14-NY Page 17

Changing Your Policy Benefits Provided by Your Policy (continued)

A change to a nonsmoker risk class will be subject to: application to change the risk class; evidence of insurability; and our general underwriting rules in effect at that time. Those rules: may involve criteria other than tobacco/nicotine use; and may involve a definition of tobacco/nicotine use different from the definition used on the Policy Issue Date. If the risk class is changed to a nonsmoker risk class: 1. The application will be attached to and made a

part of your Policy; and 2. The application will be contestable for two years

from the effective date of the change in risk class. The contest will be limited to the difference between the premiums, rates and charges based on the smoker risk class and the premiums, rates and charges based on the nonsmoker risk class.

Changing Your Policy’s Death Benefit Option You can ask us to change your Death Benefit Option. The request must be In Writing. We may require proof that the Insured is insurable by our standards on the date of the change if the change would result in an increase in the Net Amount at Risk. The effective date of the change will be the date we approve your request. The Death Benefit payable will not change as a result of this change, but the Face Amount may change. Changes are allowed as follows: 1. Change from Death Benefit Option A to Death

Benefit Option B. The Face Amount of the Policy will be decreased, if necessary, to equal the Death Benefit less the Cash Value on the effective date of the change. This change will not be allowed if it would result in a Face Amount for the Policy that is less than the Minimum Face Amount shown on the Policy Specifications page. If the Face Amount being decreased is still in the surrender charge period, a Surrender Charge will apply to the decrease in Face Amount as explained in the Surrender Charge Schedule.

The decrease will reduce the Face Amount in the following order, unless any rider made a part of the Policy states otherwise: a. Each Requested Increase in succession,

starting with the most recent increase; and then

b. The remaining Initial Face Amount; and then

c. Any increase in Face Amount resulting from a change in Death Benefit Option.

See the riders attached to your Policy, if any, for information about how a decrease in Face Amount may cause a decrease in the amount provided by such riders.

2. Change from Death Benefit Option B to Death Benefit Option A.

The Face Amount of the Policy will be increased, if necessary, to equal the Death Benefit on the effective date of the change.

Death Benefit Payment to Your Beneficiary We will pay the Policy Proceeds to the Beneficiary upon receipt of due proof of the Insured’s death. The Policy Proceeds are equal to: 1. The Death Benefit; plus 2. Any insurance on the life of the Insured

provided by riders (unless the rider’s Face Amount or Death Benefit is reflected in the Death Benefit of the Policy); plus

3. The Total Monthly Cost of Insurance for the portion of the policy month from the date of the Insured’s death to the end of that policy month; plus

4. Any premium received after the date of the Insured’s death; less

5. Any Amount Due under a Grace Period provision as of the date of the Insured’s death; less

6. Any Policy Loan Balance. In no event will the amount payable upon the death of the Insured be less than the minimum amount required to permit the Policy to qualify as life insurance under the applicable tax law.

1E-37-14-NY Page 18

Benefits Provided by Your Policy (continued)

Death Benefit Options Your Policy allows you to choose between two Death Benefit Options. The amount of the Death Benefit depends upon the Death Benefit Option in effect on the date of the Insured's death. The Death Benefit Option in effect is shown on the most recent Policy Specifications page.

Death Benefit Option A The Death Benefit prior to Attained Age 121 is equal to the greater of: 1. The Face Amount; and 2. The Policy's Cash Value times the applicable

Minimum Death Benefit Factor for the Insured’s Attained Age as shown on the Minimum Death Benefit Factors page.

Death Benefit Option B The Death Benefit prior to Attained Age 121 is equal to the greater of: 1. The Face Amount plus the Cash Value on the

date of death; and 2. The Policy's Cash Value times the applicable

Minimum Death Benefit Factor for the Insured’s Attained Age as shown on the Minimum Death Benefit Factors page.

In no case will the Death Benefit be less than the minimum amount required to meet the definition of life insurance under applicable tax law. If the Face Amount or Death Benefit of a rider is to be included for the purposes of calculating the Death Benefit under the above Options, it will be indicated in the rider. Any time the Death Benefit less the Cash Value is greater than the then current Face Amount, we have the right to distribute a portion of the Cash Value to you. The amount of the distribution will be the amount required to make the Death Benefit less the Cash Value after the distribution equal to the then current Face Amount.

Benefits on or after Attained Age 121 Benefits Payable on or after Attained Age 121 If the Insured is living and the Policy is in force at Attained Age 121, you may choose to terminate the Policy and receive the Cash Surrender Value, if it is greater than zero, as a Maturity Benefit.

Continuation of the Policy beyond Attained Age 121 You may continue the Policy beyond Attained Age 121 until the death of the Insured. If the Policy is in force on or after Attained Age 121, the amount of the Death Benefit depends on the Death Benefit Option in effect on the date of the Insured’s death. The Death Benefit Option is shown on the most recent Policy Specifications page. Death Benefit Option A The Death Benefit on or after Attained Age 121 will be the greater of: 1. The Face Amount on the date of the Insured’s

death plus any rider death benefits determined as of the day prior to Attained Age 121 (unless otherwise indicated in the rider); and

2. 101 percent of the Cash Value on the date of the Insured’s death.

Death Benefit Option B The Death Benefit on or after Attained Age 121 will be: the Face Amount of the Policy on the date of the Insured’s death; plus the Cash Value on the date of the Insured’s death. If the Face Amount or Death Benefit of a rider made a part of the Policy is to be included for the purposes of calculating the Death Benefit under the above Options, it will be indicated in the rider. The Policy could lapse after Attained Age 121 if there is an Excess Loan. If the Policy is in force on or after Attained Age 121: loans may be taken; and loan repayments, Withdrawals, and surrenders may be made. Premiums cannot be paid on or after Attained Age 121 unless they are required under a Grace Period provision. There will be no Monthly Deductions taken on or after Attained Age 121. Please note: The Policy may not qualify as a life insurance contract under applicable tax law on or after Attained Age 121 and may be subject to tax consequences. Please consult a tax advisor prior to continuing the Policy beyond Attained Age 121.

1E-37-14-NY Page 19

Benefits Provided by Your Policy Available Payment Options (continued) Payment of the Policy Benefits Payment of the Policy Proceeds Unless otherwise requested, when the Insured dies we will pay the Policy Proceeds to the Payee in a single lump sum check. We may make other options available in addition to the single check option. The Payee can choose to apply all or part of the Policy Proceeds to any Payment Option. Further, with our consent, any Payee who is entitled to receive proceeds in one sum when a Payment Option ends, or at the death of a prior Payee, or when the proceeds are withdrawn, can choose to apply the proceeds to a Payment Option.

Payment Options Choices of Payment Options; Option Date The choice of a Payment Option and the naming of the Payee must be In Writing. You can make, change or revoke the choice before the death of the Insured. The Option Date is the effective date of the Payment Option, as chosen. When a Payment Option starts, a contract will be issued by us or by an affiliate that will describe the terms of the Option. If your Policy has a collateral assignment, it will modify a prior choice of a Payment Option. In this case, the amount due any assignee will be payable to the assignee in one sum and the balance will be applied under the Payment Option. Life Income Options Guaranteed Life Income Options are based on the age of the Payee on the Option Date. We will require proof of age. The Life Income payments will be based on the rates shown in the Life Income Tables; or, if they are greater, our Payment Option rates on the Option Date. If the rates at a given age are the same for different periods certain, the longest period certain will be deemed to have been chosen.

Single Life Income Option If this Option is chosen, we will make monthly payments during the lifetime of the Payee.

Single Life Income – 10 Year Guaranteed Payment Period Option If this Option is chosen, we will make monthly payments during the life of the Payee with a guaranteed payment period of 10 years.

Joint and Survivor Life Income Option If this Option is chosen, monthly payments will be made: 1. While either of two Payees is living, called

"Joint and Survivor Life Income", or 2. While either of two Payees is living, but for at

least 10 years, called “Joint and Survivor Life Income, 10 Years Certain".

1E-37-14-NY Page 20

Available Payment Options (continued)

Interest Only Option We will hold the proceeds at interest during the life of the Payee or for any other period agreed to by us. Interest on the proceeds: 1. Will be paid each month to the Payee starting

one month after the Option Date; or 2. Will be added to the principal amount each year

and will earn interest. At the death of the Payee, or at the end of the period agreed to, the balance of principal and any accrued interest will be paid in one sum. We will set the rate of interest each year; but the rate will not be less than 1/2 percent per year.

Other Payment Options and Frequencies Other Payment Options and payment frequencies may be arranged with us. Limitations If installments under an Option would be less than [$50.00], proceeds can be applied to a Payment Option only with our consent.

After a Payee Dies Amounts to be paid after the death of a Payee under a Payment Option will be paid as due to the successor Payee. If there is no successor Payee, amounts will be paid in one sum to the estate of the last Payee to die. If a Payee under a Life Income Option dies within 30 days after the Option Date, the amount applied to the Option, less any payments made, will be paid in one sum, unless a Payment Option is chosen.

Life Income Tables Minimum Payments under Payment Options Monthly payments for each $1,000 applied will not be less than the amounts shown in the following Tables. On request, we will provide additional information about amounts of minimum payments. The amounts shown below are based on an interest rate of 1/2 percent a year and the 2000 Annuity Mortality Table.

Single Life Income Payee's

Age Life Income

Male Female 50 $2.32 $2.15 55 2.60 2.39 60 2.96 2.69 65 3.41 3.08 70 4.02 3.60 75 4.86 4.31 80 6.01 5.33 85 7.62 6.82

90 & over 9.87 9.04

Payee's

Age 10 Year Guaranteed Payment Period

Male Female 50 $2.32 $2.15 55 2.59 2.38 60 2.93 2.68 65 3.36 3.06 70 3.92 3.55 75 4.63 4.20 80 5.47 5.03 85 6.39 6.04

90 & over 7.26 7.06

1E-37-14-NY Page 21

Available Payment Options Charges Applied to Your Policy (continued)

Joint and Survivor Life Income

Age of Both Payees

Joint and Survivor One Male and One Female

50 $1.95 55 2.14 60 2.39 65 2.69 70 3.10 75 3.64 80 4.39 85 5.45

90 & over 6.96

Age of Both Payees

Joint and Survivor, 10 Years Certain One Male and One Female

50 $1.95 55 2.14 60 2.39 65 2.69 70 3.10 75 3.63 80 4.35 85 5.28

90 & over 6.37

Charges Included in the Monthly Deduction Monthly Deduction On each monthly anniversary date, we deduct charges from your Policy’s Cash Value. The sum of these charges is called the “Monthly Deduction”. The Monthly Deduction for the next month is deducted on the monthly anniversary date and is equal to: 1. The Monthly Coverage Expense Charge; plus 2. The Monthly Policy Charge; plus 3. The monthly costs for any riders made a part of

the Policy, unless otherwise indicated in a rider; plus

4. The Total Monthly Cost of Insurance (described in the Monthly Cost of Insurance provision).

We will not take any Monthly Deductions from your Policy’s Cash Value on or after Attained Age 121.

Monthly Coverage Expense Charge A Monthly Coverage Expense Charge will be assessed for each piece of coverage, except coverage amounts resulting from a change in Death Benefit Option. The Charge for each piece of coverage is equal to: the Face Amount of the coverage; times its applicable Monthly Coverage Expense Charge rate for the year; divided by 1,000. The Maximum Monthly Coverage Expense Charge for each piece of coverage is shown on that coverage’s Policy Specifications page. The Monthly Coverage Expense Charge for each piece of coverage will never exceed the maximum rate shown on that coverage’s Policy Specifications page. If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the applicable Monthly Coverage Expense Charge.

Monthly Policy Charge A Monthly Policy Charge will be assessed on your Policy. The applicable Monthly Policy Charge will never exceed the Maximum shown on the Policy Specifications page.

1E-37-14-NY Page 22

Charges Applied Your Policy (continued)

Total Monthly Cost of Insurance A Monthly Cost of Insurance Charge will be assessed for each piece of coverage. The Charge covers the cost of providing insurance coverage for the next month. It is included in the Total Monthly Cost of Insurance. The Total Monthly Cost of Insurance is equal to: 1. The Net Amount at Risk that is allocated to the

remaining Initial Face Amount plus any increase in Face Amount resulting from a change in Death Benefit Option multiplied by the Monthly Cost of Insurance Rate for the Initial Face Amount, divided by 1,000; plus

2. The Net Amount at Risk that is allocated to each Requested Increase multiplied by the Monthly Cost of Insurance Rate for each Requested Increase, divided by 1,000.

Monthly Cost of Insurance Rates At the start of each policy year, we will set the “Monthly Cost of Insurance Rate” used to calculate the Monthly Cost of Insurance charge for your Policy. Separate Monthly Cost of Insurance Rates are determined for: the Initial Face Amount plus any increase in Face Amount resulting from a Death Benefit Option change; and for each Requested Increase. The Monthly Cost of Insurance Rate for each piece of coverage is based on the Attained Age, risk class, sex and completed years from the Policy Start Date for the Initial Face Amount and from the Date of Coverage for each Requested Increase. If the Death Benefit is equal to the Policy’s Cash Value times the applicable Minimum Death Benefit Factor, any increase in Cash Value will cause an automatic increase in the Death Benefit. The Monthly Cost of Insurance Rate for such an increase is based on the Attained Age, the risk class used for the most recent Requested Increase, sex and completed years from the Date of Coverage for the most recent Requested Increase. The Monthly Cost of Insurance Rates for each piece of coverage will never exceed the rates shown on the Table of Guaranteed Maximum Monthly Cost of Insurance Rates page for that coverage. Any change in the cost of insurance rates will apply to all persons of the same Attained Age, sex, and risk class whose coverage has been in force for the same length of time.

Other Charges Charge Applied to Your Premium Payments We will deduct a “Percent of Premium Charge” from each premium we receive. This Charge covers premiums received for the Initial Face Amount and each Requested Increase. The Charge for each piece of coverage is equal to: the amount of premium allocated to the piece of coverage; times the Percent of Premium Charge for that piece of coverage. The Maximum Percent of Premium Charge for each piece of coverage is shown on that coverage’s Policy Specifications page. Premiums will be allocated to each piece of coverage in the following order: 1. To the coverage provided by the Initial Face

Amount up to and including its Target Premium amount; and then

2. In succession starting with the first Requested Increase up to and including its Target Premium amount; and then

3. Any remaining premium will be allocated to each piece of coverage based on the percentage allocated to it in items 1. and 2. above.

If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the applicable Percent of Premium Charge.

Surrender Charges Assessed on Your Policy The Surrender Charges and the length of time they will be assessed are shown on the Surrender Charge Schedule. There will be a separate Surrender Charge Schedule for each piece of coverage. During the applicable surrender charge period, a Surrender Charge will apply upon: 1. Surrender; 2. Lapse; 3. A Withdrawal that decreases the Face Amount; 4. A change in Death Benefit Option that

decreases the Face Amount; and 5. A requested decrease in Face Amount.

1E-37-14-NY Page 23

Charges Applied to Your Policy General Provisions of Your Policy (continued)

Unless any rider made a part of the Policy states otherwise, a Surrender Charge will be applied: 1. First, with respect to each Requested Increase

in succession based on the number of months from the Date of Coverage for that increase, starting with the most recent increase; and then

2. Second, with respect to the Initial Face Amount (excluding any increase in Face Amount resulting from a Death Benefit Option change), based on the number of months from the Policy Start Date.

If the Surrender Charge for a rider is to be included for the purposes of determining the Surrender Charge applicable to the Policy, it will be indicated in the rider. If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the Surrender Charge.

Interest We Charge on Policy Loans We charge interest on any loans. The rate we charge will not exceed the Maximum Fixed Loan Interest Rate based on the policy year as shown on the Policy Specifications page. The Loan Interest is due each year on the policy anniversary. If Loan Interest is not paid when it is due, we will add it to your existing Policy Loan.

Illustration of Benefits You may request In Writing that we send you an illustration of benefits. We may charge a small fee for any requested illustration after the first in each policy year. This fee will not exceed [$25.00].

General Provisions The Contract We have issued the Policy in consideration of the Application and payment of premiums. The Policy includes the attached Application, any riders, and any endorsements. Together they comprise the entire contract and are made a part of the Policy when the insurance applied for is accepted. The Policy may be changed by mutual agreement. Any change must be In Writing and approved by our President, Vice President or Secretary. Our representatives have no authority to alter or change any terms, conditions, or agreements of the Policy, or to waive any of its provisions.

Statements Made in the Application for the Policy All statements made in the Application for the Policy will be deemed representations and not warranties. Material misrepresentations will not be used to void the Policy or any rider or to deny a claim unless made in the Application for the Policy.

Claims of Creditors To the extent permitted by law, neither the Policy nor any payment under it will be subject to the claim of creditors or to any legal process.

Misstatement of Age or Sex If we determine while the Insured is living that there was a misstatement of age or sex reflected in the Policy, the policy values will be recalculated from the Policy Start Date based on the correct information. If we determine after the Insured’s death that there was a misstatement of age or sex reflected in the Policy, the amount of the Death Benefit will be that which would be purchased by the most recent Monthly Cost of Insurance at the correct age and sex.

1E-37-14-NY Page 24

General Provisions of Your Policy (continued) Incontestability Period The insurance issued under the Policy will not be contestable after it has been in force during the lifetime of the Insured: 1. With respect to the initial coverage, for two

years from the Policy Issue Date. 2. With respect to a Requested Increase, for two

years from the Date of Coverage of the Requested Increase.

3. With respect to a Death Benefit increase caused by a premium payment that required evidence of insurability, for two years from the date we received the premium payment.

4. With respect to a Death Benefit increase caused by a change in Death Benefit Option that required evidence of insurability, for two years from the Date of Coverage of the Death Benefit increase.

5. With respect to an application for reinstatement, for two years form the date of Reinstatement.

This provision will not apply to any rider that contains its own incontestability clause. If the Policy was issued as the result of the exercise of an option given in another policy and proof of insurability was not required, the contestable period applicable to the coverage resulting from the option exercise will end at the same time that it would have ended under the original policy.

Suicide Exclusion If the Insured dies by suicide within two years from the Policy Issue Date, the amount payable will be limited to the amount of premiums paid (without interest) less any Withdrawals and any Policy Loan Balance on the date of death. If the Insured dies by suicide more than two years after the Policy Issue Date and within two years from the Date of Coverage of any Requested Increase: the increase will not be in effect; and the portion of each Monthly Deduction taken since the effective date of the increase that is attributable to the increase will be added directly to the Policy Proceeds. If the Policy was issued as the result of the exercise of an option given in another policy and proof of insurability was not required, the suicide period applicable to the coverage resulting from the option exercise will end at the same time that it would have ended under the original policy.

Tax Withholding We will deduct any withholding taxes required by applicable law upon Policy surrender, withdrawal of proceeds, or upon payment of the Policy Proceeds.

Tax Regulation of Life Insurance This Policy is intended to qualify as a life insurance contract under applicable tax law. In order to have the Policy continue to qualify, we have the right to: 1. Restrict certain changes to the Policy, such as

Death Benefit increases; 2. Make changes to the Policy; 3. Require the issuance of a new policy in

connection with such changes; and 4. Refuse a premium payment. We will give you written notice of any of the above actions.

Annual Report Each year, or more often if required by law or regulation, we will send you a report that shows: the Death Benefit; current policy values; surrenders; premiums paid and deductions made since the last report; any Policy Loan Balance; and any other information required by law or regulation.

1E-37-14-NY Page 25

General Provisions of Your Policy (continued) Owner and Beneficiary Owner of the Policy The Owner can be a person, corporation, partnership, trust or charity. The initial Owner of the Policy is named in the Application. Before the death of the Insured, you can change the Owner. The new Owner will have all of the rights of the Owner, including the right to make a further change of Owner. A change of Owner will void any prior Beneficiary designation unless there is an irrevocable Beneficiary. Irrevocable Beneficiaries must give written consent to any change of Beneficiary. If there is more than one Owner, all Owners must exercise the rights of ownership by joint action. At the death of an Owner who is a natural person, his or her estate will be the Owner, unless a successor Owner has been named. The rights of the Owner will end at the death of the Insured, except as provided in the Beneficiary of Your Policy provision.

Beneficiary of Your Policy Your Beneficiary can be a person, corporation, partnership, trust or charity. The initial Beneficiary is named in the Application. After the Policy Issue Date but before the death of the Insured, you can change the Beneficiary; however, an irrevocable Beneficiary cannot be changed without his or her written consent. The Beneficiary has no interest in the Policy until the death of the Insured. A person must survive the Insured to qualify as Beneficiary. If no Beneficiary survives, the proceeds will be paid to the Owner.

Procedure for Changing the Owner or Beneficiary You must make a request In Writing during the Insured’s lifetime to change the Beneficiary or Owner. Once the request is received, the change will take effect as of the date you signed the request, whether or not the Insured is living when we receive your request. The change will be subject to any legal restrictions. It will also be subject to any payment we made or action we took before we received the change.

Interpretation of Owner and Beneficiary Designations A numbered sequence can be used to name successive Owners or Beneficiaries. Co-beneficiaries will receive equal shares unless otherwise stated. In naming (designating) Owners or Beneficiaries, unless otherwise stated, if you use the terms below, they will be interpreted as stated in this provision: 1. A general designation of unnamed children as a

group of Beneficiaries includes all future children born to or adopted by the Insured after the date of the designation.

2. “Provision for issue” means that if a Beneficiary does not survive the Insured, the share of the Policy Proceeds for that Beneficiary will go to his or her living issue by right of representation.

3. A designation that specifies a family relationship such as “wife”, “husband” or “child” refers to their relationship to the Insured.

At the time of payment of benefits, we can rely on an affidavit of any Owner or other responsible person to determine family relations or members of a class.

Assignments If you make an absolute assignment of the Policy, the assignee will be the new Owner and Beneficiary. If you make a collateral assignment of the Policy, there is no change of Owner or Beneficiary. However, the rights of the Owner and Beneficiary will be subject to the terms of the collateral assignment. Assignments will be subject to all payments made and actions taken by us before a signed copy of the assignment form is received by us at our Designated Office. We will not be responsible for determining whether or not an assignment is valid.

See next page.

See next page.

1E-37-14-NY Page 28

Individual Flexible Premium Universal Life Insurance Policy This is an individual flexible premium universal life insurance policy where premiums can be paid until Attained Age 121. It does not pay dividends. You may continue the coverage provided by the Policy beyond Attained Age 121. If the Insured dies while the Policy is in force, we will pay the Policy Proceeds to the Beneficiary. The Policy Proceeds are described in the Payment to Your Beneficiary provision. We must receive due proof of the Insured’s death. Any payment will be subject to all of the provisions of the Policy.