Term Life Insurance Illustration Prepared For: Sample CIAB Prepared By: Valued Advisor Individual Commercial Brokerag 100 Enterprise Drive Rockaway, NJ 07866 ph: 800-422-0696 lic #: 1174278
1 Life Insurance Supplemental Quote Sample CIAB female age 60, standard, non-smoker Initial ANNUAL Premium: Face Amount: Riders: $.00 $ NONE Life Insurance Money for your Beneficiary Face Amount $ on the insured. Accelerated Living Benefits Money for Accelerated Living Benefits See the following pages for more details on these living benefits that are included in your policy: * Terminal Illness Accelerated Death Benefit * Chronic Illness Accelerated Death Benefit * Critical Illness Accelerated Death Benefit Please review policy for all terms, conditions, and exclusions of each benefit listed. This supplemental quote shows guaranteed elements. Actual results may be more favorable than shown. This supplemental quote must be accompanied by a complete basic policy quote, so please refer to the basic policy quote for your life insurance policy s guaranteed elements and other important policy and rider information. Any benefits provided by the policy will be reduced if an accelerated death benefit is paid. Benefits accelerated may be taxable and affect eligibility to public assistance in some jurisdictions. Please consult your own tax advisor regarding your particular situation. THIS IS A SUPPLEMENTAL QUOTE ONLY. NOT AN OFFER OR CONTRACT. COVERAGE IS SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. THIS SUPPLEMENTAL QUOTE IS NOT VALID WITHOUT ALL THREE PAGES. This is a quote not a contract. Presented by Valued Advisor on APRIL 22, 2014 NJ. Version 17.10 W Page 1 of 3
For Sample CIAB, female age 60, standard, non-smoker Total Face Amount = $, 1st Year Premium Outlay = $, paid annually 2 Sample CIAB female age 60, standard, non-smoker Life Insurance Supplemental Quote SUMMARY OF ACCELERATED LIVING BENEFITS Initial ANNUAL Premium: Face Amount: Riders: $.00 $ NONE Please review policy for all terms, conditions, and exclusions of each benefit listed. These benefits are automatically included in your policy. These benefits give you the choice to accelerate the face amount if the insured has a terminal, chronic, or critical illness, subject to state availability. If you choose to elect less than the amount quoted below, the accelerated payment will be lower but remaining death benefit amount will be higher. This policy gives flexibility and protection at times when you may need it most. Terminal Illness Terminal Illness Accelerated Death Benefit Benefit amount shown assumes the maximum acceleration has been elected and a claim is made in policy year 8. The maximum acceleration election is 100% of the policy face amount or $ including any other accelerated death benefits with the company, whichever is less. Under these assumptions $471,206 would be payable to the owner. If 100% of the policy face amount has been accelerated, policy coverage terminates at the time of the payment and there would be no death benefit payable to the beneficiaries at the insured s death. Chronic Illness Chronic Illness Accelerated Death Benefit Benefit amount shown assumes the maximum annual election of 24% acceleration of the policy face amount. The maximum benefit over the lifetime of the insured is 90% of the policy face amount or $ including any other accelerated death benefits with the company, whichever is less. The benefit is paid out annually and the first year benefit is shown below for each scenario. The benefit amount depends upon the severity of the chronic illness and the insured's remaining life expectancy at the time of acceleration. Estimated Maximum Accelerated Payout* Age at Claim Minor Moderate Severe 70 75 $11,950 $300 $31,859 $51,833 $94,292 $96,058 80 $300 $300 $65,307 Remaining policy face amount in effect after the maximum payout of the first year benefit = $380,000. Premiums will be reduced proportionately and will continue to be payable on the reduced face amount remaining. Critical Illness Critical Illness Accelerated Death Benefit Benefit amounts shown assumes the maximum election of 90% acceleration of the policy face amount. The maximum benefit is 90% of the policy face amount or $ including any other accelerated death benefits with the company, whichever is less. The benefit amount depends upon the severity of the critical illness and the insured's remaining life expectancy at the time of acceleration. Estimated Maximum Accelerated Payout* Age at Claim Minor Moderate Severe 70 75 80 $46,540 $196,101 $355,324 $1,000 $121,677 $362,422 $1,000 $1,000 $247,716 Remaining policy face amount in effect after the maximum payout = $50,000. Premiums will be reduced proportionately and will continue to be payable on the reduced face amount remaining. THIS IS A SUPPLEMENTAL QUOTE ONLY. NOT AN OFFER OR CONTRACT. COVERAGE IS SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. THIS SUPPLEMENTAL QUOTE IS NOT VALID WITHOUT ALL THREE PAGES. This is a quote not a contract. Presented by Valued Advisor on APRIL 22, 2014 NJ. Version 17.10 W Page 2 of 3
For Sample CIAB, female age 60, standard, non-smoker Total Face Amount = $, 1st Year Premium Outlay = $, paid annually 2 Life Insurance Supplemental Quote SUMMARY OF ACCELERATED LIVING BENEFITS (CONTINUED) Sample CIAB female age 60, standard, non-smoker Initial ANNUAL Premium: $.00 Face Amount: $ Riders: NONE *Severity is based on the reduction in the insured s life expectancy as determined by the company physician's assessment and using the industry standard 2001 Valuation Basic Tables. Minor means life expectancy is reduced 30%, moderate means life expectancy is reduced 50%; and severe means life expectancy is reduced 80%. Payouts shown above assume 6% discount rate. At the time of claim, the administrative charge for each Accelerated Death Benefit request will be $350, plus any future increases based on cumulative annual cost-of-living increases as measured by the Consumer Price Index for All Urban Consumers (CPI) since January 1, 2012. Cumulative annual cost-of-living increases will not exceed 5% per calendar year. Administrative charge and CPI increases may vary by jurisdiction. THIS IS A SUPPLEMENTAL QUOTE ONLY. NOT AN OFFER OR CONTRACT. COVERAGE IS SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. THIS SUPPLEMENTAL QUOTE IS NOT VALID WITHOUT ALL THREE PAGES. This is a quote not a contract. Presented by Valued Advisor on APRIL 22, 2014 NJ. Version 17.10 W Page 3 of 3
For Sample CIAB, female age 60, standard, non-smoker Total Face Amount = $, 1st Year Premium Outlay = $, paid annually 3 Marketing Office 1150 S. Olive Street Los Angeles, CA 90015 A CUSTOM LIFE INSURANCE QUOTE OF OUR TERM LIFE INSURANCE: Certificate Form Number: TL19 NJ FOR Sample CIAB PRESENTED BY Valued Advisor 100 Enterprise Drive Rockaway, NJ 07866 Telephone: 800-422-0696 License Number: 1174278 APRIL 22, 2014 THIS IS A QUOTE SHOWING THE GUARANTEED ELEMENTS OF THE LIFE INSURANCE CERTIFICATE. CONSISTENT WITH TRANSAMERICA'S SALES PRACTICES, THE QUOTE REFLECTS THE GUARANTEED MAXIMUM CHARGES FOR THE SCENARIO REPRESENTED. This is a quote not a contract. Presented by Valued Advisor on APRIL 22, 2014 NJ. Version 17.10 W Page 1 of 3
For Sample CIAB, female age 60, standard, non-smoker Total Face Amount = $, 1st Year Premium Outlay = $, paid annually 4 GUIDE TO THE QUOTE Annual Premium Death Benefit For the policy form named above, the annual premium is guaranteed to remain level for the first twenty policy years. This quote shows the sum of the modal premiums that you will pay during the year. For instance, if you select quarterly payments, the first year premium outlay shown above shows 4 times the quarterly premium being paid each year. Premiums increase annually starting in the twenty-first policy year. The death benefit of the policy is the amount payable to the beneficiary at the insured's death. Subject to all policy provisions, the face amount is guaranteed to remain level to the policy anniversary nearest the insured's age 105, as long as the required premium is paid before the end of the grace period. The policy owner may request a decrease in the face amount while the policy is in-force, but may not reduce the face amount below the policy minimum. Conversion Option Policy Issue Information This option allows the policy holder to exchange a Trendsetter term policy to a designated universal life insurance plan(s) made available by the Company at the time of the conversion. No underwriting will be required if the exchange is to a permanent policy with the same or lower face amount. The new policy will be issued at the class of risk of the in-force policy, if available. If such a class is not available at the time of conversion, the new policy will be issued at the class of risk that is most similar to the class of risk as the in-force policy. Actual premiums on this new policy will be based on the schedule in effect when the option is exercised. To qualify for a better class of risk, full underwriting may be required. This option must be exercised no later than the insured's 70th birthday (75th birthday on Preferred Plus class). The basic underwriting requirements based on this quote are: Paramedical, BCP, HOS, ECG Initial Modal Premiums.00 A 1,887.00 S/A 962.00 Q 962.00 Q/PAC 323.75 M/PAC 323.75 M Kind Code / Plan Code 6769 TD529C N D Terminal Illness Accelerated Death Benefit (TIADB) Chronic Illness Accelerated Death Benefit (CHADB) Critical Illness Accelerated Death Benefit (CRADB) Eligibility for the Terminal Illness Accelerated Death Benefit is determined by a condition resulting from bodily injury or disease which, as described by a Physician, has reduced life expectancy to not more than 12 months from the date of the Physician's statement. The Policy's benefits and values will be reduced proportionally in accordance with the benefits advanced under this option. Benefits advanced under TIADB may be subject to taxation. Allows the policy owner to accelerate the death benefit if the insured becomes chronically ill. Chronically ill means that the insured has been certified, within the last 12 months, by a licensed health care practitioner as being unable to perform two of the six activities of daily living without substantial assistance from another person for at least 90 days, or being severely cognitively impaired for at least 90 consecutive days. The activities of daily living include: bathing, continence, dressing, eating, toileting and transferring. No Chronic Illness accelerated benefits will be paid under this endorsement during the first 2 years it is in effect. Waiting period may vary by jurisdiction. After the waiting period, the policy owner can accelerate up to 24% of the Face Amount annually once the insured has been certified as chronically ill. The maximum amount of lifetime benefits that can be accelerated for CHADB is 90% of the Face Amount or $, whichever is less. However the actual payment will be, minus adjustments, less than the portion of the death benefits accelerated because the benefits are paid prior to death. Benefits may be subject to taxation. Benefits vary by jurisdiction. Allows the policy owner to accelerate the death benefit if the insured becomes critically ill. A critical illness is one of the qualifying events: heart attack, stroke, ALS (Lou Gehrig's disease), cancer, kidney failure, blindness due to diabetes, paralysis (loss of use of two or more limbs), and major organ transplant (Please see the policy for complete definitions of qualifying conditions). After a 30 day waiting period (may vary by jurisdiction), the policy owner can access up to 90% of the Face Amount or $, whichever is less. However the actual payment will be, minus adjustments, less than the portion of the death benefits accelerated because the benefits are paid prior to death. Benefits may be subject to taxation. Benefits vary by jurisdiction. This is a quote not a contract. Presented by Valued Advisor on APRIL 22, 2014 NJ. Version 17.10 W Page 2 of 3
For Sample CIAB, female age 60, standard, non-smoker Total Face Amount = $, 1st Year Premium Outlay = $, paid annually 4 Maximum Accelerated Death Benefit The maximum total amount of lifetime benefits that can be accelerated including all other Accelerated Death Benefits under all policies, endorsement, or riders issued by Transamerica and its affiliates covering the same insured is $ (subject to state variations). This is a quote not a contract. Presented by Valued Advisor on APRIL 22, 2014 NJ. Version 17.10 W Page 3 of 3
For Sample CIAB, female age 60, standard, non-smoker Total Face Amount = $, 1st Year Premium Outlay = $, paid annually 5 APRIL 22, 2014 INITIAL TERM PREMIUM SUMMARY* For: Sample CIAB Producer: Valued Advisor Version 17.10 W Annual Semi-Annual Quarterly Monthly-PAC Monthly Quarterly PAC Trendsetter LB 10 6751 2,335.00 1,190.85 607.10 607.10 204.31 204.31 Trendsetter LB 15 6760 2,925.00 1,491.75 760.50 760.50 255.94 255.94 Trendsetter LB 20 6769.00 1,887.00 962.00 962.00 323.75 323.75 Trendsetter LB 25 6778 5,440.00 2,774.40 1,414.40 1,414.40 476.00 476.00 * Premiums increase annually after the initial level premium period. Underwriting Requirements: Paramedical, BCP, HOS, ECG Trendsetter (R) LB 20 Certificate Form Number: TL19 NJ Kind Code / Plan Code: 6769 TD529C N D Sex: FEMALE Age: 60 Face Amount: $ Underwriting Class: STANDARD NON-SMOKER Substandard Rating: Flat Extra Rating: 0.00 Flat Extra Period: 0 Payment Mode: ANNUALLY Premium Breakdown Base: $.00 Waiver of Premium(s): Accidental Indemnity: Childrens Insurance Rider: Summary of Premiums for Trendsetter (R) LB 20 Year Age 1 60 2 61 3 62 4 63 5 64 6 65 7 66 8 67 9 68 10 69 11 70 12 71 13 72 14 73 15 74 16 75 17 76 18 77 19 78 20 79 21 80 22 81 23 82 24 83 25 84 Guar. Premiums 57,225 66,925 78,155 88,845 98,460 All products may not be approved in all jurisdictions. This is a quote not a contract. Presented by Valued Advisor on APRIL 22, 2014 NJ. Version 17.10 W Page 1 of 1
Term Life Insurance Illustration Policy Amount $ Name: Sample CIAB Female Age : 60-Standard Non-Smoker Date: 4/22/2014 Initial Payment $ Non-Guaranteed Interest Rate 0.00% Year Age Annual Premium Cumul. Premium Death Benefit 1 60 2 61 7,400 3 62 11,100 4 63 14,800 5 64 18,500 64 18,500 18,500 6 65 22,200 7 66 25,900 8 67 29,600 9 68 33,300 10 69 37,000 69 37,000 37,000 11 70 40,700 12 71 44,400 13 72 48,100 14 73 51,800 15 74 55,500 74 55,500 55,500 16 75 59,200 17 76 62,900 18 77 66,600 19 78 70,300 20 79 74,000 79 74,000 74,000 21 80 57,225 131,225 22 81 66,925 198,150 23 82 78,155 276,305 24 83 88,845 365,150 25 84 98,460 463,610 84 463,610 463,610 V2.51.00 C2.20.19. This is a supplemental quote. It must be accompanied by a Trendsetter (R) LB 20 proposal from Transamerica Life Insurance Company which contains guaranteed elements and other important information. Refer to the Federal Income Tax Considerations notes in the Guide to the Quote concerning MEC status and related information. Any non-guaranteed elements quoted are subject to change and can be either higher or lower. Presented by: Valued Advisor Page 1 of 3
Term Life Insurance Illustration Policy Amount $ Name: Sample CIAB Female Age : 60-Standard Non-Smoker Date: 4/22/2014 Initial Payment $ Non-Guaranteed Interest Rate 0.00% Year Age Annual Premium Cumul. Premium Death Benefit 26 85 109,290 572,900 27 86 119,115 692,015 28 87 133,905 825,920 29 88 149,355 975,275 30 89 165,825 1,141,100 89 1,141,100 1,141,100 31 90 181,005 1,322,105 32 91 188,685 1,510,790 33 92 203,790 1,714,580 34 93 226,200 1,940,780 35 94 249,230 94 36 95 0 37 96 0 38 97 0 39 98 0 40 99 0 99 V2.51.00 C2.20.19. This is a supplemental quote. It must be accompanied by a Trendsetter (R) LB 20 proposal from Transamerica Life Insurance Company which contains guaranteed elements and other important information. Refer to the Federal Income Tax Considerations notes in the Guide to the Quote concerning MEC status and related information. Any non-guaranteed elements quoted are subject to change and can be either higher or lower. Presented by: Valued Advisor Page 2 of 3
Term Life Insurance Illustration Column Description Page April 22, 2014 Annual Premium Total annual premium including riders. Cumul. Premium Sum of net annual outlay. Death Benefit Gross death benefit. Transamerica Life Insurance Company Page 3 of 3
Client Input Summary Company: Transamerica Product: Trendsetter LB 20 April 22, 2014 2.51.00, 6.20.19 Insured Insured Name Sample CIAB Sex Female Date of Birth Age 60 Class Standard Non-Smoker Table Rating None Flat Extra 01 to 99-0 State of Issue New Jersey Policy Info Face Amount 500000 Premium Mode Annual Print IRR Report No Print Revised Illustration No Years to Print 115 Living Benefits Projected Benefit Age 1 70 Living Benefits Projected Benefit Age 2 75 Living Benefits Projected Benefit Age 3 80 Income Protection Option Solve Manual Input Initial Lump Sum 0 Fixed Monthly Payment 0 Fixed Monthly Payment Years 5 Final Lump Sum 0 Sum of Payment Amounts Policy Riders Policy Riders No Agent Info Agent Name Valued Advisor Agent Company Individual Commercial Brokerag Agent Address 100 Enterprise Drive Agent City Rockaway Agent State New Jersey Agent Zip Code 07866 Agent Phone 800-422-0696 Agent Fax Agent License # 1174278 Agent Bank Sale No Page 1 of 2
Client Input Summary Company: Transamerica Product: Trendsetter LB 20 April 22, 2014 2.51.00, 6.20.19 Term Illustration Title Line Tax Bracket 01 to 120-35 Page 2 of 2