Project Name/Number: 10 Term Rider/LI10 Filing at a Glance Company: Reliable Life Insurance Company TOI: L04I Individual Life - Term Sub-TOI: L04I.213 Specified Age or Duration - Filing Type: Form Implementation Date Requested: 03/01/2011 State Filing Description: General Information SERFF Tr Num: UUIN-126912366 State: Arkansas SERFF Status: Closed-Approved- State Tr Num: 47379 Closed Co Tr Num: State Status: Approved-Closed Reviewer(s): Linda Bird Author: Audrey Fields Disposition Date: 11/30/2010 Date Submitted: 11/23/2010 Disposition Status: Approved- Closed Implementation Date: Project Name: 10 Term Rider Status of Filing in Domicile: Pending Project Number: LI10 Date Approved in Domicile: Requested Filing Mode: Review & Approval Domicile Status Comments: Explanation for Combination/Other: Market Type: Individual Submission Type: Resubmission Previous Filing Number: LI10 Group Market Size: Overall Rate Impact: Group Market Type: Filing Status Changed: 11/30/2010 Explanation for Other Group Market Type: State Status Changed: 11/30/2010 Deemer Date: Created By: Audrey Fields Submitted By: Audrey Fields Corresponding Filing Tracking Number: Filing Description: Submitted for your approval is a. It will be available for a ten year term, issued to policyholders between the ages of 18 and 65. This rider can be added to any previously approved whole life policy that has a premium-paying period equaling or exceeding the length of the term of the rider, except for our guaranteed issue products. We would like to begin selling this product at the end of the first quarter of 2011 through our captive agents utilizing the Home Service marketing system.
Project Name/Number: 10 Term Rider/LI10 This form was previously approved by your office on 8/11/2010 under SERFF Tracking Number UUIN-126759276. We have never marketed this product as some changes to the form were needed. The changes to the previously approved LI10 are as follows: 1. On page R-1, in the General paragraph, we have inserted the words and definitions. 2. On page R-1, in the CONVERSION paragraph, we have deleted following the Insured s 75th birthday. 3. On page R-1, in the CONVERSION paragraph, we have added the sentence If premiums are being waived under the contract at the time of conversion, the premiums under the converted policy will not be waived. 4. On page R-2, we have deleted the first paragraph which was part of the CONVERSION provision. 5. We have added an INCONTESTABILITY provision to page R-2. 6. On page R-2, in the TERMINATION paragraph, we have deleted the word or from number 3 and added it after number 4. We have renumbered item 4 as number 5 and inserted the date of conversion of this rider to a permanent plan of insurance or as number 4. 7. We have corrected the first sentence in the RESERVE BASIS paragraph, to show the valuation method as Commissioners Reserve. We have applied the Flesch Reading Ease Test to this form and achieved a score of 54. Since we have never marketed this form, we would like to use the same form number, LI10 for this revised rider. Company and Contact Filing Contact Information Audrey Fields, Compliance Specialist afields@unitrin.com 12115 Lackland Road 314-819-4627 [Phone] St. Louis, MO 63146 314-819-4768 [FAX] Filing Company Information Reliable Life Insurance Company CoCode: 68357 State of Domicile: Missouri 12115 Lackland Rd. Group Code: 215 Company Type: Life & Accident St. Louis, MO 63146 Group Name: Unitrin, Inc. State ID Number: (314) 819-4627 ext. [Phone] FEIN Number: 43-0476110 --------- Filing Fees Fee Required? Yes Fee Amount: $50.00
Project Name/Number: Retaliatory? Fee Explanation: Per Company: 10 Term Rider/LI10 Yes No COMPANY AMOUNT DATE PROCESSED TRANSACTION # Reliable Life Insurance Company $50.00 11/23/2010 42245842
Project Name/Number: 10 Term Rider/LI10 Correspondence Summary Dispositions Status Created By Created On Date Submitted Approved- Closed Linda Bird 11/30/2010 11/30/2010
Project Name/Number: Disposition 10 Term Rider/LI10 Disposition Date: 11/30/2010 Implementation Date: Status: Approved-Closed Comment: Rate data does NOT apply to filing.
Project Name/Number: 10 Term Rider/LI10 Schedule Schedule Item Schedule Item Status Public Access Supporting Document Flesch Certification Yes Supporting Document Application No Supporting Document Life & Annuity - Acturial Memo No Form Yes
Project Name/Number: Form Schedule 10 Term Rider/LI10 Lead Form Number: LI10 Schedule Item Status Form Number Form Type Form Name Action Action Specific Data LI10 Policy/Cont Level Term Revised Replaced Form #: ract/fratern Insurance Rider LI10 al Previous Filing #: Certificate: LI10 Amendmen t, Insert Page, Endorseme nt or Rider Readability Attachment 54.000 LI10.pdf
Home Office: St Louis. Missouri LEVELTERMINSURANCERIDER GENERAL This rider provideslevelterm life Insurance.It is part of the policy to which it is attached.it is subjectto all the terms and definationsof the policy exceptas modifiedherein.this rider has no cashor loanvalue. EFFECTIVEDATE This rider will be effectiveon the date of issueof the policy. If this rider is issuedafterthe policy, the effectivedate of this rider will be endorsedon the policy. PREMIUMS The amountof premiumfor this rider is shown on page3 of the policy, or as later endorsedon the policy.the premiumis payableuntil the terminationof this rider. BENEFIT We will pay to the beneficiary,upon receiptof due proof of the deathof the Insured,the benefitamount shownon page3 of the policy,or as later endorsedon the policy. This benefitwill be paidif the deathof the Insuredoccurs: 1. while this riderand the policy are in forceon a premiumpayingbasis; 2. while the Insuredis coveredby this rider;and 3. beforethe terminationof this rider. CONVERSION Whilethis rider is in force it may be convertedto a new policy,subjectto the following conditions: 1. No evidenceof insurabilityis required; 2. The new policy may be any permanentplan of insuranceofferedby us at the date of issueof the new policy; 3. The amount of insuranceunder the new policy will not be greaterthan the term insurancebenefitof this rider unlessproof of insurabilityis submittedto us and approvedby us; 4. The dateof issueof the new policywill be the sameas the dateof conversionand will takeeffectonly if the Insured is living on the date of issue. We will basethe premium rate on the Insured'sage, premiumclass,and ratesin useon the dateof conversion; 5. The new policy may includesupplementaryridersonly with our consent. The conversionwill be madeeffectiveas of a premiumdue date. If premiumsare beingwaivedunderthe contractat the time of conversion.the premiumsunderthe convertedpolicywill not be waived. li10 R-1
INCONTESTABILITY We cannotcontestthis rider after it has beenin force during the lifetimeof the Insuredfor two yearsfrom its Date of Issue.This provisionwill not applyto the non-paymentof premiums. SUICIDE If the Insuredcommits suicidewithin two yearsof the effectivedate of this rider, the amount we will pay will be limited to the premiumspaidfor this rider. REINSTATEMENT In additionto the reinstatementrequirementsof the policy, reinstatementof this rider is subject to evidenceof the Insured's insurabilitysatisfactoryto us and paymentof all unpaidpremiumswith interest compoundedannuallyat 5% to the dateof reinstatement. TERMINATION Coverageunderthis rider terminateson the earliestof: 1. the end of the graceperiod of the first unpaid premiumfor the policy or rider, whetheror not the policy is continuedundera Non-ForfeitureOption; 2. the expirationdateof this rider as shownon page3 of the policy,or as later endorsedon the policy; 3. the termination,conversion,or maturityof the policyto which the rider is attached; 4. the dateof conversionof this riderto a permanentplanof insurance;or 5. the first premium due date after we receivea signed,written requestto cancelthis rider. We may requirethe policy and rider be returnedto us for endorsement. We will not be liablefor any benefitshereunderin connectionwith a loss that occurs after this rider terminates.any premiumfor this rider receivedafterthe terminationdatewill be refunded. RESERVEBASIS Reservesfor this rider arecalculatedusingthe CommissionersReserveValuationmethod.A detailedstatementof the method of computingreserveshas beenfiled with the state in which this rider is delivered.reservesfor this rider equal or exceedthe minimum values requiredby that state. Reservesare based on the assumptionsthat death benefitsare paid at the momentof deathand net premiumsarepaidcontinuouslyover the premium-payingperiod. Signedfor The ReliableLife InsuranceCompanyat St. Louis, Missouri,on the Dateof Issue. Secretary President Ll10 R-2
Project Name/Number: 10 Term Rider/LI10 Supporting Document Schedules Satisfied - Item: Flesch Certification Comments: Attachments: Certificate of Readability.pdf Consumer Notice.pdf Guaranty Assn. Act.pdf R&R 19.pdf Item Status: Status Date: