The State Life Insurance Company P. O. Box 6062 Indianapolis, IN

Transcription

1 P. O. Box 6062 Indianapolis, IN Annuity Illustration Annuity Care II Prepared for: Male Client Presented by: Stan The Annuity Man 02/16/ This is not an offer to contract. Page 1 of 8 Version /01/15

2 Description of Policy: Annuity Care II is a single premium fixed interest deferred annuity that combines longterm asset growth and long-term care (LTC) benefits. This LTC benefit is built-in to the annuity, providing you with a combination of annuity value and additional long-term care benefits should you need them. Other Things You Should Know About This Policy: Contract Premium: The single amount you pay for this policy. This may be reduced by any applicable state premium taxes and/or premiums for optional benefits/riders. Guaranteed Interest Rate: The guaranteed interest rate for the Accumulated Value (AV) is equal to the projected (non-guaranteed) interest rate for the first policy year. The guaranteed interest rate on the AV is 1.00%. The guaranteed interest rate for the LTC Accumulated Value (LTCAV) is equal to the projected (non-guaranteed) interest rate for the first five policy years. The guaranteed interest rate on the LTCAV is 1.00%. Projected (Non-Guaranteed) Interest Rate: The projected (non-guaranteed) interest rate on the LTCAV is 2.00%. This rate is guaranteed for 5 policy years. The projected (non-guaranteed) interest rate on the AV is 1.45%. This rate is guaranteed for 1 policy year. There is a monthly charge deducted from the AV to pay for the Continuation of Benefits (COB) provision. The LTCAV is reduced on a proportional basis for the monthly charges to the AV. Cash Surrender Value: The AV, minus any surrender charges, is available to the policyowner upon surrender of the policy. Surrender charges are waived on partial surrenders up to 10% of your AV (as of the beginning of the policy year) after the first policy year. Full surrenders within 12 months of a partial surrender will result in a recapture of the waived surrender charges. Any partial surrender from the AV proportionally reduces the LTCAV. Surrender charges will be waived on qualifying LTC withdrawals from the LTCAV. Upon full surrender, these charges will be deducted in the first nine years as follows: Policy Year Charge Policy Year Charge Policy Year Charge 1 9% 4 6% 7 3% 2 8% 5 5% 8 2% 3 7% 6 4% 9 1% 10 and after 0% 02/16/ This is not an offer to contract. Page 2 of 8 Version /01/15

3 Continuation of Benefits Provision: The COB provision will continue coverage of qualifying long-term care expenses under the contract. Based on the issue age(s) and COB option selected for this illustration, the monthly cost as a percentage of the LTCAV is 0.112%. The percentage is guaranteed to never change. At issue, the COB monthly limit will equal the LTCAV divided by 24 months. LTC Accumulated Value: The amount available for payment of expenses for qualifying long-term care services incurred under the contract. COB Balance: The amount available under the Continuation of Benefits provision, which is available only when long-term care payments have reduced the LTCAV to zero (0). Total LTC Balance: The sum of the LTCAV and COB Balance. LTC Monthly Benefit: The amount payment will be based upon is the amount of actual expenses incurred for qualifying long-term care expenses up to the LTC Monthly Benefit. LTC Withdrawals: The LTCAV can be used by the policyowner to pay for qualified LTC expenses incurred by the annuitants(s) or eligible person after a 90-day elimination period is met. An outline of coverage will be provided to you with LTCAV eligibility requirements, exclusions and limitations. The LTCAV will no longer be available if you elect either a full surrender or annuitization of your contract. The withdrawal period for the LTCAV is 24 months. When LTC withdrawals are being paid from the LTCAV, the AV is reduced on a proportional basis. Tax Information: The values illustrated do not reflect withdrawals. All AV withdrawals are subject to federal income tax, to the extent of the gain in the contract. Withdrawals prior to the policyowner reaching age 59 1/2 will generally be subject to an additional 10 percent federal income tax penalty. LTCAV withdrawals should be considered federally tax-qualified and income tax-free as a reduction in basis. This illustration should not be relied on for tax advice. Any tax issues regarding this illustration or the contract should be reviewed with the policyowner's tax advisors. Please refer to the Annuity Disclosure and the Annuity Buyer's Guide, available from your insurance producer. 02/16/ This is not an offer to contract. Page 3 of 8 Version /01/15

4 Guaranteed Interest Rates End of Cash LTC LTC policy Accumulated Surrender Accumulated COB Total LTC Monthly Year Age Value Value Value Balance Balance* Benefit 1 66 $300,275 $273,250 $301,903 $905,708 $1,207,610 $12, $299,186 $275,251 $303,786 $911,359 $1,215,146 $12, $298,062 $277,197 $305,641 $916,923 $1,222,564 $12, $296,901 $279,087 $307,465 $922,395 $1,229,861 $12, $295,704 $280,919 $309,258 $927,773 $1,237,031 $12, $294,490 $282,710 $307,988 $923,964 $1,231,952 $12, $293,281 $284,483 $306,724 $920,171 $1,226,895 $12, $292,077 $286,235 $305,464 $916,393 $1,221,858 $12, $290,878 $287,969 $304,210 $912,631 $1,216,841 $12, $289,684 $289,684 $302,961 $908,884 $1,211,846 $12, $288,494 $288,494 $301,718 $905,153 $1,206,870 $12, $287,310 $287,310 $300,479 $901,437 $1,201,916 $12, $286,130 $286,130 $299,245 $897,736 $1,196,981 $12, $284,956 $284,956 $298,017 $894,050 $1,192,067 $12, $283,786 $283,786 $296,793 $890,380 $1,187,173 $12, $282,621 $282,621 $295,575 $886,724 $1,182,299 $12, $281,460 $281,460 $294,361 $883,084 $1,177,445 $12, $280,305 $280,305 $293,153 $879,458 $1,172,611 $12, $279,154 $279,154 $291,949 $875,848 $1,167,797 $12, $278,008 $278,008 $290,751 $872,252 $1,163,003 $12, $272,348 $272,348 $284,831 $854,493 $1,139,324 $11, $266,803 $266,803 $279,032 $837,096 $1,116,128 $11, $261,371 $261,371 $273,351 $820,053 $1,093,404 $11, $256,050 $256,050 $267,786 $803,357 $1,071,143 $11, $250,837 $250,837 $262,334 $787,001 $1,049,335 $10, $245,730 $245,730 $256,993 $770,978 $1,027,971 $10,708 *Includes LTC Accumulated Value and Continuation of Benefits Balance. Values do not reflect partial surrenders. 02/16/ This is not an offer to contract. Page 4 of 8 Version /01/15

5 Projected (Non-Guaranteed) Interest Rates End of Cash LTC LTC policy Accumulated Surrender Accumulated COB Total LTC Monthly Year Age Value Value Value Balance Balance* Benefit 1 66 $300,275 $273,250 $301,903 $905,708 $1,207,610 $12, $300,527 $276,485 $303,795 $911,385 $1,215,180 $12, $300,758 $279,705 $305,677 $917,030 $1,222,707 $12, $300,967 $282,909 $307,547 $922,642 $1,230,189 $12, $301,154 $286,096 $309,406 $928,219 $1,237,626 $12, $301,318 $289,266 $311,254 $933,761 $1,245,014 $12, $301,460 $292,416 $313,088 $939,264 $1,252,353 $13, $301,579 $295,547 $314,910 $944,729 $1,259,639 $13, $301,675 $298,658 $316,718 $950,154 $1,266,872 $13, $301,748 $301,748 $318,512 $955,536 $1,274,049 $13, $301,798 $301,798 $320,292 $960,876 $1,281,168 $13, $301,825 $301,825 $322,057 $966,171 $1,288,227 $13, $301,828 $301,828 $323,806 $971,419 $1,295,225 $13, $301,808 $301,808 $325,540 $976,620 $1,302,160 $13, $301,764 $301,764 $327,257 $981,771 $1,309,028 $13, $301,696 $301,696 $328,957 $986,872 $1,315,829 $13, $301,604 $301,604 $330,640 $991,921 $1,322,561 $13, $301,489 $301,489 $332,305 $996,916 $1,329,221 $13, $301,349 $301,349 $333,952 $1,001,856 $1,335,808 $13, $301,185 $301,185 $335,580 $1,006,739 $1,342,318 $13, $299,998 $299,998 $343,417 $1,030,252 $1,373,669 $14, $298,195 $298,195 $350,707 $1,052,121 $1,402,828 $14, $295,770 $295,770 $357,386 $1,072,158 $1,429,545 $14, $292,720 $292,720 $363,393 $1,090,179 $1,453,572 $15,141 Non-Guaranteed assumptions: Accumulated Value 1.45%; LTC Accumulated Value 2.00% all years. This is an illustration, not a contract. These interest rates are not guaranteed and are subject to change. As a result, the actual values may be more or less favorable than those illustrated. *Includes LTC Accumulated Value and Continuation of Benefits Balance. Values do not reflect partial surrenders. 02/16/ This is not an offer to contract. Page 5 of 8 Version /01/15

6 Projected (Non-Guaranteed) Interest Rates End of Cash LTC LTC policy Accumulated Surrender Accumulated COB Total LTC Monthly Year Age Value Value Value Balance Balance* Benefit $289,048 $289,048 $368,667 $1,106,002 $1,474,670 $15, $284,760 $284,760 $373,152 $1,119,455 $1,492,607 $15,548 Non-Guaranteed assumptions: Accumulated Value 1.45%; LTC Accumulated Value 2.00% all years. This is an illustration, not a contract. These interest rates are not guaranteed and are subject to change. As a result, the actual values may be more or less favorable than those illustrated. *Includes LTC Accumulated Value and Continuation of Benefits Balance. Values do not reflect partial surrenders. 02/16/ This is not an offer to contract. Page 6 of 8 Version /01/15

7 This annuity payment estimation is based on single life annuitization occurring at age 75 (10th contract year): Annuitization Option Guaranteed Monthly Payment Non-Guaranteed Monthly Payment Life Annuity with 120 Guaranteed Payments $1,776 $1,850 Income Rate per $1,000 $6.13 $6.13 The amount of monthly payment will be based on the cash surrender value. The LTCAV is no longer available if either a full contract surrender or annuitization is elected. 02/16/ This is not an offer to contract. Page 7 of 8 Version /01/15

8 Overview of Benefits Page Male Client Age: 65 Prepared for: Gender: Male $300,000 Single Base Contract Premium Presented By: Stan The Annuity Man End of Year One Values: LTC Accumulated Value $301,903 Continuation of Benefits Balance $905,708 Total LTC Balance $1,207,610 LTC Monthly Benefit $12,579 LTC Accumulated Value Withdrawal Period 24 Continuation of Benefits Minimum Months 72 Total Months LTC Benefits (Minimum) 96 LTC Claim Method Available for: Assisted Living, Home Health Services, LTC Facility, Adult Day Care, Hospice Services (Home or Facility) Annual Bed Reservation Benefit Annual Respite Care Benefit *Per Calendar Year Elimination Period Reimbursement 31 days* 21 days* 90 days This is a supplemental illustration. The values are based on the proposed premium shown. See attached basic illustration for important information. 02/16/ This is not an offer to contract. Page 8 of 8 Version /01/15