Guaranteed Universal Life Life Insurance Policy Proposal Prepared for: Presented by: Short Pay Jim Armstrong CLU ChFC Mutual of Omaha Mutual of Omaha Plaza Omaha, NE 68116 42-351-2313 United of Omaha Life Insurance Company, Mutual of Omaha Plaza, Omaha, Nebraska 68175 is licensed in all states, except New York 12/4/213 AFN 43615 Policy Form Number ICC1L46P Page 1 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 Guaranteed Universal Life POLICY VALUES AND BENEFITS Guaranteed Universal Life is an individual universal life insurance policy that features flexible premiums to age 12 and an adjustable death benefit. This policy provides a No-Lapse Protection, which means the policy s death benefit will remain in force, for as long as certain requirements described in the policy are met, but no longer than the policy s maturity date. Accumulation Surrender Guaranteed Elements, Variables and s The policy s accumulation value is the accumulation at Interest of the premiums paid and any additional payments made, less all applicable policy charges, less any partial withdrawals, less surrender charges applicable to reductions in the Specified Amount, and less the cost of insurance rates for both the base plan and any rider added to the policy. The policy's surrender value is the accumulation value less any applicable surrender charges and less any loan not repaid. Guaranteed policy values and benefits are shown on the following pages. All values and benefits assume that the Premium payments are received on the first day of each payment period when due, and that the assumptions on which this proposal is based do not change. The guaranteed values and benefits shown assume the guaranteed interest rate of 2.%, which is the lowest interest rate that can be credited to the policy, the guaranteed maximum cost of insurance rates, the actions specified in this proposal and any No-Lapse Protection. Partial withdrawals, loans, specified amount changes, changing the premium payment mode, and changes in rider coverages will have an impact on these guaranteed values and any No-Lapse Protection in effect. Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 2 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 Maturity Date Premium Policy No-Lapse Protection POLICY MATURITY This policy matures on the policy anniversary date following the date the insured attains the age of 12. Upon policy maturity, if the insured is still living and the policy is still in-force, we will pay the policy s death benefit, if any. PREMIUMS The Premium is the amount of premium assumed to be paid out of pocket for the mode selected, including any Section 135 rollover amounts and any additional Premium payments made. The Premium payments shown in this proposal are calculated on an annualized basis and assume that payment is made when due at the beginning of each modal period. The Premium for policy year 1 reflects either (a) the annualized requested premium, (b) the minimum premium required to issue the policy, (c) the annualized requested premium, increased by an amount necessary to meet the minimum premium required to issue the policy after applying any first year additional Premium payments and any Section 135 rollover amounts, or (d) the maximum allowable premium that will not violate the guideline maximum single premium, whichever is applicable. POLICY NO-LAPSE PROTECTION This policy provides a No-Lapse Protection as described below. All Premiums associated with a No- Lapse Protection are based on the insured s issue age, sex, risk class and rate class, the current Specified Amount and the length of time the policy has been in-force. A No-Lapse Protection is not a guarantee that the policy can never Lapse. Please see the No-Lapse Protection section of the policy for more information. Based on premiums paid as illustrated in the Premium column of this proposal, the policy s death benefit is guaranteed through policy year 85 providing premiums are paid when due and are paid according to the premium mode selected. Failure to meet any conditions required to maintain this guarantee could reduce the number of years the No-Lapse Protection remains in force or cause it to be lost. If the premium requirement necessary to maintain the No-Lapse Protection is not met, an additional premium will be required. Lifetime No-Lapse Protection The annualized premium required to guarantee a $25, death benefit to policy year 85, the policy year in which the insured attains the age of 12, is $1,762.8. This assumes that premiums are paid continuously for 85 policy years when due and that the premium payment mode is Monthly. Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 3 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 ADDITIONAL POLICY FEATURES Disbursements Policy loans are available up to the surrender value. The maximum loan amount available is the surrender value, less any loan interest owed to the end of the policy year, and less the monthly deduction amount sufficient to continue this policy in force for one month. Loan interest will be charged at the rate of 4.76% in advance, which is an effective annual interest rate of 5.%. The portion of the Accumulation which has been borrowed will be credited with an Interest Rate of 2.%. Unpaid policy loans reduce the death benefit payable upon death of the insured, or the surrender value upon surrender of the policy. Partial withdrawals from the surrender value are available after the first policy anniversary subject to the terms of the policy The amount of each partial withdrawal must be at least $5. The amount of each policy loan must be at least $1. Specified Amount Changes Changes in Specified Amount are allowed once each policy year starting after the first policy year. The insured must apply for an increase in the Specified Amount with a new application and provide evidence of insurability that United of Omaha will accept. A decrease in the Specified Amount will result in a surrender charge if done during the first 19 years of the policy. Increases in the Specified Amount are not allowed after the policy anniversary following the insured s 9 th birthday. Any change in Specified Amount will affect the No-Lapse Protection values, which determines whether the No- Lapse Protection is in effect. This means that the No-Lapse Protection could be lost unless you pay additional premiums. Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 4 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 RIDERS Riders provide extra benefits not included in the basic policy. Riders may affect your policy s accumulation values. Disability Rider If the insured becomes disabled before the policy anniversary following the insured s 6th birthday and the disability continues for at least six months, United of Omaha will waive the payment of the monthly deduction amount (cost of insurance charges and expense charges) during the continuance of the disability while the policy is in force or until the Rider terminates, whichever occurs first. The cost of this Rider is $39.14 in policy year 1 and increases thereafter. This cost is deducted from the accumulation value each year when due. Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 5 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 RIDERS - continued Waiver of Surrender Charges for Partial Withdrawals Rider Accelerated Death for Terminal and Chronic Illness Unless otherwise set forth in the rider, this Rider allows for the waiver of all applicable Surrender Charges when a partial withdrawal is made after one or more of the following events occur and the requirements set forth in the rider are met: (a) you become confined at the recommendation of a physician; for medically necessary reasons to, a hospital or a nursing home as defined in the Rider for at least 3 consecutive days, (b) you become eligible for Social Security Disability s prior to age 65, (c) you are diagnosed with a terminal illness that will, with a reasonable degree of certainty, result in your death within 12 months or less, (d) you become unemployed and have received unemployment benefits for at least 6 consecutive days, (e) you become an organ transplant donor or recipient for the body organs defined in the Rider, (f) your residence suffers physical damage in the amount of $5, or more, or (g) you experience the death of your spouse or minor dependent. Those events which qualify for a waiver of surrender charge may differ from state to state. See the rider language for the exact events and requirements to be satisfied in order to qualify for the waiver of surrender charges in your state. This Rider allows the owner to accelerate a portion of the policy's death benefit provided the Insured is either: (a) diagnosed as having a terminal illness that, with a reasonable degree of certainty, will result in the Insured's death within 12 months or less from the date a physician signs the statement of proof of terminal illness, or (b) is diagnosed as being "chronically ill"**. The cumulative maximum accelerated death benefit amount available is the lesser of: (a) $25, of the policy's current death benefit, or (b) the initial Specified Amount stated in the policy data pages minus the minimum Specified Amount as stated in the Change in Specified Amount provision of your policy. A one-time election is allowed if the Insured is diagnosed as being terminally ill. If the Insured is diagnosed with a chronic illness, the owner may request multiple accelerations provided the total amount accelerated does not exceed the maximum amount available. There is no premium or cost of insurance charge for this rider. However, there will be a $1 charge for each acceleration made. ** The definition of "chronically ill" may vary by state. See the rider language for the requirements in your state that must be met for the insured to be diagnosed as "chronically ill". See policy for additional Rider restrictions. Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 6 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 DEFINITION OF TERMS Initial Death Interest Interest Rate Guaranteed Interest Rate At Age This is the total amount of insurance selected. The term "Interest", as used in the policy, and this proposal as it relates to the policy, means the dollar amount of interest credited to the accumulation value or the Proceeds held by United of Omaha as a result of the application of an Interest Rate for a specified period of time. The term "Interest Rate", as used in the policy, and this proposal, means an annualized rate of Interest. (Note: To calculate Interest, we will multiply the accumulation value or Proceeds by a daily periodic rate which, when compounded daily, will result in the accumulation value or Proceeds earning the Interest Rate set in accordance with the applicable provisions of the policy.) This is the Interest Rate the company guarantees to credit to the accumulation value, which is 2.%. The age of the insured at the end of the policy year. Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 7 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 DEFINITION OF TERMS - continued Annualized Premium Accumulation Surrender Monthly No- Lapse Protection Test Lapse Cost of Insurance Rates Surrender Charge This is the amount of premium assumed to be paid out of pocket for the mode selected and shown on an annualized basis. This amount includes any section 135 rollover amounts and any additional Premium payments made. The policy s accumulation value is the accumulation at Interest of the premiums paid and any additional payments made, less all applicable policy administrative charges, less any partial withdrawals, less surrender charges applicable to reductions in the Specified Amount, and less the cost of insurance charges for both the base plan and any rider added to the policy. The surrender value is the accumulation value less any applicable surrender charges and less any outstanding loans and loan interest due. The test performed on the policy s Monthly Deduction Date to determine if the No-Lapse Protection remains in effect. This is termination of the policy due to insufficient surrender value to pay the monthly deduction. This is the monthly charge for each $1, of insurance. This is a charge for each $1 of insurance which is deducted from the accumulation value if the policy is surrendered during the applicable policy years. A surrender charge will also be deducted if the Specified Amount of insurance is decreased or a partial withdrawal is taken. Surrender charges last for 19 policy years and are shown in the policy. Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 8 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 Death Option: 1 (Level) Premium Mode: Monthly End of Policy Year At Age Annualized Premium End of Year Accumulation - - - - - - - Guaranteed s - - - - - - - Guaranteed Interest Rate: 2.% End of Year Surrender End of Year Death 1 36 1926 1147 25 2 37 1926 235 25 3 38 1926 3469 25 4 39 1926 4635 25 5 4 1926 583 25 6 41 1926 6969 469 25 7 42 1926 8118 2118 25 8 43 1926 9251 3751 25 9 44 1926 1358 5358 25 1 45 1926 11428 6678 25 11 46 1926 12461 8211 25 12 47 1926 13457 977 25 13 48 1926 14427 11177 25 14 49 1926 15371 12621 25 15 5 1926 16287 1437 25 16 51 1926 17149 15399 25 17 52 1926 17926 16676 25 18 53 1926 1865 17855 25 19 54 1926 19154 1894 25 2 55 1926 19518 19518 25 Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 9 of 12
End of Policy Year At Age Annualized Premium End of Year Accumulation - - - - - - - Guaranteed s - - - - - - - Guaranteed Interest Rate: 2.% End of Year Surrender End of Year Death 21 56 1926 19664 19664 25 22 57 1926 19574 19574 25 23 58 1926 19255 19255 25 24 59 1926 18695 18695 25 25 6 1926 17822 17822 25 26 61 1926 17439 17439 25 27 62 1926 16784 16784 25 28 63 1926 1583 1583 25 29 64 1926 14455 14455 25 3 65 1926 1279 1279 25 31 66 1926 1531 1531 25 32 67 # 6126 6126 25 33 68 # 1146 1146 25 34 69 # 25 35 7 # 25 36 71 # 25 37 72 # 25 38 73 # 25 39 74 # 25 4 75 # 25 41 76 # 25 42 77 # 25 43 78 # 25 44 79 # 25 45 8 # 25 46 81 # 25 47 82 # 25 48 83 # 25 49 84 # 25 5 85 # 25 51 86 # 25 52 87 # 25 53 88 # 25 54 89 # 25 55 9 # 25 Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 1 of 12
End of Policy Year At Age Annualized Premium End of Year Accumulation - - - - - - - Guaranteed s - - - - - - - Guaranteed Interest Rate: 2.% End of Year Surrender End of Year Death 56 91 # 25 57 92 # 25 58 93 # 25 59 94 # 25 6 95 # 25 61 96 # 25 62 97 # 25 63 98 # 25 64 99 # 25 65 1 # 25 66 11 # 25 67 12 # 25 68 13 # 25 69 14 # 25 7 15 # 25 71 16 # 25 72 17 # 25 73 18 # 25 74 19 # 25 75 11 # 25 76 111 # 25 77 112 # 25 78 113 # 25 79 114 # 25 8 115 # 25 81 116 # 25 82 117 # 25 83 118 # 25 84 119 # 25 85 12 # 25 Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 11 of 12
Life Insurance Proposal For Guaranteed Universal Life Insured: Short Pay Age : 35 / Male / Standard Plus Non-Tobacco Initial Death : $ 25, Premium : $ 16.5 Premium Payments # - Assumes no out-of-pocket Premium payment will be made. However, the cost of insurance charges for the base policy and any riders, plus policy charges continue to be deducted from the accumulation value. If the policy's Lifetime No-Lapse Protection is not in effect, out-of-pocket Premium payments may need to be continued or resumed to keep this policy from lapsing. Based on premiums illustrated in the Premium column of this proposal, the policy's death benefit is guaranteed through policy year 85. Guaranteed Level Annualized Premium Lifetime Premium: $1,762.8 Annualized Premium Minimum Premium: $1,225. TAMRA 7-PAY: $8,197.5 Guideline Maximum Level: $2,82.78 Guideline Max Single: $3,229. cp1713 THIS PRODUCT IS NOT INSURED BY THE FDIC OR ANY OTHER GOVERNMENT AGENCY, IS NOT A DEPOSIT OR OTHER OBLIGATION OF ANY BANK, AND IS NOT GUARANTEED BY ANY BANK. Presented by: United of Omaha - Jim Armstrong CLU ChFC Date: 12/4/213 Version: 1. Policy Form: ICC1L46P State: NE Page: 12 of 12
Life Insurance Proposal Initial Death $25, Name: Short Pay Male Age : 35-Standard Plus Non-Tobacco Date: 12/4/213 Initial Payment $ Guaranteed Interest Rate 2.% Tax Bracket 35% Year Age Net Annual Cumulative Net Annual Cash Incr / Decr Net Surrender Net Death 1 36 25, 2 37 3,852 25, 3 38 5,778 25, 4 39 7,74 25, 5 4 9,63 25, 4 9,63 9,63 25, 6 41 11,556 469 469 25, 7 42 13,482 1,649 2,118 25, 8 43 15,48 1,633 3,751 25, 9 44 17,334 1,67 5,358 25, 1 45 19,26 1,32 6,678 25, 45 19,26 19,26 6,678 6,678 25, 11 46 21,186 1,533 8,211 25, 12 47 23,112 1,496 9,77 25, 13 48 25,38 1,47 11,177 25, 14 49 26,964 1,444 12,621 25, 15 5 28,89 1,416 14,37 25, 5 28,89 28,89 14,37 14,37 25, 16 51 3,816 1,362 15,399 25, 17 52 32,742 1,277 16,676 25, 18 53 34,668 1,179 17,855 25, 19 54 36,594 1,49 18,94 25, 2 55 38,52 614 19,518 25, 55 38,52 38,52 19,518 19,518 25, 21 56 4,446 146 19,664 25, 22 57 42,372-9 19,574 25, 23 58 44,298-319 19,255 25, 24 59 46,224-56 18,695 25, 25 6 48,15-873 17,822 25, 6 48,15 48,15 17,822 17,822 25, This is a supplemental proposal. All values and benefits shown assume that the Premium payments are received on the first day of each payment period when due, and that the assumptions on which the proposal is based do not change. Presented by: Jim Armstrong CLU ChFC Case Name: Sales & Marketing Concepts 9.11.13 - #26 Page 5.1 of 5.4
Life Insurance Proposal Initial Death $25, Name: Short Pay Male Age : 35-Standard Plus Non-Tobacco Date: 12/4/213 Initial Payment $ Guaranteed Interest Rate 2.% Tax Bracket 35% Year Age Net Annual Cumulative Net Annual Cash Incr / Decr Net Surrender Net Death 26 61 5,76-383 17,439 25, 27 62 52,2-655 16,784 25, 28 63 53,928-981 15,83 25, 29 64 55,854-1,348 14,455 25, 3 65 57,78-1,746 12,79 25, 65 57,78 57,78 12,79 12,79 25, 31 66 59,76-2,178 1,531 25, 32 67 59,76-4,45 6,126 25, 33 68 59,76-4,98 1,146 25, 34 69 59,76-1,146 25, 35 7 59,76 25, 7 59,76 59,76 25, 36 71 59,76 25, 37 72 59,76 25, 38 73 59,76 25, 39 74 59,76 25, 4 75 59,76 25, 75 59,76 59,76 25, 41 76 59,76 25, 42 77 59,76 25, 43 78 59,76 25, 44 79 59,76 25, 45 8 59,76 25, 8 59,76 59,76 25, 46 81 59,76 25, 47 82 59,76 25, 48 83 59,76 25, 49 84 59,76 25, 5 85 59,76 25, 85 59,76 59,76 25, This is a supplemental proposal. All values and benefits shown assume that the Premium payments are received on the first day of each payment period when due, and that the assumptions on which the proposal is based do not change. Presented by: Jim Armstrong CLU ChFC Case Name: Sales & Marketing Concepts 9.11.13 - #26 Page 5.2 of 5.4
Life Insurance Proposal Initial Death $25, Name: Short Pay Male Age : 35-Standard Plus Non-Tobacco Date: 12/4/213 Initial Payment $ Guaranteed Interest Rate 2.% Tax Bracket 35% Year Age Net Annual Cumulative Net Annual Cash Incr / Decr Net Surrender Net Death 51 86 59,76 25, 52 87 59,76 25, 53 88 59,76 25, 54 89 59,76 25, 55 9 59,76 25, 9 59,76 59,76 25, 56 91 59,76 25, 57 92 59,76 25, 58 93 59,76 25, 59 94 59,76 25, 6 95 59,76 25, 95 59,76 59,76 25, 61 96 59,76 25, 62 97 59,76 25, 63 98 59,76 25, 64 99 59,76 25, 65 1 59,76 25, 1 59,76 59,76 25, 66 11 59,76 25, 67 12 59,76 25, 68 13 59,76 25, 69 14 59,76 25, 7 15 59,76 25, 15 59,76 59,76 25, 71 16 59,76 25, 72 17 59,76 25, 73 18 59,76 25, 74 19 59,76 25, 75 11 59,76 25, 11 59,76 59,76 25, This is a supplemental proposal. All values and benefits shown assume that the Premium payments are received on the first day of each payment period when due, and that the assumptions on which the proposal is based do not change. Presented by: Jim Armstrong CLU ChFC Case Name: Sales & Marketing Concepts 9.11.13 - #26 Page 5.3 of 5.4
Life Insurance Proposal Initial Death $25, Name: Short Pay Male Age : 35-Standard Plus Non-Tobacco Date: 12/4/213 Initial Payment $ Guaranteed Interest Rate 2.% Tax Bracket 35% Year Age Net Annual Cumulative Net Annual Cash Incr / Decr Net Surrender Net Death 76 111 59,76 25, 77 112 59,76 25, 78 113 59,76 25, 79 114 59,76 25, 8 115 59,76 25, 115 59,76 59,76 25, 81 116 59,76 25, 82 117 59,76 25, 83 118 59,76 25, 84 119 59,76 25, 85 12 59,76 25, 12 59,76 59,76 25, This is a supplemental proposal. All values and benefits shown assume that the Premium payments are received on the first day of each payment period when due, and that the assumptions on which the proposal is based do not change. Presented by: Jim Armstrong CLU ChFC Case Name: Sales & Marketing Concepts 9.11.13 - #26 Page 5.4 of 5.4
Company: Product: Case: Mutual of Omaha - United of Omaha-A GUL v1. Sales & Marketing Concepts 9.11.13 Client Input Summary December 4, 213 6.13., 6.99.6 Client #27 Insured UL Plan Guaranteed Universal Life Client Name Short Pay Sex Male Age Last Birthday 35 Risk Class Standard Plus Non-Tobacco Table Rating None Flat Extra Substandard Amount Association Member No State Code NE Solve For Solve For Premium Solve Premium Solve Option No Lapse Protection No Lapse Year/@Age Max Illustrate Catch-up Extend No Lapse Protection Year/@Age Year/@Age to Increase Premiums Face Amount 1 to 85-25 Years to Pay Premium @66 Policy Options Death Option Level Premium Mode BSP Prevent MEC No Pour-In Amount Regular 1 to 85-135 Rollover Amount Premium Basis Yes Years to Print Max Riders Riders Yes Disability Rider Yes Accidental Death No Accidental DB Amount Child Rider Units Year/@Age to Terminate Child Rider Guaranteed Insurablity Rider No Guaranteed Insurability Amount Page 1 of 2
Company: Product: Case: Mutual of Omaha - United of Omaha-A GUL v1. Sales & Marketing Concepts 9.11.13 Client Input Summary December 4, 213 6.13., 6.99.6 Client #27 Re- proposal Reproposal No Agent Info Producer Name Jim Armstrong CLU ChFC Producer Office Mutual of Omaha Producer Address Mutual of Omaha Plaza Producer City Omaha Producer State Nebraska Producer Zip Code 68116 Producer Phone 42-351-2313 Guaranteed Ledger Tax Bracket 1 to 12-35 Page 2 of 2