EX-4.2 3 policyspec.htm
Policy Specifications

Policy Number [SPECIMEN]

Insured:
[JOHN DOE]
Issue Age and Sex:
[35] [MALE]
 
Rate Class:
[STANDARD]
 
Owner:
[JANE DOE]

   
 
Initial Specified Amount:
$[100,000]
Policy Date:
[MARCH 1, 2021]
Minimum Specified Amount:
$[25,000]
Date of Issue:
[MARCH 1, 2021]
Monthly Anniversary Day:
[01]
    
       
Plan of Insurance:
INDIVIDUAL FLEXIBLE PREMIUM VARIABLE ADJUSTABLE LIFE INSURANCE WITH LONG-TERM CARE BENEFITS

Separate Account:
[Lincoln Life Flexible Premium Variable Account M]


NOTE:
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, Premium Loads, interest credited, Cost of Insurance, Administrative Fees, investment performance of the Separate Account, 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.
   
Premium Payments:
Planned Premium: $[8,000.00]
 
Premiums may be accepted until the Insured’s Attained Age [121].
 
Additional premium payments may vary by frequency or amount.
 
Payment Mode:
 
[ANNUALLY]
 
   
Minimum Additional Premium Payment Amount:
No premium payment may be less than $[200.00] Annually or $[15.00] if paid by electronic funds transfer.

Annual Premium Limit:                             $[28,725] in Policy Year [4] and thereafter.

Limit Single Premium:     $[94,005]

Limit Level Premium:     $[9,575]
 
Beneficiary:
 
[As named in the application for this Policy, unless later changed.]

Guaranteed Minimum Fixed Account Interest Rate:
 
[1.00]% annual effective rate ([0.00272616]% daily).
Policy Specifications

Policy Number [SPECIMEN]

Minimum Specified Amount Increase:
$[1,000]
   
Maximum Attained Age for a Specified Amount Increase:
Increases in Specified Amount not allowed after the Insured reaches Attained Age [70].

Maximum Number of Specified Amount Increases per Policy Year:
[Increases not allowed] in Policy Year(s) [1]; and
[1] in Policy Year [2] and thereafter.

Minimum Specified Amount Decrease:
$[1,000]
   
Maximum Number of Specified Amount Decreases per Policy Year:
[Decreases not allowed] in Policy Year(s) [1 and 2]; and
[1] in Policy Year [3] and thereafter.

Loan Information
  
   
Minimum Loan Amount:
$[100.00]
   
Minimum Loan Repayment Amount:
$[25.00]
   
Loan Interest Rate Charged:
[3.00]% annual effective rate in all Policy Years.
   
Loan Account Credited Interest Rate:
[1.00]% annual effective rate ([0.00272616]% daily) in all Policy Years.

Partial Surrenders
  
   
Amount of Partial Surrenders:
Must be at least $[500.00]; and/or not more than an amount equal to the Surrender Value of this Policy as of the end of the Valuation Period ending on the Valuation Day on which the request is received in a form acceptable to us, minus $[500.00].
 
Maximum Number of Partial Surrenders per Policy Year:
 
 
Transfers
 
 
Partial surrender not allowed in the first Policy Month; and
[1] per Policy Year beginning with the second Policy Month and thereafter.
Minimum Transfer Amount:
$[50] or the entire value of the Fixed Account or Sub-Account being transferred, whichever is less.
   
Minimum Remaining Value of the Fixed Account or any Sub-Account(s) After a Transfer:
$100.00 unless the entire value of the Fixed Account or Sub-Account(s) is being transferred.
   
Limitation on Transfers from the Fixed Account:
Cannot exceed the greater of [25.00]% of the Fixed Account Value as of the immediately preceding Policy Anniversary.
   
Account(s) available from which to transfer funds for Dollar Cost Averaging:
[money market Sub-Account
Fixed Account (may be elected at policy issue only)]
Policy Specifications

Policy Number [SPECIMEN]

Riders and Benefits Charges

Value Protection Rider

Factors used in the No-Lapse Provisions:

Policy Year
Monthly Accumulation Factor
Monthly No-Lapse Premium
[1 - 35
[1.00327374
$[352.98]
36] and thereafter
1.00486756]
$0.00

The Monthly No-Lapse Premium as of the Policy Date is shown above, and may change as described in the No-Lapse Provisions of the Value Protection Rider.

Protected LTC Ratio: [0.5000000000]


Long-Term Care Benefits Rider

Monthly LTC Charge Rate:
[1.04735]
   
Minimum LTC Duration:
[36] months
   
Initial LTC Benefit Limit:
$[150,000.12]
 
Initial Maximum Monthly LTC Benefit:
$[4,166.67]
 
Right to Purchase Optional Inflation Protection:
[ELECTED]
 
The Monthly LTC Charge Rate and Rider benefit limits as of the Policy Date are shown above, and may change as described in the Long-Term Care Benefits Rider.

 
Initial Market Benefit Floor:
 
$[75,000.00]
 
Market Benefit Multiplier:     [2]
 
Market Benefit Divisor:     [50]



Caregiver Training Benefit Limit:    $[500.00]


To contact your Long-Term Care Claims Specialist, please call [800 487-1485].


Policy Specifications

Policy Number [SPECIMEN]

Table of Surrender Charges

See Surrender Provisions for an explanation of when this table will be used.

Policy Year
  
Surrender Charge as of Beginning of Policy Year
     
[1
  
$[2,057.00
2
  
$1,983.00
3
  
$1,906.00
4
  
$1,826.00
5
  
$1,743.00
6
  
$1,657.00
7
  
$1,568.00
8
  
$1,475.00
9
  
$1,378.00
10
  
$1,277.00
11
  
$1,172.00
12
  
$1,062.00
13
  
  $948.00
14
  
  $829.00
15
  
  $704.00
16
  
  $575.00
17
  
  $440.00
18
  
  $299.00
19
  
  $153.00]
20] and thereafter
  
$0.00


Calculation of Surrender Charge for Decrease in Specified Amount
For decreases in Specified Amount, including a decrease in Specified Amount resulting from a partial surrender but excluding full surrender of this Policy, the charge will be calculated as (1) multiplied by (2), where:

(1)
is the amount of the decrease; and
(2)
is the then applicable surrender charge from the Table of Surrender Charges shown above.


See the “Surrender Charge for Full Surrender” provision for an explanation of the charge upon full surrender of this Policy.



Policy Specifications

Policy Number [SPECIMEN]

Table of Expense Charges and Fees


The following expenses and fees are charged under this Policy:

Guaranteed Maximum Premium Load
We will deduct a Premium Load from each premium payment. The Premium Load is calculated by multiplying each premium payment by the applicable percentage, which will not exceed the amount(s) shown below.  After the Insured’s Attained Age 121, no further premium payments may be made.

[25.00]% for Policy Year(s) 1 and thereafter.

Cost of Insurance
See the “Cost of Insurance” provision. The Net Amount at Risk Discount Factor used in that provision is [1.00082954].

Guaranteed Maximum Monthly Administrative Fee
The Monthly Administrative Fee equals (1) plus (2), where:
(1) is a monthly charge of [0.329] per $1,000 of Initial Specified Amount for [240] Policy Months; and
(2) is a monthly charge per $1,000 for any increase in Specified Amount for [240] Policy Months following the date of increase.
The rate used to calculate the charges described in (1) and (2) above varies by the Insured’s sex and age (Issue Age for the charges in (1) or Attained Age on the date of the increase for the charges in (2)).

Guaranteed Maximum M&E and Asset Charge Rate
[0.105]% monthly in Policy Years [[1-10];
[0.045]% monthly in Policy Years [11]] and thereafter until the Insured’s Attained Age 121.

Transfer Fee
$[25.00] per transfer request for each transfer request in excess of [24] during any Policy Year.

Guaranteed Maximum Partial Surrender Fee: $[150.00]


Policy Specifications

Policy Number [SPECIMEN]

Table of Guaranteed Maximum Cost of Insurance Rates

The monthly Cost of Insurance rates per $1,000 of net amount at risk vary by the Insured’s sex, Issue  Age and the Policy Year, but will not exceed the rates shown in the table below in accordance with the [Ultimate 2017 CSO, Male/Female, Composite Tobacco, Age Last Birthday] mortality table.

Policy
Year
  
Monthly
Rate
  
Policy
Year
  
Monthly
Rate
  
Policy
Year
  
Monthly
Rate
                     
[1
  
0.11758
  
31
  
0.93648
  
61
  
24.21720
2
  
0.12842
  
32
  
1.03082
  
62
  
26.25159
3
  
0.14094
  
33
  
1.13202
  
63
  
28.51121
4
  
0.15263
  
34
  
1.24347
  
64
  
31.02914
5
  
0.16515
  
35
  
1.37197
  
65
  
33.77547
6
  
0.17767
  
36
  
1.52184
  
66
  
36.61924
7
  
0.18936
  
37
  
1.69912
  
67
  
39.44941
8
  
0.19939
  
38
  
1.90568
  
68
  
42.34621
9
  
0.20356
  
39
  
2.14001
  
69
  
45.25809
10
  
0.20941
  
40
  
2.40147
  
70
  
48.12900
11
  
0.21442
  
41
  
2.68599
  
71
  
50.89244
12
  
0.22027
  
42
  
2.99295
  
72
  
53.99864
13
  
0.22611
  
43
  
3.32601
  
73
  
58.09567
14
  
0.23113
  
44
  
3.69588
  
74
  
62.62918
15
  
0.23948
  
45
  
4.11521
  
75
  
67.67469
16
  
0.25118
  
46
  
4.59696
  
76
  
73.32811
17
  
0.26622
  
47
  
5.14125
  
77
  
79.71406
18
  
0.28294
  
48
  
5.78293
  
78
  
80.11620
19
  
0.30300
  
49
  
6.55095
  
79
  
80.51834
20
  
0.32558
  
50
  
7.44129
  
80
  
80.92048
21
  
0.35235
  
51
  
8.47400
  
81
  
81.32262
22
  
0.38247
  
52
  
9.66230
  
82
  
81.72477
23
  
0.41762
  
53
  
11.01321
  
83
  
82.12691
24
  
0.45782
  
54
  
12.50715
  
84
  
82.52905
25
  
0.50473
  
55
  
14.11597
  
85
  
82.93119
26
  
0.55754
  
56
  
15.80879
  
86
  
83.33333
27
  
0.61877
  
57
  
17.53629
  
87 and
  
0.00000]
28
  
0.68759
  
58
  
19.27103
  
later
    
29
  
0.76488
  
59
  
20.96545
        
30
  
0.84811
  
60
  
22.53736
        

Policy Specifications

Policy Number [SPECIMEN]

Corridor Percentages Table

Death Benefit Qualification Test: Cash Value Accumulation Test

See the “Death Benefit Proceeds” provision and “Income Tax on Death Benefits” provision for an explanation of how this table will be used.

Insured’s Attained
Age
Corridor
Percentage
  
Insured’s Attained
Age
Corridor
Percentage
           
 
[35
527%
  
70
176%
 
36
509%
  
71
171%
 
37
493%
  
72
167%
 
38
477%
  
73
163%
 
39
462%
  
74
159%
           
 
40
447%
  
75
155%
 
41
433%
  
76
152%
 
42
419%
  
77
148%
 
43
406%
  
78
145%
 
44
393%
  
79
142%
           
 
45
381%
  
80
139%
 
46
369%
  
81
136%
 
47
357%
  
82
134%
 
48
345%
  
83
131%
 
49
334%
  
84
129%
           
 
50
323%
  
85
127%
 
51
313%
  
86
125%
 
52
303%
  
87
123%
 
53
293%
  
88
121%
 
54
284%
  
89
120%
           
 
55
275%
  
90
118%
 
56
266%
  
91
117%
 
57
258%
  
92
116%
 
58
250%
  
93
115%
 
59
242%
  
94
114%
           
 
60
235%
  
95
112%
 
61
227%
  
96
111%
 
62
221%
  
97
109%
 
63
214%
  
98
107%
 
64
208%
  
99
104%
           
 
65
202%
  
100
100%]
 
66
196%
  
and later
  
 
67
191%
      
 
68
186%
      
 
69
181%
      

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