EX-99.DIIB 4 exhibitdiilpbriderspec.htm EXHIBIT 99.DIIB Exhibit
POLICY NUMBER: [AA0000011]

RIDER SPECIFICATIONS -----------------------------------------------------------------------------------------------------
LAPSE PROTECTION BENEFIT RIDER

SCHEDULE OF RIDER CHARGES
ANNUAL RATES PER $1,000 OF SPECIFIED AMOUNT

SCHEDULE FOR PRIMARY INSURED: [JOHN DOE]
    
AT BEGINNING
OF POLICY YEAR
ON
[FEB 1]
RATE PER UNIT OF
SPECIFIED AMOUNT

[1
[2014
[02.34000
2
2015
2.34000
3
2016
2.34000
4
2017
1.62000
5
2018
1.62000
6
2019
1.62000
7
2020
1.62000
8
2021
1.62000
9
2022
1.62000
10
2023
1.62000
11
2024
3.51000
12
2025
3.51000
13
2026
3.51000
14
2027
3.51000
15
2028
3.51000
16
2029
3.51000
17
2030
3.51000
18
2031
3.51000
19
2032
3.51000
20
2033
5.63000
21
2034
5.63000
22
2035
5.63000
23
2036
5.63000
24
2037
5.63000
25
2038
5.63000
26
2039
5.63000
27
2040
5.63000
28
2041
5.63000
29
2042
5.63000
30
2043
5.63000
31
2044
5.63000
32
2045
5.63000
33
2046
5.63000
34
2047
5.63000
35
2048
5.63000
36
2049
5.63000
37
2050
5.63000
38
2051
5.63000
39
2052
5.63000
40]
2053]
05.63000]


ICC16_LD2    [1]
POLICY NUMBER: [AA0000011]

RIDER SPECIFICATIONS -----------------------------------------------------------------------------------------------------

LAPSE PROTECTION BENEFIT RIDER

LAPSE PROTECTION FUNDING LEVEL CHARGE THRESHOLD
AND FUNDING LEVEL REQUIRED PREMIUM

SCHEDULE FOR PRIMARY INSURED: [JOHN DOE]

AT BEGINNING
OF POLICY YEAR



ON
[FEB 1]
LAPSE PROTECTION
FUNDING LEVEL CHARGE THRESHOLD
(per $1000 of Specified Amount)
FUNDING LEVEL REQUIRED PREMIUM
 (in dollars)
 
[1
[2014
[0000.6825381915
[007.3472325209
2
2015
9.2116336045
7.3472325209
3
2016
18.3116801768
7.3472325209
4
2017
28.0395449672
7.3472325209
5
2018
38.3833517195
7.3472325209
6
2019
49.4084693596
7.3472325209
7
2020
61.1509414572
7.3472325209
8
2021
73.6188755555
7.3472325209
9
2022
86.8237932637
7.3472325209
10
2023
100.7937694770
7.3472325209
11
2024
115.5450926849
7.3472325209
12
2025
131.1024805592
7.3472325209
13
2026
147.5506909818
7.3472325209
14
2027
164.9524503299
7.3472325209
15
2028
183.5379001197
7.3472325209
16
2029
203.3707418071
7.3472325209
17
2030
224.4540394662
7.3472325209
18
2031
246.8360224114
7.3472325209
19
2032
270.5426200472
7.3472325209
20
2033
295.6121776988
7.3472325209
21
2034
322.1147018244
7.3472325209
22
2035
350.0807792281
7.3472325209
23
2036
379.5785817917
7.3472325209
24
2037
410.7002785326
7.3472325209
25
2038
443.6592860991
7.3472325209
26
2039
478.5576646176
7.3472325209
27
2040
515.3120709888
7.3472325209
28
2041
554.0840748400
7.3472325209
29
2042
594.8895641928
7.3472325209
30
2043
637.8585531245
7.3472325209
31
2044
683.2382691834
7.3472325209
32
2045
731.3149935665
7.3472325209
33
2046
782.4789086264
7.3472325209
34
2047
837.1686284039
7.3472325209
35
2048
895.8135001320
7.3472325209
36
2049
958.9517998724
7.3472325209
37
2050
1026.8160489793
7.3472325209
38
2051
1098.4973580014
7.3472325209
39
2052
1173.5751684035
7.3472325209
40]
2053]
1252.1945849505]
007.3472325209]

ICC16_LD2    [2]
POLICY NUMBER: [AA0000011]


RIDER SPECIFICATIONS -----------------------------------------------------------------------------------------------------
LAPSE PROTECTION BENEFIT RIDER

LAPSE PROTECTION INTEREST RATES
(ANNUAL RATES)

SCHEDULE FOR PRIMARY INSURED: [JOHN DOE]


AT
BEGINNING
OF POLICY
YEAR



ON
[FEB 1]
LAPSE
PROTECTION
INTEREST
RATE
(Tier 1)
LAPSE
PROTECTION
INTEREST
RATE
(Tier 2)
LAPSE
PROTECTION
THRESHOLD
(per $1000 of
Specified Amount)
[1
[2014
[07.8000000000
[01.0000000000
[0009.9765272309
 
2
2015
7.8000000000
1.0000000000
18.4950524455
 
3
2016
7.8000000000
1.0000000000
27.5839795439
 
4
2017
7.8000000000
1.0000000000
37.5007157001
 
5
2018
7.8000000000
1.0000000000
48.4681117740
 
6
2019
7.8000000000
1.0000000000
60.1522372220
 
7
2020
7.8000000000
1.0000000000
72.5610395573
 
8
2021
7.8000000000
1.0000000000
85.7044980255
 
9
2022
7.8000000000
1.0000000000
99.6117488257
 
10
2023
7.8000000000
1.0000000000
114.2988341903
 
11
2024
7.8000000000
1.0000000000
129.7849082839
 
12
2025
7.8000000000
1.0000000000
146.1580716438
 
13
2026
7.8000000000
1.0000000000
163.4650961631
 
14
2027
7.8000000000
1.0000000000
181.9502548418
 
15
2028
7.8000000000
1.0000000000
201.6829580602
 
16
2029
7.8000000000
1.0000000000
222.6621302602
 
17
2030
7.8000000000
1.0000000000
244.9380496168
 
18
2031
7.8000000000
1.0000000000
268.5358439833
 
19
2032
7.8000000000
1.0000000000
293.4907564241
 
20
2033
7.8000000000
1.0000000000
319.8765721681
 
21
2034
7.8000000000
1.0000000000
347.7206882362
 
22
2035
7.8000000000
1.0000000000
377.0901891496
 
23
2036
7.8000000000
1.0000000000
408.0659288447
 
24
2037
7.8000000000
1.0000000000
440.8694322658
 
25
2038
7.8000000000
1.0000000000
475.6215702105
 
26
2039
7.8000000000
1.0000000000
512.2156928530
 
27
2040
7.8000000000
1.0000000000
550.8273930550
 
28
2041
7.8000000000
1.0000000000
591.4634514658
 
29
2042
7.8000000000
1.0000000000
634.2438388377
 
30
2043
7.8000000000
1.0000000000
679.4132363078
 
31
2044
7.8000000000
1.0000000000
727.2492442355
 
32
2045
7.8000000000
1.0000000000
778.1377570555
 
33
2046
7.8000000000
1.0000000000
832.5194327460
 
34
2047
7.8000000000
1.0000000000
890.8132067598
 
35
2048
7.8000000000
1.0000000000
953.5927748490
 
36
2049
7.8000000000
1.0000000000
1021.1800595145
 
37
2050
7.8000000000
1.0000000000
1092.5816829789
 
38
2051
7.8000000000
1.0000000000
1167.3676374097
 
39
2052
7.8000000000
1.0000000000
1245.6820782794
 
40]
2053]
07.8000000000]
01.0000000000]
1327.6804051875]
 

ICC16_LD2    [3]
POLICY NUMBER: [AA0000011]

RIDER SPECIFICATIONS -----------------------------------------------------------------------------------------------------

LAPSE PROTECTION BENEFIT RIDER

SCHEDULE OF LAPSE PROTECTION BENEFIT FACTORS

SCHEDULE FOR PRIMARY INSURED: [JOHN DOE]
    
LAPSE PROTECTION PREMIUM FACTOR: [100.00] %

ICC16_LD2    [4]
POLICY NUMBER: [AA0000011]

RIDER SPECIFICATIONS -----------------------------------------------------------------------------------------------------

LAPSE PROTECTION BENEFIT RIDER

SCHEDULE OF LAPSE PROTECTION BENEFIT CHARGES
LAPSE PROTECTION SPECIFIED AMOUNT CHARGE and LAPSE PROTECTION ADMINISTRATIVE CHARGE (ANNUAL RATES)

SCHEDULE FOR PRIMARY INSURED: [JOHN DOE]

AT
BEGINNING
OF POLICY
YEAR
 
ON
[JUN 12]
LAPSE PROTECTION SPECIFIED AMOUNT CHARGE
(per $1000 of
Specified Amount)
LAPSE PROTECTION ADMINISTRATIVE CHARGE
(in dollars)
[1
[2014
[0000.7838757881
$[40.00
2
2015
0.8270249141
$40.00
3
2016
0.8629825190
$40.00
4
2017
0.9277062080
$40.00
5
2018
0.9852383759
$40.00
6
2019
1.0499620648
$40.00
7
2020
1.1362603167
$40.00
8
2021
1.2441331316
$40.00
9
2022
1.3663889885
$40.00
10
2023
1.5102194083
$40.00
11
2024
1.6756243911
$40.00
12
2025
1.8338378529
$40.00
13
2026
2.0064343567
$40.00
14
2027
2.1071156506
$40.00
15
2028
2.2221799865
$40.00
16
2029
2.3875849693
$40.00
17
2030
2.5817560361
$40.00
18
2031
2.8204057537
$40.00
19
2032
3.1024463291
$40.00
20
2033
3.4134141430
$40.00
21
2034
3.7822364338
$40.00
22
2035
4.1944495825
$40.00
23
2036
4.6500535888
$40.00
24
2037
5.0517419662
$40.00
25
2038
5.5147048418
$40.00
26
2039
6.0729836036
$40.00
27
2040
6.7538113618
$40.00
28
2041
7.5844212269
$40.00
29
2042
8.5171552557
$40.00
30
2043
9.4975472275
$40.00
31
2044
10.5324054201
$40.00
32
2045
11.5808801678
$40.00
33
2046
12.6429714706
$40.00
34
2047
13.7867621045
$40.00
35
2048
14.9714024039
$40.00
36
2049
16.4079489738
$40.00
37
2050
18.0147024832
$40.00
38
2051
20.1252685338
$40.00
39
2052
22.3515753033
$40.00
40]
2053]
0024.6936227916]
$40.00]


ICC16_LD2    [5]
POLICY NUMBER: [AA0000011]

RIDER SPECIFICATIONS -----------------------------------------------------------------------------------------------------

LAPSE PROTECTION BENEFIT RIDER

SCHEDULE OF LAPSE PROTECTION BENEFIT CHARGES
LAPSE PROTECTION COST OF INSURANCE CHARGES
(ANNUAL RATES PER $1,000 OF LAPSE PROTECTION NET AMOUNT AT RISK)

SCHEDULE FOR PRIMARY INSURED: [JOHN DOE]

AT
BEGINNING
OF POLICY
YEAR


ON
[FEB 1]
LAPSE
PROTECTION
COST OF INSURANCE (Tier 1)
LAPSE
PROTECTION
COST OF INSURANCE (Tier 2)
LAPSE
PROTECTION
NET AMOUNT AT RISK THRESHOLD
[01
[2014
[0001.0900000000
[0001.2964329519
[0996.8177748552
2
2015
1.1500000000
1.5655039419
989.7365748879
3
2016
1.2000000000
1.8834969301
982.2013763188
4
2017
1.2900000000
2.2014899183
974.1575669992
5
2018
1.3700000000
2.4705609083
965.6344243110
6
2019
1.4600000000
2.7885538965
956.5747766399
7
2020
1.5800000000
3.0820858856
946.9519001343
8
2021
1.7300000000
3.3756178748
936.7711403001
9
2022
1.9000000000
3.7180718620
926.0371327999
10
2023
2.1000000000
4.1339088466
914.7365434268
11
2024
2.3300000000
4.6720508267
902.8709657760
12
2025
2.5500000000
5.3080368031
890.4406834031
13
2026
2.7900000000
6.0174057767
877.3775481776
14
2027
2.9300000000
6.7267747504
863.6576505735
15
2028
3.0900000000
7.3872217259
849.0564817694
16
2029
3.3200000000
8.0232077023
833.5308360773
17
2030
3.5900000000
8.7325766760
817.1132125327
18
2031
3.9218487395
9.5397896460
799.7867756219
19
2032
4.3140336134
10.4937686106
781.5648893412
20
2033
4.7464425770
11.5455915716
762.4552951628
21
2034
5.2592997199
12.7931025253
742.4308400910
22
2035
5.8324929972
14.1873794736
721.5194259450
23
2036
6.4660224090
15.7284224164
699.7146463191
24
2037
7.1196638655
17.3183873574
677.0039217659
25
2038
7.8034733894
18.9817352957
653.2378796352
26
2039
8.9200000000
21.8192111904
628.3779696774
27
2040
9.9200000000
24.2653110997
602.6730392584
28
2041
11.1400000000
27.2495529890
576.0452217619
29
2042
12.5100000000
30.6007098646
548.6436530395
30
2043
13.9500000000
34.1230937339
520.5199335960
31
2044
15.4700000000
37.8411655960
491.6144597451
32
2045
17.0100000000
41.6081594562
461.8644776373
33
2046
18.5700000000
45.4240753146
431.1187863189
34
2047
20.2500000000
49.5335231622
399.2050114753
35
2048
21.9900000000
53.7897370042
366.0383375405
36
2049
24.1000000000
58.9510078127
331.4414608662
37
2050
26.4600000000
64.7238035986
295.5302899752
38
2051
29.5600000000
72.3067133172
258.2612708058
39
2052
32.8300000000
80.3054600204
220.0243708184
40]
2053]
0036.2700000000]
0088.7200437082]
0180.6212264726]
The Lapse Protection Net Amount at Risk is equal to the Policy’s current Death Benefit, discounted to the beginning of the month at the monthly equivalent of the Guaranteed Minimum Interest Rate, minus the Lapse Protection Value.

ICC16_LD2    [6]
POLICY NUMBER: [AA0000011]

RIDER SPECIFICATIONS -----------------------------------------------------------------------------------------------------

LAPSE PROTECTION BENEFIT RIDER

SCHEDULE OF LAPSE PROTECTION NOTIONAL SURRENDER CHARGES

SCHEDULE FOR PRIMARY INSURED: [JOHN DOE]
    
AT
BEGINNING
OF POLICY
YEAR

ON
[FEB 1]
NOTIONAL SURRENDER CHARGES
RATE PER UNIT OF
SPECIFIED AMOUNT

[1
[2014
[02.34000
2
2015
2.34000
3
2016
2.34000
4
2017
1.62000
5
2018
1.62000
6
2019
1.62000
7
2020
1.62000
8
2021
1.62000
9
2022
1.62000
10]
2023]
01.62000]


ICC16_LD2    [7]
POLICY NUMBER: [AA0000011]

RIDER SPECIFICATIONS -----------------------------------------------------------------------------------------------------

LAPSE PROTECTION BENEFIT RIDER

SCHEDULE OF LAPSE PROTECTION BENEFIT CHARGES
LAPSE PROTECTION SPECIFIED AMOUNT CHARGE and
LAPSE PROTECTION ADMINISTRATIVE CHARGE (ANNUAL RATES)

SCHEDULE FOR PRIMARY INSURED: [JOHN DOE]

AT
BEGINNING
OF POLICY
YEAR
 
ON
[JUN 12]
LAPSE PROTECTION ASSET-BASED RISK CHARGE
(per $1000 of
Specified Amount)
[1
[2014
[0000.7838757881
2
2015
0.8270249141
3
2016
0.8629825190
4
2017
0.9277062080
5
2018
0.9852383759
6
2019
1.0499620648
7
2020
1.1362603167
8
2021
1.2441331316
9
2022
1.3663889885
10
2023
1.5102194083
11
2024
1.6756243911
12
2025
1.8338378529
13
2026
2.0064343567
14
2027
2.1071156506
15
2028
2.2221799865
16
2029
2.3875849693
17
2030
2.5817560361
18
2031
2.8204057537
19
2032
3.1024463291
20
2033
3.4134141430
21
2034
3.7822364338
22
2035
4.1944495825
23
2036
4.6500535888
24
2037
5.0517419662
25
2038
5.5147048418
26
2039
6.0729836036
27
2040
6.7538113618
28
2041
7.5844212269
29
2042
8.5171552557
30
2043
9.4975472275
31
2044
10.5324054201
32
2045
11.5808801678
33
2046
12.6429714706
34
2047
13.7867621045
35
2048
14.9714024039
36
2049
16.4079489738
37
2050
18.0147024832
38
2051
20.1252685338
39
2052
22.3515753033
40]
2053]
0024.6936227916]


ICC16_LD2    [8]