EX-99.26(D)(IV) 4 d673249dex9926div.htm FORM OF DATA PAGES (ICC19-15-100-4GPT) Form of Data pages (ICC19-15-100-4GPT)

POLICY INFORMATION CONTINUED — POLICY NUMBER [XX XXX XXX]

TABLE OF PERCENTAGES

 

INSURED

PERSON’S

ATTAINED AGE

  

PERCENTAGE

  

INSURED

PERSON’S

ATTAINED AGE

  

PERCENTAGE

40 and under

      250%    61       128%

41

   243    62    126

42

   236    63    124

43

   229    64    122

44

   222    65    120

45

   215    66    119

46

   209    67    118

47

   203    68    117

48

   197    69    116

49

   191    70    115

50

   185    71    113

51

   178    72    111

52

   171    73    109

53

   164    74    107

54

   157    75-90    105

55

   150    91    104

56

   146    92    103

57

   142    93    102

58

   138    94 and above    101

59

   134      

60

   130      

The definition of life insurance in Section 7702 of the Internal Revenue Code of 1986, as amended (i.e., the “Code”), limits the amounts that may be paid into a life insurance policy relative to the benefits it provides. Even if this policy states otherwise, at no time will the “future benefits” under this policy be less than an amount such that the “premiums paid” do not exceed the Code’s “guideline premium limitations.” We may not accept or may refund any premium paid to meet these limitations. Also, at no time will the “death benefit” under the policy be less than the “applicable percentage” of the “cash surrender value” of the policy. The terms in quotations are defined in the Code. In addition, we may take certain actions, described in the policy, to meet the definitions and limitations in the Code.

 

ICC19-15-100-4GPT

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