Silver Guard Series Rate Book

Powered by INSpeed One call does it all! Silver Guard Series Rate Book Career Agency Sales Group Table of Contents Plan Information...Page 1-2 Silver Guard I Life Pay Rates...Page 3-4 Silver Guard I Ten Pay Rates...Page 5-6 Silver Guard II Rates... Page 7 Silver Guard III Rates... Page 8 Sample Disclosure Statement (Form 1589)... Page 9 Plan Information The Products The Silver Guard Series: Simplified issue, whole life insurance policies designed for final expense needs. Nonparticipating whole life policies that offer your client guaranteed premiums and death benefits. Refer to Form 7641, Silver Guard Approval and Forms List, for specific product availability in your state. Silver Guard I (Forms 7870) A full death benefit product that offers your client the flexibility to choose a life-pay premium schedule or an abbreviated 10- pay policy. To meet the underwriting requirements, the applicant must be able to answer no to all questions in Part I and Part II of the application for insurance (Form 7430-0508 or its state specific version). Silver Guard II (Forms 7959) A graded death benefit product with limited benefits for the first two policy years. To meet the underwriting requirements, the applicant must be able to answer no to all questions in Part I and no more than one yes response to questions in Part II of the application for insurance (Form 7430-0508 or its state specific version). Silver Guard III (Form 7960) A return-of-premium product with limited benefits during the first three policy years. To meet the underwriting requirements, the applicant must be able to answer no to all questions in Part 1 and no more than two yes responses to questions in Part II of the application for insurance, Form 7430-0508 or its state specific version. Issue Ages (Age last birthday) Silver Guard I: 50-80 Silver Guard II & III: 50-75 Face Amount Minimum $2,500 minimum (Minimum premium for EFT of $20 monthly or $240 annually) Maximum Silver Guard I: Silver Guard II: Silver Guard III: Ages 50-75 - $25,000 maximum; Ages 76-80 - $15,000 maximum $15,000 maximum $10,000 maximum Policy Fee $30, commissionable Premium Modes Paper Application: Monthly Electronic Funds Transfer (EFT, Bank Draft), Annual, Semi-Annual (SA), or Quarterly (Q). Note that a Policyholder cannot elect monthly direct bill. EFT Modes for Applications enrolled via INSpeed: Monthly, semi-annual, and annual. Initial and future premium will be paid via EFT. For a monthly EFT when using a paper application, complete the Monthly Automatic Check Authorization on the application, collect the first monthly premium and a voided blank check. Indicate the payor s preferred draft date in the comments section of the application. Drafts can be the 1 st through the 28 th of the month, which then becomes the policy issue date. If the applicant does not select a date, the default draft date will be the issue date of the policy. The Baltimore Life Insurance Company 10075 Red Run Boulevard Owings Mills, MD 21117-4871 800.628.5433 www.baltlife.com Form 7808-0510 For agent use only. Not for use in sales presentations. Page 1 of 9

For monthly, semi-annual, and annual EFT modes when using INSpeed, the draft is processed the next business day if no draft day is selected. If the client selects the semi-annual or annual EFT mode, the client will receive a reminder notice for all future premium dates. If your client cannot pay the initial premium and future premiums via EFT, a paper application must be used. When using a paper application, we offer monthly bank draft and direct bill modes including quarterly, semi-annual, and annual. Death Benefits Silver Guard I has a level death benefit for all policy years, $1,000 per unit. Silver Guard II is a graded death benefit product: 25% of the policy face amount in year one of coverage 50% of the policy face amount in year two of coverage 100% of the policy face amount in year three of coverage and thereafter The policy pays 100% of its face value in all policy years if death is due to an accident Silver Guard III is a return-of-premium product: Return of all premium paid, plus simple interest at 6% on those premiums, in the first three years of coverage 100% of the policy face amount in year four of coverage and thereafter The policy pays 100% of its face value in all policy years if death is due to an accident Free Look Period The length of the free look period varies per state. Please see state specific policy for details. Additional Benefits/Riders Accidental Death Benefit (Form 7922) For an additional premium, the Accidental Death Benefit rider is available for Silver Guard I Life Pay and issue ages 50 65. With this rider, Baltimore Life will pay an additional amount equal to the base benefit amount selected for death due to an accident before age 70. Exclusions apply. See rider for specific terms. Cash Draft Benefit Up to $1,000 of the policy s death benefit can be made available soon after the insured s death while the claim is pending. When an attending physician certifies the cash draft form, it can be taken to a local bank. The $1,000 draft is deducted from the ultimate claim check. This benefit is available from Baltimore Life free of charge and does not affect the premium. A cash draft form is automatically included when the policy is issued. The policy must be in force for two years or longer to use the cash draft feature. Automatic Premium Loan (APL) Option This nonforfeiture provision allows Baltimore Life to automatically pay an overdue premium for a policyowner by making a loan against the policy s cash value as long as the cash value equals or exceeds the amount of the premium due. Note: This provision must be checked yes on the application, or it will not apply. Issue Ages/Effective Dates/Special Considerations The applicant s age at his or her last birthday is the basis for the premium. Age is determined based on the date of application. The date of underwriting approval shall be the date the policy goes into effect based on the draft date, unless otherwise requested. To save age, you may request an effective date up to 30 days prior to the date of application. You may not back date to be eligible for the policy. Use a paper application only for this request. Policies may be dated up to 60 days in the future. Make this request on the Comments portion of the application. Use a paper application only for this request. Silver Guard I policies are underwritten using non-tobacco/tobacco guidelines. To qualify for non-tobacco rates, there must be no tobacco use for one year. Underwriting Simplified, Jet-Issue, INSpeed When submitting a paper application, a telephone interview is held with each applicant to verify information on the application by calling toll-free 877.909.7260 at point of sale. The hours are 10:00 AM-10:00 PM EST Monday-Friday. For applications enrolled using INSpeed, call the INSpeed Call Center toll-free at 888.252.3277 (888.BLC.EAPP). The hours are 10:00 AM - 10:00 PM EST Monday - Friday. An additional telephone interview is not required. All applicants, owners, and premium payer via bank draft must sign their paper applications. For INSpeed applications, they must be present during enrollment to provide their electronic signature using voice recognition. In almost all cases, medical underwriting (including physicals, or physician s statements) will not be used with these policies. Form 7808-0510 For agent use only. Not for use in sales presentations. Page 2 of 9

Silver Guard I: Level Death Benefit Life Pay Annual Premiums Per $1000 (Add $30 Policy Fee) Male Issue Basic Rates Accidental Cash Values Age Non-Tobacco Tobacco Death Benefit Year 5 Year 10 Year 20 Age 65 50 31 42 1.23 52 146 355 248 51 32 44 1.25 54 152 367 235 52 33 46 1.28 56 158 379 221 53 34 48 1.3 58 163 392 207 54 36 50 1.33 61 169 404 192 55 38 52 1.35 63 175 416 175 56 40 54 1.38 66 181 429 158 57 42 57 1.41 69 188 442 140 58 44 60 1.44 72 194 455 120 59 46 63 1.47 74 201 468 99 60 48 66 1.5 76 208 481 76 61 50 69 1.53 78 216 493 52 62 52 72 1.56 80 223 505 26 63 55 76 1.59 83 231 516 0 64 58 80 1.62 86 240 528 0 65 61 84 1.65 92 250 541 0 66 64 88 99 261 553 0 67 67 93 105 273 564 0 68 71 99 112 284 574 0 69 76 107 119 295 583 0 70 81 115 125 305 591 0 71 86 123 132 315 599 0 72 91 131 138 324 607 0 73 97 140 145 334 616 0 74 103 150 152 342 627 0 75 110 160 159 351 641 0 76 118 170 164 358 662 0 77 127 181 169 364 694 0 78 137 193 174 370 747 0 79 147 206 178 374 838 0 80 158 220 182 377 1000 0 Factors for calculating other modal premiums are: SA.53; Q.27; EFT.09. To calculate the modal premium, begin with the annual per-unit charge for the base policy, add the annual per-unit charge for the ADB rider (if the rider is available and elected), multiply by the number of $1,000 s of face amount, add the annual policy fee, multiply by the modal premium factor for the mode selected, and round to the nearest cent. Premiums other than annual will result in a higher total annual premium. Form 7808-0510 For agent use only. Not for use in sales presentations. Page 3 of 9

Silver Guard I: Level Death Benefit Life Pay Annual Premiums Per $1000 (Add $30 Policy Fee) Female Issue Basic Rates Accidental Cash Values Age Non-Tobacco Tobacco Death Benefit Year 5 Year 10 Year 20 Age 65 50 25 32 1.23 40 117 299 204 51 26 33 1.25 42 122 310 193 52 27 34 1.28 44 126 321 181 53 28 36 1.3 45 131 332 169 54 29 38 1.33 47 136 343 156 55 30 40 1.35 49 142 355 142 56 31 42 1.38 51 147 367 127 57 32 44 1.41 53 153 380 112 58 33 46 1.44 55 160 393 96 59 35 48 1.47 58 166 406 78 60 37 50 1.5 60 173 420 60 61 39 52 1.53 63 180 433 41 62 41 55 1.56 66 187 447 20 63 43 58 1.59 69 195 460 0 64 45 61 1.62 72 202 473 0 65 47 64 1.65 75 210 486 0 66 50 67 78 218 499 0 67 53 70 81 226 513 0 68 56 73 84 235 525 0 69 59 77 90 245 538 0 70 62 82 95 256 552 0 71 66 88 101 268 567 0 72 70 94 108 279 586 0 73 74 100 114 289 607 0 74 79 107 121 300 630 0 75 84 116 129 311 656 0 76 90 126 136 322 686 0 77 97 137 143 333 725 0 78 105 149 150 343 781 0 79 114 162 156 352 867 0 80 125 177 162 361 1000 0 Factors for calculating other modal premiums are: SA.53; Q.27; EFT.09. To calculate the modal premium, begin with the annual per-unit charge for the base policy, add the annual per-unit charge for the ADB rider (if the rider is available and elected), multiply by the number of $1,000 s of face amount, add the annual policy fee, multiply by the modal premium factor for the mode selected, and round to the nearest cent. Premiums other than annual will result in a higher total annual premium. Form 7808-0510 For agent use only. Not for use in sales presentations. Page 4 of 9

Silver Guard I: Level Death Benefit Ten Pay Annual Premiums Per $1000 (Add $30 Policy Fee) Male Issue Basic Rates Cash Values Age Non-Tobacco Tobacco Year 5 Year 10 Year 20 Age 65 50 66 88 150 403 549 474 51 68 91 155 417 565 474 52 70 94 160 431 581 474 53 72 97 165 445 596 474 54 74 100 171 459 612 474 55 77 104 178 474 628 474 56 79 107 184 489 644 422 57 82 111 191 503 659 369 58 85 115 197 518 675 316 59 88 119 204 534 690 263 60 91 123 210 549 704 210 61 95 128 216 565 719 156 62 99 133 221 581 733 102 63 103 138 227 596 746 48 64 107 143 234 612 759 0 65 111 149 240 628 772 0 66 116 156 246 644 784 0 67 121 163 253 659 796 0 68 126 170 259 675 807 0 69 132 178 264 690 817 0 70 138 186 269 704 826 0 71 145 195 274 719 836 0 72 152 205 279 733 845 0 73 159 216 283 746 854 0 74 167 228 287 759 864 0 75 175 242 290 772 874 0 76 182 250 292 784 886 0 77 190 258 292 796 902 0 78 198 266 293 807 922 0 79 206 274 292 817 953 0 80 214 282 291 826 1000 0 Factors for calculating other modal premiums are: SA.53; Q.27; EFT.09. To calculate the modal premium, multiply the annual per-unit charge by the number of $1,000 s of face amount, add the annual policy fee, multiply by the modal premium factor for the mode selected, and round to the nearest cent. Premiums other than annual will result in a higher total annual premium. Form 7808-0510 For agent use only. Not for use in sales presentations. Page 5 of 9

Silver Guard I: Level Death Benefit Ten Pay Annual Premiums Per $1000 (Add $30 Policy Fee) Female Issue Basic Rates Cash Values Age Non-Tobacco Tobacco Year 5 Year 10 Year 20 Age 65 50 63 74 130 350 484 413 51 64 77 134 362 498 413 52 65 80 138 374 513 413 53 67 83 143 387 529 413 54 69 86 147 400 544 413 55 71 90 152 413 559 413 56 73 93 157 427 575 367 57 75 97 162 441 590 321 58 77 101 168 455 606 274 59 80 105 174 469 622 227 60 83 109 180 484 638 180 61 86 112 186 498 653 133 62 89 116 193 513 669 85 63 92 120 199 529 684 37 64 95 124 206 544 699 0 65 98 128 212 559 713 0 66 101 132 219 575 728 0 67 105 136 225 590 742 0 68 109 141 231 606 756 0 69 113 146 238 622 769 0 70 117 151 244 638 782 0 71 121 157 250 653 795 0 72 125 163 255 669 810 0 73 130 169 261 684 825 0 74 135 175 267 699 841 0 75 140 182 272 713 857 0 76 145 189 277 728 874 0 77 150 196 282 742 894 0 78 155 203 285 756 919 0 79 161 211 288 769 953 0 80 168 219 290 782 1000 0 Factors for calculating other modal premiums are: SA.53; Q.27; EFT.09. To calculate the modal premium, multiply the annual per-unit charge by the number of $1,000 s of face amount, add the annual policy fee, multiply by the modal premium factor for the mode selected, and round to the nearest cent. Premiums other than annual will result in a higher total annual premium. Form 7808-0510 For agent use only. Not for use in sales presentations. Page 6 of 9

Silver Guard II: Graded Death Benefit Life Pay Annual Premiums Per $1000 of Ultimate Face Amount (Add $30 Policy Fee) Male Female Non-Tobacco & Tobacco Non-Tobacco & Tobacco Issue Basic Cash Value Cash Value Cash Value Cash Value Basic Cash Value Cash Value Cash Value Cash Value Age Rate Year 5 Year 10 Year 20 Age 65 Rate Year 5 Year 10 Year 20 Age 65 50 69 57 151 359 252 55 46 122 303 208 51 71 60 157 372 240 57 48 127 314 197 52 73 63 164 384 227 59 50 132 325 186 53 75 66 170 396 213 61 52 137 336 174 54 78 69 177 409 199 64 54 143 348 162 55 81 72 183 422 183 67 57 149 360 149 56 84 76 190 435 167 69 59 155 373 135 57 87 79 197 449 149 71 62 161 386 120 58 90 83 204 462 131 73 65 168 399 105 59 94 86 212 475 111 75 68 175 412 89 60 98 89 220 488 89 77 71 183 426 71 61 102 93 228 501 67 79 75 190 440 53 62 106 96 237 513 43 82 78 198 454 33 63 111 102 248 527 19 86 82 206 468 12 64 117 109 259 540 0 91 86 215 481 0 65 125 117 271 553 0 96 90 223 495 0 66 132 125 283 565 0 102 95 232 508 0 67 139 133 295 577 0 108 100 242 523 0 68 147 141 307 588 0 115 107 253 537 0 69 156 149 319 598 0 122 114 265 551 0 70 166 158 331 607 0 130 121 277 564 0 71 176 167 343 616 0 140 129 290 580 0 72 188 177 354 625 0 151 137 302 599 0 73 201 186 366 635 0 163 145 314 621 0 74 216 196 377 647 0 176 154 326 644 0 75 236 206 387 661 0 190 164 338 670 0 Factors for calculating other modal premiums are: SA.53; Q.27; EFT.09. To calculate the modal premium, multiply the annual per-unit charge by the number of $1,000 s of ultimate face amount, add the annual policy fee, multiply by the modal premium factor for the mode selected, and round to the nearest cent. Premiums other than annual will result in a higher total annual premium. Form 7808-0510 For agent use only. Not for use in sales presentations. Page 7 of 9

Silver Guard III: Return of Premium Life Pay Annual Premiums Per $1000 of Ultimate Face Amount (Add $30 Policy Fee) Male Female Non-Tobacco & Tobacco Non-Tobacco & Tobacco Issue Basic Cash Value Cash Value Cash Value Cash Value Basic Cash Value Cash Value Cash Value Cash Value Age Rate Year 5 Year 10 Year 20 Age 65 Rate Year 5 Year 10 Year 20 Age 65 50 69 64 157 364 258 55 52 128 308 213 51 71 67 164 376 246 57 54 133 319 203 52 73 71 171 389 233 59 57 139 330 192 53 75 74 178 402 220 61 60 144 342 181 54 78 78 185 415 206 64 62 150 354 169 55 81 82 192 428 192 67 65 157 366 157 56 84 86 199 442 176 69 69 163 379 144 57 87 90 206 455 159 71 72 170 392 130 58 90 95 214 469 142 73 76 178 406 115 59 94 99 223 482 123 75 79 185 420 100 60 98 103 231 496 103 77 83 193 434 83 61 102 109 242 510 84 79 87 202 448 66 62 106 116 253 524 63 82 92 210 462 47 63 111 123 265 538 31 86 96 219 476 19 64 117 131 277 551 0 91 101 228 490 0 65 125 138 288 564 0 96 107 238 504 0 66 132 147 301 576 0 102 114 248 519 0 67 139 155 313 588 0 108 121 260 534 0 68 147 164 326 599 0 115 128 271 548 0 69 156 172 338 609 0 122 135 283 562 0 70 166 181 350 618 0 130 143 295 575 0 71 176 191 361 626 0 140 151 308 591 0 72 188 200 373 635 0 151 159 320 610 0 73 201 209 383 645 0 163 167 332 630 0 74 216 218 393 656 0 176 176 343 653 0 75 236 225 402 670 0 190 185 355 678 0 Factors for calculating other modal premiums are: SA.53; Q.27; EFT.09. To calculate the modal premium, multiply the annual per-unit charge by the number of $1,000 s of ultimate face amount, add the annual policy fee, multiply by the modal premium factor for the mode selected, and round to the nearest cent. Premiums other than annual will result in a higher total annual premium. Form 7808-0510 For agent use only. Not for use in sales presentations. Page 8 of 9

THE BALTIMORE LIFE INSURANCE COMPANY 10075 Red Run Boulevard P.O. Box 1050 Owings Mills, Maryland 21117-6050 PENNSYLVANIA DISCLOSURE STATEMENT THIS DISCLOSURE STATEMENT WITH ALL APPLICABLE BLANKS FILLED IN IS FOR YOUR PROTECTION. IT GIVES YOU BASIC INFOR- MATION ABOUT THE COST AND COVERAGE OF THE INSURANCE BEING SOLICITED. READ IT CAREFULLY BEFORE SIGNING ANY AGREEMENT TO BUY LIFE INSURANCE. THIS DISCLOSURE STATEMENT SHALL NOT BE CONSIDERED AS AN OFFER TO CONTRACT OR AS ALTERING OR MODIFYING ANY POLICY OR RIDER THAT MAY BE ISSUED. Proposed Insured Age Sex Agent Preparing Disclosure Agency Address Agency Telephone Number Insurer The Baltimore life Insurance Company Insurer s Home Office Address 10075 Red Run Boulevard., P.O. Box 1050, Owings Mills, Maryland 21117-6050 Direct all correspondence to the Insurer s Home Office. *Policy *Rider(s) Face Amount of Coverage (1) Annual Premium Description If not applicable, If not known, Premium Title of Coverage Description of Coverage for Mode Quoted (2) *(1) The face amount of coverage of the (policy, rider) changes as follows: *(2) The premium for the (policy, rider) changes; the ultimate premium will be at policy year. mode Total premium for the policy and/or rider(s) will be. mode *Guaranteed Cash Value. If you continuously pay your premiums on this policy as they come due, you will have the following guaranteed cash value based on the policy face amount. You may borrow against this cash value at an annual % loan interest charge. Number of Years Policy Age Has Been in Force 5 10 20 65 Total Accumulated Cash Value based on the policy face amount *A Surrender Comparison Index will be provided upon delivery of the policy, or earlier if requested. This Index provides one means of comparing the relative costs of two or more similar policies. *The prospective insured has has not requested an earlier delivery of the index. Upon request, either the Company or Agent will furnish you with additional information about the insurance described. Date Applicant s Signature *If section is inapplicable to insurance being offered, blanks are to be clearly marked N/A (Not Applicable). AGENT CERTIFICATION I hereby certify that the original copy of this Disclosure Statement, satisfying the requirements of Section 83.3 of the Pennsylvania Insurance Regulations, was delivered to (applicant) no later than the time the attached application for insurance was signed by the applicant. Date Agency Agent AGENT: White copy to applicant: Attach yellow copy of Disclosure Statement to the application, and submit to the Underwriting Department Form 1589-1105